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Length change patterns and shape of a grafted tendon after anatomical medial patellofemoral ligament reconstruction differs from that in a healthy knee

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Recurrent patellar dislocation is currently treated with anatomical reconstruction of the medial patellofemoral ligament (MPFL), and favourable postoperative outcomes have been reported. However, it is uncertain if healthy MPFL function is restored by anatomical reconstruction. The hypothesis in this study was that stabilization of the patella following MPFL reconstruction would be improved compared with that before surgery, but that function of the grafted tendon would differ from that of a healthy MPFL. The objective was to analyse the length change patterns of the MPFL before surgery and the grafted tendon after surgery in patients with recurrent patellar dislocation treated with anatomical MPFL reconstruction.

Methods

The subjects were 12 patients (13 knees) in whom recurrent patellar dislocation was treated with anatomical MPFL reconstruction. The length change patterns of the MPFL and reconstructed ligament were analysed at extension and flexion of the knee joint using open MRI.

Results

The postoperative grafted tendon length was significantly shorter than that of the preoperative MPFL at knee extension, and significantly longer at 90° and 120° of knee flexion. The postoperative length of the grafted tendon only changed slightly from 0° to 30° of knee flexion, and then significantly decreased at flexion of 30° or more. The morphology of the grafted tendon was linear until 60° knee flexion, but became convex toward the extraarticular side at flexion of 90° or more.

Conclusion

The grafted tendon length at knee extension was shorter than that of the preoperative MPFL, but there was no significant difference at 30° flexion. These findings suggest that the effect of damping of the patella with a grafted tendon after MPFL reconstruction may differ from that in a healthy knee. In addition, the morphology at 60° knee flexion was improved to linear after surgery, suggesting that ligament morphology at this flexion was normalized by MPFL reconstruction.

Level of evidence

III.

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Authors and Affiliations

  1. Department of Sports and Para-Sports Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan

    Shuji Nakagawa & Yuji Arai

  2. Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Hiroaki Inoue, Manabu Hino, Yuta Fujii, Shintaro Komaki, Kazuya Ikoma, Keiichiro Ueshima, Hiroyoshi Fujiwara & Toshikazu Kubo

Authors
  1. Shuji Nakagawa
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  2. Yuji Arai
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  3. Hiroaki Inoue
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  4. Manabu Hino
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  5. Yuta Fujii
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  6. Shintaro Komaki
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  7. Kazuya Ikoma
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  8. Keiichiro Ueshima
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  9. Hiroyoshi Fujiwara
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  10. Toshikazu Kubo
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Corresponding author

Correspondence to Yuji Arai.

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Conflict of interest

All authors declare that they have no conflict of interest.

Funding

No funding was received for this study.

Ethical approval

This study was approved by the Institutional Review Board (Approval Number: ERB-C-268).

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Informed consent was obtained from all participants.

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Nakagawa, S., Arai, Y., Inoue, H. et al. Length change patterns and shape of a grafted tendon after anatomical medial patellofemoral ligament reconstruction differs from that in a healthy knee. Knee Surg Sports Traumatol Arthrosc 26, 1245–1251 (2018). https://doi.org/10.1007/s00167-017-4620-9

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