Mid-term outcome of medial patellofemoral ligament reconstruction by hamstring tendon autograft

doi:10.3969/j.issn.2095-4344.2014.42.019

Abstract

Abstract:

BACKGROUND: Autologous hamstring tendon reconstruction of the medial patellofemoral ligament is now more popular surgical procedure.
OBJECTIVE: To study the clinical mid-term outcomes of isolated medial patellofemoral ligament reconstruction for recurrent lateral patellar dislocation.
METHODS: The clinical data of 24 patients (25 knees) undergoing medial patellofemoral ligament reconstruction for recurrent patellar dislocation from September 2006 to September 2009 were retrospectively studied. Clinical, functional, and CT outcomes were assessed at an average of 3.1 years after surgery (range, 2-5 years), using recurrent instability as the primary end point.
RESULTS AND CONCLUSION: The success rate of medial patellofemoral ligament reconstruction for preventing recurrent dislocations was 92%. Two patients (8%) experienced a recurrent lateral patellar dislocation, and required a reoperation. At final follow-up, the mean IKDC, Tenger and Lycholm scores were significantly higher than those before operation (P < 0.01). Reconstruction of the medial patellofemoral ligament for recurrent patellar instability is a minimally invasive operation and has a number of benefits. The mid-term clinical outcome was satisfactory.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

全文链接：

Key words: ligaments, tendons, internal fixators, patella

CLC Number:

R318

Ren Yi-zhong, Han Chang-xu, Jia Yan-bo, Kong Ling-yue, Eerguotu. Mid-term outcome of medial patellofemoral ligament reconstruction by hamstring tendon autograft[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(42): 6822-6826.

Figures/Tables 2

References

[1] Sallay PI, Poggi J, Speer KP, et al. Acute dislocation of the patella. Am J Sports Med. 1996;24(1):52-60.
[2] Desio SM, Burks RT, Bachus KN. Soft tissue restraints to lateral patellar translation in the human knee. Am J Sports Med. 1998;26(1):59-65.
[3] Nomura E, Inoue M. Hybrid medial patellofemoral ligament reconstruction using the semitendinous tendon for recurrent patellar dislocation: minimum 3 years’ follow-up. Arthroscopy. 2006;22(7):787-793.
[4] Duchman KR, DeVries NA, McCarthy MA, et al. Biomechanical evaluation of medial patellofemoral ligament reconstruction.Lowa Orthop J. 2013;33:64-69.
[5] Ronga M, Oliva F, Longo UG, et al. Isolated medial patellofemoral ligament reconstruction for recurrent patellar dislocation. Am J Sports Med. 2009;37(9):1735-1742.
[6] Bicos J, Fulkerson JP, Amis A, et al. Current concepts review: the medial patellofemoral ligament. Am J Sports Med. 2007; 35(3):484-492.
[7] Amis AA, Firer P, Mountney J, et al. Anatomy and biomechanics of the medial patellofemoral ligament. Knee. 2003;10(3):215-220.
[8] Mountney J, Senavongse W, Amis AA, et al. Tensile strength of the medial patellofemoral ligament before and after repair or reconstruction. J Bone Joint Surg Br. 2005; 87(1):36-40.
[9] Singhal R, Rogers S, Charalambous CP. Double-bundle medial patellofemoral ligament reconstruction with hamstring tendon autograft and mediolateral patellar tunnel fixation: a meta-analysis of outcomes and complications. Bone Joint J. 2013;95-B(7):900-905.
[10] Matic GT, Magnussen RA, Kolovich GP, et al. Return to activity after medial patellofemoral ligament repair or reconstruction. Arthroscopy. 2014;30(8):1018-1025.
[11] Camp CL1, Krych AJ, Dahm DL, et al. Medial patellofemoral ligament repair. Am J Sports Med. 2010;2248-2254.
[12] Kang H, Cao J, Yu D, et al. Comparison of 2 different techniques for anatomic reconstruction of the medial patellofemoral ligament: a prospective randomized study. Am J Sports Med. 2013;41(5):1013-1021.
[13] Raghuveer RK, Mishra CB. Reconstruction of medial patellofemoral ligament for chronic patellar instability. Indian J Orthop. 2012;46(4):447-454.
[14] Schepsis AA, Rogers AJ. Medial patellofemoral ligament reconstruction: indications and technique. Sports Med Arthrosc. 2012;20(3):162-170.
[15] Shah JN, Howard JS, Flanigan DC, et al. A systematic review of complications and failures associated with medial patellofemoral ligament reconstruction for recurrent patellar dislocation. Am J Sports Med. 2012;40(8):1916-1923.
[16] 姜少伟,徐斌,徐洪港,等.自体肌腱移植双束解剖重建内侧髌股韧带[J].中国组织工程研究,2012,16(18):3281-3284.
[17] Hopper GP, Leach WJ, Rooney BP, et al. Does degree of trochlear dysplasia and position of femoral tunnel influence outcome after medial patellofemoral ligament reconstruction? Am J Sports Med. 2014;42(3):716-722.
[18] Biedert R, Warnke K. Correlation between the Q angle and the patella position:a clinical and axial computed tomography evaluation. Arch Orthop Trauma Surg. 2001; 121(6):346-349.
[19] 桂斌捷,刘德宝,卢晓林,等.Q角测量评估膝关节软组织平衡和骨性手术治疗习惯性髌骨脱位的疗效[J].中国组织工程研究, 2011, 15(39):7238-7241.
[20] Servien E, Fritsch B, Lustig S, et al. In vivo positioning analysis of medial patellofemoral ligament reconstruction. Am J Sports Med. 2011;39(1):134-139.
[21] Baldwin JL.The anatomy of the medial patellofemoral ligament. Am J Sports Med. 2009;37(12):2355-2361.
[22] Schoettle PB, Schmeling A, Rosenstiel N, et al. Radiographic landmarks for femoral tunnel placement in medial patellofemoral ligament reconstruction. Am J Sports Med. 2007; 35(5):801-804.
[23] Carey JL, Dunn WR, Dahm DL, et al. A systematic review of anterior cruciate ligament reconstruction with autograft compared with allograft. J Bone Joint Surg Am. 2009;91(9): 2242-2250.
[24] Phornphutkul C, Gruber BF, Wojtys EM, et al.Incidence of positive intraoperative allograft cultures used in knee ligament reconstruction. J Knee Surg. 2009;22(3):191-195.
[25] Mikashima Y, Kimura M, Kobayashi Y, et al. Clinical results of isolated reconstruction of the medial patellofemoral ligament for recurrent dislocation and subluxation of the patella. Acta Orthop Belg. 2006;72(1):65-71.
[26] 纪刚,王飞,董江涛,等.双束解剖重建内侧髌股韧带联合胫骨结节转移术治疗复发性髌骨脱位的临床研究[J].中华关节外科杂志(电子版),2013,7(1)7-12.
[27] Deie M, Ochi M, Adachi N, et al. Medial patellofemoral ligament reconstruction with a cylindrical bone plug and a grafted semitendinosus tendon at the original femoral site for recurrent patellar dislocation. Am J Sports Med. 2011;39(1): 140-145.
[28] Wang CH, Ma LF, Zhou JW, et al. Double-bundle anatomical versus single-bundle isometric medial patellofemoral ligament reconstruction for patellar dislocation. Int Orthop. 2013;37(4): 617-624.
[29] Steensen RN, Dopirak RM, Maurus PB, et al. A simple technique for reconstruction of the medial patellofemoral ligament using a quadriceps tendon-graft. Arthroscopy. 2005; 21:365-370.
[30] State Council of the People's Republic of China. Administrative Regulations on Medical Institution. 1994-09-01.