Clinical-radiographic correlation of the femoral insertion point of the graft in reconstruction of the medial patellofemoral ligament

Abstract

ObjectiveTo analyze the radiographic positioning of the femoral tunnel and correlate this with the postoperative clinical results among patients undergoing reconstruction of the medial patellofemoral ligament (MPFL) alone.MethodThis was a retrospective study in which 30 knees of 26 patients with recurrent dislocation of the patella that underwent MPFL reconstruction were evaluated. The femoral insertion point of the graft and the postoperative clinical condition were analyzed and correlated using the Kujala and Lysholm scales.Results22 knees presented a femoral tunnel in the anatomical area (group A) and 8 outside of this location (group B). In group A, the mean score on the Kujala scale was 89.68 points and on the Lysholm scale was 92.45 points. In group B, the mean score on the Kujala scale was 84.75 points and on the Lysholm scale was 92 points. The difference between the means was not significant on either of the two scales.ConclusionCorrelation with the clinical results did not show any difference in relation to the positioning of the femoral insertion of the graft.

Single- and double-bundle medial patellofemoral ligament reconstruction procedures result in similar recurrent dislocation rates and improvements in knee function: a systematic review

“…However, there were great variations between studies in the patellar fixation method. In the SB group, the bone tunnel was commonly located in the upper 1/3 of the medial border, and ran in the medial–lateral [2, 8, 19, 30] or medial‐anterior direction [25, 28, 42], with a graft loop with the tunnel [25, 28], or suture with the lateral retinaculum [8] or the anterior patellar aponeurosis [42], or fixation with an endobutton [2, 19]. In the DB group, two tunnels were applied in a transverse parallel [18, 32] or laterally diverging shape [12, 29], either in the medial–lateral direction [12, 18, 29, 32] or exiting anteriorly [4, 10, 11].…”

Outcomes of medial patellofemoral ligament reconstruction in patients with patella alta

“…MPFL reconstruction has produced good patellar stability and good functional results. 1 , 11 , 12 , 13 In a review article, Lind et al 14 reported the absence of post-reconstruction recurrences in five out of eight studies; in the remaining three, the recurrent dislocation rates were lower than 7%, which can be considered a success. The present study also observed no cases of postoperative dislocation.…”

“…The procedure of choice continues to be a subject of debate, and preferences vary greatly among the different authors. 1 , 2 …”