内侧髌股韧带的解剖及重建方式的研究进展
Research Progress on the Anatomy and Reconstruction of the Medial Patellofemoral Ligament
DOI: 10.12677/acm.2025.152538, PDF,   
作者: 汤家骏:暨南大学第二临床医学院,广东 深圳;陈 蓟:深圳市人民医院(暨南大学附属第二临床医学院、南方科技大学第一附属医院)骨关节科,广东 深圳
关键词: 髌股内侧的韧带髌骨脱位治疗重建术骨隧道缝合锚钉软组织固定综述Medial Patellofemoral Ligament Patellar Displacement Treatment Reconstruction Bone Tunnel Suture Anchor Soft Tissue Fixation and Review
摘要: 髌骨脱位主要是指由于先天或后天因素造成髌骨向外脱位或半脱位,这种情况是一种普遍存在的膝盖伤害,尤其在青少年群体中更为严重。在髌骨发生弯曲或者旋转的过程中,有可能造成软组织的破坏、局部的膨胀以及疼痛,更有可能引发软骨的磨损,这将对日常生活产生极大的负面效应。这篇文章的核心是对内侧髌股韧带的解剖和重建手术的方法进行概述,以便给临床医生提供借鉴。
Abstract: Patellar dislocation mainly refers to the outward dislocation or subluxation of the patella due to congenital or acquired factors. This is a common knee injury, especially in adolescents. During the bending or rotation of the patella, it may cause soft tissue damage, local swelling and pain, and it is more likely to cause cartilage wear, which will have a great negative effect on daily life. The core of this article is to provide an overview of the anatomy and reconstruction methods of the medial patellofemoral ligament in order to provide a reference for clinicians.
文章引用:汤家骏, 陈蓟. 内侧髌股韧带的解剖及重建方式的研究进展[J]. 临床医学进展, 2025, 15(2): 1792-1798. https://doi.org/10.12677/acm.2025.152538

参考文献

[1] Balcarek, P., Ammon, J., Frosch, S., Walde, T.A., Schüttrumpf, J.P., Ferlemann, K.G., et al. (2010) Magnetic Resonance Imaging Characteristics of the Medial Patellofemoral Ligament Lesion in Acute Lateral Patellar Dislocations Considering Trochlear Dysplasia, Patella Alta, and Tibial Tuberosity–trochlear Groove Distance. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 26, 926-935. [Google Scholar] [CrossRef] [PubMed]
[2] Mistry, J., Bonner, K., Gwam, C., Thomas, M., Etcheson, J. and Delanois, R. (2017) Management of Injuries to the Medial Patellofemoral Ligament: A Review. The Journal of Knee Surgery, 31, 439-447. [Google Scholar] [CrossRef] [PubMed]
[3] Peter, G., Hoser, C., Runer, A., Abermann, E., Wierer, G. and Fink, C. (2018) Medial Patellofemoral Ligament (MPFL) Reconstruction Using Quadriceps Tendon Autograft Provides Good Clinical, Functional and Patient-Reported Outcome Measurements (PROM): A 2-Year Prospective Study. Knee Surgery, Sports Traumatology, Arthroscopy, 27, 2426-2432. [Google Scholar] [CrossRef] [PubMed]
[4] Testa, E.A., Camathias, C., Amsler, F., Henle, P., Friederich, N.F. and Hirschmann, M.T. (2015) Surgical Treatment of Patellofemoral Instability Using Trochleoplasty or MPFL Reconstruction: A Systematic Review. Knee Surgery, Sports Traumatology, Arthroscopy, 25, 2309-2320. [Google Scholar] [CrossRef] [PubMed]
[5] Warren, L.F. and Marshall, J.L. (1979) The Supporting Structures and Layers on the Medial Side of the Knee. The Journal of Bone & Joint Surgery, 61, 56-62. [Google Scholar] [CrossRef
[6] Feller, J.A., Feagin, J.A. and Garrett, W.E. (1993) The Medial Patellofemoral Ligament Revisited: An Anatomical Study. Knee Surgery, Sports Traumatology, Arthroscopy, 1, 184-186. [Google Scholar] [CrossRef] [PubMed]
[7] Aragão, J.A., Reis, F.P., de Vasconcelos, D.P., Feitosa, V.L.C. and Nunes, M.A.P. (2008) Metric Measurements and Attachment Levels of the Medial Patellofemoral Ligament: An Anatomical Study in Cadavers. Clinics, 63, 541-544. [Google Scholar] [CrossRef] [PubMed]
[8] Baldwin, J.L. (2009) The Anatomy of the Medial Patellofemoral Ligament. The American Journal of Sports Medicine, 37, 2355-2361. [Google Scholar] [CrossRef] [PubMed]
[9] Migliorini, F., Trivellas, A., Eschweiler, J., Knobe, M., Tingart, M. and Maffulli, N. (2021) Comparable Outcome for Autografts and Allografts in Primary Medial Patellofemoral Ligament Reconstruction for Patellofemoral Instability: Systematic Review and Meta-analysis. Knee Surgery, Sports Traumatology, Arthroscopy, 30, 1282-1291. [Google Scholar] [CrossRef] [PubMed]
[10] Migliorini, F., Eschweiler, J., Spiezia, F., Knobe, M., Hildebrand, F. and Maffulli, N. (2022) Synthetic Graft for Medial Patellofemoral Ligament Reconstruction: A Systematic Review. Journal of Orthopaedics and Traumatology, 23, Article No. 41. [Google Scholar] [CrossRef] [PubMed]
[11] Wang, Q., Huang, W., Cai, D. and Huang, H. (2017) Biomechanical Comparison of Single-And Double-Bundle Medial Patellofemoral Ligament Reconstruction. Journal of Orthopaedic Surgery and Research, 12, Article No. 29. [Google Scholar] [CrossRef] [PubMed]
[12] Wang, C., Ma, L., Zhou, J., Ji, G., Wang, H., Wang, F., et al. (2013) Double-bundle Anatomical versus Single-Bundle Isometric Medial Patellofemoral Ligament Reconstruction for Patellar Dislocation. International Orthopaedics, 37, 617-624. [Google Scholar] [CrossRef] [PubMed]
[13] Zanon, G., Marullo, M. and Benazzo, F. (2013) Double-Bundle Medial Patellofemoral Ligament Reconstruction with a Single Patellar Tunnel. Arthroscopy Techniques, 2, e401-e404. [Google Scholar] [CrossRef] [PubMed]
[14] Mohammed, R., Hunt, N. and Gibbon, A. (2017) Patellar Complications in Single versus Double Tunnel Medial Patellofemoral Ligament Reconstruction. Journal of Orthopaedic Surgery, 25, 1-4. [Google Scholar] [CrossRef] [PubMed]
[15] Carmont, M.R. and Maffulli, N. (2007) Medial Patellofemoral Ligament Reconstruction: A New Technique. BMC Musculoskeletal Disorders, 8, Article No. 22. [Google Scholar] [CrossRef] [PubMed]
[16] Panni, A.S., Alam, M., Cerciello, S., Vasso, M. and Maffulli, N. (2011) Medial Patellofemoral Ligament Reconstruction with a Divergent Patellar Transverse 2-Tunnel Technique. The American Journal of Sports Medicine, 39, 2647-2655. [Google Scholar] [CrossRef] [PubMed]
[17] Matthews, J.J. and Schranz, P. (2009) Reconstruction of the Medial Patellofemoral Ligament Using a Longitudinal Patellar Tunnel Technique. International Orthopaedics, 34, 1321-1325. [Google Scholar] [CrossRef] [PubMed]
[18] Ahmad, R., Jayasekera, N., Schranz, P. and Mandalia, V. (2014) Medial Patellofemoral Ligament Reconstruction: A Technique with a “v”-Shaped Patellar Tunnel. Arthroscopy Techniques, 3, e589-e592. [Google Scholar] [CrossRef] [PubMed]
[19] Raoulis, V., Zibis, A., Fyllos, A., Malahias, M., Banios, K. and Hantes, M. (2021) Reconstruction of the Medial Patellofemoral Ligament Using Two Blind Transverse Semi-Patella Tunnels and an Implant-Free Technique for Patellar Fixation: A Technical Note. Journal of Orthopaedic Surgery and Research, 16, Article No. 25. [Google Scholar] [CrossRef] [PubMed]
[20] Shafizadeh, S. and Balke, M. (2014) Medial Patellofemoral Ligament Reconstruction: A New Technique for Graft Fixation at the Patella without Implants. Arthroscopy Techniques, 3, e115-e117. [Google Scholar] [CrossRef] [PubMed]
[21] Moran, T.E., Burke, J.F. and Diduch, D.R. (2020) Small (3.2-Mm), Short, Oblique Patellar Tunnels for Patellar Fixation in MPFL Reconstruction. Arthroscopy Techniques, 9, e1613-e1617. [Google Scholar] [CrossRef] [PubMed]
[22] Deasey, M.J., Moran, T.E., Lesevic, M., Burnett, Z.R. and Diduch, D.R. (2020) Small, Short, Oblique Patellar Tunnels for Patellar Fixation Do Not Increase Fracture Risk or Complications in MPFL Reconstruction: A Retrospective Cohort Study. Orthopaedic Journal of Sports Medicine, 8. [Google Scholar] [CrossRef] [PubMed]
[23] Schöttle, P.B., Hensler, D. and Imhoff, A.B. (2009) Anatomical Double-Bundle MPFL Reconstruction with an Aperture Fixation. Knee Surgery, Sports Traumatology, Arthroscopy, 18, 147-151. [Google Scholar] [CrossRef] [PubMed]
[24] Schöttle, P., Fucentese, S. and Romero, J. (2005) Clinical and Radiological Outcome of Medial Patellofemoral Ligament Reconstruction with a Semitendinosus Autograft for Patella Instability. Knee Surgery, Sports Traumatology, Arthroscopy, 13, 516-521. [Google Scholar] [CrossRef] [PubMed]
[25] Anbari, A. and Cole, B. (2008) Medial Patellofemoral Ligament Reconstruction—A Novel Approach. Journal of Knee Surgery, 21, 241-245. [Google Scholar] [CrossRef] [PubMed]
[26] Wang, H., Dong, J. and Gao, S. (2016) Medial Patellofemoral Ligament Reconstruction Using a Bone Groove and a Suture Anchor at Patellar: A Safe and Firm Fixation Technique and 3-Year Follow-Up Study. Journal of Orthopaedic Surgery and Research, 11, Article No. 138. [Google Scholar] [CrossRef] [PubMed]
[27] Dhinsa, B.S., Bhamra, J.S., James, C., Dunnet, W. and Zahn, H. (2013) Patella Fracture after Medial Patellofemoral Ligament Reconstruction Using Suture Anchors. The Knee, 20, 605-608. [Google Scholar] [CrossRef] [PubMed]
[28] Muthukumar, N. and Angus, P.D. (2004) Patellar Fracture Following Surgery for Patellar Instability. The Knee, 11, 121-123. [Google Scholar] [CrossRef] [PubMed]
[29] Kang, H., Cao, J., Yu, D., Zheng, Z. and Wang, F. (2013) Comparison of 2 Different Techniques for Anatomic Reconstruction of the Medial Patellofemoral Ligament. The American Journal of Sports Medicine, 41, 1013-1021. [Google Scholar] [CrossRef] [PubMed]
[30] Ye, M., Zhang, H. and Liang, Q. (2020) Clinical Outcomes after Medial Patellofemoral Ligament Reconstruction Using Transosseous Sutures versus Suture Anchors: A Prospective Nonrandomized Controlled Trial. Orthopaedic Journal of Sports Medicine, 8. [Google Scholar] [CrossRef] [PubMed]
[31] Siebold, R., Chikale, S., Sartory, N., Hariri, N., Feil, S. and Pässler, H.H. (2010) Hamstring Graft Fixation in MPFL Reconstruction at the Patella Using a Transosseous Suture Technique. Knee Surgery, Sports Traumatology, Arthroscopy, 18, 1542-1544. [Google Scholar] [CrossRef] [PubMed]
[32] Russ, S.D., Tompkins, M., Nuckley, D. and Macalena, J. (2014) Biomechanical Comparison of Patellar Fixation Techniques in Medial Patellofemoral Ligament Reconstruction. The American Journal of Sports Medicine, 43, 195-199. [Google Scholar] [CrossRef] [PubMed]
[33] Higuchi, T., Arai, Y., Takamiya, H., Miyamoto, T., Tokunaga, D. and Kubo, T. (2010) An Analysis of the Medial Patellofemoral Ligament Length Change Pattern Using Open-MRI. Knee Surgery, Sports Traumatology, Arthroscopy, 18, 1470-1475. [Google Scholar] [CrossRef] [PubMed]
[34] Smirk, C. and Morris, H. (2003) The Anatomy and Reconstruction of the Medial Patellofemoral Ligament. The Knee, 10, 221-227. [Google Scholar] [CrossRef] [PubMed]
[35] Stephen, J.M., Lumpaopong, P., Deehan, D.J., Kader, D. and Amis, A.A. (2012) The Medial Patellofemoral Ligament: Location of Femoral Attachment and Length Change Patterns Resulting from Anatomic and Nonanatomic Attachments. The American Journal of Sports Medicine, 40, 1871-1879. [Google Scholar] [CrossRef] [PubMed]
[36] Jaecker, V., Brozat, B., Banerjee, M., Otchwemah, R., Bouillon, B. and Shafizadeh, S. (2015) Fluoroscopic Control Allows for Precise Tunnel Positioning in MPFL Reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy, 25, 2688-2694. [Google Scholar] [CrossRef] [PubMed]
[37] Schöttle, P.B., Schmeling, A., Rosenstiel, N. and Weiler, A. (2007) Radiographic Landmarks for Femoral Tunnel Placement in Medial Patellofemoral Ligament Reconstruction. The American Journal of Sports Medicine, 35, 801-804. [Google Scholar] [CrossRef] [PubMed]
[38] Tanaka, M.J., Mirochnik, K., Simeone, F.J., Berkson, E.M., Doornberg, J.N. and Mangudi Varadarajan, K. (2023) In Vivo Length Changes between the Attachments of the Medial Patellofemoral Complex Fibers in Knees with Anatomic Risk Factors for Patellar Instability. The American Journal of Sports Medicine, 51, 1765-1776. [Google Scholar] [CrossRef] [PubMed]