Dasril DF, Randy, Hadi IAN, Guntara A. Minimal invasive medial patellofemoral ligament reconstruction using quadriceps tendon with de novo technique and arthroscopic guided: A case report.
Int J Surg Case Rep 2024;
122:110144. [PMID:
39128217 DOI:
10.1016/j.ijscr.2024.110144]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 08/03/2024] [Accepted: 08/08/2024] [Indexed: 08/13/2024] Open
Abstract
INTRODUCTION
Medial Patellofemoral ligament (MPFL) reconstruction, the primary procedure for restoring patellar stability and preventing further dislocation, has seen numerous methods and grafts. However, a consensus on the technique and graft remains elusive. This study introduces a novel approach to MPFL reconstruction, utilizing a unique combination of minimal invasiveness, de novo method, and arthroscopic guidance to harvest a quadriceps tendon (QT) graft without the need for a harvesting tool.
CASE ILLUSTRATION
A 37-year-old female presented to the emergency room with the chief complaints of left knee pain and swelling following the third spontaneous dislocation of the patella. The patient had a few episodes of locking sensation and instability of the left knee while walking, especially while climbing stairs. A knee MRI revealed MPFL tear in the left knee. A modified minimal invasive MPFL reconstruction technique was performed. The IKDC, Lysholm, and Modified Cincinnati scores improved significantly from preoperatively 48.3 %, 49 %, and 51 % to 89.7 %, 90 %, and 95 % consecutively. No recurrent patellar dislocations or swelling were reported during follow-up.
DISCUSSION
While quadriceps graft harvesting for MPFL reconstruction is typically highly invasive, using quadriceps tendons has consistently shown excellent outcomes. This study, however, takes it a step further by demonstrating that a minimally invasive procedure for harvesting quadriceps tendons, even without specialized instrumentation, can also yield excellent results.
CONCLUSION
MPFL reconstruction using superficial quadriceps tendon autograft can be achieved using a minimally invasive technique without the use of specialized instrumentation and has shown excellent knee functional improvement.
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