[Reconstruction of the medial patellofemoral ligament by tunnel transfer of the semitendinosus tendon].

OBJECTIVE

Stabilization of the patella by reconstruction of the medial patellofemoral ligament.

INDICATIONS: Chronic recurrent lateral dislocation or subluxation of the patella. Habitual lateral dislocation of the patella.

CONTRAINDICATIONS: Primary dislocation of the patella. Genu valgum with a Q-angle > 15 degrees . Status following semitendinosus tendon transfer to reconstruct the anterior cruciate ligament. Joint infection. Neurogenic instability, ischiocrural muscle deficiency.

SURGICAL TECHNIQUE: Division of the distal insertion of the semitendinosus muscle at the pes anserinus. Subligamentous tunneling at the proximal insertion of the medial collateral ligament. The distal end of the semitendinosus tendon is transferred through the subligamentous tunnel to the medial patellar margin. Fixation of the tendon to the medioproximal patellar margin by passing it through an oblique transpatellar drill hole.

RESULTS

The patella was stabilized by dynamic reconstruction of the medial patellofemoral ligament in 14 patients with chronic recurrent or habitual lateral patellar dislocation. Ten patients were available for clinical follow-up assessment at an average of 13 months (8-27 months) postoperatively. The postoperative Kujala Index (maximum 100 points) increased on average from 56 to 95 points.