Evaluation of Quadriceps Strength Post-medial Patellofemoral Ligament Reconstruction Using Quadriceps Tendon Autografts

Sholahuddin Rhatomy; Roy  Lisang; Noha Roshadiansyah  Soekarno; Bambang  Kisworo

doi:10.3889/oamjms.2020.5551

Authors

Sholahuddin Rhatomy Department of Orthopaedics and Traumatology, Dr. Soeradji Tirtonegoro General Hospital, Klaten, Indonesia; 2Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
Roy Lisang Department of Orthopaedics and Traumatology, Awal Bros Hospital, Pekanbaru, Indonesia
Noha Roshadiansyah Soekarno Department of Orthopaedics and Traumatology, Dr. Chasbullah Abdulmadjid General Hospital, Bekasi, Indonesia
Bambang Kisworo Department of Orthopaedics and Traumatology, Panti Rapih Hospital, Yogyakarta, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2020.5551

Keywords:

Quadriceps strength, Medial patellofemoral ligament reconstruction, Range of motion

Abstract

BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction using quadriceps tendon (QT) grafts provides favorable results with minimal complications and can be performed in patients with open epiphyseal plates. Following MPFL reconstruction using QT grafts, the outcomes have been evaluated, but the residual quadriceps strength (QS) has never been evaluated.

AIM: We analyzed the knee’s range of motion (ROM), thigh circumference (TC), and QS at donor leg sites compared with those at contralateral healthy sites after MPFL reconstruction. The hypothesis was that there is no morbidity at donor sites.

MATERIALS AND METHODS: Patients who underwent MPFL reconstruction using QT autografts between January and December 2017 were recruited. The ROM, TC, and QS were measured 6 months postoperatively.

RESULTS: Twenty-one patients (8 men, 14 women; mean age, 28.40 ± 10.78 years [range, 16–45]) were included in the study. The TCs at the donor and contralateral sites (medians: 37 and 37.5 cm, respectively) showed no significant difference (p = 0.64). QS measurements showed means of 182 ± 4.6 N and 190 ± 4.7 N at the donor and contralateral sites, respectively (p = 0.376). There were no ROM deficits.

CONCLUSIONS: The ROM, TC, and QS at donor sites were similar to those at contralateral sites. The QT is a suitable graft for MPFL reconstruction.

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References

Loeb AE, Tanaka MJ. The medial patellofemoral complex. Curr Rev Musculoskelet Med. 2018;11(2):201-8. PMid:29728862

Monllau JC, Erquicia JI, Ibañez M, Gelber PE, Ibañez F, Masferrer-Pino A, et al. Reconstruction of the medial patellofemoral ligament. Arthrosc Tech. 2017;6(5):e1471-6. https://doi.org/10.1016/j.eats.2017.06.039 PMid:29354460

Fink C, Steensen R, Gföller P, Lawton R. Quadriceps tendon autograft medial patellofemoral ligament reconstruction. Curr Rev Musculoskelet Med. 2018;11(2):209-20. https://doi.org/10.1007/s12178-018-9476-1 PMid:29679209

Azimi H, Anakwenze O. Medial patellofemoral ligament reconstruction using dual patella docking technique. Arthrosc Tech. 2017;6(6):e2093-100. https://doi.org/10.1016/j.eats.2017.08.018 PMid:29349002

Peter G, Hoser C, Runer A, Abermann E, Wierer G, Fink C. Medial patellofemoral ligament (MPFL) reconstruction using quadriceps tendon autograft provides good clinical, functional and patient-reported outcome measurements (PROM): A 2-year prospective study. Knee Surgery, Sport Traumatol Arthrosc. 2019;27(8):2426-32. https://doi.org/10.1007/s00167-018-5226-6 PMid:30374571

Nelitz M, Williams SR. Anatomic reconstruction of the medial patellofemoral ligament in children and adolescents using a pedicled quadriceps tendon graft. Arthrosc Tech. 2014;3(2):e303-8. https://doi.org/10.1016/j.eats.2014.01.005 PMid:24904782

Fink C, Veselko M, Herbort M, Hoser C. Minimally invasive reconstruction of the medial patellofemoral ligament using quadriceps tendon. Arthrosc Tech. 2014;3(3):e325-9. https://doi.org/10.1016/j.eats.2014.01.012 PMid: 25126496

Rhatomy S, Soekarno NR, Setyawan R, Primasara S, Gaol IL, Budipharama NC. Minimal invasive MPFL reconstruction using quadriceps tendon graft with lateral release: 2 years follow up. Int J Surg Open. 2019;17:20-6. https://doi.org/10.1016/j.ijso.2019.01.004

World Health Organization. Noncommunicable Diseases and their Risk Factors STEPS Sample Size Calculator and Sampling Spreadsheet. Geneva: World Health Organization; 2017.

Jibri Z, Jamieson P, Rakhra KS, Sampaio ML, Dervin G. Patellar maltracking: An update on the diagnosis and treatment strategies. Insights Imaging. 2019;10(1):1-11. https://doi.org/10.1186/s13244-019-0755-1 PMid:31201575

Fithian DC, Powers CM, Khan N. Rehabilitation of the knee after medial patellofemoral ligament reconstruction. Clin Sports Med. 2010;29:283-90. https://doi.org/10.1016/j.csm.2009.12.008 PMid:20226320

Lightsey HM, Wright ML, Trofa DP, Popkin CA, Ahmad CS, Redler LH. Rehabilitation variability following medial patellofemoral ligament reconstruction. Phys Sportsmed. 2018;46:441-8. https://doi.org/10.1080/00913847.2018.1487 240 PMid:29888637