Fixation of osteochondral fractures of the patella using autologous bone screws when reconstructing the medial patellofemoral ligament after recurrent patellar dislocation: report of two cases

2014 ◽  
Vol 19 (2) ◽  
pp. 359-364 ◽  
Author(s):  
Nobuyuki Kumahashi ◽  
Suguru Kuwata ◽  
Shinji Imade ◽  
Michihaya Kono ◽  
Hiroshi Takuwa ◽  
...  
Keyword(s):  
Patellar Dislocation ◽  
Medial Patellofemoral Ligament ◽  
Bone Screws ◽  
Recurrent Patellar Dislocation ◽  
Autologous Bone ◽  
Osteochondral Fractures

scholarly journals Clinical Outcomes After Medial Patellofemoral Ligament Reconstruction With Suture Fixation of the Gracilis Tendon via Transosseous Tunnels

2020 ◽  
Vol 8 (2) ◽  
pp. 232596711990037
Author(s):  
Hangzhou Zhang ◽  
Mao Ye ◽  
Qingwei Liang
Keyword(s):  
Patellar Dislocation ◽  
Medial Patellofemoral Ligament ◽  
Case Series ◽  
Mpfl Reconstruction ◽  
Suture Fixation ◽  
Recurrent Patellar Dislocation ◽  
Patellar Tilt ◽  
Transosseous Suture ◽  
Patellar Tilt Angle

Background: Several fixation methods have been introduced in medial patellofemoral ligament (MPFL) reconstruction. However, the optimal management of patients with recurrent patellar dislocation remains controversial. Purpose: To present a case series with a minimum 2-year follow-up of 29 patients with recurrent patellar dislocation who underwent a new transosseous suture fixation technique for MPFL reconstruction. Study Design: Case series; Level of evidence, 4. Methods: From January 2014 through February 2016, a total of 29 patients with recurrent patellar dislocation for which the MPFL was reconstructed with transosseous suture patellar fixation were studied. All patients were available for follow-up (mean, 37.52 months; range, 26-48 months). The patellar attachment was fixed by transosseous patellar sutures. The International Knee Documentation Committee (IKDC) subjective knee score, Kujala score, Tegner score, range of motion, congruence angle, patellar tilt angle, and complications were assessed both pre- and postoperatively. Results: No recurrent dislocation was observed in any of the 29 patients for a minimum of 2 years. All outcome scores improved significantly from preoperatively to postoperatively: the average IKDC subjective knee evaluation score from 53 to 87, Kujala from 54 to 90, Lysholm from 50 to 89, and Tegner from 3 to 5 ( P < .001 for all). The congruence angle significantly decreased from 22° preoperatively to –3° postoperatively, and the patellar tilt angle (Merchant) decreased from 23° preoperatively to 5° postoperatively ( P < .001 for both). In total, 25 patients (25/29; 86.21%) were completely pain-free when performing activities of daily living at the last follow-up, and 27 patients (93.1%) rated themselves as very satisfied or satisfied with the results. Conclusion: In patients with chronic recurrent patellar dislocation, transosseous patellar suture fixation for MPFL reconstruction can significantly improve patellar stability and achieve good results at short-term follow-up.

scholarly journals Closing-Wedge Distal Femoral Osteotomy Combined with Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Dislocation with Genu Valgum

2020 ◽  
Author(s):  
Lizhong Jing ◽  
Xiaole Wang ◽  
Kun Liu ◽  
Xiaotan Wang ◽  
Lu Jiang ◽  
...  
Keyword(s):  
Patellar Dislocation ◽  
Ligament Reconstruction ◽  
Medial Patellofemoral Ligament ◽  
Weight Bearing ◽  
Femoral Osteotomy ◽  
Genu Valgum ◽  
Imaging Findings ◽  
Medial Patellofemoral Ligament Reconstruction ◽  
Recurrent Patellar Dislocation ◽  
Distal Femoral Osteotomy

Abstract Background: Medial patellofemoral ligament reconstruction (MPFLR) is a well-established procedure for addressing recurrent patellar dislocation (RPD) in young patients. However, for RPD with genu valgum, simultaneous MPFLR and closing-wedge distal femoral osteotomy (CWDFO) may be a promising procedure yet rarely reported. This study’s purpose was to observe and analyse the clinical and imaging findings of CWDFO combined with MPFLR for RPD with genu valgum.Methods: From May 2015 to Apirl 2018, 25 patients with RPD and genu valgum were surgically treated in our department. Anteroposterior long-leg, weight-bearing, lower-extremity radiographs, lateral radiographs and computed tomography (CT) scans of the patellofemoral joint were obtained, and the femorotibial angle (FTA), mechanical lateral distal femoral angle (mLDFA), weight-bearing line rate (WBLR), patellar height, patellar lateral shift (PLS) and tibial tubercle–trochlear groove (TT-TG) distance were analysed. Validated knee scores, such as the Kujala, Lysholm, visual analogue scale (VAS) scores and Tegner socres, were evaluated preoperatively and 2 years postoperatively.Results: 25 patients, with an average age of 19.8 years (14–27), were evaluated. All patients had been able to achieve a better sports level without any problems during the 2-year follow-up period. There has been no recurrence of patellar instability. Compared with preoperation, the FTA, mLDFA, WBLR and PLS showed statistically significant improvement following the procedure (p < 0.001). Meanwhile, no significant differences in the Insall index and TT-TG distance was found. The mean Kujala score, average Lysholm score, VAS score and Tegner socres showed significant improvement postoperatively.Conclusions: CWDFO combined with MPFLR is a suitable treatment for RPD with genu valgum, as it leads to significant improvement in the clinical and imaging findings of the knee in the short term.

scholarly journals Closing-wedge distal femoral osteotomy combined with medial patellofemoral ligament reconstruction for recurrent patellar dislocation with genu valgum

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Lizhong Jing ◽  
Xiaole Wang ◽  
Xiaoliang Qu ◽  
Kun Liu ◽  
Xiaotan Wang ◽  
...  
Keyword(s):  
Patellar Dislocation ◽  
Ligament Reconstruction ◽  
Medial Patellofemoral Ligament ◽  
Weight Bearing ◽  
Femoral Osteotomy ◽  
Genu Valgum ◽  
Imaging Findings ◽  
Medial Patellofemoral Ligament Reconstruction ◽  
Recurrent Patellar Dislocation ◽  
Distal Femoral Osteotomy

Abstract Background Medial patellofemoral ligament reconstruction (MPFLR) is a well-established procedure for addressing recurrent patellar dislocation (RPD) in young patients. However, despite being a promising procedure for RPD with genu valgum, there is a scarcity of reports on simultaneous MPFLR and closing-wedge distal femoral osteotomy (CWDFO). The purpose of the present study was to observe and analyse the clinical and imaging findings of CWDFO combined with MPFLR for RPD with genu valgum. Methods From May 2015 to April 2018, 25 patients with RPD and genu valgum were surgically treated in our department. Anteroposterior long-leg, weight-bearing, lower-extremity radiographs, lateral radiographs and computed tomography (CT) scans of the patellofemoral joint were obtained, and the anatomical femorotibial angle (aFTA), mechanical lateral distal femoral angle (mLDFA), weight-bearing line rate (WBLR), patellar height, patellar lateral shift (PLS) and tibial tubercle–trochlear groove (TT-TG) distance were analysed. Validated knee scores, such as the Kujala, Lysholm, visual analogue scale (VAS) scores and Tegner socres, were evaluated preoperatively and 2 years postoperatively. Results 25 patients, with an average age of 19.8 years (14–27), were evaluated. During the 2-year follow-up period, all patients were able to achieve a better sports level without any problems, with no recurrence of patellar instability. Compared with preoperation, the aFTA, mLDFA, WBLR and PLS showed statistically significant improvement following the procedure (p < 0.001). Meanwhile, no significant differences in the Insall index and TT-TG distance were found. The mean Kujala score, average Lysholm score, VAS score and Tegner socres showed significant postoperative improvement. Conclusions CWDFO combined with MPFLR is a suitable treatment for RPD with genu valgum, and can lead to significant improvement in the clinical and imaging findings of the knee in the short term.

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