Alan M. Hirahara, MD, FRCSC
Orthopaedic SurgeonSpecialist in Sports Medicine

Ultrasound-Guided Percutaneous Repair of Medial Patellofemoral Ligament: Surgical Technique and Outcomes

Hirahara AM, Andersen WJ
American Journal of Orthopedics
PMID: 28666039

May 1st 2017

A lateral patellar dislocation causes a medial patellofemoral ligament (MPFL) tear that begins affecting patellar biomechanics. Reconstruction is difficult because of the inability to reliably and accurately determine proper placement of sockets. Studies of MPFL anatomy have found significant variability in attachment site locations, which suggests MPFL procedures cannot be used universally and must be approached differently for each patient. Recurrent dislocations result in patellar and trochlear chondral and bony damage. In this article, we present a novel technique that uses ultrasound to locate the MPFL tear and the MPFL attachment sites, and perform anatomical repair of the native tissue at the patellar attachment site, the femoral attachment site, or both. We also describe our retrospective analysis of 10 cases of this ultrasound-guided percutaneous procedure, performed since its development in 2013. In each case, patellar stability was restored completely and without complications. The promising results, the ease of the surgery, and the limited rate of complications indicate this surgical technique should be considered before reconstruction and early in trauma cases, before onset of chondral or bony damage.