Patellofemoral pathology may have multiple etiologies, but most are due to trauma, arthritis, and/or different static and passive factors. These factors include imbalance of quadriceps strength, patella alta, alignment of the lower limb, dysplasia of the trochlea, and functionality of the medial patellofemoral ligament (MPFL). Many injuries and anatomic issues can predispose patients to patellofemoral malalignment, leading to the diagnosis of patellofemoral syndrome or instability. Operative intervention is aimed at correcting the underlying osseous deformity, repairing or replacing damaged cartilage surfaces, and reconstructing/repairing the soft tissues.

Knee

Procedure

Product

Ruptures of the quadriceps and patellar tendons are common in elite and recreational athletes. Most surgeons treat these injuries surgically to lessen the risk of long-term disability and morbidity. Historically, open techniques have been used for rupture repairs but may be complicated by wound-healing issues and infection. The minimally invasive Percutaneous Achilles Repair System (PARS) technique can be used to treat quadriceps, patellar, and Achilles tendon ruptures.
The PARS system helps facilitate consistently reliable capture of the distal aspect of the quadriceps tendon and includes color-coded FiberWire® and FiberTape® sutures. The anatomically contoured guide is reusable, while the suture and passing needles come packaged in a convenient kit. The PARS system provides the option of using transverse or locking sutures, or both. The colored FiberWire sutures offer a more organized approach to identifying and securing matched pairs.

Quad Tendon Repair with PARS System Technique

PARS Quadriceps Repair

Ruptures of the quadriceps and patellar tendons are common in elite and recreational athletes. Most surgeons treat these injuries surgically to lessen the risk of long-term disability and morbidity, while providing the opportunity for a convenient rehabilitation. Historically, open techniques have been used for rupture repairs but may be complicated by wound-healing issues and infection. The minimally invasive Percutaneous Achilles Repair System (PARS) technique can be used to treat quadriceps, patellar, and Achilles tendon ruptures.
The PARS system helps facilitate consistently reliable capture of the distal aspect of the quadriceps tendon and includes color-coded FiberWire® and FiberTape® sutures. The anatomically contoured guide is reusable, while the suture and passing needles come packaged in a convenient kit. The PARS system provides the option of using transverse or locking sutures, or both. The colored FiberWire sutures offer a more organized approach to identifying and securing matched pairs.

Secondary (C)

The anatomic double-bundle technique replicates the native shape of the medial patellofemoral ligament (MPFL), provides stability in both flexion and extension, and effectively limits rotation throughout ROM, helping minimize postoperative instability. The technique, if accomplished directly and anatomically, can also provide for more aggressive rehabilitation protocols and earlier return to activity.1
Successful MPFL reconstruction is dependent on anatomic placement of the graft. The technique incorporates the use of a femoral template to ensure proper placement of the graft in the femur. This position provides a static fixation point that equalizes the tension across the graft in flexion and extension, thus helping minimize stress across the patellofemoral joint.
Arthrex offers 4 MPFL convenience packs to address each patient's unique needs as well as each surgeon's preference for fixation. The newest kits use 3.9 mm BioComposite SwiveLock® anchors for patellar fixation and either a 6 mm × 20 mm BioComposite FastThread™ interference screw or an ACL TightRope® implant for femoral fixation.
Reference
1. Schöttle PB, Hensler D, Imhoff AB. Anatomical double-bundle MPFL reconstruction with an aperture fixation. Knee Surg Sports Traumatol Arthrosc. 2010;18(2):147-151. doi:10.1007/s00167-009-0868-z

MPFL Reconstruction

The Arthrex T3 AMZ system was designed to facilitate tibial tubercle osteotomy and transfer in a reproducible manner for extensor mechanism realignment and patellar unloading. The instrument set and disposables kit consist of 3 cutting guide arms, (45˚, 60˚ and 90˚) that rigidly connect to the tubercle pin and cutting block post placing the cutting block at specific angles on the tibial tubercle according to the most common cut angles needed.

Tibial Tubercle Osteotomy

Patellofemoral Realignment and Reconstruction

Anteromedialization procedures have been well documented as an effective treatment option for the correction of patellofemoral malalignment and to unload the lateral patellar facet in deep flexion.

Ruptures of the quadriceps and patellar tendons are common in elite and recreational athletes. Most surgeons treat these injuries surgically to lessen the risk of long-term disability and morbidity. Historically, open techniques have been used for rupture repairs, but these techniques may be complicated by wound-healing issues and infection. The minimally invasive Percutaneous Achilles Repair System (PARS) technique can be used to treat quadriceps, patellar, and Achilles tendon ruptures.

Patellar Tendon Repair

Tendon Repair

Ruptures of the quadriceps and patellar tendons are common in elite and recreational athletes. Most surgeons treat these injuries surgically to lessen the risk of long-term disability and morbidity. Historically, open techniques have been used for rupture repairs but may be complicated by wound-healing issues and infection. The minimally invasive Percutaneous Achilles Repair System (PARS) technique can be used to treat quadriceps, patellar, and Achilles tendon ruptures.
The PARS system helps facilitate consistently reliable capture of the distal aspect of the quadriceps tendon and includes color-coded FiberWire® and FiberTape® sutures. The anatomically contoured guide is reusable, while the suture and passing needles come packaged in one convenient kit. The PARS system provides the option of using transverse or locking sutures, or both. The colored FiberWire sutures offer a more organized approach to identifying and securing matched pairs.

Patellofemoral Devices

PARS Quadriceps Repair

Patellofemoral Realignment and Reconstruction

Tendon Repair