Background: Several MPFL reconstructions are commonly performed for recurrent patellar dislocation, but misleading data are currently available in the literature on the ability of the different techniques to re-create a functioning ligament.
Materials And Methods: In this study, we showed the biomechanical properties of two different procedures for MPFL reconstruction using a natural orientation during uniaxial tensile testing. Eighteen fresh-frozen human knees were randomly assigned to two groups of nine each. In the group A, the reconstruction was performed using a double converging tunnels technique and in the group B was used a single-tunnel technique with semitendinosus autograft. The specimens were loaded in natural orientation using an Instron tensile test machine, and the stiffness and ultimate load were determined.
Results: The ultimate load was 213 ± 90 and 171 ± 51 N using our double-bundle technique (group A) and the single-bundle technique (group B), respectively. One (11 %) specimen failed at the patellar side due to patellar fracture in the group B. There was no statistical significant difference (p > 0.05) between the two groups in terms of stiffness and ultimate load.
Conclusion: This study is the first biomechanical evaluation of the MPFL reconstructions in natural orientation. Both the procedures achieved safe fixation of the graft at the femoral attachment; however, the single-bundle technique reported 11 % of failure at the patellar side due to patellar fracture. In addition, the double-bundle technique can better restore the anatomy of the native ligament.
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http://dx.doi.org/10.1007/s12306-016-0397-0 | DOI Listing |
J Knee Surg
January 2025
Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Shijingshan District, Beijing, People's Republic of China.
Single-bundle (SB) and double-bundle (DB) anterior cruciate ligament reconstruction (ACLR) have been compared for years, and long-term outcomes of the two techniques remain inconclusive. We compared the 10-year outcomes of SB and DB reconstruction, in terms of subjective scores, knee stability, graft failure, and osteoarthritis (OA). We searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials for relevant studies, without restrictions on study design, language, or publication date.
View Article and Find Full Text PDFKnee
January 2025
Department of Orthopaedics and Traumatology, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
Background: The aim of this study was to predict intraoperative graft diameter with our new method by evaluating the cross-sectional areas (CSAs) of the hamstrings in axial sections of MRI.
Methods: This study included 78 patients who underwent single-bundle ACLR between 2022 and 2023. MRIs of the patients were evaulated preoperatively and four CSAs of the hamstring tendons were measured in two different regions by two participants.
Arthrosc Tech
December 2024
Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A.
The medial patellofemoral complex provides the primary static restraint to lateral patellar translation and is composed of the medial patellofemoral ligament and medial quadriceps tendon femoral ligament. Multiple techniques including medial patellofemoral ligament and/or medial quadriceps tendon femoral ligament reconstruction have demonstrated good results; however, modification of the femoral fixation technique is required for skeletally immature patients or revision cases in which anatomic bony fixation on the femur is not possible. This technique describes an all-soft-tissue procedure for single-bundle medial patellofemoral complex reconstruction in which the graft is fixed on the adductor tendon while using the medial collateral ligament as a distalizing pulley, for anatomic and isometric recreation of the native ligament.
View Article and Find Full Text PDFZhongguo Yi Xue Ke Xue Yuan Xue Bao
December 2024
Department of Sport and Rehabilitation Medicine,Beijing Chao-Yang Hospital, Capital Medical University,Beijing 100020,China.
Objective To compare the five-year subjective functional outcomes of single-bundle anterior cruciate ligament reconstruction (ACLR) with three different femoral tunnel positions under arthroscopic guidance. Methods A retrospective study was conducted on the clinical data of 165 patients who underwent ACLR at the Department of Sports Traumatology,Sports Hospital,National Institute of Sports Medicine,General Administration of Sport of China from January 2012 to December 2017.According to femoral tunnel positions,the patients were assigned into three groups of low centre (LC)section (=53),high centre (HC) section (=45),and high anterior medial (HAM) section (=67).
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