PURPOSE: The influence of the medial patellar ligamentous structures on patellar tracking has rarely been studied. Thus the main purpose of this cadaveric biomechanical study was to determine the influence of the medial patellofemoral (MPFL), medial patellomeniscal (MPML) and medial patellotibial (MPTL) ligaments on the three-dimensional patellar tracking during knee flexion. This study was conducted using a validated cadaveric optoelectronic protocol for analysis of patellar kinematics. METHODS: For each cadaveric knee study, four successive acquisitions were performed; first was studied patellar tracking in healthy knees, then the junction between MPFL and vastus medialis obliquus (VMO) was sectioned, the MPFL was released at its patellar attachment and finally was released the insertion of the MPML and MPTL. RESULTS: In this study, the MPFL accounts for 50-60% of the medial stabilization forces of the lateral patellar shift during patellar engagement in the femoral trochlea. This work confirm and clarify the role of the MPFL as the primary stabilizer of the patella during the initial 30° of knee flexion. Moreover, this study shows no significant results regarding the stabilizing action of the VMO on the patella during knee flexion. CONCLUSION: This in vitro study, conducted with an experimental protocol previously validated in the literature, helps quantify the actions of the MPFL, the VMO, and the MPML/MPTL respectively, and identify areas of joint motion where these structures have the most significant influence. This confirms the importance of reconstruction in the treatment of chronic patellar instability. During its reconstruction, care should be taken to adjust the MPFL balance during the initial 20°-30° of flexion.
PURPOSE: The influence of the medial patellar ligamentous structures on patellar tracking has rarely been studied. Thus the main purpose of this cadaveric biomechanical study was to determine the influence of the medial patellofemoral (MPFL), medial patellomeniscal (MPML) and medial patellotibial (MPTL) ligaments on the three-dimensional patellar tracking during knee flexion. This study was conducted using a validated cadaveric optoelectronic protocol for analysis of patellar kinematics. METHODS: For each cadaveric knee study, four successive acquisitions were performed; first was studied patellar tracking in healthy knees, then the junction between MPFL and vastus medialis obliquus (VMO) was sectioned, the MPFL was released at its patellar attachment and finally was released the insertion of the MPML and MPTL. RESULTS: In this study, the MPFL accounts for 50-60% of the medial stabilization forces of the lateral patellar shift during patellar engagement in the femoral trochlea. This work confirm and clarify the role of the MPFL as the primary stabilizer of the patella during the initial 30° of knee flexion. Moreover, this study shows no significant results regarding the stabilizing action of the VMO on the patella during knee flexion. CONCLUSION: This in vitro study, conducted with an experimental protocol previously validated in the literature, helps quantify the actions of the MPFL, the VMO, and the MPML/MPTL respectively, and identify areas of joint motion where these structures have the most significant influence. This confirms the importance of reconstruction in the treatment of chronic patellar instability. During its reconstruction, care should be taken to adjust the MPFL balance during the initial 20°-30° of flexion.
Authors: Marcos V Katchburian; Anthony M J Bull; Yi-Fen Shih; Frederick W Heatley; Andrew A Amis Journal: Clin Orthop Relat Res Date: 2003-07 Impact factor: 4.176
Authors: A D Cooney; Z Kazi; N Caplan; M Newby; A St Clair Gibson; D F Kader Journal: Knee Surg Sports Traumatol Arthrosc Date: 2012-01-26 Impact factor: 4.342
Authors: N Caplan; D Lees; M Newby; A Ewen; R Jackson; A St Clair Gibson; D Kader Journal: Knee Surg Sports Traumatol Arthrosc Date: 2014-03-21 Impact factor: 4.342
Authors: Camila Cohen Kaleka; Leandro Jun Aihara; Anderson Rodrigues; Sebastião Ferreira de Medeiros; Victor Marques de Oliveira; Ricardo de Paula Leite Cury Journal: Knee Surg Sports Traumatol Arthrosc Date: 2016-10-08 Impact factor: 4.342
Authors: Johannes F Plate; Thorsten M Seyler; Jason J Halvorson; Anthony C Santago; Jason E Lang Journal: Knee Surg Sports Traumatol Arthrosc Date: 2013-01-19 Impact factor: 4.342