Complications of medial patellofemoral ligament reconstruction: common technical errors and factors for success: AAOS exhibit selection

Miho J Tanaka; Matthew J Bollier; Jack T Andrish; John P Fulkerson; Andrew J Cosgarea

doi:10.2106/JBJS.K.01449

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Complications of medial patellofemoral ligament reconstruction: common technical errors and factors for success: AAOS exhibit selection

Journal article

Peer reviewed

Complications of medial patellofemoral ligament reconstruction: common technical errors and factors for success: AAOS exhibit selection

Miho J Tanaka, Matthew J Bollier, Jack T Andrish, John P Fulkerson and Andrew J Cosgarea

Journal of bone and joint surgery. American volume, Vol.94(12), pp.e87-e87

06/20/2012

DOI: 10.2106/JBJS.K.01449

PMID: 22717839

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Abstract

The role of medial patellofemoral ligament reconstruction in reestablishing patellofemoral joint stability has recently been reported with increasing frequency. The purpose of this study was to review the reported complications of medial patellofemoral ligament reconstruction, highlight the common technical errors, and discuss the potential complications that can arise from this procedure. We review the literature on medial patellofemoral ligament reconstruction, including the reported causes of failure. In addition, we present three cases and discuss the multiple factors that are crucial for success, including patient selection, tunnel placement, graft isometry, and determination of the need for concurrent realignment surgery. The principles of surgical management require a thorough understanding of proper patient selection and of the interaction between the roles of the osseous and soft-tissue restraints on the patella. Creating a logical treatment algorithm based on pathoanatomy can elucidate the need for concurrent distal realignment procedures. Tunnel positioning is critical in recreating appropriate patellofemoral alignment. The reported complications include patellofemoral arthrosis, graft impingement, and graft failure. Many of the complications that can arise from medial patellofemoral ligament reconstruction are the result of technical error and can be avoided by understanding the potential complications associated with this procedure.

Joint Instability - surgery

Ligaments, Articular - pathology

Arthroplasty - adverse effects

Knee Joint

Humans

Joint Instability - pathology

Ligaments, Articular - surgery

Joint Instability - etiology

Arthroplasty - methods

Details

Title: Subtitle: Complications of medial patellofemoral ligament reconstruction: common technical errors and factors for success: AAOS exhibit selection
Creators: Miho J Tanaka - Department of Orthopaedic Surgery, Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue #A665, Baltimore, MD 21224, USA
Matthew J Bollier
Jack T Andrish
John P Fulkerson
Andrew J Cosgarea
Resource Type: Journal article
Publication Details: Journal of bone and joint surgery. American volume, Vol.94(12), pp.e87-e87
DOI: 10.2106/JBJS.K.01449
PMID: 22717839
NLM abbreviation: J Bone Joint Surg Am
ISSN: 0021-9355
eISSN: 1535-1386
Publisher: Journal of Bone and Joint Surgery Incorporated; United States
Language: English
Date published: 06/20/2012
Academic Unit: Orthopedics and Rehabilitation
Record Identifier: 9984040287102771

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