Biomechanical Evaluation of Medial Patellofemoral Ligament Reconstruction

Overview

Journal Iowa Orthop J

Specialty Orthopedics

Date 2013 Sep 13

PMID 24027463

Citations 10

Authors

Kyle R Duchman

Nicole A DeVries

Mark A McCarthy

Justin J Kuiper

Nicole M Grosland

Matthew J Bollier

Affiliations

Soon will be listed here.

Abstract

Background: The medial patellofemoral ligament (MPFL) is the most frequently injured soft tissue structure following acute lateral patellar dislocation. MPFL reconstruction has become a popular option to restore patellar stability following lateral patellar dislocation due to the high incidence of recurrent instability following conservative management. Anatomic reconstruction of the MPFL minimizes graft length changes during full knee range of motion and restores patellar stability.

Materials & Methods: Four fresh frozen cadaver specimens underwent biomechanical testing in a materials testing machine. With the knee fixed in 30° of flexion, the patella was translated laterally a distance of 10 mm and continuous force-displace- ment data was collected with the intact MPFL and again following a newly described MPFL reconstruction technique. Lateral force-displacement and stiffness data were calculated, allowing comparison between the intact and reconstructed MPFL.

Results: The average lateral restraining force provided by the intact MPFL was 10.6 ± 5.7, 36.6 ± 2.7, and 69.0 ± 5.9 N while the lateral restraining force following MPFL reconstruction was 0.4 ± 4.3, 50.3 ± 16.3, and 110.2 ± 17.5 N at 1, 5, and 10 mm of lateral displacement, respectively.

Conclusion: Anatomic MPFL reconstruction displays similar lateral restraining force compared to the intact MPFL at low levels of lateral displacement. At higher levels of displacement, the reconstructed MPFL provides increased lateral restraining force compared to the intact MPFL, improving patellar stability in pathologic knees.

Citing Articles

Patient-Reported Outcomes Following Medial Patellofemoral Reconstruction With Peroneus Longus Allografts Demonstrate Good Results.

Long J, Pappa N, Stitgen M, Flanigan D, Fowler B, DiBartola A Arthrosc Sports Med Rehabil. 2023; 5(1):e201-e206.

PMID: 36866312 PMC: 9971893. DOI: 10.1016/j.asmr.2022.11.014.

Effect of Lateral Retinacular Release on Medial Patellofemoral Ligament Reconstruction.

Gallagher B, Mistretta K, Abbasi P, Levine R Orthop J Sports Med. 2022; 10(2):23259671221076877.

PMID: 35187185 PMC: 8848066. DOI: 10.1177/23259671221076877.

Tibiofemoral Cartilage Contact Pressures in Athletes During Landing: A Dynamic Finite Element Study.

Erbulut D, Sadeqi S, Summers R, Goel V J Biomech Eng. 2021; 143(10).

PMID: 34008847 PMC: 8299805. DOI: 10.1115/1.4051231.

Anatomical femoral tunnel positioning in the medial patellofemoral ligament reconstruction: is the free-hand technique accurate?.

de Abreu-E-Silva G, Buarque F, Dias T, Lei P, Bueno E, de Andrade M Ann Transl Med. 2020; 8(15):924.

PMID: 32953724 PMC: 7475416. DOI: 10.21037/atm-19-3925.

Finite Element Analysis of Patella Alta: A Patellofemoral Instability Model.

Watson N, Duchman K, Grosland N, Bollier M Iowa Orthop J. 2017; 37:101-108.

PMID: 28852343 PMC: 5508303.

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