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MPFL reconstruction

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https://www.readbyqxmd.com/read/27904790/current-concepts-in-the-treatment-of-gross-patellofemoral-instability
#1
Grant Buchanan, LeeAnne Torres, Brian Czarkowski, Charles E Giangarra
: Patellofemoral instability is a painful and commonly recurring condition, which often must be managed surgically. Diagnosis can be aided by the use of a variety of physical exam signs, such as the Q angle, Beighton hypermobility score, glide test, J sign, patellar tilt test, and apprehension test. Imaging modalities including x-ray, CT, and MRI guide both diagnosis and management by revealing trochlear dysplasia, bony malalignment, and ligamentous injury that contribute to instability...
December 2016: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/27842571/medial-patellofemoral-ligament-reconstruction-using-a-bone-groove-and-a-suture-anchor-at-patellar-a-safe-and-firm-fixation-technique-and-3-year-follow-up-study
#2
Hong-De Wang, Jiang-Tao Dong, Shi-Jun Gao
BACKGROUND: Graft fixation is critical to the restoration of the medial patella of femoral ligament function and long-term success. Numerous fixations at the patella have been described, while the complications including patellar fractures, violation of the posterior patella and delay of tendon-to-bone healing remain significant challenges. Here, we describe a safe and firm fixation at the patellar for medial patellofemoral ligament (MPFL) reconstruction and explore the safety angle of drilling the suture anchor at different morphology of the patellar...
November 14, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27810430/outcomes-of-surgical-stabilization-in-patients-with-combined-acl-deficiency-and-patellofemoral-instability-a-case-series
#3
Laurie A Hiemstra, Sarah Kerslake, Mark Heard, Gregory Buchko, Mark Lafave
BACKGROUND: The purpose of this study was to assess the disease-specific quality of life, and the objective clinical and functional outcomes of patients with symptomatic ACL deficiency and patellofemoral instability following surgical stabilization of both ligaments. METHODS: Between February 2010 and August 2013, 22 subjects underwent a combined ACL reconstruction and patellofemoral stabilization. The anterior cruciate ligament quality of life questionnaire (ACL-QOL) was completed pre-operatively and two-years post-operatively...
October 31, 2016: Knee
https://www.readbyqxmd.com/read/27796419/results-of-medial-patellofemoral-ligament-reconstruction-compared-with-trochleoplasty-plus-individual-extensor-apparatus-balancing-in-patellar-instability-caused-by-severe-trochlear-dysplasia-a-systematic-review-and-meta-analysis
#4
REVIEW
Peter Balcarek, Stephan Rehn, Nick R Howells, Jonathan D Eldridge, Keisuke Kita, David Dejour, Manfred Nelitz, Ingo J Banke, Delphine Lambrecht, Markus Harden, Tim Friede
PURPOSE: Many studies have reported satisfactory clinical outcomes and low redislocation rates after reconstruction of the medial patellofemoral ligament (MPFL) for the treatment of lateral patellar instability. Despite uncorrected severe trochlear dysplasia (Dejour type B to D) being acknowledged as a major reason for less favourable clinical outcomes and a higher incidence of patellar redislocations after an isolated MPFL reconstruction, the evidence for a deepening trochleoplasty procedure remains scarce in the current literature...
October 27, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27709116/dynamic-simulation-of-the-effects-of-graft-fixation-errors-during-medial-patellofemoral-ligament-reconstruction
#5
John J Elias, Michael J Kelly, Kathryn E Smith, Kenneth A Gall, Jack Farr
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction is performed to prevent recurrent instability, but errors in femoral fixation can elevate graft tension. HYPOTHESIS: Errors related to femoral fixation will overconstrain the patella and increase medial patellofemoral pressures. STUDY DESIGN: Controlled laboratory study. METHODS: Five knees with patellar instability were represented with computational models...
September 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/27631645/origin-and-insertion-of-the-medial-patellofemoral-ligament-a-systematic-review-of-anatomy
#6
Arash Aframian, Toby O Smith, T Duncan Tennent, Justin Peter Cobb, Caroline Blanca Hing
PURPOSE: The medial patellofemoral ligament (MPFL) is the major medial soft-tissue stabiliser of the patella, originating from the medial femoral condyle and inserting onto the medial patella. The exact position reported in the literature varies. Understanding the true anatomical origin and insertion of the MPFL is critical to successful reconstruction. The purpose of this systematic review was to determine these locations. METHODS: A systematic search of published (AMED, CINAHL, MEDLINE, EMBASE, PubMed and Cochrane Library) and unpublished literature databases was conducted from their inception to the 3 February 2016...
September 8, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27600522/biomechanical-and-histological-comparison-between-the-cryopreserved-and-the-lyophilized-gracilis-tendon-allograft-for-mpfl-reconstruction-a-cadaveric-experimental-study
#7
Roberto Negrín, Jaime Duboy, Fernando Olavarría, Mauricio Wainer, Horacio Jimenez, Facundo Las Heras, Nicolas Reyes, Hugo Godoy
BACKGROUND: Medial patellofemoral ligament (MPFL) is the main restrictor of lateral shifting of the patella, contributing by 60 % in the first 20° flexion of the knee. MPFL reconstruction has been performed in order to restore the stability of the patella with good results.Lyophilized Gracilis tendon allograft (LGA) compared to Cryopreserved Gracilis tendon allograft (CGA) has a lower cost, does not require to maintain cooling chain or preparation. The purpose of this study is to compare the histological and biomechanical characteristics of an experimental model of reconstruction of the MPFL in porcine patellas with LGA versus CGA...
December 2016: Journal of Experimental Orthopaedics
https://www.readbyqxmd.com/read/27590642/does-the-utilization-of-allograft-tissue-in-medial-patellofemoral-ligament-reconstruction-in-pediatric-and-adolescent-patients-restore-patellar-stability
#8
Eric Hohn, Nirav K Pandya
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction is one of several surgical procedures used to treat patellofemoral instability. Use of allograft tissue can preserve autogenous tissue and may be preferable in patients with connective tissue disorders or ligamentous laxity. Although there are successful reports in adults, it is unclear if the use of allograft tissue in MPFL reconstruction can restore patellofemoral stability in children and adolescents. QUESTIONS/PURPOSES: (1) Does allograft tissue in MPFL reconstruction in pediatric and adolescent patients restore patellar stability? (2) What complications were associated with allograft MPFL reconstructions in children and adolescents? METHODS: Between June 2012 and August 2015, one surgeon (NKP) performed 26 MPFL reconstructions in 23 patients with gracilis allograft for traumatic patellar instability...
September 2, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27565481/an-evaluation-of-the-effectiveness-of-medial-patellofemoral-ligament-reconstruction-using-an-anatomical-tunnel-site
#9
Kars P Valkering, Aysha Rajeev, Nick Caplan, Wim E Tuinebreijer, Deiary F Kader
PURPOSE: Medial patellofemoral ligament (MPFL) reconstruction for recurrent patellar instability has gained popularity, and anatomical and biomechanical studies have recently altered our operative techniques. The aim of this study was to report the clinical outcome of this new anatomical MPFL reconstructive technique and investigate whether correlating factors could be identified. METHODS: Between 2009 and 2012, a total of 31 consecutive patients underwent MPFL reconstruction using an autologous gracilis graft and anatomical tunnel placement...
August 26, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27544273/patellar-tracking-after-isolated-medial-patellofemoral-ligament-reconstruction-dynamic-evaluation-using-computed-tomography
#10
Riccardo G Gobbi, Marco K Demange, Luiz Francisco Rodrigues de Ávila, José de Arimatéia Batista Araújo Filho, Ramon Alfredo Moreno, Marco Antônio Gutierrez, Marina de Sá Rebelo, Luis Eduardo Passarelli Tírico, José Ricardo Pécora, Gilberto Luis Camanho
PURPOSE: Medial patellofemoral ligament (MPFL) reconstruction offers good clinical results with a very low rate of instability recurrence. However, its in vivo effect on patellar tracking is not clearly known. The aim of this study is to investigate the effects of MPFL reconstruction on patellar tracking using dynamic 320-detector-row CT. METHODS: Ten patients with patellofemoral instability referred to isolated MPFL reconstruction surgery were selected and subjected to dynamic CT before and ≥6 months after surgery...
August 20, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27474384/the-relationship-of-the-femoral-physis-and-the-medial-patellofemoral-ligament-in-children-a-cadaveric-study
#11
Kevin G Shea, Alexandra C Styhl, John C Jacobs, Theodore J Ganley, Matthew D Milewski, Peter C Cannamela, Allen F Anderson, John D Polousky
BACKGROUND: Young athletes sustain patellar dislocations in a variety of sports. The medial patellofemoral ligament (MPFL) is a critical structure that functions as an anatomic checkrein to help prevent lateral patellar dislocation. Reconstruction of this ligament is challenging in patients with open physes because of concerns about iatrogenic damage to the femoral physis. PURPOSE: To evaluate the relationship of the distal femoral physis and the MPFL. STUDY DESIGN: Descriptive laboratory study...
November 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27405577/complications-of-medial-patellofemoral-ligament-reconstruction-using-two-transverse-patellar-tunnels
#12
Loes Schiphouwer, Akkie Rood, Siebren Tigchelaar, Sander Koëter
PURPOSE: The aim of this study was to report the complication rate after a medial patellofemoral ligament (MPFL) reconstruction using transverse patellar tunnels in a retrospective case series performed in a single institution. METHODS: Case series of 179 patients (192 knees) that had an MPFL reconstruction, with or without additional bony realignment procedures, between January 2009 and March 2015. Data were obtained from available patient charts. RESULTS: Thirty-nine complications (20...
July 12, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27386447/acute-patellofemoral-instability-in-children-and-adolescents
#13
Pierluigi Antinolfi, Matteo Bartoli, Giacomo Placella, Andrea Speziali, Valerio Pace, Marco Delcogliano, Claudio Mazzola
Patellofemoral problems are considered to be among the most frequent causes of knee pain in children and adolescents. Correcting bone abnormalities through specific and targeted interventions is mandatory in skeletally immature patients. Medial patellofemoral ligament (MPFL) reconstruction is the preferred procedure, but there are several important precautionary considerations that the surgeon must take into account. It must always be remembered that MPFL rupture is the result, not the cause, of an altered extensor mechanism; therefore, patellar stabilization with MPFL reconstruction is only the first step to be accomplished in the management of an MPFL rupture...
January 2016: Joints
https://www.readbyqxmd.com/read/27372556/a-prospective-randomized-trial-evaluating-two-different-tensioning-techniques-for-medial-patellofemoral-ligament-reconstruction
#14
Huijun Kang, Fei Wang, Jianhui Cao, Xiaohui Liu, Gang Ji
BACKGROUND: In the literature, graft tension was mostly assessed under direct arthroscopy vision for a MPFL reconstruction. The purpose of this study was to prospectively assess the outcomes of MPFL reconstruction with graft tension of self-balance technique in comparison with arthroscopy-view technique. METHODS: Sixty patients with recurrent patellar dislocation were randomly divided into two groups to undergo MPFL reconstruction with graft tension either by the self-balance technique (SB group) or the arthroscopy-view technique (AV group)...
October 2016: Knee
https://www.readbyqxmd.com/read/27354953/soft-tissue-loop-for-medial-patellofemoral-ligament-reconstruction
#15
Mohd Fairudz Bin Mohd Miswan, Mohamed Zubair Mohamed Al-Fayyadh, Teo Seow Hui, Mohamed Razif Bin Mohamed Ali, Wuey Min Ng
A patient with patellar instability frequently presents with anterior knee pain, patellar subluxation, or dislocation. Medial patellofemoral ligament (MPFL) has a key role for normal patella tracking and stability. Reconstruction of the MPFL using a hamstring graft is a commonly used procedure for the treatment of chronic lateral subluxation of patella. Anchor sutures and bony tunnels are used for the patellar attachment of the graft. This can be associated with complications such as patella fracture; besides, it does not produce an anatomical reconstruction for the native MPFL that can alter the direction of tension applied on the patella...
April 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27339584/acute-patellar-dislocation-with-multiple-ligament-injuries-after-knee-dislocation-and-single-session-reconstruction
#16
Gokay Gormeli, Cemile Ayse Gormeli, Mustafa Karakaplan, Sukru Gurbuz, Zeynep Ozdemir, Mustafa Ozer
Knee dislocation is a relatively rare condition of all orthopaedic injuries. Accompanying multiple ligament injuries are common after knee dislocations. A 41-year-old male presented to the emergency department suffering from right knee dislocation in June 2013. The patient had anterior cruciate ligament, medial collateral ligament (MCL), medial patellofemoral ligament (MPFL) rupture, and lateral meniscal tear. A single-bundle anatomic reconstruction, medial collateral ligament reconstruction, medial patellofemoral ligament reconstruction and meniscus repair were performed in single session...
June 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27331033/medial-patello-femoral-ligament-mpfl-reconstruction-using-suture-anchors-fixation-preliminary-results
#17
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
https://www.readbyqxmd.com/read/27317639/medial-patellofemoral-ligament-reconstruction-for-patellar-instability-following-total-knee-arthroplasty-a-review-of-6-cases
#18
A Lamotte, T Neri, A Kawaye, B Boyer, F Farizon, R Philippot
INTRODUCTION: Patellar instability is a frequent cause of total knee arthroplasty (TKA) failure. In cases of post-arthroplasty patellar instability, the medial structures may be damaged. The objective of this study was to study the effectiveness of medial patellofemoral ligament (MPFL) reconstruction. We hypothesized that MPFL reconstruction will effectively realign the patella, making it a viable treatment option for managing post-arthroplasty patellar instability. MATERIAL AND METHODS: In this retrospective study of six patients treated by four different surgeons, patients were included if they had a recurring or permanent patellar dislocation after undergoing TKA...
September 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27289460/impact-of-the-patella-height-on-the-strain-pattern-of-the-medial-patellofemoral-ligament-after-reconstruction-a-computer-model-based-study
#19
Thomas Tischer, Andreas Geier, Robert Lenz, Christoph Woernle, Rainer Bader
PURPOSE: Medial patellofemoral ligament (MPFL) reconstruction is a key procedure for treating patellofemoral instability. However, controversy exists regarding the correct graft placement in different patellar heights. Therefore, our study aimed to investigate the influence of patellar height on MPFL insertion points. METHODS: Strain patterns of the reconstructed MPFL were calculated using a dynamic musculoskeletal multibody simulation. Numerous patellar (proximal, central, distal) and femoral attachment sites (around the radiological point according to Schöttle) were analysed in the presence of different patella heights [Insall-Salvati (IS) indices 0...
June 11, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27284321/treatment-of-patellar-instability-in-a-case-of-hereditary-onycho-osteodysplasia-nail-patella-syndrome-with-medial-patellofemoral-ligament-reconstruction-a-case-report
#20
Yubao Gong, Chen Yang, Yang Liu, Jianguo Liu, Xin Qi
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...
June 2016: Experimental and Therapeutic Medicine
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