Christian Fink1, Matjaz Veselko2, Mirco Herbort3, Christian Hoser4. 1. Sportsclinic Austria, Innsbruck Austria. 2. Department of Traumatology, University Medical Center, Ljubljana, Slovenia. 3. Department of Trauma-, Hand- and Reconstructive Surgery, Westfaelian-Wilhelms University of Muenster, Muenster, Germany. 4. Sportsclinic Austria, Innsbruck Austria. Electronic address: christian.hoser@sportsclinicaustria.com.
Abstract
BACKGROUND: We describe the preliminary clinical results of a new operative technique for MPFL reconstruction using a strip of quadriceps tendon (QT). PATIENTS: 17 patients (7 male, 10 female; mean age 21.5 years ± 3.9) have been operated on with this technique. All patients were evaluated clinically, radiologically and with subjective questionnaires (Tegner-, Lysholm-, Kujala Score) pre-operatively and post-operatively at 6 and 12 months (m). SURGICAL TECHNIQUE: A 10 to 12 mm wide, 3mm thick and 8 to 10 cm long strip from the central aspect of quadriceps tendon is harvested subcutaneously. The tendon strip is then dissected distally on the patella, left attached, diverged 90° medially underneath the medial prepatellar tissue and fixed with 2 sutures. The graft is fixed in 20° of knee flexion with a bioabsorbable interference screw. RESULTS: Lysholm score at 6m was 81.9 ± 11.7 and at 12 m 88.1 ± 10.9, Kujala score at 12 m was 89.2 ± 7.1 and Tegner Score was 4.9 ± 2.0 (6m) and 5.0 ± 1.9 (12 m). Two patients had a positive apprehension test at 12 months. There was no re-dislocation during the follow-up period. CONCLUSION: MPFL reconstruction with a strip of QT harvested in a minimal invasive technique was found to be associated with good short term clinical results. We think that this technique presents a valuable alternative to common hamstring techniques for primary MPFL reconstruction in children and adults, as well as for MPFL revision surgery. LEVEL OF EVIDENCE: IV, prospective case series.
BACKGROUND: We describe the preliminary clinical results of a new operative technique for MPFL reconstruction using a strip of quadriceps tendon (QT). PATIENTS: 17 patients (7 male, 10 female; mean age 21.5 years ± 3.9) have been operated on with this technique. All patients were evaluated clinically, radiologically and with subjective questionnaires (Tegner-, Lysholm-, Kujala Score) pre-operatively and post-operatively at 6 and 12 months (m). SURGICAL TECHNIQUE: A 10 to 12 mm wide, 3mm thick and 8 to 10 cm long strip from the central aspect of quadriceps tendon is harvested subcutaneously. The tendon strip is then dissected distally on the patella, left attached, diverged 90° medially underneath the medial prepatellar tissue and fixed with 2 sutures. The graft is fixed in 20° of knee flexion with a bioabsorbable interference screw. RESULTS: Lysholm score at 6m was 81.9 ± 11.7 and at 12 m 88.1 ± 10.9, Kujala score at 12 m was 89.2 ± 7.1 and Tegner Score was 4.9 ± 2.0 (6m) and 5.0 ± 1.9 (12 m). Two patients had a positive apprehension test at 12 months. There was no re-dislocation during the follow-up period. CONCLUSION: MPFL reconstruction with a strip of QT harvested in a minimal invasive technique was found to be associated with good short term clinical results. We think that this technique presents a valuable alternative to common hamstring techniques for primary MPFL reconstruction in children and adults, as well as for MPFL revision surgery. LEVEL OF EVIDENCE: IV, prospective case series.
Authors: C Domnick; M Herbort; M J Raschke; B Schliemann; R Siebold; R Śmigielski; C Fink Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-08-14 Impact factor: 4.342
Authors: Daniel K Schneider; Brian Grawe; Robert A Magnussen; Adrick Ceasar; Shital N Parikh; Eric J Wall; Angelo J Colosimo; Christopher C Kaeding; Gregory D Myer Journal: Am J Sports Med Date: 2016-02-12 Impact factor: 6.202