A biomechanical analysis of four medial patellofemoral ligament reconstruction techniques

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-02-01 DOI:10.1016/j.clinbiomech.2024.106401

Thomas A. Bedard, Christopher K. Johnson, Richard L. Amendola, Matthew G. Scuderi, Nathaniel R. Ordway, Frederick W. Werner, John P. Cannizzaro

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引用次数: 0

Abstract

Background

Implant free medial patellofemoral ligament reconstruction is an increasingly popular technique to address patellar instability. There remains sparse literature on the biomechanical differences between the most common femoral attachment fixation points including Schottle's point, superficial medial collateral ligament, and adductor magnus tendon. This study compared these reconstruction techniques as well as a novel triangle reconstruction integrating both superficial medial collateral ligament and adductor magnus tendon.

Methods

Eight cadaveric knees were tested in a muscle activated knee simulator which mimicked a standing, shallow knee bend movement. Patella lateral displacement, external rotation and flexion were measured with and without a lateral load applied under the following conditions: 1) intact, 2) medial patellofemoral ligament cut, 3) Schottle's point reconstruction, 4) adductor magnus tendon reconstruction, 5) superficial medial collateral ligament reconstruction, 6) triangle reconstruction. Differences were analyzed using a repeated measures analysis of variance at 20, 30, 45 and 60 degrees of knee flexion.

Findings

All reconstruction techniques had significantly less lateral displacement compared to the cut condition when a lateral load was applied. Between reconstruction conditions, there was significantly less lateral displacement using Schottle's point and superficial medial collateral ligament as compared to adductor magnus tendon (p < 0.05). All reconstruction techniques had a trend towards medial constraint as compared to intact.

Interpretation

An over constrained position of the patella through early flexion of the knee may increase the likelihood of secondary patellofemoral arthritis. Although there were differences in magnitude of displacement/constraint, further studies are needed to assess clinical differences regarding constraint.

查看原文本刊更多论文

四种内侧髌股韧带重建技术的生物力学分析。

背景：游离髌股内侧韧带重建是一种日益流行的治疗髌骨不稳的技术。关于最常见的股骨附着固定点（包括Schottle点、浅内侧副韧带和大收肌肌腱）的生物力学差异的文献仍然很少。本研究比较了这些重建技术以及结合浅内侧副韧带和大收肌肌腱的新型三角重建。方法：在肌肉激活膝关节模拟器中对8具尸体的膝关节进行测试，模拟站立、浅膝关节弯曲运动。在以下条件下测量髌骨外侧位移、外旋和屈曲情况：1)完整，2)髌股内侧韧带切断，3)Schottle点重建，4)大收肌肌腱重建，5)内侧浅副韧带重建，6)三角重建。采用重复测量法分析膝关节屈曲20度、30度、45度和60度的差异。结果：与施加横向载荷时的切割条件相比，所有重建技术的横向位移都显著减少。在重建条件之间，与大内提肌腱相比，使用Schottle’s点和浅内侧副韧带的外侧移位明显更少(p)。解释：早期膝关节屈曲导致髌骨位置过度受限可能增加继发性髌股关节炎的可能性。尽管移位/约束的大小存在差异，但需要进一步的研究来评估有关约束的临床差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.