Knee squatting was simulated to characterize the influence of medial patellofemoral ligament (MPFL) reconstruction on patellar tracking and contact pressures for knees with mild patella alta (Caton-Deschamps index = 1.3-1.4). Eight computational models represented knees in the pre-operative condition and following MPFL reconstruction. MPFL reconstruction significantly reduced patellar lateral tracking at low flexion angles based on bisect offset index, significantly decreased the maximum lateral pressure in mid-flexion, and significantly increased the maximum medial pressure in mid-flexion. MPFL reconstruction improves patellar stability for knees with mild patella alta and can reduce the pressure applied to lateral cartilage on the patella.
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http://dx.doi.org/10.1080/10255842.2023.2168122 | DOI Listing |
Background: Medial patellofemoral ligament reconstruction (MPFLR) is an excellent surgical option for patients with recurrent patellar instability. This technique has demonstrated significant improvements in patient-reported outcomes, high rates of return to sport, and low rates of failure. However, there is debate regarding the use of isolated MPFLR in the setting of concomitant pathoanatomic features such as patella alta, trochlear dysplasia, or a lateralized tibial tubercle.
View Article and Find Full Text PDFAm J Sports Med
January 2025
Department of Sports Medicine, Peking University Third Hospital; Institute of Sports Medicine of Peking University; Beijing Key Laboratory of Sports Injuries, Beijing, China.
Background: There is a lack of evidence and continuous debate on whether femoral tunnel displacement substantially influences the clinical efficacy of medial patellofemoral ligament reconstruction (MPFL-R) in addressing recurrent patellar dislocation.
Purpose: To investigate possible associations between inaccurate femoral tunnel placement during MPFL-R and clinical outcomes, with a specific focus on proximal tunnel malpositioning.
Study Design: Cohort study; Level of evidence, 3.
J Knee Surg
January 2025
Lenox Hill Hospital Department of Orthopedic Surgery, Northwell Health, New York, United States.
Patellar instability following total knee arthroplasty (TKA) is a rare, yet serious complication, potentially requiring revision surgery or resulting in chronic dysfunction. When encountered, it is paramount to understand the etiologies, diagnostic approaches, treatment options, and outcomes of the selected treatment. The most common cause of patella instability is improper positioning of components, leading to lateral maltracking of the patella.
View Article and Find Full Text PDFJ Exp Orthop
January 2025
Department of Orthopedic Surgery and Traumatology, Freiburg University Hospital Albert Ludwigs University Freiburg Freiburg Germany.
Introduction: The medial patellofemoral ligament (MPFL) is the main patellar stabilizer in low knee flexion degrees (0-30°). Isolated MPFL reconstruction (MPFLr) is therefore considered the gold standard of surgical procedures for low flexion patellofemoral instabilities (PFIs). Despite excellent clinical results, little is known about the effect of MPFLr on kinematic parameters (KPs) of the patellofemoral joint in vivo.
View Article and Find Full Text PDFKnee Surg Sports Traumatol Arthrosc
December 2024
Sporthopaedicum, Berlin, Germany.
Purpose: Sulcus-deepening trochleoplasty (TP) effectively treats patellofemoral (PF) instability (PFI) caused by high-grade trochlear dysplasia (TD), but current evidence is based on small case series. We hypothesised, that TP would result in significant functional improvements and a low re-dislocation rate but would not accelerate the progression of PF cartilage deterioration.
Methods: We retrospectively reviewed all TP cases performed by a single surgeon between 2015 and 2021.
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