HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Sign In to gain access to subscriptions and/or personal tools.

This Article Full Text Full Text (PDF) All Versions of this Article: 36/4/747    most recent 0363546508314410v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Google Scholar Articles by Melegari, T. M. Articles by Matthews, L. S. PubMed PubMed Citation Articles by Melegari, T. M. Articles by Matthews, L. S. Related Collections Kinematics and kinetics Knee Patella

Patellofemoral Contact Area and Pressure After Medial Patellofemoral Ligament Reconstruction

From the Department of Orthopaedic Surgery, The Union Memorial Hospital, Baltimore, Maryland

^* Address correspondence to Leslie S. Matthews, MD, c/o Lyn Camire, Editor, Union Memorial Orthopaedics, The Johnston Professional Building, #400, 3333 North Calvert Street, Baltimore, MD 21218 (e-mail: lyn.camire{at}medstar.net).

Background: It is not known whether nonisometric femoral graft attachment diminishes the effectiveness of medial patellofemoral ligament reconstruction.

Purpose: To determine whether a nonisometric femoral attachment point is associated with differences in contact area and pressure in the patellofemoral joint as compared with an isometric attachment point.

Study Design: Controlled laboratory study.

Methods: Eleven cadaveric knees were amputated and secured in a loading fixture. The quadriceps tendon was clamped 5 cm above the proximal pole of the patella and fixed to a plate. Colinear compressive forces were applied. Forces were set to achieve isometric quadriceps moments at 30°, 45°, 60°, and 90° of knee flexion. Contact areas and pressures were measured using a sensor system. Initially, isometric reconstruction was done using the known isometric femoral attachment point of the posterior medial epicondyle. The attachment was then revised in each specimen to the known nonisometric femoral attachment of the adductor tubercle.

Results: Before medial patellofemoral ligament reconstruction, average facet patellofemoral contact area and pressure generally increased with angle of knee flexion. With few exceptions, initial versus postprocedure data and isometric versus nonisometric contact area and pressure data did not differ significantly at any angle tested. Percentage contact area and contact pressure in the medial facet did not differ significantly from the initial percentage for either attachment, and no difference was found in the percentage medial contact area or pressure for isometric versus nonisometric attachment at the angles tested.

Conclusion: Use of the nonisometric attachment point of the adductor tubercle in medial patellofemoral ligament reconstruction did not appear to alter knee contact area or contact pressures as compared with isometric femoral attachment at the posterior medial epicondyle.

Clinical Relevance: In medial patellofemoral ligament reconstruction, patellofemoral contact area and pressure may not be adversely affected by use of the nonisometric femoral attachment point used in this study.

Key Words: cadaveric • femur • knee • patella • medial patellofemoral ligament • reconstruction