1. Medial Patella Femoral Ligament Reconstruction With Periosteal Tunnels and Suture Fixation 
Jefferson Brand, M.D., Richard Hardy, Ed.D., A.T.C., Paul Westerberg, M.A., A.T.C., O.T.C. 
Arthroscopy Techniques 
Volume 6, Issue 5, Pages e1973-e1978 (October 2017)
DOI: /j.eats
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2. Fig 1 Guide pin is marked with a clamp.
Arthroscopy Techniques 2017 6, e1973-e1978DOI: ( /j.eats )
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3. Fig 2 Patella periosteal tunnels are created.
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4. Fig 3 The tunnels are undermined with a No. 15 blade.
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5. Fig 4
First completed tunnel at the junction of the proximal 1/3 and middle 1/3 of the patella.
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6. Fig 5
Suture passed “Under, Over, Under” to allow graft passage later in the procedure.
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7. Fig 6
The second periosteal tunnel is created at the junction of the patella and quadriceps tendon.
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8. Fig 7 Suture passed “Under, Over, Under” in the second tunnel as well.
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9. Fig 8 The sutures are passed between layer 2 and layer 1.
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10. Fig 9
The graft is placed in the femoral tunnel, and secured with an interference biocomposite screw.
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11. Fig 10
The 2 limbs of the graft are separated before being passed under layer 2.
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12. Fig 11
Each graft limb is secured on each of the 2 periosteal tunnels with 2 No. 2 sutures in a figure-of-8 fashion.
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13. Fig 12 A total of 4 sutures on each graft limb are used.
Arthroscopy Techniques 2017 6, e1973-e1978DOI: ( /j.eats )
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