ArticleJournal of clinical medicine2019
Evaluation of Patellar Contact Pressure Changes after Static versus Dynamic Medial Patellofemoral Ligament Reconstructions Using a Finite Element Model.
Article in Journal of clinical medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Medial Patellofemoral Ligament Reconstruction Using Gracilis With Pes Anserinus Preservation and Adductor Magnus Pulley.Arthroscopy techniques · 2026Article
- No significant side-to-side differences in retropatellar load distribution using more than 7.5 years after isolated MPFL reconstruction: A CT-osteoabsorptiometry pilot study in nine patients.Journal of experimental orthopaedics · 2026Article
- Anatomical and clinical significance of the Cyrano long-nosed patella in combination with patellofemoral instability: a case report and review of literature.Journal of medical case reports · 2025Review
- MR imaging after patellar MACI and MPFL reconstruction: a comparison of isolated versus combined procedures.Skeletal radiology · 2024Article
- Outcomes of an All-Soft Tissue Fixation Technique for Reconstruction of the Medial Patellofemoral Complex Using Double-Bundle Quadriceps Tendon Autograft for Recurrent Patellar Dislocation in Skeletally Immature Patients.Orthopaedic journal of sports medicine · 2024Article
- Model Properties and Clinical Application in the Finite Element Analysis of Knee Joint: A Review.Orthopaedic surgery · 2024Review
- Article
- After MPFL reconstruction, femoral tunnel widening and migration increase with poor tunnel positioning and are related to poor clinical outcomes.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Double-Bundle Quadriceps Tendon Autograft for Reconstruction of the Medial Patellofemoral Complex to Manage Recurrent Patellar Dislocation in Patients With Open Physes.Arthroscopy techniques · 2023Article
- Simultaneous Medial Patellofemoral Ligament and Medial Quadriceps Tendon-Femoral Ligament Reconstructions Using an Artificial Ligament for Lateral Patella Instability.Arthroscopy techniques · 2022Article
- Patellar instability MRI measurements are associated with knee joint degeneration after reconstruction of the medial patellofemoral ligament.Skeletal radiology · 2022Article
- Isolated reconstruction of medial patellofemoral ligament with an elastic femoral fixation leads to excellent clinical results.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2021Article
- Dynamic-Anatomical Reconstruction of Medial Patellofemoral Ligament in Open Physis.Arthroscopy techniques · 2020Article
- Lateral Retinaculum Lengthening and Medial Patellofemoral Ligament Reconstruction With Adductor Sling Technique.Video journal of sports medicineArticle
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo evaluate the effect of various medial patellofemoral ligament (MPFL) fixation techniques on patellar pressure compared with the native knee.
methodsA finite element model of the patellofemoral joint consisting of approximately 30,700 nodes and 22,200 elements was created from computed tomography scans of 24 knees with chronic lateral patellar instability. Patellar contact pressures and maximum MPFL graft stress at five positions of flexion (0°, 30°, 60°, 90°, and 120°) were analyzed in three types of MPFL reconstruction (MPFLr): (1) static/anatomic, (2) dynamic, using the adductor magnus tendon (AMT) as the femoral fixation, and (3) dynamic, using the quadriceps tendon as the attachment (medial quadriceps tendon-femoral ligament (MQTFL) reconstruction).
resultsIn the static/anatomic technique, the patellar contact pressures at 0° and 30° were greater than in the native knee. As in a native knee, the contact pressures at 60°, 90°, and 120° were very low. The maximum MPFL graft stress at 0° and 30° was greater than in a native knee. However, the MPFL graft was loose at 60°, 90°, and 120°, meaning it had no tension. In the dynamic MPFLr using the AMT as a pulley, the patellar contact pressures were like those of a native knee throughout the entire range of motion. However, the maximum stress of the MPFL graft at 0° was less than that of a native ligament. Yet, the maximum MPFL graft stress was greater at 30° than in a native ligament. After 30° of flexion, the MPFL graft loosened, similarly to a native knee. In the dynamic MQTFL reconstruction, the maximum patellar contact pressure was slightly greater than in a normal knee. The maximum stress of the MPFL graft was much greater at 0° and 30° than that of a native MPFL. After 30° of flexion, the MQPFL graft loosened just as in the native knee.
conclusionsThe patellar contact pressures after the dynamic MPFLr were like those of the native knee, whereas a static reconstruction resulted in greater pressures, potentially increasing the risk of patellofemoral osteoarthritis in the long term. Therefore, the dynamic MPFLr might be a safer option than a static reconstruction from a biomechanical perspective.
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