Skip to main content
SpringerLink
Log in

Bei Vorliegen einer relevanten Trochleadysplasie

MPFL-Rekonstruktion plus Trochleaplastik — ein gutes Team

  • Fortbildung
  • Published:
Orthopädie & Rheuma Aims and scope

Der alleinige Ersatz des medialen patellofemoralen Ligaments (MPFL) bei gleichzeitiger Trochleadysplasie führt in der Hälfte der Fälle zu Rezidivluxationen und zu einem nicht zufriedenstellenden Ergebnis. Deshalb sollte eine höhergradige Trochleadysplasie gleichzeitig adressiert werden. Bereits bei der Erstluxation kommt es in über 90 % der Fälle zu Rupturen des MPFL. Aus diesen Gründen wird zunehmend propagiert, die MPFL-Rekonstruktion und die Trochleaplastik gemeinsam durchzuführen.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5
Abb. 6
Abb. 7
Abb. 8
Abb. 9
Abb. 10
Abb. 11

Literatur

  1. Dejour H, Walch G, Nove-Josserand L, Guier C. Factors of patellar instability: an anatomic radiographic study. Knee Surg Sports Traumatol Arthrosc 1994;2:19–26

    Article  CAS  Google Scholar 

  2. Arendt EA, Moeller A, Agel J. Clinical outcomes of medial patellofemoral ligament repair in recurrent (chronic) lateral patella dislocations. Knee Surg Sports Traumatol Arthrosc 2011;19:1909–14

    Article  Google Scholar 

  3. Shah JN, Howard JS, Flanigan DC, Brophy RH, Carey JL, Lattermann C. A systematic review of complications and failures associated with medial patellofemoral ligament reconstruction for recurrent patellar dislocation. Am J Sports Med 2012;40:1916–23

    Article  Google Scholar 

  4. Jerosch J, Franz A, Aldinger P, eds. Knieteilersatz — Patellofemorale und femorotibiale Teilendoprothesen. Köln: Deutscher Ärzteverlag; 2012

  5. Insall J, Goldberg V, Salvati E. Recurrent dislocation and the high-riding patella. Clin Orthop Relat Res 1972;88:67–9

    Article  CAS  Google Scholar 

  6. Schoettle PB, Zanetti M, Seifert B, Pfirrmann CW, Fucentese SF, Romero J. The tibial tuberosity-trochlear groove distance; a comparative study between CT and MRI scanning. Knee 2006;13:26–31

    Article  Google Scholar 

  7. Hinterwimmer S, Rosenstiel N, Lenich A, Waldt S, Imhoff AB. Femorale Osteotomien bei patellofemoraler Instabilität. Unfallchirurg 2012;115:410–6

    Article  CAS  Google Scholar 

  8. Waldt S, Rummeny EJ. Bildgebung der patellofemoralen Instabilität. Radiologe 2012;52:1003–11

    Article  CAS  Google Scholar 

  9. 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;9:139–43

    Article  CAS  Google Scholar 

  10. von Engelhardt LV, Raddatz M, Bouillon B, Spahn D, Dàvid A, Haage P et al. How reliable is MRI in diagnosing cartilaginous lesions in patients with first and recurrent lateral patellar dislocations? BMC Musculoskelet Disord 2010;11:149

    Article  Google Scholar 

  11. Tanner SM, Garth WP Jr, Soileau R, Lemons JE. A modified test for patellar instability: the biomechanical basis. Clin J Sport Med 2003;13:327–38

    Article  Google Scholar 

  12. Lippacher S, Dejour D, Elsharkawi M, Dornacher D, Ring C, Dreyhaupt J et al. Observer agreement on the Dejour trochlear dysplasia classification: a comparison of true lateral radiographs and axial magnetic resonance images. Am J Sports Med 2012;40:837–43

    Article  Google Scholar 

  13. Albee F. The bone graft wedge in the treatment of habitual dislocation of the patella. Med Rec 1915;88:257–9

    Google Scholar 

  14. Masse Y. [Trochleoplasty. Restoration of the intercondylar groove in subluxations and dislocations of the patella]. Rev Chir Orthop Reparatrice Appar Mot 1978;64:3–17

    CAS  PubMed  Google Scholar 

  15. Dejour H, Walch G, Neyret P, Adeleine P. [Dysplasia of the femoral trochlea]. Rev Chir Orthop Reparatrice Appar Mot 1990;76:45–54

    CAS  PubMed  Google Scholar 

  16. Goutallier D, Raou D, Van Driessche S. [Retro-trochlear wedge reduction trochleoplasty for the treatment of painful patella syndrome with protruding trochleae. Technical note and early results]. Rev Chir Orthop Reparatrice Appar Mot 2002;88:678–85

  17. Beaufils P, Thaunat M, Pujol N, Scheffler S, Rossi R, Carmont M. Trochleoplasty in major trochlear dysplasia: current concepts. Sports Med Arthrosc Rehabil Ther Technol 2012;21: 7

    Article  Google Scholar 

  18. Thaunat M, Bessiere C, Pujol N, Boisrenoult P, Beaufils P. Recession wedge trochleoplasty as an additional procedure in the surgical treatment of patellar instability with major trochlear dysplasia: early results. Orthop Traumatol Surg Res 2011;97:833–45

    Article  CAS  Google Scholar 

  19. Bereiter H, Gautier E. Die Trochleaplastik als chirurgische Therapie der rezidivierenden Patellaluxation bei Trochleadysplasie des Femurs. Arthroskopie 1994;7:281–6

    Google Scholar 

  20. von Engelhardt LV, Fuchs T, Lahner M, Jerosch J. Implant-free, anatomical MPFL plastic: Clinical outcome and patient safety with a mean follow-up of 23 months. OUP 2014;7:346–51

    Google Scholar 

  21. von Engelhardt LV, Fuchs T, Weskamp P, Jerosch J. Effective patellofemoral joint stabilization and low complication rates using a hardware-free MPFL reconstruction technique with an intra-operative adjustment of the graft tension. Knee Surg Sports Traumatol Arthrosc 2017, doi: 10.1007/s00167-017-4723-3

    Article  Google Scholar 

  22. von Engelhardt LV, Weskamp P, Lahner M, Spahn G, Jerosch J. Deepening trochleoplasty combined with balanced medial patellofemoral ligamentreconstruction for an adequate graft tensioning. World J Orthop 2017;8:935–45

    Article  Google Scholar 

  23. Wagner D, Pfalzer F, Hingelbaum S, Huth J, Mauch F, Bauer G. The influence of risk factors on clinical outcomes following anatomical medial patellofemoral ligament (MPFL) reconstruction using the gracilis tendon. Knee Surg Sports Traumatol Arthrosc 2013;21:318–24

    Article  Google Scholar 

  24. Blønd L, Haugegaard M. Combined arthroscopic deepening trochleoplasty and reconstruction of the medial patellofemoral ligament for patients with recurrent patella dislocation and trochlear dysplasia. Knee Surg Sports Traumatol Arthrosc 2014;22:2484–90

    Article  Google Scholar 

  25. Schöttle PB, Schmeling A, Rosenstiel N, Weiler A. Radiographic landmarks for femoral tunnel placement in medial patellofemoral ligament reconstruction. Am J Sports Med 2007;35:801–4

    Article  Google Scholar 

  26. Schöttle PB, Schell H, Duda G, Weiler A. Cartilage viability after trochleoplasty. Knee Surg Sports Traumatol Arthrosc 2007;15:161–7

    Article  Google Scholar 

  27. von Knoch F, Böhm T, Bürgi ML, von Knoch M, Bereiter H. Trochleaplasty for recurrent patellar dislocation in association with trochlear dysplasia. A 4- to 14-year follow-up study. J Bone Joint Surg Br 2006;88:1331–5

    Article  CAS  Google Scholar 

  28. Utting MR, Mulford JS, Eldridge JD. A prospective evaluation of trochleoplasty for the treatment of patellofemoral dislocation and instability. J Bone Joint Surg Br 2008;90:180–5

    Article  CAS  Google Scholar 

  29. Nelitz M, Dreyhaupt J, Lippacher S. Combined trochleoplasty and medial patellofemoral ligament reconstruction for recurrent patellar dislocations in severe trochlear dysplasia: a minimum 2-year follow-up study. Am J Sports Med 2013;41:1005–12

    Article  Google Scholar 

  30. Fucentese SF, Schottle PB, Pfirrmann CW, Romero J. CT changes after trochleoplasty for symptomatic trochlear dysplasia. Knee Surg Sports Traumatol Arthrosc 2007;15:168–74

    Article  CAS  Google Scholar 

  31. Fucentese SF, Zingg PO, Schmitt J, Pfirrmann CW, Meyer DC, Koch PP. Classification of trochlear dysplasia as predictor of clinical outcome after trochleoplasty. Knee Surg Sports Traumatol Arthrosc 2011;19:1655–61

    Article  Google Scholar 

  32. Dejour D, Byn P, Ntagiopoulos PG. The Lyon®s sulcus-deepening trochleoplasty in previous unsuccessful patellofemoral surgery. Int Orthop 2013;37:433–9

    Article  Google Scholar 

  33. Donell ST, Joseph G, Hing CB, Marshall TJ. Modified Dejour trochleoplasty for severe dysplasia: Operative technique and early clinical results. Knee 2006;13:266–73

    Article  Google Scholar 

  34. Ntagiopoulos PG, Byn P, Dejour D. Midterm results of comprehensive surgical reconstruction including sulcus-deepening trochleoplasty in recurrent patellar dislocations with high-grade trochlear dysplasia. Am J Sports Med 2013;41:998–1004

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Abteilung für Orthopädie, Unfallchirurgie und Sportmedizin, Johanna-Etienne-Krankenhaus, Am Hasenberg 46, 41462, Neuss, Deutschland

    Jörg Jerosch, Pia Weskamp & Lars Victor von Engelhardt

  2. Private Universität Witten/Herdecke, Fakultät für Gesundheit, Witten, Deutschland

    Lars Victor von Engelhardt

Authors
  1. Jörg Jerosch
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pia Weskamp
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lars Victor von Engelhardt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jörg Jerosch.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jerosch, J., Weskamp, P. & von Engelhardt, L.V. MPFL-Rekonstruktion plus Trochleaplastik — ein gutes Team. Orthop. Rheuma 21, 46–51 (2018). https://doi.org/10.1007/s15002-018-1446-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s15002-018-1446-x

Search

Navigation