Reconstruction of the medial patellofemoral ligament using autologous gracilis tendon in an implant-free technique on the patellar side
Operative Orthopadie und Traumatologie, ISSN: 1439-0981, Vol: 28, Issue: 1, Page: 65-77
2016
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Article Description
Objective: Anatomic reconstruction of the medial patellofemoral ligament using autologous gracilis tendon in an implant-free technique on the patellar side to regain patellofemoral stability. Indications: Recurrent dislocations, primary dislocation with high risk of recurrence, and dislocations with (osteo-)chondral flake fractures. As combined approach together with other procedures (trochleoplasty, tibial tubercle osteotomy). Revisions. Contraindications: As an isolated procedure in patients with high degrees of trochlear dysplasia, chronic dislocation of the patella, and patellofemoral maltracking without instability. Surgical technique: Harvesting of the gracilis tendon. Drilling of a V-shaped tunnel with a special aiming device in anatomic position on the medial side of the patella. Drilling of a femoral tunnel in anatomic position under fluoroscopic control. Passage of the graft, arthroscopic-guided tensioning, and femoral fixation with a biodegradable interference screw. Postoperative management: Partial weight bearing (20 kg) for 1–2 weeks. No limitation in range of motion. No orthosis. Specific sports allowed after approximately 3 months. Results: Perioperative complications associated specifically with the technique were observed in 1.0 % (7 of 729 cases). In a series of 72 consecutive cases from May 2010 to October 2010, the following were recorded after 4.0 ± 0.1 years: recurrent dislocations in 3.2 %, a Tegner activity score of 5.1 ± 1.8, and subjective satisfaction in 92 % (follow-up rate 87.5 %). No fracture of the patella was seen in any of our patients.
Bibliographic Details
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84957900082&origin=inward; http://dx.doi.org/10.1007/s00064-015-0404-x; http://www.ncbi.nlm.nih.gov/pubmed/26162786; http://link.springer.com/10.1007/s00064-015-0404-x; https://dx.doi.org/10.1007/s00064-015-0404-x; https://link.springer.com/article/10.1007/s00064-015-0404-x
Springer Science and Business Media LLC
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