Top

Archives of Orthopaedic and Trauma Surgery

Published in:

01-05-2008 | Arthroscopy & Sports Medicine

Technical note: anatomical reconstruction of the medial patellofemoral ligament using a free gracilis autograft

Authors: Philip B. Schottle, Jose Romero, Arno Schmeling, Andreas Weiler

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 5/2008

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 surgical technique to restore patellofemoral stability. Recently, various procedures have been described addressing the reconstruction of the medial patellofemoral complex. We present a technique where the MPFL is reconstructed anatomically to restore physiological kinematics and stability using a free gracilis tendon autograft.

Amis AA, Firer P, Mountney J, Senavongse W, Thomas NP (2003) Anatomy and biomechanics of the medial patellofemoral ligament. Knee 10:215–220PubMedCrossRef

Avikainen VJ, Nikku RK, Seppanen-Lehmonen TK (1993) Adductor magnus tenodesis for patellar dislocation. Technique and preliminary results. Clin Orthop 297:12–16PubMed

Bernard M, Hertel P, Hornung H, Cierpinski T (1997) Femoral insertion of the ACL. Radiographic quadrant method. Am J Knee Surg 10:14–21; discussion 21–12

Chassaing V, Tremoulet J (2005) Medial patellofemoral ligament reconstruction with gracilis autograft for patellar instability. Rev Chir Orthop Reparatrice Appar Mot 91:335–340PubMed

Christoforakis J, Bull AM, Strachan RK, Shymkiw R, Senavongse W, Amis AA (2006) Effects of lateral retinacular release on the lateral stability of the patella. Knee Surg Sports Traumatol Arthrosc 14:273–277PubMedCrossRef

Deie M, Ochi M, Sumen Y, Adachi N, Kobayashi K, Yasumoto M (2005) A long-term follow-up study after medial patellofemoral ligament reconstruction using the transferred semitendinosus tendon for patellar dislocation. Knee Surg Sports Traumatol Arthrosc 13:522–528PubMedCrossRef

Dejour D, Reynaud P, Lecoultre B (1998) Douleurs et instabilité rotulienne. Essai de classification. Med Hyg 56:1466–1471

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

Drez D Jr, Edwards TB, Williams CS (2001) Results of medial patellofemoral ligament reconstruction in the treatment of patellar dislocation. Arthroscopy 17:298–306PubMedCrossRef

10.

Elias JJ, Cosgarea AJ (2006) Technical errors during medial patellofemoral ligament reconstruction could overload medial patellofemoral cartilage: a computational analysis. Am J Sports Med 34:1478–1485PubMedCrossRef

11.

Elias DA, White LM, Fithian DC (2002) Acute lateral patellar dislocation at MR imaging: injury patterns of medial patellar soft-tissue restraints and osteochondral injuries of the inferomedial patella. Radiology 225:736–743PubMedCrossRef

12.

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

13.

Hautamaa PV, Fithian DC, Kaufman KR, Daniel DM, Pohlmeyer AM (1998) Medial soft tissue restraints in lateral patellar instability and repair. Clin Orthop 174–182

14.

Herald J, Cooper L, Machart F (2002) Tourniquet-induced restriction of the quadriceps muscle mechanism. Fact or fiction? J Bone Joint Surg Br 84:856–857PubMedCrossRef

15.

Moller BN, Moller-Larsen F, Frich LH (1989) Chondromalacia induced by patellar subluxation in the rabbit. Acta Orthop Scand 60:188–191PubMedCrossRef

16.

Nomura E, Inoue M (2003) Surgical technique and rationale for medial patellofemoral ligament reconstruction for recurrent patellar dislocation. Arthroscopy 19:E47PubMedCrossRef

17.

Nomura E, Horiuchi Y, Kihara M (2000) Medial patellofemoral ligament restraint in lateral patellar translation and reconstruction. Knee 7:121–127PubMedCrossRef

18.

Nomura E, Horiuchi Y, Inoue M (2002) Correlation of MR imaging findings and open exploration of medial patellofemoral ligament injuries in acute patellar dislocations. Knee 9:139–143PubMedCrossRef

19.

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 13:510–515PubMedCrossRef

20.

Noyes FR, Albright JC (2006) Reconstruction of the medial patellofemoral ligament with autologous quadriceps tendon. Arthroscopy 22:904 e1–7PubMedCrossRef

21.

Palmer I (1938) Om injuries to the ligaments of the ankle joint. A clinical study. Acta Chir Scand 53(Suppl):1–282

22.

Sallay PI, Poggi J, Speer KP, Garrett WE (1996) Acute dislocation of the patella. A correlative pathoanatomic study. Am J Sports Med 24:52–60

23.

Sanders TG, Morrison WB, Singleton BA, Miller MD, Cornum KG (2001) Medial patellofemoral ligament injury following acute transient dislocation of the patella: MR findings with surgical correlation in 14 patients. J Comput Assist Tomogr 25:957–962PubMedCrossRef

24.

Sandmeier RH, Burks RT, Bachus KN, Billings A (2000) The effect of reconstruction of the medial patellofemoral ligament on patellar tracking. Am J Sports Med 28:345–349PubMed

25.

Schottle PB, Weiler A (2006) Die anatomische Rekonstruktion des ligamentum patellofemorale mediale. Endo-Press, Tuttlingen

26.

Schottle PB, Fucentese SF, Romero J (2005) Clinical and radiological outcome of medial patellofemoral ligament reconstruction with a semitendinosus autograft for patella instability. Knee Surg Sports Traumatol Arthrosc 13:516–521PubMedCrossRef

27.

Schottle PB, Scheffler SU, Schwarck A, Weiler A (2006) Arthroscopic medial retinacular repair after patella dislocation with and without underlying trochlear dysplasia—a preliminary report. Arthroscopy 11:231–238

28.

Schottle PB, Schmeling A, Rosenstiel N, Weiler A (2007) Radiographic landmark for femoral tunnel placement in medial patellofemoral ligament reconstruction. Am J Sports Med [Epub ahead of print]

29.

Senavongse W, Amis AA (2005) The effects of articular, retinacular, or muscular deficiencies on patellofemoral joint stability. J Bone Joint Surg Br 87:577–582PubMed

30.

Steensen RN, Dopirak RM, McDonald WG III (2004) The anatomy and isometry of the medial patellofemoral ligament: implications for reconstruction. Am J Sports Med 32:1509–1513PubMedCrossRef

31.

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

32.

Warren LA, Marshall JL, Girgis F (1974) The prime static stabilizer of the medical side of the knee. J Bone Joint Surg Am 56:665–674PubMed

33.

Weiler A, Richter M, Schmidmaier G, Kandziora F, Sudkamp NP (2001) The EndoPearl device increases fixation strength and eliminates construct slippage of hamstring tendon grafts with interference screw fixation. Arthroscopy 17:353–359PubMedCrossRef

34.

Weiler A, Peine R, Pashmineh-Azar A, Abel C, Sudkamp NP, Hoffmann RF (2002) Tendon healing in a bone tunnel. Part I: biomechanical results after biodegradable interference fit fixation in a model of anterior cruciate ligament reconstruction in sheep. Arthroscopy 18:113–123PubMedCrossRef

Title: Technical note: anatomical reconstruction of the medial patellofemoral ligament using a free gracilis autograft
Authors: Philip B. Schottle
Jose Romero
Arno Schmeling
Andreas Weiler
Publication date: 01-05-2008
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 5/2008
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-007-0300-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Technical note: anatomical reconstruction of the medial patellofemoral ligament using a free gracilis autograft

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 5/2008

Endoscopic resection of the gouty tophi of the first metatarsophalangeal joint

The deficit of joint position sense in the chronic unstable ankle as measured by inversion angle replication error

Relationship of the menstrual cycle phase to anterior cruciate ligament injuries in teenaged female athletes

Bilateral osteochondritis dissecans of the lateral trochlea of the femur: a case report

Biceps long head tendon revisited: a case report of split tendon arising from single origin

A giant extrasynovial osteochondroma in the infrapatellar fat pad: end stage Hoffa’s disease