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patella fracture

Qiuju Miao, Huanwen Ding, Hong Wang, Qiang Tu, Jiarong Chen, Huiliang Liu
Objective: To evaluate the effectiveness of precise orthormorphia of tibial angulation deformity and shortening deformity by using digital technology combined with external fixator. Methods: Twenty-six cases of tibial angulation deformity combined with shortening deformity were treated between June 2012 and August 2016, including 12 males and 14 females aged from 1 to 19 years with an average age of 16.5 years. There were 6 cases of congenital patella pseudoarthrosis, 1 case of fibrous dysplasia of femur and tibia, 3 cases of limb shortening deformity caused by infantile paralysis, 16 cases of fracture malunion...
August 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
B Thomas, N Binkley, P A Anderson, D Krueger
INTRODUCTION: Total knee arthroplasty (TKA) is increasingly being performed. Distal femur periprosthetic fracture is a potentially catastrophic complication following TKA and existing data document substantial distal femur bone mineral density (BMD) loss following TKA. However, distal femur BMD is virtually never measured clinically as no consensus approach exists. This pilot study's purpose was to define regional BMD variation throughout the femur, suggest standard dual-energy X-ray absorptiometry (DXA) regions of interest (ROIs) and evaluate BMD reproducibility at these ROIs...
August 13, 2018: Journal of Clinical Densitometry
Hannah Louise Morley, Aadhar Sharma, Paul Whittingham-Jones
We describe the case of a 15-year-old girl who presented to the Accident and Emergency Department with right knee pain and a tense effusion following a twist and fall directly onto her right knee. An MRI scan demonstrated that she had an incarcerated dislocated patella with an associated patella avulsion fracture. This required open reduction. Open reduction and fixation was performed using suture anchors. We feel that this case is particularly pertinent since nearly all previous case reports describe an incarcerated patella with an associated femur fracture...
September 14, 2018: BMJ Case Reports
Nabil Alassaf
Objectives: Diagnosis of Sinding-Larsen-Johansson disease may not be an easy task. Several sport-related conditions affect the distal pole of the patella in the adolescent, and treatment varies considerably. The article describes a patient that had radiographic features of Sinding-Larsen-Johansson disease associated with an atypical acute presentation. Methods: Case report and literature review. Results: A 10-year-old boy presented with a sudden pain after a noncontact soccer injury...
2018: SAGE Open Medical Case Reports
Jordane Mouton, Romain Gaillard, Christopher Bankhead, Cécile Batailler, Elvire Servien, Sébastien Lustig
BACKGROUND: Management of severe varus deformity requires soft tissue balancing for implantation of low-constraint knee prosthesis. Patellar complications have been rarely studied in this specific group. Our hypothesis was that severe genu varum (>15°) would increase the rate of patellar complications. METHODS: Using a prospective cohort of 4216 prostheses performed at a single center beginning in 1987, we analyzed 280 prostheses having preoperative varus greater than 15°, compared to 673 total knee arthroplasties (TKAs) with a preoperative hip-knee-ankle angle of 180° ± 2°...
August 7, 2018: Journal of Arthroplasty
Yinwang Zhang, Zhen Xu, Wuxue Zhong, Fuhai Liu, Jie Tang
BACKGROUND: To compare the efficacy and safety of K-wire tension band fixation (KTB) with other alternative approaches (cannulated screws, cable pin, and ring pin) for treatment of patella fractures by performing a meta-analysis. METHODS: PubMed and EMBASE databases were searched for all relevant studies. Standardized mean difference (SMD) or relative risk (RR) and their corresponding 95% confidence intervals (CIs) were calculated for continuous or dichotomous outcomes via either a fixed- or random-effect model using Stata 13...
September 5, 2018: Journal of Orthopaedic Surgery and Research
Sang Jun Song, Se Gu Kang, Cheol Hee Park, Dae Kyung Bae
Purpose: The purposes of this study were to compare clinical results after total knee arthroplasty (TKA) using the Attune and PFC Sigma knee designs and to investigate whether the use of the Attune prosthesis increased the risk of patellar injury in Asian patients. Materials and Methods: Three hundred knees that underwent TKA using Attune (group A) were compared to 300 knees that underwent TKA using PFC Sigma (group B). The Knee Society knee score (KS) and function score (FS), and range of motion (ROM) were compared...
August 31, 2018: Knee Surgery & related Research
Hatice Tuba Sanal, Christian Krestan, Mark Schurz
Related to fractures of and around the knee, inappropriate technical factors related to the surgery, severe comminution of the fracture, early overly arduous rehabilitation of the patient, and patient-related noncompliances may have the potential for the risk of inadequate fixation and other complications. Loss of fixation, malunion/nonunion, infection, arthritis, arthrofibrosis, and symptomatic hardware are among postsurgical complications that may necessitate further reconstructive techniques. In this review, complications that may be encountered in the postsurgical period of fractures involving the patella, supracondylar femur, and tibial plateau are described...
September 2018: Seminars in Musculoskeletal Radiology
Avinesh Agarwalla, Richard Puzzitiello, Grant H Garcia, Brian Forsythe
Anterior cruciate ligament (ACL) reconstruction with a bone-patellar tendon-bone autograft yields good clinical outcomes. Despite appropriate clinical outcomes, the most common complaint after reconstruction with a bone-patellar tendon-bone autograft is anterior knee pain at the donor graft sites. Synthetic bone grafts, such as beta-tricalcium phosphate (β-TCP), have been previously used to fill the bony defect in fractures as well as removal of bony tumors, and have shown positive utility in improving anterior knee pain after ACL reconstruction...
July 2018: Arthroscopy Techniques
Alisa Alayan, Ruben Maldonado, Landon Polakof, Atul Saini, Melodie Metzger, Carol Lin, Charles Moon
The traditional technique for patella fracture fixation utilizes prominent hardware. Prominent hardware use, however, results in a high rate of reoperation for symptomatic implant removal. This biomechanical study evaluates the effectiveness of a novel patella fixation technique that minimizes implant prominence. Patellar transverse osteotomies were created in 13 pairs of cadaveric knees. Paired knees were assigned to either standard fixation (SF) using cannulated partially threaded screws and stainless steel wire tension band, or buried fixation (BF) using headless compression screws with a No...
July 2018: American Journal of Orthopedics
Louis Dagneaux, Raphael Allal, Martine Pithioux, Patrick Chabrand, Matthieu Ollivier, Jean-Noël Argenson
BACKGROUND: Malrotation of the femur is a frequent complication in the management of a diaphyseal fracture. It is often responsible for pain and adverse functional results. Among these complications, contact stress effects on the patellofemoral joint are recognized as predictive factors of impaired results. The purpose of this study was to analyze the effect of malrotation on stress distribution on the patellofemoral joint, using radiological measurement and three-dimensional finite element models...
October 2018: Knee
Chih-Wei Chang, Yen-Nien Chen, Chun-Ting Li, Yu-Hsuan Chung, Chih-Han Chang, Yao-Te Peng
PURPOSE: Clinical and biomechanical studies have reported that using supportive screws and a wire instead of the common Kirschner wires for modified tension band wiring improves the stability of fractured patellae. However, the effect of screw proximity on the fixation of a fractured patella remains unclear. Therefore a numerical study was conducted to examine the effects of screw proximity on biomechanical responses in a simulated patellar fracture fixed using two parallel cannulated screws and anterior tension band wiring...
May 2018: Journal of Orthopaedic Surgery
Stef Jozef Marie Smeets, Wouter Vening, Michiel Bernard Winkes, Gerrit Paulus Kuijt, Gerrit Dirk Slooter, Percival Victor van Eerten
PURPOSE: Patellar finger tapping produces a typical sound that can be detected by a stethoscope positioned on the pubic bone (patellar pubic percussion test (PPPT)). Characteristics of this sound are determined by continuity of bone between patella and pelvis. We hypothesized that a PPPT was able to detect overt hip fractures and occult hip fractures that may not be determined by a standard radiological examination. METHODS: Two independent observers performed a PPPT in patients with a suspected hip or pelvic fracture, just before a conventional radiograph (X-ray) was performed...
July 17, 2018: International Orthopaedics
Yehia H Bedeir, Melissa A Summers, Dhavalkumar J Patel, Brian M Grawe, Angelo J Colosimo
Medial patellofemoral ligament reconstruction is an essential component of surgical treatment for recurrent dislocation of the patella. Various techniques have been described, most of which potentially increase the risk of patellar fracture. We present a new technique for anatomic medial patellofemoral ligament reconstruction without using suture anchors or patellar tunnels, therefore, eliminating the risk of iatrogenic patellar fracture and making a revision procedure easier in case of failure.
June 2018: Arthroscopy Techniques
Jennifer Kurowicki, Samuel J Mease, Steven Palacios, Anthony Festa, Vincent K McInerney, Anthony J Scillia
Recurrent patella instability is a common condition that may potentiate substantial knee dysfunction resulting in loss of time from work and sports. There are numerous factors that contribute to recurrent patella instability including tearing of the medial patellofemoral ligament (MPFL), shallow trochlea, valgus alignment, externally rotated tibia tubercle, ligamentous laxity, elevated Q angle, and increased tibial tuberosity trochlear groove distance. Reconstruction of the MPFL has been shown to restore patella stability where concomitant pathology is within acceptable limits...
June 2018: Arthroscopy Techniques
Shuai Han, Dongdong Li, Peixun Zhang, Xiaofeng Yin, Yuhui Kou, Na Han, Zhongguo Fu
Pain and reoperation after fixation using tension band wiring and K-wires is not uncommon. A novel hook plate was designed to improve the treatment of patella fractures. The aim of this study was to compare the stability of the hook plate with that of tension band wiring and K-wires in a simulated patellar transverse fracture model (AO/OTA classification 34-C1.1). The authors tested 16 embalmed cadaver knee joints fixed with the hook plate and tension band wiring and K-wires under cyclic loading. Specimens underwent 100 cycles extending the knee joint from 90° of flexion to full extension at a velocity of 50 mm/min...
September 1, 2018: Orthopedics
Sophie Putman, Florian Boureau, Julien Girard, Henri Migaud, Gilles Pasquier
Patellar complications are a source of poor total knee arthroplasty (TKA) outcomes that can require re-operation or prosthetic revision. Complications can occur with or without patellar resurfacing. The objective of this work is to answer six questions. (1) Have risk factors been identified, and can they help to prevent patellar complications? Patellar complications are associated with valgus, obesity, lateral retinacular release, and a thin patella. Selecting a prosthetic trochlea that will ensure proper patellar tracking is important...
July 7, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Xiaozheng Tang, Yayun Liu, Hongyan Wu, Feipeng Gong, Yuxu Li, Hong Zeng, Baofu Yu
INTRODUCTION: Fixation of displaced patella fractures with metal implants may be associated with implant failure, post-operative pain, and high re-operation rate. This study reports preliminary clinical results of using five-pointed star lattice sutures for the management of patella transverse fractures. METHODS: A five-pointed star lattice suture configuration was produced intraoperatively, and 25 patients with patella transverse fractures were treated with this newly designed sutures fixation...
June 22, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Simone Wurm, Volker Bühren, Peter Augat
The standard treatment for patella fractures is tension band wiring. However, with tension band wiring anatomical reduction and rigid fixation can be challenging and the clinical outcome after patella fracture is often not satisfying. The purpose of this prospective clinical observation was to evaluate the clinical outcome in patients with patella fractures treated with an angular stable patella plate. Between 2011 and 2015 a total of 67 patients were treated with an angular stable patella plate. Outcome in these patients was evaluated by the Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL) and range of motion of the knee joint was assessed...
June 2018: Injury
Anuj Chawla, Ernest B K Kwek
No abstract text is available yet for this article.
June 2018: Journal of Clinical Orthopaedics and Trauma
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