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Suture Tape Augmentation Repair of the Medial Patellofemoral Ligament.

ABSTRACT: Adolescents with osteochondral loose bodies after a first-time patellar dislocation are most commonly treated with surgical intervention. However, the ideal method of managing a concurrent medial patellofemoral ligament (MPFL) disruption is still unknown. Recent evidence suggests high failure rates are associated with primary MPFL repair. The purpose of this Technical Note is to describe an alternative surgical technique for managing acute first-time patellar dislocations by using high-strength suture augmentation of the MPFL.

SUBMITTER: Sherman B

PROVIDER: S-EPMC6948125 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Medial Patellofemoral Ligament Repair With Suture Tape Augmentation.

Project description:The medial patellofemoral ligament (MPFL) is the main restraining force in the first 20° of flexion against lateral patellar displacement and is disrupted after patellar subluxation or dislocation. MPFL reconstruction is frequently performed when conservative management fails and the patient has recurrent patellar dislocations. However, a variety of complications have been reported in the literature with this procedure. Internal bracing with suture tape augmentation encourages healing and allows early mobilization. This article describes, with video illustration, MPFL repair with suture tape augmentation.

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Anterior Talofibular Ligament Repair With Suture Tape Augmentation.

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Ultrasound-Guided Suture Tape Augmentation and Stabilization of the Medial Collateral Ligament.

Project description:Management of medial collateral ligament (MCL) injuries usually consists of time and conservative management; however, patients are typically immobilized and need extensive time to return to sport. Although the MCL has been shown to have the ability to heal given time, surgical management is still sometimes needed to provide stability to the knee. Operative techniques vary in methodology, but are typically highly invasive and technically demanding. In the event of multiligamentous or severe injuries, reinforcing the MCL with an ultrahigh-strength, 2-mm-wide suture tape allows for early functional rehabilitation, permitting the native MCL tissue to heal and avoiding late reconstructions. This technical report details an ultrasound-guided technique for the percutaneous suture tape augmentation and stabilization of the MCL with or without repair. Ultrasound allows for anatomic percutaneous placement of the sockets, as opposed to landmark palpation guidance that has proven to be unreliable. This is a simple, quick procedure that provides instant stability to the MCL with or without operating on the ligament itself, allowing patients to return to activity faster with the reduced risk of reinjury due to less muscle atrophy and loss of function.

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Project description:The medial collateral ligament (MCL) is the most commonly injured ligament of the knee. Given its extra-articular location, the MCL has great healing capacity such that the mainstay of treatment for most injuries remains conservative management. However, certain injury patterns place patients and athletes at risk of residual valgus laxity, which may require delayed surgical care and prolonged time out from sports. As such, identifying the specific injuries known to place patients at risk for failure with nonoperative management is of paramount importance. Although controversy remains regarding the optimal treatment of grade III MCL injuries, it is generally accepted that MCL ruptures from the distal tibia attachment require operative fixation. This technique article with accompanying video provides a detailed description of a technique for repairing the distal MCL attachment with suture augmentation. There are several advantages associated with an augmented direct repair including early, safe rehabilitation; prevention of valgus instability; and avoiding the comorbidities associated with a larger reconstruction.

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Primary Repair of the Medial Collateral Ligament with a Double Row Suture Technique and Suture Tape Augmentation for Acute Tibial-Sided Injuries.

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Anterior Cruciate Ligament Reconstruction With Suture Tape Augmentation.

Project description:The advent of suture tape augmentation has led to increased use in knee, elbow, and ankle ligament repairs and reconstructions. Recent biomechanical analysis of the use of suture tape augmentation have shown superior strength characteristics compared with repair or reconstruction alone. Despite its increased use in extra-articular ligament procedures, its use as an augment to anterior cruciate ligament reconstruction has not been widely described. This article details a simple technique to incorporate the use of suture tape augmentation during concurrent anterior cruciate ligament reconstruction using hamstring autograft.

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Posterolateral Corner Repair With Suture Tape Augmentation.

Project description:The posterolateral corner (PLC) of the knee is the main restraint to varus forces of the knee as well as posterolateral rotation of the tibia relative to the femur. Primary PLC repairs have been associated with a high failure rate in past literature. However, with modern improved arthroscopic instrumentation and devices, there has been a renewed interest in repair of the ligaments around the knee. Internal bracing with suture tape augmentation encourages healing and allows early mobilization. This article describes, with video illustration, PLC repair with suture tape augmentation.

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