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Combined Reconstruction of the Medial Patellofemoral Ligament With Quadricipital Tendon and the Medial Patellotibial Ligament With Patellar Tendon.

ABSTRACT: Although the medial patellotibial ligament (MPTL) has been neglected regarding its function in patellar stability, recently, its importance in terminal extension and during flexion has been recognized. Indications for reconstruction of the medial patellofemoral ligament combined with the MPTL are extension subluxation, flexion instability, children with anatomic risk factors for patellar instability, and knee hyperextension associated with generalized laxity. We describe a combined reconstruction of the medial patellofemoral ligament with quadricipital tendon and reconstruction of the MPTL with patellar tendon autografts.

SUBMITTER: Hinckel BB

PROVIDER: S-EPMC4810877 | biostudies-literature | 2016 Feb

REPOSITORIES: biostudies-literature

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Combined Reconstruction of the Medial Patellofemoral Ligament With Quadricipital Tendon and the Medial Patellotibial Ligament With Patellar Tendon.

Hinckel Betina Bremer BB Gobbi Riccardo Gomes RG Demange Marco Kawamura MK Bonadio Marcelo Batista MB Pécora José Ricardo JR Camanho Gilberto Luis GL

Arthroscopy techniques 20160125 1

Although the medial patellotibial ligament (MPTL) has been neglected regarding its function in patellar stability, recently, its importance in terminal extension and during flexion has been recognized. Indications for reconstruction of the medial patellofemoral ligament combined with the MPTL are extension subluxation, flexion instability, children with anatomic risk factors for patellar instability, and knee hyperextension associated with generalized laxity. We describe a combined reconstructio ...[more]

PMID: 27073782

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Combined Medial Patellofemoral Ligament, Medial Quadriceps Tendon-Femoral Ligament, and Medial Patellotibial Ligament Reconstruction for Patellar Instability: A Technical Note.

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Project description:Lateral patellar dislocations represent a common orthopaedic condition in young, active individuals who experience patellar instability. Despite increasing interest in re-creating the natural biomechanics and native knee anatomy when performing medial patellar soft-tissue reconstructive procedures, there is no consensus among surgeons regarding the best techniques to use when reconstructing the medial patellofemoral ligament and medial quadriceps tendon-femoral ligament. This article details a method to reconstruct the medial patellofemoral ligament and medial quadriceps tendon-femoral ligament using a single graft and a single all-suture knotless anchor on the patella.

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Combined Soft Tissue Reconstruction of the Medial Patellofemoral Ligament and Medial Quadriceps Tendon-Femoral Ligament.

Project description:Patellar dislocation is a major orthopaedic concern in pediatric and adult populations, with both conservative and surgical options available. Several surgical techniques of the combined or isolated reconstruction of the medial patellofemoral ligament are described in the literature using different grafts, locations, and types of fixations, providing different advantages and disadvantages. New recent developments in cadaveric dissection studies have unveiled the importance of structures that were neglected until recently, such as the medial quadriceps tendon-femoral ligament, which provides a connection between the medial femur and the quadriceps tendon component of the knee extensor mechanism. Hence, we present a surgical technique with combined reconstruction of the medial patellofemoral ligament and medial quadriceps tendon-femoral ligament without the use of hardware and with no need for patellar or femoral drilling (no physis compromise or risk of patellar fracture), which can be used concomitantly with other bony procedures.

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Project description:Patella alta is a common pathoanatomic contributor to various knee pathologies, including patella instability, fat pad impingement, and patellar tendinopathy. The 2 most common surgical techniques used to treat patella alta include a distalizing tibial tubercle osteotomy and patella tendon imbrication. Although these 2 surgical techniques are effective, they are associated with significant surgical morbidity and a limiting postoperative course with prolonged rehabilitation. In this Technical Note, we propose a simple means of distalizing the patella and improving patella maltracking via the addition of a medial patellotibial ligament reconstruction. The described technique is easy to perform, has little postoperative morbidity, and is familiar to most knee surgeons who perform anterior cruciate ligament reconstruction.

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Medial Patellofemoral Ligament Reconstruction With Concomitant Lateral Patellofemoral Reconstruction for Patellar Instability.

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Combined Reconstruction of the Medial Patellofemoral Ligament and Medial Quadriceps Tendon Femoral Ligament in Skeletally Immature Patients.

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