Influencing factors of medial patellofemoral ligament reconstruction for patellar dislocation_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

GAO Zhitao ¹ ,  LI Yanlin ² , WANG Guoliang ² , CAI Guofeng ²

1. The 4th Department of Surgery, the People’s Hospital of Anning, Anning Yunnan, 650300, P.R.China;
2. Department of Sports Medicine, the First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, 650032, P.R.China;

Corresponding author：

LI Yanlin, Email: 852387873@qq.com

Keywords：

Patellar dislocation; medial patellofemoral ligament; ligament reconstruction; influencing factor

DOI：

10.7507/1002-1892.201710049

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Objective To review the influencing factors of medial patellofemoral ligament (MPFL) reconstruction for patellar dislocation. Methods The literature of MPFL reconstruction for patellar dislocation at home and abroad in recent years were summarized and analyzed. Results The influencing factors such as the location of the femoral insertion point, the tension and the fixed angle of the grafts, the dysplasia of the femoral trochlear before operation, the abnormal tuberositas tibiae-trochlear groove value, the high position of the patellar, and the tilting angle of the patellar, are all the factors affecting the effectiveness of MPLF reconstruction. Conclusion During MPFL reconstruction, the surgical techniques and elimination of other factors that caused patellar instability need to be focused in order to reduce the complications and operation failure.

Citation： GAO Zhitao, LI Yanlin, WANG Guoliang, CAI Guofeng. Influencing factors of medial patellofemoral ligament reconstruction for patellar dislocation. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(8): 1047-1051. doi: 10.7507/1002-1892.201710049 Copy

1.	Shah JN, Howard JS, Flanigan DC, et al. A systematic review of complications and failures associated with medial patellofemoral ligament reconstruction for recurrent patellar dislocation. Am J Sports Med, 2012, 40(8): 1916-1923.
2.	Parikh SN, Nathan ST, Wall EJ, et al. Complications of medial patellofemoral ligament reconstruction in young patients. Am J Sports Med, 2013, 41(5): 1030-1038.
3.	Sanchis-Alfonso V, Ramirez-Fuentes C, Montesinos-Berry E, et al. Femoral insertion site of the graft used to replace the medial patellofemoral ligament influences the ligament dynamic changes during knee flexion and the clinical outcome. Knee Surg Sports Traumatol Arthrosc, 2017, 25(8): 2433-2441.
4.	Stephen JM, Kaider D, Lumpaopong P, et al. The effect of femoral tunnel position and graft tension on patellar contact mechanics and kinematics after medial patellofemoral ligament reconstruction. Am J Sports Med, 2014, 42(2): 364-372.
5.	Thaunat M, Erasmus PJ. Management of overtight medial patellofemoral ligament reconstruction. Knee Surg Sports Traumatol Arthrosc, 2009, 17(5): 480-483.
6.	Sanchis-Alfonso V, Montesinos-Berry E, Ramirez-Fuentes C, et al. Failed medial patellofemoral ligament reconstruction: Causes and surgical strategies. World J Orthop, 2017, 8(2): 115-129.
7.	Tanaka MJ. Variability in the patellar attachment of the medial patellofemoral ligament. Arthroseopy, 2016, 32(8): 1667-1670.
8.	Kang HJ, Wang F, Chen BC, et al. Functional bundles of the medial patellofemoral ligament. Knee Surg Sports Traumatol Arthrosc, 2010, 18(11): 1511-1516.
9.	Nelitz M, Dornacher D, Dreyhaupt J, et al. The relation of the distal femoral physis and the medial patellofemoral ligament. Knee Surg Sports Traumatol Arthrosc, 2011 , 19(12): 2067-2071.
10.	Kepler CK, Bogner EA, Hammoud S, et al. Zone of injury of the medial patellofemoral ligament after acute patellar dislocation in children and adolescents. Am J Sports Med, 2011, 39(7): 1444-1449.
11.	Schöttle PB, Schmeling A, Rosenstiel N, et al. Radiographic landmarks for femoral tunnel placement in medial patellofemoral ligament reconstruction. Am J Sports Med, 2007, 35(5): 801-804.
12.	Stephen JM, Lumpaopong P, Deehan DJ, et al. The medial patellofemoral ligament: location of femoral attachment and length change patterns resulting from anatomic and nonanatomic attachments. Am J Sports Med, 2012, 40(8): 1871-1879.
13.	Sanchis-Alfonso V, Ramirez-Fuentes C, Montesinos-Berry E, et al. Does radiographic location ensure precise anatomic location of the femoral fixation site in medial patellofemoral ligament surgery? Knee Surg Sports Traumatol Arthrosc, 2016, 24(9): 2838-2844.
14.	Ziegler CG, Fulkerson JP, Edgar C. Radiographic reference points are inaccurate with and without a true lateral radiograph. Am J Sports Med, 2016, 44(1): 133-142.
15.	Fujino K, Tajima G, Yan J, et al. Morphology of the femoral insertion site of the medial patellofemoral ligament. Knee Surg Sports Traumatol Arthrosc, 2015, 23(4): 998-1003.
16.	Kikuchi S, Tajima G, Yan J, et al. Morphology of insertion sites on patellar side of medial patellofemoral ligament. Knee Surg Sports Traumatol Arthrosc, 2017, 25(8): 2488-2493.
17.	Barnett AJ, Howells NR, Burston BJ, et al. Radiographic landmarks for tunnel placement in reconstruction of the medial patello-femoral ligament. Knee Surg Sports Traumatol Arthrosc, 2012, 20(12): 2380-2384.
18.	Weinberger JM, Fabricant PD, Taylor SA, et al. Influence of graft source and configuration on revision rate and patient-reported outcomes after MPFL reconstruction: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc, 2016, 25(8): 2511-2519.
19.	Sanchis-Alfonso V. Guidelines for medial patellofemoral ligament reconstruction in chronic lateral patellar instability. J Am Acad Orthop Surg, 2014, 22(3): 175-182.
20.	Fabricant PD, Ladenhauf HN, Salvati EA, et al. Medial patellofemoral ligament (MPFL) reconstruction improves radiographic measures of patella alta in children. Knee, 2014, 21(6): 1180-1184.
21.	Arendt EA. Medial side patellofemoral anatomy: surgical implications in patellofemoral instability//Patellofemoral Pain, Instability, and Arthritis. Berlin: Springer, 2010: 149-152.
22.	Yoo YS, Chang HG, Seo YJ, et al. Changes in the length of the medial patellofemoral ligament: An in vivo analysis using 3-dimensional computed tomography. Am J Sports Med, 2012, 40(9): 2142-2148.
23.	Frederick MA, Canale ST, Beaty JH.Campbell’s operative orthopaedics. 13th eds. Philadelphia: Elsevier, 2017: 2346-2363.
24.	Antinolfi P, Bartoli M, Placella G, et al. Acute patellofemoral instability in children and adolescents. Joints, 2016, 4(1): 47-51.
25.	Lewallen L, McIntosh A, Dahm D. First-time patellofemoral dislocation: risk factors for recurrent instability. J Knee Surg, 2015, 28(4): 303-310.
26.	Nelitz M, Theile M, Dornacher D, et al. Analysis of failed surgery for patellar instability in children with open growth plates. Knee Surg Sports Traumatol Arthrosc, 2012, 20(5): 822-828.
27.	Wagner D, Pfalzer F, Hingelbaum S, et al. The influence of risk factors on clinical outcomes following anatomical medial patellofemoral ligament (MPFL) reconstruction using the gracilis tendon. Knee Surg Sports Traumatol Arthrosc, 2013, 21(2): 318-324.
28.	Kita K, Tanaka Y, Toritsuka Y, et al. Factors affecting the outcomes of double-bundle medial patellofemoral ligament reconstruction for recurrent patellar dislocations evaluated by multivariate analysis. Am J Sports Med, 2015, 43(12): 2988-2996.
29.	Fucentese SF, Zingg PO, Schmitt J, et al. Classification of trochlear dysplasia as predictor of clinical outcome after trochleoplasty. Knee Surg Sports Traumatol Arthrosc, 2011, 19(10): 1655-1661.
30.	Bollier M, Fulkerson JP. The role of trochlear dysplasia in patellofemoral instability. J Am Acad Orthop Surg, 2011, 19(1): 8-16.
31.	Matsushita T, Kuroda R, Oka S, et al. Clinical outcomes of medial patellofemoral ligament reconstruction in patients with an increased tibial tuberosity-trochlear groove distance. Knee Surg Sports Traumatol Arthrosc, 2014, 22(10): 2438-2444.
32.	Sanchis-Alfonso V. How to deal with chronic patellar instability: What does the literature tell us? Sports Health, 2016, 8(1): 86-90.
33.	Tischer T, Geier A, Lenz R, et al. Impact of the patella height on the strain pattern of the medial patellofemoral ligament after reconstruction: a computer model-based study. Knee Surg Sports Traumatol Arthrosc, 2016, 25(10): 3123-3133.
34.	Reider B, Marshall JL, Koslin B, et al. The anterior aspect of knee joint. J Bone Joint Surg (Am), 1981, 63(3): 351-356.
35.	李保灿, 殷晓东, 郭旗, 等. 髌骨倾斜角动态变化分析对髌股关节不稳的诊断价值. 临床放射学杂志, 2015, 34(8): 1329-1332.
36.	吴俊峰, 刘丽思, 郑卓肇, 等. MR 横断面定量测量指标对髌股关节不稳患者的诊断价值. 中华放射学杂志, 2014, 48(8): 659-663.

1. Shah JN, Howard JS, Flanigan DC, et al. A systematic review of complications and failures associated with medial patellofemoral ligament reconstruction for recurrent patellar dislocation. Am J Sports Med, 2012, 40(8): 1916-1923.
2. Parikh SN, Nathan ST, Wall EJ, et al. Complications of medial patellofemoral ligament reconstruction in young patients. Am J Sports Med, 2013, 41(5): 1030-1038.
3. Sanchis-Alfonso V, Ramirez-Fuentes C, Montesinos-Berry E, et al. Femoral insertion site of the graft used to replace the medial patellofemoral ligament influences the ligament dynamic changes during knee flexion and the clinical outcome. Knee Surg Sports Traumatol Arthrosc, 2017, 25(8): 2433-2441.
4. Stephen JM, Kaider D, Lumpaopong P, et al. The effect of femoral tunnel position and graft tension on patellar contact mechanics and kinematics after medial patellofemoral ligament reconstruction. Am J Sports Med, 2014, 42(2): 364-372.
5. Thaunat M, Erasmus PJ. Management of overtight medial patellofemoral ligament reconstruction. Knee Surg Sports Traumatol Arthrosc, 2009, 17(5): 480-483.
6. Sanchis-Alfonso V, Montesinos-Berry E, Ramirez-Fuentes C, et al. Failed medial patellofemoral ligament reconstruction: Causes and surgical strategies. World J Orthop, 2017, 8(2): 115-129.
7. Tanaka MJ. Variability in the patellar attachment of the medial patellofemoral ligament. Arthroseopy, 2016, 32(8): 1667-1670.
8. Kang HJ, Wang F, Chen BC, et al. Functional bundles of the medial patellofemoral ligament. Knee Surg Sports Traumatol Arthrosc, 2010, 18(11): 1511-1516.
9. Nelitz M, Dornacher D, Dreyhaupt J, et al. The relation of the distal femoral physis and the medial patellofemoral ligament. Knee Surg Sports Traumatol Arthrosc, 2011 , 19(12): 2067-2071.
10. Kepler CK, Bogner EA, Hammoud S, et al. Zone of injury of the medial patellofemoral ligament after acute patellar dislocation in children and adolescents. Am J Sports Med, 2011, 39(7): 1444-1449.
11. Schöttle PB, Schmeling A, Rosenstiel N, et al. Radiographic landmarks for femoral tunnel placement in medial patellofemoral ligament reconstruction. Am J Sports Med, 2007, 35(5): 801-804.
12. Stephen JM, Lumpaopong P, Deehan DJ, et al. The medial patellofemoral ligament: location of femoral attachment and length change patterns resulting from anatomic and nonanatomic attachments. Am J Sports Med, 2012, 40(8): 1871-1879.
13. Sanchis-Alfonso V, Ramirez-Fuentes C, Montesinos-Berry E, et al. Does radiographic location ensure precise anatomic location of the femoral fixation site in medial patellofemoral ligament surgery? Knee Surg Sports Traumatol Arthrosc, 2016, 24(9): 2838-2844.
14. Ziegler CG, Fulkerson JP, Edgar C. Radiographic reference points are inaccurate with and without a true lateral radiograph. Am J Sports Med, 2016, 44(1): 133-142.
15. Fujino K, Tajima G, Yan J, et al. Morphology of the femoral insertion site of the medial patellofemoral ligament. Knee Surg Sports Traumatol Arthrosc, 2015, 23(4): 998-1003.
16. Kikuchi S, Tajima G, Yan J, et al. Morphology of insertion sites on patellar side of medial patellofemoral ligament. Knee Surg Sports Traumatol Arthrosc, 2017, 25(8): 2488-2493.
17. Barnett AJ, Howells NR, Burston BJ, et al. Radiographic landmarks for tunnel placement in reconstruction of the medial patello-femoral ligament. Knee Surg Sports Traumatol Arthrosc, 2012, 20(12): 2380-2384.
18. Weinberger JM, Fabricant PD, Taylor SA, et al. Influence of graft source and configuration on revision rate and patient-reported outcomes after MPFL reconstruction: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc, 2016, 25(8): 2511-2519.
19. Sanchis-Alfonso V. Guidelines for medial patellofemoral ligament reconstruction in chronic lateral patellar instability. J Am Acad Orthop Surg, 2014, 22(3): 175-182.
20. Fabricant PD, Ladenhauf HN, Salvati EA, et al. Medial patellofemoral ligament (MPFL) reconstruction improves radiographic measures of patella alta in children. Knee, 2014, 21(6): 1180-1184.
21. Arendt EA. Medial side patellofemoral anatomy: surgical implications in patellofemoral instability//Patellofemoral Pain, Instability, and Arthritis. Berlin: Springer, 2010: 149-152.
22. Yoo YS, Chang HG, Seo YJ, et al. Changes in the length of the medial patellofemoral ligament: An in vivo analysis using 3-dimensional computed tomography. Am J Sports Med, 2012, 40(9): 2142-2148.
23. Frederick MA, Canale ST, Beaty JH.Campbell’s operative orthopaedics. 13th eds. Philadelphia: Elsevier, 2017: 2346-2363.
24. Antinolfi P, Bartoli M, Placella G, et al. Acute patellofemoral instability in children and adolescents. Joints, 2016, 4(1): 47-51.
25. Lewallen L, McIntosh A, Dahm D. First-time patellofemoral dislocation: risk factors for recurrent instability. J Knee Surg, 2015, 28(4): 303-310.
26. Nelitz M, Theile M, Dornacher D, et al. Analysis of failed surgery for patellar instability in children with open growth plates. Knee Surg Sports Traumatol Arthrosc, 2012, 20(5): 822-828.
27. Wagner D, Pfalzer F, Hingelbaum S, et al. The influence of risk factors on clinical outcomes following anatomical medial patellofemoral ligament (MPFL) reconstruction using the gracilis tendon. Knee Surg Sports Traumatol Arthrosc, 2013, 21(2): 318-324.
28. Kita K, Tanaka Y, Toritsuka Y, et al. Factors affecting the outcomes of double-bundle medial patellofemoral ligament reconstruction for recurrent patellar dislocations evaluated by multivariate analysis. Am J Sports Med, 2015, 43(12): 2988-2996.
29. Fucentese SF, Zingg PO, Schmitt J, et al. Classification of trochlear dysplasia as predictor of clinical outcome after trochleoplasty. Knee Surg Sports Traumatol Arthrosc, 2011, 19(10): 1655-1661.
30. Bollier M, Fulkerson JP. The role of trochlear dysplasia in patellofemoral instability. J Am Acad Orthop Surg, 2011, 19(1): 8-16.
31. Matsushita T, Kuroda R, Oka S, et al. Clinical outcomes of medial patellofemoral ligament reconstruction in patients with an increased tibial tuberosity-trochlear groove distance. Knee Surg Sports Traumatol Arthrosc, 2014, 22(10): 2438-2444.
32. Sanchis-Alfonso V. How to deal with chronic patellar instability: What does the literature tell us? Sports Health, 2016, 8(1): 86-90.
33. Tischer T, Geier A, Lenz R, et al. Impact of the patella height on the strain pattern of the medial patellofemoral ligament after reconstruction: a computer model-based study. Knee Surg Sports Traumatol Arthrosc, 2016, 25(10): 3123-3133.
34. Reider B, Marshall JL, Koslin B, et al. The anterior aspect of knee joint. J Bone Joint Surg (Am), 1981, 63(3): 351-356.
35. 李保灿, 殷晓东, 郭旗, 等. 髌骨倾斜角动态变化分析对髌股关节不稳的诊断价值. 临床放射学杂志, 2015, 34(8): 1329-1332.
36. 吴俊峰, 刘丽思, 郑卓肇, 等. MR 横断面定量测量指标对髌股关节不稳患者的诊断价值. 中华放射学杂志, 2014, 48(8): 659-663.

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Influencing factors of medial patellofemoral ligament reconstruction for patellar dislocation

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