PMC6914906_01
Atrophy muscle of the right thigh was seen from the anterior (a), lateral (b), and posterior (c) view.
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fig1
We observed the atrophy of the thigh muscle from the anterior, lateral, and posterior view (Figure 1).
Radiographic imaging of the right knee in anteroposterior (a), lateral (b), and skyline (c) view showed lateral patellar dislocation.
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fig2
The trochlear groove was relatively normal (Figure 2).
Extensive lateral release that included the fascia (a), lateral capsule (b), and vastus lateralis muscle (c).
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fig3
We then cut the fascia of the medial vastus until the dislocated patella was fully released (Figure 3).
The step of MPFL reconstruction including the patellar side graft insertion (a). The drilling of the femoral part to make a tunnel at the Schottle point (b), and the insertion of the graft to the femoral side after the edge was sutured with ETHIBOND (c).
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fig4
We then sutured the graft end with ETHIBOND (Ethicon, Somerville, NJ) no. 2 and passed the graft through a medial side of the femur until the end of the tendon coming out from the lateral femoral side (Figure 4).
The cancellous screw and washer were put at the lateral side of the femur just above the femoral tunnel as the anchored point. The ETHIBOND suture was anchored to the screw and washer.
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fig5
The end of the graft was sutured with ETHIBOND, and the ETHIBOND suture was then anchored to the cancellous screw and washer as the fixation of the patella to prevent it from redislocation (Figure 5).
Radiographic examination to confirm the position of the endobutton, cancellous screw, and washer postoperatively.
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fig6
After that, we did confirmation X-ray to confirm the position of the inserted screw at the lateral side of the distal femur (Figure 6).