MPFL Reconstruction - Surgical Technique Guide | MedShape MPFL Reconstruction - Surgical Technique Guide Me | Page 10

9 SURGICAL TECHNIQUE MPFL RECONSTRUCTION Patellar Fixation 10a Thread the free ends of the graft between layers two and three and out through the patellar incision. With the knee in 20 degrees of flexion, knot the suture threads over the free-ends of the graft several times, cinching them into place. 10b For secure fixation, fold and suture the free- ends of the graft back upon themselves. Pearl #6. In this position, the graft should experience neither tension nor laxity. With increasing flexion, the graft should become lax. In extension, the graft should tension only slightly. Ensure that the patella is not over-tensioned or tilted medially throughout the full range of motion. Closure Tie off and trim any remaining sutures. Close the incisions per surgeon preference.