Reconstruction of the medial patellofemoral ligament for the treatment of habitual or recurrent dislocation of the patella in children.
نویسندگان
چکیده
We investigated the clinical outcome of a reconstructive procedure of the medial patellofemoral ligament for the treatment of habitual or recurrent dislocation of the patella in four children (6 knees), with a minimum follow-up of four years. The technique involves transfer of the tendon of semitendinosus to the patella using the posterior one-third of the femoral insertion of the medial collateral ligament as a pulley. There was no recurrence of dislocation after surgery. The mean Kujala score at follow-up was 96.3 points. Radiological assessment showed that the congruence angle, the tilt angle and the lateral shift radio were restored to normal. The lateral and medial stress shift ratios and the Insall-Salvati ratio remained abnormal. We conclude that this technique can be recommended for the treatment of habitual or recurrent patellar dislocation in children, although hypermobility and patella alta are not fully corrected.
منابع مشابه
Medial patellofemoral ligament reconstruction.
The medial patellofemoral ligament has been recognized as the structure primarily responsible for preventing patellar subluxation or dislocation.1-3 Anatomic dissection studies identified the medial patellofemoral ligament as a band of tissue connecting the femoral medial epicondyle to the proximal part of the medial edge of the patella (Figure 1).1-6 Imaging studies7-11 and surgical exploratio...
متن کاملMPFL reconstruction for recurrent patella dislocation: a new surgical technique and review of the literature.
Recurrent dislocation, subluxation and functional instability due to patellofemoral pain might be present in 30 % to 60 % of patients managed non-operatively for posttraumatic patella instability. Disruption of the capsule, medial patella retinaculum and/or vastus medialis obliquus have been associated with recurrent patella instability but recently the medial patellofemoral ligament (MPFL) has...
متن کاملTreatment of Habitual Patellar Dislocation in an Adult by Isolated Medial Patellofemoral Ligament Reconstruction
Habitual patellar dislocations are rare in adults. Treatment is difficult, and often associated with significant morbidity. A 30-year-old man, construction worker, presented a habitual patellofemoral dislocation which was caused by direct trauma to the knee as a child. Clinical examination showed a 3 cm leg-length discrepancy with no rotational deformities. The patient had a limp and loss of fu...
متن کاملA simple technique for reconstruction of medial patellofemoral ligament with bone-fascia tunnel fixation at the medial margin of the patella: a 6-year-minimum follow-up study
BACKGROUND Medial patellofemoral ligament (MPFL) reconstruction has become an accepted technique to treat patellofemoral instability, and numerous surgical techniques have been described to reconstruct the MPFL. We describe a MPFL reconstruction procedure where bone-fascia tunnel fixation occurs at the medial margin of the patella for recurrent patellar dislocation. OBJECTIVE MPFL reconstruct...
متن کاملCase report of a ruptured endobutton used in medial patellofemoral ligament reconstruction causing patellofemoral impingement
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 ...
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ورودعنوان ژورنال:
- The Journal of bone and joint surgery. British volume
دوره 85 6 شماره
صفحات -
تاریخ انتشار 2003