The role of the medial ligamentous structures on patellar tracking during knee flexion
Purpose The influence of the medial patellar ligamentous structures on patellar tracking has rarely been studied. Thus the main purpose of this cadaveric biomechanical study was to determine the influence of the medial patellofemoral (MPFL), medial patellomeniscal (MPML) and medial patellotibial (MP...
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| Veröffentlicht in: | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2012-02, Vol.20 (2), p.331-336 |
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| container_title | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA |
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| creator | Philippot, R. Boyer, B. Testa, R. Farizon, F. Moyen, B. |
| description | Purpose
The influence of the medial patellar ligamentous structures on patellar tracking has rarely been studied. Thus the main purpose of this cadaveric biomechanical study was to determine the influence of the medial patellofemoral (MPFL), medial patellomeniscal (MPML) and medial patellotibial (MPTL) ligaments on the three-dimensional patellar tracking during knee flexion. This study was conducted using a validated cadaveric optoelectronic protocol for analysis of patellar kinematics.
Methods
For each cadaveric knee study, four successive acquisitions were performed; first was studied patellar tracking in healthy knees, then the junction between MPFL and vastus medialis obliquus (VMO) was sectioned, the MPFL was released at its patellar attachment and finally was released the insertion of the MPML and MPTL.
Results
In this study, the MPFL accounts for 50–60% of the medial stabilization forces of the lateral patellar shift during patellar engagement in the femoral trochlea. This work confirm and clarify the role of the MPFL as the primary stabilizer of the patella during the initial 30° of knee flexion. Moreover, this study shows no significant results regarding the stabilizing action of the VMO on the patella during knee flexion.
Conclusion
This in vitro study, conducted with an experimental protocol previously validated in the literature, helps quantify the actions of the MPFL, the VMO, and the MPML/MPTL respectively, and identify areas of joint motion where these structures have the most significant influence. This confirms the importance of reconstruction in the treatment of chronic patellar instability. During its reconstruction, care should be taken to adjust the MPFL balance during the initial 20°–30° of flexion. |
| doi_str_mv | 10.1007/s00167-011-1598-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_hal_p</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_hal_00985174v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>917159991</sourcerecordid><originalsourceid>FETCH-LOGICAL-c436t-5b8d30500aa3df8d2a4e660e1866132a98c3f81adf1bb58f26c344d29e8cab733</originalsourceid><addsrcrecordid>eNqFkUFv1DAQhS1URJe2P6AXZPWCOARmbMexj1UFFGklLoWr5SSTNm02Xuykgn-Po5QiVap6mpH1zfO8eYydInxEgOpTAkBdFYBYYGlNoV-xDSopi0qq6oBtwCpRCCj1IXub0i1AbpV9ww4FVspIqzbs59UN8RgG4qHjU-531PZ-4EN_7Xc0TmFOPE1xbqY5UuJh5Hs_0TD4yKfom7t-vObtHJdyNxLxbqDffRiP2evOD4lOHuoR-_Hl89XFZbH9_vXbxfm2aJTUU1HWppVQAngv2860wivSGgiN1iiFt6aRnUHfdljXpemEbqRSrbBkGl9XUh6xD6vujR_cPvY7H_-44Ht3eb51yxuANWV2e4-Zfb-y-xh-zZQmt-tTs3gZKdt0VmgLBrV8mcQq39vaRfPsCXkb5jhmyxnSRldQ2gzhCjUxpBSpe9wUwS1BujVIl4N0S5BO55l3D8JznSN5nPiXXAbECqT9cn2K_39-XvUvotanNA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>916867059</pqid></control><display><type>article</type><title>The role of the medial ligamentous structures on patellar tracking during knee flexion</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><source>SpringerLink Journals - AutoHoldings</source><creator>Philippot, R. ; Boyer, B. ; Testa, R. ; Farizon, F. ; Moyen, B.</creator><creatorcontrib>Philippot, R. ; Boyer, B. ; Testa, R. ; Farizon, F. ; Moyen, B.</creatorcontrib><description>Purpose
The influence of the medial patellar ligamentous structures on patellar tracking has rarely been studied. Thus the main purpose of this cadaveric biomechanical study was to determine the influence of the medial patellofemoral (MPFL), medial patellomeniscal (MPML) and medial patellotibial (MPTL) ligaments on the three-dimensional patellar tracking during knee flexion. This study was conducted using a validated cadaveric optoelectronic protocol for analysis of patellar kinematics.
Methods
For each cadaveric knee study, four successive acquisitions were performed; first was studied patellar tracking in healthy knees, then the junction between MPFL and vastus medialis obliquus (VMO) was sectioned, the MPFL was released at its patellar attachment and finally was released the insertion of the MPML and MPTL.
Results
In this study, the MPFL accounts for 50–60% of the medial stabilization forces of the lateral patellar shift during patellar engagement in the femoral trochlea. This work confirm and clarify the role of the MPFL as the primary stabilizer of the patella during the initial 30° of knee flexion. Moreover, this study shows no significant results regarding the stabilizing action of the VMO on the patella during knee flexion.
Conclusion
This in vitro study, conducted with an experimental protocol previously validated in the literature, helps quantify the actions of the MPFL, the VMO, and the MPML/MPTL respectively, and identify areas of joint motion where these structures have the most significant influence. This confirms the importance of reconstruction in the treatment of chronic patellar instability. During its reconstruction, care should be taken to adjust the MPFL balance during the initial 20°–30° of flexion.</description><identifier>ISSN: 0942-2056</identifier><identifier>EISSN: 1433-7347</identifier><identifier>DOI: 10.1007/s00167-011-1598-6</identifier><identifier>PMID: 21748394</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Analysis ; Biomechanical Phenomena ; Biomechanics ; Engineering Sciences ; Humans ; In Vitro Techniques ; Joints ; Kinematics ; Knee ; Knee Joint - physiology ; Knees ; Ligaments ; Ligaments, Articular - physiology ; Mechanics ; Medicine ; Medicine & Public Health ; Orthopedics ; Patella - physiology ; Sports ; Statistical analysis ; Surgery ; Variance analysis ; Work</subject><ispartof>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2012-02, Vol.20 (2), p.331-336</ispartof><rights>Springer-Verlag 2011</rights><rights>Springer-Verlag 2012</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c436t-5b8d30500aa3df8d2a4e660e1866132a98c3f81adf1bb58f26c344d29e8cab733</citedby><cites>FETCH-LOGICAL-c436t-5b8d30500aa3df8d2a4e660e1866132a98c3f81adf1bb58f26c344d29e8cab733</cites><orcidid>0000-0001-6427-9491 ; 0000-0001-8335-9729</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00167-011-1598-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00167-011-1598-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21748394$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-00985174$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Philippot, R.</creatorcontrib><creatorcontrib>Boyer, B.</creatorcontrib><creatorcontrib>Testa, R.</creatorcontrib><creatorcontrib>Farizon, F.</creatorcontrib><creatorcontrib>Moyen, B.</creatorcontrib><title>The role of the medial ligamentous structures on patellar tracking during knee flexion</title><title>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</title><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><description>Purpose
The influence of the medial patellar ligamentous structures on patellar tracking has rarely been studied. Thus the main purpose of this cadaveric biomechanical study was to determine the influence of the medial patellofemoral (MPFL), medial patellomeniscal (MPML) and medial patellotibial (MPTL) ligaments on the three-dimensional patellar tracking during knee flexion. This study was conducted using a validated cadaveric optoelectronic protocol for analysis of patellar kinematics.
Methods
For each cadaveric knee study, four successive acquisitions were performed; first was studied patellar tracking in healthy knees, then the junction between MPFL and vastus medialis obliquus (VMO) was sectioned, the MPFL was released at its patellar attachment and finally was released the insertion of the MPML and MPTL.
Results
In this study, the MPFL accounts for 50–60% of the medial stabilization forces of the lateral patellar shift during patellar engagement in the femoral trochlea. This work confirm and clarify the role of the MPFL as the primary stabilizer of the patella during the initial 30° of knee flexion. Moreover, this study shows no significant results regarding the stabilizing action of the VMO on the patella during knee flexion.
Conclusion
This in vitro study, conducted with an experimental protocol previously validated in the literature, helps quantify the actions of the MPFL, the VMO, and the MPML/MPTL respectively, and identify areas of joint motion where these structures have the most significant influence. This confirms the importance of reconstruction in the treatment of chronic patellar instability. During its reconstruction, care should be taken to adjust the MPFL balance during the initial 20°–30° of flexion.</description><subject>Analysis</subject><subject>Biomechanical Phenomena</subject><subject>Biomechanics</subject><subject>Engineering Sciences</subject><subject>Humans</subject><subject>In Vitro Techniques</subject><subject>Joints</subject><subject>Kinematics</subject><subject>Knee</subject><subject>Knee Joint - physiology</subject><subject>Knees</subject><subject>Ligaments</subject><subject>Ligaments, Articular - physiology</subject><subject>Mechanics</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedics</subject><subject>Patella - physiology</subject><subject>Sports</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Variance analysis</subject><subject>Work</subject><issn>0942-2056</issn><issn>1433-7347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkUFv1DAQhS1URJe2P6AXZPWCOARmbMexj1UFFGklLoWr5SSTNm02Xuykgn-Po5QiVap6mpH1zfO8eYydInxEgOpTAkBdFYBYYGlNoV-xDSopi0qq6oBtwCpRCCj1IXub0i1AbpV9ww4FVspIqzbs59UN8RgG4qHjU-531PZ-4EN_7Xc0TmFOPE1xbqY5UuJh5Hs_0TD4yKfom7t-vObtHJdyNxLxbqDffRiP2evOD4lOHuoR-_Hl89XFZbH9_vXbxfm2aJTUU1HWppVQAngv2860wivSGgiN1iiFt6aRnUHfdljXpemEbqRSrbBkGl9XUh6xD6vujR_cPvY7H_-44Ht3eb51yxuANWV2e4-Zfb-y-xh-zZQmt-tTs3gZKdt0VmgLBrV8mcQq39vaRfPsCXkb5jhmyxnSRldQ2gzhCjUxpBSpe9wUwS1BujVIl4N0S5BO55l3D8JznSN5nPiXXAbECqT9cn2K_39-XvUvotanNA</recordid><startdate>20120201</startdate><enddate>20120201</enddate><creator>Philippot, R.</creator><creator>Boyer, B.</creator><creator>Testa, R.</creator><creator>Farizon, F.</creator><creator>Moyen, B.</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><general>Springer Verlag</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0001-6427-9491</orcidid><orcidid>https://orcid.org/0000-0001-8335-9729</orcidid></search><sort><creationdate>20120201</creationdate><title>The role of the medial ligamentous structures on patellar tracking during knee flexion</title><author>Philippot, R. ; Boyer, B. ; Testa, R. ; Farizon, F. ; Moyen, B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c436t-5b8d30500aa3df8d2a4e660e1866132a98c3f81adf1bb58f26c344d29e8cab733</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Analysis</topic><topic>Biomechanical Phenomena</topic><topic>Biomechanics</topic><topic>Engineering Sciences</topic><topic>Humans</topic><topic>In Vitro Techniques</topic><topic>Joints</topic><topic>Kinematics</topic><topic>Knee</topic><topic>Knee Joint - physiology</topic><topic>Knees</topic><topic>Ligaments</topic><topic>Ligaments, Articular - physiology</topic><topic>Mechanics</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedics</topic><topic>Patella - physiology</topic><topic>Sports</topic><topic>Statistical analysis</topic><topic>Surgery</topic><topic>Variance analysis</topic><topic>Work</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Philippot, R.</creatorcontrib><creatorcontrib>Boyer, B.</creatorcontrib><creatorcontrib>Testa, R.</creatorcontrib><creatorcontrib>Farizon, F.</creatorcontrib><creatorcontrib>Moyen, B.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Philippot, R.</au><au>Boyer, B.</au><au>Testa, R.</au><au>Farizon, F.</au><au>Moyen, B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The role of the medial ligamentous structures on patellar tracking during knee flexion</atitle><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle><stitle>Knee Surg Sports Traumatol Arthrosc</stitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><date>2012-02-01</date><risdate>2012</risdate><volume>20</volume><issue>2</issue><spage>331</spage><epage>336</epage><pages>331-336</pages><issn>0942-2056</issn><eissn>1433-7347</eissn><abstract>Purpose
The influence of the medial patellar ligamentous structures on patellar tracking has rarely been studied. Thus the main purpose of this cadaveric biomechanical study was to determine the influence of the medial patellofemoral (MPFL), medial patellomeniscal (MPML) and medial patellotibial (MPTL) ligaments on the three-dimensional patellar tracking during knee flexion. This study was conducted using a validated cadaveric optoelectronic protocol for analysis of patellar kinematics.
Methods
For each cadaveric knee study, four successive acquisitions were performed; first was studied patellar tracking in healthy knees, then the junction between MPFL and vastus medialis obliquus (VMO) was sectioned, the MPFL was released at its patellar attachment and finally was released the insertion of the MPML and MPTL.
Results
In this study, the MPFL accounts for 50–60% of the medial stabilization forces of the lateral patellar shift during patellar engagement in the femoral trochlea. This work confirm and clarify the role of the MPFL as the primary stabilizer of the patella during the initial 30° of knee flexion. Moreover, this study shows no significant results regarding the stabilizing action of the VMO on the patella during knee flexion.
Conclusion
This in vitro study, conducted with an experimental protocol previously validated in the literature, helps quantify the actions of the MPFL, the VMO, and the MPML/MPTL respectively, and identify areas of joint motion where these structures have the most significant influence. This confirms the importance of reconstruction in the treatment of chronic patellar instability. During its reconstruction, care should be taken to adjust the MPFL balance during the initial 20°–30° of flexion.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>21748394</pmid><doi>10.1007/s00167-011-1598-6</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0001-6427-9491</orcidid><orcidid>https://orcid.org/0000-0001-8335-9729</orcidid></addata></record> |
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| ispartof | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2012-02, Vol.20 (2), p.331-336 |
| issn | 0942-2056 1433-7347 |
| language | eng |
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| source | MEDLINE; Access via Wiley Online Library; SpringerLink Journals - AutoHoldings |
| subjects | Analysis Biomechanical Phenomena Biomechanics Engineering Sciences Humans In Vitro Techniques Joints Kinematics Knee Knee Joint - physiology Knees Ligaments Ligaments, Articular - physiology Mechanics Medicine Medicine & Public Health Orthopedics Patella - physiology Sports Statistical analysis Surgery Variance analysis Work |
| title | The role of the medial ligamentous structures on patellar tracking during knee flexion |
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