title: Reconstruction of medial patello-femoral ligament: Comparison of two surgical techniques.
abstract: The medial patello-femoral ligament is considered the most important passive patellar stabilizer and its proper functionality is essential for the patello-femoral joint stability. In this work, 18 human knees were randomly divided into two groups and reconstructed through two different surgical techniques: the "Through tunnel tendon" and the "Double converging tunnel" reconstructions. Subsequently, the samples were mechanically tested to evaluate the structural properties of reconstructed femur-MPFL-Patella complex (rFMPC). Particular attention was given to maintain the anatomical orientation between the patella and the graft. Both procedures showed lower stiffness and higher ultimate strain and absorbed energy compared to the native MPFL, but the advantages of the double converging tunnel technique are related to the restoration of the native MPFL sail-shape, to a better stress distribution on the patella, to the use of a single interference screw as fixation device and to the simplicity, rapidity and cost-effectivity of the surgical procedure. The evaluation of the structural properties of rMPFL is fundamental to evaluate the adequacy of the different techniques to restore the physiological structural properties of the native MPFL.
authors.affiliation: Istituto di Ricerca Traslazionale per l׳Apparato Locomotore-Nicola Cerulli-LPMRI, Via A. Einstein 12, 52100 Arezzo, Italy; Research Center "E. Piaggio", University of Pisa, Largo Lucio Lazzarino 1, 56126 Pisa, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Criscenti
authors.affiliation: Research Center "E. Piaggio", University of Pisa, Largo Lucio Lazzarino 1, 56126 Pisa, Italy. Electronic address: carmelo.demaria@centropiaggio.unipi.it.
authors.forename: C
authors.initials: C
authors.lastname: De Maria
authors.affiliation: Istituto di Ricerca Traslazionale per l׳Apparato Locomotore-Nicola Cerulli-LPMRI, Via A. Einstein 12, 52100 Arezzo, Italy; Department of Orthopedic surgery, University of Perugia, via S. Andrea delle Fratte 1, 06134 Perugia, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Sebastiani
authors.affiliation: Istituto di Ricerca Traslazionale per l׳Apparato Locomotore-Nicola Cerulli-LPMRI, Via A. Einstein 12, 52100 Arezzo, Italy; Department of Orthopedic surgery, University of Perugia, via S. Andrea delle Fratte 1, 06134 Perugia, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Tei
authors.affiliation: Istituto di Ricerca Traslazionale per l׳Apparato Locomotore-Nicola Cerulli-LPMRI, Via A. Einstein 12, 52100 Arezzo, Italy; Department of Orthopedic surgery, University of Perugia, via S. Andrea delle Fratte 1, 06134 Perugia, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Placella
authors.affiliation: Istituto di Ricerca Traslazionale per l׳Apparato Locomotore-Nicola Cerulli-LPMRI, Via A. Einstein 12, 52100 Arezzo, Italy; Department of Orthopedic surgery, University of Perugia, via S. Andrea delle Fratte 1, 06134 Perugia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Speziali
authors.affiliation: Research Center "E. Piaggio", University of Pisa, Largo Lucio Lazzarino 1, 56126 Pisa, Italy; Department of Ingegneria dell׳Informazione, University of Pisa, via G. Caruso 16, 56126 Pisa, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Vozzi
authors.affiliation: Istituto di Ricerca Traslazionale per l׳Apparato Locomotore-Nicola Cerulli-LPMRI, Via A. Einstein 12, 52100 Arezzo, Italy; Department of Orthopedic surgery, University of Perugia, via S. Andrea delle Fratte 1, 06134 Perugia, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Cerulli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D005260:Female; D005269:Femur; D006801:Humans; D008023:Ligaments, Articular / Q000601:surgery*; D008297:Male; D010329:Patella; D057071:Patellofemoral Joint / Q000601:surgery*; D011897:Random Allocation; D019651:Plastic Surgery Procedures / Q000379:methods*; D013710:Tendons
keywords: Ligament biomechanics; Ligament reconstruction; Medial patello-femoral ligament (MPFL); Structural properties; Surgical techniques