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Medial patellofemoral ligament

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
Kurt P Spindler, Laura J Huston, Kevin M Chagin, Michael W Kattan, Emily K Reinke, Annunziato Amendola, Jack T Andrish, Robert H Brophy, Charles L Cox, Warren R Dunn, David C Flanigan, Morgan H Jones, Christopher C Kaeding, Robert A Magnussen, Robert G Marx, Matthew J Matava, Eric C McCarty, Richard D Parker, Angela D Pedroza, Armando F Vidal, Michelle L Wolcott, Brian R Wolf, Rick W Wright
BACKGROUND: The long-term prognosis and risk factors for quality of life and disability after anterior cruciate ligament (ACL) reconstruction remain unknown. Hypothesis/Purpose: Our objective was to identify patient-reported outcomes and patient-specific risk factors from a large prospective cohort at a minimum 10-year follow-up after ACL reconstruction. We hypothesized that meniscus and articular cartilage injuries, revision ACL reconstruction, subsequent knee surgery, and certain demographic characteristics would be significant risk factors for inferior outcomes at 10 years...
March 2018: American Journal of Sports Medicine
Guang-Ying Zhang, Hong-Xia Zhu, En-Miao Li, Hao Shi, Wei Liu, Lei Zheng, Zheng-Wu Bai, Hong-Yu Ding
Objective: To evaluate the correlation between the injury patterns of the medial patellofemoral ligament (MPFL) on magnetic resonance imaging in an acute first-time lateral patellar dislocation (LPD) and incidence of a second-time LPD. Materials and Methods: Magnetic resonance images were prospectively analyzed in 147 patients after an acute first-time LPD with identical nonoperative management. The injury patterns of MPFL in acute first-time LPDs were grouped by location and severity for the analysis of the incidence of second-time LPD in a 5-year follow-up...
March 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Lei Zhang, Zhiyao Li
Medial patellofemoral ligament (MPFL) reconstruction is a satisfactory technique for patellar instability, and the anatomical double bundle variant is recommended for better clinical results. However, long-term outcomes are still uncharacterized. This study aimed to assess the effectiveness of double bundle reconstruction of the MPFL for patellar instability by means of established scores. A total of 68 patients with chronic patellar instability who underwent surgery from May 2005 to February 2010 were included prospectively...
March 7, 2018: Journal of Knee Surgery
Raashad Hasan, Wiqqas Jamil
The medial patellofemoral ligament (MPFL) is a key soft tissue stabilizer of the medial patella, with deficiency proven to be a key contributor to patellar dislocation. Reconstruction of this ligament has become a widely employed procedure in managing patients with recurrent patellar dislocation, and is also gaining popularity in the setting of primary dislocation. A wide variety of techniques have been described, differing in the type of graft used, sites for fixation and fixation technique. A number of complications have also been reported in the literature, including post-operative stiffness, apprehension, patellar fracture and recurrence of instability and dislocation...
February 2018: Journal of Surgical Case Reports
Takehiko Matsushita, Daisuke Araki, Yuichi Hoshino, Shinya Oka, Kyohei Nishida, Toshikazu Tanaka, Nobuaki Miyaji, Noriyuki Kanzaki, Kazuyuki Ibaraki, Tomoyuki Matsumoto, Masahiro Kurosaka, Ryosuke Kuroda
BACKGROUND: A fluoroscopic guidance method for medial patellofemoral ligament (MPFL) reconstruction has been widely used to determine the anatomic femoral attachment site. PURPOSE: To examine the graft length change patterns in MPFL reconstruction with a fluoroscopic guidance method. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Forty-four knees of 42 patients who underwent MPFL reconstruction for the treatment of recurrent patellar dislocation were examined prospectively...
February 1, 2018: American Journal of Sports Medicine
Yong-Xiang Zuo, Zi-Ping Ma
OBJECTIVE: To explore the operating procedures and therapeutic effects of medial patellofemoral ligament reconstruction with Tightrope(Arthrex, FL, USA) button fixation at lateral femoral cortex. METHODS: From May 2014 to July 2016, 9 patients with traumatic patellar dislocation were treated. There were 5 males and 4 females, ranging in age from 16 to 47 years old, with an average of 23.7 years old. All the patients underment arthroscopic lateral retinaculum release and joint debridement first...
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Li-Chuang Wu, Hai-Bo Zhou, Chao Zhang, Lei Chen, Cai-Long Liu
OBJECTIVE: To study clinical effects of triad operation including reconstruction of medial patellofemoral ligament, release of lateral retinaculum, Fulkerson tibial tubercle osteotomy, medial transfer and advancement under arthroscopy for the treatment of habitual dislocation of patella. METHODS: From March 2010 to May 2016, 35 patients with habitual patellar dislocation were treated with the triad operation, including 14 males, 21 females, ranging in age from 18 to 38 years old, with an average of 25...
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Zhi-Dong Zhao, Peng-Cui Li, Xiao-Chun Wei
Up to now, surgical treatment of recurrent lateral patellar dislocation mainly includes: medial patellofemoral ligament reconstruction, tibial tubercle osteotomy, trochleoplasty, lateral retinacular release, derotation osteotomy and so on . Clinical reports show that: the use of a single or combined with several methods have achieved ideal short to mid-term clinical outcomes. However, there is no consolidate criterion concerning the choices of different kinds of surgical ways for the treatment of individual recurrent lateral patellar dislocation...
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Gang Ji, Yifei Sun, Jiangfeng Lu, Yingzhen Niu, Fei Wang
The purpose of this study was to explore the anatomy and discuss functional regions of the medial patellofemoral ligament (MPFL). Twelve fresh-frozen knees specimens were dissected. All medial surfaces of knees were intact and did not have indication of injury. General feature of the MPFL were observed. All anatomical landmarks were carefully identified and marked. The length of the two functional regions were conducted and recorded. All data were obtained, described, and analyzed in the form of mean ± standard deviation...
February 14, 2018: Journal of Knee Surgery
Chuan-Qiang Shao, Chang-Chun Chen, Chun-Cheng Zhao, Hong-Mei Yang, Yan-Zhong Kang
OBJECTIVE: To investigate surgical method and clinical curative effects of medial patellofemoral ligament (MPFL) reconstruction with great adductor muscular tendon in treating teenagers' recurrent patellar dislocation. METHODS: From May 2012 to September 2014, 19 patients with recurrent dislocation of patellar, including 6 males and 13 females with an average of 16 years old (ranged from 13 to 17 years), the courses of disease ranged from 3 to 18 months(averaged 6 months)...
June 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Miho J Tanaka
Medial patellofemoral ligament reconstruction is commonly performed to treat patellofemoral instability by recreating the static soft tissue restraint to lateral patellar translation. Concurrent tibial tuberosity osteotomy can be indicated in the setting of bony malalignment, such as a lateralized tuberosity or patella alta; however, the exact indications for this have been difficult to define due to the multifactorial nature of this problem. Understanding the role of tuberosity lateralization and patella alta on the function of medial patellofemoral ligament grafts can help to identify the interplay of some factors that contribute to patellar stability and improve our understanding of when and how concurrent tibial tuberosity osteotomy may be indicated...
February 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
S Otsuki, Y Okamoto, T Murakami, K Nakagawa, N Okuno, H Wakama, M Neo
INTRODUCTION: Although several surgical treatments for patellar instability with patella alta have been reported, the clinical outcomes and optimal surgical procedures for patellar instability with patella alta in middle-aged patients are still controversial. We hypothesized that optimal surgical procedures for patellar instability with patella alta in middle-aged patients may induce good clinical outcomes with better patellofemoral geometry. MATERIALS AND METHODS: Twelve middle-aged patients with a mean age of 44 years (range: 40-55 years), who presented with patellar instability and patella alta, were treated with a combination of several surgeries, such as medial patellofemoral ligament (MPFL) reconstruction, trochleoplasty, lateral release, and three-dimensional transfer of the tibial tuberosity, based on a surgical algorithm...
February 1, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Jarret M Woodmass, Nick R Johnson, Robert A Cates, Aaron J Krych, Michael J Stuart, Diane L Dahm
Background: Patellar height has long been considered a risk factor for patellofemoral instability. However, recent pediatric literature demonstrated a reduction in patellar height measurements following medial patellofemoral ligament (MPFL) reconstruction. Purpose: To assess the mean change in patellar height and the percentage of skeletally mature patients with patellar height ratios reduced to within-normal limits following MPFL reconstruction. Study Design: Case series; Level of evidence, 4...
January 2018: Orthopaedic Journal of Sports Medicine
Maike B Czasche, Jon E Goodwin, Anthony M J Bull, Daniel J Cleather
Objectives: To use a musculoskeletal model of the lower limb to evaluate the effect of a strength training intervention on the muscle and joint contact forces experienced by untrained women during landing. Methods: Sixteen untrained women between 18 and 28 years participated in this cohort study, split equally between intervention and control groups. The intervention group trained for 8 weeks targeting improvements in posterior leg strength. The mechanics of bilateral and unilateral drop landings from a 30 cm platform were recorded preintervention and postintervention, as was the isometric strength of the lower limb during a hip extension test...
2018: BMJ Open Sport & Exercise Medicine
D Dammerer, M C Liebensteiner, U M Kujala, K Emmanuel, S Kopf, F Dirisamer, J M Giesinger
INTRODUCTION: The Kujala score is the most frequently used questionnaire for patellofemoral disorders like pain, instability or osteoarthritis. Unfortunately, we are not aware of a validated German version of the Kujala score. The aim of our study was the translation and linguistic validation of the Kujala score in German-speaking patients with patella instability and the assessment of its measurement characteristics. MATERIALS AND METHODS: The German Kujala score was developed in several steps of translation...
January 25, 2018: Archives of Orthopaedic and Trauma Surgery
Ryan J McNeilan, Joshua S Everhart, Patrick K Mescher, Moneer Abouljoud, Robert A Magnussen, David C Flanigan
PURPOSE: To determine whether graft selection or patient age affects the following after isolated medial patellofemoral ligament (MPFL) reconstruction: (1) rates of recurrent instability, (2) rates of postoperative complications (other than instability), and (3) subjective symptom improvement. METHODS: A systematic search identified studies reporting outcomes for isolated MPFL reconstruction. Rates of recurrent instability, subjective Kujala knee function scores, and complications were tabulated...
January 20, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Juan C Monllau, Juan I Erquicia, Maximiliano Ibañez, Pablo E Gelber, Federico Ibañez, Angel Masferrer-Pino, Xavier Pelfort
Patellar instability has been shown to be associated with different major factors. However, studies have demonstrated that soft tissue reconstructions are adequate enough to reestablish patellar constraint. In recent years, the medial patellofemoral ligament has been recognized as the primary passive restraint for lateral translation of the patella. Their reconstruction has gain popularity as the procedure is quite simple and fast. Although several surgical techniques have been described for their reconstruction, no clear consensus has been reached as to which is best...
October 2017: Arthroscopy Techniques
Márcio B Ferrari, George Sanchez, Nicholas I Kennedy, Anthony Sanchez, Katrina Schantz, Matthew T Provencher
Patellofemoral instability is a common cause of anterior knee pain, especially in younger and more active patients. Treatment of instability varies considerably depending on the patient's symptoms as well as the cause of the instability. Lateral instability has a particularly broad spectrum of treatment algorithms including patellar taping, arthroscopy, lateral release, medial patellofemoral ligament (MPFL) reconstruction, MPFL repair, and osteotomy of the tibial tubercle for realignment. Acute traumatic lateral dislocation is commonly associated with a tear of the MPFL and, therefore, needs to be addressed...
August 2017: Arthroscopy Techniques
Wan-Quan Cao, Zi-Quan Yang, Gang Wang, Ya-Xun Men, Xiang-Yun Cheng
Patients who suffer from the recurrent patellar dislocation mainly show the recurrent dislocation of patellar, giving way, most patients have the history of trauma or dysplasia of keen joint. Traditional therapies of recurrent patellar dislocation include medical retinaculum placation, lateral retinaculum release, tibial tubercle osteotomy, femoral trochleoplasty etc. In recent years, with the development of anatomical and biomechanical researches on medial patellofemoral ligament(MPFL), more and more experts focus on the role of MPFL played in preventing the patellar dislocation...
March 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
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