The Consequences of Femoral Tunnel Misplacement in MPFL Reconstruction

Description

The presentation, led by David Dejour at BOSTAA 2021, focuses on the implications of femoral tunnel misplacement in MPFL (Medial Patellofemoral Ligament) reconstruction. Dejour emphasizes that improper placement can lead to failure of the procedure, characterized by pain, stiffness, instability, and potential re-dislocation of the patella. He discusses the importance of technique, particularly on the femoral side, where misalignment can significantly impact outcomes. Key pointers include the necessity of using fluoroscopy for accurate positioning and the effects of over-tensioning or under-tensioning the graft on recovery.



Dejour critiques the common errors that can occur if the surgery is not conducted with attention to patient-specific anatomical factors, such as trochlear dysplasia and patella alta, and underscores that these evaluations are crucial to ensure the success of the MPFL procedure. He concludes by stressing the significance of accurate diagnostics and tailored procedural approaches for patellar instability, reiterating the need for comprehensive imaging and understanding of biomechanical factors to avoid complications.

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