Abstract:

The medial patellofemoral ligament (MPFL) is essential to maintain patella stability; however, its role in total knee replacement (TKR) has not been studied. Forty-six consecutive TKRs in 40 patients were reviewed. Standard closure was performed in 29 TKRs. The MPFL was isolated and anatomically re-approximated in 17 subsequent TKRs. Blinded radiographic evaluation of patellar tilt and subluxation was performed preoperatively and 4 months postoperatively. Despite greater preoperative lateral tilt, the MPFL repair group demonstrated greater correction in patellar tilt compared with the standard closure group (p = 0.02). Patellar tracking also was optimized in the MPFL group, despite equivalent preoperative lateral patellar subluxation in the two groups. Simple repair of the MPFL at arthrotomy closure appears to optimize patellar stability radiographically and may improve long-term results by minimizing patellar complications and wear.

Authors:

R. Michael Meneghini, MD, Associate Professor of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana, Director of Joint Replacement, Orthopedics and Sports Medicine, Indiana University Health Physicians, Fishers, Indiana, Mary Ziemba-Davis, Director of Research for Orthopedics, Academic Health Center, Orthopedics and Sports Medicine, Indiana University Health Physicians, Fishers, Indiana, Shelly Smits, RN, BSN, ONC, Clinical Nurse Coordinator, Orthopedics and Sports Medicine, Indiana University Health Physicians, Fishers, Indiana, James Bicos, MD, Assistant Professor, Oakland University William Beaumont School of Medicine, William Beaumont Hospital, Bingham Farms, Michigan

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