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Medial patello femoral ligament reconstruction

M-L Louis, P D'ingrado, F P Ehkirch, S Bertiaux, P Colombet, B Sonnery-Cottet, B Schlatterer, R Pailhé, J C Panisset, C Steltzlen, S Lustig, C Lutz, F Dalmay, P Imbert, D Saragaglia
BACKGROUND: A careful analysis of the reasons for ACL reconstruction failure is essential to selection of the optimal surgical revision technique designed to ensure good rotational stability and to minimise the risk of re-rupture. OBJECTIVE: To evaluate anterolateral ligament (ALL) stabilisation during revision ACL reconstruction. HYPOTHESIS: ALL stabilisation during revision ACL reconstruction provides good rotational stability without increasing the risk of complications...
September 7, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
Filippo Calanna, Luca Pulici, Giulia Carimati, Alessandro Quaglia, Piero Volpi
PURPOSE: several surgical techniques have been described for the MPFL reconstruction, using many femoral and patellar fixation techniques and different grafts (autograft, allograft, synthetic). The goal of our study is to evaluate the safety and efficacy of MPFL reconstruction using Juggerknot™ (BIOMET, Warsaw, Indiana) suture anchors fixation with a clinical evaluation pre/post surgery of our patients with objective patellofemoral (PF) instability. METHODS: from January 2013 to March 2015, 19 patients underwent isolated MPFL reconstruction using Juggerknot™ (BIOMET, Warsaw, Indiana) suture anchors fixation...
January 2016: Muscles, Ligaments and Tendons Journal
G Criscenti, C De Maria, E Sebastiani, M Tei, G Placella, A Speziali, G Vozzi, G Cerulli
The medial patello-femoral ligament is considered the most important passive patellar stabilizer and its proper functionality is essential for the patello-femoral joint stability. In this work, 18 human knees were randomly divided into two groups and reconstructed through two different surgical techniques: the "Through tunnel tendon" and the "Double converging tunnel" reconstructions. Subsequently, the samples were mechanically tested to evaluate the structural properties of reconstructed femur-MPFL-Patella complex (rFMPC)...
June 2016: Journal of the Mechanical Behavior of Biomedical Materials
G Placella, A Speziali, E Sebastiani, S Morello, M M Tei, G Cerulli
BACKGROUND: Several MPFL reconstructions are commonly performed for recurrent patellar dislocation, but misleading data are currently available in the literature on the ability of the different techniques to re-create a functioning ligament. MATERIALS AND METHODS: In this study, we showed the biomechanical properties of two different procedures for MPFL reconstruction using a natural orientation during uniaxial tensile testing. Eighteen fresh-frozen human knees were randomly assigned to two groups of nine each...
August 2016: Musculoskeletal Surgery
D T Crebs, C A Anthony, P T McCunniff, M J Nieto, M W Beckert, J P Albright
BACKGROUND: Patients with femoral trochlear dysplasia are at risk for chronic recurrent patellofemoral dislocations, with extreme cases often requiring a surgical procedure. Anteromedialization of the tibial tubercle with intraoperative femoral nerve stimulation and concurrent medial patella-femoral ligament (MPFL) reconstruction is a previously reported method of maximizing patello-femoral congruency. We hypothesize the Fulkerson osteotomy with intraoperative femoral nerve stimulation and concurrent MPFL reconstruction in patients with severe trochlear dysplasia provides equivalent postoperative clinical outcomes to the same procedure in patients with low level trochlear dysplasia...
2015: Iowa Orthopaedic Journal
Martin Kaipel, Sebastian Schützenberger, Sebastian Farr, Istvan Gergely, Alexander Vlcek, Franz Kainberger, Harald Boszotta, Michael Pretterklieber
PURPOSE: Anatomically correct graft positioning at the femoral insertion site is a key factor in surgical reconstruction of the medial patello-femoral ligament (MPFL). Basically there are two techniques to define this point in fluoroscopy during surgery. The role of the anatomical femoral torsion on the accuracy and reproducibility of both procedures has not been clarified. METHODS: Twenty human anatomical leg specimens were dissected. The femoral insertion of the MPFL was marked by two K-wires...
March 2015: International Orthopaedics
G Placella, M Tei, E Sebastiani, A Speziali, P Antinolfi, M Delcogliano, A Georgoulis, G Cerulli
BACKGROUND: Although many studies have investigated the anatomy of the Medial Patello-Femoral Ligament (MPFL), some studies have even questioned its existence. In the last 20 years, there is a renewed interest on the role of the MPFL in patello-femoral instability. As a result, several studies have been published that describe the anatomy, function and possible surgical reconstruction of the MPFL. Despite the large amount of literature produced, there is still a lack of consensus on what is its real anatomy as there are currently no systematic reviews on this topic...
August 2015: Musculoskeletal Surgery
Frank W Roemer, Richard Frobell, L Stefan Lohmander, Jingbo Niu, Ali Guermazi
OBJECTIVE: To develop a whole joint scoring system, the Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS), for magnetic resonance imaging (MRI)-based assessment of acute anterior cruciate ligament (ACL) injury and follow-up of structural sequelae, and to assess its reliability. DESIGN: Baseline and follow-up 1.5 T MRI examinations from 20 patients of the KANON study, a randomized controlled study comparing a surgical and non-surgical treatment strategy, were assessed for up to six longitudinal visits using a novel MRI scoring system incorporating acute structural tissue damage and longitudinal changes including osteoarthritis (OA) features...
May 2014: Osteoarthritis and Cartilage
Anthony Viste, Florian Chatelet, Romain Desmarchelier, Michel-Henri Fessy
PURPOSE: The aim of this dissection study was to describe the anatomical insertions of the medial patello-femoral ligament (MPFL), and to assess its relationship with surrounding structures to improve its surgical reconstruction. METHODS: Twelve knees (7 cadavers) were included for the study. Measurements and general features of the MPFL were assessed: lengths, widths and insertions. RESULTS: The MPFL was found in all knees, presenting a triangular shape, and extending from the medial part of the patella to its femoral insertion (its length was of 59 ± 6...
October 2014: Surgical and Radiologic Anatomy: SRA
F Chotel, J Bérard, S Raux
Paediatric patellar instability encompasses many anatomic entities located along a continuum of knee extensor mechanism abnormalities. Major or minor clinical manifestations may occur at a variable age. In major forms with irreducible patellar dislocation or habitual patellar dislocation during knee flexion, shortness of the quadriceps is a consistent feature. A comprehensive aetiological work-up is in order, as syndromic conditions are common. Early surgical treatment is mandatory and should be performed by an experienced paediatric orthopaedic surgeon, as the procedure is technically challenging...
February 2014: Orthopaedics & Traumatology, Surgery & Research: OTSR
Raghuveer K Reddy, Vamsi Kondreddi
Habitual dislocation of the patella (HDP) is a common presentation in pediatric age unlike adults. Many surgical procedures using proximal realignment and distal realignment have been reported to treat HDP in children with satisfactory results. However, late presentation of habitual patellar dislocation with osteoarthritis is rare and treatment plan has not yet been established. We present a case of neglected iatrogenic habitual patellar dislocation with osteoarthritis in a 50-year-old woman. Two-staged procedure was planned, first with patellar realignment and later with definitive total knee arthroplasty...
November 2013: Indian Journal of Orthopaedics
Scott Mellecker, Thomas Ebinger, Paul Butler, John Albright
BACKGROUND: Patellofemoral instability is a complex problem with most previous treatment plans addressing static alignment and static stabilizers. Although the quadriceps muscles are known to affect the tracking of the patella, they are rarely taken into account during a surgical procedure. PURPOSE: The purpose of this study is to determine the two year minimum results of 37 knees which received a Southwick-Fulkerson Osteotomy and MPFL repair or reconstruction both under the guidance of femoral nerve stimulation...
2013: Iowa Orthopaedic Journal
Ayman M Ebied, Wael El-Kholy
PURPOSE: The importance of the medial patello-femoral (MPFL) and medial patello-tibial ligaments (MPTL) to the stability of the patella is undoubted. The purpose of this work was to present a technique for the reconstruction of both ligaments and prospectively record its outcome. METHODS: Cadaveric part: the MPFL and MPTL were identified in five knee specimens. Sequential cutting and reattaching of these ligaments were performed to study their effect on patellar stability...
May 2012: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Gernot Felmet
OBJECTIVE: The aim of this study is to determine the outcome of anterior cruciate ligament (ACL) reconstruction without foreign material with patellar tendon bone graft in the fixation with bone dowels near the native insertion. MATERIALS AND METHODS: Between 1998 and 1999, 189 patients were operated with ACL reconstruction with BTB patellar tendon graft. In a prospective study, 148 (78%) (91M, 57F) patients could be seen for a mean follow-up of 10.3 years. All had foreign material-free press-fit and a bottom-to-top (BTT) fixation in 120 degrees knee flexion...
August 2010: Archives of Orthopaedic and Trauma Surgery
Norimasa Nakamura, Shuji Horibe, Yukiyoshi Toritsuka, Tomoki Mitsuoka, Takashi Natsu-ume, Kenji Yoneda, Masayuki Hamada, Yoshinari Tanaka, Richard S Boorman, Hideki Yoshikawa, Konsei Shino
Although many different interventions have been proposed for treating cartilage lesions at the time of ACL reconstruction, the normal healing response of these injuries has not been well documented. To address this point, we compared the arthroscopic status of chondral lesions at the time of ACL reconstruction with that obtained at second-look arthroscopy. We hypothesized that there might be a location-specific difference in the healing response of damaged articular cartilage. Between September 1998 and March 2000, 383 patients underwent arthroscopically-assisted hamstring ACL reconstruction without any intervention to the articular cartilage...
September 2008: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
P Hertel, H Behrend, T Cierpinski, V Musahl, G Widjaja
Multiple techniques for anterior cruciate ligament (ACL) reconstruction are currently available, most of which use hardware or resorbable material for fixation of the graft inside or outside the bony tunnels. In this study, the long-term results of 95 patients at a mean follow-up of 10.7 years were assessed. The ACL was reconstructed using a patellar tendon autograft with a press-fit fixation. Between 1987 and 1991, 159 patients were operated by the senior author (PH), 95 could be seen for follow-up. Evaluation included detailed history, physical examination, functional knee ligament testing, KT-1000 arthrometer testing, the IKDC standard evaluation form, Lysholm, Flandry, and Tegner scoring systems...
May 2005: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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