Results of medial patellofemoral ligament reconstruction in the treatment of patellar dislocation

Drez, David; Edwards, T. Bradley; Williams, Claude S.

doi:10.1053/jars.2001.21490

Cited by 304 publications

(317 citation statements)

References 37 publications

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“…Maenpaa and Lehto described mean Kujala scores ranging from 74 to 82 points in their 100 patients with nonoperatively treated patellar dislocations in a followup study (average, 13 years) [32]. Previous studies describing several promising MPFL reconstructive techniques with followups are summarized [6,14,15,40,47] (Table 6). So far, only one study on MPFL reconstruction techniques has exceeded followup of 10 years [40].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Ligament Reconstruction versus Distal Realignment for Patellar Dislocation

Sillanpää

Mattila

Visuri

et al. 2008

Clinical Orthopaedics &Amp; Related Research

107

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Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

Ligament Reconstruction versus Distal Realignment for Patellar Dislocation

Sillanpää

Mattila

Visuri

et al. 2008

Clinical Orthopaedics &Amp; Related Research

107

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show abstract

“…Some reports in the literature have described case series of combined MPFL and MPTL reconstructions, mostly in children, with good results. [13][14][15][16][17] These reconstructions use the semitendinosus or gracilis tendons with preservation of their tibial insertions, which does not coincide with the anatomic insertion of the MPTL. Reconstruction of the MPTL with the patellar tendon associated with procedures other than MPFL reconstruction (lateral retinacular lengthening, vastus medialis obliquus advancement, medial retinaculum closure, and tibial tuberosity osteotomy) has also been described with good outcomes.…”

mentioning

confidence: 99%

Combined Reconstruction of the Medial Patellofemoral Ligament With Quadricipital Tendon and the Medial Patellotibial Ligament With Patellar Tendon

Hinckel

Gobbi

Demange

et al. 2016

Arthroscopy Techniques

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Although the medial patellotibial ligament (MPTL) has been neglected regarding its function in patellar stability, recently, its importance in terminal extension and during flexion has been recognized. Indications for reconstruction of the medial patellofemoral ligament combined with the MPTL are extension subluxation, flexion instability, children with anatomic risk factors for patellar instability, and knee hyperextension associated with generalized laxity. We describe a combined reconstruction of the medial patellofemoral ligament with quadricipital tendon and reconstruction of the MPTL with patellar tendon autografts.L ateral patellar dislocation is responsible for 2% to 3% of all knee injuries and is the second leading cause of hemarthrosis. 1,2 The medial ligaments responsible for maintaining the stability of the patellofemoral joint are the medial patellofemoral ligament (MPFL), medial patellotibial ligament (MPTL), and medial patellomeniscal ligament (MPML).There are several studies on the MPFL and its anatomic and biomechanical characteristics 2-6 ; however, little is known about the MPTL and MPML. 2,3,5,6 The first biomechanical studies showed that the MPFL contributes 50% to 60% to medial restriction during initial flexion (between 0 and 30 of flexion). [4][5][6] The contribution of the secondary restrictors varies among those studies, ranging from 0% to 24% for the MPTL and from 8% to 38% for the MPML. 3,5,6 However, in a more recent study, Philippot et al. 2 evaluated the medial ligaments in higher degrees of flexion (from 0 to 90 of flexion), showing that the contributions of the MPTL and MPML to lateral translation restriction increase from 26% in extension to 46% at 90 of flexion. In addition, the influences of the MPTL and MPML at 90 of flexion were 72% in patellar tilt and 92% in patellar rotation. 2 In the study by Philippot et al., the combined importance of the MPTL and MPML was evaluated rather than the isolated actions of each of these ligaments. In a clinical study, Garth et al. 7 observed the presence of clinical and arthroscopic subluxation in patients with isolated MPML lesions with the knee in extension. Thus the MPTL and MPML are important in maintaining normal kinematics of the patellofemoral joint in all ranges of motion, especially at extension and higher degrees of flexion.Usually, surgical treatment involves a combination of reconstruction of the injured MPFL and adjuvant procedures for better alignment and congruence of the patellofemoral joint. Several types of grafts have been described for the reconstruction of the MPFL, and they have shown good results. [8][9][10] In a systematic review of the complications associated with exclusive reconstruction of the MPFL, the observed complication rate was 26.1% of cases. Clinical failure presenting with persistence of

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“…Apesar da grande variação de técnicas descritas para sua reconstrução, se acumulam evidências que mostram bons resultados clínicos dessa cirurgia [4][5][6][7][8][9]72,84 . Além dos estudos clínicos, outros trabalhos biomecânicos sugerem que o reparo ou reconstrução do LPFM restaura a fisiologia PF 15,45 .…”

Section: Discussionunclassified

“…Apesar dessa importância biomecânica, o conhecimento da reconstrução do LPFM é relativamente recente, tendo ocorrido principalmente nas últimas duas décadas, com a descrição de muitas técnicas, com diferentes fontes de enxerto e métodos de fixação. Mesmo com toda essa variedade, se acumulam evidências que mostram bons resultados clínicos dessa cirurgia [4][5][6][7][8][9] , com taxa muito baixa de recidiva da instabilidade.…”

Section: Introductionunclassified

Avaliação tomográfica dinâmica pré e pós-reconstrução do ligamento patelofemoral medial de pacientes com instabilidade patelar recidivante

Gobbi¹

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Results of medial patellofemoral ligament reconstruction in the treatment of patellar dislocation

Cited by 304 publications

References 37 publications

Ligament Reconstruction versus Distal Realignment for Patellar Dislocation

Ligament Reconstruction versus Distal Realignment for Patellar Dislocation

Combined Reconstruction of the Medial Patellofemoral Ligament With Quadricipital Tendon and the Medial Patellotibial Ligament With Patellar Tendon

Avaliação tomográfica dinâmica pré e pós-reconstrução do ligamento patelofemoral medial de pacientes com instabilidade patelar recidivante

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