Document Detail


Dynamic measurement of patellofemoral contact pressure following reconstruction of the medial patellofemoral ligament: an in vitro study.
MedLine Citation:
PMID:  17118499     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Surgical reconstruction of the medial patellofemoral ligament used to stabilize the patella against lateral dislocation may concomitantly produce alteration of the patellofemoral contact pressure distribution. Two different tendon transfer techniques of reconstructing the medial patellofemoral ligament, one dynamic and one static, as well as a proximal soft tissue realignment of the patella were investigated. METHODS: Eight human knee specimens were mounted in a kinematic knee simulator and isokinetic extension motion was simulated. Patellofemoral pressure was measured using a pressure sensitive film while a 100 N laterally directed dislocation load was applied to the patella. The specimens were evaluated in a physiologic state, as well as after dynamic reconstruction of the medial patellofemoral ligament using a distal transfer of the semitendinosus tendon, following static reconstruction using a semitendinosus autograft, and following proximal soft tissue realignment of the patella. FINDINGS: Following both reconstruction techniques of the medial patellofemoral ligament patellofemoral contact pressure was not significantly (P=0.49) altered. In contrast, after proximal realignment a trend (P=0.07) towards higher contact pressure near knee extension was observed. In the absence of a lateral dislocation load dynamic and static reconstruction resulted in a medialization (P=0.04) of the center of pressure, whereas under the application of a 100 N dislocation load the center of pressure showed no significant alteration. Following proximal realignment the center of pressure was significantly medialized without (P<0.01) and with a dislocation load (P=0.01) throughout the entire range of knee motion. INTERPRETATION: Static and dynamic ligament reconstruction of the medial patellofemoral ligament did not alter patellofemoral pressure. Proximal realignment, on the other hand, resulted in a constant medialization of the patellofemoral pressure. The data suggest that the reconstruction techniques would be associated with a low risk of causing premature cartilage degeneration due to excessive patellofemoral contact pressure, whereas proximal realignment could cause medial overload of the patellofemoral joint.
Authors:
Sven Ostermeier; Marc Holst; Michael Bohnsack; Christof Hurschler; Christina Stukenborg-Colsman; Carl-Joachim Wirth
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Publication Detail:
Type:  Journal Article     Date:  2006-11-22
Journal Detail:
Title:  Clinical biomechanics (Bristol, Avon)     Volume:  22     ISSN:  0268-0033     ISO Abbreviation:  Clin Biomech (Bristol, Avon)     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-02-12     Completed Date:  2007-03-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8611877     Medline TA:  Clin Biomech (Bristol, Avon)     Country:  England    
Other Details:
Languages:  eng     Pagination:  327-35     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, Hannover Medical School (MHH), Anna-von.-Borries-Str. 1-7, 30625 Hannover, Germany. sven.ostermeier@annastift.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Female
Humans
Joint Instability / surgery*
Knee Joint / physiopathology*
Ligaments, Articular / surgery*
Male
Middle Aged
Pressure
Reconstructive Surgical Procedures

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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