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Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 22, Issue 10, pp 2364–2371 | Cite as

Simulation of the optimal femoral insertion site in medial patellofemoral ligament reconstruction

  • Shinya Oka
  • Takehiko MatsushitaEmail author
  • Seiji Kubo
  • Tomoyuki Matsumoto
  • Hiroyuki Tajimi
  • Masahiro Kurosaka
  • Ryosuke Kuroda
Knee

Abstract

Purpose

To develop and validate a new simulation system to predict the optimal femoral insertion site of the medial patellofemoral ligament (MPFL) using preprogrammed conditions of graft length change.

Methods

A computed tomography scan was performed for constructing bone surface models of the patella and the femur. Lateral radiographs of the knee and axial radiographs of the patellofemoral joint at knee flexion were used for constructing a three-dimensional patellofemoral joint model by 3D–2D image matching at each knee flexion angle. To determine the optimal femoral insertion site, the following three conditions were devised: (1) MPFL behaves isometric from 0° to 60°, (2) MPFL is most taut at full extension, and (3) MPFL is slack at more than 60° of knee flexion. Every condition was applied to the femoral bone surface model, and the area that fulfilled all three conditions was defined as the optimal femoral insertion site of MPFL. Twenty knees of ten healthy volunteers were assessed to verify the simulation. Comparison between simulated optimal femoral insertion and anatomical insertion was done.

Results

The mean simulated optimal femoral insertion was close to the anatomical insertion site. There were no significant differences in the proximal–distal position and anterior–posterior position between the simulated insertion and the anatomical insertion sites.

Conclusion

The system can be useful for predicting the optimal femoral insertion site as a part of a preoperative plan for MPFL reconstruction, and it may help surgeons to determine the optimal femoral insertion site during MPFL reconstruction.

Keywords

Medial patellofemoral ligament Reconstruction Simulation Femoral insertion 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Shinya Oka
    • 1
  • Takehiko Matsushita
    • 1
    Email author
  • Seiji Kubo
    • 1
  • Tomoyuki Matsumoto
    • 1
  • Hiroyuki Tajimi
    • 2
  • Masahiro Kurosaka
    • 1
  • Ryosuke Kuroda
    • 1
  1. 1.Department of Orthopaedic SurgeryKobe University Graduate School of MedicineKobeJapan
  2. 2.Department of Mechanical EngineeringKobe University Graduate School of EngineeringKobeJapan

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