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

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.