Failed medial patellofemoral ligament reconstruction

Patellar instability is a common clinical problem encountered by orthopedic surgeons specializing in the knee. For patients with chronic lateral patellar instability, the standard surgical approach is to stabilize the patella through a medial patellofemoral ligament (MPFL) reconstruction. Foreseeabl...

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Detalles Bibliográficos
Autores: Sanchis-Alfonso, Vicente|||0000-0002-9191-796X, Montesinos-Berry, Erik, Ramírez-Fuentes, Cristina, Leal Blanquet, Joan|||0000-0001-6616-6175, Gelber Ghertner, Pablo Eduardo|||0000-0001-5063-5133, Monllau García, Joan Carles|||0000-0002-2418-4874
Tipo de recurso: artículo
Fecha de publicación:2017
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:288770
Acceso en línea:https://ddd.uab.cat/record/288770
https://dx.doi.org/urn:doi:10.5312/wjo.v8.i2.115
Access Level:acceso abierto
Palabra clave:3D-CT in patellofemoral surgery
Failed medial patellofemoral ligament reconstruction
Medial patellofemoral ligament
Trochleoplasty
Descripción
Sumario:Patellar instability is a common clinical problem encountered by orthopedic surgeons specializing in the knee. For patients with chronic lateral patellar instability, the standard surgical approach is to stabilize the patella through a medial patellofemoral ligament (MPFL) reconstruction. Foreseeably, an increasing number of revision surgeries of the reconstructed MPFL will be seen in upcoming years. In this paper, the causes of failed MPFL reconstruction are analyzed: (1) incorrect surgical indication or inappropriate surgical technique/patient selection; (2) a technical error and (3) an incorrect assessment of the concomitant risk factors for instability. An understanding of the anatomy and biomechanics of the MPFL and cautiousness with the imaging techniques while favoring clinical over radiological findings and the use of common sense to determine the adequate surgical technique for each particular case, are critical to minimizing MPFL surgery failure. Additionally, our approach to dealing with failure after primary MPFL reconstruction is also presented.