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patellar tendon stabilization

Sung-Jae Kim, Chong Hyuk Choi, Sung-Hwan Kim, Su-Keon Lee, Wonyong Lee, Taeyup Kim, Min Jung
PURPOSE: The present study aimed to compare 2- and 5-year outcomes of ACL reconstruction between patients with and without generalized joint laxity and to perform comparative evaluation between two types of grafts used for ACL reconstruction in patients with generalized joint laxity. METHODS: Two hundred and thirty-seven patients who underwent ACL reconstruction from 2001 to 2008 were included. Patients were classified into two groups according to the presence or the absence of generalized joint laxity, and further subdivided into two subgroups based on the type of graft used: bone-patellar tendon-bone (BPTB) or hamstring...
March 3, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Fateme Esfandiarpour, Constance M Lebrun, Sukhvinder Dhillon, Pierre Boulanger
Understanding of the exact cause of Patellofemoral Pain has been limited by methodological challenges to evaluate in-vivo joint motion. This study compared six degree-of-freedom patellar motion during a dynamic lunge task between individuals with patellofemoral pain and healthy individuals. Knee joints of eight females with patellofemoral pain and ten healthy females were imaged using a CT scanner in supine lying position, then by a dual-orthogonal fluoroscope while they performed a lunge. To quantify patellar motion, the three-dimensional models of the knee bones, reconstructed from CT scans, were registered on the fluoroscopy images using the Fluomotion registration software...
February 28, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
M A Faisal, A Z Chowdhury, I K Kundu, K N Arifeen, A S Ullah, C I Mahmud, O M Dastagir, M A Islam, M S Paul
Graft selection for primary anterior cruciate ligament reconstruction is very important part of knee stability. The purpose of this Qasi experimental study was to compare the clinical outcomes after ACL reconstruction using either a BPTB graft or a four-strand hamstrings graft and conducted from January 2012 to December 2013. Patients presented with a symptomatic unilateral ACL rupture who were underwent ACL reconstruction by using either BPTB or Hamstrings graft, IPD of Department of Orthopedics at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka as well as in a private hospital in Dhaka, Bangladesh were selected as study population...
January 2018: Mymensingh Medical Journal: MMJ
Rimtautas Gudas, Rokas Jurkonis, Alfredas Smailys
BACKGROUND The aim of this study was to evaluate the reconstruction of a torn anterior cruciate ligament (ACL) with 10 mm diameter BPTB (bone-patellar tendon-bone) autograft versus 8 mm HT (hamstring tendon) autografts, to compare the ability to restore pre-injury sports activities and reduce revision risk after these procedures. MATERIAL AND METHODS A prospective clinical review was performed to compare results of patients who underwent primary anatomical ACLR with 10 mm BPTB autografts with patients who underwent 8 mm diameter HT autografts, between January 2011 and January 2014...
February 17, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Rene B Svensson, Stuart T Smith, Patrick J Moyer, S Peter Magnusson
Connective tissues are ubiquitous throughout the body and consequently affect the function of many organs. In load bearing connective tissues like tendon, the mechanical functionality is provided almost exclusively by collagen fibrils that in turn are stabilized by covalent cross-links. Functionally distinct tendons display different cross-link patterns, which also change with maturation, but these differences have not been studied in detail at the fibril level. In the present study, a custom built nanomechanical test platform was designed and fabricated to measure tensile mechanics of individual fibrils from rat tendons...
February 12, 2018: Acta Biomaterialia
Daan T van Yperen, Max Reijman, Eline M van Es, Sita M A Bierma-Zeinstra, Duncan E Meuffels
BACKGROUND: An anterior cruciate ligament (ACL) rupture has major consequences at midterm follow-up, with an increasing chance of developing an old knee in a young patient. The long-term (≥20 years) effects of the operative and nonoperative treatment of ACL ruptures are still unclear. PURPOSE: To compare the long-term treatment outcomes of operative versus nonoperative treatment of ACL ruptures in high-level athletes. STUDY DESIGN: Cohort study; Level of evidence, 2...
February 1, 2018: American Journal of Sports Medicine
Yoon-Ho Kwak, Sahnghoon Lee, Myung Chul Lee, Hyuk-Soo Han
BACKGROUND: Quadriceps tendon-patellar bone (QTPB) autograft is an excellent graft option with good clinical outcome. Use of QTPB autografts have increased because they minimize donor-site morbidity including anterior knee pain, while providing adequate mechanical strength. Although, there were many clinical results about allografts that used in anterior cruciate ligament (ACL) reconstruction, it have never been reported about the clinical outcome of ACL reconstruction with QTPB allograft...
February 9, 2018: BMC Musculoskeletal Disorders
Chuan-Qiang Shao, Chang-Chun Chen, Chun-Cheng Zhao, Hong-Mei Yang, Yan-Zhong Kang
OBJECTIVE: To investigate surgical method and clinical curative effects of medial patellofemoral ligament (MPFL) reconstruction with great adductor muscular tendon in treating teenagers' recurrent patellar dislocation. METHODS: From May 2012 to September 2014, 19 patients with recurrent dislocation of patellar, including 6 males and 13 females with an average of 16 years old (ranged from 13 to 17 years), the courses of disease ranged from 3 to 18 months(averaged 6 months)...
June 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Ricardo Bastos Filho, Alberto Monteiro, Renato Andrade, M J S Fredrick Michael, Nuno Sevivas, Bruno Pereira, André Sarmento, João Espregueira-Mendes
Patellofemoral dysfunction, due to either a patellofemoral malalignment or patellar instability, is a complex and debilitating condition that significantly decreases the knee function. Conservative management may yield significant clinical outcomes; however, when morphologic anomalies are identified, the surgical approach should be employed. Hence, several surgical procedures have been described in the scientific literature aiming the correction of underlying extensor mechanism malalignments. Still, the rate of complications is higher than desirable...
December 2017: Arthroscopy Techniques
Hassan Azimi, Oke Anakwenze
Medial patellofemoral ligament (MPFL) injuries are common in children and young adults. In patients with recurrent patellar dislocations with normal lower-extremity alignment, anatomic reconstruction of the MPFL has been shown to restore patellar stability. We describe a technique that creates an anatomic reconstruction using a dual docking technique into the patella. Our technique is simple and efficacious for reconstructing the MPFL without implant fixation in the patella, allowing a maximal bone-tendon interface for healing...
December 2017: Arthroscopy Techniques
Charles A Baumann, Eli L Pratte, Seth L Sherman, Elizabeth A Arendt, Betina B Hinckel
PURPOSE: The medial patellotibial ligament (MPTL), the medial patellofemoral ligament (MPFL), and the medial patellomeniscal ligament (MPML) support the stability of the patellofemoral joint. The purpose of this systematic review was to report the surgical techniques and clinical outcomes of the repair or reconstruction of the MPTL in isolation or concomitant with the MPFL and/or other procedures. METHODS: A systematic review of the literature was conducted. Inclusion criteria were articles in the English language that reported clinical outcomes of the reconstruction of the MPTL in isolation or in combination with the MPFL and/or other procedures...
January 17, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Niclas H Eysturoy, Kåre Amtoft Nissen, Torsten Nielsen, Martin Lind
BACKGROUND: The method of graft fixation in primary anterior cruciate ligament (ACL) reconstruction is important for initial stability of the graft. Poor graft fixation can result in failure of the reconstruction. The effect of ACL graft fixation principles and fixation implant combinations on the risk of revision after ACL reconstruction is not well understood. PURPOSE: The study aimed to compare the risk of revision among 4 categories of femoral fixation divided by their principle of function using a hamstring tendon (HT) graft only...
January 1, 2018: American Journal of Sports Medicine
Yasutaka Tashiro, Ken Okazaki, Koji Murakami, Hirokazu Matsubara, Kanji Osaki, Yukihide Iwamoto, Yasuharu Nakashima
AIM: To quantitatively assess rotatory and anterior-posterior instability in vivo after anterior cruciate ligament (ACL) reconstruction using bone-patellar tendon-bone (BTB) autografts, and to clarify the influence of tunnel positions on the knee stability. METHODS: Single-bundle ACL reconstruction with BTB autograft was performed on 50 patients with a mean age of 28 years using the trans-tibial (TT) ( n = 20) and trans-portal (TP) ( n = 30) techniques. Femoral and tibial tunnel positions were identified from the high-resolution 3D-CT bone models two weeks after surgery...
December 18, 2017: World Journal of Orthopedics
Aishwarya Gulati, Christopher McElrath, Vibhor Wadhwa, Jay P Shah, Avneesh Chhabra
Anterior knee pain in active young adults is commonly related to patellofemoral pain syndrome, which can be broadly classified into patellar malalignment and patellar maltracking. Imaging is performed to further elucidate the exact malalignment and maltracking abnormalities and exclude other differentials. This article details the role of the stabilizers of the patellofemoral joint, findings on conventional and multimodality imaging aiding in patellofemoral pain syndrome diagnosis and characterization, and current perspectives of various treatment approaches...
January 22, 2018: British Journal of Radiology
Trevor J Carver, John B Schrock, Matthew J Kraeutler, Eric C McCarty
BACKGROUND: Previous studies have analyzed the treatment patterns used to manage injuries in National Collegiate Athletic Association (NCAA) Division I football players. HYPOTHESIS: Treatment patterns used to manage injuries in NCAA Division I football players will have changed over the study period. STUDY DESIGN: Descriptive epidemiology study. LEVEL OF EVIDENCE: Level 5. METHODS: The head orthopaedic team physicians for all 128 NCAA Division I football teams were asked to complete a survey containing questions regarding experience as team physician, medical coverage of the team, reimbursement issues, and treatment preferences for some of the most common injuries occurring in football players...
January 1, 2018: Sports Health
Shuji Taketomi, Hiroshi Inui, Ryota Yamagami, Nobuyuki Shirakawa, Kohei Kawaguchi, Takumi Nakagawa, Sakae Tanaka
The purpose of this retrospective study was to first compare the clinical outcome of anatomical double-bundle (DB) anterior cruciate ligament reconstruction (ACLR) with hamstring tendon (HT) autografts and anatomical rectangular tunnel ACLR with bone-patellar tendon-bone (BPTB) autografts. Secondly, we aimed to demonstrate the quantitative locations of the femoral and tibial tunnel apertures using postoperative three-dimensional computed tomography (3D CT).Twenty-five patients underwent anatomical rectangular tunnel ACLR using BPTB grafts (Group B) and 23 patients underwent anatomical DB ACLR using HT grafts (Group H)...
December 28, 2017: Journal of Knee Surgery
Giulia Bugelli, Francesco Ascione, Niki Cazzella, Edoardo Franceschetti, Francesco Franceschi, Giacomo Dell'Osso, Eleonor Svantesson, Kristian Samuelsson, Stefano Giannotti
PURPOSE: One of the complications in total knee arthroplasty (TKA) is pseudo-patella baja (PPB). PPB is present when there is no shortening of the patellar tendon, but the joint line is elevated. The purpose of this study is to investigate the incidence of PPB after TKA and its clinical effects. METHODS: A case series of 158 patients undergoing TKA surgery between 1999 and 2012 at the 2nd Department of Orthopaedics and Traumatology, Pisa were retrospectively reviewed...
December 23, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Kalpit N Shah, Steven F DeFroda, James Kristopher Ware, Sarath C Koruprolu, Brett D Owens
Background: Medial instability of the patellofemoral joint is a rare but known phenomenon that may result from an incompetent lateral patellofemoral ligament (LPFL). Surgical reconstruction of the LPFL has been described. However, anatomic details of the ligament have not been the subject of scrutiny. Purpose: To describe the anatomic origin and insertion of the LPFL. Study Design: Descriptive laboratory study. Methods: Ten fresh-frozen, unpaired human cadaveric knees (mean age, 57 years) were dissected to identify the LPFL...
December 2017: Orthopaedic Journal of Sports Medicine
Omar M Albtoush, Abtehag A Taib, Marius Horger, Fabian Springer
The pes anserinus is a common tendon comprising the tendinous insertions of the sartorius, gracilis, and semitendinosus muscles. It inserts at the anteromedial aspect of the tibia and plays a significant role in stabilization of the medial side of the knee joint. The current article presents a case with recurrent lateral patellar dislocations causing chronic stress along the medial knee stabilizers and consecutive enthesophyte formation at the insertion of the pes anserinus tendon that showed a transverse fracture upon a subsequent incident of traumatic lateral patellar dislocation...
November 23, 2017: Skeletal Radiology
Hayden B Schuette, Matthew J Kraeutler, Darby A Houck, Eric C McCarty
Background: Previous meta-analyses have compared bone-patellar tendon-bone (BPTB) with hamstring tendon (HT) autografts for primary anterior cruciate ligament reconstruction (ACLR). Purpose: To conduct a systematic review of overlapping meta-analyses comparing BPTB with HT autografts for ACLR to determine which meta-analyses provide the best available evidence. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was performed by searching the PubMed and Cochrane Library databases...
November 2017: Orthopaedic Journal of Sports Medicine
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