Medial Soft Tissue Restraints in Lateral Patellar Instability and Repair

Hautamaa, Paul V.; Fithian, Donald C.; Kaufman, Kenton R.; Daniel, Dale M.; Pohlmeyer, Andrew M.

doi:10.1097/00003086-199804000-00021

Cited by 518 publications

(434 citation statements)

References 13 publications

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“…These studies show the MPFL, by contributing greater than 50% of the total force, is the major medial soft tissue restraint to prevent lateral displacement of the patella. A biomechanical investigation [21] on cadavers showed 50% of the lateral restraining force is provided by the MPFL alone, leading to the conclusion that other medial retinacular tissues play only a minor role. Other medial retinacular tissues affecting patellar stability are the superficial medial retinaculum and the medial patellotibial ligament.…”

Section: Introductionmentioning

confidence: 99%

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Ligament Reconstruction versus Distal Realignment for Patellar Dislocation

Sillanpää

Mattila

Visuri

et al. 2008

Clinical Orthopaedics &Amp; Related Research

108

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Section: Introductionmentioning

confidence: 99%

“…It has been hypothesized that the failure to identify and correct incompetence of the MPFL at the site of disruption may contribute to recurrent instability [21]. In 1993, Avikainen et al [6] described a method to reconstruct the MPFL by adductor magnus tenodesis.…”

Section: Introductionmentioning

confidence: 99%

Ligament Reconstruction versus Distal Realignment for Patellar Dislocation

Sillanpää

Mattila

Visuri

et al. 2008

Clinical Orthopaedics &Amp; Related Research

108

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show abstract

“…Such fact was also verified in our study, in which the MPFL was present in all knees and presented size mean range of 1.6cm of width and 4.8cm of length, being these values close to the ones found by other authors, who have also demonstrated that, despite its small size, this ligament resists considerable tensile pressure l (18) . In the last decade, important biomechanical investigations have been carried out confirming the importance of this ligament, demonstrating that it is the most important medial static structure for prevention of the patellar lateral dislocation, contributing with over 50% of this strength (19)(20)21) . An interesting biomechanical essay was performed by Sandmeieret al (22) , in which they promoted the MPFL reconstruction with the tendon of the gracilis muscle, observing reestablishment of normal patellofemoral exam after the ligament reconstruction.…”

Section: Discussionmentioning

confidence: 99%

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

Fávaro

Severino²,

Fávaro

et al. 2011

Rev Bras Med Esporte

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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.

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“…3,4 Acting as a checkrein, the MPFL serves as the primary static soft-tissue restraint to lateral patellar translation in the first 20 to 30 of flexion and becomes lax in higher degrees of flexion. 1,3,[5][6][7] In the absence of trochlear dysplasia, the trochlea produces osseous restraint beyond 30 of flexion, maintaining patellofemoral stability. 8 The goal of MPFL reconstruction is to restore normal functional anatomy.…”

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confidence: 99%

Medial Patellofemoral Ligament Reconstruction Using a Modified “Reverse-Loop” Technique

Sampatacos

Getelman

2013

Arthroscopy Techniques

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Medial patellofemoral ligament reconstruction is a commonly performed procedure for patellofemoral instability. In recent years the surgery has evolved considerably as the anatomy and goals of reconstruction have become more defined. This has resulted in numerous surgical options involving various fixation devices. Furthermore, as biomechanical data accumulate regarding the importance of graft position and tension, surgical techniques for applying this knowledge with precision are needed. This technical note with an accompanying video details one such technique that may be applied to various methods of fixation, allowing for improved precision and possibly resulting in a stronger fixation construct.

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Medial Soft Tissue Restraints in Lateral Patellar Instability and Repair

Cited by 518 publications

References 13 publications

Ligament Reconstruction versus Distal Realignment for Patellar Dislocation

Ligament Reconstruction versus Distal Realignment for Patellar Dislocation

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

Medial Patellofemoral Ligament Reconstruction Using a Modified “Reverse-Loop” Technique

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