Medial patellofemoral ligament reconstruction with Gracilis tendon in traumatic recurrent dislocation of patella: A prospective clinical study of 30 cases MPFL reconstruction in traumatic recurrent dislocation of patella

Article Sidebar

PDF Download
Published Sep 28, 2020
DOI: https://doi.org/10.18103/mra.v8i9.2217

Downloads

Download data is not yet available.

Submit your own article

Register as an author to reserve your spot in the next issue of the Medical Research Archives.

Author Registration

Join the Society

The European Society of Medicine is more than a professional association. We are a community. Our members work in countries across the globe, yet are united by a common goal: to promote health and health equity, around the world.

Join Europe’s leading medical society and discover the many advantages of membership, including free article publication.

Membership

Main Article Content

Amit lakhani, MS Orthopaedics
Professor, Maharishi Markendeshwar Medical College And Hospital Solan HP
Ena Sharma, MDS Periodontics
Associate Professor Maharishi Markandeshwar college of dental sciences and Hospital Mullana, Ambala Haryana
SM Bhatnagar, MS Orthopaedics
HOD & Prof, Maharishi Markandeshwar medical college and hospital, Solan HP

Abstract

Background


Recurrent dislocation of the patella is a challenging problem due to complex biomechanics of patellar stabilty. Reconstruction of Medial patellofemoral ligament (MPFL) is becoming a common surgical procedure in treating patellar instability.Patella apprehension test, q angle and Insall index are various parameters which helps in deciding the line of treatment..


 


Material and method


MPFL reconstruction was performed using gracilis graft and fixed on patella by making a loop using two tunnels in 30 patients. The femoral side was fixed with bio screw. Patients were evaluated for pain relief, functional improvement and radiographic analysis The patients were followed on an average mean of 28 (16-40) months Patient function measures included:with subjective criteria of Kujala score and Lysholm score.


 


Result


The mean preoperative mean Kujala score was 33.93 and Lysholm score was 36.92. The mean postoperative mean Kujala score was 83.22 and Lysholm score was 84.88. No patient had reported with redislocation till date.


 


Conclusion


There was no episode of recurrent dislocation and range of motion was normal in all cases. This method gives rigid fixation on both sides and provides adequate stability.

Keywords: MPFL, q angle, Insall index, apprehension test

Article Details

How to Cite
LAKHANI, Amit; SHARMA, Ena; BHATNAGAR, SM. Medial patellofemoral ligament reconstruction with Gracilis tendon in traumatic recurrent dislocation of patella: A prospective clinical study of 30 cases. Medical Research Archives, [S.l.], v. 8, n. 9, sep. 2020. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/2217>. Date accessed: 08 nov. 2024. doi: https://doi.org/10.18103/mra.v8i9.2217.
ABNT APA BibTeX CBE EndNote - EndNote format (Macintosh & Windows) MLA ProCite - RIS format (Macintosh & Windows) RefWorks Reference Manager - RIS format (Windows only) Turabian
Issue
Vol 8 No 9 (2020): Vol.8 Issue 9, September, 2020
Section
Research Articles

The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.

 

References

1. Atkin DM, Fithian DC, Marangi KS, Stone ML, Dobson BE, Mendelsohn C. Characteristics of patients with primary acute lateral patellar dislocation and their recovery within the first 6 months of injury. Am J Sports Med. 2000;28:472–479.
2. Stefancin J, Parker R. First-time traumatic patellar dislocation: a systematic review. ClinOrthopRelat Res. 2007;455:93–101.
3. Maenpaa H, Huhtala H, Lehto MU. Recurrence after patellar dislocation: redislocation in 37/75 patients followed for 6-24 years. ActaOrthop Scand. 1997;68:424–426.
4. S.Mu.L.T. first-time patellar dislocation guidelines.Muscles Ligaments Tendons J. 2017 Jan-Mar; 7(1): 1–10.
5. Sandmeier R.H., Burks R.T., Bachus K.N., Billings A. The effect of reconstruction of the medial patellofemoral ligament on patellar tracking. Am J Sports Med. 2000;28:345–49.
6. .Smirk C., Morris H. The anatomy and reconstruction of the medial patello femoral ligament.Knee. 2003;10:221–27.
7. Nomura E, Horiuchi Y, Inoue M. Correlation of MR imaging findings and open exploration of medial patellofemoral ligament injuries in acute patellar dislocations. Knee. 2002;9:139–143.
8. Amis AA , Firer P et al. Anatomy and biomechanics of medial patellofemoral ligament. Knee 2003;10(3):215-220.
9. Nomura E, Inoue M. Surgical technique and rationale for medial patellofemoral ligament reconstruction for recurrent patellar dislocation. Arthroscopy. 2003;19:May-Jun;19(5):E47
10. Dopirak RM1, Steensen RN, MaurusPB.The medial patella- femoralligament.Orthopedics. 2008 Apr;31(4):331-8.
11. Warren LF, Marshall JL. The supporting structures and layers on the medial side of the knee: an anatomical analysis. J Bone Joint Surg Am. 1979 Jan;61(1):56-62.
12. Panni A, Vasso M, Cerciello S. Acute patellar dislocation. What to do? Knee Surg Sports TraumatolArthrosc. 2013;21:275–278.
13. NomuraE, InoueM, Osada N. Anatomical Analysis of the medical patella femoral ligament of the knee, especially the femoral attachment .Kneesurge Sports TraumatolArthrosc.2005;13(7):510–15.
14. Kyung H.-S., Kim H.-J. Medial patellofemoral ligament reconstruction: A comprehensive review. Knee SurgRelat Res. 2015;27:133–140.
15. Song S.Y., Kim I.S., Chang H.G., Shin J.-H., Kim H.J., Seo Y.-J. Anatomic medial patellofemoral ligament reconstruction using patellar suture anchor fixation for recurrent patellar instability.KneeSurg Sports TraumatolArthrosc. 2014;22:2431–37.
16. Amis AA, Senavongse W, Darcy P: Biomechanics of patellofemoral joint prostheses. ClinOrthoRelat Res 2005; 436:20.
17. ZhongguoGuShang.Injury and reconstruction of medial patellofemoral ligament. 2010 Mar;23(3):189-93
18. Schottle PB, Romero J, Schmeli A, Weiler A. Technical note: anatomical reconstruction of the medial patellofemoral ligament using a free gracilisautograft. Arch Orthop Trauma Surg. 2008;128:479–84.
19. Tariq Hendawi, Brian Godshaw et al. Autograft Vs Allograft in paediatric medial patellofemoral ligament reconstruction. Ochsner J,2019 summer;19(2):96-101
20. Muneta T, Sekiya I, Tsuchiya M, Shinomiya K. A technique for reconstruction of the medial patellofemoral ligament. CORR. 1999;359:151–155.
21. Schock EJ, Burks RT. Medial Patellofemoral ligament reconstruction using a hamstring graft. Op Tech Sports Med. 2001;9:169–175.
22. Fernandez E, Sala D, Castejon M. Reconstruction of the medial patellofemoral ligament for patella instability using a semiteninosusautograft. ActaOrthop Belg. 2005;71:303–308.
23. Farr J, Schepsis AA. Reconstruction of the medial patellofemoral ligament for recurrent patella instability. J Knee Surg. 2006;19:307–316.
24. Ellera Gomes JL. Medial patellofemoral ligament reconstruction for recurrent dislocation of the patella: a preliminary report. Arthroscopy. 1992;8:335–340.
25. Nomura E, Horiuchi Y, Kihara M. A mid-term follow-up of medial patellofemoral ligament reconstruction using an artificial ligament for recurrent patella dislocation. The Knee. 2000;7:211–215.
26. Ellera Gomes JL, Stigler Marczyk LR, César de César P, Jungblut CF. Medial patellofemoral ligament reconstruction with semitendinosus autograft for chronic patellar instability: A followup study. Arthroscopy. 2004;20:147–51. [PubMed] [Google Scholar]
27. Steiner TM, Torga-Spak R, Teitge RA. Medial patellofemoral ligament reconstruction in patients with lateral patellar instability and trochlear dysplasia. Am J Sports Med. 2006;34:1254–61. [PubMed] [Google Scholar]
28. Deie M, Ochi M, Sumen Y, Adachi N, Kobayashi K, Yasumoto M. A long term followup study after medial patellofemoral ligament reconstruction using the transferred semitendinosus tendon for patellar dislocation. Knee Surg Sports TraumatolArthrosc. 2005;13:522–8. [PubMed] [Google Scholar]
29. Drez D, Jr, Edwards TB, Williams CS. Results of medial patellofemoral ligament reconstruction in the treatment of patellar dislocation. Arthroscopy. 2001;17:298–306. [PubMed] [Google Scholar]
30. Schöttle PB, Fucentese SF, Romero J. Clinical and radiological outcome of medial patellofemoral ligament reconstruction with a semitendinosus autograft for patella instability. Knee Surg Sports TraumatolArthrosc. 2005;13:516–21. [PubMed] [Google Scholar]
31. Brown et al,. 1984. Brown DE, Alexander AH, Lichtman D: The Elmslie-Trillat procedure: evaluation in patellar dislocation and subluxation. Am J Sports Med 1984; 12:104.