Técnica quirúrgica para la reconstrucción del ligamento patelofemoral medial

Abstract

Patellofemoral instability is one of the most frequent problems in young patients, and represents 2 to 3% of all knee injuries.¹ It denotes an important cause of morbidity due to the limitation of various activities of daily living and in the long term the appearance of osteoarthritis.²

Patellofemoral instability is defined as the deficiency of passive constriction that generates a total or partial lateral displacement of the patella from its normal position with respect to the trochlea.³ Patellofemoral disorders are the result of an aberrant anatomy, they are given by an alteration in bone alignment and generates a biomechanical imbalance.⁴ There are four classic factors that generate patellar instability: high patella, trochlear dysplasia, alteration in distance (TT-TG) and excessive patellar inclination.⁵ When generating the dislocation, the medial patellofemoral ligament is affected in at least 25% of cases. The diagnostic complement is carried out through X-rays, computed tomography and nuclear magnetic resonance.

Restoration of function surgical treatment has shown similar results to conservative treatment in primoluxations, however it has been seen that reconstruction of the medial patellofemoral ligament presents better clinical results for the patient.⁶

To date, nineteen patients we have been operated on with the technique described of whom there is no reported reluxation of the patella and who have a Lysholm scale of 85 points that is within a good parameter.