Return to Play Considerations After Patellar Instability.

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Abstract

Conflict of interest statement: The authors did not receive any funding or grants in support of the research for or preparation of this work. The authors declare no conflict of interest. 16. World J Orthop. 2017 Feb 18;8(2):115-129. doi: 10.5312/wjo.v8.i2.115. eCollection 2017 Feb 18. Failed medial patellofemoral ligament reconstruction: Causes and surgical strategies. Sanchis-Alfonso V(1), Montesinos-Berry E(1), Ramirez-Fuentes C(1), Leal-Blanquet J(1), Gelber PE(1), Monllau JC(1). Author information: (1)Vicente Sanchis-Alfonso, Department of Orthopaedic Surgery, Hospital Arnau de Vilanova Valencia and Hospital 9 de Octubre, 46015 Valencia, Spain. Patellar instability is a common clinical problem encountered by orthopedic surgeons specializing in the knee. For patients with chronic lateral patellar instability, the standard surgical approach is to stabilize the patella through a medial patellofemoral ligament (MPFL) reconstruction. Foreseeably, an increasing number of revision surgeries of the reconstructed MPFL will be seen in upcoming years. In this paper, the causes of failed MPFL reconstruction are analyzed: (1) incorrect surgical indication or inappropriate surgical technique/patient selection; (2) a technical error; and (3) an incorrect assessment of the concomitant risk factors for instability. An understanding of the anatomy and biomechanics of the MPFL and cautiousness with the imaging techniques while favoring clinical over radiological findings and the use of common sense to determine the adequate surgical technique for each particular case, are critical to minimizing MPFL surgery failure. Additionally, our approach to dealing with failure after primary MPFL reconstruction is also presented. DOI: 10.5312/wjo.v8.i2.115 PMCID: PMC5314141