Reconstruction of the medial patellofemoral ligament using autologous graft from quadriceps tendon to treat recurrent patellar dislocation

Calapodopulos, Constantino Jorge; Nogueira, Marcelo Corvino; Eustáquio, José Martins Juliano; Calapodopulos Júnior, Constantino Jorge; Rodrigues, Oreston Alves

doi:10.1016/j.rboe.2016.01.012

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Revista Brasileira de Ortopedia

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Original Article • Rev. bras. ortop. 51 (2) • Mar-Apr 2016 • https://doi.org/10.1016/j.rboe.2016.01.012 copy

Reconstruction of the medial patellofemoral ligament using autologous graft from quadriceps tendon to treat recurrent patellar dislocation^☆ ☆ Work performed at the Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, MG, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

The objective of this study was to evaluate the efficacy of the surgical technique using the quadriceps tendon as a graft in static reconstruction of the medial patellofemoral ligament.

METHODS:

This was a prospective case series study in which the participants were 22 patients with a diagnosis of recurrent patellar dislocation without any other anatomical alterations that required surgical treatment. The functional results from the technique were evaluated using clinical data and the Lysholm questionnaire, one year after the operation.

RESULTS:

It was observed that the patients were predominantly female (86%) and under 21 years of age (73%), just like in the literature. At the first annual return after the surgery, there was no significant pain on medium efforts, no loss of range of motion and a positive apprehension test. According to the questionnaire used, the results were graded as good. The patients who reported having severe pain on greater effort were involved in employment-related legal disputes.

CONCLUSION:

This technique showed low morbidity and good functional results over the short term.

Patellofemoral ligament; Quadriceps tendon; Patellar dislocation

Patient	Sex	Age	Side	Employment-law issues	Limping	Weight-bearing	Locking	Instability	Pain	Swelling	Going up stairs	Squatting	TOTAL SCORE
1	F	16	L	N	5	5	10	25	20	10	10	4	89
2	F	18	R	N	3	5	15	25	20	10	10	4	92
3	F	15	R	N	5	5	10	20	20	6	6	2	74
4	F	21	R	N	3	5	15	20	20	6	10	4	83
5	M	21	L	N	5	5	15	25	20	10	10	5	95
6	F	20	L	N	5	5	20	20	25	6	4	5	80
7	F	21	L	N	5	5	15	20	25	10	10	5	95
8	F	18	R	N	5	5	10	25	20	10	3	4	82
9	F	19	L	N	5	5	10	20	20	10	10	4	84
10	F	39	L	Y	5	5	10	15	10	3	6	2	56
11	F	19	R	N	5	5	15	25	25	10	10	4	99
12	F	40	L	Y	5	5	6	25	10	0	3	2	56
13	M	19	L	N	5	5	10	25	20	10	10	5	90
14	F	28	R	N	5	5	15	25	25	10	10	5	100
15	F	18	L	N	5	5	15	25	25	10	10	2	97
16	F	26	R	N	3	5	15	25	20	10	10	5	93
17	F	18	R	N	5	5	10	25	20	10	3	2	80
18	F	28	L	N	3	5	15	20	20	6	10	4	83
19	F	48	L	Y	5	5	10	15	10	3	6	4	58
20	F	20	R	N	5	5	15	25	25	10	10	2	97
21	M	19	L	N	5	5	15	20	20	10	10	4	89
22	F	17	L	N	5	5	10	25	20	10	10	5	90

Lysholm score	Number of patients	% of the patients
Excellent	06	27.2
Good	07	31.8
Regular	06	27.2
Poor	03	13.8

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] * Corresponding author. E-mail: mcorvino.ort@gmail.com (M.C. Nogueira).

Claudication (5 points)	Pain (25 points)
Never = 5 Mild or periodic = 3 Severe and constant = 0	None = 25 Mild or periodic during physical effort = 20 Greater pain during or after walking > 2 km = 10 Grater pain during or after walking < 2 km = 5 Constant = 0
Weight-bearing (5 points)	Edema (10 points)
None = 5 With stick or crutch = 2 Impossible = 0	None = 10 With heavy exercise = 6 With ordinary exercise = 3 Constant = 0
Locking (15 points)	Going up stairs (10 points)
No locking or feeling of this = 15 Feeling but without locking = 10 Occasional = 6 Frequent = 2 Joint locked during examination = 0	No problem = 10 Slightly impaired = 6 One step at a time = 3 Impossible = 0
Instability (25 points)	Squatting (5 points)
Never = 25 Rarely during physical effort = 20 Frequently during effort = 15 Occasionally during daily activities = 10 Frequently during daily activities = 5 At each step = 0	No problem = 5 Slightly impaired = 4 Not possible beyond 90 degrees = 2 Impossible = 0
Total score:

Patient	Sex	Age	Side	Employment-law issues	Limping	Weight-bearing	Locking	Instability	Pain	Swelling	Going up stairs	Squatting	TOTAL SCORE
1	F	16	L	N	5	5	10	25	20	10	10	4	89
2	F	18	R	N	3	5	15	25	20	10	10	4	92
3	F	15	R	N	5	5	10	20	20	6	6	2	74
4	F	21	R	N	3	5	15	20	20	6	10	4	83
5	M	21	L	N	5	5	15	25	20	10	10	5	95
6	F	20	L	N	5	5	20	20	25	6	4	5	80
7	F	21	L	N	5	5	15	20	25	10	10	5	95
8	F	18	R	N	5	5	10	25	20	10	3	4	82
9	F	19	L	N	5	5	10	20	20	10	10	4	84
10	F	39	L	Y	5	5	10	15	10	3	6	2	56
11	F	19	R	N	5	5	15	25	25	10	10	4	99
12	F	40	L	Y	5	5	6	25	10	0	3	2	56
13	M	19	L	N	5	5	10	25	20	10	10	5	90
14	F	28	R	N	5	5	15	25	25	10	10	5	100
15	F	18	L	N	5	5	15	25	25	10	10	2	97
16	F	26	R	N	3	5	15	25	20	10	10	5	93
17	F	18	R	N	5	5	10	25	20	10	3	2	80
18	F	28	L	N	3	5	15	20	20	6	10	4	83
19	F	48	L	Y	5	5	10	15	10	3	6	4	58
20	F	20	R	N	5	5	15	25	25	10	10	2	97
21	M	19	L	N	5	5	15	20	20	10	10	4	89
22	F	17	L	N	5	5	10	25	20	10	10	5	90

Patient	Sex	Age	Side	Employment-law issues	Limping	Weight-bearing	Locking	Instability	Pain	Swelling	Going up stairs	Squatting	TOTAL SCORE
1	F	16	L	N	5	5	10	25	20	10	10	4	89
2	F	18	R	N	3	5	15	25	20	10	10	4	92
3	F	15	R	N	5	5	10	20	20	6	6	2	74
4	F	21	R	N	3	5	15	20	20	6	10	4	83
5	M	21	L	N	5	5	15	25	20	10	10	5	95
6	F	20	L	N	5	5	20	20	25	6	4	5	80
7	F	21	L	N	5	5	15	20	25	10	10	5	95
8	F	18	R	N	5	5	10	25	20	10	3	4	82
9	F	19	L	N	5	5	10	20	20	10	10	4	84
10	F	39	L	Y	5	5	10	15	10	3	6	2	56
11	F	19	R	N	5	5	15	25	25	10	10	4	99
12	F	40	L	Y	5	5	6	25	10	0	3	2	56
13	M	19	L	N	5	5	10	25	20	10	10	5	90
14	F	28	R	N	5	5	15	25	25	10	10	5	100
15	F	18	L	N	5	5	15	25	25	10	10	2	97
16	F	26	R	N	3	5	15	25	20	10	10	5	93
17	F	18	R	N	5	5	10	25	20	10	3	2	80
18	F	28	L	N	3	5	15	20	20	6	10	4	83
19	F	48	L	Y	5	5	10	15	10	3	6	4	58
20	F	20	R	N	5	5	15	25	25	10	10	2	97
21	M	19	L	N	5	5	15	20	20	10	10	4	89
22	F	17	L	N	5	5	10	25	20	10	10	5	90

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Reconstruction of the medial patellofemoral ligament using autologous graft from quadriceps tendon to treat recurrent patellar dislocation☆ ☆ Work performed at the Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, MG, Brazil.

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSION:

Reconstruction of the medial patellofemoral ligament using autologous graft from quadriceps tendon to treat recurrent patellar dislocation^☆ ☆ Work performed at the Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, MG, Brazil.

Patient	Sex	Age	Side	Employment-law issues	Limping	Weight-bearing	Locking	Instability	Pain	Swelling	Going up stairs	Squatting	TOTAL SCORE
1	F	16	L	N	5	5	10	25	20	10	10	4	89
2	F	18	R	N	3	5	15	25	20	10	10	4	92
3	F	15	R	N	5	5	10	20	20	6	6	2	74
4	F	21	R	N	3	5	15	20	20	6	10	4	83
5	M	21	L	N	5	5	15	25	20	10	10	5	95
6	F	20	L	N	5	5	20	20	25	6	4	5	80
7	F	21	L	N	5	5	15	20	25	10	10	5	95
8	F	18	R	N	5	5	10	25	20	10	3	4	82
9	F	19	L	N	5	5	10	20	20	10	10	4	84
10	F	39	L	Y	5	5	10	15	10	3	6	2	56
11	F	19	R	N	5	5	15	25	25	10	10	4	99
12	F	40	L	Y	5	5	6	25	10	0	3	2	56
13	M	19	L	N	5	5	10	25	20	10	10	5	90
14	F	28	R	N	5	5	15	25	25	10	10	5	100
15	F	18	L	N	5	5	15	25	25	10	10	2	97
16	F	26	R	N	3	5	15	25	20	10	10	5	93
17	F	18	R	N	5	5	10	25	20	10	3	2	80
18	F	28	L	N	3	5	15	20	20	6	10	4	83
19	F	48	L	Y	5	5	10	15	10	3	6	4	58
20	F	20	R	N	5	5	15	25	25	10	10	2	97
21	M	19	L	N	5	5	15	20	20	10	10	4	89
22	F	17	L	N	5	5	10	25	20	10	10	5	90