Purpose: Two different operative techniques for stabilizing the patella against lateral displacement
movement were investigated. Type of Study: In vitro experimental study. Methods: Five human cadaver knee specimens with a normal Q-angle were mounted in a kinematic
knee simulator and investigated under simulated isokinetic extension motions. Patellar
movement was measured while a 100-N laterally directed subluxation load was applied
to the patella. Ligament loading of the medial patellofemoral ligament was measured
using a strain gage based buckle transducer inserted in the fibers of the ligament.
The knee was evaluated in an intact physiologic state, as well as after medial transfer
of the tibial tuberosity, and after the medial patellofemoral ligament was transected
and reconstructed using a hamstring autograft. Results: A significant reduction in lateral displacement and ligament load was observed with
the use of the hamstring autograft reconstruction compared with the medial transfer
of the tibial tuberosity. Conclusions: Medial transfer of the tibial tuberosity showed no significant relief of ligament
loading and stabilizing effect on patellar movement, whereas reconstruction of the
medial patellofemoral ligament showed a significant stabilizing effect on patellar
movement. Clinical Relevance: In cadaver specimens, we evaluated the effect of tibial tubercle transfer and the
patellofemoral ligament and found that reconstruction of the patellofemoral ligament
alone was sufficient to restore stability in a cadaveric model. Additionally, we found
that the flexion angle had little effect on the loading of the medial patellofemoral
ligament autograft, which would support early mobilization of patients after surgery.
We found that the graft was not unduly loaded.
Key Words
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© 2006 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
