A prospective randomized trial evaluating two different tensioning techniques for medial patellofemoral ligament reconstruction

Kang, Huijun; Wang, Fei; Cao, Jianhui; Liu, Xiaohui; Ji, Gang

doi:10.1016/j.knee.2016.02.008

Cited by 16 publications

(19 citation statements)

References 26 publications

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“…Our present study did not demonstrate any incidence of recurrent dislocation 2 years following surgery; this is identical with the findings utilizing several other techniques [16, 18, 19, 22–25]. However, the literature does mention various percentages of recurring dislocation following certain surgeries [1, 15, 17, 20, 21, 26, 27].…”

Section: Discussionsupporting

confidence: 90%

“…This result compares favorably with the literature, which reports similar scores 2–2.5 years post-surgery of 73.40 [19], 80.90 [20], 86.00 [15], 87.00 [14], 89.20 [21], 91.40 [22], 92.00 [23], 94.03 [24], 94.69 [16] and 99.69 [18]. …”

Section: Discussionsupporting

confidence: 85%

“…Administration of the Kujala questionnaire at the 2-year mark in our study demonstrated an average score of 89.20 (range: 78.95–99.45). This result compares favorably with the literature, which reports similar scores 2–2.5 years post-surgery of 73.40 [ 19 ], 80.90 [ 20 ], 86.00 [ 15 ], 87.00 [ 14 ], 89.20 [ 21 ], 91.40 [ 22 ], 92.00 [ 23 ], 94.03 [ 24 ], 94.69 [ 16 ] and 99.69 [ 18 ].…”

Section: Discussionsupporting

confidence: 85%

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A new minimally invasive surgical technique for medial retinaculum repair following traumatic patellar dislocation

Shtarker

Assaf

Deltoff

2018

Eur J Orthop Surg Traumatol

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A new surgical method is introduced offering a less invasive approach to reattach the medial retinaculum following acute patellar dislocation. This retrospective analysis comprised 12 cases of medial retinacular repair in 10 patients. The surgical technique achieved reinforced reattachment of the torn region of the medial retinaculum for improved patellar support and stabilization. During follow-up, no recurrent patellar dislocations occurred, except where one patient reported a subjective feeling of patellar dislocation. The average Kujala score for our sample group after 2 years was 89.2. A plethora of methods are described in the literature to repair a tear to the medial patellofemoral ligament, which attaches at the superomedial patella. However, it is our contention that traumatic patellar dislocation invariably results in osteochondral avulsion at the inferomedial patella, refuting medial patellofemoral ligament involvement, and, rather, implicating the inferior aspect of the deep layer of medial retinaculum. Our surgical technique enables stable fixation of the region, decreasing the rate of recurrent dislocations. No grafts are used, permitting tendinous and ligamentous anatomy to remain intact. We further postulate that performing a CT examination preoperatively may reduce time between diagnosis and surgery, in addition to locating fracture sites more precisely.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 85%

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A new minimally invasive surgical technique for medial retinaculum repair following traumatic patellar dislocation

Shtarker

Assaf

Deltoff

2018

Eur J Orthop Surg Traumatol

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“…63 The graft should be tensioned such that it allows for one to two quadrants of patellar displacement, while preventing any further excursion. 64 Wagner et al 65 presented a series of 50 patients with MPFL reconstruction using an autologous gracilis tendon with a minimum follow-up of 12 months. Eighty percent of patients were able to return to the same or higher level of physical activity, and the mean Kujala score increased from 70 to 87 points postoperatively (p < 0.001).…”

Section: Gracilis Tendon Graftingmentioning

confidence: 99%

Management of Injuries to the Medial Patellofemoral Ligament: A Review

et al. 2017

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The medial patellofemoral ligament (MPFL) is thought to be the most important medial structure providing restraint to lateral subluxation of the patella. After an initial patellar dislocation, the MPFL is frequently injured and can usually be treated with conservative measures. However, these patients often suffer from recurrent dislocations, which thereby necessitate operative intervention. In the setting of normal anatomy and kinematics, isolated reconstruction of the MPFL is an effective treatment for preventing recurrent dislocations. Various surgical techniques have been described, with differences in fixation and graft selection. The treatment of MPFL injuries should aim to provide patellar stabilization and restore normal kinematics throughout the joint. This review will discuss the following: (1) anatomy of the MPFL, (2) presentation and assessment of MPFL injuries, (3) management of patients with MPFL injuries, and (4) complications following MPFL reconstruction.

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“…There are numerous surgical options available to treat patellar dislocation but no consensus as yet on which one is the most effective. Medial patellofemoral ligament (MPFL) reconstruction can provide excellent clinical results and has been increasingly applied in recent years [9][10][11]. The MPFL is composed of an inferior-straight bundle at the medial aspect of the patella and a superior-oblique bundle at the superiormedial aspect of patella [12].…”

Section: Introductionmentioning

confidence: 99%

Treatment of patellar dislocation with arthroscopic medial patellofemoral ligament reconstruction using gracilis tendon autograft and modified double-patellar tunnel technique: minimum 5-year patient-reported outcomes

Gao

Liu

2020

J Orthop Surg Res

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Background: The purpose of this study was to retrospectively analyze the clinical outcomes of patients with recurrent patellar dislocation who underwent arthroscopic medial patellofemoral ligament (MPFL) reconstruction using gracilis tendon autograft and a modified double-patellar tunnel method. We hypothesized that our modified method would provide good clinical outcomes. Methods: Patients who underwent arthroscopic MPFL reconstruction with autograft gracilis tendon and modified double-patellar tunnels technique for recurrent patellar dislocation and were followed up for a minimum of 5 years were identified, and the clinical and follow-up data were retrospectively analyzed. Preoperatively, joint hypermobility was assessed with the Beighton score. The Insall-Salvati ratio, TT-TG distance, and Q angle were measured on radiographic images. Patient-reported outcomes including the Kujala, Lysholm, and Tegner scores were collected preoperatively and postoperatively. Patient satisfaction was assessed at the end of 5 years. Complications and recurrent dislocation occurring after surgery were recorded. Results: A total of 79 patients (94 knees) were enrolled; of these, 13 (16.5%) were lost to follow-up. The data of 66 patients (80 knees) were available for final analysis. Mean age at surgery was 21.3 ± 7.8 years. Mean follow-up time was 66.1 ± 5.5 months (range, 60-78 months). Postoperative patient-reported outcome was not associated with Beighton score, Insall-Salvati ratio, or TT-TG distance. Q angle was negatively correlated to Kujala scores and Lysholm scores. Severity of trochlear dysplasia was not associated with postoperative patient-reported outcome. The mean Kujala score increased from 69.4 ± 7.9 to 96.1 ± 1.9, the mean Tegner score increased from 3.1 ± 1.3 to 5.9 ± 1.3, and the mean Lysholm score increased from 73.5 ± 14.6 to 95.3 ± 3.4. Two patients experienced recurrent patellar dislocation during follow-up. Conclusions: MPFL reconstruction using autologous gracilis tendon under arthroscopy appears to be a reliable and safe method for treating recurrent patellar dislocation. Level of evidence: Level IV.

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A prospective randomized trial evaluating two different tensioning techniques for medial patellofemoral ligament reconstruction

Cited by 16 publications

References 26 publications

A new minimally invasive surgical technique for medial retinaculum repair following traumatic patellar dislocation

A new minimally invasive surgical technique for medial retinaculum repair following traumatic patellar dislocation

Management of Injuries to the Medial Patellofemoral Ligament: A Review

Treatment of patellar dislocation with arthroscopic medial patellofemoral ligament reconstruction using gracilis tendon autograft and modified double-patellar tunnel technique: minimum 5-year patient-reported outcomes

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