Minipatellar Tunnels for Transosseous Fixation of Medial Patellofemoral Ligament Graft Using High-strength Suture

Abstract

Patellar dislocation is a common knee injury, with concomitant pathoanatomical risk factors that synergistically interact and predispose to patellofemoral instability. Medial patellofemoral ligament (MPFL) reconstruction has demonstrated significant potential in the re-establishment of MPFL anatomic and biological function, with low patellar redislocation rates. Although many techniques for MPFL reconstruction have been developed, challenges such as patella fractures and high costs persist. Herein, to further reduce bone defects and ensure the reliability of fixation, we developed a microbone tracts technique for MPFL reconstruction on the patella side using high-strength sutures. This technique passes high-strength sutures through the microtransosseous tunnels to fix the tendon graft on the patella side, aiming to achieve minimized patella damage with no additional implants for graft fixation, while resuturing the fascia on the surface of the patella with the suture ends further strengthens the graft fixation. This technique provides an economic and reliable solution for graft fixation on the patella with minimal bone disruption.