2024, Número 1
<< Anterior
Acta Ortop Mex 2024; 38 (1)
Reconstrucción con aloinjerto del complejo femororrotuliano medial en pacientes esqueléticamente inmaduros: nota técnica
Masquijo J
Idioma: Ingles.
Referencias bibliográficas: 18
Paginas: 60-65
Archivo PDF: 302.29 Kb.
RESUMEN
La inestabilidad patelofemoral (PFI) es un trastorno común en niños y adolescentes. La estabilización quirúrgica de la rótula plantea desafíos en pacientes esqueléticamente inmaduros debido a peculiaridades anatómicas en esta etapa, lo que lleva a la ausencia de una técnica de reconstrucción estándar establecida. Recientemente, ha habido un interés notable en el complejo femororrotuliano medial (MPFC), que abarca el ligamento femororrotuliano medial (MPFL) y el ligamento femoral del tendón del cuádriceps medial (MQTFL), debido a su papel en la restricción del desplazamiento rotuliano lateral. Este artículo tiene como objetivo describir la técnica quirúrgica empleada por el autor para reconstruir el complejo femororrotuliano medial con aloinjerto en pacientes esqueléticamente inmaduros con inestabilidad femororrotuliana. Diseño del estudio: técnica quirúrgica.
REFERENCIAS (EN ESTE ARTÍCULO)
Dejour DH, Mesnard G, Giovannetti de Sanctis E. Updated treatment guidelines for patellar instability: "un menu à la carte". J Exp Orthop. 2021; 8(1): 109. doi: 10.1186/s40634-021-00430-2.
Edmonds EW, Glaser DA. Adolescent patella instability extensor mechanics: insall extensor realignment versus medial patellofemoral ligament reconstruction. J Pediatr Orthop. 2016; 36(3): 262-7. doi: 10.1097/BPO.0000000000000430.
Fulkerson JP, Edgar C. Medial quadriceps tendon-femoral ligament: surgical anatomy and reconstruction technique to prevent patella instability. Arthrosc Tech. 2013; 2(2): e125-8. doi: 10.1016/j.eats.2013.01.002.
Tanaka MJ. Editorial commentary: the medial patellofemoral complex is composed of the medial patellofemoral ligament and the medial quadriceps tendon-femoral ligament: do we need to reconstruct both? Arthroscopy. 2023; 39(1): 112-3. doi: 10.1016/j.arthro.2022.08.027.
Spang R, Egan J, Hanna P, Lechtig A, Haber D, DeAngelis JP, et al. Comparison of patellofemoral kinematics and stability after medial patellofemoral ligament and medial quadriceps tendon-femoral ligament reconstruction. Am J Sports Med. 2020; 48(9): 2252-9. doi: 10.1177/0363546520930703.
Masquijo J, Parikh SN, Kothari A. Evaluation of the optimal femoral fixation site for medial patellofemoral ligament reconstruction in the skeletally immature patient. Orthopedics. 2023; 46(2): 108-13. doi: 10.3928/01477447-20221031-07.
Irarrázaval S, Besa P, Fernández F, Fernández T, Tuca M, Lira MJ, et al. Anterior and distal tunnel orientation for anatomic reconstruction of the medial patellofemoral ligament is safer in patients with open growth plates. Knee Surg Sports Traumatol Arthrosc. 2021; 29(6): 1822-9. doi: 10.1007/s00167-020-06229-5.
Nguyen CV, Farrow LD, Liu RW, Gilmore A. Safe drilling paths in the distal femoral epiphysis for pediatric medial patellofemoral ligament reconstruction. Am J Sports Med. 2017; 45(5): 1085-9. doi: 10.1177/0363546516677795.
Elias JJ, Jones KC, Lalonde MK, Gabra JN, Rezvanifar SC, Cosgarea AJ. Allowing one quadrant of patellar lateral translation during medial patellofemoral ligament reconstruction successfully limits maltracking without overconstraining the patella. Knee Surg Sports Traumatol Arthrosc. 2018; 26(10): 2883-90. doi: 10.1007/s00167-017-4799-9.
Baskar D, Stavinoha TJ, Sanchez M, Gupta A, Randhawa SD, Rohde MS, et al. Quantifying the relationship between the medial quadriceps tendon-femoral ligament and patellar borders: a pediatric cadaveric study. Am J Sports Med. 2022; 50(9): 2433-8. doi: 10.1177/03635465221103250.
Arendt EA, Moeller A, Agel J. Clinical outcomes of medial patellofemoral ligament repair in recurrent (chronic) lateral patella dislocations. Knee Surg Sports Traumatol Arthrosc. 2011; 19(11): 1909-14. doi: 10.1007/s00167-011-1516-y.
Christian DR, Redondo ML, Cancienne JM, Shewman EF, Farr J, Cole BJ, et al. Differential contributions of the quadriceps and patellar attachments of the proximal medial patellar restraints to resisting lateral patellar translation. Arthroscopy. 2020; 36(6): 1670-6. doi: 10.1016/j.arthro.2020.01.058.
Flanigan DC, Shemory S, Lundy N, Stitgen M, Long JM, Magnussen RA. Medial patellofemoral ligament reconstruction with allograft versus autograft tissue results in similar recurrent dislocation risk and patient-reported outcomes. Knee Surg Sports Traumatol Arthrosc. 2020; 28(7): 2099-104. doi: 10.1007/s00167-020-05920-x.
Migliorini F, Trivellas A, Eschweiler J, Knobe M, Tingart M, Maffulli N. Comparable outcome for autografts and allografts in primary medial patellofemoral ligament reconstruction for patellofemoral instability: systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2022; 30(4): 1282-91. doi: 10.1007/s00167-021-06569-w.
Cruz AI Jr, Beck JJ, Ellington MD, Mayer SW, Pennock AT, Stinson ZS, et al. Failure rates of autograft and allograft ACL reconstruction in patients 19 years of age and younger: a systematic review and meta-analysis. JB JS Open Access. 2020; 5(4): e20.00106. doi: 10.2106/JBJS.OA.20.00106.
Fabricant PD. CORR Insights®: does the utilization of allograft tissue in medial patellofemoral ligament reconstruction in pediatric and adolescent patients restore patellar stability? Clin Orthop Relat Res. 2017; 475(6): 1570-2. doi: 10.1007/s11999-016-5081-z.
Allahabadi S, Pandya NK. Allograft medial patellofemoral ligament reconstruction in adolescent patients results in a low recurrence rate of patellar dislocation or subluxation at midterm follow-up. Arthroscopy. 2022; 38(1): 128-38. doi: 10.1016/j.arthro.2021.05.005.
Husen M, Milbrandt TA, Shah V, Krych AJ, Stuart MJ, Saris DBF. Medial patellofemoral ligament reconstruction using allografts in skeletally immature patients. Am J Sports Med. 2023; 51(6): 1513-24. doi: 10.1177/03635465231164400.