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Sports Medicine and Arthroscopy Review

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https://www.readbyqxmd.com/read/28459754/rehabilitation-after-medial-patellofemoral-ligament-reconstruction
#1
Terrence G McGee, Andrew J Cosgarea, Kevin McLaughlin, Miho Tanaka, Ken Johnson
Patellar instability resulting from subluxation or dislocation is a painful and commonly recurring condition. Retinacular restraints control patellar tracking, limiting the movement of the patella in the trochlear groove. The medial patellofemoral ligament (MPFL) is considered the main soft tissue stabilizer against lateral displacement. Few studies of patellar instability discuss rehabilitation after MPFL reconstruction. In this review, we discuss the phases of rehabilitation after MPFL reconstruction, typical interventions by rehabilitation specialists, and patient-specific guidelines for return to prior level of function...
June 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28459753/surgical-options-for-patellar-stabilization-in-the-skeletally-immature-patient
#2
Jack Andrish
The surgical management of children and youth with patellar instability can be a challenging exercise. It is possible to identify the various pathoanatomies that coexist with and predispose to patellar instability and in so doing, it is possible to address some, but not all, of these pathoanatomies as part of the surgical management. Although reconstruction of the medial patellofemoral ligament has become a mainstay of treatment, it is not without potential complications. Understanding the importance of surgical technique as it relates to the unique anatomies involved is crucial...
June 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28459752/patellar-instability-when-is-trochleoplasty-necessary
#3
S Evan Carstensen, Heather M Menzer, David R Diduch
Trochleoplasty is a very effective procedure for correcting trochlear dysplasia and addressing instability of the patella. With an increasing knowledge about the anatomy and biomechanics of the anterior distal femur, a wider array of surgical techniques may be applied to address specific conditions. Patients must be carefully selected to undergo trochleoplasty by use of a thorough history and physical examination as well as basic and advanced imaging. The presence of a "J sign" on physical examination, a history of recurrent instability, patella alta, trochlear dysplasia, and elevated tibial tubercle to trochlear groove are signs and symptoms for which the patient should be evaluated...
June 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28459751/complications-of-tibial-tuberosity-osteotomy
#4
Alex A Johnson, Andrew J Cosgarea
It is important to understand potential complications of tibial tuberosity osteotomies (TTOs) and how to avoid them. TTO is associated with a 1% to 3% rate of tibial fracture and 1% rate of nonunion. Early weight-bearing and complete detachment of the distal tuberosity may increase these risks. Painful screws requiring removal occur in 3% to 77% of cases. Use of small (3.5- mm diameter), countersunk screws reduces this risk. Recurrent instability occurs in ∼5% of cases at 5 years. The risk of deep-vein thrombosis (4%) after TTO is higher than that associated with other sports surgeries (1% to 2%)...
June 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28459750/when-and-how-far-to-move-the-tibial-tuberosity-in-patients-with-patellar-instability
#5
Taylor D'Amore, Miho J Tanaka, Andrew J Cosgarea
The many factors contributing to patellar instability have led to various surgical techniques that are used commonly today. When surgery is deemed necessary, the operation should be tailored to the patient's specific pathoanatomy. Patients with malalignment can often be stabilized by moving the tibial tuberosity to a more medial, anteromedial, or distal position. Subsequent changes in the forces acting on the patellofemoral joint will depend on the direction and distance of the tuberosity repositioning. When planning tuberosity osteotomies, it is crucial to understand how to use clinical and imaging modalities to measure and quantify tuberosity position accurately to achieve the desired degree of realignment...
June 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28459749/nonoperative-treatment-of-patellar-instability
#6
Sameer Dixit, Rajwinder S Deu
The treatment of patellar instability is challenging and typically begins with nonoperative methods. Clinical decisions are made on an individual basis and may vary according to a number of factors. First-time patellar dislocations most commonly occur during sports participation. Initial evaluation, including patient history, physical examination, and appropriate imaging, determines care. Although nonoperative treatment consists primarily of regressive immobilization and physical therapy, there is little evidence to support particular protocols for either...
June 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28459748/diagnosis-and-characterization-of-patellofemoral-instability-review-of-available-imaging-modalities
#7
Arya Haj-Mirzaian, Gaurav K Thawait, Miho J Tanaka, Shadpour Demehri
Patellofemoral instability (PI) is defined as single or multiple episodes of patellar dislocation. Imaging modalities are useful for characterization of patellar malalignment, maltracking, underlying morphologic abnormalities, and stabilizing soft-tissue injuries. Using these findings, orthopedic surgeons can decide when to operate, determine the best operation, and measure degree of correction postoperatively in PI patients. Also, these methods assist with PI diagnosis in some suspicious cases. Magnetic resonance imaging is the preferred method especially in the setting of acute dislocations...
June 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28459747/biomechanical-analysis-of-tibial-tuberosity-medialization-and-medial-patellofemoral-ligament-reconstruction
#8
John J Elias, Bradley W Smith, Blake T Daney
Biomechanical studies are commonly performed to evaluate the influence of medial patellofemoral ligament (MPFL) reconstruction and tibial tuberosity medialization on patellar tracking and patellofemoral contact pressures. The most common method is in vitro simulation of knee function, but computational simulation of knee function and computational reconstruction of in vivo motion can also be utilized. The current review of the biomechanical literature indicates that MPFL reconstruction and tibial tuberosity medialization reduce lateral patellar tracking...
June 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28459746/the-anatomy-of-the-medial-patellofemoral-complex
#9
Miho J Tanaka
The term "medial patellofemoral complex" (MPFC) was proposed to describe the static medial stabilizer of the patella, typically referred to as the medial patellofemoral ligament. In light of our increasing understanding of the attachment of its fibers to the quadriceps tendon in addition to the patella, the term MPFC is used in this article. The purpose of this article is to describe and discuss the anatomy of the MPFC.
June 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28459745/smar-patellofemoral-instability-editorial-volume-25-issue-2
#10
Andrew J Cosgarea
No abstract text is available yet for this article.
June 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28045874/surgical-treatment-for-failure-of-repair-of-patellar-and-quadriceps-tendon-rupture-with-ipsilateral-hamstring-tendon-graft
#11
Nicola Maffulli, Rocco Papalia, Guglielmo Torre, Vincenzo Denaro
Tears of the patellar and quadriceps tendon are common in the active population, especially in athletes. At present, several techniques for surgical repair and reconstruction are available. When reruptures occur, a reconstruction is mandatory. In the present paper, we describe a surgical technique for patellar and quadriceps tendon reconstruction using ipsilateral hamstring autograft. After routine hamstring tendon harvesting, the tendon ends are prepared using a whip stitch. A transverse tunnel is drilled in the midportion of the patella, the hamstring graft is passed through the patella, and firmly secured to the patellar tunnel openings with sutures...
March 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28045873/the-management-of-extensor-mechanism-disruption-after-total-knee-arthroplasty-a-systematic-review
#12
Nicola Maffulli, Filippo Spiezia, Luca La Verde, Michele Attilio Rosa, Francesco Franceschi
We performed a literature search on PubMed, Web of Science, Science Direct/Scopus, Google Scholar, and Google to evaluate results of several techniques to manage disruption of the extensor mechanism after total knee arthroplasty. Different methods to manage extensor mechanism disruption are available at present, with no level I studies informing surgeons in an evidence-based fashion. Primary repair is not indicated. Allograft reconstruction could be effective, providing that appropriate surgical technique and allograft tensioning are implemented...
March 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28045872/revision-surgery-for-failed-patellar-tendinopathy-exploration
#13
Nicola Maffulli, Alessio Giai Via, Francesco Oliva
Chronic patellar tendinopathy affects athletes, with a higher incidence in high-impact sporting activities. It can seriously impair sports activities. Many patients respond well to conservative treatment, but about 10% of them are refractory to conservative treatment. In these cases, surgery is indicated. Multiple surgical techniques have been reported, including both open and arthroscopic procedures with good results. However, in a small percentage of patients surgery is unsuccessful. This group of patients presents a major challenge, as options are limited...
March 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28045871/revision-posterior-cruciate-ligament-surgery
#14
Gregory C Fanelli, Matthew G Fanelli, David G Fanelli
Successful posterior cruciate ligament (PCL) reconstruction surgery results from identification and treatment of associated pathology such as posterolateral instability, posteromedial instability, and lower extremity malalignment. The use of strong graft material, properly placed tunnels to as closely as possible approximate the PCL insertion sites, and minimization of graft bending also enhance the probability of PCL reconstruction success. In addition, mechanical graft tensioning, primary and back-up PCL graft fixation, and the appropriate postoperative rehabilitation program are also necessary ingredients for PCL reconstruction success...
March 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28045870/preoperative-planning-for-acl-revision-surgery
#15
Leonardo Osti, Matteo Buda, Raffaella Osti, Leo Massari, Nicola Maffulli
The number of patients undergoing revision surgery following failure of anterior cruciate ligament (ACL) reconstruction has increased over the recent past, following the overall increased number of primary ACL reconstruction performed. Failure of primary ACL reconstruction can be attributed to technical errors, biological failures, or new traumatic injuries. Technical errors include femoral and/or tibial tunnels malposition, untreated associated ligaments insufficiencies, uncorrected lower limb malalignment, and graft fixation failures...
March 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28045869/why-do-patellofemoral-stabilization-procedures-fail-keys-to-success
#16
Nick Caplan, Islam Nassar, Bobby Anand, Deiary F Kader
In recent years, surgical interventions for patellofemoral joint instability have gained popularity, possibly revitalized by the recent advances in our understanding of patellofemoral joint instability and the introduction of a number of new surgical procedures. This rise in surgical intervention has brought about various complications. In this review article, we present the complications that are associated with 5 main surgical procedures to stabilize the patella-medial patellofemoral ligament reconstruction, tibial tubercle osteotomy, trochleoplasty, lateral release/lateral retinacular lengthening, and derotation osteotomies...
March 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28045868/failure-of-autologous-chondrocyte-implantation
#17
Luca Andriolo, Giulia Merli, Giuseppe Filardo, Maurilio Marcacci, Elizaveta Kon
Long-term results of autologous chondrocyte implantation and matrix-assisted autologous chondrocyte transplantation in the knee are satisfying, but not enough attention has been paid to the evaluation of failures. Thus, a systematic review of the literature was performed, underlining a failure rate in the 58 included articles of 14.9% among 4294 patients, most of them occurring in the first 5 years after surgery, and with no difference between autologous chondrocyte implantation and matrix-assisted autologous chondrocyte transplantation...
March 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28045867/failure-of-bone-marrow-stimulation-techniques
#18
Rachel M Frank, Eric J Cotter, Islam Nassar, Brian Cole
Marrow stimulation techniques, including microfracture, are among the most commonly performed cartilage restoration procedures for symptomatic chondral defects of the knee. For the vast majority of patients, marrow stimulation results in reduced pain and improved function, providing overall satisfactory outcomes. In some cases, however, marrow stimulation fails, resulting in symptom recurrence and often, the need for repeat surgery. This review will describe the indications and outcomes of microfracture as a primary surgical treatment for focal chondral defects of the knee, identify patient and procedure-specific factors associated with poor clinical outcomes, and will discuss treatment options and their respective outcomes for patients with a failed prior microfracture surgery...
March 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28045866/revision-surgery-of-the-knee
#19
Nicola Maffulli
No abstract text is available yet for this article.
March 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/27811520/shoulder-and-elbow-injuries-in-the-adolescent-athlete
#20
Mia Smucny, Joel Kolmodin, Paul Saluan
With the recent increase in youth sports participation and single-sport youth athletes over the past 30 years, there has been an increase in the number of acute and overuse sports injuries in this population. This review focuses on overuse and traumatic injuries of the shoulder and elbow in young athletes. In particular we discuss little league shoulder, glenohumeral internal rotation deficit, glenohumeral instability, superior labrum anterior posterior lesions, Little League elbow, Panner disease, osteochondritis dissecans of the capitellum, posteromedial elbow impingement, and posterolateral rotatory instability of the elbow...
December 2016: Sports Medicine and Arthroscopy Review
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