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Medial patellofemoral ligament reconstruction: a new technique.

Carmont MR, Maffulli N - BMC Musculoskelet Disord (2007)

Bottom Line: Primary patellofemoral dislocations are common.In most patients, non-operative management produces satisfactory outcome.We describe our transverse patella double tunnel technique to reconstruct the medial patellofemoral ligament using a free autologous gracilis or semitendinous graft.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Trauma and Orthopaedics, University Hospital of North Staffordshire, Keele University School of Medicine, Stoke on Trent, UK. mcarmont@hotmail.com <mcarmont@hotmail.com>

ABSTRACT

Background: Primary patellofemoral dislocations are common. In most patients, non-operative management produces satisfactory outcome. If the dislocation recurs after a trial of rehabilitation, operative intervention is considered, with the aim of restoring the soft tissue anatomy to normal. Ninety four percent of patients suffer a tear to the medial patellofemoral ligament (MPFL) following a patellar dislocation.

Results: We describe our transverse patella double tunnel technique to reconstruct the medial patellofemoral ligament using a free autologous gracilis or semitendinous graft.

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Related in: MedlinePlus

The improved stability of the patella is confirmed.
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Figure 8: The improved stability of the patella is confirmed.

Mentions: The medial epicondyle is palpated through the skin and exposed using a 2 cm incison. The Beath pin is then advanced along the transepicondylar axis laterally from the superior aspect of the medial epicondyle. A medial blind tunnel, normally about 3 cm long, is drilled along the guide pin to accommodate a double thickness of graft to an adequate depth to allow optimal graft tension. The Vicryl locking suture is then passed through the transepicondylar axis using the Beath pin, pulling the graft into the medial tunnel, and the patella is positioned in the femoral trochlea (Figure 6). The knee is cycled several times from full flexion to full extension with the graft under tension. In this way, the graft is prestretched to eliminate "give". Both ends of the graft are then secured within the medial epicondyle tunnel using a bioabsorbable interference fit screw (Depuy Mitek, Norwood, MA) (Figure 7, Figure 8) with the knee flexed to 20°. The graft thus acts as a check rein ensuring that the patella is stabilised within the trochlea. In summary, the graft passes through the superior and inferior transverse patella tunnels, forming a loop through the patella, with both ends being secured in the medial epicondyle tunnel.


Medial patellofemoral ligament reconstruction: a new technique.

Carmont MR, Maffulli N - BMC Musculoskelet Disord (2007)

The improved stability of the patella is confirmed.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1808455&req=5

Figure 8: The improved stability of the patella is confirmed.
Mentions: The medial epicondyle is palpated through the skin and exposed using a 2 cm incison. The Beath pin is then advanced along the transepicondylar axis laterally from the superior aspect of the medial epicondyle. A medial blind tunnel, normally about 3 cm long, is drilled along the guide pin to accommodate a double thickness of graft to an adequate depth to allow optimal graft tension. The Vicryl locking suture is then passed through the transepicondylar axis using the Beath pin, pulling the graft into the medial tunnel, and the patella is positioned in the femoral trochlea (Figure 6). The knee is cycled several times from full flexion to full extension with the graft under tension. In this way, the graft is prestretched to eliminate "give". Both ends of the graft are then secured within the medial epicondyle tunnel using a bioabsorbable interference fit screw (Depuy Mitek, Norwood, MA) (Figure 7, Figure 8) with the knee flexed to 20°. The graft thus acts as a check rein ensuring that the patella is stabilised within the trochlea. In summary, the graft passes through the superior and inferior transverse patella tunnels, forming a loop through the patella, with both ends being secured in the medial epicondyle tunnel.

Bottom Line: Primary patellofemoral dislocations are common.In most patients, non-operative management produces satisfactory outcome.We describe our transverse patella double tunnel technique to reconstruct the medial patellofemoral ligament using a free autologous gracilis or semitendinous graft.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Trauma and Orthopaedics, University Hospital of North Staffordshire, Keele University School of Medicine, Stoke on Trent, UK. mcarmont@hotmail.com <mcarmont@hotmail.com>

ABSTRACT

Background: Primary patellofemoral dislocations are common. In most patients, non-operative management produces satisfactory outcome. If the dislocation recurs after a trial of rehabilitation, operative intervention is considered, with the aim of restoring the soft tissue anatomy to normal. Ninety four percent of patients suffer a tear to the medial patellofemoral ligament (MPFL) following a patellar dislocation.

Results: We describe our transverse patella double tunnel technique to reconstruct the medial patellofemoral ligament using a free autologous gracilis or semitendinous graft.

Show MeSH
Related in: MedlinePlus