Aperture Fixation Instead of Transverse Tunnels at the Patella for Medial Patellofemoral Ligament Reconstruction

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2011 Jun 17

PMID 21678092

Citations 24

Authors

Onur Hapa

Ertugrul Aksahin

Raif Ozden

Murad Pepe

Ahmet Nedim Yanat

Yunus Dogramaci

Ergun Bozdag

Emin Sunbuloglu

Affiliations

Soon will be listed here.

Abstract

Purpose: Medial patellofemoral ligament (MPFL) reconstruction is an effective option for the treatment of recurrent patellar instability. Most techniques utilize the passage of a tendon graft through tunnels at the patella with the risk of patellar fracture. The purpose of this study was to investigate the strength of the recent MPFL reconstruction techniques (transverse tunnel, interference screw, anchor, and docking technique).

Methods: Thirty-six saw bones were divided into four groups (transverse tunnel, interference screw, anchor fixation, and docking technique) with nine patellae in each. Patella-tendon constructs were pre-loaded to 10 N and cyclically loaded for 20 cycles from 2 to 30 N under load control at a rate of 5 N/sec. The construct was then tested to failure at a constant displacement rate of 6 mm/sec. Ultimate load (N), stiffness (N/mm), and failure mode were recorded for each specimen.

Results: The docking group had lower ultimate load [106 (SD 41) N] and stiffness [14 (SD 2) N/mm] values than the other groups tested (P = 0.007). The anchor group had lower stiffness [21 (SD 6) N/mm] values than the tunnel group [28 (SD 3) N/mm (P = 0.01)] and the interference screw group [31 (SD 6) N/mm, (P = 0.004)]. There was no significant difference in the ultimate load between anchor [299 (SD 116) N], tunnel [304 (SD 140) N], and interference screw groups [241 (SD 103) N] (n.s.).

Conclusion: Aperture fixation techniques, especially interference screw fixation, were as strong as the technique utilizing tunnels in the patella for MPFL reconstruction.

Citing Articles

Ellipsoidal patellar bone tunnel fixation with Toggleloc suspension system for medial patellofemoral ligament reconstruction: A 5 years follow-up.

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What is the best fixation method in medial patellofemoral ligament reconstruction? A biomechanical comparison of common methods for femoral graft attachment.

Vezole L, Gunst S, Gras L, Shatrov J, Mertbakan O, Lustig S SICOT J. 2024; 10:7.

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Biomechanical Comparison of 2 Patellar Fixation Techniques in Medial Patellofemoral Ligament Reconstruction: Transosseous Sutures vs Suture Anchors.

Zhao X, Zhang H Orthop J Sports Med. 2021; 9(10):23259671211041404.

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Reconstruction of the medial patellofemoral ligament using two blind transverse semi-patella tunnels and an implant-free technique for patellar fixation: a technical note.

Raoulis V, Zibis A, Fyllos A, Malahias M, Banios K, Hantes M J Orthop Surg Res. 2021; 16(1):25.

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Clinical Outcomes After Medial Patellofemoral Ligament Reconstruction Using Transosseous Sutures Versus Suture Anchors: A Prospective Nonrandomized Controlled Trial.

Ye M, Zhang H, Liang Q Orthop J Sports Med. 2020; 8(5):2325967120917112.

PMID: 32490023 PMC: 7238809. DOI: 10.1177/2325967120917112.

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