Medial Patellofemoral Ligament Reconstruction With Concomitant Tibial Tubercle Transfer: A Systematic Review of Outcomes and Complications

Burnham, Jeremy M.; Howard, Jennifer S.; Hayes, Christopher; Lattermann, Christian

doi:10.1016/j.arthro.2015.11.039

Cited by 46 publications

(31 citation statements)

References 54 publications

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“…Many surgical procedures have been performed, and good or excellent clinical outcomes have been reported. 4 , 5 , 6 However, few reports exist on the long-term outcome after MPFL reconstruction. At our institution, MPFL reconstruction with Insall’s proximal realignment 7 has been performed in patients who complained of patellar instability since 1999.…”

Section: Introductionmentioning

confidence: 99%

Middle-to long-term outcome after medial patellofemoral ligament reconstruction with Insall’s proximal realignment for patellar instability

Shimizu

Sumen

Sakaridani

et al. 2019

Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilit

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Background Recently, medial patellofemoral ligament (MPFL) reconstruction has become a common, widely used procedure to treat patellar instability. However, few reports exist on the long-term outcome after MPFL reconstruction. We elucidated the middle- to long-term outcome after MPFL reconstruction with Insall’s proximal realignment. Methods: From 1999 to 2012, 42 knees of 32 patients who underwent MPFL reconstruction with Insall’s proximal realignment were reviewed with a minimum follow-up of five years. Patients who could visit our office and receive some designated examinations were included in this study. The re-dislocation rate and patellar apprehension sign postoperatively were evaluated. The Kujala score and Knee Injury and Osteoarthritis Outcome Score (KOOS) were calculated. We assessed the images using plane x-ray and magnetic resonance imaging (MRI). The tilting angle (TA), congruence angle (CA), and lateral shift ratio (LSR) on the plane x-ray were measured pre- and postoperatively and at final follow-up. Using MRI, osteochondral lesions at the patellofemoral joint were evaluated. Results A total of 20 knees of 15 patients (two male, 13 female) who could visit our office were studied. The follow-up rate was 47.6%. The mean age at operation was 19.9 (11–41) years and mean follow-up was 123 (60–215) months. One knee (5.5%) had a history of postoperative subluxation, and five (25%) had a positive apprehension sign. The mean Kujala score significantly improved from 65.5 to 86.1 points (P < 0.05). The mean KOOS (symptom, pain, activities of daily living [ADL], sports, quality of life [QOL]) was 74.4, 92.4, 97.3, 84.1, and 73.2 points, respectively, at final follow-up. On the plane x-ray, patellofemoral alignment was improved postoperatively, and this improvement was maintained at final follow-up. On MRI, in five of 20 cases, the patellofemoral osteoarthritic change was observed at final follow-up. However, in four of these five knees with severe osteochondral lesions, osteochondral fixation or transplantation surgery had been performed. Only one of the remaining 15 knees had a patellofemoral osteoarthritic change observed at final follow-up. Conclusion Middle- to long-term outcome after MPFL reconstruction with Insall’s proximal realignment at our institution was evaluated, and good clinical results were observed. Most patients who did not have a severe cartilage lesion preoperatively did not develop osteoarthritic change.

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Section: Introductionmentioning

confidence: 99%

Middle-to long-term outcome after medial patellofemoral ligament reconstruction with Insall’s proximal realignment for patellar instability

Shimizu

Sumen

Sakaridani

et al. 2019

Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilit

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“…In a systematic review on MPFL reconstruction with tibial tubercle transfer, Burnham et al. 18 reported a low to moderate risk of complications with positive treatment outcomes at an average follow-up of 38 months.…”

Section: Discussionmentioning

confidence: 99%

Medial Patellofemoral Ligament Reconstruction in a Revision Setting: Anchor and Interference Screw Fixation

Ferrari

Sánchez

Chang

et al. 2017

Arthroscopy Techniques

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Recurrent patellar instability is a common pathology and typically affects younger and more active patients. To prevent complete lateral dislocation of the patella, several osseous and soft-tissue procedures have been previously described, including reconstruction of the medial patellofemoral ligament (MPFL), which has been identified as the primary medial stabilizer of the patella. Several techniques have been reported for reconstruction of the MPFL, sometimes in conjunction with other procedures, with the majority showing success in the treatment and resolution of patellar instability. However, MPFL reconstruction is not free of complications, with previous reports of recurrence of medial patellar instability and patellar fracture after surgery. The objective of this Technical Note is to describe our preferred technique, comprising anchor as well as interference screw fixation, for reconstruction of the MPFL in a primary or revision setting.

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“…10 and 13) or trochleoplasty to address multiple coexistent risk factors. 64 The most frequent complication of tubercle realignment is painful screws that can be removed after the osteotomy has healed. 65 Fractures of the shifted tubercle (►Fig.…”

Section: Distal Patellar Tendon Realignmentmentioning

confidence: 99%

“…reconstruction, the rates and types of complications are similar compared with those reported for MPFL reconstruction alone. 64…”

Section: Distal Patellar Tendon Realignmentmentioning

confidence: 99%

Postoperative Imaging of the Knee Extensor Mechanism

Long

Rubin

2018

Semin Musculoskelet Radiol

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The extensor mechanism of the knee plays an important role in many movements of the lower extremity. Although its main function is to extend the knee, it also stabilizes the patellofemoral joint and resists passive flexion of the knee when landing from jumping. Pathologic conditions of the extensor mechanism can be acute or chronic, and they can negatively affect daily activities. Fortunately, many surgical treatments are available aimed at restoring function to the injured extensor mechanism. Understanding the surgical techniques and common complications of these procedures enables the radiologist to recognize expected and unexpected postoperative imaging appearances.

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Medial Patellofemoral Ligament Reconstruction With Concomitant Tibial Tubercle Transfer: A Systematic Review of Outcomes and Complications

Abstract: Level IV, systematic review of Level II and IV studies.

Cited by 46 publications

References 54 publications

Middle-to long-term outcome after medial patellofemoral ligament reconstruction with Insall’s proximal realignment for patellar instability

Middle-to long-term outcome after medial patellofemoral ligament reconstruction with Insall’s proximal realignment for patellar instability

Medial Patellofemoral Ligament Reconstruction in a Revision Setting: Anchor and Interference Screw Fixation

Postoperative Imaging of the Knee Extensor Mechanism

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