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patellar tendon stabilization

Michael Saper, Candice Brady, Robert Zondervan, David Shneider
BACKGROUND: We describe the preliminary clinical results of a patellar stabilization technique to treat bidirectional patellar subluxation (BPS). METHODS: Patients: six patients (one male, five females; mean age 30.2years) underwent this procedure with a minimum of 24months follow-up. Patients were assessed for clinical instability, patellar complications, and need for revision surgery. Patient functional outcomes were evaluated using the criteria of Crosby and Insall and the Kujala Anterior Knee Pain Scale at the time of final follow-up...
October 31, 2016: Knee
G Bressy, V Brun, A Ferrier, D Dujardin, N Oubaya, N Morel, N Fontanin, X Ohl
INTRODUCTION: The use of the semitendinosus tendon alone for anterior cruciate ligament reconstruction keeps the gracilis muscle intact and decreases anterior pain in comparison with the use of the patellar tendon. Recently, Lubowitz described a new all-inside technique with an ST4 tendon fixed with a cortical button in both femoral and tibial sides. We hypothesized that this type of graft with cortical button fixation provides well-controlled residual anterior tibial translation (<3mm)...
October 4, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Walter Kim, Peter McQueen, Jonathan N Watson, Mark R Hutchinson
Anterior cruciate ligament (ACL) reconstruction is one of the most extensively studied surgical procedures in orthopaedics. The importance of this ligament for knee function and stability has been widely studied. For athletes who participate in activities involving cutting, twisting, and running, surgical reconstruction of the ACL has become the standard of care. However, there is much debate regarding the techniques involved in ACL reconstruction, including graft choice, technique of drilling the femoral tunnel, and single- versus double-bundle reconstruction...
August 2016: Arthroscopy Techniques
Brian Forsythe, Marc S Haro, Ljiljana Bogunovic, Michael J Collins, Thomas A Arns, Katie J Trella, Elizabeth F Shewman, Nikhil N Verma, Bernard R Bach
BACKGROUND: Long-term studies of posterior cruciate ligament (PCL) reconstruction suggest that normal stability is not restored in the majority of patients. The Achilles tendon allograft is frequently utilized, although recently, the quadriceps tendon has been introduced as an alternative option due to its size and high patellar bone density. PURPOSE/HYPOTHESIS: The purpose of this study was to compare the biomechanical strength of PCL reconstructions using a quadriceps versus an Achilles allograft...
August 2016: Orthopaedic Journal of Sports Medicine
Xiaoliang Mei, Zhenxiang Zhang, Jingwen Yang
PURPOSE: To evaluate the clinical results of a randomized controlled trial of single-layer versus double-layer bone-patellar tendon-bone (BPTB) anterior cruciate ligament (ACL) reconstruction. METHODS: Fifty-eight subjects who underwent primary ACL reconstruction with a BPTB allograft were prospectively randomized into two groups: single-layer reconstruction (n = 31) and double-layer reconstruction (n = 27). The following evaluation methods were used: clinical examination, KT-1000 arthrometer measurement, muscle strength, Tegner activity score, Lysholm score, subjective rating scale regarding patient satisfaction and sports performance level, graft retear, contralateral ACL tear, and additional meniscus surgery...
August 27, 2016: Archives of Orthopaedic and Trauma Surgery
Adrian Kurz, Nathan Evaniew, Marco Yeung, Kristian Samuelsson, Devin Peterson, Olufemi R Ayeni
PURPOSE: This systematic review examined the methodological credibility and quality of reporting of all meta-analyses which have compared bone-patellar tendon-bone (BPTB) versus hamstring tendon (HT) for anterior cruciate ligament (ACL) reconstruction (ACLR). METHODS: EMBASE, MEDLINE, and The Cochrane Library were systematically searched, and two reviewers independently assessed eligibility, credibility according to the Users' Guide to medical literature, and completeness of reporting according to the preferred reporting items for systematic review and meta-analyses (PRISMA) checklist...
August 20, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Hidenori Otsubo, Tomoaki Kamiya, Tomoyuki Suzuki, Miki Kuroda, Yasutoshi Ikeda, Takashi Matsumura, Toshihiko Yamashita
Rupture of the patellar tendon is an uncommon injury that requires acute surgical repair to restore the function of the knee. Multiple techniques for repair have been described in the literature. Complications with these repair techniques include rerupture and extensor lag caused by gap formation at the site of repair. Thus, many surgeons have suggested augmenting the standard repair. Several methods of augmentation have been described each with disadvantages. The purpose of this article was to present our case series of six patients with acute patella tendon ruptures treated by a novel procedure using strong sutures...
August 16, 2016: Journal of Knee Surgery
Simon Michael Thompson, Lucy J Salmon, Alison Waller, James Linklater, Justin P Roe, Leo A Pinczewski
BACKGROUND: Long-term prospective studies of isolated endoscopic anterior cruciate ligament (ACL) reconstruction are limited and may include confounding factors. PURPOSE: This study aimed to compare the outcomes of isolated ACL reconstruction using the patellar tendon (PT) autograft and the hamstring (HT) autograft in 180 patients over 20 years. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: A total of 180 participants undergoing isolated ACL reconstruction between 1993 and 1994 were prospectively recruited...
December 2016: American Journal of Sports Medicine
M Retournard, A Bilmont, E Asimus, S Palierne, A Autefage
The effects of Tibial Tuberosity Advancement (TTA) on Cranial Tibial Subluxation (CTS) and Tibial Rotation Angle (TRA) were evaluated in a model of feline Cranial Cruciate Ligament (CrCL)-deficient stifle joint. Ten hindlimbs of adult cats were used. Quadriceps and gastrocnemius muscles were simulated using cables, turnbuckles and a spring. An axial load of 30% body weight was applied. The stifle and talocrural joint angles were adjusted to 120°. Patellar tendon angle (PTA), CTS and TRA were measured radiographically before and after CrCL section, after TTA and after additional advancement by 1 and 2mm...
August 2016: Research in Veterinary Science
Xiaozuo Zheng, Tong Li, Juan Wang, Jiangtao Dong, Shijun Gao
BACKGROUND: The medial collateral ligament (MCL) is the main static stabilizer of the medial knee. The surgical treatment was recommended in cases with serious medial collateral ligament insufficiency combined with multi-ligament injuries and chronic symptomatic medial instability. Several surgical techniques have been described for the MCL reconstruction, while potential problems including donor site morbidity, complicated procedure, and high risk of femoral tunnel collision were reported...
2016: Journal of Orthopaedic Surgery and Research
Roberto Padua, Federica Alviti, Michele Venosa, Carlo Mazzola, Luca Padua
PURPOSE: the aim of the present study was to investigate the influence of graft tunnel position on both clinical outcome and instrumental knee stability in patients submitted to arthroscopic ACL reconstruction using a bone-patellar tendon-bone (BPTB) graft. METHODS: thirty patients (24 men and 6 women) who underwent ACL reconstruction performed using an autologous bone-patellar tendon-bone graft were studied at a mean follow-up of 18 months. Clinical outcome was assessed on the basis of the Lysholm score, Tegner activity level, International Knee Documentation Committee (IKDC) subjective form and the Short Form-36...
January 2016: Joints
Haluk Çabuk, Fatmagül Kuşku Çabuk
Proprioceptive inputs from the joints and limbs arise from mechanoreceptors in the muscles, ligaments and tendons. The knee joint has a wide range of movements, and proper neuroanatomical organization is critical for knee stability. Four ligaments (the anterior (ACL) and posterior (PCL) cruciate ligaments and the medial (MCL) and lateral (LCL) collateral ligaments) and four tendons (the semitendinosus (STT), gracilis (GT), popliteal (PoT), and patellar (PaT) tendons) from eight fresh frozen cadavers were harvested...
September 2016: Clinical Anatomy
Rachel Shakked, Maxwell Weinberg, Jason Capo, Laith Jazrawi, Eric Strauss
With the increasing incidence of anterior cruciate ligament (ACL) reconstruction in women and younger patients, the optimal graft choice in the young female patient has become the subject of much debate. This study aimed to evaluate patient-reported outcomes, objective knee stability, complication rates, and the incidence of failure after ACL reconstruction using bone-patellar tendon-bone (BPTB) autograft compared with hamstring (HS) autograft in young female patients. Female patients who underwent primary ACL reconstruction with BPTB or HS autograft between ages 15 and 25 years were identified...
June 30, 2016: Journal of Knee Surgery
Marco Bigoni, Marco Turati, Marta Gandolla, Paola Sacerdote, Massimiliano Piatti, Alberto Castelnuovo, Silvia Franchi, Massimo Gorla, Daniele Munegato, Diego Gaddi, Alessandra Pedrocchi, Robert J Omeljaniuk, Vittorio Locatelli, Antonio Torsello
Anterior cruciate ligament (ACL) reconstruction restores knee stability but does not reduce the incidence of posttraumatic osteoarthritis induced by inflammatory cytokines. The aim of this research was to longitudinally measure IL-1β, IL-6, IL-8, IL-10, and TNF-α levels in patients subjected to ACL reconstruction using bone-patellar tendon-bone graft. Synovial fluid was collected within 24-72 hours of ACL rupture (acute), 1 month after injury immediately prior to surgery (presurgery), and 1 month thereafter (postsurgery)...
2016: Mediators of Inflammation
Yubao Gong, Chen Yang, Yang Liu, Jianguo Liu, Xin Qi
Hereditary onycho-osteodysplasia, also known as nail-patella syndrome (NPS), is a rare genetic disorder that is primarily characterized by poorly developed nails and patella. Patients with NPS frequently suffer from patellar instability that requires surgical management. The present case report describes a 25-year-old man with NPS. The patient presented with left knee pain and was found to have recurrent left patellar dislocation. The knee pain was first reported 1-year after a minor knee trauma incident. Following complete evaluation, a diagnosis of NPS was reached...
June 2016: Experimental and Therapeutic Medicine
Michael Osti, Doris Hierzer, Franz-Josef Seibert, Karl Peter Benedetto
Purpose The present study evaluates the medium-term functional and radiological outcome as well as complications following an arthroscopic tibial inlay reconstruction of the posterior cruciate ligament (PCL). Methods A total of 39 patients (mean age: 32.6 ± 12.4 years) with acute and chronic PCL instabilities received a single-bundle all-inside arthroscopic tibial inlay reconstruction with quadriceps tendon autograft and were available for clinical follow-up on average after 3.8 ± 1.8 years. Assessment was conducted utilizing visual analogue scale (VAS), International Knee Documentation Committee (IKDC), Tegner, Lysholm, and knee injury and osteoarthritis outcome (KOOS) scores...
May 20, 2016: Journal of Knee Surgery
Betina Bremer Hinckel, Riccardo Gomes Gobbi, Marco Kawamura Demange, Marcelo Batista Bonadio, José Ricardo Pécora, Gilberto Luis Camanho
Although the medial patellotibial ligament (MPTL) has been neglected regarding its function in patellar stability, recently, its importance in terminal extension and during flexion has been recognized. Indications for reconstruction of the medial patellofemoral ligament combined with the MPTL are extension subluxation, flexion instability, children with anatomic risk factors for patellar instability, and knee hyperextension associated with generalized laxity. We describe a combined reconstruction of the medial patellofemoral ligament with quadricipital tendon and reconstruction of the MPTL with patellar tendon autografts...
February 2016: Arthroscopy Techniques
Anthony Herbert, Christopher Brown, Paul Rooney, John Kearney, Eileen Ingham, John Fisher
Anterior cruciate ligament rupture is rising in its prevalence amongst the young and those with physically active lifestyles. Acellular human patellar tendon (PT) grafts offer a promising restoration solution, returning knee joint stability and overcoming some of the current disadvantages of autologous or allogeneic grafts. However, it is necessary to ensure that the decellularisation bio-processes involved do not cause structural changes in the microstructure of the tendon tissue that may adversely affect the mechanical properties, particularly with respect to the physiological range of loading...
June 14, 2016: Journal of Biomechanics
Nobuyuki Kumahashi, Suguru Kuwata, Hiroshi Takuwa, Norimasa Egusa, Yuji Uchio
BACKGROUND: Longitudinal changes in patellar stiffness following reconstruction of the medial patellofemoral ligament for recurrent patellar dislocation at full extension are unknown. METHODS: Fifteen consecutive patients (three men and twelve women, with a mean age of twenty-two years) with seventeen knees were matched by sex and age to thirty-two reference subjects in this prospective study. The follow-up period was a minimum of twenty-four months. The medial patellofemoral ligament reconstruction used an autograft semitendinosus tendon and an interference screw system with or without lateral release under 10 N of laterally directed force...
April 6, 2016: Journal of Bone and Joint Surgery. American Volume
Diego Costa Astur, Saulo Gomes Oliveira, Ricardo Badra, Gustavo Gonçalves Arliani, Camila Cohen Kaleka, Wahi Jalikjian, Pau Golanó, Moisés Cohen
The knee extensor mechanism is a complex structure formed by the quadriceps muscle and tendon, the patella, the patellar tendon and the ligaments that surround and help stabilize the knee. Through using a three-dimensional viewing technique on images of the knee extensor apparatus, we aimed to didactically show the structures that compose this bone-muscle-ligament complex. Anatomical dissection of the knee with emphasis on the structures of its extensor mechanism was performed, followed by taking photographs using a camera and lenses suitable for simulating human vision, through a technique for constructing three-dimensional images...
September 2011: Revista Brasileira de Ortopedia
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