Charles A Baumann1, Eli L Pratte1, Seth L Sherman2, Elizabeth A Arendt3, Betina B Hinckel4. 1. Thompson Laboratory for Regenerative Orthopaedics, Missouri Orthopaedic Institute, University of Missouri, Columbia, MO, USA. 2. Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA. 3. Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA. 4. Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA. betinahinckel@me.com.
Abstract
PURPOSE: The medial patellotibial ligament (MPTL), the medial patellofemoral ligament (MPFL), and the medial patellomeniscal ligament (MPML) support the stability of the patellofemoral joint. The purpose of this systematic review was to report the surgical techniques and clinical outcomes of the repair or reconstruction of the MPTL in isolation or concomitant with the MPFL and/or other procedures. METHODS: A systematic review of the literature was conducted. Inclusion criteria were articles in the English language that reported clinical outcomes of the reconstruction of the MPTL in isolation or in combination with the MPFL and/or other procedures. Included articles were then cross-referenced to find additional journal articles not found in the initial search. The methodological quality of the articles was determined using the Coleman Methodology Score. RESULTS: Nineteen articles were included detailing the clinical outcomes of 403 knees. The surgical procedures described included hamstrings tenodesis with or without other major procedures, medial transfer of the medial patellar tendon with or without other major procedures and the reconstruction of the MPTL in association with the MPFL. Overall, good and excellent outcomes were achieved in > 75% of cohorts in most studies and redislocations were < 10%, with or without the association of the MPFL. An exception was one study that reported a high failure rate of 82%. Results were consistent across different techniques. The median CMS for the articles was 66 out of 100 (range 30-85). CONCLUSION: Across different techniques, the outcomes are good with low rates of recurrence, with one article reporting a high rate of recurrence. Quality of the articles is variable, from low to high. Randomized control trials are needed for a better understanding of the indications, surgical techniques, and clinical outcomes. This systematic review suggests that the reconstruction of the MPTL leads to favorable clinical outcomes and supports the role of the procedure as a valid surgical patellar stabilization procedure. LEVEL OF EVIDENCE: IV: systematic review of level I-IV studies.
PURPOSE: The medial patellotibial ligament (MPTL), the medial patellofemoral ligament (MPFL), and the medial patellomeniscal ligament (MPML) support the stability of the patellofemoral joint. The purpose of this systematic review was to report the surgical techniques and clinical outcomes of the repair or reconstruction of the MPTL in isolation or concomitant with the MPFL and/or other procedures. METHODS: A systematic review of the literature was conducted. Inclusion criteria were articles in the English language that reported clinical outcomes of the reconstruction of the MPTL in isolation or in combination with the MPFL and/or other procedures. Included articles were then cross-referenced to find additional journal articles not found in the initial search. The methodological quality of the articles was determined using the Coleman Methodology Score. RESULTS: Nineteen articles were included detailing the clinical outcomes of 403 knees. The surgical procedures described included hamstrings tenodesis with or without other major procedures, medial transfer of the medial patellar tendon with or without other major procedures and the reconstruction of the MPTL in association with the MPFL. Overall, good and excellent outcomes were achieved in > 75% of cohorts in most studies and redislocations were < 10%, with or without the association of the MPFL. An exception was one study that reported a high failure rate of 82%. Results were consistent across different techniques. The median CMS for the articles was 66 out of 100 (range 30-85). CONCLUSION: Across different techniques, the outcomes are good with low rates of recurrence, with one article reporting a high rate of recurrence. Quality of the articles is variable, from low to high. Randomized control trials are needed for a better understanding of the indications, surgical techniques, and clinical outcomes. This systematic review suggests that the reconstruction of the MPTL leads to favorable clinical outcomes and supports the role of the procedure as a valid surgical patellar stabilization procedure. LEVEL OF EVIDENCE: IV: systematic review of level I-IV studies.
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: Avinesh Agarwalla; Anirudh K Gowd; Joseph N Liu; Richard N Puzzitiello; Adam B Yanke; Nikhil N Verma; Brian Forsythe Journal: Orthop J Sports Med Date: 2019-04-12
Authors: Riccardo Gomes Gobbi; Betina Bremer Hinckel; Paulo Renan Lima Teixeira; Pedro Nogueira Giglio; Bruno Romano Lucarini; José Ricardo Pécora; Gilberto Luis Camanho; Marco Kawamura Demange Journal: Orthop J Sports Med Date: 2019-12-04
Authors: Nilson Roberto Severino; Fabrício Roberto Severino; Osmar Pedro Arbix de Camargo; Luiz Gabriel Betoni Guglielmetti; Victor Marques de Oliveira; Ricardo de Paula Leite Cury Journal: Rev Bras Ortop (Sao Paulo) Date: 2020-11-02