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CC BY-NC-ND 4.0 · Sports Med Int Open 2022; 6(01): E25-E31
DOI: 10.1055/a-1807-8549
Orthopedics & Biomechanics

Analysis of Hemodynamic Changes After Medial Patellofemoral Ligament Reconstruction

Hiroaki Inoue 
1   Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
,
Yuji Arai
2   Department of Sports and Para-Sport Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
,
Shuji Nakagawa
2   Department of Sports and Para-Sport Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
,
Yuta Fujii
1   Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
,
Kenta Kaihara
1   Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
,
Kenji Takahashi
1   Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Abstract

The resumption of blood flow is an important factor in the remodeling process of the graft. The purpose of this study is to evaluate hemodynamic changes after medial patellofemoral ligament (MPFL) reconstruction using magnetic resonance angiography (MRA) as the evaluation of graft remodeling. Eleven knees that underwent anatomical MPFL reconstruction with the semitendinosus tendon were studied. We evaluated the blood flow around the bone tunnel wall in the arterial phase using MRA approximate 3 months and 1 year after surgery. Clinical and radiological evaluations were also analyzed. MRA showed an inflow vessel into the bone tunnel wall from the medial superior genicular artery on the femoral side, and from the articular branch of the descending genicular artery and the medial superior genicular artery on the patellar side. This contrast effect was decreased at 12 months after surgery in all cases. The clinical scores improved from baseline one year postoperatively. We revealed the blood flow to the bone tunnel wall after anatomical MPFL reconstruction is detected by MRA. The blood flow started within 2 or 3 months postoperatively and was sustained for 12 months. This study supported remodeling of the graft continues 3 months after surgery when the conformity of the patellofemoral joint stabilizes.

Key words

patellar instability - blood supply - imaging - remodeling - graft healing - ligament reconstruction


Publication History

Received: 06 November 2021
Received: 12 March 2022

Accepted: 14 March 2022

Accepted Manuscript online:
04 April 2022

Article published online:
29 April 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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