Display options
Cite
Takahashi T, Takeshita K. Medial Patellofemoral Ligament Reconstruction Using the Hamstring Tendon for Patellofemoral Joint Instability in an 81-Year-Old Female. Open Orthop J. 2017;11:1028-1034doi: 10.2174/1874325001711011028.
Takahashi, T., & Takeshita, K. (2017). Medial Patellofemoral Ligament Reconstruction Using the Hamstring Tendon for Patellofemoral Joint Instability in an 81-Year-Old Female. The open orthopaedics journal, 111028-1034. https://doi.org/10.2174/1874325001711011028
Takahashi, Tsuneari, and Takeshita, Katsushi. "Medial Patellofemoral Ligament Reconstruction Using the Hamstring Tendon for Patellofemoral Joint Instability in an 81-Year-Old Female." The open orthopaedics journal vol. 11 (2017): 1028-1034. doi: https://doi.org/10.2174/1874325001711011028
Takahashi T, Takeshita K. Medial Patellofemoral Ligament Reconstruction Using the Hamstring Tendon for Patellofemoral Joint Instability in an 81-Year-Old Female. Open Orthop J. 2017 Aug 29;11:1028-1034. doi: 10.2174/1874325001711011028. eCollection 2017. PMID: 28979605; PMCID: PMC5612026.
Copy Download .nbib Format: NLM
Share it on

Open Orthop J. 2017 Aug 29;11:1028-1034. doi: 10.2174/1874325001711011028. eCollection 2017.

Medial Patellofemoral Ligament Reconstruction Using the Hamstring Tendon for Patellofemoral Joint Instability in an 81-Year-Old Female.

The open orthopaedics journal

Tsuneari Takahashi, Katsushi Takeshita

Affiliations

  1. Department of Orthopedic Surgery, Jichi Medical University, Shimotsuke, Japan.

PMID: 28979605 PMCID: PMC5612026 DOI: 10.2174/1874325001711011028

Abstract

INTRODUCTION: Chronic patellofemoral instability occurs mainly in adolescent females and can also be induced by medial patellofemoral ligament (MPFL) injury. There are no case reports of MPFL reconstruction for chronic patellofemoral instability due to MPFL injury in aged populations.

CASE PRESENTATION: 81-year-old female presented with left knee pain, giving way, and patellar instability while climbing stairs, which continued for 18 months. Patellar apprehension test was positive, and roentgenogram showed lateral patellar subluxation. Conservative therapy was not successful; hence, we performed a lateral release and MPFL reconstruction surgery.

OPERATIVE PROCEDURE: After arthroscopic lateral release, the hamstring tendon was harvested, and a graft composite made of doubled hamstring tendon and polyester tape with a suspensory fixation device was prepared. Then, a femoral bone tunnel was constructed in a socket shape at the anatomical footprint of the MPFL. The graft was passed through the femoral tunnel, and free ends of the graft composite were sutured to the periosteum of the patella, using two suture anchors at 60° of knee flexion with patellar reduction. Physiotherapy was gradually started using a patella-stabilizing orthosis on the first postoperative day. Her Kujala score improved from 66 to 97 points, and Barthel index score improved from 70 to 100 points at 1 year after surgery. She neither developed patellofemoral joint OA nor had any recurrence of symptoms at the 5-year postoperative follow up.

CONCLUSION: MPFL reconstruction using the hamstring tendon is an effective procedure for patients with chronic patellofemoral instability even after the age of 80 years.

Keywords: Hamstring tendon graft; Hip OA; MPFL reconstruction; Medial patellofemoral ligament; Patellofemoral instability; Physiotherapy

References

  1. Ann Rheum Dis. 1957 Dec;16(4):494-502 - PubMed
  2. Knee. 2003 Sep;10(3):215-20 - PubMed
  3. Knee Surg Sports Traumatol Arthrosc. 2009 Mar;17(3):254-9 - PubMed
  4. J Orthop Sci. 2010 Jul;15(4):452-8 - PubMed
  5. Orthopedics. 2015 Dec;38(12 ):e1155-9 - PubMed
  6. J Bone Joint Surg Am. 2008 Dec;90(12):2751-62 - PubMed
  7. Unfallchirurg. 2012 May;115(5):397-409 - PubMed
  8. J Bone Joint Surg Am. 2003;85-A Suppl 2:45-57 - PubMed
  9. Arthroscopy. 1993;9(2):159-63 - PubMed
  10. Clin Orthop Relat Res. 2013 Apr;471(4):1271-6 - PubMed
  11. Acta Orthop Belg. 2006 Jan;72(1):65-71 - PubMed
  12. Md State Med J. 1965 Feb;14:61-5 - PubMed
  13. J Bone Joint Surg Am. 1969 Jun;51(4):737-55 - PubMed
  14. Orthop Traumatol Surg Res. 2016 Sep;102(5):607-10 - PubMed
  15. Knee Surg Sports Traumatol Arthrosc. 2014 Oct;22(10):2569-73 - PubMed
  16. Knee Surg Sports Traumatol Arthrosc. 2005 Oct;13(7):510-5 - PubMed
  17. Bull Hosp Jt Dis. 1993 Summer;53(3):41-6 - PubMed

Publication Types