Medial patellofemoral ligament reconstruction with autologous gracilis tendon: Clinical and radiological outcomes at a mean 6 years of follow up

The Knee ◽  
2021 ◽  
Vol 33 ◽  
pp. 252-259
Author(s):  
Marco Basso ◽  
Enrico Arnaldi ◽  
Jacopo Tamini ◽  
Andrea A.M. Bruno
Keyword(s):  
Ligament Reconstruction ◽  
Medial Patellofemoral Ligament ◽  
Medial Patellofemoral Ligament Reconstruction ◽  
Gracilis Tendon

scholarly journals An Isolated Medial Patellofemoral Ligament Reconstruction with Patellar Tendon Autograft

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Dariusz Witoński ◽  
Rafał Kęska ◽  
Marek Synder ◽  
Marcin Sibiński
Keyword(s):  
Patellar Tendon ◽  
Patellofemoral Joint ◽  
Ligament Reconstruction ◽  
Medial Patellofemoral Ligament ◽  
Effective Procedure ◽  
Medial Patellofemoral Ligament Reconstruction ◽  
Role Functioning ◽  
The Mean ◽  
Tendon Autograft

The aim of the study was to evaluate the results of the medial patellofemoral ligament reconstruction with a medial strip of patellar tendon autograft after a minimum 2-year followup. Ten patients (10 knees) were operated on by one surgeon, according to the modified technique, described by Camanho, without any bone plug at free graft end. The mean age of the patients was 27.2 years (ranging from 18 to 42 years). The mean follow-up period was 3 years and 7 months. All patients were reviewed prospectively. At the last follow-up visit, all the patients demonstrated a significant improvement in terms of patellofemoral joint stability, all aspects of the KOOS questionnaire, and Kujala et al.’s score (59.7 points preoperatively and 84.4 points at the last followup). No patient revealed recurrent dislocation. The SF-36 score revealed a significant improvement in bodily pain, general health, physical role functioning, social role functioning, and physical functioning domains. The described MPFL reconstruction with the use of the medial 1/3rd of patella tendon is an effective procedure that gives satisfactorily patellofemoral joint functions, improves the quality of life, and provides much pain relief. It is relatively simple, surgically not extensive, and economically cost-effective procedure.

scholarly journals Isolated medial patellofemoral ligament reconstruction for recurrent patellofemoral instability: analysis of outcomes and risk factors

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Filippo Migliorini ◽  
Francesco Oliva ◽  
Gayle D. Maffulli ◽  
Jörg Eschweiler ◽  
Matthias Knobe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Outcomes ◽  
Ligament Reconstruction ◽  
Medial Patellofemoral Ligament ◽  
Patellofemoral Instability ◽  
Mpfl Reconstruction ◽  
Medial Patellofemoral Ligament Reconstruction ◽  
The Mean ◽  
Tegner Score

Abstract Background The medial patellofemoral ligament (MPFL) is always damaged after patellar dislocation. In selected patients, MPFL reconstruction is necessary to restore a correct patellar tracking. Despite the large number of different techniques reported to reconstruct the MPFL, there is no consensus concerning the optimal procedure, and debates is still ongoing. The present study analysed the results after isolated MPFL reconstruction in patients with patellofemoral instability. Furthermore, a subgroup analysis of patients presenting pathoanatomical risk factors was made. Methods In November 2020, the main electronic databases were accessed. All articles reporting the results of primary isolated MPFL reconstruction for recurrent patellofemoral instability were considered for inclusion. Only articles reporting a minimum 12-month follow-up were eligible. Results Data from a total of 1777 knees were collected. The mean age of the patients involved was 22.8 ± 3.4 years. The mean follow-up was 40.7 ± 25.8 months. Overall, the range of motion (+ 27.74; P < 0.0001) and all the other scores of interests improved at last follow-up: Kujala (+ 12.76; P = 0.0003), Lysholm (+ 15.69; P < 0.0001), Tegner score (+ 2.86; P = 0.006). Seventy-three of 1780 patients (4.1%) showed a positive apprehension test. Thirty of 1765 patients (1.7%) experienced re-dislocations, while 56 of 1778 patients (3.2%) showed persisting joint instability. Twenty-five of 1786 patients (1.4%) underwent revision surgeries. Conclusion Isolated MPFL reconstruction for recurrent patellofemoral instability provides reliable surgical outcomes. Patients with pathoanatomical predisposing factors reported worse surgical outcomes.

Combined Medial Patellofemoral Ligament Reconstruction and Tibial Tubercle Transfer Results at a Follow-Up of 2 years

2016 ◽  
Vol 30 (01) ◽  
pp. 42-46 ◽  
Author(s):  
Marius Calciu ◽  
Narlaka Jayasekera ◽  
Peter Schranz ◽  
Vipul Mandalia ◽  
Riaz Ahmad
Keyword(s):  
Ligament Reconstruction ◽  
Medial Patellofemoral Ligament ◽  
Tibial Tubercle ◽  
Medial Patellofemoral Ligament Reconstruction ◽  
Tibial Tubercle Transfer

Midterm Results after Implant-Free Patellar Fixation Technique for Medial Patellofemoral Ligament Reconstruction

2019 ◽  
Vol 33 (11) ◽  
pp. 1140-1146
Author(s):  
Philipp Mayer ◽  
Philipp Schuster ◽  
Michael Schlumberger ◽  
Martin Eichinger ◽  
Michael Pfaff ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Surgical Technique ◽  
Functional Outcome ◽  
Revision Surgery ◽  
Ligament Reconstruction ◽  
Medial Patellofemoral Ligament ◽  
Return To Sports ◽  
Medial Patellofemoral Ligament Reconstruction ◽  
Preoperative Level

AbstractProblems and complications concerning the patellar fixation in medial patellofemoral ligament reconstruction (MPFLR) have been reported. The purpose of this retrospective study was to systematically analyze the surgical technique for MPFLR with a V-shaped patellar bonetunnel for implant-free fixation of an autologous gracilis tendon, allowing early functional rehabilitation, regarding restoration of the patellofemoral stability, patient satisfaction, return to sports, and technique-specific complications. In 2010, 128 cases of consecutive isolated MPFLR were performed. All these cases were included. After a minimum follow-up of 3 years, 104 cases were retrospectively analyzed (follow-up: 81.3%) with regard to redislocation, subjective functional outcome (Tegner's score and sports level compared with preoperative level), patient satisfaction, revision surgery, and technique-specific complications. After a follow-up of 45.7 ± 3.2 months, 101 of 104 cases (97.1%) showed no redislocation. Mean Tegner's score was 5.1 ± 1.8 (range, 2–9). A total of 61.5% patients reported about a higher sports level compared with their preoperative level. The patient satisfaction was high with 94.2%. In two cases (1.9%), technique-specific problems occurred as the bone bridge of the V-shaped tunnel was insufficient due to a malpositioning of the aiming device. No further technique-specific problems occurred and no revision surgery was necessary during the observational period. The presented surgical technique is safe and it reliably restores the patellofemoral stability, with a low rate of redislocations, an excellent subjective functional outcome, and a high-patient-reported satisfaction. No major technique-specific complications occurred.

scholarly journals Extensive Lateral Release and Medial Patellofemoral Ligament Reconstruction in 25 Years of Chronic Fixed Lateral Patellar Dislocation: A 5-Year Follow-Up Case Report

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Andri M. T. Lubis ◽  
Petrus Aprianto ◽  
Yudistira P. Siregar
Keyword(s):  
Patellar Dislocation ◽  
Ligament Reconstruction ◽  
Medial Patellofemoral Ligament ◽  
Daily Activities ◽  
Lateral Release ◽  
Medial Patellofemoral Ligament Reconstruction ◽  
Lateral Dislocation ◽  
Lateral Patellar Dislocation ◽  
The Right

Lateral dislocation of the patella is not uncommon and may impede daily activities as this causes compressive dysfunction and instabilities. Most cases of patellar lateral dislocation are due to damage to the medial patellofemoral ligament (MPFL), either rupture of detachment of the patella or femoral attachment. MPFL reconstruction alone was considered adequate for the treatment of this condition. We present a case of a 49-year-old male with chronic posttraumatic lateral patellar dislocation of the right knee of 25 years, which we treated with extensive lateral release and right medial patellofemoral ligament reconstruction with 5-year follow-up data.

Persistent morbidity after Medial Patellofemoral Ligament Reconstruction — A registry study with an eight-year follow-up on a nationwide cohort from 1996 to 2014

The Knee ◽  
2019 ◽  
Vol 26 (1) ◽  
pp. 20-25 ◽  
Author(s):  
Kasper Skriver Gravesen ◽  
Thomas Kallemose ◽  
Lars Blønd ◽  
Anders Troelsen ◽  
Kristoffer Weisskirchner Barfod
Keyword(s):  
Ligament Reconstruction ◽  
Medial Patellofemoral Ligament ◽  
Medial Patellofemoral Ligament Reconstruction ◽  
Registry Study

scholarly journals Clinical Outcomes after Isolated Medial Patellofemoral Ligament Reconstruction for Patellar Instability

2017 ◽  
Vol 5 (3_suppl3) ◽  
pp. 2325967117S0012
Author(s):  
Joseph N. Liu ◽  
Jacqueline Munch ◽  
Claire Berdelle Ryan ◽  
Irene L. Kalbian ◽  
Sabrina M. Strickland ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Medial Patellofemoral Ligament ◽  
Trochlear Dysplasia ◽  
Patellofemoral Instability ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Return To Sports ◽  
Medial Patellofemoral Ligament Reconstruction ◽  
Patient Reported

Objectives: Medial patellofemoral ligament (MPFL) reconstruction has become an increasingly popular means to regain stability in the setting of recurrent lateral patellar dislocation, with nearly twice the number of medical centers performing reconstruction of the MPFL and outcomes reported on nearly double the number of patients in recent years. While recent studies have demonstrated improved patient reported outcome measures and a high rate of return to sports, limited literature has explored its effectiveness as an isolated intervention in the context of trochlear dysplasia. The purpose of this study was to determine the efficacy of isolated MPFL reconstruction in treating patellar instability in the setting of trochlear dysplasia. Methods: This was a retrospective review of consecutive patients who underwent unilateral or bilateral medial patellofemoral ligament reconstruction for patellofemoral instability. No osteotomies were included. All patients with minimum 2 year follow up were included. Pre- and postoperative assessment included ligamentous laxity, patellar crepitus, tilt, translation, and apprehension, and radiographic features including tibial tubercle-trochlear groove (TT-TG) ratio, Dejour classification, and Caton Deschamps ratio. Final follow up consisted of patient reported outcome measures including the Kujala score, International Knee Documentation Committee (IKDC) score, Lysholm score, and visual analog scale (VAS). Results: 105 MPFL reconstructions were included. Average age at surgery was 23.8 years (SD 9.7, range 12.1 - 57.0) with an average BMI of 23.4 (SD 4.7, range 16.3-43.6) and an average of 4.4 (SD 6.8) dislocation events prior to surgery. Average follow up was 44 months (range 24-111). 76% of patients were female. Average preoperative TT-TG ratio was 13.5 (SD 3.9, range 3.2-22) and Caton Deschamps ratio was 1.2 (SD 0.2, range 0.9-1.6); 74.5% of patients had Dejour C or D trochlear grooves. Kujala score improved from 54.5 (SD 3.8) preoperatively to 87.2 (SD 2.1) at 2 year follow up (p < 0.0001), Lysholm improved from 57.7 (SD 3.6) to 86.4 (SD 2.0) (p < 0.0001), IKDC improved from 52.1 (SD 3.8) to 79.5 (SD 2.6) (p < 0.0001), and VAS pain score improved from 2.9 (SD 0.3) to 1.7 (SD 0.3) (p<0.017). 78.9% of patients were able to return to sports at 1 year, with 69% returning to the same or higher level of play. At minimum 2-year follow up, only 5 patients reported either a postoperative dislocation or subluxation event. Conclusion: This study is the largest single series to report on the effectiveness of isolated MPFL reconstructions in a cohort of patients with a high incidence of trochlear dysplasia. In patients with normal TT-TG ratios, isolated medial patellofemoral ligament reconstruction provides safe and effective treatment for patellofemoral instability, despite the presence of Dejour class C or D trochlear grooves. Most patients are able to return to sports by 1 year postoperatively at the same or higher level of play.

scholarly journals Adolescent Medial Patellofemoral Ligament Reconstruction: A Comparison of the Use of Autograft Versus Allograft Hamstring

2018 ◽  
Vol 6 (5) ◽  
pp. 232596711877427 ◽  
Author(s):  
Nikhil Kumar ◽  
Tracey P. Bastrom ◽  
M. Morgan Dennis ◽  
Andrew T. Pennock ◽  
Eric W. Edmonds
Keyword(s):  
Patellar Instability ◽  
Ligament Reconstruction ◽  
Medial Patellofemoral Ligament ◽  
Cruciate Ligament ◽  
Lateral Release ◽  
Return To Sports ◽  
Medial Patellofemoral Ligament Reconstruction ◽  
Level Of Evidence ◽  
Significant Difference

Background: Recurrent patellar instability is commonly treated with medial patellofemoral ligament reconstruction (MPFLR), and the use of allograft in anterior cruciate ligament reconstructions has demonstrated inferior outcomes. Purpose: To compare the outcomes of allografts versus autografts in adolescent MPFLR for patellar instability. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective chart review was completed on patients younger than 18 years who underwent MPFLR for recurrent instability after failed nonoperative management over an 8-year period with a minimum 2-year follow-up. Patients were divided into autograft or allograft hamstring cohorts for comparison. Primary outcome measures were return to normal activity, incidence of redislocation/subluxation, pain, stiffness, other complications, and Kujala scores. Statistical analysis using unpaired t tests was performed, with an alpha value set at P < .05. Results: After criteria were applied, 59 adolescents (36 allograft, 23 autograft; 38 girls, 21 boys) with a mean ± SD age of 15.2 ± 1.7 years and a mean follow-up of 4.1 ± 1.9 years (allograft, 3.3 ± 1.1 years; autograft, 5.7 ± 2.1 years; P ≤ .001) were included. Seven patients had concurrent osteotomies (3 allograft, 4 autograft), 11 patients had concurrent loose body removals (5 allograft, 6 autograft), and 9 patients had concurrent lateral release (7 allograft, 2 autograft). Between groups, no significant difference was found in change between preoperative and most recent follow-up (mean, 1.2 ± 2.1) or rate of return to sports (mean, 73.3%). In total, 9 surgeries failed (3 allograft, 6 autograft). For the surviving grafts, a statistical difference in mean Kujala scores at final follow-up was noted (allograft, 92.7; autograft, 97.4; P = .02). Conclusion: We identified no significant differences in return to activity, pain score changes, and incidences of failure between patients undergoing MPFLR with allograft versus autograft. Although teenagers with surviving autograft MPFLR reported statistically higher Kujala scores, the mean score difference of 5 points was not clinically significant. It appears that using allograft tendon instead of autograft tissue for MPFLR in this teenage population does not adversely affect long-term outcomes.

Medial patellofemoral ligament reconstruction with bioactive synthetic ligament is an option. A 3-year follow-up study

2014 ◽  
Vol 22 (10) ◽  
pp. 2419-2425 ◽  
Author(s):  
Massimo Berruto ◽  
Paolo Ferrua ◽  
Francesco Uboldi ◽  
Eva Usellini ◽  
Luca Gala ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Medial Patellofemoral Ligament ◽  
Medial Patellofemoral Ligament Reconstruction ◽  
Follow Up Study ◽  
Synthetic Ligament
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