Strain behavior of native and reconstructed medial patellofemoral ligaments during dynamic knee flexion - a cadaveric study

Background Surgical reconstruction of the Medial Patello-Femoral Ligament (MPFL) has been recognized as an effective treatment for patients with instability despite conservative treatment. The purpose of this cadaveric study is to compare the strain patterns within the native and reconstructed single and double-bundle MPFL. This will help ascertain if the native biomechanics are restored with the reconstructions. Methods Twelve cadaveric knees were dissected and the native MPFL of each specimen was identified. The knees were subjected to dynamic flexion using a customized jig. Continuous strain measurements were taken for each knee from 0 to 120 degrees flexion and then back to full extension using differential variable reluctance transducers (DVRTs). The MPFL was then cut. Six single bundle and six double bundle MPFL reconstructions were performed using hamstring tendon grafts. The DVRTs were reattached to the grafts and strain measurements were retaken. Statistical analysis was performed using a paired t-test. Results Strain patterns of the native and reconstructed MPFL showed an increase in strain from 0 to 120 degrees of flexion except for the inferior bundle of the double bundle reconstruction. The strain patterns in the intact specimens were higher than the reconstructed MPFL through different degrees of knee flexion. In the double-bundle group, the superior graft had statistically significantly lower strains compared to the native MPFL with p -value