Medial Quadriceps Tendon Femoral Ligament (MQTFL) Reconstruction
Medial quadriceps tendon femoral ligament ligament (MQTFL) reconstruction is a surgical procedure indicated in patients with more severe patellar instability. Medial quadriceps tendon femoral ligament is a band of tissue that extends from the femur to the quadriceps insertion at the patella. Medial quadriceps tendon femoral ligament is the major ligament which stabilizes the patella and helps in preventing patellar subluxation (partial dislocation) or dislocation. This ligament can rupture or get damaged when there is patellar lateral dislocation. Dislocation can be caused by direct blow to the knee, twisting injury to the lower leg, strong muscle contraction, or because of a congenital abnormality such as shallow or malformed joint surfaces.
Medial quadriceps tendon femoral ligament reconstruction using tissue grafts is done by following the basic principles of ligament reconstruction such as:
- Graft Selection: Strong and stiff graft should be selected
- Location: The graft should be located isometrically
- Correct tension: The tension set in the graft should be appropriate
- Secure Fixation: Stable fixation of the graft should be achieved
Surgical Technique
An incision is made on the inner aspect of the knee and a socket is drilled at the origin of the medial quadriceps tendon femoral ligament. A graft is docked in the socket and fixed with a screw. Then the graft is tunneled under the soft tissue to another incision made over the quadriceps insertion on the patella. The graft is then woven into the quadriceps tendon and folded back to itself and secured with high-tension sutures. The soft tissues are closed and a dressing is applied.
Post-operative care
Rehabilitation exercises are initiated for range of motion, strength, and endurance. Return to full activities is usually 5-6 months after surgery.
