Research progress on femoral attachment positioning during medial patellofemoral ligament reconstruction_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YAN Peng’an ¹ , LU Fan ^1,2,3 , CAI Yifan ¹ , YAN Zhenxing ¹ , WEI Yuqiao ¹ , SUN Chongxiao ¹ , GENG Bin ^1,2,3 ,  XIA Yayi ^1,2,3

1. Department of Orthopaedics , the Second Hospital of Lanzhou University, Lanzhou Gansu, 730030, P. R. China;
2. Orthopaedic Clinical Research Center of Gansu Province, Lanzhou Gansu, 730030, P. R. China;
3. Intelligent Orthopaedic Industry Technology Center of Gansu Province, Lanzhou Gansu, 730030, P. R. China;

Corresponding author：

XIA Yayi, Email: xiayy@lzu.edu.cn

Keywords：

Patellar dislocation; medial patellofemoral ligament reconstruction; femoral attachment positioning; research progress

DOI：

10.7507/1002-1892.202405051

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To review research progress on femoral attachment positioning during medial patellofemoral ligament (MPFL) reconstruction, so as to provide a reference for accurate positioning in clinic. Methods The literature at home and abroad on femoral attachment positioning during MPFL reconstruction was extensively reviewed and summarized. Results MPFL is the main ligament that restricts patellar outward migration, so MPFL reconstruction is the main treatment for patellar dislocation, but the accuracy of intraoperative femoral attachment positioning will significantly affect the effectiveness. At present, there are three main methods for femoral attachment positioning in MPFL reconstruction, including imaging positioning, bony landmark positioning, and new technology. Among them, the main imaging positioning method is the “Schöttle point” method, but it has high requirements for fluoroscopic positioning, and can only be accurately positioned under standard lateral fluoroscopy of the femur. The bony landmark positioning method mainly locates the femoral attachment by touching or dissecting the bony landmarks such as adductor tubercles and medial epicondyle of femur, but its disadvantages are that the positioning is not accurate enough, the intraoperative visual field exposure requirements are high, and a large incision is required. In order to avoid the problem that the simple bony landmark positioning method, in recent years, the combination of bony landmarks combined with arthroscopy, three-dimensional (3D) printing technology, and robot-assisted positioning methods have begun to be used in clinical practice. New technology localization methods have shown good results by preparing guides before operation, planning positioning paths in advance, or directly using robots to assist positioning during operation. Conclusion The accurate positioning of the femoral attachment in MPFL reconstruction is crucial, and the method of accurate and rapid intraoperative determination needs to be further improved and optimized. In the future, it is expected that the combination of computer image recognition correction technology and intraoperative position assistance will solve this problem.

Citation： YAN Peng’an, LU Fan, CAI Yifan, YAN Zhenxing, WEI Yuqiao, SUN Chongxiao, GENG Bin, XIA Yayi. Research progress on femoral attachment positioning during medial patellofemoral ligament reconstruction. Chinese Journal of Reparative and Reconstructive Surgery, 2024, 38(10): 1276-1282. doi: 10.7507/1002-1892.202405051 Copy

1.	Baer MR, Macalena JA. Medial patellofemoral ligament reconstruction: patient selection and perspectives. Orthop Res Rev, 2017, 9: 83-91.
2.	Patil S, Ahmad M, Patel M, et al. Cadaveric study to define the anatomy of the medial patellofemoral ligament (MPFL) and its variant patterns. Cureus, 2023, 15(5): e39333. doi: 10.7759/cureus.39333.
3.	Hopper GP, Leach WJ, Rooney BP, et al. Does degree of trochlear dysplasia and position of femoral tunnel influence outcome after medial patellofemoral ligament reconstruction? Am J Sports Med, 2014, 42(3): 716-722.
4.	Anbari A, Cole BJ. Medial patellofemoral ligament reconstruction: a novel approach. J Knee Surg, 2008, 21(3): 241-245.
5.	黄勇, 陈斐, 杨远, 等. 内侧髌股韧带联合髌胫韧带重建治疗髌骨不稳的研究进展. 中华骨与关节外科杂志, 2021, 14(1): 70-75.
6.	Maione A, Tradati D, Ferrua P, et al. Accuracy of femoral tunnel positioning in medial patellofemoral ligament reconstruction: anatomic insertion leads to better clinical outcome. Knee Surg Sports Traumatol Arthrosc, 2023, 31(7): 2810-2817.
7.	McCarthy M, Ridley TJ, Bollier M, et al. Femoral tunnel placement in medial patellofemoral ligament reconstruction. Iowa Orthop J, 2013, 33: 58-63.
8.	阿依丁·夏哈太, 张克远, 刘阳. 内侧髌股韧带重建术后股骨隧道位置对膝关节功能的影响研究. 中国修复重建外科杂志, 2015, 29(8): 951-954.
9.	Tscholl PM, Ernstbrunner L, Pedrazzoli L, et al. The relationship of femoral tunnel positioning in medial patellofemoral ligament reconstruction on clinical outcome and postoperative complications. Arthroscopy, 2018, 34(8): 2410-2416.
10.	Bollier M, Fulkerson J, Cosgarea A, et al. Technical failure of medial patellofemoral ligament reconstruction. Arthroscopy, 2011, 27(8): 1153-1159.
11.	Anderson G, Diduch DR. Medial patellofemoral ligament reconstruction: tips and tricks to get it right. Clin Sports Med, 2022, 41(1): 89-96.
12.	Blatter SC, Fürnstahl P, Hirschmann A, et al. Femoral insertion site in medial patellofemoral ligament reconstruction. Knee, 2016, 23(3): 456-459.
13.	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.
14.	Cregar WM, Huddleston HP, Wong SE, et al. Inconsistencies in reporting risk factors for medial patellofemoral ligament reconstruction failure: a systematic review. Am J Sports Med, 2022, 50(3): 867-877.
15.	Walker M, Maini L, Kay J, et al. Femoral tunnel malposition is the most common indication for revision medial patellofemoral ligament reconstruction with promising early outcomes following revision reconstruction: a systematic review. Knee Surg Sports Traumatol Arthrosc, 2022, 30(4): 1352-1361.
16.	Ewald F, Klasan A, Putnis S, et al. After MPFL reconstruction, femoral tunnel widening and migration increase with poor tunnel positioning and are related to poor clinical outcomes. Knee Surg Sports Traumatol Arthrosc, 2023, 31(6): 2315-2322.
17.	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.
18.	Kay J, Memon M, Ayeni OR, et al. Medial patellofemoral ligament reconstruction techniques and outcomes: a scoping review. Curr Rev Musculoskelet Med, 2021, 14(6): 321-327.
19.	Hiemstra LA, Kerslake S, O’Brien CL, et al. Accuracy and learning curve of femoral tunnel placement in medial patellofemoral ligament reconstruction. J Knee Surg, 2017, 30(9): 879-886.
20.	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.
21.	Zhang N, Jiang Z, Wen X, et al. The triangle zone as a femoral attachment location in medial patellofemoral ligament reconstruction: An in vivo three-dimensional analysis using an open MRI scanner. Knee, 2015, 22(6): 585-590.
22.	Jaecker V, Brozat B, Banerjee M, et al. Fluoroscopic control allows for precise tunnel positioning in MPFL reconstruction. Knee Surg Sports Traumatol Arthrosc, 2017, 25(9): 2688-2694.
23.	程峰, 殷振宇, 汪志芳, 等. 透射定位法在复发性髌骨脱位重建内侧髌股韧带中的应用. 中华关节外科杂志: 电子版, 2018, 12(6): 863-867.
24.	Emre TY, Cetin H, Selcuk H, et al. Comparison of five different fluoroscopic methods for identifying the MPFL femoral footprint. Arch Orthop Trauma Surg, 2024, 144(4): 1675-1684.
25.	Jaecker V, Neumann L, Shafizadeh S, et al. Radiographic images are inapplicable for a precise evaluation of the femoral tunnel position following MPFL reconstruction. Knee Surg Sports Traumatol Arthrosc, 2019, 27(11): 3432-3440.
26.	Koenen P, Shafizadeh S, Pfeiffer TR, et al. Intraoperative fluoroscopy during MPFL reconstruction improves the accuracy of the femoral tunnel position. Knee Surg Sports Traumatol Arthrosc, 2018, 26(12): 3547-3552.
27.	Sanchis-Alfonso V, Ramírez-Fuentes C, Montesinos-Berry E, et al. Radiographic location does not ensure a precise anatomic location of the femoral fixation site in medial patellofemoral ligament reconstruction. Orthop J Sports Med, 2017, 5(11): 2325967117739252. doi: 10.1177/2325967117739252.
28.	Ziegler CG, Fulkerson JP, Edgar C. Radiographic reference points are inaccurate with and without a true lateral radiograph: the importance of anatomy in medial patellofemoral ligament reconstruction. Am J Sports Med, 2016, 44(1): 133-142.
29.	Balcarek P, Walde TA. Accuracy of femoral tunnel placement in medial patellofemoral ligament reconstruction: the effect of a nearly true-lateral fluoroscopic view. Am J Sports Med, 2015, 43(9): 2228-2232.
30.	Zhang X, Xie G, Zhang C, et al. Comparation and evaluation of the accuracy of the sulcus localization method to establish the medial patellofemoral ligament femoral tunnel: a cadaveric and clinical study. BMC Musculoskelet Disord, 2019, 20(1): 53. doi: 10.1186/s12891-019-2439-x.
31.	Chen J, Xiong Y, Han K, et al. Computed tomography imaging analysis of the MPFL femoral footprint morphology and the saddle sulcus: evaluation of 1094 knees. Orthop J Sports Med, 2022, 10(2): 23259671211073608. doi: 10.1177/23259671211073608.
32.	Chen J, Han K, Jiang J, et al. Radiographic reference points do not ensure anatomic femoral fixation sites in medial patellofemoral ligament reconstruction: A quantified anatomic localization method based on the saddle sulcus. Am J Sports Med, 2021, 49(2): 435-441.
33.	张文豪, 易林, 张思平, 等. 基于解剖学鞍沟区确定股骨止点进行内侧髌股韧带重建治疗髌骨脱位的早期疗效分析. 生物骨科材料与临床研究, 2024, 21(1): 90-93.
34.	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.
35.	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.
36.	Wang HJ, Song YF, Yan X, et al. Using anatomic landmarks to locate Schöttle’s point was accurate without fluoroscopy during medial patellofemoral ligament reconstruction. Arthroscopy, 2021, 37(6): 1902-1908.
37.	夏亚一, 耿彬, 孙重霄, 等. 一种针对于髌骨脱位的手术用股骨骨道定位器: CN202223001008.9. 2023-07-07.
38.	de Abreu-E-Silva GM, Buarque FAR, Dias TS, et al. Anatomical femoral tunnel positioning in the medial patellofemoral ligament reconstruction: is the free-hand technique accurate? Ann Transl Med, 2020, 8(15): 924. doi: 10.21037/atm-19-3925.
39.	Servien E, Fritsch B, Lustig S, et al. In vivo positioning analysis of medial patellofemoral ligament reconstruction. Am J Sports Med, 2011, 39(1): 134-139.
40.	Belkin NS, Meyers KN, Redler LH, et al. Medial patellofemoral ligament isometry in the setting of patella alta. Arthroscopy, 2020, 36(12): 3031-3036.
41.	Izadpanah K, Meine H, Kubosch J, et al. Fluoroscopic guided tunnel placement during medial patellofemoral ligament reconstruction is not accurate in patients with severe trochlear dysplasia. Knee Surg Sports Traumatol Arthrosc, 2020, 28(3): 759-766.
42.	Drapeau-Zgoralski V, Swift B, Caines A, et al. Lateral patellar instability. J Bone Joint Surg (Am), 2023, 105(5): 397-409.
43.	张召贺, 方禹舜, 李亚楠, 等. 机器人辅助定位股骨隧道在内侧髌股韧带重建术中的应用. 中华创伤骨科杂志, 2024, 26(1): 19-25.
44.	张勇, 程飚, 杨林. 关节镜辅助下内侧髌股韧带重建术治疗髌骨脱位股骨侧止点定位方法研究. 中国修复重建外科杂志, 2020, 34(10): 1233-1237.
45.	钟名金, 崔家鸣, 黄子荣, 等. 改良全关节镜下内侧髌股韧带重建术治疗复发性髌骨脱位的疗效. 中华创伤杂志, 2023, 39(8): 695-702.
46.	Hu F, Shi W, Wang H, et al. A novel technique of arthroscopic femoral tunnel placement during medial patellofemoral ligament reconstruction for recurrent patellar dislocation. J Clin Med, 2023, 12(2): 680. doi: 10.3390/jcm12020680.
47.	Zhang W, Mou L, Zhang S, et al. 3D-printed individualized navigation template versus the fluoroscopic guide to defining the femoral tunnel for medial patellofemoral ligament reconstruction: A retrospective study. Medicine (Baltimore), 2023, 102(4): e32729. doi: 10.1097/md.0000000000032729.
48.	杨贤光, 张艳, 李彦林, 等. 3D打印导板辅助定位与C形臂X线机透视定位股骨隧道重建内侧髌股韧带治疗复发性髌骨脱位的疗效比较. 中华创伤杂志, 2023, 39(7): 583-592.
49.	Privalov M, Kordon F, Kunze H, et al. Software-based method for automated intraoperative planning of Schoettle Point in surgical medial patellofemoral ligament reconstruction: A comparative validation study. Int J Med Robot, 2024, 20(1): e2607. doi: 10.1002/rcs.2607.
50.	Deie M, Ochi M, Sumen Y, et al. Reconstruction of the medial patellofemoral ligament for the treatment of habitual or recurrent dislocation of the patella in children. J Bone Joint Surg (Br), 2003, 85(6): 887-890.
51.	Nelitz M, Dreyhaupt J, Reichel H, et al. Anatomic reconstruction of the medial patellofemoral ligament in children and adolescents with open growth plates: surgical technique and clinical outcome. Am J Sports Med, 2013, 41(1): 58-63.
52.	Featherall J, Metz AK, Froerer DL, et al. The Schöttle point is consistently located distal to the medial femoral physis in pediatric patients: a digitally reconstructed radiographic study. Am J Sports Med, 2022, 50(13): 3565-3570.
53.	Huston KL, Okoroafor UC, Kaar SG, et al. Evaluation of the Schöttle technique in the pediatric knee. Orthop J Sports Med, 2017, 5(11): 2325967117740078. doi: 10.1177/2325967117740078.
54.	Uppstrom TJ, Price M, Black S, et al. Medial patellofemoral ligament (MPFL) reconstruction technique using an epiphyseal femoral socket with fluoroscopic guidance helps avoid physeal injury in skeletally immature patients. Knee Surg Sports Traumatol Arthrosc, 2019, 27(11): 3536-3542.
55.	熊藉培, 亓建洪. 内侧髌股韧带重建治疗青少年髌骨脱位研究进展. 中国矫形外科杂志, 2022, 30(14): 1282-1286.
56.	Farrow LD, Alentado VJ, Abdulnabi Z, et al. The relationship of the medial patellofemoral ligament attachment to the distal femoral physis. Am J Sports Med, 2014, 42(9): 2214-2218.
57.	Nguyen CV, Farrow LD, Liu RW, et al. Safe drilling paths in the distal femoral epiphysis for pediatric medial patellofemoral ligament reconstruction. Am J Sports Med, 2017, 45(5): 1085-1089.
58.	Irarrázaval S, Besa P, Fernández F, et al. Anterior and distal tunnel orientation for anatomic reconstruction of the medial patellofemoral ligament is safer in patients with open growth plates. Knee Surg Sports Traumatol Arthrosc, 2021, 29(6): 1822-1829.
59.	Matsushita T, Araki D, Hoshino Y, et al. Analysis of graft length change patterns in medial patellofemoral ligament reconstruction via a fluoroscopic guidance method. Am J Sports Med, 2018, 46(5): 1150-1157.

1. Baer MR, Macalena JA. Medial patellofemoral ligament reconstruction: patient selection and perspectives. Orthop Res Rev, 2017, 9: 83-91.
2. Patil S, Ahmad M, Patel M, et al. Cadaveric study to define the anatomy of the medial patellofemoral ligament (MPFL) and its variant patterns. Cureus, 2023, 15(5): e39333. doi: 10.7759/cureus.39333.
3. Hopper GP, Leach WJ, Rooney BP, et al. Does degree of trochlear dysplasia and position of femoral tunnel influence outcome after medial patellofemoral ligament reconstruction? Am J Sports Med, 2014, 42(3): 716-722.
4. Anbari A, Cole BJ. Medial patellofemoral ligament reconstruction: a novel approach. J Knee Surg, 2008, 21(3): 241-245.
5. 黄勇, 陈斐, 杨远, 等. 内侧髌股韧带联合髌胫韧带重建治疗髌骨不稳的研究进展. 中华骨与关节外科杂志, 2021, 14(1): 70-75.
6. Maione A, Tradati D, Ferrua P, et al. Accuracy of femoral tunnel positioning in medial patellofemoral ligament reconstruction: anatomic insertion leads to better clinical outcome. Knee Surg Sports Traumatol Arthrosc, 2023, 31(7): 2810-2817.
7. McCarthy M, Ridley TJ, Bollier M, et al. Femoral tunnel placement in medial patellofemoral ligament reconstruction. Iowa Orthop J, 2013, 33: 58-63.
8. 阿依丁·夏哈太, 张克远, 刘阳. 内侧髌股韧带重建术后股骨隧道位置对膝关节功能的影响研究. 中国修复重建外科杂志, 2015, 29(8): 951-954.
9. Tscholl PM, Ernstbrunner L, Pedrazzoli L, et al. The relationship of femoral tunnel positioning in medial patellofemoral ligament reconstruction on clinical outcome and postoperative complications. Arthroscopy, 2018, 34(8): 2410-2416.
10. Bollier M, Fulkerson J, Cosgarea A, et al. Technical failure of medial patellofemoral ligament reconstruction. Arthroscopy, 2011, 27(8): 1153-1159.
11. Anderson G, Diduch DR. Medial patellofemoral ligament reconstruction: tips and tricks to get it right. Clin Sports Med, 2022, 41(1): 89-96.
12. Blatter SC, Fürnstahl P, Hirschmann A, et al. Femoral insertion site in medial patellofemoral ligament reconstruction. Knee, 2016, 23(3): 456-459.
13. 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.
14. Cregar WM, Huddleston HP, Wong SE, et al. Inconsistencies in reporting risk factors for medial patellofemoral ligament reconstruction failure: a systematic review. Am J Sports Med, 2022, 50(3): 867-877.
15. Walker M, Maini L, Kay J, et al. Femoral tunnel malposition is the most common indication for revision medial patellofemoral ligament reconstruction with promising early outcomes following revision reconstruction: a systematic review. Knee Surg Sports Traumatol Arthrosc, 2022, 30(4): 1352-1361.
16. Ewald F, Klasan A, Putnis S, et al. After MPFL reconstruction, femoral tunnel widening and migration increase with poor tunnel positioning and are related to poor clinical outcomes. Knee Surg Sports Traumatol Arthrosc, 2023, 31(6): 2315-2322.
17. 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.
18. Kay J, Memon M, Ayeni OR, et al. Medial patellofemoral ligament reconstruction techniques and outcomes: a scoping review. Curr Rev Musculoskelet Med, 2021, 14(6): 321-327.
19. Hiemstra LA, Kerslake S, O’Brien CL, et al. Accuracy and learning curve of femoral tunnel placement in medial patellofemoral ligament reconstruction. J Knee Surg, 2017, 30(9): 879-886.
20. 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.
21. Zhang N, Jiang Z, Wen X, et al. The triangle zone as a femoral attachment location in medial patellofemoral ligament reconstruction: An in vivo three-dimensional analysis using an open MRI scanner. Knee, 2015, 22(6): 585-590.
22. Jaecker V, Brozat B, Banerjee M, et al. Fluoroscopic control allows for precise tunnel positioning in MPFL reconstruction. Knee Surg Sports Traumatol Arthrosc, 2017, 25(9): 2688-2694.
23. 程峰, 殷振宇, 汪志芳, 等. 透射定位法在复发性髌骨脱位重建内侧髌股韧带中的应用. 中华关节外科杂志: 电子版, 2018, 12(6): 863-867.
24. Emre TY, Cetin H, Selcuk H, et al. Comparison of five different fluoroscopic methods for identifying the MPFL femoral footprint. Arch Orthop Trauma Surg, 2024, 144(4): 1675-1684.
25. Jaecker V, Neumann L, Shafizadeh S, et al. Radiographic images are inapplicable for a precise evaluation of the femoral tunnel position following MPFL reconstruction. Knee Surg Sports Traumatol Arthrosc, 2019, 27(11): 3432-3440.
26. Koenen P, Shafizadeh S, Pfeiffer TR, et al. Intraoperative fluoroscopy during MPFL reconstruction improves the accuracy of the femoral tunnel position. Knee Surg Sports Traumatol Arthrosc, 2018, 26(12): 3547-3552.
27. Sanchis-Alfonso V, Ramírez-Fuentes C, Montesinos-Berry E, et al. Radiographic location does not ensure a precise anatomic location of the femoral fixation site in medial patellofemoral ligament reconstruction. Orthop J Sports Med, 2017, 5(11): 2325967117739252. doi: 10.1177/2325967117739252.
28. Ziegler CG, Fulkerson JP, Edgar C. Radiographic reference points are inaccurate with and without a true lateral radiograph: the importance of anatomy in medial patellofemoral ligament reconstruction. Am J Sports Med, 2016, 44(1): 133-142.
29. Balcarek P, Walde TA. Accuracy of femoral tunnel placement in medial patellofemoral ligament reconstruction: the effect of a nearly true-lateral fluoroscopic view. Am J Sports Med, 2015, 43(9): 2228-2232.
30. Zhang X, Xie G, Zhang C, et al. Comparation and evaluation of the accuracy of the sulcus localization method to establish the medial patellofemoral ligament femoral tunnel: a cadaveric and clinical study. BMC Musculoskelet Disord, 2019, 20(1): 53. doi: 10.1186/s12891-019-2439-x.
31. Chen J, Xiong Y, Han K, et al. Computed tomography imaging analysis of the MPFL femoral footprint morphology and the saddle sulcus: evaluation of 1094 knees. Orthop J Sports Med, 2022, 10(2): 23259671211073608. doi: 10.1177/23259671211073608.
32. Chen J, Han K, Jiang J, et al. Radiographic reference points do not ensure anatomic femoral fixation sites in medial patellofemoral ligament reconstruction: A quantified anatomic localization method based on the saddle sulcus. Am J Sports Med, 2021, 49(2): 435-441.
33. 张文豪, 易林, 张思平, 等. 基于解剖学鞍沟区确定股骨止点进行内侧髌股韧带重建治疗髌骨脱位的早期疗效分析. 生物骨科材料与临床研究, 2024, 21(1): 90-93.
34. 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.
35. 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.
36. Wang HJ, Song YF, Yan X, et al. Using anatomic landmarks to locate Schöttle’s point was accurate without fluoroscopy during medial patellofemoral ligament reconstruction. Arthroscopy, 2021, 37(6): 1902-1908.
37. 夏亚一, 耿彬, 孙重霄, 等. 一种针对于髌骨脱位的手术用股骨骨道定位器: CN202223001008.9. 2023-07-07.
38. de Abreu-E-Silva GM, Buarque FAR, Dias TS, et al. Anatomical femoral tunnel positioning in the medial patellofemoral ligament reconstruction: is the free-hand technique accurate? Ann Transl Med, 2020, 8(15): 924. doi: 10.21037/atm-19-3925.
39. Servien E, Fritsch B, Lustig S, et al. In vivo positioning analysis of medial patellofemoral ligament reconstruction. Am J Sports Med, 2011, 39(1): 134-139.
40. Belkin NS, Meyers KN, Redler LH, et al. Medial patellofemoral ligament isometry in the setting of patella alta. Arthroscopy, 2020, 36(12): 3031-3036.
41. Izadpanah K, Meine H, Kubosch J, et al. Fluoroscopic guided tunnel placement during medial patellofemoral ligament reconstruction is not accurate in patients with severe trochlear dysplasia. Knee Surg Sports Traumatol Arthrosc, 2020, 28(3): 759-766.
42. Drapeau-Zgoralski V, Swift B, Caines A, et al. Lateral patellar instability. J Bone Joint Surg (Am), 2023, 105(5): 397-409.
43. 张召贺, 方禹舜, 李亚楠, 等. 机器人辅助定位股骨隧道在内侧髌股韧带重建术中的应用. 中华创伤骨科杂志, 2024, 26(1): 19-25.
44. 张勇, 程飚, 杨林. 关节镜辅助下内侧髌股韧带重建术治疗髌骨脱位股骨侧止点定位方法研究. 中国修复重建外科杂志, 2020, 34(10): 1233-1237.
45. 钟名金, 崔家鸣, 黄子荣, 等. 改良全关节镜下内侧髌股韧带重建术治疗复发性髌骨脱位的疗效. 中华创伤杂志, 2023, 39(8): 695-702.
46. Hu F, Shi W, Wang H, et al. A novel technique of arthroscopic femoral tunnel placement during medial patellofemoral ligament reconstruction for recurrent patellar dislocation. J Clin Med, 2023, 12(2): 680. doi: 10.3390/jcm12020680.
47. Zhang W, Mou L, Zhang S, et al. 3D-printed individualized navigation template versus the fluoroscopic guide to defining the femoral tunnel for medial patellofemoral ligament reconstruction: A retrospective study. Medicine (Baltimore), 2023, 102(4): e32729. doi: 10.1097/md.0000000000032729.
48. 杨贤光, 张艳, 李彦林, 等. 3D打印导板辅助定位与C形臂X线机透视定位股骨隧道重建内侧髌股韧带治疗复发性髌骨脱位的疗效比较. 中华创伤杂志, 2023, 39(7): 583-592.
49. Privalov M, Kordon F, Kunze H, et al. Software-based method for automated intraoperative planning of Schoettle Point in surgical medial patellofemoral ligament reconstruction: A comparative validation study. Int J Med Robot, 2024, 20(1): e2607. doi: 10.1002/rcs.2607.
50. Deie M, Ochi M, Sumen Y, et al. Reconstruction of the medial patellofemoral ligament for the treatment of habitual or recurrent dislocation of the patella in children. J Bone Joint Surg (Br), 2003, 85(6): 887-890.
51. Nelitz M, Dreyhaupt J, Reichel H, et al. Anatomic reconstruction of the medial patellofemoral ligament in children and adolescents with open growth plates: surgical technique and clinical outcome. Am J Sports Med, 2013, 41(1): 58-63.
52. Featherall J, Metz AK, Froerer DL, et al. The Schöttle point is consistently located distal to the medial femoral physis in pediatric patients: a digitally reconstructed radiographic study. Am J Sports Med, 2022, 50(13): 3565-3570.
53. Huston KL, Okoroafor UC, Kaar SG, et al. Evaluation of the Schöttle technique in the pediatric knee. Orthop J Sports Med, 2017, 5(11): 2325967117740078. doi: 10.1177/2325967117740078.
54. Uppstrom TJ, Price M, Black S, et al. Medial patellofemoral ligament (MPFL) reconstruction technique using an epiphyseal femoral socket with fluoroscopic guidance helps avoid physeal injury in skeletally immature patients. Knee Surg Sports Traumatol Arthrosc, 2019, 27(11): 3536-3542.
55. 熊藉培, 亓建洪. 内侧髌股韧带重建治疗青少年髌骨脱位研究进展. 中国矫形外科杂志, 2022, 30(14): 1282-1286.
56. Farrow LD, Alentado VJ, Abdulnabi Z, et al. The relationship of the medial patellofemoral ligament attachment to the distal femoral physis. Am J Sports Med, 2014, 42(9): 2214-2218.
57. Nguyen CV, Farrow LD, Liu RW, et al. Safe drilling paths in the distal femoral epiphysis for pediatric medial patellofemoral ligament reconstruction. Am J Sports Med, 2017, 45(5): 1085-1089.
58. Irarrázaval S, Besa P, Fernández F, et al. Anterior and distal tunnel orientation for anatomic reconstruction of the medial patellofemoral ligament is safer in patients with open growth plates. Knee Surg Sports Traumatol Arthrosc, 2021, 29(6): 1822-1829.
59. Matsushita T, Araki D, Hoshino Y, et al. Analysis of graft length change patterns in medial patellofemoral ligament reconstruction via a fluoroscopic guidance method. Am J Sports Med, 2018, 46(5): 1150-1157.

Previous Article
Research progress in repair and reconstruction of tumor-related bone defects in proximal femur
Next Article
Mechanism of cold atmospheric plasma in treatment of chronic skin ulcer

Chinese Journal of Reparative and Reconstructive Surgery

Research progress on femoral attachment positioning during medial patellofemoral ligament reconstruction

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content