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International Orthopaedics

Published in:

01-05-2021 | Original Paper

Clinical outcomes after medial patellofemoral ligament reconstruction: an analysis of changes in the patellofemoral joint alignment

Authors: Yuta Fujii, Shuji Nakagawa, Yuji Arai, Hiroaki Inoue, Hiroyuki Kan, Manabu Hino, Kenta Kaihara, Yasuo Mikami

Published in: International Orthopaedics | Issue 5/2021

Abstract

Purpose

Medial patellofemoral ligament (MPFL) reconstruction using the hamstring tendon is widely performed to treat recurrent patellar dislocation. MPFL reconstruction includes a post-operative process of necrosis and reperfusion of the hamstring tendon graft. We hypothesise that the patella gradually shifts laterally because of this process, ultimately affecting the patellofemoral joint alignment. This study aimed to analyse the chronological changes in the patellofemoral joint alignment and the outcomes of MPFL reconstruction.

Methods

In this retrospective case-series study, the Knee Society, Lysholm, and Kujala scores were evaluated in 24 consecutive patients (27 knees). To evaluate patellar tracking defects, radiographic indices including the tilting angle, the lateral shift ratio, and the congruence angle were measured before, immediately after, and three, 12, and 36 months after MPFL reconstruction.

Results

Post-operative Kujala, Knee Society, and Lysholm scores for the study population significantly improved relative to the pre-operative scores. The tilting and congruence angles at three months after the operation significantly increased relative to those recorded immediately after the operation. The tilting and congruence angles were not significantly different at three, 12, and 36 months after the operation.

Conclusions

The post-operative outcomes of MPFL reconstruction for recurrent patellar dislocation were favourable. Insufficient union between the bone tunnel and tendon graft, along with an elongation of the necrotic tendon graft, may change the alignment of the patellofemoral joint within three months after the operation. Therefore, we believe it is necessary to refrain from knee rotation that places lateral stress on the patella until three months after the operation.

ACL: anterior cruciate ligament; MPFL: medial patellofemoral ligament; MRA: magnetic resonance angiography; PF: patellofemoral

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Title: Clinical outcomes after medial patellofemoral ligament reconstruction: an analysis of changes in the patellofemoral joint alignment
Authors: Yuta Fujii
Shuji Nakagawa
Yuji Arai
Hiroaki Inoue
Hiroyuki Kan
Manabu Hino
Kenta Kaihara
Yasuo Mikami
Publication date: 01-05-2021
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 5/2021
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-020-04765-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical outcomes after medial patellofemoral ligament reconstruction: an analysis of changes in the patellofemoral joint alignment

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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