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. 2025 Apr 16;12(2):e70240.
doi: 10.1002/jeo2.70240. eCollection 2025 Apr.

Medial patellofemoral ligament fixation with suture tape augmentation decreases lateral patellar motion without changing contact pressure

Nima Rezaie  1 , Wesley R Stroud  1 , David P Beason  1 , Jonathan S Slowik  1 , Travis Dias  1 , Grant M Uldrich  1 , Glenn S Fleisig  1 , Jeffrey R Dugas  1   2
Affiliations

Medial patellofemoral ligament fixation with suture tape augmentation decreases lateral patellar motion without changing contact pressure

Nima Rezaie et al. J Exp Orthop. .

Abstract

Purpose: Medial patellofemoral ligament (MPFL) reconstruction has been the standard of care for recurrent patellar dislocations and chronic patellar instability. MPFL repair has been used as an alternative surgical option. The purpose of this study was to assess patellar stability and patellofemoral contact mechanics following MPFL fixation with suture tape augmentation. We hypothesized that lateral patellar motion would be reduced.

Methods: In twelve cadaver knees, a hole was drilled near the midpoint of the medial patella. Three locations were drilled on the femur Schöttle's point, 1 cm anterior to Schöttle's point and 1 cm proximal to Schöttle's point. Each knee was then held at 30° of knee flexion, and the patella was subjected to a physiologic lateral force. The resulting motion was measured, and patellofemoral contact forces were recorded. This process was performed with the MPFL torn and then bolstered with suture tape augmentation anchored centrally in the medial patella and each of the three femur hole locations.

Results: All MPFL augmentations provided significantly less lateral patellar motion compared to the torn condition. Contact area was significantly greater in the augmented condition than in the torn condition, but no statistical differences were observed in patellofemoral contact pressure. No significant differences in lateral patellar motion, contact pressure or contact area were found between femoral anchor positions.

Conclusions: MPFL fixation with suture tape augmentation significantly decreased lateral patellar motion compared to the torn condition without causing significant changes in contact pressures within the patellofemoral joint.

Level of evidence: N/A.

Keywords: MPFL augmentation; Schöttle's point; biomechanics.

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Conflict of interest statement

Dr. Nima Rezaie declares that educational support is available from Arthrex (the study sponsor), Fones Marketing Management and Smith & Nephew. Dr. Wesley R. Stroud declares educational support from Prime Surgical and Smith & Nephew and reimbursement for travel and lodging from Zimmer Biomet. Dr. Jeffrey R. Dugas is/was a paid consultant for Arthrex (the study sponsor), Bioventus, DJO and Royal Biologics. Dr. Jeffrey R. Dugas has received non‐consulting and/or speaking fees, reimbursement for travel and lodging, and royalties/licences for Arthrex (the study sponsor). Dr. Jeffrey R. Dugas declares educational support, hospitality and royalties/licences from DJO. The remaining authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Fluoroscopic image of a left knee with the radiolucent MPFL guide placed in the proper position to identify Schöttle's point. The insertion point (red dot) is approximately (a) 1 mm anterior to the posterior cortex extension line, (b) 2.5 mm distal to the posterior articular border of the medial femoral condyle and (c) proximal to the level of the posterior point of Blumensaat's line [3]. MPFL, medial patellofemoral ligament.
Figure 2
Figure 2
Two patellar and four medial femoral hole locations with electromagnetic microsensors in place in the right knee.
Figure 3
Figure 3
Suture tape in place between the patellar hole and Schöttle's point femoral hole on the right knee.
Figure 4
Figure 4
Biomechanical testing setup. Note that the patella is attached to a separate component of the fixture, which is held stationary and fixed to the torque cell, while the rest of the knee is attached to the rotating actuator.
Figure 5
Figure 5
Suture tape augmentation, when spanning the half‐patella and all three femoral anchor locations, resulted in improved (i.e., reduced) lateral motion compared to the torn condition for anterior (p = 0.0094), proximal (p = 0.0005) and Schöttle's (p = 0.0019). Significant differences from torn are marked (*) within the bars.
See this image and copyright information in PMC

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