# Fascia Lata Allograft Medial Patellofemoral Ligament Reconstruction—Restore the Nature as Close as Possible

## TL;DR

A new surgical technique uses fascia lata allografts to reconstruct the MPFL more accurately, avoiding tension issues seen in traditional methods.

## Contribution

A novel MPFL reconstruction technique using fascia lata allografts that better mimics the natural anatomy and tension distribution.

## Key findings

- Fascia lata allografts allow for a flat and wide patellar attachment similar to the natural MPFL.
- Precise control of graft tension based on knee flexion angle reduces risks of under- or overtensioning.
- The technique ensures proper patellar mobility by replicating the natural anisometry of the MPFL.

## Abstract

Various surgical techniques for medial patellofemoral ligament (MPFL) reconstruction have been described, commonly using hamstring auto- or allografts. Despite their widespread use, these techniques have limitations due to the tubular structure of the hamstring tendons, which does not match the flat, sail-like anatomy of the MPFL. Furthermore, over- or undertensioning of the graft due to tunnel misplacement remains a significant risk, even if anatomic and radiologic landmarks are used. To address these issues, a fascia lata allograft MPFL reconstruction with assessment of angular anisometry is presented. This technique allows for reconstruction of the MPFL as close as possible to its nature with a flat and wide patellar attachment and a gradual transition of maximal tension across the graft fibers, depending on the knee flexion angle. Precise intraoperative control of predefined graft angular anisometry allows for achievement of the desired amount of tension at specific flexion angles. This mitigates the risk of under- or overtensioning and subsequently ensures proper medial-lateral mobility of the patella.