Navigating medial patellotibial ligament reconstruction: Clinical perspectives and surgical strategies

Abstract

The surgical approach for patellar instability usually refers to reconstruction of the medial patellofemoral ligament associated with an osteotomy of the tibial tuberosity or a trochleoplasty when required. The medial patellotibial ligament and the medial patellomeniscal ligament are secondary stabilizers of the patella. Despite this, both the medial patellotibial and patellofemoral ligaments aid in patellar rotation and tilt when the knee is flexed beyond 45°. The medial patellotibial ligament plays a particularly important role in the final stages of stretching in extension and between 40 degrees to 90 degrees of flexion. The clinical relevance and surgical indications for medial patellotibial ligament reconstruction associated with medial patellofemoral ligament reconstruction are still controversial. This editorial explores the surgical indications and clinical results for medial patellotibial ligament reconstruction to improve readers’ understanding of this technique, especially because reported clinical outcomes have remained sparse.

Keywords: Medial patellotibial ligament; Patellar instability; Reconstruction; Surgical

Core Tip: Though the medial patellotibial ligament reconstruction technique was described in 1922, its indication remains limited. Surgical indications are still not precisely delineated. Regardless, it is a viable option for young patients experiencing recurrent patellar instability with osseous abnormalities or patients facing severe instabilities in both extension and flexion.