TY - JOUR
T1 - Editorial Commentary
T2 - Socket or Knock It? Considerations in Patellar Fixation During Medial Patellofemoral Ligament Reconstruction
AU - Tanaka, Miho J.
N1 - Publisher Copyright:
© 2019 Arthroscopy Association of North America
PY - 2019/5
Y1 - 2019/5
N2 - The medial patellofemoral ligament (MPFL) is the primary static stabilizer to lateral patellar translation, and reconstruction of this ligament has been shown to be successful in reducing dislocation rates and improving functional outcomes in the treatment of patellar instability. Recent studies have warned that complication rates after MPFL reconstruction can be as high as 25%, with patellar fracture being one of the most catastrophic complications that can occur after this procedure. While the use of a bone socket versus cortical fixation on the patella does not appear to influence outcomes, surgeons should take into account the factors of graft and tunnel positioning, graft length/tension, and the need for concurrent procedures in each individual patient when performing this procedure. Any violation of the patella, whether as a socket or for anchor placement, should avoid the anterior cortex and maintain an adequate bony bridge that should be modified according to the patient's anatomy. The optimal technique for MPFL reconstruction continues to evolve, and further studies are needed to identify the ideal type and position of patellar fixation to minimize risks of complications and optimize surgical outcomes when performing MPFL reconstruction in the treatment of patellar instability.
AB - The medial patellofemoral ligament (MPFL) is the primary static stabilizer to lateral patellar translation, and reconstruction of this ligament has been shown to be successful in reducing dislocation rates and improving functional outcomes in the treatment of patellar instability. Recent studies have warned that complication rates after MPFL reconstruction can be as high as 25%, with patellar fracture being one of the most catastrophic complications that can occur after this procedure. While the use of a bone socket versus cortical fixation on the patella does not appear to influence outcomes, surgeons should take into account the factors of graft and tunnel positioning, graft length/tension, and the need for concurrent procedures in each individual patient when performing this procedure. Any violation of the patella, whether as a socket or for anchor placement, should avoid the anterior cortex and maintain an adequate bony bridge that should be modified according to the patient's anatomy. The optimal technique for MPFL reconstruction continues to evolve, and further studies are needed to identify the ideal type and position of patellar fixation to minimize risks of complications and optimize surgical outcomes when performing MPFL reconstruction in the treatment of patellar instability.
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U2 - 10.1016/j.arthro.2019.01.008
DO - 10.1016/j.arthro.2019.01.008
M3 - Editorial
C2 - 31054735
AN - SCOPUS:85064670201
SN - 0749-8063
VL - 35
SP - 1629
EP - 1630
JO - Arthroscopy - Journal of Arthroscopic and Related Surgery
JF - Arthroscopy - Journal of Arthroscopic and Related Surgery
IS - 5
ER -