Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 2/2010

01-02-2010 | Knee

Anatomical double-bundle MPFL reconstruction with an aperture fixation

Authors: Philip B. Schöttle, Daniel Hensler, Andreas B. Imhoff

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 2/2010

Login to get access

Abstract

Since biomechanical studies have shown that the medial patellofemoral ligament (MPFL) is the main restraint against lateral patella displacement, reconstruction of the MPFL has become an accepted method of restoring patellofemoral stability and numerous techniques were described. Due to biomechanical examinations and clinical results, an anatomical double-bundle reconstruction of the “sail-like” MPFL is a reasonable method for achieving stability during complete extension and lower flexion degree. This method also serves to avoid rotation of the patella, providing immediate stability throughout the normal range of motion. However, until today, an aperture fixation technique at the patellar insertion with two bundles has not been described previously. This technique can provide an immediate stability to allow an early rehabilitation with full range of motion.
Literature
1.
go back to reference Amis AA, Firer P, Mountney J, Senavongse W, Thomas NP (2003) Anatomy and biomechanics of the medial patellofemoral ligament. Knee 10:215–220CrossRefPubMed Amis AA, Firer P, Mountney J, Senavongse W, Thomas NP (2003) Anatomy and biomechanics of the medial patellofemoral ligament. Knee 10:215–220CrossRefPubMed
2.
go back to reference Brand J Jr, Weiler A, Caborn DN, Brown CH Jr, Johnson DL (2000) Graft fixation in cruciate ligament reconstruction. Am J Sports Med 28:761–774PubMed Brand J Jr, Weiler A, Caborn DN, Brown CH Jr, Johnson DL (2000) Graft fixation in cruciate ligament reconstruction. Am J Sports Med 28:761–774PubMed
3.
go back to reference Christiansen SE, Jacobsen BW, Lund B, Lind M (2008) Reconstruction of the medial patellofemoral ligament with gracilis tendon autograft in transverse patellar drill holes. Arthroscopy 24:82–87PubMed Christiansen SE, Jacobsen BW, Lund B, Lind M (2008) Reconstruction of the medial patellofemoral ligament with gracilis tendon autograft in transverse patellar drill holes. Arthroscopy 24:82–87PubMed
4.
go back to reference Desio SM, Burks RT, Bachus KN (1998) Soft tissue restraints to lateral patellar translation in the human knee. Am J Sports Med 26:59–65PubMed Desio SM, Burks RT, Bachus KN (1998) Soft tissue restraints to lateral patellar translation in the human knee. Am J Sports Med 26:59–65PubMed
5.
go back to reference Elias JJ, Cech JA, Weinstein DM, Cosgrea AJ (2004) Reducing the lateral force acting on the patella does not consistently decrease patellofemoral pressures. Am J Sports Med 32:1202–1208CrossRefPubMed Elias JJ, Cech JA, Weinstein DM, Cosgrea AJ (2004) Reducing the lateral force acting on the patella does not consistently decrease patellofemoral pressures. Am J Sports Med 32:1202–1208CrossRefPubMed
6.
go back to reference Elias JJ, Wilson DR, Adamson R, Cosgarea AJ (2004) Evaluation of a computational model used to predict the patellofemoral contact pressure distribution. J Biomech 37:295–302CrossRefPubMed Elias JJ, Wilson DR, Adamson R, Cosgarea AJ (2004) Evaluation of a computational model used to predict the patellofemoral contact pressure distribution. J Biomech 37:295–302CrossRefPubMed
7.
go back to reference Ellera Gomes JL, Stigler Marczyk LR, Cesar de Cesar P, Jungblut CF (2004) Medial patellofemoral ligament reconstruction with semitendinosus autograft for chronic patellar instability: a follow-up study. Arthroscopy 20:147–151PubMedCrossRef Ellera Gomes JL, Stigler Marczyk LR, Cesar de Cesar P, Jungblut CF (2004) Medial patellofemoral ligament reconstruction with semitendinosus autograft for chronic patellar instability: a follow-up study. Arthroscopy 20:147–151PubMedCrossRef
8.
go back to reference Nomura E, Inoue M (2003) Surgical technique and rationale for medial patellofemoral ligament reconstruction for recurrent patellar dislocation. Arthroscopy 19:E47PubMed Nomura E, Inoue M (2003) Surgical technique and rationale for medial patellofemoral ligament reconstruction for recurrent patellar dislocation. Arthroscopy 19:E47PubMed
9.
go back to reference Nomura E, Inoue M, Osada N (2005) Anatomical analysis of the medial patellofemoral ligament of the knee, especially the femoral attachment. Knee Surg Sports Traumatol Arthrosc 13:510–515CrossRefPubMed Nomura E, Inoue M, Osada N (2005) Anatomical analysis of the medial patellofemoral ligament of the knee, especially the femoral attachment. Knee Surg Sports Traumatol Arthrosc 13:510–515CrossRefPubMed
10.
go back to reference Ostermeier S, Stukenborg-Colsman C, Wirth CJ, Bohnsack M (2007) Reconstruction of the medial patellofemoral ligament by tunnel transfer of the semitendinosus tendon. Oper Orthop Traumatol 19:489–501CrossRefPubMed Ostermeier S, Stukenborg-Colsman C, Wirth CJ, Bohnsack M (2007) Reconstruction of the medial patellofemoral ligament by tunnel transfer of the semitendinosus tendon. Oper Orthop Traumatol 19:489–501CrossRefPubMed
11.
go back to reference Schottle PB, Romero J, Schmeling A, Weiler A (2008) Technical note: anatomical reconstruction of the medial patellofemoral ligament using a free gracilis autograft. Arch Orthop Trauma Surg 128:479–484CrossRefPubMed Schottle PB, Romero J, Schmeling A, Weiler A (2008) Technical note: anatomical reconstruction of the medial patellofemoral ligament using a free gracilis autograft. Arch Orthop Trauma Surg 128:479–484CrossRefPubMed
12.
go back to reference Schottle PB, Schmeling A, Rosenstiel N, Weiler A (2007) Radiographic landmarks for femoral tunnel placement in medial patellofemoral ligament reconstruction. Am J Sports Med 35:801–804CrossRefPubMed Schottle PB, Schmeling A, Rosenstiel N, Weiler A (2007) Radiographic landmarks for femoral tunnel placement in medial patellofemoral ligament reconstruction. Am J Sports Med 35:801–804CrossRefPubMed
13.
go back to reference Steensen RN, Dopirak RM, Maurus PB (2005) A simple technique for reconstruction of the medial patellofemoral ligament using a quadriceps tendon graft. Arthroscopy 21:365–370PubMedCrossRef Steensen RN, Dopirak RM, Maurus PB (2005) A simple technique for reconstruction of the medial patellofemoral ligament using a quadriceps tendon graft. Arthroscopy 21:365–370PubMedCrossRef
14.
go back to reference Steensen RN, Dopirak RM, McDonald WG 3rd (2004) The anatomy and isometry of the medial patellofemoral ligament: implications for reconstruction. Am J Sports Med 32:1509–1513CrossRefPubMed Steensen RN, Dopirak RM, McDonald WG 3rd (2004) The anatomy and isometry of the medial patellofemoral ligament: implications for reconstruction. Am J Sports Med 32:1509–1513CrossRefPubMed
15.
go back to reference Thaunat M, Erasmus PJ (2007) The favourable anisometry: an original concept for medial patellofemoral ligament reconstruction. Knee 14:424–428CrossRefPubMed Thaunat M, Erasmus PJ (2007) The favourable anisometry: an original concept for medial patellofemoral ligament reconstruction. Knee 14:424–428CrossRefPubMed
Metadata
Title
Anatomical double-bundle MPFL reconstruction with an aperture fixation
Authors
Philip B. Schöttle
Daniel Hensler
Andreas B. Imhoff
Publication date
01-02-2010
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 2/2010
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-009-0868-z

Other articles of this Issue 2/2010

Knee Surgery, Sports Traumatology, Arthroscopy 2/2010 Go to the issue