Editorial Commentary: Two Fixation Points Are Better for Medial Patellofemoral Ligament Reconstruction-To Minimize Complications, Bone Tunnels Should Be Avoided.

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Abstract

[Indexed for MEDLINE] 20. Arthroscopy. 2024 Apr;40(4):1277-1278. doi: 10.1016/j.arthro.2023.10.042. Epub 2024 Jan 11. Editorial Commentary: When Managing Patellofemoral Instability, Mind Your P's and Q's: Medial Patellofemoral Ligament Versus Medial Quadriceps Tendon Femoral Ligament Versus Medial Patellofemoral Complex. Matzkin E. Comment on Arthroscopy. 2024 Apr;40(4):1264-1276.e1. doi: 10.1016/j.arthro.2023.08.079. Our understanding of patellar instability and the medial patellofemoral complex (MPFC) has evolved over the past 15 years. Despite advancements and appreciation of the anatomy and biomechanics of the MPFC, the best surgical treatment for recurrent patellar instability has yet to be determined. The goals of medial patellofemoral ligament (MPFL), medial quadriceps tendon femoral ligament (MQTFL), or MPFC reconstructions (with grafts from both the patella and quad to the femur) are to return patients back to activity and avoid complications such as recurrent instability, overconstraint, secondary arthrosis, and potential patellar fracture from surgical drill holes. Other considerations when managing recurrent instability include patella alta, hypermobility, and whether an osteotomy procedure is indicated. Although we always need to make good choices and mind our P's and Q's, the big question remains: Is MPFL, MQTFL, or MPFC the best choice for our patients? Copyright © 2023 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.arthro.2023.10.042