Andrew J. Cosgarea
LAS VEGAS — Medial quadriceps tendon femoral ligament reconstruction may be a valid alternative to medial patellofemoral ligament reconstruction, according to a presenter at the Arthroscopy Association of North American and American Orthopaedic Society for Sports Medicine Specialty Day at the American Academy of Orthopaedic Surgeons Annual Meeting.
“[Medial quadriceps tendon femoral ligament] MQTFL reconstruction is an alternative to the more traditional [medial patellofemoral ligament] MPFL reconstruction technique, although published clinical outcome studies remain limited at this time,” Andrew J. Cosgarea, MD, told Healio.com/Orthopedics.
Cosgarea said when he and his colleagues compared techniques with the MPFL, medial patellofemoral complex and MQTFL, the MPFL and MPFC limited lateral patellar maltracking and decreased the length of the MQTFL. Also, the MPFL and medial patellofemoral complex decreased maximum contact pressure which reduced the length of the MQTFL and provided similar results.
“According to unpublished computational modeling data from [John J.] Elias, [PhD,] both MPFL and MQTFL techniques can normalize tracking and joint contact pressure when the grafts are placed anatomically,” Cosgarea said.
He said there was no single optimal technique and that there are many ways to perform reconstruction.
“I perform MPFL reconstruction for recurrent patella instability when
there is not substantial malalignment,” Cosgarea said. “MPFL reconstruction predictably stabilizes the patella with a low risk of patella fracture when performed using a shallow socket for graft fixation on the patella.”
Cosgarea prefers to perform MPFL reconstruction but noted that other orthopedic surgeons have found the MQTFL to be successful. Cosgarea uses MPFL in most patients; however, he said he would consider MQTFL in some patients who need revision. – by Monica Jaramillo
Cosgarea AJ. MPFL vs. MQTFL: What I do and why. Presented at: Arthroscopy Association of North American and American Orthopaedic Society for Sports Medicine Specialty Day at the American Academy of Orthopaedic Surgeons Annual Meeting; March 16, 2019; Las Vegas.
Disclosure: Cosgarea reports no relevant financial disclosures.