Results of anatomic gracilis MPFL reconstruction with precise tensioning

Carnesecchi, Olivier; Néri, Thomas; Iorio, A. Di; Farizon, Frédéric; Philippot, Rémi

doi:10.1016/j.knee.2015.01.006

Cited by 21 publications

(23 citation statements)

References 29 publications

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“…[78] stated that the ideal graft tension was 10 N, and the results of this study were implemented in a clinical trial conducted by Carnesecchi et al. [79], who demonstrated excellent clinical results in 50 patients whose MPFL graft was fixed with tension of 10 N. However, a more recent biomechanical study by Stephen et al. [69] confirming the results previously obtained by Beck et al.…”

Section: Mpfl Reconstructionsupporting

confidence: 78%

Proximal medial patellar restraints and their surgical reconstruction

et al. 2019

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Reconstruction of the medial patellofemoral ligament (MPFL) has been increasing as a surgical solution for treatment of recurrent lateral patellofemoral dislocation. Recent attention has been given to fibers extending from the femur to the quadriceps tendon, proximal to the MPFL, termed the medial quadriceps tendon-femoral ligament. This article briefly reviews the proximal medial patellar restraints and surgical procedures for their reconstruction.

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Section: Mpfl Reconstructionsupporting

confidence: 78%

Proximal medial patellar restraints and their surgical reconstruction

et al. 2019

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“…Finally, a key role is played by the knee flexion angle in fixation, especially if there is a lack of consensus regarding the ideal knee flexion angle during MPFL fixation. The recommendations in the existing literature provide a wide range of descriptions, which present a challenge for surgeons seeking evidence-based guidance [ 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Complications and Recurrence of Patellar Instability after Medial Patellofemoral Ligament Reconstruction in Children and Adolescents: A Systematic Review

et al. 2021

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Background: This study aimed to review the data available in the current literature concerning the complications and recurrence of instability following medial patellofemoral ligament (MPFL) reconstruction for patellar instability in young and adolescent patients (those <20 years old). Methods: A systematic review was performed based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Two independent reviewers searched the PubMed, Scopus, EMBASE, and Cochrane databases. The terms “medial patellofemoral ligament” or “MPFL” and “reconstruction” and “young” or “adolescents” or “children” were used. The inclusion criteria for the literature review comprised studies that reported the complications and recurrences of instability in patients who had undergone MPFL reconstruction for patellar instability. Results: In all, 332 patients were included in the review, of which 195 were females (63.5%) and 112 were males (36.5%), and they totaled 352 treated knees. The mean age at the time of the surgery was 14.28 years, and the mean follow-up duration was 30.17 months. A total of 16 (4.5%) complications were reported: one (0.3%) patella fracture, one (0.3%) screw removal due to intolerance, one (0.3%) infection, five (1.4%) wound complications, six (1.7%) subluxations and two (0.6%) instances of post-operative stiffness. A total of 18 (5.1%) recurrences of patellar instability were recorded. Conclusions: MPFL reconstruction in young patients can be considered an effective and safe treatment leading to clinical improvement in terms of recurrence of dislocation. No major complications related to the technique were reported, but a high level of research evidence is required to better evaluate the clinical results in a long-term follow-up.

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“…c With external femoral rotation, now the lateral condyle (blue dashed line) appears posterior to the medial condyle (red dashed line). Importantly, the location of where the guide pin contacts the femur (green arrow) appears to change substantially based on rotation of the femur even though these are actually all the same location location has been associated with reduced patellar instability and low complication rates [65,76]. The onlay method secures the loop portion of the tendon graft to the insertion site with two suture anchors tied over the graft (Fig.…”

Section: Patellar Placement and Fixationmentioning

confidence: 99%

Avoiding Complications with MPFL Reconstruction

Smith

Werner

Diduch

2018

Curr Rev Musculoskelet Med

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Multiple cadaveric studies have characterized the anatomy of the MPFL and the related morphologic abnormalities that contribute to recurrent lateral patellar instability. Such abnormalities include patella alta, excessive tibial tubercle to trochlear grove (TT-TG) distance, trochlear dysplasia, and malalignment. Recent studies have evaluated the clinical outcomes associated with the treatment of concomitant pathology in combination with MPFL reconstruction, which is critical in avoiding recurrent instability and complications. Although there remains a lack of consensus regarding various critical aspects of MPFL reconstruction, certain concepts remain imperative. Our preferred methods and rationales for surgical techniques are described. These include appropriate work up, a combination of procedures to address abnormal morphology, anatomical femoral insertion, safe and secure patellar fixation, appropriate graft length fixation, and thoughtful knee flexion during fixation.

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Results of anatomic gracilis MPFL reconstruction with precise tensioning

Cited by 21 publications

References 29 publications

Proximal medial patellar restraints and their surgical reconstruction

Proximal medial patellar restraints and their surgical reconstruction

Complications and Recurrence of Patellar Instability after Medial Patellofemoral Ligament Reconstruction in Children and Adolescents: A Systematic Review

Avoiding Complications with MPFL Reconstruction

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