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Patellofemoral Instability: Medial Patellofemoral Ligament (MPFL) Reconstruction

  • E. Carlos Rodríguez-Merchán
  • Carlos Encinas-Ullán
  • Primitivo Gómez-Cardero
Chapter

Abstract

Medial patellofemoral ligament (MPFL) reconstruction is a procedure that is routinely carried out for patellar instability; however several questions remain. In this chapter, we report the results of MPFL reconstruction in isolation and in combination with other procedures. The results using different surgical techniques in different patient groups are compared.

Keywords

Patellar instability Recurrent dislocation MPFL reconstruction Surgical techniques Results 

References

  1. 1.
    Aframian A, Smith TO, Tennent TD, Cobb JP, Hing CB. Origin and insertion of the medial patellofemoral ligament: a systematic review of anatomy. Knee Surg Sports Traumatol Arthrosc. 2017;25:3755–72.CrossRefGoogle Scholar
  2. 2.
    Amis AA, Firer P, Mountney J, Senavongse W, Thomas NP. Anatomy and biomechanics of the medial patellofemoral ligament. Knee. 2003;10:215–20.CrossRefGoogle Scholar
  3. 3.
    Goyal D. Medial patellofemoral ligament reconstruction: the superficial quad technique. Am J Sports Med. 2013;41:1022–9.CrossRefGoogle Scholar
  4. 4.
    Parikh SN, Nathan ST, Wall EJ, Eismann EA. Complications of medial patellofemoral ligament reconstruction in young patients. Am J Sports Med. 2013;41:1030–8.CrossRefGoogle Scholar
  5. 5.
    Hinterwimmer S, Imhoff AB, Minzlaff P, Saier T, Rosenstiel N, Hawe W, Feucht MJ. Anatomical two-bundle medial patellofemoral ligament reconstruction with hardware-free patellar graft fixation: technical note and preliminary results. Knee Surg Sports Traumatol Arthrosc. 2013;21:2147–54.CrossRefGoogle Scholar
  6. 6.
    Buckens CF, Saris DB. Reconstruction of the medial patellofemoral ligament for treatment of patellofemoral instability: a systematic review. Am J Sports Med. 2010;38:181–8.CrossRefGoogle Scholar
  7. 7.
    Fisher B, Nyland J, Brand E, Curtin B. Medial patellofemoral ligament reconstruction for recurrent patellar dislocation: a systematic review including rehabilitation and return-to-sports efficacy. Arthroscopy. 2010;26:1384–94.CrossRefGoogle Scholar
  8. 8.
    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.CrossRefGoogle Scholar
  9. 9.
    Smith TO, Walker J, Russell N. Outcomes of medial patellofemoral ligament reconstruction for patellar instability: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2007;15:1301–14.CrossRefGoogle Scholar
  10. 10.
    McNeilan RJ, Everhart JS, Mescher PK, Abouljoud M, Magnussen RA, Flanigan DC. Graft choice in isolated medial Patellofemoral ligament reconstruction: a systematic review with meta-analysis of rates of recurrent instability and patient-reported outcomes for autograft, allograft, and synthetic options. Arthroscopy. 2018;34:1340–54.CrossRefGoogle Scholar
  11. 11.
    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.CrossRefGoogle Scholar
  12. 12.
    Weinberger JM, Fabricant PD, Taylor SA, Mei JY, Jones KJ. Influence of graft source and configuration on revision rate and patient-reported outcomes after MPFL reconstruction: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2017;25:2511–9.CrossRefGoogle Scholar
  13. 13.
    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.CrossRefGoogle Scholar
  14. 14.
    Sanchis-Alfonso V, Montesinos-Berry E, Ramirez-Fuentes C, Leal-Blanquet J, Gelber PE, Monllau JC. Failed medial patellofemoral ligament reconstruction: causes and surgical strategies. World J Orthop. 2017;8:115–29.CrossRefGoogle Scholar
  15. 15.
    Kang H, Cao J, Yu D, Zheng Z, Wang F. Comparison of 2 different techniques for anatomic reconstruction of the medial patellofemoralligament: a prospective randomized study. Am J Sports Med. 2013;41:1013–21.CrossRefGoogle Scholar
  16. 16.
    Becher C, Kley K, Lobenhoffer P, Ezechieli M, Smith T, Ostermeier S. Dynamic versus static reconstruction of the medial patellofemoral ligament for recurrent lateral patellar dislocation. Knee Surg Sports Traumatol Arthrosc. 2014;22:2452–7.CrossRefGoogle Scholar
  17. 17.
    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:900–5.CrossRefGoogle Scholar
  18. 18.
    Schneider DK, Grawe B, Magnussen RA, Ceasar A, Parikh SN, Wall EJ, Colosimo AJ, Kaeding CC, Myer GD. Outcomes after isolated medial patellofemoral ligament reconstruction for the treatment of recurrent lateral patellar dislocations: a systematic review and meta-analysis. Am J Sports Med. 2016;44:2993–3005.CrossRefGoogle Scholar
  19. 19.
    Stupay KL, Swart E, Shubin Stein BE. Widespread implementation of medial patellofemoral ligament reconstruction for recurrent patellar instability maintains functional outcomes at midterm to long-term follow-up while decreasing complication rates: a systematic review. Arthroscopy. 2015;31:1372–80.CrossRefGoogle Scholar
  20. 20.
    Kita K, Tanaka Y, Toritsuka Y, Amano H, Uchida R, Takao R, Horibe S. Factors affecting the outcomes of double-bundle medial patellofemoral ligament reconstruction for recurrent patellar dislocations evaluated by multivariate analysis. Am J Sports Med. 2015;43:2988–96.CrossRefGoogle Scholar
  21. 21.
    Liu JN, Brady JM, Kalbian IL, Strickland SM, Ryan CB, Nguyen JT, Shubin Stein BE. Clinical outcomes after isolated medial patellofemoral ligament reconstrution for patellar instability among patients with trochlear dysplasia. Am J Sports Med. 2018;46:833–9.Google Scholar
  22. 22.
    Matsushita T, Oka S, Araki D, Nishida K, Tanaka T, Kanzaki N, Nishida K, Kuroda R. Patient-based outcomes after medial patellofemoral ligament reconstruction. Int Orthop. 2017;41:1147–53.CrossRefGoogle Scholar
  23. 23.
    Chatterton A, Nielsen TG, Sørensen OG, Lind M. Clinical outcomes after revision surgery for medial patellofemoral ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2018;26:739–45.CrossRefGoogle Scholar
  24. 24.
    Burnham JM, Howard JS, Hayes CB, Lattermann C. Medial patellofemoral ligament reconstruction with concomitant tibial tubercle transfer: a systematic review of outcomes and complications. Arthroscopy. 2016;32:1185–95.CrossRefGoogle Scholar
  25. 25.
    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.CrossRefGoogle Scholar
  26. 26.
    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.CrossRefGoogle Scholar
  27. 27.
    Banke IJ, Kohn LM, Meidinger G, Otto A, Hensler D, Beitzel K, Imhoff AB, Schöttle PB. Combined trochleoplasty and MPFL reconstruction for treatment of chronic patellofemoralinstability: a prospective minimum 2-year follow-up study. Knee Surg Sports Traumatol Arthrosc. 2014;22:2591–8.CrossRefGoogle Scholar
  28. 28.
    von Engelhardt LV, Weskamp P, Lahner M, Spahn G, Jerosch J. Deepening trochleoplasty combined with balanced medial patellofemoral ligament reconstruction for an adequate graft tensioning. World J Orthop. 2017;8:935–45.CrossRefGoogle Scholar
  29. 29.
    Nelitz M, Dreyhaupt J, Reichel H, Woelfle J, Lippacher S. Anatomic reconstruction of the medial patellofemoral ligament in children and adolescents with open growth plates: surgical technique and clinical outcome. Am J Sports Med. 2013;41:58–63.CrossRefGoogle Scholar
  30. 30.
    Lind M, Enderlein D, Nielsen T, Christiansen SE, Faunø P. Clinical outcome after reconstruction of the medial patellofemoral ligament in paediatric patients with recurrent patella instability. Knee Surg Sports Traumatol Arthrosc. 2016;24:666–71.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • E. Carlos Rodríguez-Merchán
    • 1
  • Carlos Encinas-Ullán
    • 1
  • Primitivo Gómez-Cardero
    • 1
  1. 1.Department of Orthopaedic Surgery“La Paz” University Hospital-IdiPazMadridSpain

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