Failed medial patellofemoral ligament reconstruction:Causes and surgical strategies  

作　　者：Vicente Sanchis-Alfonso Erik Montesinos-Berry Cristina Ramirez-Fuentes Joan Leal-Blanquet Pablo E Gelber Joan Carles Monllau 

机构地区：[1]Department of Orthopaedic Surgery,Hospital Arnau de Vilanova Valencia and Hospital 9 de Octubre [2]Agoriaz Orthopaedic Center,1632 Riaz and Clinique CIC,1815 Clarens [3]Department of Radiology,Hospital Universitario y Politécnico La Fe and GIBI230 IIS La Fe Research Group [4]Department of Orthopaedic Surgery,Hospital del Mar,Universitat Autònoma de Barcelona [5]Department of Orthopaedic Surgery,Hospital de la Santa Creu i Sant Pau,Universitat Autònoma de Barcelona

出　　处：《World Journal of Orthopedics》2017年第2期115-129,共15页世界骨科杂志（英文版）

摘　　要：Patel ar 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.Patel ar 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.

关 键 词：MEDIAL PATELLOFEMORAL LIGAMENT FAILED MEDIAL PATELLOFEMORAL LIGAMENT RECONSTRUCTION TROCHLEOPLASTY 3D-CT in PATELLOFEMORAL surgery 

分 类 号：R687.4[医药卫生—骨科学]