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Effects of medial patellofemoral ligament reconstruction on patellar tracking

Knee Surgery, Sports Traumatology, Arthroscopy volume 20, pages 829–837 (2012)Cite this article

Abstract

Purpose

Medial patellofemoral ligament (MPFL) reconstruction has been performed to treat recurrent patellar dislocation. However, the effects on patellar tracking have not been well documented, particularly in patients. The purpose of this study is to compare patellar tracking pattern and chondral status at MPFL reconstruction with those at second-look arthroscopy.

Methods

Between 1999 and 2008, 71 patients with recurrent patellar dislocation underwent MPFL reconstruction using a double-looped semitendinosus tendon. Of these, 25 knees in 24 patients underwent second-look arthroscopy (at 6–26 months after initial surgery), forming the subject for the present study. No other surgical procedures such as tibial tuberosity transfer, lateral release, or osteotomy were performed in any patients. To assess the patellar tracking pattern, the position of the patella on femoral groove was evaluated arthroscopically during passive knee motion through lateral suprapatellar portal.

Results

Before MPFL reconstruction, the patella in all patients was shifted laterally throughout the entire range of knee motion. Immediately after MPFL reconstruction, patellar malalignment was corrected in all cases. On second-look arthroscopy, two different patellar tracking patterns were observed. In 9 knees, the patella was located on the center of the femoral groove throughout the range of motion. Meanwhile, in the remaining 16 knees, the patella was shifted laterally at knee extension and migrated to the center of femoral groove with increased knee flexion. No significant deteriorations in chondral status were seen on second-look arthroscopy.

Conclusion

The present study revealed that not all improved patellar trackings after MPFL reconstruction remained intact at follow-up. Chondral status in patellofemoral joint was not aggravated by MPFL reconstruction.

Level of evidence

Therapeutic studies, Level IV.

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Conflict of interest

The authors report no conflict of interest.

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Affiliations

  1. Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan

    Keisuke Kita, Norimasa Nakamura, Tatsuo Mae, Ken Nakata & Hideki Yoshikawa

  2. Department of Sports Orthopaedics, Osaka Rosai Hospital, 1179-3, Nagasone-cho, Kita-ku, Sakai, Osaka, Japan

    Shuji Horibe, Yoshinari Tanaka & Yasukazu Yonetani

  3. Department of Orthopaedic Sports Medicine, Kansai Rosai Hospital, 3-1-69, Inaba-so, Amagasaki, Hyogo, Japan

    Yukiyoshi Toritsuka

  4. Faculty of Comprehensive Rehabilitation, Osaka Prefecture University, 3-7-30, Habikino, Habikino, Osaka, Japan

    Konsei Shino

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  1. Keisuke Kita
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  2. Shuji Horibe
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  3. Yukiyoshi Toritsuka
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  6. Yasukazu Yonetani
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  7. Tatsuo Mae
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  8. Ken Nakata
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Correspondence to Keisuke Kita.

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Kita, K., Horibe, S., Toritsuka, Y. et al. Effects of medial patellofemoral ligament reconstruction on patellar tracking. Knee Surg Sports Traumatol Arthrosc 20, 829–837 (2012). https://doi.org/10.1007/s00167-011-1609-7

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  • DOI: https://doi.org/10.1007/s00167-011-1609-7

Keywords

  • Lateral patellar dislocation
  • Medial patellofemoral ligament reconstruction
  • Second-look arthroscopy
  • Patellar tracking pattern
  • Chondral status