Reconstruction of the medial patellofemoral ligament using autologous graft from quadriceps tendon to treat recurrent patellar dislocation

Calapodopulos, Constantino Jorge; Nogueira, Marcelo Corvino; Eustáquio, José Martins Juliano; Júnior, Constantino Jorge Calapodopulos; Rodrigues, Oreston Alves

doi:10.1016/j.rboe.2016.01.012

Cited by 7 publications

(4 citation statements)

References 23 publications

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“…Further advantages of MPFL reconstruction are the low recurrence rates and the restoration of anatomic structures; however, this is an invasive and technically demanding procedure, requiring an additional graft harvest, and relies on sufficient surgical experience. Furthermore, expensive equipment is required during MPFL reconstruction [4]; however, there is no consensus regarding the ideal surgical technique for the treatment of patellar dislocation [5]. For rehabilitation issues, quadriceps muscle strength seems to be an important factor for a good outcome after knee surgery.…”

Section: Introductionmentioning

confidence: 99%

Functional outcome after recurrent patellar dislocation

Kéilani

Palma

Crevenna

et al. 2019

Wien Klin Wochenschr

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SummaryBackgroundThere is no final consensus regarding the ideal surgical technique for the treatment of patellar dislocation. The aim of this retrospective pilot study was to describe muscle strength, body composition, self-reported physical performance, and pain in male patients after patellar dislocation treatment with two different surgical techniques: medial patellofemoral ligament (MPFL) reconstruction vs. the Elmslie-Trillat procedure.MethodsIsokinetic testing of knee extensor muscles was performed using a Biodex System 3 pro dynamometer at an angular velocity of 60°/s. Body composition was measured with bioelectrical impedance analysis (Nutribox). Self-reported physical performance and pain were assessed by the SF-36 subscales of physical functioning, role physical and bodily pain. The outcome variables of peak torque normalized to participant’s body mass (Nm/kg), lean body mass, phase angle, self-reported physical performance, and pain were compared between the study groups.ResultsOf the 12 included male patients, 6 had been treated with MPFL reconstruction (age: median = 33 years, range = 18–38 years; BMI: median = 26 kg/m2, range = 23–29) and 6 with the Elmslie-Trillat procedure (age: median = 26 years, range = 19–32 years; BMI: median = 23 kg/m2, range = 19–28). No statistically significant differences were found between the groups in any outcome parameter of muscle strength, body composition, self-reported physical performance, or pain.ConclusionsThe results of the present pilot study revealed that MPFL reconstruction shows equal results to the Elmslie-Trillat procedure, with respect to isokinetic knee muscle strength, body composition, self-reported physical performance and pain in male patients suffering from recurrent patellar dislocation.

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Section: Introductionmentioning

confidence: 99%

Functional outcome after recurrent patellar dislocation

Kéilani

Palma

Crevenna

et al. 2019

Wien Klin Wochenschr

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“…The quadriceps turndown technique, a form of MPFL reconstruction, has been studied in the adult population, but data are lacking in the adolescent population. [12][13][14][15][16][17] The purpose of this study is to review the results of MPFL reconstruction via a quadriceps turndown technique in the adolescent population. We hypothesized that the use of the quadriceps turndown technique would be safe and efficacious in the treatment of patellar instability in this patient population.…”

mentioning

confidence: 99%

“…MPFL reconstruction attempts to restore the medial stability of the knee, either as an isolated procedure or in conjunction with other techniques. The quadriceps turndown technique, a form of MPFL reconstruction, has been studied in the adult population, but data are lacking in the adolescent population 12–17. The purpose of this study is to review the results of MPFL reconstruction via a quadriceps turndown technique in the adolescent population.…”

mentioning

confidence: 99%

Outcomes of MPFL Reconstruction Utilizing a Quadriceps Turndown Technique in the Adolescent/Pediatric Population

Fisher

Singh

Samora

et al. 2021

Journal of Pediatric Orthopaedics

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Purpose: Recurrent instability following a lateral patellar dislocation is a common indication for surgical intervention. Several surgical procedures are described in the literature to address recurrent patellar instability. Medial patellofemoral ligament (MPFL) reconstruction utilizing the quadriceps turndown technique attempts to restore medial stability. Results of the quadriceps turndown technique have previously only been reported in adult populations. The purpose of this study was to assess the safety, efficacy, and patient-reported outcomes following a quadriceps turndown MPFL reconstruction in the pediatric and adolescent population. Methods: Records of all patients who underwent MPFL reconstruction using a quadriceps turndown technique between 2011 and 2018 were reviewed for demographics, risk factors, complications, mechanism of injury, and concomitant procedures. Return to activities of daily living (ADLs), return to presurgery level of sport, length of bracing, and recurrent instability were assessed with the administration of the Kujala Anterior Knee Pain Score. All analyses were completed using IBM SPSS Statistics 26. Results: Thirty-six knees [14 female (39%), 22 male (61%)] from 34 patients met inclusion/exclusion criteria. The average followup length was 35.9 ± 15.2 months. The average age was 16.3 ± 1.8 years at the time of surgery. The average time for resumption of ADLs was 8.1 ± 6.0 weeks after surgery. Ninetyfour percent of patients returned to preinjury level of sport at an average of 23.6 ± 12.0 weeks after surgery. Mean Kujala Anterior Knee Pain Score was 90.7 ± 10.3. Female patients (P < 0.001) reported significantly lower Kujala scores. Three patients (8%) experienced recurrent instability during ADLs and an additional 4 (11%) reported subjective feelings of instability only during sport or elevated activity. One knee required a return to the operating room for irrigation and debridement due to infection. Conclusion:This study demonstrates that the quadriceps turndown technique for MPFL reconstruction is a safe and effective procedure for the management of recurrent patellar instability in pediatric and adolescent patients. Level of Evidence: Level III-therapeutic.

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“…Acute patellar dislocation is a common injury, especially among adolescents, and is usually related to sports and physical activities [1]. It may be triggered by traumatic or nontraumatic events [2]. About 15-44% of patients who are treated conservatively after an acute dislocation will have recurrent patellar dislocation [3,4].…”

Section: Introductionmentioning

confidence: 99%

Treatment of patellar dislocation with arthroscopic medial patellofemoral ligament reconstruction using gracilis tendon autograft and modified double-patellar tunnel technique: minimum 5-year patient-reported outcomes

Gao

Liu

2020

J Orthop Surg Res

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Background: The purpose of this study was to retrospectively analyze the clinical outcomes of patients with recurrent patellar dislocation who underwent arthroscopic medial patellofemoral ligament (MPFL) reconstruction using gracilis tendon autograft and a modified double-patellar tunnel method. We hypothesized that our modified method would provide good clinical outcomes. Methods: Patients who underwent arthroscopic MPFL reconstruction with autograft gracilis tendon and modified double-patellar tunnels technique for recurrent patellar dislocation and were followed up for a minimum of 5 years were identified, and the clinical and follow-up data were retrospectively analyzed. Preoperatively, joint hypermobility was assessed with the Beighton score. The Insall-Salvati ratio, TT-TG distance, and Q angle were measured on radiographic images. Patient-reported outcomes including the Kujala, Lysholm, and Tegner scores were collected preoperatively and postoperatively. Patient satisfaction was assessed at the end of 5 years. Complications and recurrent dislocation occurring after surgery were recorded. Results: A total of 79 patients (94 knees) were enrolled; of these, 13 (16.5%) were lost to follow-up. The data of 66 patients (80 knees) were available for final analysis. Mean age at surgery was 21.3 ± 7.8 years. Mean follow-up time was 66.1 ± 5.5 months (range, 60-78 months). Postoperative patient-reported outcome was not associated with Beighton score, Insall-Salvati ratio, or TT-TG distance. Q angle was negatively correlated to Kujala scores and Lysholm scores. Severity of trochlear dysplasia was not associated with postoperative patient-reported outcome. The mean Kujala score increased from 69.4 ± 7.9 to 96.1 ± 1.9, the mean Tegner score increased from 3.1 ± 1.3 to 5.9 ± 1.3, and the mean Lysholm score increased from 73.5 ± 14.6 to 95.3 ± 3.4. Two patients experienced recurrent patellar dislocation during follow-up. Conclusions: MPFL reconstruction using autologous gracilis tendon under arthroscopy appears to be a reliable and safe method for treating recurrent patellar dislocation. Level of evidence: Level IV.

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Reconstruction of the medial patellofemoral ligament using autologous graft from quadriceps tendon to treat recurrent patellar dislocation

Cited by 7 publications

References 23 publications

Functional outcome after recurrent patellar dislocation

Functional outcome after recurrent patellar dislocation

Outcomes of MPFL Reconstruction Utilizing a Quadriceps Turndown Technique in the Adolescent/Pediatric Population

Treatment of patellar dislocation with arthroscopic medial patellofemoral ligament reconstruction using gracilis tendon autograft and modified double-patellar tunnel technique: minimum 5-year patient-reported outcomes

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