Dynamic versus static reconstruction of the medial patellofemoral ligament for recurrent lateral patellar dislocation

Becher, Christoph; Kley, Kristian; Lobenhoffer, Philipp; Ezechieli, Marco; Smith, Tomas; Ostermeier, Sven

doi:10.1007/s00167-014-3020-7

Cited by 45 publications

(52 citation statements)

References 35 publications

(50 reference statements)

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“…There has been controversy regarding the proper knee flexion angle during graft fixation, with estimates ranging from 15° to 70° 19 20 21) . However, recent studies primarily recommend around 30° flexion 20 22 23) . Schottle et al 24) reported that graft fixation should be performed with the knee at 30° of flexion since biomechanical studies have shown that 30° flexion position is where the MPFL has its maximal restraint against patellar lateralization 4) .…”

Section: Surgical Techniquementioning

confidence: 99%

Medial Patellofemoral Ligament Reconstruction: A Comprehensive Review

Kyung

Kim

2015

Knee Surg Relat Res

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It has been suggested that in the majority of patellar dislocation cases, the medial patellofemoral ligament (MPFL) is disrupted with a high recurrence rate especially in female patients. Although MPFL tear is not the primary cause of instability, MPFL reconstruction is effective for stabilizing the knee and may alone prevent lateral patellar dislocation. There is limited but growing evidence that MPFL reconstruction for patellofemoral instability leads to excellent functional outcomes. Growing awareness of the biomechanical contribution of the MPFL has led to an upsurge in the publication of techniques and trials dealing with reconstructive techniques, warranting a review that includes the most recent evidence. The aim of this article was to review and summarize the recent literatures concerning MPFL reconstruction and provide a comprehensive review of previous studies ranging from basic science to current surgical techniques and results.

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Section: Surgical Techniquementioning

confidence: 99%

Medial Patellofemoral Ligament Reconstruction: A Comprehensive Review

Kyung

Kim

2015

Knee Surg Relat Res

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“…MPFL reconstruction can be performed with either a gracilis ( 49 - 52 ) or semitendinosus tendon ( 53 - 55 ), quadriceps tendon graft ( 56 ), or patellar tendon graft ( 16 ). The transfer of the distal adductor magnus tendon is advocated by some authors to avoid donor site morbidity ( 57 , 58 )…”

Section: Resultsmentioning

confidence: 99%

Current Concepts for Patellar Dislocation

et al. 2015

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Context:Patellar dislocation usually occurs to the lateral side, leading to ruptures of the Medial Patellofemoral Ligament (MPFL) in about 90% of the cases. Even though several prognostic factors are identified for patellofemoral instability after patellar dislocation so far, the appropriate therapy remains a controversial issue.Evidence Acquisition:Authors searched the Medline library for studies on both surgical and conservative treatment for patellar dislocation and patellofemoral instability. Additionally, the reference list of each article was searched for additional studies.Results:A thorough analysis of the anatomical risk factors with a particular focus on patella alta, increased Tibial Tuberosity-Trochlear Groove (TT-TG) distance, trochlear dysplasia as well as torsional abnormalities should be performed early after the first dislocation to allow adequate patient counseling. Summarizing the results of all published randomized clinical trials and comparing surgical and conservative treatment after the first-time patellar dislocation until today indicated no significant evident difference for children, adolescents, and adults. Therefore, nonoperative treatment was indicated after a first-time patellar dislocation in the vast majority of patients.Conclusions:Surgical treatment for patellar dislocation is indicated primarily in case of relevant concomitant injuries such as osteochondral fractures, and secondarily for recurrent dislocations.

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“…The MPTL influences tilt and rotation movements of the knee: combined reconstruction of both MPTL and MPFL may contribute to maintain the normal kinematics of the patellofemoral joint throughout the range of motion (12). Several techniques have been described (13) to control patellar instability. Many of these are employed in patients with skeletal immaturity, high riding patella, trochlear dysplasia, and ligament hyperlaxity (14).…”

Section: Introductionmentioning

confidence: 99%

“…Many of these are employed in patients with skeletal immaturity, high riding patella, trochlear dysplasia, and ligament hyperlaxity (14). They vary in terms of graft choice, type of fixation, patellar and femoral attachments and graft tension at the time of fixation (13,(15)(16)(17). A standard surgical technique to manage this condition remains elusive (15).…”

Section: Introductionmentioning

confidence: 99%

Combined reconstruction of the medial patellotibial and patellofemoral ligaments

Maffulli

Aicale

Tarantino

et al. 2019

Muscle Ligaments and Tendons J

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Background. Patellofemoral instability is commonly associated with the rupture of the medial patellofemoral ligament (MPFL), and the role of the medial patellotibial ligament (MPTL) is slowly emerging. Soft tissue reconstructions are able to restore patellar stability. Methods. We present a surgical technique for the combined reconstruction of the MPFL and MPTL using gracilis or semitendinosus tendon (ST) autograft and two patellar tunnels, looping the free end of the tendon graft around the adductor magnus tendon. Results. In this surgical technique the femoral physeal plate is not affected, no femoral tunnel needs to be drilled, no hardware is needed to fix the graft to the bone. Conclusion. The technique described is simple, safe, inexpensive, reproducible and does not require intraoperative fluoroscopy.

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Dynamic versus static reconstruction of the medial patellofemoral ligament for recurrent lateral patellar dislocation

Abstract: III.

Cited by 45 publications

References 35 publications

Medial Patellofemoral Ligament Reconstruction: A Comprehensive Review

Medial Patellofemoral Ligament Reconstruction: A Comprehensive Review

Current Concepts for Patellar Dislocation

Combined reconstruction of the medial patellotibial and patellofemoral ligaments

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