Espregueira-Mendes João, Andrade Renato, Bastos Ricardo, Joseph Sheeba, Fulkerson John P, Silva Luís Duarte
School of Medicine, Minho University, Braga, Portugal.
Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal.
Arthrosc Tech. 2019 Apr 17;8(5):e481-e488. doi: 10.1016/j.eats.2019.01.006. eCollection 2019 May.
Patellar dislocation is a major orthopaedic concern in pediatric and adult populations, with both conservative and surgical options available. Several surgical techniques of the combined or isolated reconstruction of the medial patellofemoral ligament are described in the literature using different grafts, locations, and types of fixations, providing different advantages and disadvantages. New recent developments in cadaveric dissection studies have unveiled the importance of structures that were neglected until recently, such as the medial quadriceps tendon-femoral ligament, which provides a connection between the medial femur and the quadriceps tendon component of the knee extensor mechanism. Hence, we present a surgical technique with combined reconstruction of the medial patellofemoral ligament and medial quadriceps tendon-femoral ligament without the use of hardware and with no need for patellar or femoral drilling (no physis compromise or risk of patellar fracture), which can be used concomitantly with other bony procedures.
髌骨脱位是儿童和成人主要的骨科问题,有保守和手术两种治疗选择。文献中描述了几种使用不同移植物、位置和固定类型的内侧髌股韧带联合或单独重建的手术技术,各有优缺点。尸体解剖研究的最新进展揭示了一些直到最近才被忽视的结构的重要性,比如内侧股四头肌肌腱 - 股骨韧带,它在股骨内侧和膝关节伸肌机制的股四头肌肌腱部分之间提供连接。因此,我们提出一种内侧髌股韧带和内侧股四头肌肌腱 - 股骨韧带联合重建的手术技术,该技术无需使用金属器械,也无需对髌骨或股骨进行钻孔(不会损害骨骺或有髌骨骨折风险),并且可以与其他骨手术同时进行。