Medial soft tissue restraints in lateral patellar instability and repair.

Abstract:

:This study was undertaken to evaluate the medial ligamentous stabilizers of the patella in restraining lateral displacement and to assess their relative contribution after individual repair. Seventeen fresh frozen human anatomic specimen knee joints were studied. The specimens were loaded onto a testing instrument that was designed to measure the compliance of the medial and lateral patellar restraints in the coronal plane. Two different cutting and repair sequences were used to test the individual contributions of the patellar ligaments. The medial patellofemoral ligament was found to be the major medial ligamentous stabilizer of the patella. Isolated release resulted in a 50% increase in lateral displacement, and isolated repair restored balance to the patella. In addition, the patellotibial and patellomeniscal ligament complex played an important secondary role in restraining lateral patellar displacement. Isolated repair of these ligaments restored balance to near normal levels. The medial patellofemoral retinaculum played only a minor role in patellofemoral instability. Proximal realignment or medial ligament repair for patellofemoral instability specifically should address repair of the deep layers that contain the restraints to lateral patellar displacement. Failure to include these structures in repair, especially of the medial patellofemoral ligament, may lead to persistent or recurrent instability.

journal_name

Clin Orthop Relat Res

authors

Hautamaa PV,Fithian DC,Kaufman KR,Daniel DM,Pohlmeyer AM

doi

10.1097/00003086-199804000-00021

subject

Has Abstract

pub_date

1998-04-01 00:00:00

pages

174-82

issue

349

eissn

0009-921X

issn

1528-1132

pub_type

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