Dynamic Analysis of Anatomical Parameters that Limit the Effectiveness of MPFL Reconstruction in Pediatric Patellar Instability
Grant Recipient: Kerwyn C Jones, MD - Basic Science
Co-Investigators: John J Elias, PhD
- Childrens Hospital Med Ctr of Akron, OH
- Presentations & Publications:
Abstract will be submitted to the 2017 POSNA annual meeting as an e-poster or podium.
- Further Funding:
- Received R21AR069150, NIH/NIAMS grant, entitled “Computational simulation of dynamic motion for knees with patellar instability to compare MPFL reconstruction to tibial tuberosity medialization as a function of knee anatomy.
- Additional Information:
- In a previous study, MRI and/or CT images for eight patients with patellar instability scheduled for surgery were used to create computer generated models. These models enabled the surgeon to track patellar motion during knee function based on three-dimensional graphical models. In this study, simulation models were created from the computational models by adding mathematical representations of ligaments, muscles and contact between bones. The simulation models were validated when patellar tracking was found to be similar to motion determined from dynamic CT imaging in five patients. The simulation models were then used to analyze numerous variations in 3 commonly performed surgeries for patellar instability, namely tibial tuberosity medialization, MPFL reconstruction, and medialization of the lateral half of the patellar tendon. All procedures improved patellar tracking by decreasing the lateral shift and tilt of the patella. However, some variations tended to over-constrain the patella. This POSNA funded study enabled the investigators to obtain additional funding from the National Institute of Health. More models will be developed to cover a wider range of anatomy to help surgeons determine the best surgery for their pediatric patients based on the anatomical factors causing instability.