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Objective <p>Restoration of a&#xa0;functionally intact and stable medial patellofemoral ligament (MPFL).</p> Indications <p>a)&#xa0;Persistent patellofemoral instability following patellar dislocation with rupture of the MPFL; b)&#xa0;failure of conservative therapy following patellar dislocation; c)&#xa0;partial step: recurrent patellar dislocations with treatment of risk factors leading to dislocation (e.g., trochlear dysplasia, patella alta) by means of, for example, deepening trochleoplasty or tuberosity osteotomy; d)&#xa0;isolated: traumatic patellar dislocations with no or only minor risk factors; e)&#xa0;no age limits.</p> Contraindications <p>a)&#xa0;Failure to address/treat the risk factors leading to patellar dislocation; b)&#xa0;first time dislocation without the need for immediate surgery (e.g., osteochondral lesion); c)&#xa0;no recurrent dislocation with good progress under conservative therapy; d)&#xa0;malcompliance.</p> Surgical technique <p>Parapatellar lateral skin incision, two layer incision of the lateral joint capsule and LPFL, sharp dissection of the capsule up to the medial epicondyle, hemostasis. Exposure of the MPFL and incision of the fibrous layer along the fiber direction without opening the synovial layer. Doubling of the MPFL with single sutures and continuous overlock suture, lateral tension-free closure using continuous suture.</p> Postoperative management <p>Mobilization in knee brace with weight-bearing according to pain immediately after surgery. Immediate start of physiotherapy according to in-house protocol, depending on the patella stabilizing procedure (e.g., isolated MPFL, trochleoplasty with MPFL, tuberosity osteotomy with MPFL). Thromboembolism prophylaxis using low molecular weight heparin. Removal of suture material 14&#xa0;days postoperatively.</p> Results <p>Between November 2011 and April&#xa0;2024, 116&#xa0;patients aged 13–48&#xa0;years (mean age 19.8) underwent MPFL doubling surgery. Depending on the individual pathologies, 78&#xa0;(67.2%) patients underwent deepening trochleoplasty, 16&#xa0;(13.8%) underwent tuberosity osteotomy, and 15&#xa0;(12.9%) underwent a&#xa0;combination of the three procedures. Seven (6.0%) patients underwent MPFL duplication surgery. Postoperatively, 104 (89.7%) patients were symptom-free and satisfied. Twelve (10.3%) patients experienced postoperative complications.</p>

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MPFL-Doppelungs- und laterale Erweiterungsplastik („Weichteilbalancing“) nach Urs W. Müller

  • 期刊论文

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  • 发表日期：

    2026年7月10日

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  • Stephan Bernhart,
  • Constance Raith,
  • Flavio Cagienard,
  • Jan-Christoph Stadelmann,
  • Urs W. Müller,
  • Judith Bering

摘要

Objective

Restoration of a functionally intact and stable medial patellofemoral ligament (MPFL).

Indications

a) Persistent patellofemoral instability following patellar dislocation with rupture of the MPFL; b) failure of conservative therapy following patellar dislocation; c) partial step: recurrent patellar dislocations with treatment of risk factors leading to dislocation (e.g., trochlear dysplasia, patella alta) by means of, for example, deepening trochleoplasty or tuberosity osteotomy; d) isolated: traumatic patellar dislocations with no or only minor risk factors; e) no age limits.

Contraindications

a) Failure to address/treat the risk factors leading to patellar dislocation; b) first time dislocation without the need for immediate surgery (e.g., osteochondral lesion); c) no recurrent dislocation with good progress under conservative therapy; d) malcompliance.

Surgical technique

Parapatellar lateral skin incision, two layer incision of the lateral joint capsule and LPFL, sharp dissection of the capsule up to the medial epicondyle, hemostasis. Exposure of the MPFL and incision of the fibrous layer along the fiber direction without opening the synovial layer. Doubling of the MPFL with single sutures and continuous overlock suture, lateral tension-free closure using continuous suture.

Postoperative management

Mobilization in knee brace with weight-bearing according to pain immediately after surgery. Immediate start of physiotherapy according to in-house protocol, depending on the patella stabilizing procedure (e.g., isolated MPFL, trochleoplasty with MPFL, tuberosity osteotomy with MPFL). Thromboembolism prophylaxis using low molecular weight heparin. Removal of suture material 14 days postoperatively.

Results

Between November 2011 and April 2024, 116 patients aged 13–48 years (mean age 19.8) underwent MPFL doubling surgery. Depending on the individual pathologies, 78 (67.2%) patients underwent deepening trochleoplasty, 16 (13.8%) underwent tuberosity osteotomy, and 15 (12.9%) underwent a combination of the three procedures. Seven (6.0%) patients underwent MPFL duplication surgery. Postoperatively, 104 (89.7%) patients were symptom-free and satisfied. Twelve (10.3%) patients experienced postoperative complications.