NOTES - Surgical Procedures :
VMO Advancement? - - Posted by smelton5 (smelton5), 18 September 2004
I was looking at the success board and saw a girl who had a LR and VMO advancement. I know it may sound like a stupid question, but what is a VMO advancement? Is it similar to medial reefing? Just curious.
Stacy
Posted by anasta5ia (anasta5ia), 19 September 2004
Hey there-
In a VMO advancement, the OS actually will cut the insertion of the VMO and then reattach it in a position that is more favorable in correcting the tracking of the patella.
With medial reefing, the structures that are reefed are actually the medial retinaculum and not necessarily the insertion point of the VMO.
Often times, the VMO advancement is done along with medial reefing. Both are proximal realignment procedures.
I have had a VMO advancement done in conjunction with my TTTs and with my MPFL reconstructions.
Hope this helps....If you have any other questions, feel free to IM me.
-Heather G.
Posted by cat (cat), 19 September 2004
Hey there,
I had a VMO advancement along with medial reefing, Z-release and TTT. Here's some info from The Patella- A Team Approach by Ronald P Grelsamer and Jenny McConnel-
Quote:Medial Plication
The medial retinaculum and medial patellofemoral ligament provide a passive medial restraint to lateral displacement of the patella and the vastus medialis obliquus (VMO) is the major dynamic stabilizer of the patella. It is natural to try to increase the pull on the inner (medial) aspect of the kneecap.
The simplest procedure in this category is the medial plication as popularized in the United States by Hughston. The medial retinaculum is divided as it inserts into the patella. It is then re-attached more medially onto the patella itself in a "pants-over-vest " fashion.
In addition to plicating the medial retinaculum, the VMO can be dissected free by dissecting along its insertion and then dissecting along its inferior border. The muscle can then be pulled in the direction of its fibers as far as one wishes onto the supero medial portion of the patella. The inferior fibers can also be sutured more distally to "horizontalize" the VMO. Dissection of the VMO changes the rehabilitation considerably since vigorous contraction of the muscle could conceivably pull the VMO out of its new position.
*Note: A lateral release is carried out in conjunction with either of the above medial procedures
Hope that helps,
cat
Posted by smelton5 (smelton5), 19 September 2004
Thanks! You guys help me understand all of these confusing procedures! 
Updated Sat Nov 21 2009
