G Placella1, A Speziali2, E Sebastiani3, S Morello4, M M Tei2, G Cerulli2. 1. Fondazione Policlinico Agostino Gemelli, Istituto di Clinica Ortopedica e Traumatologica, Università Cattolica del Sacro Cuore di Roma, Largo Agostino Gemelli, 1 Policlinico Gemelli di Roma, 00135, Rome, Italy. giacomo.placella@gmail.com. 2. Fondazione Policlinico Agostino Gemelli, Istituto di Clinica Ortopedica e Traumatologica, Università Cattolica del Sacro Cuore di Roma, Largo Agostino Gemelli, 1 Policlinico Gemelli di Roma, 00135, Rome, Italy. 3. Ospedale S. Maria della Misericordia, Clinica Ortopedica e Traumatologica, Univesità degli Studi di Perugia, Perugia, Italy. 4. Policlinico P. Giaccone, Clinica Ortopedica e Traumatologica, Univerità degli Studi di Palermo, Palermo, Italy.
Abstract
BACKGROUND: Several MPFL reconstructions are commonly performed for recurrent patellar dislocation, but misleading data are currently available in the literature on the ability of the different techniques to re-create a functioning ligament. MATERIALS AND METHODS: In this study, we showed the biomechanical properties of two different procedures for MPFL reconstruction using a natural orientation during uniaxial tensile testing. Eighteen fresh-frozen human knees were randomly assigned to two groups of nine each. In the group A, the reconstruction was performed using a double converging tunnels technique and in the group B was used a single-tunnel technique with semitendinosus autograft. The specimens were loaded in natural orientation using an Instron tensile test machine, and the stiffness and ultimate load were determined. RESULTS: The ultimate load was 213 ± 90 and 171 ± 51 N using our double-bundle technique (group A) and the single-bundle technique (group B), respectively. One (11 %) specimen failed at the patellar side due to patellar fracture in the group B. There was no statistical significant difference (p > 0.05) between the two groups in terms of stiffness and ultimate load. CONCLUSION: This study is the first biomechanical evaluation of the MPFL reconstructions in natural orientation. Both the procedures achieved safe fixation of the graft at the femoral attachment; however, the single-bundle technique reported 11 % of failure at the patellar side due to patellar fracture. In addition, the double-bundle technique can better restore the anatomy of the native ligament.
RCT Entities:
BACKGROUND: Several MPFL reconstructions are commonly performed for recurrent patellar dislocation, but misleading data are currently available in the literature on the ability of the different techniques to re-create a functioning ligament. MATERIALS AND METHODS: In this study, we showed the biomechanical properties of two different procedures for MPFL reconstruction using a natural orientation during uniaxial tensile testing. Eighteen fresh-frozen human knees were randomly assigned to two groups of nine each. In the group A, the reconstruction was performed using a double converging tunnels technique and in the group B was used a single-tunnel technique with semitendinosus autograft. The specimens were loaded in natural orientation using an Instron tensile test machine, and the stiffness and ultimate load were determined. RESULTS: The ultimate load was 213 ± 90 and 171 ± 51 N using our double-bundle technique (group A) and the single-bundle technique (group B), respectively. One (11 %) specimen failed at the patellar side due to patellar fracture in the group B. There was no statistical significant difference (p > 0.05) between the two groups in terms of stiffness and ultimate load. CONCLUSION: This study is the first biomechanical evaluation of the MPFL reconstructions in natural orientation. Both the procedures achieved safe fixation of the graft at the femoral attachment; however, the single-bundle technique reported 11 % of failure at the patellar side due to patellar fracture. In addition, the double-bundle technique can better restore the anatomy of the native ligament.
Authors: G Placella; M M Tei; E Sebastiani; G Criscenti; A Speziali; C Mazzola; A Georgoulis; G Cerulli Journal: Knee Surg Sports Traumatol Arthrosc Date: 2014-08-17 Impact factor: 4.342
Authors: Armin Arshi; Jeremiah R Cohen; Jeffrey C Wang; Sharon L Hame; David R McAllister; Kristofer J Jones Journal: Orthop J Sports Med Date: 2016-08-31