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https://www.readbyqxmd.com/read/28646869/long-term-outcomes-after-combined-arthroscopic-medial-reefing-and-lateral-release-in-patients-with-recurrent-patellar-instability-a-retrospective-analysis
#1
Dominik Schorn, Sera Yang-Strathoff, Georg Gosheger, Tim Vogler, Sebastian Klingebiel, Carolin Rickert, Dimosthenis Andreou, Dennis Liem
BACKGROUND: There is currently no consensus regarding the optimal surgical treatment method for patients with recurrent patella instability. Our goal was to evaluate the long-term results of combined arthroscopic medial reefing and lateral release, to identify possible risk factors for recurrent dislocations and residual complaints after surgical treatment and to assess functional outcome. METHODS: We performed a retrospective study of 38 patients (43 knees) treated with all-inside technique between 2001 and 2010...
June 24, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28633148/clinical-and-functional-results-of-119-patients-with-knee-dislocations
#2
Nicholas R Scarcella, Douglas S Weinberg, Stephen Bowen, Heather A Vallier
OBJECTIVES: To describe clinical results and functional outcomes of knee dislocations treated with a consistent strategy within our institution. DESIGN: Retrospective case series. SETTING: Level 1 trauma center. PATIENTS: One hundred nineteen patients were treated at one institution between 2000 and 2014 for knee dislocation. MAIN OUTCOME MEASUREMENTS: Knee range of motion, functional instability, and complications were recorded...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28631024/the-use-of-tibial-tuberosity-trochlear-groove-indices-based-on-joint-size-in-lower-limb-evaluation
#3
Peter Wilhelm Ferlic, Armin Runer, Florian Dirisamer, Peter Balcarek, Johannes Giesinger, Rainer Biedermann, Michael Christian Liebensteiner
PURPOSE: The correlation between tibial tuberosity-trochlear groove distance (TT-TG) and joint size, taking into account several different parameters of knee joint size as well as lower limb dimensions, is evaluated in order to assess whether TT-TG indices should be used in instead of absolute TT-TG values. METHODS: This study comprised a retrospective analysis of knee CT scans, including 36 cases with patellofemoral instability (PFI) and 30 controls. Besides TT-TG, five measures of knee joint size were evaluated in axial CT slices: medio-lateral femur width, antero-posterior lateral condylar height, medio-lateral width of the tibia, width of the patella and the proximal-distal joint size (TT-TE)...
June 19, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28628800/increased-internal-femoral-torsion-can-be-regarded-as-a-risk-factor-for-patellar-instability-a-biomechanical-study
#4
Peter Kaiser, Werner Schmoelz, Philip Schoettle, Marit Zwierzina, Christian Heinrichs, Rene Attal
BACKGROUND: Increased internal femoral torsion is regarded as a risk factor for patellar instability. Biomechanical investigations confirming this hypothesis are missing. METHODS: Eight fresh-frozen cadaver knees were tested on a specially designed simulator. Patellar motion and patellofemoral pressure were evaluated for 0°, 10°, and 20° of increased internal and external femoral torsion with native and with transected medial patellofemoral ligaments used to simulate patellar instability...
June 10, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28625567/dose-postural-control-improve-following-application-of-transcutaneous-electrical-nerve-stimulation-in-diabetic-peripheral-neuropathic-patients-a-randomized-placebo-control-trial
#5
Z Saadat, Z Rojhani-Shirazi, L Abbasi
BACKGROUND: peripheral neuropathy is the most common problem of diabetes. Neuropathy leads to lower extremity somatosensory deficits and postural instability in these patients. However, there are not sufficient evidences for improving postural control in these patients. AIM: To investigate the effects of transcutaneous electrical nerve stimulation (TENS) on postural control in patients with diabetic neuropathy. METHODS: Twenty eighth patients with diabetic neuropathy (40-55 Y/O) participated in this RCT study...
June 9, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28623415/a-stand-alone-lateral-condyle-elevating-trochlear-osteotomy-leads-to-high-residual-instability-but-no-excessive-increase-in-patellofemoral-osteoarthritis-at-12-year-follow-up
#6
S Tigchelaar, J van Sambeeck, S Koeter, A van Kampen
PURPOSE AND HYPOTHESIS: Trochlear osteotomy is a rarely performed procedure, only indicated in selected cases. Due to its nature, it can potentially lead to cartilage damage and subsequent early osteoarthritis. Satisfactory short-term results from lateral condyle-elevating osteotomy have previously been reported. The long-term effects of this procedure on clinical outcomes, patellar stability and radiological osteoarthritis are reported here. METHODS: Sixteen patients (19 knees) with patellar instability due to trochlear dysplasia were included...
June 16, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28617518/tibiofemoral-instability-after-primary-total-knee-arthroplasty-posterior-stabilized-implants-for-obese-patients
#7
Ata Can, Fahri Erdogan, Ayse Ovul Erdogan
Tibiofemoral instability is a common complication after total knee arthroplasty (TKA), accounting for up to 22% of all revision procedures. Instability is the second most common cause of revision in the first 5 years after primary TKA. In this study, 13 knees with tibiofemoral instability after TKA were identified among 693 consecutive primary TKA procedures. Patient demographics, body mass index, clinical symptoms, previous deformity, previous knee surgery, complications, interval between index TKA and first tibiofemoral instability, causes of instability, and interval between index TKA and revision TKA were retrospectively reviewed...
June 15, 2017: Orthopedics
https://www.readbyqxmd.com/read/28615108/kinematics-of-different-components-of-the-posterolateral-corner-of-the-knee-in-the-lateral-collateral-ligament-intact-state-a-human-cadaveric%C3%A2-study
#8
Christoph Domnick, Karl-Heinz Frosch, Michael J Raschke, Nils Vogel, Martin Schulze, Mathias von Glahn, Tobias C Drenck, Mirco Herbort
PURPOSE: To determine the static stabilizing effects of different anatomical structures of the posterolateral corner (PLC) of the knee in the lateral collateral ligament (LCL)-intact state. METHODS: Thirteen fresh-frozen human cadaveric knees were dissected and tested using an industrial robot with an optical tracking system. Kinematics were determined for 134 N anterior/posterior loads, 10 N m valgus/varus loads, and 5 N m internal/external rotatory loads in 0°, 20°, 30°, 60°, and 90° of knee flexion...
June 11, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28614288/evaluation-of-the-tibial-tubercle-to-posterior-cruciate-ligament-distance-in-a-pediatric-patient-population
#9
Blake Clifton, Dustin L Richter, Dan Tandberg, Matthew Ferguson, Gehron Treme
BACKGROUND: Evaluation of distal extensor mechanism alignment continues to evolve in children with patella instability. Prior studies support the use of the tibial tubercle to trochlear groove (TT-TG) distance but limitations exist for this measurement including: changes in the TT-TG distance with knee flexion, difficulty with finding the deepest part of a dysplastic trochlea, and limitations regarding identification of the site of the anatomic abnormality. The tibial tubercle-posterior cruciate ligament (TT-PCL) distance has been introduced as an alternative measure to address the shortcomings in the TT-TG distance by quantifying the position of the TT independent of the trochlea and with respect to the tibia only...
June 13, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28614283/recurrent-patellar-instability-implications-of-preoperative-patellar-crepitation-on-the-status-of-the-patellofemoral-articular-cartilage
#10
Scott J Luhmann, June C Smith, Mario Schootman, Nandan Prasad
BACKGROUND: The purpose of the study was to quantify the frequency, severity, and location of patellofemoral (PF) articular cartilage changes recurrent patellar instability treated surgically in patients with preoperative clinical patellar crepitation. METHODS: A single-surgeon database was queried for all knees with recurrent patellar instability between 3/2000 and 6/2012 (n=214). Only knees which underwent knee arthroscopy during the surgical treatment were included (n=148)...
June 13, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28610477/lower-extremity-joint-coupling-variability-during-gait-in-young-adults-with-and-without-chronic-ankle-instability
#11
Thomas Lilley, Christopher C Herb, Joseph Hart, Jay Hertel
Chronic ankle instability (CAI) is a condition resulting from a lateral ankle sprain. Shank-rearfoot joint-coupling variability differences have been found in CAI patients; however, joint-coupling variability (VCV) of the ankle and proximal joints has not been explored. Our purpose was to analyse VCV in adults with and without CAI during gait. Four joint-coupling pairs were analysed: knee sagittal-ankle sagittal, knee sagittal-ankle frontal, hip frontal-ankle sagittal and hip frontal-ankle frontal. Twenty-seven adults participated (CAI:n = 13, Control:n = 14)...
June 13, 2017: Sports Biomechanics
https://www.readbyqxmd.com/read/28608009/clinical-outcomes-of-extra-articular-tenodesis-anterolateral-reconstruction-in-the-acl-injured-knee
#12
REVIEW
Bertrand Sonnery-Cottet, Nuno Camelo Barbosa, Thais Dutra Vieira, Adnan Saithna
PURPOSE: The role of concomitant extra-articular procedures in improving the outcome of ACL reconstruction has experienced a recent resurgence in interest. The aim of this article is to highlight the differences in philosophies and outcomes of historical lateral extra-articular tenodesis (LET) and contemporary, anterolateral reconstruction. METHODS: A narrative review was performed using PubMed/MEDLINE using the keywords "lateral extra-articular tenodesis" and "anterolateral ligament reconstruction"...
June 12, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28607939/the-role-of-the-peripheral-passive-rotation-stabilizers-of-the-knee-with-intact-collateral-and-cruciate-ligaments-a-biomechanical-study
#13
Alexander R Vap, Jason M Schon, Gilbert Moatshe, Raphael S Cruz, Alex W Brady, Grant J Dornan, Travis Lee Turnbull, Robert F LaPrade
BACKGROUND: A subset of patients have clinical internal and/or external knee rotational instability despite no apparent injury to the cruciate or collateral ligaments. PURPOSE/HYPOTHESIS: The purpose of this study was to assess the effect of sequentially cutting the posterolateral, anterolateral, posteromedial, and anteromedial structures of the knee on rotational stability in the setting of intact cruciate and collateral ligaments. It was hypothesized that cutting of the iliotibial band (ITB), anterolateral ligament and lateral capsule (ALL/LC), posterior oblique ligament (POL), and posteromedial capsule (PMC) would significantly increase internal rotation, while sectioning of the anteromedial capsule (AMC) and the popliteus tendon and popliteofibular ligament (PLT/PFL) would lead to a significant increase in external knee rotation...
May 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28603610/does-additional-reconstruction-of-the-anterolateral-ligament-during-a-primary-anterior-cruciate-ligament-reconstruction-affect-tibial-rotational-laxity-a-case-series
#14
Rohi Shah, Runveer Singh, Clodagh Dugdale, Guido Geutjens
BACKGROUND: The current evidence suggests that rotational stability in not restored in patients with anterior cruciate ligament (ACL) ruptures, despite reconstructive surgery. The graded pivot-shift is a useful clinical test to delineate extent of ligamentous laxity within the knee. Given its lateralised position, we hypothesized that reconstruction of the anterolateral ligament (ALL) would provide restraint to excessive internal rotation, restoring rotational stability. METHODS: 10 patients with MRI confirmed diagnosis of an isolated ACL rupture were included...
July 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28600607/-osteotomies-around-the-knee-for-ligament-insufficiency
#15
REVIEW
M J Feucht, T Tischer
BACKGROUND: The osseous geometry of the lower limb has a significant impact on knee instability after ligament injuries, and osseous malalignment has been shown to be a significant risk factor for the failure of ligament reconstruction procedures. Therefore, osteotomies around the knee have gained importance as a combined or isolated treatment option in the ligament deficient and malaligned knee. In addition to unloading of an arthritic knee compartment, osteotomies are also performed to protect a reconstructed ligament and to stabilize the joint without ligament surgery...
June 9, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28594500/patellofemoral-arthroplasty-an-evolving-science
#16
Jess H Lonner
Patellofemoral arthroplasty (PFA) has long been a clinical option for patients with isolated patellofemoral arthritis. However, a high rate of failure as a result of patellar instability related to component malposition, soft-tissue imbalance, errant surgical techniques, and poor trochlear implant designs contributed to the underutilization of PFA. The evolution of surgical indications, trochlear implant design, component positioning, and soft-tissue balance has led to improved patellar tracking, fewer failures related to patellar instability, and improved functional outcomes...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28585997/diagnosis-and-management-of-traumatic-patellar-instability-in-the-pediatric-patient
#17
Steven F DeFroda, Joseph A Gil, Alex Boulos, Aristides I Cruz
Instability of the patella is a common cause of knee pain and dysfunction in pediatric and adolescent patients and can be due to several factors. Although some patients will recall a specific traumatic event others may not, requiring the diagnosis to be made on the basis of physical examination and imaging. Congenital dislocation and connective tissue disorders should also be considered, even in the setting of trauma. There are radiographic parameters that may identify causes of instability such as trochlear and patellar abnormalities, and magnetic resonance imaging can identify signs of trauma such as bony edema, loose osteochondral fragments, and increased tibial tubercle-trochlear groove distance...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28580267/fatigue-behavior-of-nitinol-anterior-cruciate-ligament-graft-and-inappropriate-femoral-tunnel-placement-single-stage-revision-anterior-cruciate-ligament-reconstruction-surgery
#18
Fatih Karaaslan, Sinan Karaoğlu
Anterior cruciate ligament (ACL) injury is the most common ligament injury in the knee, and progressive instability and disability may develop in a significant number of patients. The incidence of ACL reconstruction is rapidly increasing, as is the number of failures. Although ACL reconstruction is a common procedure, less than satisfactory outcomes have been reported to occur in up to 25% of patients. The reasons for clinical failure after ACL reconstruction are numerous but can be broadly separated into 3 categories: technical, biological, and mechanical failures...
April 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28580262/minimally-invasive-combined-anterior-and-anterolateral-stabilization-of-the-knee-using-hamstring-tendons-and-adjustable-loop-suspensory-fixation-device-surgical-technique
#19
Achilleas Boutsiadis, Paul Brossard, Jean-Claude Panisset, Nicolas Graveleau, Johannes Barth
Despite the numerous techniques described regarding isolated anterior cruciate ligament (ACL) reconstruction, many authors have reported that residual knee rotational instability is not always eliminated. The combination of lateral extra-articular knee tenodesis and ACL reconstruction is an alternative surgical approach with very promising clinical results. The purpose of this article is to describe a reliable and reproducible technique of combined ACL reconstruction and lateral extra-articular knee tenodesis using a continuous looped hamstring tendon autograft...
April 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28580253/arthroscopic-patellar-lateral-facetectomy
#20
Marcio B Ferrari, George Sanchez, Jorge Chahla, Gilbert Moatshe, Robert F LaPrade
Isolated patellofemoral osteoarthritis is relatively prevalent, with the lateral facet of the patella being the most commonly affected portion. This pathology can be a result of a patellar maltracking syndrome, patella instability, or idiopathic degenerative changes. A thorough diagnostic work-up with a physical examination and imaging studies are mandatory for a proper diagnosis and to rule out other causes of patellofemoral knee pain. These patients are often treated nonoperatively with exercises for patella mobility, intra-articular injections, braces, patellar tracking, quadriceps balance and strength, and activity modification...
April 2017: Arthroscopy Techniques
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