Department of Orthopaedic Surgery, Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue #A665, Baltimore, MD 21224, USA.
J Bone Joint Surg Am. 2012 Jun 20;94(12):e87. doi: 10.2106/JBJS.K.01449.
The role of medial patellofemoral ligament reconstruction in reestablishing patellofemoral joint stability has recently been reported with increasing frequency. The purpose of this study was to review the reported complications of medial patellofemoral ligament reconstruction, highlight the common technical errors, and discuss the potential complications that can arise from this procedure.
We review the literature on medial patellofemoral ligament reconstruction, including the reported causes of failure. In addition, we present three cases and discuss the multiple factors that are crucial for success, including patient selection, tunnel placement, graft isometry, and determination of the need for concurrent realignment surgery.
The principles of surgical management require a thorough understanding of proper patient selection and of the interaction between the roles of the osseous and soft-tissue restraints on the patella. Creating a logical treatment algorithm based on pathoanatomy can elucidate the need for concurrent distal realignment procedures. Tunnel positioning is critical in recreating appropriate patellofemoral alignment. The reported complications include patellofemoral arthrosis, graft impingement, and graft failure.
Many of the complications that can arise from medial patellofemoral ligament reconstruction are the result of technical error and can be avoided by understanding the potential complications associated with this procedure.
内侧髌股韧带重建在重建髌股关节稳定性方面的作用最近报道越来越频繁。本研究的目的是回顾内侧髌股韧带重建的报告并发症，强调常见的技术错误，并讨论该手术可能出现的潜在并发症。
我们回顾了内侧髌股韧带重建的文献，包括报告的失败原因。此外，我们介绍了三个病例，并讨论了成功的多个关键因素，包括患者选择、隧道放置、移植物等长、以及是否需要同时行矫正手术。
手术管理原则需要对适当的患者选择以及骨骼和软组织对髌骨的约束作用之间的相互作用有透彻的了解。根据病理解剖学制定合理的治疗算法可以阐明是否需要同时行远端矫正手术。隧道定位在重建合适的髌股排列方面至关重要。报告的并发症包括髌股关节炎、移植物撞击和移植物失败。
内侧髌股韧带重建可能出现的许多并发症是技术错误的结果，通过了解与该手术相关的潜在并发症，可以避免这些并发症。
