scholarly journals Treatment of Habitual Patellar Dislocation in an Adult by Isolated Medial Patellofemoral Ligament Reconstruction

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Yoann Bohu ◽  
Mathieu Thaunat ◽  
Nicolas Lefevre ◽  
Shahnaz Klouche ◽  
Serge Herman ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Patellar Dislocation ◽  
Medial Patellofemoral Ligament ◽  
Functional Results ◽  
Tendon Graft ◽  
Loss Of Function ◽  
Leg Length ◽  
Assessment Scores ◽  
Gracilis Tendon Graft ◽  
Bone Anomalies

Habitual patellar dislocations are rare in adults. Treatment is difficult, and often associated with significant morbidity. A 30-year-old man, construction worker, presented a habitual patellofemoral dislocation which was caused by direct trauma to the knee as a child. Clinical examination showed a 3 cm leg-length discrepancy with no rotational deformities. The patient had a limp and loss of function; the patella was dislocated laterally and had locked at 20° of flexion with a range of motion of 0°/0°/30°. Open surgery was performed associating lateral retinacular release, reconstruction of the medial patellofemoral ligament with an ipsilateral gracilis tendon graft. The postoperative course was simple with no complications. Four months after surgery the patient has begun working normally. At the final 50-month clinical follow-up, knee range of motion was 0°/0°/130°, and functional results were excellent on clinical assessment scores of Kujala, Lysholm, and subjective IKDC. MPFL reconstruction alone seems effective in habitual posttraumatic patellar dislocation in adults without any associated bone anomalies.

The Effect of Reconstruction of the Medial Patellofemoral Ligament on Patellar Tracking

2000 ◽  
Vol 28 (3) ◽  
pp. 345-349 ◽  
Author(s):  
Robert H. Sandmeier ◽  
Robert T. Burks ◽  
Kent N. Bachus ◽  
Annette Billings
Keyword(s):  
Medial Patellofemoral Ligament ◽  
Testing Machine ◽  
Lateral Force ◽  
Tendon Graft ◽  
Patellar Tracking ◽  
Materials Testing ◽  
Gracilis Tendon ◽  
Position Sensing ◽  
Sensing System ◽  
Gracilis Tendon Graft

We evaluated patellar tracking in six cadaveric knees with the medial restraints intact and then sectioned to determine their contribution to lateral translation of the patella with and without a lateral force on the patella. The medial patellofemoral ligament was then reconstructed with a gracilis tendon graft and patellar tracking was again evaluated. The knees were extended using a materials testing machine, and patellar tracking was measured with a position sensing system. With no lateral force applied to the patella, patellar tracking was unaffected by the presence or absence of the medial restraints or by reconstruction of the medial patellofemoral ligament. With a lateral force applied to the patella, patellar tracking was changed significantly by the loss of the medial restraints. Normal patellar tracking was substantially restored by reconstruction of the medial patellofemoral ligament.

3D Computed Tomography Evaluation of Morphological Changes in the Femoral Tunnel After Medial Patellofemoral Ligament Reconstruction With Hamstring Tendon Graft for Recurrent Patellar Dislocation

2017 ◽  
Vol 45 (7) ◽  
pp. 1599-1607 ◽  
Author(s):  
Keisuke Kita ◽  
Yoshinari Tanaka ◽  
Yukiyoshi Toritsuka ◽  
Hiroshi Amano ◽  
Ryohei Uchida ◽  
...  
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Patellar Dislocation ◽  
Medial Patellofemoral Ligament ◽  
Femoral Tunnel ◽  
Morphological Changes ◽  
Hamstring Tendon ◽  
Tendon Graft ◽  
Mpfl Reconstruction ◽  
Kujala Score

Background: Reconstruction of the medial patellofemoral ligament (MPFL) for recurrent lateral patellar dislocation is gaining popularity. However, the morphological changes in the femoral tunnel after MPFL reconstruction are still not fully documented. Purpose: This study used 3-dimensional (3D) computed tomography to evaluate morphological changes in the femoral tunnel after MPFL reconstruction with hamstring tendon graft to investigate factors affecting the phenomenon and to elucidate whether it is associated with clinical outcomes. Study Design: Case series; Level of evidence, 4. Methods: Twenty-three patients with recurrent patellar dislocation were prospectively enrolled in this study. The patients included 6 males and 17 females with a mean age of 24 years (range, 14-53). The MPFL was reconstructed by creating 2 patellar bone sockets and 1 femoral bone socket anatomically under X-ray control, and the semitendinosus autograft was fixed with cortical suspension devices. Computed tomography scans obtained 3 weeks and 1 year after surgery were reconstructed into 3D constructs with a volume analyzer. Cross-sectional areas (CSAs) of the aperture and inside the femoral tunnel were compared between the 2 time points. Likewise, the location of tunnel walls and center of the femoral tunnel footprint were evaluated. Relationships were assessed between femoral tunnel morphological changes and potential risk factors—such as age, body mass index, sex, femoral tunnel positioning, patellar height, sulcus angle, congruence angle, lateral tilt angle, degree of trochlear dysplasia, lateral deviation of the tibial tubercle, and Kujala score. Results: No patient reported recurrence of patellar dislocation during the follow-up period. The CSA of the femoral tunnel aperture enlarged by 41.1% ± 34.7% ( P < .01). The center, anterior border, and proximal border of the femoral tunnel significantly shifted in the anterior direction ( P < .01). The distal border significantly shifted in both anterior and distal directions ( P < .01). Patella alta was associated with distal migration of the tunnel center ( P < .05). Morphological changes were not associated with other risk factors or Kujala score. Conclusion: The CSA of the femoral tunnel aperture enlarged, and the tunnel aperture migrated anteriorly with time after MPFL reconstruction. Risk factors for patellar dislocation other than patella alta did not influence morphological changes of the femoral tunnel.

scholarly journals Short-term Results of Medial Patellofemoral Ligament Reconstruction for Patellar Dislocation

2009 ◽  
Vol 58 (2) ◽  
pp. 266-270
Author(s):  
Koji Sakuraba ◽  
Hiromasa Miura ◽  
Shuichi Matsuda ◽  
Ken Okazaki ◽  
Shinji Fukuoka ◽  
...  
Keyword(s):  
Patellar Dislocation ◽  
Ligament Reconstruction ◽  
Medial Patellofemoral Ligament ◽  
Medial Patellofemoral Ligament Reconstruction ◽  
Short Term

Evaluation of an Arm Support With Trunk Motion Capability

2016 ◽  
Vol 10 (4) ◽  
Author(s):  
A. G. Dunning ◽  
M. M. H. P. Janssen ◽  
P. N. Kooren ◽  
J. L. Herder
Keyword(s):  
Range Of Motion ◽  
Daily Living ◽  
Loss Of Function ◽  
Semg Signal ◽  
Trunk Motion ◽  
Robotic Exoskeleton ◽  
Progressive Muscle Weakness ◽  
Trunk Movements ◽  
Arm Support ◽  
Arm Muscles

Due to progressive muscle weakness, the arm function in boys with Duchenne muscular dystrophy (DMD) reduces. An arm support can compensate for this loss of function. Existing arm supports are wheelchair bound, which restricts the ability to perform trunk movements. To evaluate the function of a body-bound arm support, a prototype (based on the Wilmington robotic exoskeleton (WREX) arm support) that allows trunk movements was built. In order to examine the effect of this device and to compare it with an existing wheelchair-bound device, three healthy subjects performed single joint movements (SJMs) and activities of daily living (ADL) with and without the devices. The range of motion (RoM) of the arm and the surface electromyography (sEMG) signal of five different arm muscles were measured. The range of motion increased when compared to the wheelchair-bound device, and the trunk motion was perceived as important to make specific movements easier and more natural, especially the more extreme movements like reaching for a far object and reaching to the top of the head. The sEMG signal was comparable to that of the wheelchair-bound device. This means that an arm support with trunk motion capability can increase the range of motion of the user, while the amount of support to the arm is equal.

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