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- Title
The horizontal Y-shaped graft with respective graft tension angles in anatomical two-bundle medial patellofemoral ligament reconstruction.
- Authors
Kang, Hui; Cao, Jian; Pan, Shuo; Wang, Xiao; Yu, Da; Zheng, Zhi
- Abstract
Purpose: Various techniques for medial patellofemoral ligament (MPFL) reconstruction have been described with two bundles of graft tensioned simultaneously. The present study was to introduce an anatomical reconstruction procedure using a horizontal Y-shaped graft with respective graft tension angles and report the preliminary results. Methods: A surgical technique for MPFL reconstruction using a horizontal Y-shaped semitendinosus tendon autograft with two bundles tensioned at 0° and 30° of knee flexion was described in detail. The patellar stability was evaluated with the apprehension test and an axial computed tomography (CT) scan at 30° of knee flexion. The knee function was evaluated using the Lysholm and Kujala scores. Results: No recurrent dislocation or subluxation was reported for 45 patients at a mean of 33.7-month follow-up. On CT images, congruence angle, patellar tilt angle, lateral patellar angle and lateral displacement were restored to the normal range. At the last follow-up, the mean Lysholm score improved from 51.8 ± 6.2 to 91.7 ± 4.1 and mean Kujala score was from 53.4 ± 5.3 to 90.9 ± 6.6 ( P < 0.01). Conclusions: The present anatomical MPFL reconstruction technique with a horizontal Y-shaped two-bundle graft tensioned at respective knee flexion angles could not only recreate the fan-shape of MPFL but also mimic the function bundles of native ligament. Clinical follow-up confirms the good restoration of the patellar stability and significant improvement of knee function without special complications. Level of evidence: Therapeutic, Level IV.
- Subjects
PATELLOFEMORAL joint; PATELLAR ligament surgery; COMPUTED tomography; BONE grafting; ANATOMY; SURGERY
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2014, Vol 22, Issue 10, p2445
- ISSN
0942-2056
- Publication type
Article
- DOI
10.1007/s00167-014-3005-6