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Comparative Study
. 2017 Feb 13;12(1):29.
doi: 10.1186/s13018-017-0530-2.

Biomechanical comparison of single- and double-bundle medial patellofemoral ligament reconstruction

Qing Wang  1   2 , Wenhan Huang  3 , Daozhang Cai  4 , Huayang Huang  5
Affiliations
Comparative Study

Biomechanical comparison of single- and double-bundle medial patellofemoral ligament reconstruction

Qing Wang et al. J Orthop Surg Res. .

Abstract

Background: Recurrent patellar dislocation is common clinically, primarily in adolescents. However, the biomechanical properties of single- and double-bundle medial patellofemoral ligament (MPFL) reconstruction remain poorly understood.

Methods: Six fresh frozen adult cadaveric knee specimens were obtained for this study. Each specimen was fixed at 0° to test the force needed when the patella was laterally shifted 10 mm at a speed of 0.5 mm/s, and the test was repeated three times. This test was repeated when knee flexion was at 0°, 15°, 30°, 45°, 60°, and 90°. All six specimens were tested in four statuses, including MPFL intact, MPFL torn, single-bundle MPFL reconstruction, and double-bundle MPFL reconstruction.

Results: Similar force is required in these MPFL statuses at 0° of flexion, except for the MPFL torn group with a smaller force (45.5 ± 9.6 N, p < 0.05). The force required in the MPFL torn group reduced from 12.8 to 38.8% compared to other groups, at 0°, 15°, 30°, and 45° of flexion angles. At the flexion of 15°, the double-bundle reconstruction group required a statistically greater force (85.9 ± 10.1 N) compared to the single-bundle reconstruction group (74.0 ± 7.9 N). Interestingly, no statistical difference was found at flexions of 60° and 90° in these four groups.

Conclusions: Both single-bundle and double-bundle MPFL reconstruction can restore the stability of the patella. The double-bundle reconstruction has an angular synergy effect that simulates the MPFL wide footprint in the patella, which enables it to have greater capacity to resist patellar dislocation before the patella entering the femoral trochlea at a smaller flexion angle.

Keywords: Biomechanics; Double bundle; Medial patellofemoral ligament reconstruction; Single bundle.

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Figures

Fig. 1
Fig. 1
Force collected by the biomechanical material dynamic mechanical testing system. a Overview of the testing system. b The experimental setup
Fig. 2
Fig. 2
a MPFL reconstruction with single bundle on the left; b double-bundle MPFL reconstruction on the right
Fig. 3
Fig. 3
The force required when the patella shifts 10 mm laterally
See this image and copyright information in PMC

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