Medial patellofemoral ligament reconstruction with bioactive synthetic ligament is an option. A 3-year follow-up study

Abstract

IV.

Indications for Medial Patellofemoral Ligament Reconstruction: A Systematic Review

“…Similarly, an increased tibial tubercle-trochlear groove (TT-TG) distance was a common reason suggested for not doing an isolated MPFLR. Some of the specific measurements were reported; one study (1.8%) used a cutoff of greater than 22 mm, 37 seven studies 26,34,[38][39][40][41][42] (12.5%) greater than 20 mm, one study 43 (1.8%) greater than 17 mm, and five studies 17,32,33,44,45 (8.9%) used a TT-TG distance greater than 15 mm.…”

“…Patella alta was often an identified reason for not performing an isolated MPFLR (13 studies, 23.2%). Several studies provided specific numbers; one study 31 (1.8%) used an Insall-Salvati ratio of greater than 1.3 and five studies 25,26,[32][33][34] (8.9%) an Insall-Salvati ratio of greater than 1.2, and one study 42 (1.8%) used a Caton-Deschamps index of greater than 1.35 and four studies [38][39][40]43 (7.1%) used a Caton-Deschamps index of greater than 1.2 as a cutoff.…”

“…►Table 4 outlines the clinical outcomes of MPFLR when clearly reported in the included studies. [17][18][19] Minimum two or more patellar dislocations 12 (21.4%) 17,32,33,37,40,44,45,50,51,53,59,60 Minimum three or more patellar dislocations 3 (5.4%) 25,26,42 Primary patellar dislocation a 11 (19.6%) [17][18][19]23,32,33,45,54,56,59,63 With ongoing instability symptoms 5 (8.9%) 17,18,32,33,45 Associated osteochondral fracture 3 (5.4%) 56,59,63 Loose osteochondral lesion 1 (1.8%) 35 Painful subluxation 5 (8.9%) 17,18,46,49,67 Patellar instability-clinical examination a 9 (16.1%) 32,34,[39][40][41]…”

Minimally invasive medial patellofemoral ligament reconstruction for patellar instability using an artificial ligament: A two year follow-up

“…It is 28 consequently the most important medial soft-tissue restraint and has been shown to 29 be consistently injured after a patellar dislocation [4]. Brückner was the first to 30 present a technique of transferring the medial part of the patellar ligament to the 31 medial epicondyle to stabilize the patella [13]. But only recently with the evolution of 32 shoulder surgery there has been an increased focus on reconstruction of the MPFL.…”

Strategies for Reconstruction of the Medial Patellofemoral Ligament

“…Since the earliest reports of MPFL reconstruction in the early 1990s, 16 many techniques have been described using a variety of grafts [17][18][19][20][21][22][23][24][25][26][27] and fixation techniques. [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] In this article, we present 3 techniques for MPFL reconstruction which vary based on the mode of fixation of the graft on the patella:…”