AJSM June 2023 Podcast: In Vivo Length Changes Between the Attachments of the Medial Patellofemoral Complex Fibers in Knees With Anatomic Risk Factors for Patellar Instability
Medial patellofemoral complex (MPFC)
reconstruction plays an important role in the surgical treatment of
patellar instability. Anatomic reconstruction is critical in
re-creating the native function of the ligament, which includes
minimizing length changes that occur in early flexion. Anatomic
risk factors for patellar instability such as trochlear dysplasia,
patella alta, and increased tibial tuberosity to trochlear groove
(TT-TG) distance have been shown to influence the function of the
MPFC graft in cadaveric studies, but the native length change
patterns of the MPFC fibers in knees with anatomic risk factors
have not been described.
In conclusion, the MPFC fibers demonstrated
increased length changes in knees when a greater number of
morphological risk factors for patellar instability were present,
which worsened in the setting of nonanatomic configurations. This
suggests that the function of the intact MPFC in patients with
anatomic risk factors may not reflect previously described findings
in anatomically normal knees. Further studies are needed to
understand the pathoanatomy related to these changes, as well as
the implications for graft placement and assessment of length
changes during MPFC reconstruction techniques.
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