Quadriceps Tendon Autograft Medial Patellofemoral Ligament Reconstruction.

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Abstract

Conflict of interest statement: CONFLICT OF INTEREST: Christian Fink is a consultant for Karl Storz, Medacta and Zimmer Biomet and reports royalties from Karl Storz. The other authors have no conflict of interest. HUMAN AND ANIMAL RIGHTS AND INFORMED CONSENT: This article does not contain any studies with human or animal subjects performed by any of the authors. 19. Arthroscopy. 2022 Nov;38(11):3068-3069. doi: 10.1016/j.arthro.2022.06.021. Editorial Commentary: Two Fixation Points Are Better for Medial Patellofemoral Ligament Reconstruction-To Minimize Complications, Bone Tunnels Should Be Avoided. Strickland S(1). Author information: (1)Weill Cornell Medical School, Hospital for Special Surgery. Comment on Arthroscopy. 2022 Nov;38(11):3058-3067. doi: 10.1016/j.arthro.2022.04.019. Medial patellofemoral ligament (MPFL) reconstruction has gained in popularity over the past 15 years, with most studies showing a clear advantage over techniques such as MPFL repair or medial imbrication for the treatment of patellar instability. A debate continues as to the type of fixation on the patella, tunnel versus suture anchor, as well as the number of fixation points. In fact, some senior patellofemoral surgeons have opted away from patellar bony fixation altogether to avoid complications associated with patellar fixation such as fracture or penetration of the articular cartilage. In my practice, I prefer to use 2 all-suture suture anchors for patellar fixation as there is minimal risk of fracture or significant cartilage damage compared with tunnel drilling or placement of larger suture anchors. The graft choice for MPFL reconstruction has been shown to be relatively unimportant, and for this reason, I typically choose gracilis allograft to avoid graft-site morbidity and hamstring weakness. Copyright © 2022 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.arthro.2022.06.021