Division of Orthopedic Sports Medicine, Rush University Medical Center, Chicago, Illinois.
J Knee Surg. 2023 May;36(6):622-630. doi: 10.1055/s-0041-1741549. Epub 2022 Feb 10.
The purpose of this study was to investigate whether differences exist in preventing lateral patellar translation between three distinct medial patellofemoral complex (MPFC) reconstruction procedures at varying knee flexion angles. Six cadaveric knee specimens were dissected, potted, and placed in a customized jig for testing. Lateral patellar displacement was measured at intervals between 0 and 90 degrees of knee flexion using a tensile testing machine with a 20 N lateral force applied to the patella. Each specimen was tested with the MPFC intact, sectioned, and after each of the three reconstruction techniques: MPFL, hybrid, and medial quadriceps-tendon femoral (MQTFL) reconstructions. There was significantly increased lateral patellar displacement following MPFC sectioning when compared with the intact state in early degrees of flexion (10-30 degrees) ( < 0.05). All three reconstruction groups restored patella stability and reduced lateral patellar displacement following sectioning from 0 to 30 degrees of flexion ( < 0.05). When compared with the intact group, all three reconstruction groups demonstrated reduced patella translation at full knee extension, while the MPFL and hybrid reconstruction groups additionally demonstrated significant reduction in patella translation at 10 degrees of flexion ( < 0.05). No significant differences were observed between the three reconstruction groups. This biomechanical study demonstrates the efficacy of three MPFC reconstruction techniques in patella stabilization following sectioning. Our results suggest that MPFL reconstruction may provide the most robust patella stabilization, whereas MQTFL reconstruction may be the most forgiving construct. This study suggests that MQTFL and hybrid reconstructions provide adequate resistance to lateral translation and may be used as an alternative to MPFL reconstruction.
本研究旨在探讨在不同膝关节屈曲角度下，三种不同内侧髌股复合结构（MPFC）重建术式在预防外侧髌骨平移方面是否存在差异。对 6 个尸体膝关节标本进行解剖、种植并放置在定制夹具中进行测试。使用带有 20N 外侧力的拉伸试验机，在 0 到 90 度膝关节屈曲范围内测量髌骨外侧位移。每个标本分别在 MPFC 完整、切开以及三种重建技术（MPFL、混合和内侧四头肌腱股骨（MQTFL）重建）后进行测试。与完整状态相比，在早期（10-30 度）膝关节屈曲时，MPFC 切开后髌骨外侧位移显著增加（<0.05）。所有三种重建组均在 0 到 30 度的膝关节屈曲时恢复了髌骨稳定性并减少了髌骨外侧位移（<0.05）。与完整组相比，所有三种重建组在膝关节完全伸展时均减少了髌骨平移，而 MPFL 和混合重建组在 10 度膝关节屈曲时也显著减少了髌骨平移（<0.05）。三种重建组之间没有观察到显著差异。这项生物力学研究表明，三种 MPFC 重建技术在切开后对髌骨稳定具有疗效。我们的结果表明，MPFL 重建可能提供最稳健的髌骨稳定，而 MQTFL 重建可能是最宽容的结构。本研究表明，MQTFL 和混合重建提供了足够的抵抗外侧平移的能力，可作为 MPFL 重建的替代方法。
