[Research progress in femoral tunnel positioning points of medial patellofemoral ligament reconstruction]

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 Feb 15;35(2):258-264. doi: 10.7507/1002-1892.202006059.
[Article in Chinese]

Abstract

Objective: To review the research progress of location methods and the best femoral insertion position of medial patellofemoral ligament (MPFL) reconstruction of femoral tunnel, and provide reference for surgical treatment.

Methods: The literature about femoral insertion position of the MPFL reconstruction in recent years was extensively reviewed, and the anatomical and biomechanical characteristics of MPFL, as well as the advantages and disadvantages of femoral tunnel positioning methods were summarized.

Results: The accurate establishment of the femoral anatomical tunnel is crucial to the success of MPFL reconstruction. At present, there are mainly two kinds of methods for femoral insertion: radiographic landmark positioning method and anatomical landmark positioning method. Radiographic landmark positioning method has such advantages as small incision and simple operation, but it can not be accurately positioned for patients with severe femoral trochlear dysplasia. It is suggested to combine with the anatomical landmark positioning method. These methods have their own advantages and disadvantages, and there is no unified positioning standard. In recent years, the use of three-dimensional design software can accurately assist in the MPFL reconstruction, which has become a new trend.

Conclusion: Femoral tunnel positioning of the MPFL reconstruction is very important. The current positioning methods have their own advantages and disadvantages. Personalized positioning is a new trend and has not been widely used in clinic, its effectiveness needs further research and clinical practice and verification.

目的: 对内侧髌股韧带(medial patellofemoral ligament,MPFL)重建术中股骨隧道定位方法及最佳定位点的发展趋势进行综述,为手术治疗提供参考。.

方法: 广泛查阅近年来国内外 MPFL 重建术中股骨隧道定位点的相关文献,对 MPFL 的解剖及生物力学特点,以及股骨隧道定位方法的优缺点进行总结。.

结果: 精确建立股骨隧道对 MPFL 重建术的成功起至关重要的作用。目前股骨隧道定位法主要有影像学界标定位法及解剖学界标定位法两大类,影像学界标定位法切口小、操作简单,但对于重度滑车发育不良患者不能精确定位,建议结合解剖学界标定位法。两种定位方法各有优缺点,尚无统一选择标准。近年来利用 3D 设计软件精确辅助重建 MPFL 成为新的流行趋势。.

结论: MPFL 重建术中股骨隧道定位十分重要,目前临床常用的定位方法各有优缺点,个性化定位是新趋势,尚未广泛进入临床应用,需要进一步研究及临床实践验证。.

Keywords: Medial patellofemoral ligament; anatomy; femoral tunnel; location point.

Publication types

  • Review

MeSH terms

  • Bone Diseases*
  • Femoral Artery
  • Femur / surgery
  • Humans
  • Ligaments, Articular / surgery
  • Surgical Wound*

Grants and funding

云南省骨关节疾病临床医学中心项目(ZX-2019-03-04);云南省陈世益专家工作站项目(2018IC102);云南省领军人才资助项目(L-201601)