Medial Patellofemoral Ligament Reconstruction: Fixation Strength of 5 Different Techniques for Graft Fixation at the Patella

Lenschow, Simon; Schliemann, Benedikt; Gestring, Jens; Herbort, Mirco; Schulze, Martin; Kösters, Clemens

doi:10.1016/j.arthro.2012.12.004

Cited by 99 publications

(130 citation statements)

References 42 publications

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“…In our study, we obtained a 2.04 mm elongation at the end of the cycles (range 0.99–3.05 mm) in the LGA group and 2.75 mm (range 1.87–3.42 mm) in CGA group, less than what was observed in vivo, which could mean greater stiffness of the construct when applied in vivo in accordance with the Lenschow et al findings (Lenschow et al 2013). …”

Section: Discussionsupporting

confidence: 88%

Biomechanical and histological comparison between the cryopreserved and the lyophilized Gracilis tendon allograft for MPFL reconstruction, a cadaveric experimental study

et al. 2016

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BackgroundMedial patellofemoral ligament (MPFL) is the main restrictor of lateral shifting of the patella, contributing by 60 % in the first 20° flexion of the knee. MPFL reconstruction has been performed in order to restore the stability of the patella with good results.Lyophilized Gracilis tendon allograft (LGA) compared to Cryopreserved Gracilis tendon allograft (CGA) has a lower cost, does not require to maintain cooling chain or preparation. The purpose of this study is to compare the histological and biomechanical characteristics of an experimental model of reconstruction of the MPFL in porcine patellas with LGA versus CGA.MethodsRandomized controlled experimental study in porcine model conducted on 36 porcine patellas in which 18 were intervened with LGA and 18 were intervened with CGA. The confluent tunnel technique was used for MPFL reconstruction. Maximum tensile force, allograft elongation and stiffness of the construct were measured. The cellularity and collagen tissue distribution were evaluated in the allografts. The histological and biomechanical characteristics of the LGA were compared to those of the CGA.ResultsThe median of the maximum tensile force for the LGA group was 299.63 N and 280.86 N for the CGA group (p = 0.45). The median of the stiffness was 57.86 N/mm for the LGA and 54.23 N/mm for the CGA (p = 0.2). The median of the elongation for the LGA was 5.95 mm and 6.12 mm for the CGA (p = 0,29). The bone bridge failed in 88.88 % of the constructs with LGA and 94.44 % in those with CGA (p = 0.5).ConclusionsNo differences were observed between the LGA group and the CGA group in maximum tensile force, elongation, stiffness, site of rupture and histological characteristics. The use of a lyophilized Gracilis tendon allograft for MPFL reconstruction confers the same histological and biomechanical characteristics as a cryopreserved Gracilis tendon allograft.

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Section: Discussionsupporting

confidence: 88%

Biomechanical and histological comparison between the cryopreserved and the lyophilized Gracilis tendon allograft for MPFL reconstruction, a cadaveric experimental study

et al. 2016

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“…This model has been used in numerous biomechanical studies addressing ligament reconstructions of the knee. 7,[38][39][40][41] Although the bone mineral density is comparable with that of the human distal femora and proximal tibiae, a transfer to the in vivo situation in humans was not thoroughly possible. 42 Nurmi et al 43 showed in their study that porcine tibiae were only a poor substitute for human bone, particularly when interference fixation is used.…”

Section: Limitationsmentioning

confidence: 98%

Influence of Different Tibial Fixation Techniques on Initial Stability in Single-Stage Anterior Cruciate Ligament Revision With Confluent Tibial Tunnels: A Biomechanical Laboratory Study

Schliemann

Treder

Schulze

et al. 2016

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…The MPFL is the most important soft tissue stabilizer and contributes 50-60 % to the medial constraints of the patella [4,5,8,17,24]. Subsequent dislocations are often associated with significant soft tissue damage [5,8] and chronic instability often causes severe damage to the articular cartilage…”

Section: Introductionmentioning

confidence: 98%

Clinical outcome after medial patellofemoral ligament reconstruction and autologous chondrocyte implantation following recurrent patella dislocation

Siebold

Karidakis

Fernandez

2014

Knee Surg Sports Traumatol Arthrosc

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Medial Patellofemoral Ligament Reconstruction: Fixation Strength of 5 Different Techniques for Graft Fixation at the Patella

Cited by 99 publications

References 42 publications

Biomechanical and histological comparison between the cryopreserved and the lyophilized Gracilis tendon allograft for MPFL reconstruction, a cadaveric experimental study

Biomechanical and histological comparison between the cryopreserved and the lyophilized Gracilis tendon allograft for MPFL reconstruction, a cadaveric experimental study

Influence of Different Tibial Fixation Techniques on Initial Stability in Single-Stage Anterior Cruciate Ligament Revision With Confluent Tibial Tunnels: A Biomechanical Laboratory Study

Clinical outcome after medial patellofemoral ligament reconstruction and autologous chondrocyte implantation following recurrent patella dislocation

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