A mid-term follow-up of medial patellofemoral ligament reconstruction using an artificial ligament for recurrent patellar dislocation

Severino²,

et al. 2011

Rev Bras Med Esporte

Objective: Acute patellar luxation is a complex disease that mainly affects young patients. Its physiopathology is little known and the understanding of it and its therapeutic conduct are controversial. The medial patellofemoral ligament (MPFL) is the main static stabilizer for preventing lateral displacement of the patella. In order to assess the stability of the patellofemoral joint, the authors radiographically assessed the presence, or absence of lateral displacement and inclination of the patella before and after the MPFL section in the knees of cadavers. Methods: Thirty knees of cadavers were radiographed on the axial incidence of the patella by means of the technique described by Merchant before and after MPFL section. The Merchant congruence angle and Laurin lateral patellofemoral angle were measured. Results: The medial patellofemoral ligament presented mean length of 4.8cm, and width of 1.6 cm. In six anatomical pieces there was no change in the Laurin lateral patellofemoral angle (20%), in three anatomical pieces the change was one degree (10%), in 20 (67%) two degrees and in one anatomical piece it was four degrees (3%). Changes occurred between zero and two degrees in 97% of the knees of cadavers. In six anatomical pieces there was no change in the Merchant congruence angle (17%); in six anatomical pieces the change was one degree (20%), in 17 (57%) two degrees, in one anatomical piece it was three degrees (3%) and in one it was six degrees (3%). These changes occurred between zero and two degrees in 93% of the knees of cadavers. Conclusion: Analysis of the results obtained in this study allowed us to conclude that the medial patellofemoral ligament is important in the lateral inclination and displacement of the patella with knee flexed at 45º.

Section: Discussioncontrasting

confidence: 99%

Importância do ligamento femoropatelar medial no deslocamento e na inclinação lateral da patela: estudo radiográfico em cadáveres

Severino²,

et al. 2011

Rev Bras Med Esporte

“…The reconstruction of the MPFL medial patellofemoral ligament allows for the restoration of normal length and stiffness of the medial soft tissue. Success rates of procedures which restore the medial restraints using different types of grafts and techniques range between 80 and 90% [34,35]. In our series, we reported a mean success rate of 85.7%, similar to the data provided in the literature.…”

Section: Discussionsupporting

confidence: 84%

Medial Patellofemoral Ligament Reconstruction in Adolescents Affected by Patellar Instability

Testa

Pavone

Lucenti

et al. 2017

JFMK

Patellar instability is a heterogeneous group of morphological and functional disorders of the knee extensor mechanism. The medial patellofemoral ligament (MPFL) has been recognized as being important in stabilizing the patella and preventing lateral patellar dislocation. Recurrent dislocations in the pediatric population may benefit from surgical intervention. The aim of this study is to retrospectively evaluate adolescent patients treated with surgical reconstruction of medial patello-femoral ligament. Between January 2009 and December 2014, seven patients with patellar instability were treated at the Department of Orthopaedics and Traumatology of the University of Catania, Sicily. Five patients (71.4%) were female and two (28.6%) were male. The mean age at the time of surgery was 14.9 ± 1.1 years (range 13-16 years). All cases were treated with reconstruction of the MPFL. Clinical outcomes and complications were reported. Mean follow-up was 26.1 ± 10.9 months (range 12-46 months). Evaluation at two years after surgery identified an average Knee Society Score (KSS) of 94.3 ± 7.4 (range 78-100). An excellent result was obtained in six patients (85.7%) and a good result was obtained in one patient (14.3%). A recurrence was reported in one patient (14.3%). This study shows that surgical treatment of patellar instability by reconstruction of MPFL leads to satisfying results at mid-term follow-up.

“…Avikainen et al beschrieben die Tenodese des M. adductor magnus [3]. Spä-ter wurde die Verstärkung oder Rekonstruktion der medialen Strukturen beschrieben [14,17,23]. Ostermeier et al zeigten erfolgreich die MPFL-Rekonstruktion durch Tunneltransfer der Semitendinosussehne [24].…”

Section: Anatomische Rekonstruktion Des Medialen Patellofemoralen Banunclassified

Anatomische Rekonstruktion des medialen patellofemoralen Bands mit gedoppelter Gracilissehne

Quirbach

Smekal

Rosenberger

et al. 2012

Oper Orthop Traumatol