Simultaneous Medial and Lateral Patellofemoral Ligament Reconstruction for Combined Medial and Lateral Patellar Subluxation

Abstract

Medial patellar subluxation (MPS) is a disabling, often iatrogenic patellar instability due to previous lateral release for patellar instability. Lateral release destabilizes the patella on the lateral side, worsening the initial lateral instability and causing MPS. MPS is poorly recognized and may range from subluxation to true dislocation. This report describes a technique developed in response to episodes of medial and lateral patellar subluxation after failed lateral release for patellar instability. The technique uses a graft that extends from the medial patellofemoral ligament origin through the quadriceps tendon to the lateral epicondyle, thereby reconstructing both the medial and lateral patellofemoral ligaments, as well as providing simultaneous stability to both the medial and lateral sides of the patella.