Isolated Medial Patellofemoral Ligament Reconstruction under Increased Femoral Anteversion is Associated with Increased Contact Pressure of Medial Patellofemoral Facet at Deep Flexion Angle: A Cadaveric Study.

IF 4.4 1区 医学 Q1 ORTHOPEDICS
Jisu Park, Zhanguang Piao, Seonjin Shin, Tae Woo Kim, Moon Jong Chang, Darryl D D'Lima, Dai-Soon Kwak
{"title":"Isolated Medial Patellofemoral Ligament Reconstruction under Increased Femoral Anteversion is Associated with Increased Contact Pressure of Medial Patellofemoral Facet at Deep Flexion Angle: A Cadaveric Study.","authors":"Jisu Park, Zhanguang Piao, Seonjin Shin, Tae Woo Kim, Moon Jong Chang, Darryl D D'Lima, Dai-Soon Kwak","doi":"10.1016/j.arthro.2025.03.040","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to analyze (1) whether isolated medial patellofemoral ligament (MPFL) reconstruction in increased femoral anteversion could replicate patellofemoral (PF) pressure pattern of a hypothetical normal population, and (2) the change of PF pressure according to MPFL state under the same anteversion setting.</p><p><strong>Methods: </strong>Ten fresh-frozen cadaveric knees were used. Experiments were performed from knee flexion 0° to 90° with three MPFL state (intact, released, and reconstructed) and three anteversion (initial state, 10° and 20° more increased). Medial and lateral PF joint contact pressures were measured at each point.</p><p><strong>Results: </strong>At 0° flexion, lateral PF pressure was increased to 62.1 ± 7.8 psi in 10° and 67.3 ± 13.5 psi in 20° more increased anteversion, compared to 43.2 ± 8.6 psi of hypothetical normal population (P-value 0.027 and 0.004, respectively). At 30° flexion, medial PF pressure was decreased to 31.3 ± 11.9 psi in 10° and 27.3 ± 17.5 psi in 20° more increased anteversion, compared to 44.1 ± 10.3 psi of hypothetical normal population (P-value 0.009 and 0.027, respectively). Within the same femoral anteversion, when anteversion was increased 10° and 20° more than the initial state, medial facet pressure after MPFL reconstruction at 90° flexion was increased from 28.7 ± 11.4 to 40.0 ± 9.9 psi and 16.7 ± 10.8 to 33.9 ± 15.0 psi compared to the intact MPFL (P-value 0.047 and <0.001, respectively).</p><p><strong>Conclusions: </strong>Biomechanically, isolated MPFL reconstruction under increased femoral anteversion was unable to replicate the state of a hypothetical normal population. Even when comparing within the same femoral anteversion, isolated MPFL reconstruction at increased femoral anteversion caused medial PF overpressure at 90° flexion angle.</p><p><strong>Clinical relevance: </strong>When performing MPFL reconstruction for recurrent patellar dislocation, femoral anteversion should be assessed. Increased femoral anteversion can cause overpressure on the medial facet following isolated MPFL reconstruction.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4000,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.arthro.2025.03.040","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose: This study aimed to analyze (1) whether isolated medial patellofemoral ligament (MPFL) reconstruction in increased femoral anteversion could replicate patellofemoral (PF) pressure pattern of a hypothetical normal population, and (2) the change of PF pressure according to MPFL state under the same anteversion setting.

Methods: Ten fresh-frozen cadaveric knees were used. Experiments were performed from knee flexion 0° to 90° with three MPFL state (intact, released, and reconstructed) and three anteversion (initial state, 10° and 20° more increased). Medial and lateral PF joint contact pressures were measured at each point.

Results: At 0° flexion, lateral PF pressure was increased to 62.1 ± 7.8 psi in 10° and 67.3 ± 13.5 psi in 20° more increased anteversion, compared to 43.2 ± 8.6 psi of hypothetical normal population (P-value 0.027 and 0.004, respectively). At 30° flexion, medial PF pressure was decreased to 31.3 ± 11.9 psi in 10° and 27.3 ± 17.5 psi in 20° more increased anteversion, compared to 44.1 ± 10.3 psi of hypothetical normal population (P-value 0.009 and 0.027, respectively). Within the same femoral anteversion, when anteversion was increased 10° and 20° more than the initial state, medial facet pressure after MPFL reconstruction at 90° flexion was increased from 28.7 ± 11.4 to 40.0 ± 9.9 psi and 16.7 ± 10.8 to 33.9 ± 15.0 psi compared to the intact MPFL (P-value 0.047 and <0.001, respectively).

Conclusions: Biomechanically, isolated MPFL reconstruction under increased femoral anteversion was unable to replicate the state of a hypothetical normal population. Even when comparing within the same femoral anteversion, isolated MPFL reconstruction at increased femoral anteversion caused medial PF overpressure at 90° flexion angle.

Clinical relevance: When performing MPFL reconstruction for recurrent patellar dislocation, femoral anteversion should be assessed. Increased femoral anteversion can cause overpressure on the medial facet following isolated MPFL reconstruction.

股骨前倾增加下的髌股内侧韧带重建与髌股内侧关节面深度屈曲角接触压力增加有关:一项尸体研究。
目的:本研究旨在分析(1)股骨前倾角增大时孤立髌股内侧韧带(MPFL)重建能否复制假设正常人群的髌股内侧韧带(PF)压力模式,以及(2)相同前倾角条件下MPFL状态下PF压力的变化。方法:采用新鲜冷冻尸体膝关节10例。实验从膝关节屈曲0°到90°,有三种MPFL状态(完整、释放和重建)和三种前倾状态(初始状态、10°和20°增加)。在每个点测量内侧和外侧PF关节接触压力。结果:与假设正常人群的43.2±8.6 psi (p值分别为0.027和0.004)相比,在0°屈曲时,侧PF压力增加到10°时的62.1±7.8 psi和20°时的67.3±13.5 psi。与假设正常人群的44.1±10.3 psi (p值分别为0.009和0.027)相比,在30°屈曲时,内侧PF压力在10°和20°增加时分别降至31.3±11.9 psi和27.3±17.5 psi。在相同的股骨前倾情况下,当前倾比初始状态分别增加10°和20°时,与完整的MPFL相比,90°弯曲时MPFL重建后的内侧关节面压力从28.7±11.4 psi增加到40.0±9.9 psi,从16.7±10.8 psi增加到33.9±15.0 psi (p值为0.047)。结论:从生物力学角度来看,股骨前倾增加下的孤立MPFL重建无法复制假设的正常人群的状态。即使在相同的股骨前倾范围内进行比较,在股骨前倾增加时孤立的MPFL重建也会导致内侧PF在90°屈曲角处超压。临床意义:在对复发性髌骨脱位进行MPFL重建时,应评估股骨前倾角。股骨前倾增加可导致孤立性强韧带重建后内侧关节面压力过大。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
9.30
自引率
17.00%
发文量
555
审稿时长
58 days
期刊介绍: Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信