Cadaveric-biomechanical study on medial retinaculum: its stabilising role for the patella against lateral dislocation

• Autorzy: Mitrogiannis L. , Barbouti A. , Kanavaros P. , Paraskevas G. , Kitsouli A. , Mitrogiannis G. , Kitsoulis P.
• Języki publikacji: EN

Abstrakty

EN

Background: The aim of this study was to analyse the biomechanical role of medial retinaculum, as a stabilising factor against lateral patellar dislocation. Materials and methods: This cadaveric-biomechanical study included the patellae of 10 cadaveric knees, which were surgically exposed and the medial retinaculum of each one was located. A stable 24.51 N force was applied to the four parts of the quadriceps, and an increasing lateral displacing force was applied to the patella, up to 5 mm dislocation. The study was repeated for 0°, 45°, and 90° of knee flexion, with the medial retinaculum intact and dissected. The Wilcoxon signed rank test was used for data analysis. A p value < 0.05 was considered as statistical significant. Results: After the dissection of medial retinaculum, the lateral displacement force was lower at every angle of knee flexion (p = 0.005, p = 0.007, p = 0.005, respectively). The lateral displacement force increased as the flexion angle increased (p = 0.005), regardless of medial retinaculum integrity. Conclusions: Medial retinaculum acts as a stabilising factor for the patella, against its lateral dislocation in lower flexion angles. Therefore, methods of surgical reinforcement or repair of medial retinaculum could provide protection against recurrent patellar dislocation. (Folia Morphol 2018; 77, 4: 742–747)

• Wydawca: -
• Czasopismo: Folia Morphologica
• Rocznik: 2018
• Tom: 77
• Numer: 4
• Opis fizyczny: p.742–747,fig.,ref.

Twórcy

autor

Mitrogiannis L.

• Laboratory of Anatomy-Histology-Embryology, School of Medicine, University of Ioannina, Gravias 1, Ioannina, PC: 11524, Greece

autor

Barbouti A.

• Laboratory of Anatomy-Histology-Embryology, School of Medicine, University of Ioannina, Gravias 1, Ioannina, PC: 11524, Greece

autor

Kanavaros P.

• Laboratory of Anatomy-Histology-Embryology, School of Medicine, University of Ioannina, Gravias 1, Ioannina, PC: 11524, Greece

autor

Paraskevas G.

• Laboratory of Anatomy-Histology-Embryology, School of Medicine, Aristotle University, Thessaloniki, Greece

autor

Kitsouli A.

• Laboratory of Anatomy-Histology-Embryology, School of Medicine, University of Ioannina, Gravias 1, Ioannina, PC: 11524, Greece

autor

Mitrogiannis G.

• Laboratory of Anatomy-Histology-Embryology, School of Medicine, University of Ioannina, Gravias 1, Ioannina, PC: 11524, Greece

autor

Kitsoulis P.

• Laboratory of Anatomy-Histology-Embryology, School of Medicine, University of Ioannina, Gravias 1, Ioannina, PC: 11524, Greece

Bibliografia

• 1. Cerciello S, Lustig S, Costanzo G, et al. Medial retinaculum reefing for the treatment for patellar instability. Knee Surg Sports Traumatol Arthrosc. 2014; 22(10): 2505–2512, doi: 10.1007/s00167-014-3171-6, indexed in Pubmed: 25059335.
• 2. Coons DA, Barber FA. Thermal medial retinaculum shrinkage and lateral release for the treatment of recurrent patellar instability. Arthroscopy. 2006; 22(2): 166–171, doi: 10.1016/j.arthro.2005.08.043, indexed in Pubmed: 16458802.
• 3. Dainer RD, Barrack RL, Buckley SL, et al. Arthroscopic treatment of acute patellar dislocations. Arthroscopy. 1988; 4(4): 267–271, indexed in Pubmed: 3233116.
• 4. Duchman KR, DeVries NA, McCarthy MA, et al. Biomechanical evaluation of medial patellofemoral ligament reconstruction. Iowa Orthop J. 2013; 33: 64–69, indexed in Pubmed: 24027463.
• 5. Ebied AM, El-Kholy W. Reconstruction of the medial patello-femoral and patello-tibial ligaments for treatment of patellar instability. Knee Surg Sports Traumatol Arthrosc. 2012; 20(5): 926–932, doi: 10.1007/s00167-011-1659-x, indexed in Pubmed: 21935619.
• 6. Farahmand F, Naghi Tahmasbi M, Amis A. The contribution of the medial retinaculum and quadriceps muscles to patellar lateral stability--an in-vitro study. Knee. 2004; 11(2): 89–94, doi: 10.1016/j.knee.2003.10.004, indexed in Pubmed: 15066616.
• 7. Frosch S, Balcarek P, Walde TA, et al. [The treatment of patellar dislocation: a systematic review]. Z Orthop Unfall. 2011; 149(6): 630–645, doi: 10.1055/s-0030-1250691, indexed in Pubmed: 21544786.
• 8. Ma LF, Wang F, Chen BC, et al. Medial retinaculum plasty versus medial patellofemoral ligament reconstruction for recurrent patellar instability in adults: a randomized controlled trial. Arthroscopy. 2013; 29(5): 891–897, doi: 10.1016/j.arthro.2013.01.030, indexed in Pubmed: 23566568.
• 9. Meyers AB, Laor T, Sharafinski M, et al. Imaging assessment of patellar instability and its treatment in children and adolescents. Pediatr Radiol. 2016; 46(5): 618–636, doi: 10.1007/s00247-015-3520-8, indexed in Pubmed: 26860094.
• 10. Mikashima Y, Kimura M, Kobayashi Y, et al. Clinical results of isolated reconstruction of the medial patellofemoral ligament for recurrent dislocation and subluxation of the patella. Acta Orthop Belg. 2006; 72(1): 65–71, indexed in Pubmed: 16570897.
• 11. Neri T, Philippot R, Carnesecchi O, et al. Medial patellofemoral ligament reconstruction: clinical and radiographic results in a series of 90 cases. Orthop Traumatol Surg Res. 2015; 101(1): 65–69, doi: 10.1016/j.otsr.2014.09.023, indexed in Pubmed: 25530480.
• 12. Ostermeier S, Stukenborg-Colsman C, Hurschler C, et al. In vitro investigation of the effect of medial patellofemoral ligament reconstruction and medial tibial tuberosity transfer on lateral patellar stability. Arthroscopy. 2006; 22(3): 308–319, doi: 10.1016/j.arthro.2005.09.024, indexed in Pubmed: 16517316.
• 13. Panagiotopoulos E, Strzelczyk P, Herrmann M, et al. Cadaveric study on static medial patellar stabilizers: the dynamizing role of the vastus medialis obliquus on medial patellofemoral ligament. Knee Surg Sports Traumatol Arthrosc. 2006; 14(1): 7–12, doi: 10.1007/s00167-005-0631-z, indexed in Pubmed: 16001289.
• 14. Rillmann P, Fischer A, Berbig R, et al. [Arthroscopic repair of the medial retinaculum after first time dislocation of the patella]. Unfallchirurg. 1999; 102(3): 167–172, indexed in Pubmed: 10232032.
• 15. Schöttle PB, Scheffler SU, Schwarck A, et al. Arthroscopic medial retinacular repair after patellar dislocation with and without underlying trochlear dysplasia: a preliminary report. Arthroscopy. 2006; 22(11): 1192–1198, doi: 10.1016/j.arthro.2006.07.002, indexed in Pubmed: 17084296.
• 16. Shelbourne KD, Urch SE, Gray T. Results of medial retinacular imbrication in patients with unilateral patellar dislocation. J Knee Surg. 2012; 25(5): 391–396, doi: 10.1055/s0032-1313750, indexed in Pubmed: 23150348.
• 17. Warren LF, Marshall JL. The supporting structures and layers on the medial side of the knee: an anatomical analysis. J Bone Joint Surg Am. 1979; 61(1): 56–62, indexed in Pubmed: 759437.
• 18. Yamamoto RK. Arthroscopic repair of the medial retinaculum and capsule in acute patellar dislocations. Arthroscopy. 1986; 2(2): 125–131, indexed in Pubmed: 3730064.
• 19. Zaffagnini S, Colle F, Lopomo N, et al. The influence of medial patellofemoral ligament on patellofemoral joint kinematics and patellar stability. Knee Surg Sports Traumatol Arthrosc. 2013; 21(9): 2164–2171, doi: 10.1007/s00167-012-2307-9, indexed in Pubmed: 23179455.
• 20. Zhao J, Huangfu X, He Y, et al. Recurrent patellar dislocation in adolescents: medial retinaculum plication versus vastus medialis plasty. Am J Sports Med. 2012; 40(1): 123–132, doi: 10.1177/0363546511420551, indexed in Pubmed: 21900625.
• 21. Zhao J, Huangfu X, He Y. The role of medial retinaculum plication versus medial patellofemoral ligament reconstruction in combined procedures for recurrent patellar instability in adults. Am J Sports Med. 2012; 40(6): 1355–1364, doi: 10.1177/0363546512439193, indexed in Pubmed: 22437282.

Identyfikatory

DOI

10.5603/FM.a2018.0032