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Knee instability

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https://www.readbyqxmd.com/read/28341281/uncemented-metal-backed-tantalum-patellar-components-in-total-knee-arthroplasty-have-a-high-fracture-rate-at-midterm-follow-up
#1
Jeremy Y Chan, Nicholas J Giori
BACKGROUND: There is interest in uncemented total knee arthroplasty due to the hope for long-term biologic fixation, but limited data are available regarding uncemented tantalum patellar components. The purpose of this study was to evaluate the radiographic outcomes of uncemented tantalum patellar implants at midterm follow-up. METHODS: We retrospectively reviewed a consecutive series of 30 knees in 29 patients who underwent cementless total knee arthroplasty with an uncemented metal-backed tantalum patella between September 2006 and April 2009...
March 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28339288/the-proximal-tibiofibular-joint-a-biomechanical-analysis-of-the-anterior-and-posterior-ligamentous-complexes
#2
Daniel Cole Marchetti, Gilbert Moatshe, Brian M Phelps, Kimi D Dahl, Marcio Balbinotti Ferrari, Jorge Chahla, Travis Lee Turnbull, Robert F LaPrade
BACKGROUND: Dislocation of the proximal tibiofibular joint is a complex injury that is often overlooked or misdiagnosed. Surgical management is recommended for severe acute or for chronic symptomatic instability of the proximal tibiofibular joint. Although the anterior ligamentous complex has been reported to be stronger than the posterior complex, biomechanical data are lacking. PURPOSE: To determine the ultimate load of the anterior and posterior ligamentous complexes of the proximal tibiofibular joint to determine optimal graft selection...
March 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28332046/ramp-lesions-in-acl-deficient-knees-in-children-and-adolescent-population-a-high-prevalence-confirmed-in-intercondylar-and-posteromedial-exploration
#3
Matthieu Malatray, Sebastien Raux, Adrien Peltier, Clemence Pfirrmann, Romain Seil, Franck Chotel
PURPOSE: Ramp lesions are common in ACL deficient knees. Their diagnosis is difficult and, therefore, they may be underestimated. So far, no study analyzed their prevalence in a pediatric population. The diagnosis of these Ramp lesions is of major clinical relevance because of a frequent misestimating and technic difficulties. Ramp lesions might be associated with residual knee pain and instability after ACL reconstruction. The aim of this study was to evaluate the prevalence of ramp lesions explored through a systematic intercondylar and posteromedial arthroscopic approach during an ACL reconstruction in a pediatric and adolescent population...
March 22, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28330756/femoral-articular-geometry-and-patellofemoral-stability
#4
Farhad Iranpour, Azhar M Merican, Seow Hui Teo, Justin P Cobb, Andrew A Amis
BACKGROUND: Patellofemoral instability is a major cause of anterior knee pain. The aim of this study was to examine how the medial and lateral stability of the patellofemoral joint in the normal knee changes with knee flexion and measure its relationship to differences in femoral trochlear geometry. METHODS: Twelve fresh-frozen cadaveric knees were used. Five components of the quadriceps and the iliotibial band were loaded physiologically with 175N and 30N, respectively...
March 19, 2017: Knee
https://www.readbyqxmd.com/read/28326408/traumatic-anterior-knee-dislocation-after-total-knee-arthroplasty
#5
Richard S Ahn, Matthew J Brown, Mario D Santilli
This article describes a traumatic complete anterior knee dislocation of a previously well-functioning total knee arthroplasty. A thorough physical examination with appropriate radiographic imaging study is required for proper evaluation and treatment of this injury, as it is often associated with neurovascular injury and subsequent global instability of the injured knee is likely.
September 2016: Arthroplast Today
https://www.readbyqxmd.com/read/28326407/instability-of-the-proximal-tibiofibular-joint-associated-with-total-knee-arthroplasty
#6
Martin Bédard, Simon Corriveau-Durand
To our knowledge, proximal tibiofibular joint instability has never been reported in a patient with a total knee arthroplasty (TKA). We present the case of a patient with anterolateral proximal tibiofibular joint instability associated with a complex primary TKA. In 2010, a male patient of 47 years was referred for TKA after posttraumatic osteoarthritis. The patient's history includes a fracture of the left lateral tibial plateau in 2008 and removal of osteosynthesis material in 2009. TKA with a lateral metal augment and intramedullary stem was performed in 2010...
September 2016: Arthroplast Today
https://www.readbyqxmd.com/read/28321423/the-anterolateral-ligament-an-anatomic-study-on-sex-based-differences
#7
Matt Daggett, Camilo Helito, Matthew Cullen, Andrew Ockuly, Kyle Busch, Joseph Granite, Barth Wright, Bertrand Sonnery-Cottet
BACKGROUND: The anterolateral ligament (ALL) has been shown to have an important role in rotatory stability of the knee. While there is abundant research on sex-based differences related to anterior cruciate ligament (ACL) rupture, there is a paucity of literature related to such differences in the ALL. PURPOSE: To define any sex-based differences in the ALL with regard to length, width, and thickness. STUDY DESIGN: Descriptive laboratory study...
February 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28318932/patellar-instability-treated-with-distal-femoral-osteotomy
#8
Ishaan Swarup, Osama Elattar, S Robert Rozbruch
BACKGROUND: Patellar instability can cause significant disability in both pediatric and adult patients, and it is associated with several factors including genu valgum. In this study, we describe the role of a lateral opening wedge distal femoral osteotomy (DFO) combined with lateral retinacular release in addressing genu valgum with associated patellar instability. The rationale for this approach is to medialize the patellar tendon insertion and decrease the Q angle with DFO. METHODS: A consecutive series of patients were studied, and our outcomes of interest included improvements in radiographic measures and patient outcomes...
March 17, 2017: Knee
https://www.readbyqxmd.com/read/28303844/significance-of-diffusion-tensor-imaging-of-vastus-medialis-oblique-in-recurrent-patellar-dislocation
#9
Li-Si Liu, Zhuo-Zhao Zheng, Hui-Shu Yuan
BACKGROUND: Numerous studies have investigated the influence of osseous factors on patellofemoral joint instability, but research on the influence of dynamic muscle factors in vivo is still in the exploratory stage. This study aimed to use magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) to evaluate vastus medialis oblique (VMO) fiber bundles in patients with recurrent patellar dislocation to explore the changes in muscle morphology and function. METHODS: This prospective study involved 30 patients (7 males and 23 females; average age, 21...
March 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28299431/changes-of-posterior-condylar-offset-results-in-midflexion-instability-in-single-radius-total-knee-arthroplasty
#10
Georg Matziolis, Steffen Brodt, Christoph Windisch, Eric Roehner
INTRODUCTION: There is no algorithm for the management of joint stability in midflexion up to now. Change in the joint line (JL) is considered to be the primary cause, although it only determines the extension gap. The purpose of this study was to determine the influence of the posterior condylar offsets (PCO), which defines the flexion gap, on midflexion instability. MATERIALS AND METHODS: Forty-two knee joints (38 patients) were included in this study, patients undergoing navigated total knee arthroplasty due to primary osteoarthritis of the knee...
March 16, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28299387/anterolateral-knee-biomechanics
#11
Andrew A Amis
This article reviews the evidence for the roles of the anterolateral soft-tissue structures in rotatory stability of the knee, including their structural properties, isometry, and contributions to resisting tibial internal rotation. These data then lead to a biomechanical demonstration that the ilio-tibial band is the most important structure for the restraint of anterolateral rotatory instability. Level of evidence V.
March 15, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28298062/traumatic-patellar-dislocation-and-cartilage-injury
#12
Essi E Salonen, Teemu Magga, Petri J Sillanpää, Tommi Kiekara, Heikki Mäenpää, Ville M Mattila
BACKGROUND: Patellofemoral cartilage deterioration and osteoarthritis are reported to be associated with recurrent patellar dislocation. However, the association between first-time traumatic patellar dislocation and cartilage deterioration is unknown. PURPOSE: The aim of this study was to assess long-term cartilage deterioration in the patellofemoral and tibiofemoral joint after conservatively treated traumatic lateral patellar dislocation. STUDY DESIGN: Case series; Level of evidence, 4...
February 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28293966/anatomic-reconstruction-of-the-anterior-cruciate-ligament-of-the-knee-with-or-without-reconstruction-of-the-anterolateral-ligament
#13
Samir Abdulrazik Ibrahim, Emad Mureed Shohdy, Yousef Marwan, Sami Abdulghaffar Ramadan, Abdulrahman Khalid Almisfer, Mohammad Wagdy Mohammad, Wael Shoabe Abdulsattar, Shiref Khirat
BACKGROUND: Rotational instability of the knee remains an issue after anterior cruciate ligament (ACL) reconstruction. Hypothesis/Purpose: The purpose was to evaluate the subjective and objective outcomes of combined reconstruction of the ACL and anterolateral ligament (ALL) of the knee. The hypothesis was that favorable outcomes can be achieved with this surgical procedure compared with isolated anatomic reconstruction of the ACL. STUDY DESIGN: Randomized controlled trial; Level of evidence, 2...
February 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28293698/anterolateral-ligament-abnormalities-are-associated-with-peripheral-ligament-and-osseous-injuries-in-acute-ruptures-of-the-anterior-cruciate-ligament
#14
Camilo Partezani Helito, Paulo Victor Partezani Helito, Renata Vidal Leão, Marco Kawamura Demange, Marcelo Bordalo-Rodrigues
PURPOSE: Few studies have used MRI to identify the ALL. As it was shown that it is not possible to precisely characterize this ligament in all examination, it is important to identify concomitant lesions that can help in diagnosing ALL abnormalities. It is important to characterise this injury due to its association with anterolateral knee instability. Thus, the present study was performed to determine the frequency of ALL injuries in patients with acute ACL rupture and to analyse its associated knee lesions...
March 14, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28293511/de-novo-reconstruction-of-a-hybrid-patella-by-staged-fabrication-of-a-microvascular-bone-transplant-with-an-osteointegrated-prosthetic-socket
#15
Goetz A Giessler, Christian Hendrich
Total patellectomy is sometimes unavoidable but usually results in severely impaired function, pain, and instability in the affected knee. Any patellar prosthetic solutions rely on a certain amount of remaining bone and therefore are not applicable after total patellectomy. Traditionally, reconstruction of a neopatella by avascular or allogeneic bone grafts is hampered by mechanical failure, resorption, or infection. We developed a new, 3-stage approach to reconstruct a hybrid patella composed of a revascularized scapula tip transplant fabricated with a prosthetic socket...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28285037/a-targeted-approach-to-ligament-balancing-using-kinetic-sensors
#16
Kenneth A Gustke, Gregory J Golladay, Martin W Roche, Leah C Elson, Christopher R Anderson
BACKGROUND: Currently, soft-tissue imbalance contributes to several of the foremost reasons for revision following primary TKA, including instability, stiffness, and aseptic loosening. In order to decrease the incidence of soft-tissue imbalance, intraoperative sensors were developed to provide real-time, quantitative load data within the knee. This study examines the intraoperative data of a group of multicenter patients to determine how targeted ligament releases affect intra-articular loading, and to understand which types of releases are necessary to achieve quantified ligament balance...
February 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28282674/patellar-height-measurements-on-radiograph-and-magnetic-resonance-imaging-in-patellar-instability-and-control-patients
#17
R Alexander Yue, Elizabeth A Arendt, Marc A Tompkins
Insall-Salvati (IS) ratio, modified IS ratio (mIS), Caton-Deschamps (CD) index, and Blackburne-Peel (BP) index are patellar height measurements commonly made on lateral radiographs (XRs) in patients with patellofemoral instability. More recently, magnetic resonance imaging (MRI) has been used as an additional imaging modality to measure patellar height. However, different imaging modalities have not been previously compared for all of these measurements. First, to compare the patellar height measurements of IS, mIS, CD, and BP on XR and MRI in first-time lateral patellar dislocation (LPD) patients and a control population and, second, to evaluate for the effect of sex and skeletal maturity...
March 10, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28280905/clinical-outcomes-after-revision-surgery-for-medial-patellofemoral-ligament-reconstruction
#18
Andreas Chatterton, Torsten Grønbech Nielsen, Ole Gade Sørensen, Martin Lind
PURPOSE: Medial patellofemoral ligament reconstruction (MPFL-R) is the standard surgical intervention for patella instability. However, limited knowledge exists concerning the causes for failure, and outcome after revision MPFL-R. The purpose of this study is to evaluate the causes of primary MPFL-R failure and clinical outcomes after revision MPFL-R. METHODS: Twenty-three patients (6 males and 17 females) with failed primary MPFL-R underwent isolated revision MPFL-R or combined revision MPFL-R with tibial tuberosity osteotomy (TTO)...
March 9, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28278134/limited-open-quadriceps-release-for-treatment-of-congenital-dislocation-of-the-knee
#19
Ahmed Omar Youssef
BACKGROUND: Congenital dislocation of the knee (CDK) is a rare condition for which the treatment is difficult and remains controversial. The aim of this case series is to evaluate the results of limited open quadriceps release for treatment of CDK. METHODS: Sixteen patients with CDK were managed at our institute from May 2006 to May 2014, and included 10 boys and 6 girls, with a mean age at presentation of 5 weeks (range, 1 to16 wk). Three patients who had an underlying neuromuscular syndrome were excluded...
April 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28268001/return-to-duty-following-combat-related-multi-ligamentous-knee-injury
#20
Aaron E Barrow, Andrew J Sheean, Travis C Burns
INTRODUCTION: This retrospective cohort study characterized injury patterns, treatment practices, and identified the return to duty (RTD) rate following combat-related multi-ligament knee injuries (MLKI). PATIENTS AND METHODS: We evaluated injury characteristics and treatment methods of 46 military service members who had sustained a MLKI during combat activity. The primary clinical outcome measure was ability to return to active military duty. Secondary outcomes included subjective pain score, knee motion, knee instability, and use of ambulatory assistive device...
February 22, 2017: Injury
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