Reconstruction of the Lateral Patellofemoral Ligament: How I Do It

Abstract

Ostensibly, reconstruction of the lateral patellofemoral ligament should be used for the treatment of medial instability of the patella.¹,⁶,⁷,¹⁵ And that it should. But in my hands, a far more frequent use of this lateral reconstruction is for the surgical reconstruction of the extensor mechanism of knee after having failed prior surgery for the treatment of lateral instability of the patella when a lateral retinacular release had been included in the procedure. The relative contributions of the lateral retinaculum to medial and lateral patellar stability have been well described.³,⁸,¹² But in brief, the lateral retinaculum contributes not only to medial restraint of the patella,but lateral restraint as well. Perhaps it is best if we remember to visualize the lateral retinaculum as exerting a sagittal force upon the patella that helps to engage and hold the patella within the femoral trochlea, rather than a predominantly ­horizontal force that would be implied from most illustrations.