Video, Part 1. Femoral Attachment
1. Ultrasound is used to identify femoral and patellar attachments of medial patellofemoral ligament (MPFL).
2. MPFL is followed from patella to its attachment near adductor tubercle.
3. In-plane ultrasound guidance is used to place needle anterior and distal to tubercle.
4. Percutaneous incision is made down to needle tip. Spear is placed at needle tip for anatomical placement of socket.
5. Socket is drilled.
6. 3.0-mm suture anchor (BioComposite Knotless SutureTak; Arthrex) is placed.
7. Leading edge of torn MPFL is identified.
8. Suture passer (Labral FastPass Scorpion; Arthrex) is used to pass sutures through leading edge of torn MPFL to create horizontal mattress.
9. Sutures are tied.
10. Repair is complete.
Video, Part 2. Patellar Attachment
1. Ultrasound is used to scan patella to identify ideal or exact location of tear. In-plane ultrasound guidance is used to place spinal needle at desired socket location.
2. After spinal needle is positioned, in-line percutaneous incision is made, and needle is palpated at patella.
3. Spear is then placed at spinal needle tip for anatomical positioning of socket.
4. Socket is drilled.
5. 3.0-mm suture anchor (BioComposite Knotless SutureTak; Arthrex) is placed in socket.
6. Leading edge of torn medial patellofemoral ligament (MPFL) is identified.
7. Suture passer (Labral Past Pass Scorpion; Arthrex) is used to pass suture from anchor in horizontal mattress fashion through leading edge of torn MPFL.
8. Wire with loop (FiberSnare; Arthrex) is used as part of knotless technology to pull suture back through anchor to create knotless fixation.
9. Suture is pulled for appropriate tensioning of tissue.
10. Ultrasound is used to visualize construct to confirm that MPFL tissue abuts anchor and that repair is complete.