In vitro investigation of the effect of medial patellofemoral ligament reconstruction and medial tibial tuberosity transfer on lateral patellar stability

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
Sven OstermeierCarl-Joachim Wirth

Abstract

Two different operative techniques for stabilizing the patella against lateral displacement movement were investigated. In vitro experimental study. Five human cadaver knee specimens with a normal Q-angle were mounted in a kinematic knee simulator and investigated under simulated isokinetic extension motions. Patellar movement was measured while a 100-N laterally directed subluxation load was applied to the patella. Ligament loading of the medial patellofemoral ligament was measured using a strain gauge based buckle transducer inserted in the fibers of the ligament. The knee was evaluated in an intact physiologic state, as well as after medial transfer of the tibial tuberosity, and after the medial patellofemoral ligament was transected and reconstructed using a hamstring autograft. A significant reduction in lateral displacement and ligament load was observed with the use of the hamstring autograft reconstruction compared with the medial transfer of the tibial tuberosity. Medial transfer of the tibial tuberosity showed no significant relief of ligament loading and stabilizing effect on patellar movement, whereas reconstruction of the medial patellofemoral ligament showed a significant stabilizing effect on patellar movement. I...Continue Reading

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