METHOD OF GRAFT FIXATION DURING MEDIAL PATELLOFEMOROAL LIGAMENT PLASTY Russian patent published in 2024 - IPC A61B17/56 

FIELD: medicine; traumatology and orthopedics.

SUBSTANCE: invention can be used for graft fixation during plastic surgery of the medial patellofemoral ligament, includes the formation of tunnels in the patella for passing threads and fixing the patellar part of the graft, wrapping and pulling the graft around the tendon of the adductor magnus muscle of the thigh for fixation femoral part of the graft. Using two wires with an eye, two parallel tunnels are formed in the patella from the inside to the outside, the first tunnel is formed 5 mm below the attachment of the tendon of the vastus medialis femoris muscle. Two conductor threads, folded in half, are threaded into the eye of the first wire. Both loops of threads are brought out through the outer edge of the patella. The second tunnel is formed below the first and conductor threads are passed through it in the same way; then the non-absorbable thread is threaded through one loop of the guide thread in the first transverse tunnel and through one loop in the second transverse tunnel, by pulling the free ends of the guide threads into the loops of which the non-absorbable thread is threaded. The non-absorbable thread is passed through the tunnels to the inner edge of the patella in such a way that two loops of the non-absorbable thread stand out from the apertures of both tunnels along the inner edge of the patella, and both free ends of the non-absorbable thread — from the apertures along the outer edge of the patella. A tendon graft is passed through loops of non-absorbable thread extending along the inner edge of the patella, so that the loops of thread are located in the middle of the length of the graft. By traction on the free ends of the non-absorbable suture at the outer edge of the patella, the graft is pressed to the inner edge of the patella. The free end of a non-absorbable thread coming out of the outer aperture of the second bone tunnel is threaded into the free loop of the remaining guide thread of the first bone tunnel, and with the help of a guide thread it is brought out through the internal aperture of the first bone tunnel. The free end of a non-absorbable thread coming out of the outer aperture of the first bone tunnel is threaded into the free loop of the remaining guide thread of the second bone tunnel, and with the help of a guide thread it is brought out through the internal aperture of the second bone tunnel; the guide threads are removed, the free ends of the non-absorbable thread coming out of the internal apertures of both tunnels are tied together, the ends of the threads are cut off, and the nodes are immersed in soft tissue. The free ends of the graft are passed through the thickness of the knee joint capsule to the area of attachment of the adductor magnus tendon; a loop is formed around the adductor magnus tendon from the free end of the graft, which is then sutured with threads.

EFFECT: method reduces the incidence of complications and eliminates the use of additional implants due to a significant reduction in the volume of tunnels formed in the patella for graft fixation.

1 cl, 2 dwg, 2 ex