Intraoperative fluoroscopy during MPFL reconstruction improves the accuracy of the femoral tunnel position

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
Paola KoenenVera Jaecker

Abstract

Reconstruction of the medial patellofemoral ligament (MPFL) has been established as standard of care for patellofemoral instability. An anatomic femoral tunnel position has been shown to be a prerequisite for restoration of patellofemoral stability and biomechanics. However, the incidence of malpositioning of the femoral tunnel during MPFL reconstruction continues to be notable. Palpation of anatomic landmarks and intraoperative fluoroscopy are the two primary techniques for tunnel placement. The aim of this study was to compare the accuracy of these two methods for femoral tunnel placement. From 2016 to 2017, 64 consecutive patients undergoing MPFL reconstruction for patelllofemoral instability were prospectively enrolled. During surgery, the presumed femoral MPFL insertion was identified by both palpation of anatomic landmarks and using fluoroscopy, both of these points were separately documented on true lateral radiographs. They were then analysed and deviations from the Schoettle's Point were measured as anterior-posterior and proximal-distal deviations. A tunnel position within a radius of 7 mm around the Schoettle's Point was designated as an "accurate tunnel position". Compared to the method of palpation, fluoroscopy led...Continue Reading

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Citations

May 10, 2019·The American Journal of Sports Medicine·Willem A KernkampTsung-Yuan Tsai
Aug 6, 2019·The American Journal of Sports Medicine·Vera JaeckerSven Shafizadeh
Feb 5, 2019·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Vera JaeckerThorsten Tjardes
Jan 25, 2020·Archives of Orthopaedic and Trauma Surgery·Vera JaeckerThomas R Pfeiffer
Feb 5, 2021·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·Hai-Jun WangJia-Kuo Yu
Dec 1, 2021·The American Journal of Sports Medicine·Marie CastoldiEtienne Cavaignac

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