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Eine neue Methode zur patellaren Fixation von MPFL-Transplantaten

A new method for patellar fixation of medial patellofemoral grafts

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Zusammenfassung

Zur operativen Versorgung der rezidivierenden Patellaluxation ist bei normalem TTTG-Abstand (TTTG „tibial tuberosity/trochlea groove“) die Rekonstruktion des medialen patellofemoralen Bandes (MPFL) mit einem autologen Sehnentransplantat eine Therapieoption. Ein technisches Problem war bisher die Fixation des Transplantats an der Patella.

Wir haben eine Technik etabliert, bei der die Schlaufen eines doppelsträngigen Transplantats in „blind“ endende 4,5- mal 10 mm messende Tunnel gezogen und mit einer Kordel aus Polyester (1 mm Ethibond) extrakortikal an der Patella fixiert werden. Dieses Verfahren ist kostengünstig und hat sich bisher in unserer klinischen Praxis bewährt. Fixationsspezifische Komplikationen sind bisher nicht aufgetreten.

Abstract

The reconstruction of the medial patellofemoral ligament (MPFL) with an autologous tendon graft is an option for treatment of patellar instability by normal tibial tuberosity/trochlea groove distances. A previous technical problem was the fixation of the graft to the patella. We have developed a technique with extracortical fixation of a double loop graft which is pulled through a blind ending 4.5x10 mm tunnel with a polyester cord (1 mm Ethibond). The technique is not expensive and has been successful in our daily clinical routine. Fixation-specific complications have not yet been observed.

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Literatur

  1. Amis AA (2007) Current concepts on anatomy and biomechanics of patellar stability. Sports Med Arthrosc 15(2):48–56. Review

    Article  PubMed  Google Scholar 

  2. Bicos J, Fulkerson JP, Amis A (2007) Current concepts review: the medial patellofemoral ligament. Am J Sports Med 35(3):484–492

    Article  PubMed  Google Scholar 

  3. Carmont MR, Maffulli N (2007) Medial patellofemoral ligament reconstruction: a new technique. BMC Musculoskelet Disord 8:22

    Article  PubMed  Google Scholar 

  4. Christiansen SE, Jacobsen BW, Lund B, Lind M (2008) Reconstruction of the medial patellofemoral ligament with gracilis tendon autograft in transverse patellar drill holes. Arthroscopy 24(1):82–87

    PubMed  Google Scholar 

  5. Feller JA, Amis AA, Andrish JT et al (2007) Surgical biomechanics of the patellofemoral joint. Arthroscopy 23(5):542–553

    PubMed  Google Scholar 

  6. Mikashima Y, Kimura M, Kobayashi Y et al (2006) Clinical results of isolated reconstruction of the medial patellofemoral ligament for recurrent dislocation and subluxation of the patella. Acta Orthop Belg 72(1):65–71

    PubMed  Google Scholar 

  7. Mountney J, Senavongse W, Amis AA, Thomas NP (2005) Tensile strength of the medial patellofemoral ligament before and after repair or reconstruction. J Bone Joint Surg [Br] 87(1):36–40

    Google Scholar 

  8. Schöttle PB, Fucentese SF, Romero J (2005) Clinical and radiological outcome of medial patellofemoral ligament reconstruction with a semitendinosus autograft for patella instability. Knee Surg Sports Traumatol Arthrosc 13(7):516–521

    Article  PubMed  Google Scholar 

  9. Schöttle PB, Schmeling A, Rosenstiel N, Weiler A (2007) Radiographic landmarks for femoral tunnel placement in medial patellofemoral ligament reconstruction. Am J Sports Med 35(5):801–804

    Article  PubMed  Google Scholar 

  10. Schöttle P, Schmeling A, Romero J, Weiler A (2009) Anatomical reconstruction of the medial patellofemoral ligament using a free gracilis autograft. Arch Orthop Trauma Surg 129(3):305–309

    Article  PubMed  Google Scholar 

  11. Schöttle P, Beitzel K, Imhoff A (2009) Die kindliche Patellaluxation. Anatomie, Pathomorphologie und Behandlungsstrategien. Arthroskopie 22:51–59

    Article  Google Scholar 

  12. Steensen RN, Dopirak RM, Maurus PB (2005) A simple technique for reconstruction of the medial patellofemoral ligament using a quadriceps tendon graft. Arthroscopy 21(3):365–370

    Article  PubMed  Google Scholar 

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Interessenkonflikt

Beratende Tätigkeit für die Fa. Karl Storz, Tuttlingen.

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Authors and Affiliations

  1. Klinik für Orthopädie und Unfallchirurgie, Martin-Luther-Krankenhaus Berlin, Caspar-Theyss-Str. 27-31, 14193, Berlin, Deutschland

    W. Petersen

  2. Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Münster, Deutschland

    T. Zantop

Authors
  1. W. Petersen
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  2. T. Zantop
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Correspondence to W. Petersen.

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Petersen, W., Zantop, T. Eine neue Methode zur patellaren Fixation von MPFL-Transplantaten. Arthroskopie 22, 237–240 (2009). https://doi.org/10.1007/s00142-009-0529-8

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  • DOI: https://doi.org/10.1007/s00142-009-0529-8

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