Reconstruction of the Medial Patellofemoral Ligament With Gracilis Tendon Autograft in Transverse Patellar Drill Holes

Christiansen, Sofus; Jacobsen, Bent W.; Lund, Bent; Lind, Martin

doi:10.1016/j.arthro.2007.08.005

Cited by 251 publications

(257 citation statements)

References 25 publications

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“…Its disadvantage is the need to make a 5.0-mm-wide patellar tunnel. Gracilis graft could permit a smaller bony tunnel, but semitendinosus graft is stiffer and has a higher ultimate load than gracilis graft, 6 which may make it more suitable in patients with associated abnormalities.…”

Section: Discussionmentioning

confidence: 99%

Double-Bundle Medial Patellofemoral Ligament Reconstruction With a Single Patellar Tunnel

Zanon

Marullo

Benazzo

2013

Arthroscopy Techniques

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Medial patellofemoral ligament (MPFL) reconstruction is an established method to prevent patellofemoral instability. Nevertheless, the anatomy and the biomechanical behavior of native MPFL are still under investigation, but in recent years they have become more defined. We propose a technique for MPFL reconstruction based on the results of recent anatomic studies regarding the patellar insertion of the MPFL. A double-bundle MPFL is reconstructed by use of the semitendinosus tendon passed through a single patellar tunnel, which crosses the patella from the midpoint of its medial border until its superolateral corner is reached. This method permits a strong patellar fixation, potentially reducing the risk of patellar fracture compared with doubleepatellar tunnel techniques. Moreover, it requires no fixation devices at the patella and only a single interference screw on the femoral side.

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Section: Discussionmentioning

confidence: 99%

Double-Bundle Medial Patellofemoral Ligament Reconstruction With a Single Patellar Tunnel

Zanon

Marullo

Benazzo

2013

Arthroscopy Techniques

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“…In a recent meta-analysis, a total of 1,065 MPFL reconstructions were identified in 31 studies, and it was found that autograft reconstructions were associated with greater postoperative improvements in Kujala scores when compared to allograft, and that double-limbed reconstructions were associated with both improved postoperative Kujala scores and lower failure rate [58]. Overall, in the absence of significant malalignment, MPFL reconstructions appear to provide long-term functional improvement with improved Kujala scores, low rate of redislocation, and decreases in apprehension and patellofemoral pain [59,60,61,62,63,64]. However, the current literature on MPFL outcomes has substantial methodological limitations with small sample sizes and limited follow-ups [65].…”

Section: Surgical Managementmentioning

confidence: 99%

Patellofemoral Joint Instability: A Review of Current Concepts

Kader¹,

Matar²,

Caplan³

2016

jot

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The patellofemoral joint remains the enigma of orthopedics and sports medicine. Patellar dislocation is a common problem in the younger and athletic population and it is more disabling than cruciate ligament injuries. The pathology is often multifactorial and complex with no one factor being the sole defining etiology. The current management of patella dislocation has been linked with poor patient satisfaction possibly due to a prolonged period of conservative treatment and the general tendency to delay surgical intervention. This review will address the main abnormal anatomical factors contributing to patellar instability, their clinical and radiological diagnoses, and the role of various surgical interventions, including the medial patellofemoral ligament reconstruction in stabilizing the patella.

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“…1D). The medial patellofemoral ligament structure was not found; therefore, the medial patellofemoral ligament was reconstructed using the surgical technique described by Christiansen et al (11). The gracilis tendon was harvested through a 3-cm incision over the pes anserinus.…”

Section: Case Reportmentioning

confidence: 99%

“…On the medial side, the free ends of the tendon were passed under the fascia to the femoral drill hole. The two tendon ends were tightened into the femoral drill hole using a Beath pin pullout technique (11). The tension and isometricity of the reconstruction were tested through the arc of motion, and once confirmed the tendons were fixed in the femoral condyle with a bioresorbable interference screw (Milagro ® ; DePuy Synthes, Raynham, MA, USA; Fig.…”

Section: Case Reportmentioning

confidence: 99%

“…Various surgical options, individually and in combination, have been described for the management of the recurrent patellar dislocation in such cases (7)(8)(9)(10). The present case report describes a patient with NPS associated with dislocation of the patella surgically treated by medial patellofemoral ligament reconstruction using the method previously described by Christiansen et al (11).…”

Section: Introductionmentioning

confidence: 99%

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Treatment of patellar instability in a case of hereditary onycho-osteodysplasia (nail-patella syndrome) with medial patellofemoral ligament reconstruction: A case report

Yang

Liu

et al. 2016

Experimental and Therapeutic Medicine

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Abstract.Hereditary onycho-osteodysplasia, also known as nail-patella syndrome (NPS), is a rare genetic disorder that is primarily characterized by poorly developed nails and patella. Patients with NPS frequently suffer from patellar instability that requires surgical management. The present case report describes a 25-year-old man with NPS. The patient presented with left knee pain and was found to have recurrent left patellar dislocation. The knee pain was first reported 1-year after a minor knee trauma incident. Following complete evaluation, a diagnosis of NPS was reached. The patient underwent surgical intervention using medial patellofemoral ligament (MPFL) reconstruction with a gracilis tendon autograft looped through two transverse 3.2-mm drill holes in the patella and fixed at the natural MPFL insertion site on the medial femoral condyle with an interference screw. The surgery resulted in stabilization of the patella in the femoral trochlea and the patient did not have any subsequent dislocations or subluxations. The patient had an excellent range of knee movement in the follow-up period. This case indicates that MPFL reconstruction in patients with patellar dislocation secondary to NPS can successfully restore normal patellar tracking and result in good range of movement and functional activity.

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Reconstruction of the Medial Patellofemoral Ligament With Gracilis Tendon Autograft in Transverse Patellar Drill Holes

Cited by 251 publications

References 25 publications

Double-Bundle Medial Patellofemoral Ligament Reconstruction With a Single Patellar Tunnel

Double-Bundle Medial Patellofemoral Ligament Reconstruction With a Single Patellar Tunnel

Patellofemoral Joint Instability: A Review of Current Concepts

Treatment of patellar instability in a case of hereditary onycho-osteodysplasia (nail-patella syndrome) with medial patellofemoral ligament reconstruction: A case report

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