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.

Knee

Product

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 allow 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.
Other options include Knee FiberTak® anchors for onlay MPFL techniques as well as 4 MPFL convenience packs to address each patient's unique needs and each surgeon's fixation preference. 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

Jonathan Riboh, MD (Charlotte, NC), demonstrates an all-epiphyseal, all-onlay MPFL reconstruction using Knee FiberTak® anchors.

Not Hidden

English  - en

video

All-Epiphyseal, All-Onlay MPFL Reconstruction Using Knee FiberTak® Anchors

Gautam P. Yagnik, MD (Miami, FL), demonstrates an onlay MPFL reconstruction using Knee FiberTak® hybrid anchors in the patella and a FastThread™ interference screw on the femur.&nbsp;

Onlay MPFL Using Knee FiberTak® Hybrid Anchors

The 3.9 mm BioComposite SwiveLock® implant kits were developed for reconstruction of the MPFL in cases of acute patellar dislocation or chronic patellofemoral instability. Providing surgeons and operative staff with a complete, convenient solution for MPFL reconstruction procedures, the kits include either an ACL TightRope® implant or a 6 mm × 20 mm BioComposite FastThread™ interference screw for femoral fixation. Parallel and angled drill guides, which help accurately and reproducibly drill for the patellar anchors, are also provided along with staggered-length guide pins to ease drilling.

3.9 mm BioComposite SwiveLock® and TightRope® MPFL Implant Kit

application/pdf

Medial Patellofemoral Ligament (MPFL) Reconstruction

MPFL Implant System:  6 mm × 20 mm BioComposite FastThread™ Screw and 3.9 mm BioComposite SwiveLock® Anchors

MPFL Reconstruction

Child (D)

Patients with patellar instability suffer from recurrent patellar dislocations and are limited in their performance of activities of daily life.
In order to create congruent bony anatomy, the sulcus deepening trochleoplasty procedure helps patients get back to daily living activities.
Deepening trochleoplasty demands precise surgical skills and customized technical solutions for each individual patient and indication. The new Arthrex Trochlea Guide System enhances reproducible cartilage preparation, with 3 mm and 5 mm Offset Aiming Guides and effective, solid bone modelation with the dedicated 2.9 mm Burr. In conjunction with Arthrex PushLock® or SwiveLock® anchor fixations, this technique offers a solution for an anatomic trochlea recreation.
Please note that certain bio (PLLA) anchors and screws are not available for sale in EMEA.

Trochleoplasty for Patellar Instability Due to Trochlea Dysplasia

Philip Schöttle, MD, PhD, (Munich, Germany) demonstrates an innovative trochleoplasty technique for chronic patellar instability. He utilizes the new Arthrex® trochleoplasty instrumentation designed to safely and reproducibly fold back the cartilage layer using a marking hook and burr. The trochlea is then shaped to a more natural curve. The cartilage is reattached using PushLock® or SwiveLock® suture anchors and resorbable sutures.

Deepening Trochleoplasty

One of the most frequent causes for patellofemoral dysfunction is habitual patella dislocation or subluxation. This technique guide shows one method of how to solve structural causes of patella instability by doing a deepening trochleoplasty.

Trochleoplasty - Indications and Methods

Philip Schöttle, MD, (Munich, Germany) explains and classifies patellar instability and discusses MPFL reconstruction in detail. In patients with flat or convex trochleae, Dr. Schöttle shows how MPFL reconstruction is often not enough to provide adequate stability. For these patients, he shows how trochleoplasty can recreate a new groove in the trochlea, using a specially designed guide.

MPFL Reconstruction and Trochleoplasty Presentation

Trochleoplasty

Anteromedialization (AMZ) 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. The comprehensive T3 AMZ System is designed to achieve precise cutting angles during tibial tuberosity AMZ osteotomy procedures to accurately realign the extensor mechanisms and unload the patellofemoral joint. 
 

Benefits:
<ul>
 <li>Precise, instrumented osteotomy through anatomically referenced cuts</li>
 <li>Fixed angle (45˚, 60˚, and 90˚) cutting guides provide accurate, reproducible control of relative anteriorization and medialization based on chosen angle</li>
 <li>Included soft-tissue retractor protects vital posterior structures 
</li>
</ul>

Eric J. Strauss, MD, (New York, NY) presents a case on a young soccer player who presents with right patellar instability and recent dislocation. Dr. Strauss performs a tibial tubercle osteotomy using the T3 AMZ System combined with a medial patellofemoral ligament reconstruction.

Tibial Tubercle Osteotomy with Anteromedialization (AMZ) and MPFL Reconstruction

Laith M. Jazrawi, MD, (New York, NY) moves the tibial tubercle medially and distally on a patient with a shallow trochlea and patella alta using the T3 AMZ system.

Patellofemoral Realignment and Reconstruction

MPFL Reconstruction

Trochleoplasty

T3 AMZ System for Tibial Tuberosity