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MPFL reconstruction

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https://www.readbyqxmd.com/read/29225329/medial-patellofemoral-ligament-reconstruction-with-semi-patellar-tunnel-fixation-surgical-technique-and-mid-term-follow-up
#1
Jinghui Niu, Qi Qi, Kunpeng Fu, Guman Duan, Chang Liu, Fei Wang
BACKGROUND The present study aimed to describe a new safe and economical technique for medial patellofemoral ligament (MPFL) reconstruction with satisfactory clinical outcomes, and present the results of a four-year follow-up. MATERIAL AND METHODS Thirty-two patients with recurrent patella dislocation, who underwent MPFL reconstruction with two semi-patellar tunnels and hardware-free patellar fixation between 2011 and 2013, were included in the study. Patella stability was tested by an apprehension test preoperatively and at follow-up...
December 11, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29204862/the-trochlear-isometric-point-is-different-in-patients-with-recurrent-patellar-instability-compared-to-controls-a-radiographical-study
#2
Tulio Campos, Akash Soogumbur, Iain R McNamara, Simon T Donell
PURPOSE: The purpose of the study was to investigate the theoretical isometric point based of the curve of the femoral groove and relating it to the origin of the MPFL femoral tunnel on lateral radiograph by comparing a patellar instability cohort with a control cohort. METHODS: From a Patellar Instability database the radiographs of 40 consecutive patients were analysed to define Schöttle's point, and the arc of the circle of the trochlear groove. A comparison population of 20 radiographs from comparable patients with tibiofemoral joint disorders was used as a control...
December 4, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29201929/evaluation-of-the-sch%C3%A3-ttle-technique-in-the-pediatric-knee
#3
Kellen L Huston, Ugochi C Okoroafor, Scott G Kaar, Christa L Wentt, Paul Saluan, Lutul D Farrow
Background: The Schöttle point is commonly used for anatomic femoral tunnel placement during medial patellofemoral ligament (MPFL) reconstruction. This technique has not been previously validated in the skeletally immature patient, in whom femoral tunnel placement may put the distal femoral physis at risk of iatrogenic injury. Hypothesis: Interobserver reliability for femoral tunnel placement will be higher in adult knees compared with pediatric knees. Study Design: Cross-sectional study (diagnosis); Level of evidence, 3...
November 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29201927/radiographic-location-does-not-ensure-a-precise-anatomic-location-of-the-femoral-fixation-site-in-medial-patellofemoral-ligament-reconstruction
#4
Vicente Sanchis-Alfonso, Cristina Ramírez-Fuentes, Erik Montesinos-Berry, Isabel Elía, Luis Martí-Bonmatí
Background: A frequently used method to determine the anatomic femoral fixation point in the operating room during medial patellofemoral ligament (MPFL) reconstruction is the radiographic method. However, the ability of this radiological method to establish an anatomic femoral attachment point might not be as accurate as expected. Purpose: (1) To evaluate the accuracy of the radiological method to locate the anatomic femoral fixation point in MPFL reconstruction surgery and (2) to determine the factors influencing the predictability of this method to obtain this objective...
November 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29138916/lateral-retinaculum-plasty-instead-of-lateral-retinacular-release-with-concomitant-medial-patellofemoral-ligament-reconstruction-can-achieve-better-results-for-patellar-dislocation
#5
Chang Liu, Guman Duan, Yingzhen Niu, Pengkai Cao, Kunpeng Fu, Jinghui Niu, Fei Wang
PURPOSE: To elucidate the outcomes of lateral retinaculum plasty versus lateral retinacular release with concomitant medial patellofemoral ligament (MPFL) reconstruction. METHODS: In a prospective study, 59 patients treated at our institution from 2012 to 2014 were included. The 59 patients were randomly divided into two groups. Group I included 27 patients who underwent lateral retinacular release and MPFL reconstruction. Group II included 32 patients who underwent lateral retinaculum plasty and MPFL reconstruction...
November 14, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29134368/-patellofemoral-instability
#6
S F Fucentese
Patellofemoral instability is an extremely limiting pathology in young and active patients. Anatomical reasons for patellar instability, such as high-riding patella, elevated distance from the tibial tuberosity to trochlear groove (TTTG), trochlear dysplasia, insufficient medial patellofemoral ligament (MPFL) and malpositioning of the axes and torsion can lead to chronic patellofemoral instability and must be thoroughly analyzed. The first dislocation can be treated conservatively, with the exception of an osteochondral defect...
November 13, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/29128875/allowing-one-quadrant-of-patellar-lateral-translation-during-medial-patellofemoral-ligament-reconstruction-successfully-limits-maltracking-without-overconstraining-the-patella
#7
John J Elias, Kerwyn C Jones, Molly K Lalonde, Joseph N Gabra, S Cyrus Rezvanifar, Andrew J Cosgarea
PURPOSE: Graft tensioning during medial patellofemoral ligament (MPFL) reconstruction typically allows for lateral patellar translation within the trochlear groove. Computational simulation was performed to relate the allowed patellar translation to patellofemoral kinematics and contact pressures. METHODS: Multibody dynamic simulation models were developed to represent nine knees with patellar instability. Dual limb squatting was simulated representing the pre-operative condition and simulated MPFL reconstruction...
November 11, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29100777/anisometry-of-medial-patellofemoral-ligament-reconstruction-in-the-setting-of-increased-tibial-tubercle-trochlear-groove-distance-and-patella-alta
#8
Lauren H Redler, Kathleen N Meyers, Jacqueline M Brady, Elizabeth R Dennis, Joseph T Nguyen, Beth E Shubin Stein
PURPOSE: To assess the impact elevated tibial tubercle-trochlear groove (TT-TG) distance and patella height, as measured by the Caton-Deschamps Index (CDI), have on the isometry of a reconstructed medial patellofemoral ligament (MPFL). METHODS: Nine fresh-frozen cadaveric knees were placed on a custom testing fixture, with a fixed femur and a mobile tibia. A suture fixed to the MPFL origin on the patella and free to move at the Schöttle point on the femur represented a reconstructed MPFL...
October 31, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29083227/variation-in-the-medial-patellofemoral-ligament-origin-in-the-skeletally-immature-knee-an-anatomic-study
#9
Kevin G Shea, W Duncan Martinson, Peter C Cannamela, Connor G Richmond, Peter D Fabricant, Allen F Anderson, John D Polousky, Theodore J Ganley
BACKGROUND: The medial patellofemoral ligament (MPFL) is frequently reconstructed to treat recurrent patellar instability. The femoral origin of the MPFL is well described in adults but not in the skeletally immature knee. PURPOSE: To identify a radiographic landmark for the femoral MPFL attachment in the skeletally immature knee and study its relationship to the distal femoral physis. STUDY DESIGN: Descriptive laboratory study. METHODS: Thirty-six cadaveric specimens between 2 and 11 years old were dissected and examined (29 male and 7 female)...
October 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29016187/quantitative-and-qualitative-analysis-of-the-medial-patellar-ligaments-an-anatomic-and-radiographic-study
#10
Bradley M Kruckeberg, Jorge Chahla, Gilbert Moatshe, Mark E Cinque, Kyle J Muckenhirn, Jonathan A Godin, Taylor J Ridley, Alex W Brady, Elizabeth A Arendt, Robert F LaPrade
BACKGROUND: The qualitative and quantitative anatomy of the medial patellar stabilizers has been reported; however, a quantitative analysis of the anatomic and radiographic attachments of all 4 ligaments relative to anatomic and osseous landmarks, as well as to one another, has yet to be performed. PURPOSE: To perform a qualitative and quantitative anatomic and radiographic evaluation of the medial patellofemoral ligament (MPFL), medial patellotibial ligament (MPTL), medial patellomeniscal ligament (MPML), and medial quadriceps tendon femoral ligament (MQTFL) attachment sites, with attention to their relationship to pertinent osseous and soft tissue landmarks...
October 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28979605/medial-patellofemoral-ligament-reconstruction-using-the-hamstring-tendon-for-patellofemoral-joint-instability-in-an-81-year-old-female
#11
Tsuneari Takahashi, Katsushi Takeshita
INTRODUCTION: Chronic patellofemoral instability occurs mainly in adolescent females and can also be induced by medial patellofemoral ligament (MPFL) injury. There are no case reports of MPFL reconstruction for chronic patellofemoral instability due to MPFL injury in aged populations. CASE PRESENTATION: 81-year-old female presented with left knee pain, giving way, and patellar instability while climbing stairs, which continued for 18 months. Patellar apprehension test was positive, and roentgenogram showed lateral patellar subluxation...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28970976/medial-patellofemoral-ligament-reconstruction-in-a-revision-setting-anchor-and-interference-screw%C3%A2-fixation
#12
Marcio B Ferrari, George Sanchez, Angela Chang, Sami Ferdousian, Matthew T Provencher
Recurrent patellar instability is a common pathology and typically affects younger and more active patients. To prevent complete lateral dislocation of the patella, several osseous and soft-tissue procedures have been previously described, including reconstruction of the medial patellofemoral ligament (MPFL), which has been identified as the primary medial stabilizer of the patella. Several techniques have been reported for reconstruction of the MPFL, sometimes in conjunction with other procedures, with the majority showing success in the treatment and resolution of patellar instability...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28932880/double-bundle-anatomical-medial-patellofemoral-ligament-reconstruction-with-lateral-retinaculum-plasty-can-lead-to-good-outcomes-in-patients-with-patellar-dislocation
#13
Yingzhen Niu, Xinmin Wang, Chang Liu, Xiaomeng Wang, Zhenyue Dong, Jinghui Niu, Fei Wang
PURPOSE: To evaluate the clinical outcomes of double-bundle anatomical medial patellofemoral ligament (MPFL) reconstruction combined with lateral retinaculum plasty versus isolated MPFL reconstruction for patellar dislocation. METHODS: From 2011 to 2013, 64 patients underwent either double-bundle anatomical MPFL reconstruction combined with lateral retinaculum plasty (Group A, 32 patients), or isolated MPFL reconstruction (Group B, 32 patients). Clinical evaluations were performed 2 years post-operatively and included determination of the number of patients with patellar redislocation, the patellar tilt angle, lateral patellar shift, subjective symptoms, and functional outcomes as evaluated with the Kujala score and Lysholm score...
September 20, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28932876/effective-patellofemoral-joint-stabilization-and-low-complication-rates-using-a-hardware-free-mpfl-reconstruction-technique-with-an-intra-operative-adjustment-of-the-graft-tension
#14
Lars V von Engelhardt, Torsten Fuchs, Pia Weskamp, Joerg Jerosch
PURPOSE: Even if medial patellofemoral ligament (MPFL) reconstruction is a proven method, complications such as implant loosening, patella fractures, recurrent luxations, knee pain or knee stiffness are frequently described. Besides a correct tunnel positioning and implant-specific complications, this might be caused by difficulties with an appropriate graft tensioning. The study presented here is a necessary first step in exploring our technique of a double-limbed, hardware-free MPFL reconstruction, which provides another way to test and adjust the graft tension before permanent fastening...
September 20, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28929187/modern-synthetic-material-is-a-safe-and-effective-alternative-for-medial-patellofemoral-ligament-reconstruction
#15
Paul Y F Lee, David Golding, Sam Rozewicz, Amit Chandratreya
PURPOSE: Medial patellofemoral ligament (MPFL) reconstruction is often performed using gracilis autografts, which may be associated with donor site morbidity and complications. The use of a synthetic material can circumvent a harvest operation and has previously been demonstrated to be effective in other types of reconstructive procedures and may be effective in MPFL reconstruction. This study reports the clinical result with the use of a modern ultra-high molecular weight polyethylene with a braided jacket of polyester tape (FT) in MPFL reconstruction compared to using standard autografts...
September 19, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28867290/modified-adductor-sling-technique-a-surgical-therapy-for-patellar-instability-in-skeletally-immature-patients
#16
Lena Alm, Matthias Krause, Carolin Mull, Karl-Heinz Frosch, Ralph Akoto
BACKGROUND: Due to open femoral physis the therapy of patellar instability in skeletally immature patients is challenging. We developed a modified surgical technique of the 'Adductor-Sling-Approach' by Sillanpää. The purpose of this study was to evaluate the clinical outcome of the operative technique and to analyse the reasons for failure. METHODS: Thirty 'modified adductor sling' reconstructions in 28 patients were included in the study. From 2010 to 2016 modified adductor sling reconstruction was performed by looping the gracilis or semitendinosus tendon around the adductor magnus tendon and attaching it at the medial facet of the patella...
August 31, 2017: Knee
https://www.readbyqxmd.com/read/28852343/finite-element-analysis-of-patella-alta-a-patellofemoral-instability-model
#17
Nicole A Watson, Kyle R Duchman, Nicole M Grosland, Matthew J Bollier
BACKGROUND: This study aims to provide biomechanical data on the effect of patella height in the setting of medial patellofemoral ligament (MPFL) reconstruction using finite element analysis. The study will also examine patellofemoral joint biomechanics using variable femoral insertion sites for MPFL reconstruction. METHODS: A previously validated finite element knee model was modified to study patella alta and baja by translating the patella a given distance to achieve each patella height ratio...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28845005/-treatment-of-patellofemoral-instability-in-adolescent-by-anatomical-double-bundle-medial-patellofemoral-ligament-reconstruction-with-double-suture-anchor-technique
#18
Weihong Zhu, You Chen, Qi Tang, Lele Liao, Ding Li
To explore the clinical outcomes of anatomical double-bundle medial patellofemoral ligament (MPFL) reconstruction with double suture anchor technique in treating patellofemoral instability in adolescent.
 Methods: Twenty-five young people with patellofemoral instability (25 knees) in our department from January 2013 to December 2014 were enrolled for this study. All patients were performed anatomical double-bundle MPFL reconstruction with arthroscopic-assisted suture anchors technique in the patella, and fixed in the femoral socket with absorbable interference screw...
July 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28801826/brain-activity-changes-in-somatosensory-and-emotion-related-areas-with-medial-patellofemoral-ligament-deficiency
#19
Masaru Kadowaki, Taku Tadenuma, Nobuyuki Kumahashi, Yuji Uchio
BACKGROUND: Patellar instability with medial patellofemoral ligament (MPFL) deficiency is a common sports injury among young people. Although nonoperative and surgical treatment can provide stability of the patella, patients often have anxiety related to the knee. We speculate that neural dysfunction may be related to anxiety in these patients; however, the mechanism in the brain that generates this anxiety remains unknown. QUESTIONS/PURPOSES: (1) How does brain activity in patients with MPFL deficiency change in the areas related to somatic sensation against lateral shift of the patella? (2) How does patella instability, which can lead to continuous fear or apprehension for dislocation, influence brain activity in the areas related to emotion? METHODS: Nineteen patients with MPFL deficiency underwent surgical reconstruction in our hospital from April 2012 to March 2014...
November 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28741155/length-change-patterns-and-shape-of-a-grafted-tendon-after-anatomical-medial-patellofemoral-ligament-reconstruction-differs-from-that-in-a-healthy-knee
#20
Shuji Nakagawa, Yuji Arai, Hiroaki Inoue, Manabu Hino, Yuta Fujii, Shintaro Komaki, Kazuya Ikoma, Keiichiro Ueshima, Hiroyoshi Fujiwara, Toshikazu Kubo
PURPOSE: Recurrent patellar dislocation is currently treated with anatomical reconstruction of the medial patellofemoral ligament (MPFL), and favourable postoperative outcomes have been reported. However, it is uncertain if healthy MPFL function is restored by anatomical reconstruction. The hypothesis in this study was that stabilization of the patella following MPFL reconstruction would be improved compared with that before surgery, but that function of the grafted tendon would differ from that of a healthy MPFL...
July 24, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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