Adductor Magnus Tenodesis for Patellar Dislocation

Ligament Reconstruction versus Distal Realignment for Patellar Dislocation

“…Strengths of the study included homogeneity of the patients, all being young, healthy male adults, which resulted in good comparability between the groups. The median followup for the adductor magnus group was 10.1 years, which is longer than in the previously published study of adductor magnus tenodesis [6]. Furthermore, no previous studies have focused on the long-term MRI characteristics of OA after patellar dislocation.…”

“…Because the surgeons took turns on duty, the choice of procedure depended on the available surgeon and his personal preference, and thus the patients were not randomized. The adductor magnus tenodesis operations were performed using the technique described by Avikainen et al [6] ( Figs. 1, 2).…”

“…The graft then was fixed with nonresorbable sutures near the medial border of the patellar periosteum to reconstruct the MPFL. In the original study, Avikainen et al [6] performed this surgery mainly on acute primary dislocations and reinserted the MPFL into the periosteum of the medial femoral epicondyle. In our study of recurrent dislocations, reinsertion of the MPFL was not done because an acute tear site of the MPFL could not be identified in any of the cases.…”

“…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. Their report on 14 patients, 10 with acute and four with recurrent patellar dislocations, showed good results for 12 patients in a 7-year followup, but absence of a control group was a limitation of the study.…”

“…So far, no other studies have been published concerning this specific MPFL reconstruction technique. Although many repair or reconstructive techniques of the MPFL have been described [6,14,15,17,36,40,42,47], the studies have lacked control groups and have reported only short-or midterm followup.…”