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• W4252214047 abstract "Thanks for reading our article with interest and for your positive comments. Patellar maltracking can be ascessed reasonably well by keen observation of the patella during knee range of motion. Many authors did not use an arthroscope for intaoperative assessment of patellar tracking.1Carmont M.R. Maffulli N. Medial patellofemoral ligament reconstruction: a new technique.BMC Musculoskelet Disord. 2007; 8: 22Crossref PubMed Scopus (45) Google Scholar, 2Deie M. Ochi M. Sumen Y. Yasumoto M. Kobayashi K. Kimura H. Reconstruction of the medial patellofemoral ligament for the treatment of habitual or recurrent dislocation of the patella in children.J Bone Joint Surg Br. 2003; 85-B: 887-890Google Scholar, 3Schock E.J. Burks R.T. Medial Patellofemoral ligament reconstruction using a hamstring graft.Oper Tech Sports Med. 2001; 9: 169-175Abstract Full Text PDF Scopus (31) Google Scholar We also avoided the same and avoided joint penetration for an otherwise extraarticular procedure. MPFL as such serves only as a static checkrein preventing patella subluxation.1Carmont M.R. Maffulli N. Medial patellofemoral ligament reconstruction: a new technique.BMC Musculoskelet Disord. 2007; 8: 22Crossref PubMed Scopus (45) Google Scholar We assessed dynamic tracking of the patella and the tension of the reconstructed MPFL from 0° to full knee flexion intraoperatively just after graft fixation and confirmed appropriate tension in the graft as was done by Deie et al.2Deie M. Ochi M. Sumen Y. Yasumoto M. Kobayashi K. Kimura H. Reconstruction of the medial patellofemoral ligament for the treatment of habitual or recurrent dislocation of the patella in children.J Bone Joint Surg Br. 2003; 85-B: 887-890Google Scholar Though some trochlear dysplasia was present in our case, patella was adequately stabilised by MPFL reconstruction and hence no additional procedure was necessary. Trochleoplasty should be reserved for severe dysplasia in which patellofemoral stability cannot otherwise be achieved.4Bollier M. Fulkerson J.P. The role of trochlear dysplasia in patellofemoral instability.J Am Acad Orthop Surg. 2011 Jan; 19: 8-16PubMed Google Scholar We take your point well that an interference screw would have been better for femoral fixation of the graft. We however used a cancellous screw to reduce the cost of surgery for this unaffording patient. Cancellous screw for femoral side graft fixation was also successfully used by Schock et al.1Carmont M.R. Maffulli N. Medial patellofemoral ligament reconstruction: a new technique.BMC Musculoskelet Disord. 2007; 8: 22Crossref PubMed Scopus (45) Google Scholar, 3Schock E.J. Burks R.T. Medial Patellofemoral ligament reconstruction using a hamstring graft.Oper Tech Sports Med. 2001; 9: 169-175Abstract Full Text PDF Scopus (31) Google Scholar Though the risk of cutting out of the graft was there, the adequacy of fixation was provided by compression of the graft by the non-threaded portion of the screw against the tunnel. Additionally, compression by washer also helped in maintaining the fixation. The fixation of the graft on the patellar side was done by suturing at both the ends of the tunnel with non-absorbable no 2 ethibond suture which gives reasonably strong hold, avoiding additional implant use. Other authors have also used suture fixation on the patellar side with success.2Deie M. Ochi M. Sumen Y. Yasumoto M. Kobayashi K. Kimura H. Reconstruction of the medial patellofemoral ligament for the treatment of habitual or recurrent dislocation of the patella in children.J Bone Joint Surg Br. 2003; 85-B: 887-890Google Scholar, 5Ellera Gomes J.L. Marczyk L.R.S. de Cesar P.C. Jungblut C.F. Medial patellofemoral ligament reconstraction with semitendinous autograft for chronic patellar instability: a follow study.Arthroscopy. 2004; 20: 147-151Abstract Full Text Full Text PDF PubMed Scopus (178) Google Scholar Ultimately we were also able to achieve a good result. Finally, we appreciate all your efforts and sincerity in bringing out certain drawbacks of the technique. No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. Medial patellofemoral ligament reconstructionJournal of Clinical Orthopaedics & TraumaVol. 4Issue 1PreviewI read the article by Kalra et al with great interest in December 2012 issue, in which the authors have described their way of performing medial patellofemoral ligament (MPFL) reconstruction.1 I congratulate the authors for this description; however, I would like to make the following points: Full-Text PDF" @default.
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• W4252214047 date "2013-03-01" @default.
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• W4252214047 title "Reply to Letter to the Editor" @default.
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• W4252214047 doi "https://doi.org/10.1016/j.jcot.2013.02.001" @default.
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