SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2022
Femoral tunnel malposition is the most common indication for revision medial patellofemoral ligament reconstruction with promising early outcomes following revision reconstruction: a systematic review.
Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- Factors affecting patellofemoral contact pressure during medial patellofemoral ligament reconstruction. A systematic review of cadaveric biomechanical testing.Journal of orthopaedic surgery and research · 2025Pooled it
- A Comprehensive Guide to Revision Medial Patellofemoral Ligament Reconstruction in Adolescents.Journal of the Pediatric Orthopaedic Society of North America · 2026Review
- Accuracy of the Schöttle Technique for Femoral Medial Patellofemoral Ligament Footprint Localization in Trochlear Dysplasia: A Fluoroscopic Case-Control Study on 3-Dimensional-Printed Femurs.Clinics in orthopedic surgery · 2026Article
- Double-Bundle Artificial Medial Patellofemoral Ligament Reconstruction Using a Femoral Suture-Sliding Anchor and Patellar Staged Tension Adjustment.Arthroscopy techniques · 2026Article
- Quantifying the impact of femoral rotation on medial patellofemoral ligament reconstruction: a cadaveric study using radiographic analysis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Reporting Bias Is Highly Prevalent in Systematic Reviews and Meta-Analyses Related to Medial Patellofemoral Ligament Reconstruction.Arthroscopy, sports medicine, and rehabilitation · 2025Review
- Comparative analysis of intraoperative fluoroscopic vs. Anatomical landmark positioning methods in MPFL reconstruction for recurrent patellar dislocation.BMC musculoskeletal disorders · 2025Article
- Increased femoral antetorsion results in decreased difference between the radiographic and anatomic determined Schoettle's point in MPFL reconstruction.Journal of experimental orthopaedics · 2025Article
- Fascia Lata Allograft Medial Patellofemoral Ligament Reconstruction-Restore the Nature as Close as Possible.Arthroscopy techniques · 2025Article
- A Landscape of Recent Literature on the Predictors of Success and Failure in Medial Patellofemoral Ligament Reconstruction.Orthopedic reviews · 2025Article
- [Research progress of Schöttle's method for femoral tunnel localization in medial patellofemoral ligament reconstruction].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2024Review
- The Effect of C-Arm Position on Femoral Tunnel Placement in Medial Patellofemoral Ligament Reconstruction.Orthopaedic journal of sports medicine · 2024Article
- [Research progress on femoral attachment positioning during medial patellofemoral ligament reconstruction].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2024Review
- Comparison of five different fluoroscopic methods for identifying the MPFL femoral footprint.Archives of orthopaedic and trauma surgery · 2024Article
- The adductor magnus tendon is a viable option for medial patellofemoral ligament reconstruction, but with a busy surrounding neurovascular topography.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Medium to long-term outcomes of medial patellofemoral ligament reconstruction using the superficial quadriceps versus a hamstring autograft in patellar instability patients.Scientific reports · 2023Article
- Patellofemoral Instability in the Pediatric Population.Current reviews in musculoskeletal medicine · 2023Review
- Accuracy of femoral tunnel positioning in medial patellofemoral ligament reconstruction: anatomic insertion leads to better clinical outcome.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- A Novel Technique of Arthroscopic Femoral Tunnel Placement during Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Dislocation.Journal of clinical medicine · 2023Article
- [Mid-term effectiveness analysis of combined knee extensor mechanism realignment with bone anchor for recurrent patella dislocation].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2022Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of this study was to identify the causes of failure of previous medial patellofemoral ligament reconstruction (MPFL-R), and to furthermore report the surgical techniques available for MPFL revision surgery.
methodsFour databases [PubMed, Ovid (MEDLINE), Cochrane Database, and EMBASE] were searched until September 29, 2020 for human studies pertaining to revision MPFL. Two reviewers screened the literature independently and in duplicate. Methodological quality of the included studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria, or the CAse REport guidelines (CARE), where appropriate.
resultsFourteen studies (one level II, one level III, two level IV, ten level V) were identified. This search resulted in a total of 76 patients with a mean age (range) of 22 (14-39) years. The patients were 75% female with a mean (range) time to revision of 24.1 (1-60) months and mean (range) follow-up of 36.2 (2-48) months. The most common indication for revision surgery was malpositioning of the femoral tunnel (38.1%), unaddressed trochlear dysplasia (18.4%), patellar fracture (11.8%). Femoral tunnel malposition was typically treated via revision MPFL-R with quadriceps tendon or semitendinosus autograft and may retain the primary graft if fixation points were altered. Unaddressed trochlear dysplasia was treated with deepening trochleoplasty with or without revision MPFL-R, and patella fracture according to the nature of the fracture pattern and bone quality. Though generally, outcomes in the revision scenario across all indications were inferior to those post-primary procedure, overall, revision patients demonstrated positive improvements in pain and instability symptoms. Transverse patella fractures treated with debridement and filling with demineralized bone matrix if required with further fixation according to the fracture pattern.
conclusionThe most common causes of MPFL failure in literature published to date, in order of decreasing frequency, are: malposition of the femoral tunnel, unaddressed trochlear dysplasia, and patellar fracture. Although surgical techniques of revision MPFL-R to manage these failures were varied, promising outcomes have been reported to date. Larger prospective comparative studies would be useful to clarify optimal surgical management of MPFL-R failure at long-term follow-up. LEVEL OF EVIDENCE: IV.
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