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Medial Patellofemoral Ligament Reconstruction Using Suture Tape for Patellofemoral Joint Instability

OBJECTIVE: To describe a surgical technique using suture tape for reconstruction of the medial patellofemoral ligament (MPFL). This technique restores the stability of the reconstructed ligament and has excellent postoperative outcomes. METHOD: This is a retrospective analysis. From January 2016 to...

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Autores principales: Xu, Jun‐cai, Zhang, Bo‐xuan, Jia, Yan‐feng, Wang, Xiao‐feng, Shen, Ke, Ren, Wei‐bin, Sun, Ran
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons Australia, Ltd 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8126912/
https://www.ncbi.nlm.nih.gov/pubmed/33749146
http://dx.doi.org/10.1111/os.12945
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author Xu, Jun‐cai
Zhang, Bo‐xuan
Jia, Yan‐feng
Wang, Xiao‐feng
Shen, Ke
Ren, Wei‐bin
Sun, Ran
author_facet Xu, Jun‐cai
Zhang, Bo‐xuan
Jia, Yan‐feng
Wang, Xiao‐feng
Shen, Ke
Ren, Wei‐bin
Sun, Ran
author_sort Xu, Jun‐cai
collection PubMed
description OBJECTIVE: To describe a surgical technique using suture tape for reconstruction of the medial patellofemoral ligament (MPFL). This technique restores the stability of the reconstructed ligament and has excellent postoperative outcomes. METHOD: This is a retrospective analysis. From January 2016 to June 2018, 17 patients underwent MPFL reconstruction using high‐strength suture (FiberTape; Arthrex) augmentation, with at least 12 months of follow up. There were 11 female and 6 male patients. The mean age at the time of MPFL reconstruction was 22.1 years (range 13–34 years). Clinical outcomes included pain level, knee range of motion, passive patellar hypermobility, and maltracking at follow‐up. The lateral patellofemoral angles, congruence angles, and patellar tilt angles were measured in a skyline view by CT at 30° of knee flexion at 12 months. Functional outcomes were assessed using the Lysholm knee scoring scale, the SF‐12 score, the Tegner score, and the Crosby and Insall grading system at yearly follow‐up. RESULT: No patients were lost at the last follow up. One patient had recurrence of patellar dislocation and none of the others had serious complications. The success rate of MPFL repair for preventing recurrent dislocations was 94.1% (16 of 17 knees). Fifteen knees had full range of motion of more than 130°. At follow‐up, 2 knees were judged to have mild hypermobility and none had severe hypermobility or maltracking. Using the Crosby and Insall grading system, 12 knees (70.6%) were graded as excellent, 4 knees (23.5%) as good, 1 knee (5.9%) as fair to poor, and none as worse at the last follow‐up assessment. In all patients, the Lysholm knee score (55.12 ± 13.52 vs 79.88 ± 7.50, P < 0.01), the SF‐12 score (47 ± 9.53 vs 65.24 ± 12.82, P < 0.01), and the Tegner score (2.76 ± 1.39 vs 6.53 ± 1.70, P < 0.01) had improved at their 12‐month follow up. Compared with preoperative radiological findings, there was a significant improvement in lateral patellofemoral angle (−10.24 ± 7.10 vs 6 ± 5.43, P < 0.01), patellar tilt angle (26.53 ± 7.23 vs 9.88 ± 4.24, P < 0.01), and congruence angle (29.59 ± 11.95 vs −8.65 ± 4.86, P < 0.01). CONCLUSION: The use of FiberTape in MPFL reconstruction can improve the stability of the knee following surgery and has good midterm clinical results and low complication rates.
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spelling pubmed-81269122021-05-21 Medial Patellofemoral Ligament Reconstruction Using Suture Tape for Patellofemoral Joint Instability Xu, Jun‐cai Zhang, Bo‐xuan Jia, Yan‐feng Wang, Xiao‐feng Shen, Ke Ren, Wei‐bin Sun, Ran Orthop Surg Clinical Articles OBJECTIVE: To describe a surgical technique using suture tape for reconstruction of the medial patellofemoral ligament (MPFL). This technique restores the stability of the reconstructed ligament and has excellent postoperative outcomes. METHOD: This is a retrospective analysis. From January 2016 to June 2018, 17 patients underwent MPFL reconstruction using high‐strength suture (FiberTape; Arthrex) augmentation, with at least 12 months of follow up. There were 11 female and 6 male patients. The mean age at the time of MPFL reconstruction was 22.1 years (range 13–34 years). Clinical outcomes included pain level, knee range of motion, passive patellar hypermobility, and maltracking at follow‐up. The lateral patellofemoral angles, congruence angles, and patellar tilt angles were measured in a skyline view by CT at 30° of knee flexion at 12 months. Functional outcomes were assessed using the Lysholm knee scoring scale, the SF‐12 score, the Tegner score, and the Crosby and Insall grading system at yearly follow‐up. RESULT: No patients were lost at the last follow up. One patient had recurrence of patellar dislocation and none of the others had serious complications. The success rate of MPFL repair for preventing recurrent dislocations was 94.1% (16 of 17 knees). Fifteen knees had full range of motion of more than 130°. At follow‐up, 2 knees were judged to have mild hypermobility and none had severe hypermobility or maltracking. Using the Crosby and Insall grading system, 12 knees (70.6%) were graded as excellent, 4 knees (23.5%) as good, 1 knee (5.9%) as fair to poor, and none as worse at the last follow‐up assessment. In all patients, the Lysholm knee score (55.12 ± 13.52 vs 79.88 ± 7.50, P < 0.01), the SF‐12 score (47 ± 9.53 vs 65.24 ± 12.82, P < 0.01), and the Tegner score (2.76 ± 1.39 vs 6.53 ± 1.70, P < 0.01) had improved at their 12‐month follow up. Compared with preoperative radiological findings, there was a significant improvement in lateral patellofemoral angle (−10.24 ± 7.10 vs 6 ± 5.43, P < 0.01), patellar tilt angle (26.53 ± 7.23 vs 9.88 ± 4.24, P < 0.01), and congruence angle (29.59 ± 11.95 vs −8.65 ± 4.86, P < 0.01). CONCLUSION: The use of FiberTape in MPFL reconstruction can improve the stability of the knee following surgery and has good midterm clinical results and low complication rates. John Wiley & Sons Australia, Ltd 2021-03-21 /pmc/articles/PMC8126912/ /pubmed/33749146 http://dx.doi.org/10.1111/os.12945 Text en © 2021 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Clinical Articles
Xu, Jun‐cai
Zhang, Bo‐xuan
Jia, Yan‐feng
Wang, Xiao‐feng
Shen, Ke
Ren, Wei‐bin
Sun, Ran
Medial Patellofemoral Ligament Reconstruction Using Suture Tape for Patellofemoral Joint Instability
title Medial Patellofemoral Ligament Reconstruction Using Suture Tape for Patellofemoral Joint Instability
title_full Medial Patellofemoral Ligament Reconstruction Using Suture Tape for Patellofemoral Joint Instability
title_fullStr Medial Patellofemoral Ligament Reconstruction Using Suture Tape for Patellofemoral Joint Instability
title_full_unstemmed Medial Patellofemoral Ligament Reconstruction Using Suture Tape for Patellofemoral Joint Instability
title_short Medial Patellofemoral Ligament Reconstruction Using Suture Tape for Patellofemoral Joint Instability
title_sort medial patellofemoral ligament reconstruction using suture tape for patellofemoral joint instability
topic Clinical Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8126912/
https://www.ncbi.nlm.nih.gov/pubmed/33749146
http://dx.doi.org/10.1111/os.12945
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