MPFL reconstruction for recurrent patella dislocation: a new surgical technique and review of the literature.
نویسندگان
چکیده
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 been recognised as the most important ligamentous stabiliser preventing lateral dislocation of the patella. Many nonanatomical surgical techniques for the treatment of recurrent patellar dislocation have been described in the literature. These procedures alter the pre-morbid patella mechanics by several principles, including the release of tight lateral ligaments, tensioning of loose medial structures and distal realignment of the extensor mechanism or a combination of these. Very few address the principle site of pathology in patella dislocation, i.e., the torn MPFL. The outcomes are inconsistent and many studies have reported recurrent dislocations and patellofemoral pain and arthritis in up to 40 %. We describe a simple technique of MPFL reconstruction using a single hamstring tendon graft which is passed through the medial intermuscular septum at the adductor's magnus insertion and is fixed to the superomedial pole of the patella. A comprehensive review of the existing techniques of MPFL reconstruction using semitendinosus tendon autografts is also provided.
منابع مشابه
A 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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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 f...
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Primary patellar dislocation injures the medial patellofemoral ligament (MPFL), the major soft-tissue stabilizer of the patella, which may lead to recurrent patellar instability. Recurrent patellar dislocation are common and may require surgical intervention. The variation in location of injury of the MPFL and the presence of an osteochondral fracture produces challenges in clinical decision ma...
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It has been suggested that recurrent dislocation, subluxation, and functional instability due to patellofemoral pain are experienced by 30% to 60% of patients with post-traumatic patella instability who are managed with non-surgical methods [1-3]. Recently, the medial patellofemoral ligament (MPFL) has been recognized as the most important ligamentous stabilizer for preventing lateral dislocati...
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ورودعنوان ژورنال:
- International journal of sports medicine
دوره 29 5 شماره
صفحات -
تاریخ انتشار 2008