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Knee lateral retinaculum

Alan C Merchant, John P Fulkerson, Wayne Leadbetter
Our purpose is to provide simple guidelines for the diagnosis and early care of patellofemoral disorders. Any clinician who treats knee problems, including family practitioners, rheumatologists, orthopedic surgeons, or physical therapists, must know how to make the correct diagnosis, or at least a presumptive diagnosis, at the initial visit. This can avoid unneeded and costly tests, ineffective treatment, and even damaging exercises and unnecessary surgery. The diagnosis of patellofemoral disorders is confusing because they can have many causes...
March 2017: American Journal of Orthopedics
Kosuke Kumagai, Mitsuhiko Kubo, Tsutomu Maeda, Susumu Araki, Suguru Shioji, Noriaki Okumura, Hitomi Fujikawa, Taku Kawasaki, Shinji Imai, Yoshitaka Matsusue
Prolonged dislocation of the patella is a rare condition and is often related to severe osteoarthritis (OA) of the femorotibial (FT) joint. For this condition's treatment, numerous surgical techniques using total knee arthroplasty (TKA) have been published. To the best of our knowledge, this case report is the first description of the use of lateral release alone to treat recurrent patellar subluxation with TKA. An interesting point in this case is that the patient had a good recovery after TKA in spite of quite a long-term (a duration of almost 55 years) dislocation of her patella and development of secondary OA...
March 2017: Arthroplasty Today
Artit Laoruengthana, Piti Rattanaprichavej, Supachok Rasamimongkol, Monton Galassi
BACKGROUND: Currently, various techniques are used to overcome postoperative pain after total knee arthroplasty. A local analgesic infiltration with periarticular multimodal drug injection (PMDI) is favorable because of its simplicity, safety, and efficacy. The present study compared the efficacy of a PMDI at the anterior vs posterior compartments. METHODS: Forty-six patients were randomized to receive the PMDI at either the anterior or posterior compartment, with the contralateral knee receiving the PMDI at the opposite compartment...
February 24, 2017: Journal of Arthroplasty
Ji Su Kim, Seong Jong Yun, Wook Jin, Gou Young Kim, So Young Park, Ji Seon Park, Kyung Nam Ryu
OBJECTIVE: The purpose of this study is to retrospectively investigate the frequency of a focal defect at the lateral patellar retinaculum on knee MRI and to determine the variables that are significantly associated with the defect. MATERIALS AND METHODS: Two radiologists independently reviewed 99 knee MR images for the presence of a focal defect at the lateral patellar retinaculum and categorized patients with concordant results into two groups: a group with the defect (≥ 3 mm; group 1) and a group without the defect (< 3 mm; group 2)...
May 2017: AJR. American Journal of Roentgenology
Le Qin, Mei Li, Weiwu Yao, Ji Shen
We aimed to assess the CT-based bony tunnel valuations and their correlation with knee function after patellar dislocation triple surgeries. A retrospective study was performed on 66 patients (70 knees) who underwent patellar dislocation triple surgeries. The surgery was MPFL reconstruction primarily, combined with lateral retinaculum release and tibial tubercle osteotomy. CT examinations were performed to determine the femoral tunnel position, along with the patellar and femoral tunnel width 3 days and more than 1 year after operation for follow-up...
January 25, 2017: Scientific Reports
Gökhan İlyas, Ali Turgut, Duygu Ayaz, Önder Kalenderer
BACKGROUND: Angiolipomas are benign tumors usually seen in patients during their 2(nd) and 3(rd) decades. The subcutaneous region of the trunk, neck and extremities are the places where they generally settle. There is only one case report on angiolipoma in the knee joint that was resected by arthroscopic procedure in the English literature. CASE REPORT: We present a case of a giant-size multilobular non-infiltrating angiolipoma, extending outside of the right knee joint and causing lateral patellar dislocation in a thirteen-year-old boy...
November 2016: Balkan Medical Journal
Hülya Kurtul Yildiz, Elif Evrim Ekin
PURPOSE: The medial patellofemoral ligament (MPFLL)/lateral patellar retinaculum (LPR) ratio were assessed in knees as a means to detect patellar malalignment. We also aimed to evaluate the prevalence of the various types of trochlear dysplasia in patients with patellar malalignment. MATERIALS AND METHODS: After approval of our institutional ethics committee, we conducted a retrospective study that included 450 consecutive patients to evaluate them for the presence of patellar malalignment...
2016: SpringerPlus
Sercan Capkin, Gulsah Zeybek, Ipek Ergur, Can Kosay, Amac Kiray
OBJECTIVE: The lateral patellofemoral ligament (LPFL) is part of the lateral retinaculum cut during arthroscopic or open release. We investigated its anatomic and morphometric characteristics. MATERIALS AND METHODS: We identified the LPFL insertion point on the condyle in vertical and sagittal planes in 32 adult cadaveric knees. We measured its length and width at the insertion point. We located the midpoint of this point and measured from it to the distal and posterior condylar ends...
January 2017: Acta Orthopaedica et Traumatologica Turcica
A P Rosales-Varo, O Roda-Murillo, N Prados-Olleta, M A García-Espona
OBJECTIVE: To describe a novel coronal osteotomy of the external facet of the patella, and to evaluate if the outcomes of the treatment of lateral knee compartment syndrome (LKCS) with this osteotomy, combined with the release of the external lateral retinaculum, are better than the isolated lateral retinacular release. MATERIAL AND METHODS: A prospective study with a 2 year follow up that included 70 patients diagnosed with LKCS, distributed into 2 groups. The first group included 50 patients on whom the lateral retinacular release combined with osteotomy was performed, and a second group on whom an isolated retinacular release was performed...
September 2016: Revista Española de Cirugía Ortopédica y Traumatología
H-R Springorum, C Baier, B Craiovan, G Maderbacher, T Renkawitz, J Grifka, A Keshmiri
INTRODUCTION: Patellofemoral maltracking is a relevant problem after total knee arthroplasty (TKA). Patella navigation is a tool that allows real time monitoring of patella tracking. MATERIAL: This video contribution demonstrates the technique of patellofemoral navigation and a possible consequence of intraoperative monitoring. A higher postoperative lateral tilt is addressed with a widening of the lateral retinaculum in a particular manner. CONCLUSION: In selected cases of patellofemoral problems, patella navigation is a helpful tool to evaluate patellofemoral tracking intraoperatively...
July 2016: Der Orthopäde
Mohd Fairudz Bin Mohd Miswan, Mohamed Zubair Mohamed Al-Fayyadh, Teo Seow Hui, Mohamed Razif Bin Mohamed Ali, Wuey Min Ng
A patient with patellar instability frequently presents with anterior knee pain, patellar subluxation, or dislocation. Medial patellofemoral ligament (MPFL) has a key role for normal patella tracking and stability. Reconstruction of the MPFL using a hamstring graft is a commonly used procedure for the treatment of chronic lateral subluxation of patella. Anchor sutures and bony tunnels are used for the patellar attachment of the graft. This can be associated with complications such as patella fracture; besides, it does not produce an anatomical reconstruction for the native MPFL that can alter the direction of tension applied on the patella...
April 2016: Arthroscopy Techniques
Gangyong Huang, Jun Xia, Siqun Wang, Yibing Wei, Jianguo Wu, Feiyan Chen, Jie Chen, Jingsheng Shi
BACKGROUND: Apart from transepicondylar axis, the native femoral sulcus was also reported to be used as a guide for the femoral component position in total knee arthroplasty (TKA). However, it was not shown in patients with severe knee osteoarthritis. This study was conducted to compare the position of trochlear groove in patients with and without osteoarthritis, and to assess whether trochlear groove could be used as a guide for position of femoral component in TKA for severe knee osteoarthritis...
May 23, 2016: BMC Surgery
K-D Heller
BACKGROUND: Patellofemoral complications after total knee arthroplasty are responsible for a variety of surgical revisions. OBJECTIVE: The causes of the various types of instability of the patella are listed in a differentiated way and the importance of clinical and imaging diagnostics as well as preventive strategies are elaborated. MATERIAL AND METHODS: This article is based on a selective literature search in the PubMed database and on the long-standing experience of the author...
May 2016: Der Orthopäde
Zhu Dai, Di You, Ying Liao, Zhiwei Chen, Jiabin Peng
OBJECTIVE: To explore the treatment methed of recurrent patellar dislocation associated with old osteochondral fracture and to evaluate its effectiveness. METHODS: Between August 2010 and August 2014, 12 cases of recurrent patellar dislocation with old osteochondral fracture were treated. There were 4 males and 8 females with an average age of 18.3 years (range, 15-24 years). The left knee was involved in 7 cases and the right knee in 5 cases. All the patients had a history of patellar dislocation, the average interval from injury to first hospitalization was 7...
January 2016: Chinese Journal of Reparative and Reconstructive Surgery
Hee Kyung Kim, Sahar Shiraj, Chang Ho Kang, Christopher Anton, Dong Hoon Kim, Paul S Horn
OBJECTIVE: The purpose of this study was to compare MRI findings between groups with and without patellofemoral instability and to correlate the MRI findings with the severity of patellar cartilage damage. MATERIALS AND METHODS: Fifty-three children with patellofemoral instability and 53 age- and sex-matched children without patellofemoral instability (15.9 ± 2.4 years) were included. Knee MRI with T2-weighted mapping was performed. On MR images, femoral trochlear dysplasia, patellofemoral malalignment, medial retinaculum injury, and bone marrow edema were documented...
June 2016: AJR. American Journal of Roentgenology
Hatai A Yiding-Xia, Keyuan Zhang, Yang Liu
OBJECTIVE: To study the effect of the femoral tunnel position on the knee function recovery after medial patellofemoral ligament (MPFL) reconstruction. METHODS: A retrospective analysis was made on the clinical date of 43 cases (43 knees) of recurrent patellar dislocation undergoing MPFL reconstruction and patellofemoral lateral retinaculum lysis between August 2013 and March 2014. There were 12 males and 31 females, aged 19.4 years on average (range, 9-35 years)...
August 2015: Chinese Journal of Reparative and Reconstructive Surgery
Brandon J Erickson, Kevin Campbell, Gregory L Cvetanovich, Joshua D Harris, Bernard R Bach, Seth L Sherman
Knee pain is one of the most frequent complaints evaluated by orthopedic surgeons. It encompasses a broad range of pathology and can present in a variety of ways. Most of this pain can be attributed to essential structures of the knee, including the menisci, cruciate or collateral ligaments, and articular cartilage. However, there are underrecognized structures in and around the knee that can frequently be a cause of knee pathology and pain. Knee pain stemming from these structures may be missed or incorrectly diagnosed, and these patients often present for second and third opinions because of failure to diagnose and treat the underlying pathology...
January 2016: Orthopedics
Nancy A Chauvin, Asef Khwaja, Monica Epelman, Michael J Callahan
BACKGROUND: We report the radiologic findings of herniation of Hoffa's fat pad through a defect in the lateral patellar retinaculum in young children who presented with painless masses visible by ultrasound (US) only with flexion of the knee. MATERIAL AND METHODS: Six children, between the ages of 1-8 years, presented with an anterolateral knee mass that was not tender and was only seen and palpable with knee flexion. An US was performed in all patients, magnetic resonance imaging (MRI) in 2 patients and knee radiographs in 1 patient...
April 2016: Pediatric Radiology
Brian Noehren, Logan Shuping, Aron Jones, David A Akers, Heather M Bush, Kathleen A Sluka
OBJECTIVES: Chronic patellofemoral pain (PFP) is a common orthopedic condition for which little is understood of the alterations in pain processing such as hyperalgesia, hypoesthesia, and the relationship of altered knee mechanics to hyperalgesia. We assessed pain, pressure pain thresholds (PPT), detection to light touch, and the relationship of pain and PPTs to knee abduction angle during a stair step down task between females with and without PFP. MATERIALS AND METHODS: Twenty females diagnosed with PFP and 20 age-matched pain-free females participated in this study...
October 2016: Clinical Journal of Pain
Michael G Saper, David A Shneider
Medial patellar subluxation is a poorly recognized clinical condition characterized by chronic anterior knee pain that is exacerbated with knee flexion. Additional symptoms include instability, limited knee motion, and pain with squatting and stair climbing. Full characterization of the patient's knee pain requires an accurate history and physical examination. Diagnosis is typically confirmed during diagnostic arthroscopy. When nonsurgical management (eg, physical rehabilitation, patella-stabilizing bracing) fails, surgery (eg, medial retinacular release, lateral retinacular imbrication, newer techniques to repair or reconstruct the lateral retinaculum/lateral patellofemoral ligament) can lead to good results...
November 2015: American Journal of Orthopedics
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