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Medial patellofemoral ligament

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https://www.readbyqxmd.com/read/29752638/avoiding-complications-with-mpfl-reconstruction
#1
REVIEW
Marvin K Smith, Brian C Werner, David R Diduch
PURPOSE OF REVIEW: To discuss the potentially significant complications associated with medial patellofemoral ligament (MPFL) reconstruction. Additionally, to review the most current and relevant literature with an emphasis on avoiding these potential complications. RECENT FINDINGS: Multiple cadaveric studies have characterized the anatomy of the MPFL and the related morphologic abnormalities that contribute to recurrent lateral patellar instability. Such abnormalities include patella alta, excessive tibial tubercle to trochlear grove (TT-TG) distance, trochlear dysplasia, and malalignment...
May 12, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29752499/intraoperative-fluoroscopy-during-mpfl-reconstruction-improves-the-accuracy-of-the-femoral-tunnel-position
#2
P Koenen, S Shafizadeh, T R Pfeiffer, A Wafaisade, B Bouillon, A C Kanakamedala, V Jaecker
PURPOSE: Reconstruction of the medial patellofemoral ligament (MPFL) has been established as standard of care for patellofemoral instability. An anatomic femoral tunnel position has been shown to be a prerequisite for restoration of patellofemoral stability and biomechanics. However, the incidence of malpositioning of the femoral tunnel during MPFL reconstruction continues to be notable. Palpation of anatomic landmarks and intraoperative fluoroscopy are the two primary techniques for tunnel placement...
May 11, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29741911/long-term-comparison-of-semitendinosus-and-gracilis-tendon-versus-patellar-tendon-autografts-for-anterior-cruciate-ligament-reconstruction-a-17-year-follow-up-of-a-randomized-controlled-trial
#3
Matjaz Sajovic, Domen Stropnik, Katja Skaza
BACKGROUND: Short-term and mid-term differences between hamstring and patellar tendon autografts for anterior cruciate ligament (ACL) reconstruction are well documented. Systematic reviews highlight the lack of long-term results between the two grafts. HYPOTHESIS: Seventeen years after ACL reconstruction, no difference will be found in functional outcome, quality of life, and graft failure between patients with patellar tendon (PT) or semitendinosus and gracilis tendon (STG) autografts; however, a significant difference will be seen in the prevalence of osteoarthritis...
May 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29724252/synthetic-versus-autologous-reconstruction-syn-var-of-the-medial-patellofemoral-ligament-a-study-protocol-for-a-randomised-controlled-trial
#4
Adam Tucker, Sam McMahon, Bronwyn McArdle, Bridgeen Rutherford, Danny Acton
BACKGROUND: Recurrent patellar instability incidence is 5.8/100,000 population, and recurrent dislocations are reported in the range of 15-80%. Recurrent instability is multifactorial and can be associated with disorder of limb alignment, osseous development, congruity of the patella in the trochlea and soft tissue static and dynamic constraints. The multifactorial aetiology makes management challenging, and a lack studies in a heterogeneous population with robust clinical outcomes compounds this further...
May 3, 2018: Trials
https://www.readbyqxmd.com/read/29723036/patellar-redislocation-rates-and-clinical-outcomes-after-medial-patellofemoral-ligament-reconstruction-suture-anchor-versus-double-transpatellar-tunnel-fixation
#5
Jae-Won Heo, Kyung-Han Ro, Dae-Hee Lee
BACKGROUND: Few studies to date have compared clinical outcomes in patients who have undergone medial patellofemoral ligament (MPFL) reconstruction using the suture anchor and double transpatellar tunnel fixation methods. This meta-analysis therefore compared the clinical results, including the patellar redislocation rate and improvement in functional scores, of suture anchor and double transpatellar tunnel fixation. HYPOTHESIS: The recurrence rate and improvement in functional outcomes after surgery would be similar using the suture anchor and double transpatellar tunnel fixation methods...
May 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29721691/nonoperative-treatment-of-pcl-injuries-goals-of-rehabilitation-and-the-natural-history-of-conservative-care
#6
REVIEW
Dean Wang, Jessica Graziano, Riley J Williams, Kristofer J Jones
PURPOSE OF REVIEW: To review the current practices of nonoperative management of posterior cruciate ligament (PCL) injuries, the natural history of conservative care, and the latest PCL rehabilitation strategies. RECENT FINDINGS: PCL injuries often occur as part of a multiligamentous knee injury and occasionally occur in isolation. Although patients may be able to tolerate or compensate for a PCL-deficient knee, long-term outcomes after conservative care demonstrate a high rate of arthrosis in the medial and patellofemoral compartments resulting from altered knee kinematics and loads...
May 2, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29682680/mpfl-in-first-time-dislocators
#7
REVIEW
Beth E Shubin Stein, Simone Gruber, Jacqueline M Brady
PURPOSE OF REVIEW: Historically, the standard of care for patients with an acute patella dislocation has been non-operative with the exception being those with a loose body or osteochondral fracture requiring fixation or removal. RECENT FINDINGS: Recent literature has brought into question this standard of care approach and defined a higher risk subset of first-time dislocators who may benefit from early operative treatment. In addition, these studies suggest that operative treatment not only reduces the risk of recurrence but may improve outcomes overall and specifically in the pediatric population...
April 23, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29679209/quadriceps-tendon-autograft-medial-patellofemoral-ligament-reconstruction
#8
REVIEW
Christian Fink, Robert Steensen, Peter Gföller, Robert Lawton
PURPOSE: Critically evaluate the published literature related to quadriceps tendon (QT) medial patellofemoral ligament (MPFL) reconstruction. RECENT FINDINGS: Hamstring tendon (HT) MPFL reconstruction techniques have been shown to successfully restore patella stability, but complications including patella fracture are reported. Quadriceps tendon (QT) reconstruction techniques with an intact graft pedicle on the patella side have the advantage that patella bone tunnel drilling and fixation are no longer needed, reducing risk of patella fracture...
April 20, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29662782/quantitative-analysis-of-t2-relaxation-times-of-the-patellofemoral-joint-cartilage-3-years-after-anterior-cruciate-ligament-reconstruction
#9
Chang-Wan Kim, Ali Hosseini, Lin Lin, Yang Wang, Martin Torriani, Thomas Gill, Alan J Grodzinsky, Guoan Li
Objective: To evaluate patient-specific patellofemoral joint (PFJ) cartilage 3 years postoperatively using T2 mapping magnetic resonance imaging and the uninjured contralateral side as control. Hypothesis: The cartilage of the PFJ in the anterior cruciate ligament (ACL) reconstructed knees would show increased T2 values compared to the uninjured contralateral knees at 3-year follow-up, and the femoral (trochlear) cartilage would be more susceptible than the patella in degeneration in ACL-reconstructed knees...
January 2018: Journal of Orthopaedic Translation
https://www.readbyqxmd.com/read/29653442/examination-under-anesthesia-in-patients-with-recurrent-patellar-dislocation-prognostic-study
#10
Ismail Fathalla, James Holton, Tanweer Ashraf
Surgical management of patellar instability is a matter of wide debate. While some authors believe that isolated medial patellofemoral ligament (MPFL) reconstruction is sufficient, others advocate procedures to treat the underlying pathology, namely, patella alta and trochlear dysplasia. Radiological studies have been traditionally used as a determinant of these pathologies and to determine the need for an additional procedure. The value of examination under anesthesia (EUA) in formulating a treatment plan remains unknown...
April 13, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29629916/distal-femoral-varus-osteotomy-for-the-management-of-valgus-deformity-of-the-knee
#11
Seth L Sherman, Samuel F Thompson, John C F Clohisy
Distal femoral varus osteotomy is a well-described treatment option for patients with valgus malalignment associated with a variety of underlying conditions. This procedure may be the definitive treatment option in active patients with isolated lateral compartment osteoarthritis or posttraumatic arthritis. It may be a useful concomitant procedure in young patients with lateral meniscus deficiency, focal chondral defects, chronic medial collateral ligament insufficiency, and/or patellofemoral instability. Distal femoral varus osteotomy can be performed with medial closing wedge or lateral opening wedge techniques...
May 1, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29623377/the-increase-in-posterior-tibial-slope-provides-a-positive-biomechanical-effect-in-posterior-stabilized-total-knee-arthroplasty
#12
Kyoung-Tak Kang, Sae Kwang Kwon, Juhyun Son, Oh-Ryong Kwon, Jun-Sang Lee, Yong-Gon Koh
PURPOSE: This study aims to clarify the influence of the posterior tibial slope (PTS) on knee joint biomechanics after posterior-stabilized (PS) total knee arthroplasty (TKA) using a computer simulation. METHODS: A validated TKA computational model was used to evaluate and quantify the effects of an increased PTS. In order to conduct a squat simulation, models with a - 3° to 15° PTS using increments of 3° were developed. Forces on the quadriceps and collateral ligament, a tibial posterior translation, contact point on a polyethylene (PE) insert, and contact stress on the patellofemoral (PF) joint and post in a PE insert were compared...
April 5, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29622265/editorial-commentary-medial-patellofemoral-ligament-reconstruction-alone-works-well-when-the-patient-has-normal-alignment-but-don-t-forget-to-move-the-tibial-tubercle-when-necessary
#13
EDITORIAL
John P Fulkerson
Medial patellofemoral ligament reconstruction works very well, regardless of graft choice, for controlling lateral patella instability when performed correctly in patients with normal alignment, even in the face of trochlea dysplasia. However, sometimes a tibial tubercle transfer is necessary in patella instability surgery.
April 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29622246/editorial-commentary-knee-medial-patellofemoral-ligament-reconstruction-does-not-always-result-in-the-bee-s-knees
#14
EDITORIAL
Aman Dhawan
Reconstruction of the medial patellofemoral ligament has gained in popularity as a surgical technique to reconcile recurrent lateral patellar instability. This technique has shown success in a variety of settings including with concomitant osseous abnormalities. Despite the general good to excellent results with medial patellofemoral ligament reconstruction, a number of technical errors are still commonly made and may result in decreased range of motion, pain, chondrosis, and arthrofibrosis. In a recent study, the importance of knee flexion angle during final fixation of the graft is emphasized...
April 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29611848/special-considerations-for-pediatric-patellar-instability
#15
Sean Keyes, Meghan Price, Daniel W Green, Shital N Parikh
Patellar instability in children and adolescents is a challenging subset to treat. Varied forms of instability, ranging from episodic dislocation to fixed dislocation, have been recognized. It is of utmost importance for the treating physician to recognize these different patterns of instability and their associated risk factors, as more complex patterns of instability would require more extensive surgical procedures. Medial patellofemoral ligament (MPFL) reconstruction, by itself, may not suffice or may not be appropriate for the more complex instability patterns...
March 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29611007/femoral-tunnel-widening-is-associated-with-tunnel-malposition-but-not-with-clinical-failure-after-medial-patellofemoral-ligament-reconstruction-with-a-free-gracilis-tendon-graft
#16
Karl-Friedrich Schüttler, A Hoeger, T J Heyse, J Figiel, N Timmesfeld, T Stein, E Ziring, T Efe
INTRODUCTION: MPFL reconstruction is widely and successfully used for treating patella instability, either as a standalone procedure or in combination. Although different techniques allow for MPFL reconstruction, the use of a free tendon graft is one of the most commonly used. The phenomenon of tunnel widening or tunnel enlargement is well described in ACL reconstruction, but so far only little effort has been put into evaluating this phenomenon after MPFL reconstruction. MATERIALS AND METHODS: Patients who received an MPFL reconstruction with a free gracilis tendon graft were identified by review of patient files...
April 2, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29569702/an-anatomical-study-of-the-origin-structure-and-insertion-of-the-medial-patellofemoral-ligament
#17
Chang-Hui Li, David Ricketts, Xi-Shan Wang, Teng-Bo Yu, Chao Qi, Yong-Le Zhu
BACKGROUND: Repair and reconstruction of the medial patellofemoral ligament (MPFL) has been undertaken for the treatment of patellar instability. For successful surgery detailed knowledge of the anatomy of the ligament is required. The aim of this study was to describe the origin, structure and insertion of the MPFL. MATERIALS AND METHODS: We studied cadaveric knees from 30 Chinese adults. We studied the origin, course and insertion of the MPFL. RESULTS: We found that the MPFL was composed of two main strands, superficial and deep...
March 23, 2018: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/29554436/biomechanical-evaluation-of-the-medial-stabilizers-of-the-patella
#18
Matthew D LaPrade, Samantha L Kallenbach, Zachary S Aman, Gilbert Moatshe, Hunter W Storaci, Travis Lee Turnbull, Elizabeth A Arendt, Jorge Chahla, Robert F LaPrade
BACKGROUND: Quantification of the biomechanical properties of each individual medial patellar ligament will facilitate an understanding of injury patterns and enhance anatomic reconstruction techniques by improving the selection of grafts possessing appropriate biomechanical properties for each ligament. PURPOSE: To determine the ultimate failure load, stiffness, and mechanism of failure of the medial patellofemoral ligament (MPFL), medial patellotibial ligament (MPTL), and medial patellomeniscal ligament (MPML) to assist with selection of graft tissue for anatomic reconstructions...
March 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29552477/sulcus-deepening-trochleoplasty-and-medial-patellofemoral-ligament-reconstruction-for-recurrent-patellar-instability
#19
Michael S Laidlaw, Scott M Feeley, Jeffrey R Ruland, David R Diduch
There are multiple etiologies for recurrent patellar instability. While patella alta, an elevated tibial tubercle trochlear groove distance, and prior lateral patellar dislocations with medial patellofemoral ligament (MPFL) insufficiency have been shown to be risk factors for recurrent patellar instability, trochlear dysplasia can result in a significant impediment to normal patellar tracking. With the adequate identification of risk factors, appropriate surgical treatments can be individually tailored to the patient...
February 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29544985/dynamic-tracking-influenced-by-anatomy-following-medial-patellofemoral-ligament-reconstruction-computational-simulation
#20
John J Elias, Kerwyn C Jones, S Cyrus Rezvanifar, Joseph N Gabra, Melanie A Morscher, Andrew J Cosgarea
BACKGROUND: Continued patellar instability can occur following medial patellofemoral ligament (MPFL) reconstruction. Computational simulation of function was used to investigate the influence of the lateral position of the tibial tuberosity, trochlear dysplasia and patella alta on lateral patellar tracking following MPFL reconstruction. METHODS: Multibody dynamic simulation models were developed to represent nine knees being treated for recurrent patellar instability...
March 12, 2018: Knee
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