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Reconstruction of medial patellofemoral ligament for chronic patellar instability.
[trochlear dysplasia]
Disruption
of
the
capsule
,
medial
patellar
retinaculum
,
and
/
or
vastus
medialis
obliqus
has
been
associated
with
recurrent
patellar
instability
.
Biomechanical
studies
have
shown
that
the
medial
patellofemoral
ligament
(
MPFL
)
is
the
main
restraint
against
lateral
patella
displacement
and
reconstruction
of
the
MPFL
has
become
an
accepted
surgical
technique
to
restore
patellofemoral
stability
in
patients
having
recurrent
patellar
dislocation
.
We
report
a
prospective
series
of
patients
of
chronic
patellar
instability
treated
by
reconstruction
of
medial
patellofemoral
ligament
.
Twelve
patients
(
15
knees
)
with
recurrent
dislocation
of
patella
,
were
operated
between
January
2006
and
December
2008
.
All
patients
had
generalised
ligament
laxity
with
none
had
severe
grade
of
patella
alta
or
trochlear
dysplasia
.
The
MPFL
was
reconstructed
with
doubled
semitendinosus
tendon
.
Patients
were
followed
up
with
subjective
criteria
,
patellar
inclination
angle
,
and
Kujala
score
.
The
mean
duration
of
followup
after
the
operative
procedures
was
an
average
of
42
months
(
range
24
-
60
months
)
10
knees
showed
excellent
results
,
3
knees
gave
good
results
,
and
2
knees
had
a
fair
result
.
The
average
patellar
inclination
angle
decreased
from
34
.
3
°
to
18
.
6
°
.
The
average
preoperative
Kujala
functional
score
was
44
.
8
and
the
average
postoperative
score
was
91
.
9
.
MPFL
reconstruction
using
the
semitendinosus
tendon
gives
good
results
in
patients
with
chronic
patellar
instability
without
predisposing
factors
like
severe
patella
alta
and
high
-grade
trochlear
dysplasia
,
and
for
revision
cases
.
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symptom
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pyruvate dehydrogenase deficiency
sneddon syndrome
triple a syndrome
trochlear dysplasia
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