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KMID : 0361620110460060443
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Journal of the Korean Orthopaedic Association
2011 Volume.46 No. 6 p.443 ~ p.450
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Anatomical Reconstruction of the Medial Patellofemoral Ligament: Development of a Novel Procedure Based on Anatomical Dissection
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Lee Hee-Sung
Choe Jung-Yoon
Ha Jeong-Ku
Lee Yong-Seuk
Yoo Jae-Ho
Kim Min-Kyu
Kim Jin-Goo
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Abstract
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This paper reports a novel method for reconstructing the medial patellofemoral ligament (MPFL) using hamstring tendon autografts, based on the results of an anatomical study by cadaveric dissection. Five fresh frozen cadaveric knees were studied. MPFL was found present in all cases, and the average length was 54 mm (49.6-59.3 mm). The shape of the MPFL was triangular wherein the femoral attachment was narrow and the patellar attachment was relatively broad. The MPFL was less stiff and a weaker structure compared to the other ligaments. This study could refl ect a novel surgical technique for the MPFL reconstruction with its anatomical and biomechanical properties. The study population comprises of 9 patients (5 males and 4 females) who underwent primary MPFL reconstruction at our clinic between April 2008 and February 2010. The mean follow-up period was 17.6 months. The Kujala score improved signifi cantly from 51.1 points to 81.4 points (p<0.001), the Lysholm score improved signifi cantly from 47.8 points to 84.9 points (p<0.001) and the Tegner activity level improved signifi cantly from 2.9 to 5.1 (p<0.001). There was no case of recurrent dislocation and complications according to the short term follow-up results. Our novel soft tissue fixation method using double bundle reconstruction with hamstring tendon autografts would not only be an anatomic reconstruction but also would be effective for reconstruction of the MPFL.
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KEYWORD
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medial patellofemoral ligament, anatomy, patellar dislocation, reconstruction
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