Medial soft tissue restraints in lateral pateliar instability and repair

Paul V. Hautamaa, Donald C. Fithian, Kenton R Kaufman, Dale M. Daniel, Andrew M. Pohlmeyer

Research output: Contribution to journalArticle

361 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)174-182
Number of pages9
JournalClinical Orthopaedics and Related Research
Issue number349
StatePublished - Apr 1998

Fingerprint

Ligaments
Patella
Patellar Ligament
Knee Joint
Compliance

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Hautamaa, P. V., Fithian, D. C., Kaufman, K. R., Daniel, D. M., & Pohlmeyer, A. M. (1998). Medial soft tissue restraints in lateral pateliar instability and repair. Clinical Orthopaedics and Related Research, (349), 174-182.

Medial soft tissue restraints in lateral pateliar instability and repair. / Hautamaa, Paul V.; Fithian, Donald C.; Kaufman, Kenton R; Daniel, Dale M.; Pohlmeyer, Andrew M.

In: Clinical Orthopaedics and Related Research, No. 349, 04.1998, p. 174-182.

Research output: Contribution to journalArticle

Hautamaa, PV, Fithian, DC, Kaufman, KR, Daniel, DM & Pohlmeyer, AM 1998, 'Medial soft tissue restraints in lateral pateliar instability and repair', Clinical Orthopaedics and Related Research, no. 349, pp. 174-182.
Hautamaa, Paul V. ; Fithian, Donald C. ; Kaufman, Kenton R ; Daniel, Dale M. ; Pohlmeyer, Andrew M. / Medial soft tissue restraints in lateral pateliar instability and repair. In: Clinical Orthopaedics and Related Research. 1998 ; No. 349. pp. 174-182.
@article{b194759df2174846a524427f620bb548,
title = "Medial soft tissue restraints in lateral pateliar 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.",
author = "Hautamaa, {Paul V.} and Fithian, {Donald C.} and Kaufman, {Kenton R} and Daniel, {Dale M.} and Pohlmeyer, {Andrew M.}",
year = "1998",
month = "4",
language = "English (US)",
pages = "174--182",
journal = "Clinical Orthopaedics and Related Research",
issn = "0009-921X",
publisher = "Springer New York",
number = "349",

}

TY - JOUR

T1 - Medial soft tissue restraints in lateral pateliar instability and repair

AU - Hautamaa, Paul V.

AU - Fithian, Donald C.

AU - Kaufman, Kenton R

AU - Daniel, Dale M.

AU - Pohlmeyer, Andrew M.

PY - 1998/4

Y1 - 1998/4

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=0031968950&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031968950&partnerID=8YFLogxK

M3 - Article

SP - 174

EP - 182

JO - Clinical Orthopaedics and Related Research

JF - Clinical Orthopaedics and Related Research

SN - 0009-921X

IS - 349

ER -