Allowing one quadrant of patellar lateral translation during medial patellofemoral ligament reconstruction successfully limits maltracking without overconstraining the patella.

摘要: Graft tensioning during medial patellofemoral ligament (MPFL) reconstruction typically allows for lateral patellar translation within the trochlear groove. Computational simulation was performed to relate allowed kinematics and contact pressures. Multibody dynamic models were developed represent nine knees with instability. Dual limb squatting simulated representing pre-operative condition MPFL reconstruction. The graft tensioned allow 10, 5, 0 mm of at 30° knee flexion. pressure distribution quantified using discrete element analysis. For 5 10 mm conditions, shift decreased significantly 0° 20°. nearly all flexion angles. All conditions tilt 0°, additional significant decreases conditions. increased maximum multiple angles, increasing by 57% 30°, but did not alter pressure. Allowing limits maltracking, thereby decreasing risk post-operative recurrent no reduces maltracking further, can overconstrain patella, applied cartilage already fibrillated or eroded from an instability episode.