Medial Patellofemoral Ligament Repair for Recurrent Patellar Dislocation.
Summary of "Medial Patellofemoral Ligament Repair for Recurrent Patellar Dislocation."
The medial patellofemoral ligament (MPFL) is the primary restraint to extreme lateral displacement and is typically disrupted with an acute lateral patellar dislocation. Patients who fail a comprehensive nonoperative program and experience recurrent lateral patellar instability episodes are candidates for surgical treatment. Current surgical procedures include a variety of proximal realignment techniques, including repair or reconstruction of the MPFL along with distal realignment of the tibial tubercle when indicated.
The objective of this study was to review the clinical, functional, and radiographic outcomes of isolated MPFL repair for recurrent lateral patellar dislocation. STUDY
Case series; Level of evidence, 4.
The records of all patients undergoing MPFL repair for recurrent patellar dislocation at the Mayo Clinic from 2001 to 2006 were retrospectively reviewed. Twenty-seven patients (29 knees) with an average age of 19 years (range, 11-32 years) were included in this study. Clinical, functional, and radiographic outcomes were assessed at an average of 4 years after surgery (range, 2-7 years), using recurrent instability as the primary end point.
The success rate of MPFL repair for preventing recurrent dislocations was 72% (21 of 29 knees). Eight patients (28%) experienced a recurrent lateral patellar dislocation. Five of these patients required a reoperation, including two MPFL reconstructions, 1 tibial tubercle osteotomy with MPFL reconstruction, 1 tibial tubercle osteotomy with revision MPFL repair, and 1 revision MPFL repair. At final follow-up, the mean Lysholm and Kujala scores were 86 (range, 42-100) and 92 (range, 57-105), respectively. Postoperative radiographs revealed a mean patellofemoral congruence angle improvement of 27 degrees (range, 5 degrees -44 degrees ). The only statistically significant risk factor for failure was nonanatomical MPFL repair at the medial femoral condyle (P = .004).
Isolated repair of the MPFL for recurrent patellar instability is associated with a relatively high failure rate, but remains a viable surgical option if surgical technique principles are followed. The clinical success of this operation depends on restoration of the anatomical origin of the MPFL and careful patient selection.
This article was published in the following journal.
Name: The American journal of sports medicine
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20716682
- DOI: http://dx.doi.org/10.1177/0363546510376230
Medical and Biotech [MESH] Definitions
A band of fibrous tissue that attaches the apex of the PATELLA to the lower part of the tubercle of the TIBIA. The ligament is actually the caudal continuation of the common tendon of the QUADRICEPS FEMORIS. The patella is embedded in that tendon. As such, the patellar ligament can be thought of as connecting the quadriceps femoris tendon to the tibia, and therefore it is sometimes called the patellar tendon.
Medial Collateral Ligament, Knee
The ligament that travels from the medial epicondyle of the FEMUR to the medial margin and medial surface of the TIBIA. The medial meniscus is attached to its deep surface.
Sprains And Strains
A collective term for muscle and ligament injuries without dislocation or fracture. A sprain is a joint injury in which some of the fibers of a supporting ligament are ruptured but the continuity of the ligament remains intact. A strain is an overstretching or overexertion of some part of the musculature.
Bone-patellar Tendon-bone Graft
Fixation of the ANTERIOR CRUCIATE LIGAMENT, during surgical reconstruction, by the use of a bone- patellar tendon autograft.
Displacement of the PATELLA from the femoral groove.
PURPOSE: Patellar instability is a frequent condition in children and adolescents. The problem can be associated with malalignment resulting from different anatomical abnormaliti...
We report a prospective analysis of clinical outcome in patients treated with medial patellofemoral ligament (MPFL) reconstruction using an autologous semitendinosus graft. The technique includes supe...
PURPOSE: Patellar dislocation usually occurs to the lateral side, leading to ruptures of the medial patellofemoral ligament (MPFL) in about 90 % of all cases. Reliable prognostic factors for the stab...
PURPOSE: The first aim was to compare medial patellofemoral ligament injury patterns in children and adolescents after first-time lateral patellar dislocations with the injury patterns in adults. The...
PURPOSE: Medial patellofemoral ligament (MPFL) reconstruction has been performed to treat recurrent patellar dislocation. However, the effects on patellar tracking have not been well documented, parti...
The operative management of chronic patellar instability has been controversial. Medial patellofemoral ligament reconstruction has gained success recently and might be superior to other so...
The objective of this prospective, randomized cohort study was to evaluate the clinical results between operative and nonoperative treatment of primary patellar dislocation.
Patellar subluxation is a common disorder that may cause patellofemoral pain syndrome. The efficiency of patellar taping in the treatment of patellofemoral pain syndrome has been reported...
Background Previous studies have a great discrepancy concerning the effects of quadriceps contraction on patellar lateral displacement and tilt in patients with patellofemoral pain syndrom...
Background：Patellofemoral pain syndrome（PFPS） is a common knee disorder characterized by anterior or retropatellar pain associated with activities that load the patellofemoral joint....