The Quasi Anatomical Plication of the Medial Retinaculum. A Technical Note

Vasileios Raoulis; Freideriki Panteliadou; Styliani Stergiadou; Nikolaos Papanastasiou; Michael Hantes; Aristeidis Zibis

Abstract

First-time patellar dislocation is a common knee injury, particularly among adolescents and young adults. Treatment remains controversial, with the choice between conservative and surgical management best guided by patient-specific factors. For patients with acute, first-time patellar dislocation and concomitant chondral lesions requiring surgical management, minor soft-tissue stabilization procedures may be considered. This technical note describes an arthroscopically assisted, quasi-anatomical medial retinacular plication technique. The procedure involves the introduction of looped polydioxanone sutures (PDS) through 18-gauge needles positioned along the medial patellofemoral ligament (MPFL) trajectory, with knot tying performed extra-articularly. The maneuver can be repeated multiple times, allowing stepwise medial retinacular tightening.Keywords: Plication; Medial retinaculum; MPFL; Medial patellofemoral ligament; Patellar dislocation; Patellar instability; Arthroscopy; Kneehttps://doi.org/10.70885/hmsj.2026.02.001

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