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Indications
The indications are:
- Acute dislocation of the patella when ma
gnetic resonance imaging (MRI) demonstra
tes an extensive lesion of the MPFL (fig. 1).
Preoperative planning
In acute cases, MRI is fundamental for
analyzing the type of MPFL lesion. In cases of
extensive lesions, reconstruction is indicated.
In the other hand, in cases of isolated lesions
with defined borders in the patellar insertion,
repair should be the best approach.
Surgical technique
Our preference is to use subarachnoid
anesthesia. We then perform an examination
under anesthesia to confirm the presence of
patellofemoral instability. A pneumatic tourni
quet is routinely used.
We start the procedure with arthroscopy to treat
possible cartilage lesions. We do not perform
lateral release.
The surgical incision is planned as follows: an
incision is started proximally at the level of
the upper margin of the patella, centrally,
between the medial margin of the patella and
the medial epicondyle (fig. 1). We make an
incision going down towards the superomedial
margin of the ATT. This incision will be
associatedwith the incision for the inferomedial
portal for arthroscopy.
All Surgical Procedures
(video)
Patellar tendon procedure
G.L. Camanho
Fig. 1 : Skin incision