Medial patellofemoral ligament reconstruction for patellar instability following total knee arthroplasty: A review of 6 cases

Lamotte, A; Néri, Thomas; Kawaye, A.; Boyer, Bertrand; Farizon, Frédéric; Philippot, Rémi

doi:10.1016/j.otsr.2016.03.018

Cited by 20 publications

(23 citation statements)

References 16 publications

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“…There are four main treatment procedures for patellar dislocation after TKA: proximal realignment[ 19 ], medial patellofemoral ligament (MPFL) reconstruction[ 20 - 22 ], distal realignment including tibial tuberosity osteotomy (TTO)[ 23 ], and lateral retinaculum release[ 24 ]. When any procedure is performed, Gennip et al [ 21 ], and Goto et al [ 25 ] suggested that alignment of the implant should be assessed first, to determine whether it is within the normal range of alignment.…”

Section: Discussionmentioning

confidence: 99%

Patellar dislocation following distal femoral replacement after extra-articular knee resection for bone sarcoma: A case report

Kubota¹,

Tanaka²,

Hirakawa³

et al. 2022

WJCC

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BACKGROUND For the treatment of bone sarcoma in the distal femur, wide-margin resection and knee reconstruction with tumor endoprosthesis are standard therapies. Extra-articular knee resection is required in cases of tumor invasion of the knee joint; however, the incidence of complications, such as aseptic loosening, prosthesis infection, and implant failure, is higher than that following intra-articular knee resection. To the best of our knowledge, there are three reports of patellar dislocations after replacement of a tumor endoprosthesis. CASE SUMMARY A 36-year-old man with no significant past medical history was admitted to our institution with continuous pain in his left knee for 4 mo. An open biopsy was performed, and the patient was diagnosed with a left distal femoral malignant bone tumor. Extra-articular knee resection and knee reconstruction with a tumor endoprosthesis were performed. Although the alignment of the tumor prosthesis was acceptable, knee instability was noticed postoperatively. The axial radiographic view of the patellar and computed tomography showed lateral patellar dislocation at 4 wk postoperatively. The patient had to undergo a lateral release and proximal realignment. He could perform his daily activities at 9 mo postoperatively. Radiography revealed no patellar re-dislocation. CONCLUSION Proximal realignment may be considered during primary surgery if there is an imbalance in the forces controlling the patellar tracking.

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Section: Discussionmentioning

confidence: 99%

Patellar dislocation following distal femoral replacement after extra-articular knee resection for bone sarcoma: A case report

Kubota¹,

Tanaka²,

Hirakawa³

et al. 2022

WJCC

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“…Previously published outcomes of MPFLr in this population are limited to small case series or case reports [ 13 , 14 , [29] , [30] , [31] ] ( Table 6 ). In the largest previous series published on this topic, van Gennip et al.…”

Section: Discussionmentioning

confidence: 99%

“…However, patients experiencing patella instability after arthroplasty are comparatively older and may have poor bone quality [ 11 , 12 ]. Only a small number of studies with low numbers of patients have reported outcomes of patients with PFI after TKA treated using MPFLr [ 13 , 14 ]. Furthermore, the indications for performing MPFLr with or without a tibial tubercle osteotomy (TTO) in a TKA have not been well described previously.…”

Section: Introductionmentioning

confidence: 99%

Can Patella Instability After Total Knee Arthroplasty be Treated With Medial Patellofemoral Ligament Reconstruction?

et al. 2022

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“…However, among aged populations, cases of total knee arthroplasty (TKA) for knee OA with permanent patellar dislocation [11] or lateral patellar dislocation after TKA are often reported [12, 13]. Accordingly, the authors concluded that the causes of lateral dislocation of the patella after TKA are component malpositions of an anterior, internally rotated, and medial femur; internally rotated tibia; and lateral patella.…”

Section: Discussionmentioning

confidence: 99%

Medial Patellofemoral Ligament Reconstruction Using the Hamstring Tendon for Patellofemoral Joint Instability in an 81-Year-Old Female

Takahashi¹,

Takeshita²

2017

TOORTHJ

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Introduction:Chronic patellofemoral instability occurs mainly in adolescent females and can also be induced by medial patellofemoral ligament (MPFL) injury. There are no case reports of MPFL reconstruction for chronic patellofemoral instability due to MPFL injury in aged populations.Case Presentation:81-year-old female presented with left knee pain, giving way, and patellar instability while climbing stairs, which continued for 18 months. Patellar apprehension test was positive, and roentgenogram showed lateral patellar subluxation. Conservative therapy was not successful; hence, we performed a lateral release and MPFL reconstruction surgery.Operative Procedure:After arthroscopic lateral release, the hamstring tendon was harvested, and a graft composite made of doubled hamstring tendon and polyester tape with a suspensory fixation device was prepared. Then, a femoral bone tunnel was constructed in a socket shape at the anatomical footprint of the MPFL. The graft was passed through the femoral tunnel, and free ends of the graft composite were sutured to the periosteum of the patella, using two suture anchors at 60° of knee flexion with patellar reduction. Physiotherapy was gradually started using a patella-stabilizing orthosis on the first postoperative day. Her Kujala score improved from 66 to 97 points, and Barthel index score improved from 70 to 100 points at 1 year after surgery. She neither developed patellofemoral joint OA nor had any recurrence of symptoms at the 5-year postoperative follow up.ConclusionMPFL reconstruction using the hamstring tendon is an effective procedure for patients with chronic patellofemoral instability even after the age of 80 years.

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Medial patellofemoral ligament reconstruction for patellar instability following total knee arthroplasty: A review of 6 cases

Abstract: IV - Retrospective cohort study.

Cited by 20 publications

References 16 publications

Patellar dislocation following distal femoral replacement after extra-articular knee resection for bone sarcoma: A case report

Patellar dislocation following distal femoral replacement after extra-articular knee resection for bone sarcoma: A case report

Can Patella Instability After Total Knee Arthroplasty be Treated With Medial Patellofemoral Ligament Reconstruction?

Medial Patellofemoral Ligament Reconstruction Using the Hamstring Tendon for Patellofemoral Joint Instability in an 81-Year-Old Female

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