Arthroscopic Medial Patellofemoral Ligament Reconstruction with a Double Suspension Technique

Surgical treatment of recurrent patella dislocations is difficult, and combined techniques are required in most cases.To overcome this issue, we present the preliminary results of a novel alternative fixation technique for the medial patellofemoral ligament (MPFL) reconstruction with using a looped semitendinosus tendon autograft.Between January 2018 and January 2020, five cases with isolated MPFL injury were treated with a double-suspension technique.The double suspension technique describes the fixation of the semitendinosus autograft into the single femoral and patellar tunnels using the adjustable and fixed loop-button technique arthroscopically.Tips and tendon fixation with a double suspension technique are described here in cases applied with MPFL reconstruction using semitendinosus autograft with this technique.An evaluation was made of five patients with an average age of 25 (range 18-33) years, followed up for a mean of 16.8 months.There was a statistically significant improvement in all patient-reported outcomes from baseline to the final follow-up examination.In the clinical outcomes, the mean modified Lysholm knee score increased significantly from 48 preoperatively to 95.2 at the final follow-up examination (p<0.001).All cases returned to their daily activities and amateur sports in an average of 4±0.2 (4-6) months.Anatomic MPFL reconstruction with a double-suspension technique provides biomechanical stability closest to the tensile strength of the natural MPFL.The reconstruction of this ligament forms the main leg of the treatment.Although several different methods have been described, failure and complications are seen as related to technique inadequacies.