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https://www.readbyqxmd.com/read/29332201/gouty-involvement-of-the-patella-and-extensor-mechanism-of-the-knee-mimicking-aggressive-neoplasm-a-case-series
#1
Christopher Kester, Matthew T Wallace, James Jelinek, Albert Aboulafia
Gout is a common inflammatory crystal deposition disease that occurs in many joints throughout the body. Active gout is most often associated with painful synovitis causing searing joint pains, but gout can also produce large masses of space-occupying deposits called tophi. Tophi are most frequently seen in juxta-articular locations with or without bony erosion and are often misdiagnosed as degenerative joint disease. Soft tissue deposits and tendon involvement are also known manifestations of gout, but can present with indeterminate and alarming findings on imaging...
January 14, 2018: Skeletal Radiology
https://www.readbyqxmd.com/read/29309446/patella-alta-a-comprehensive-review-of-current-knowledge
#2
Roland M Biedert, Philippe M Tscholl
We systematically reviewed patella alta with respect to type of measurements, reported cutoff values, cutoff values for surgical correction, and proposed surgical techniques. Using the term patella alta, we performed a systematic literature search on PubMed. Inclusion criteria were original study or review articles, publication in peer-reviewed English-language journals between 2000 and 2017, and narrative description or measurement of human patellar height on plain radiographs or magnetic resonance imaging (MRI)...
November 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29308925/treatment-of-patellar-lower-pole-fracture-with-modified-titanium-cable-tension-band-plus-patellar-tibial-tunnel-steel-8-reduction-band
#3
Jiaming Li, Decheng Wang, Zhiliang He, Hao Shi
PURPOSE: To determine the efficacy of modified titanium tension band plus patellar tendon tunnel steel 8 "reduction band" versus titanium cable tension band fixation for the treatment of patellar lower pole fracture. MATERIALS AND METHODS: 58 patients with lower patella fracture were enrolled in this study, including 30 patients treated with modified titanium cable tension band plus patellar tibial tunnel wire "8" tension band internal fixation (modified group), and 28 patients with titanium cable tension band fixation...
January 8, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/29284175/surgical-management-of-simultaneous-anterior-cruciate-ligament-and-patellar-tendon-ruptures-a-systematic-review
#4
Carlos J Meheux, Robert A Jack, Patrick C McCulloch, David M Lintner, Joshua D Harris
This study performs a systematic review to determine (1) if a significant difference exists in return to preinjury activity level between one- and two-stage treatment of combined anterior cruciate ligament (ACL) and patellar tendon (PT) tears; and (2) if a significant difference exists in the number of postoperative complications between the two differing surgical treatment approaches. A systematic review was performed using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and registered on PROSPERO...
December 28, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29277060/does-additional-patella-tendon-shortening-influence-the-effects-of-multilevel-surgery-to-correct-flexed-knee-gait-in-cerebral-palsy-a-randomized-controlled-trial
#5
M C M Klotz, Britta K Krautwurst, K Hirsch, M Niklasch, M W Maier, S I Wolf, T Dreher
BACKGROUND: The aims of this study were to investigate if patellar tendon shortening (PTS) as a part of SEMLS (single event multilevel surgery) is effective for reduction of flexed knee gait in children with cerebral palsy (CP) and, if PTS leads to stiff knee gait. METHODS: In a randomized controlled study 22 children with flexed knee gait (age: 10.4 ± 2.6 years, GMFCS Level I-III) were randomized and allocated to two groups (1: SEMLS + PTS; 2: SEMLS no PTS): SEMLS was performed for correction of flexed knee gait either with or without additional PTS...
December 5, 2017: Gait & Posture
https://www.readbyqxmd.com/read/29273898/pseudo-patella-baja-a-minor-yet-frequent-complication-of-total-knee-arthroplasty
#6
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
https://www.readbyqxmd.com/read/29260429/intraarticular-arthrofibrosis-of-the-knee-alters-patellofemoral-contact-biomechanics
#7
Jacob D Mikula, Erik L Slette, Kimi D Dahl, Scott R Montgomery, Grant J Dornan, Luke O'Brien, Travis Lee Turnbull, Thomas R Hackett
BACKGROUND: Arthrofibrosis in the suprapatellar pouch and anterior interval can develop after knee injury or surgery, resulting in anterior knee pain. These adhesions have not been biomechanically characterized. METHODS: The biomechanical effects of adhesions in the suprapatellar pouch and anterior interval during simulated quadriceps muscle contraction from 0 to 90° of knee flexion were assessed. Adhesions of the suprapatellar pouch and anterior interval were hypothesized to alter the patellofemoral contact biomechanics and increase the patellofemoral contact force compared to no adhesions...
December 19, 2017: Journal of Experimental Orthopaedics
https://www.readbyqxmd.com/read/29248484/is-there-any-role-for-direct-repair-of-extensor-mechanism-disruption-following-total-knee-arthroplasty
#8
P Maxwell Courtney, Tori A Edmiston, Caleb T Pflederer, Brett R Levine, Tad L Gerlinger
BACKGROUND: Extensor mechanism disruption remains a challenging problem in total knee arthroplasty (TKA) with historically poor outcomes. The purpose of our study is to determine if patients undergoing acute extensor mechanism repair had different outcomes than patients undergoing allograft reconstruction. METHODS: We reviewed a series of 126 total knee arthroplasty patients requiring surgical repair or reconstruction of an extensor mechanism injury from 2005 to 2014 with a minimum of 24 months of follow-up...
December 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29243827/one-incision-versus-two-incision-techniques-for-arthroscopically-assisted-anterior-cruciate-ligament-reconstruction-in-adults
#9
REVIEW
Fernando C Rezende, Vinícius Y Moraes, Carlos Es Franciozi, Pedro Debieux, Marcus V Luzo, João Carlos Belloti
BACKGROUND: Anterior cruciate ligament (ACL) tears are serious knee injuries that are frequently treated surgically in the form of arthroscopically assisted reconstruction with grafts from the patella or hamstrings tendons. We reviewed the evidence for the choice of arthroscopically assisted ACL reconstruction technique in terms of whether it should involve one incision (femoral tunnel drilled from inside the knee joint under arthroscopic visualisation) or two incisions (femoral tunnel drilled from outside to inside the knee joint)...
December 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29233153/application-of-different-patella-height-indices-in-patients-undergoing-total-knee-arthroplasty
#10
Bin Xu, Wei-Xing Xu, Di Lu, Hong-Feng Sheng, Xin-Wei Xu, Wei-Guo Ding
BACKGROUND: One complication of total knee arthroplasty (TKA) is patella baja (PB). Patellar tendon shortening and joint line elevation are two main causes of PB. The purpose of this study was to determine the incidence of PB before and after TKA by measuring the patellar height and provide evidence for choosing a suitable index. METHODS: In total, 256 consecutive patients who underwent primary TKA were included in this study. Radiographic measurements were performed; the Insall-Salvati (IS) index, modified IS (MIS) index, Blackburne-Peel (BP) index, and Caton-Deschamps (CD) index were computed; and the incidence of PB was calculated before and after the operation...
December 12, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29230426/lateral-patellofemoral-ligament-an-anatomic-study
#11
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
https://www.readbyqxmd.com/read/29207687/variation-in-morphometry-of-vastus-medialis-muscle
#12
Hina B Rajput, Sangeeta J Rajani, Vasant H Vaniya
Introduction: The Vastus Medialis (VM) muscle divides into two parts, proximal Vastus Medialis Longus (VML) and distal Vastus Medialis Obliquus (VMO). The VMO originates from the tendon of adductor magnus and insert into the medial border of patella and these fibers are nearly horizontal. It exerts medial force vector to counter the lateral force vector of Vastus Lateralis (VL) hence the VM presents a biomechanical advantage over the VL. The functional importance of VML and VMO is well explained but the anatomical evidence of separate identity of VMO is lacking...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29200662/gearing-effects-of-the-patella-knee-extensor-muscle-sesamoid-of-the-helmeted-guineafowl-during-terrestrial-locomotion
#13
V R Allen, R E Kambic, S M Gatesy, J R Hutchinson
Human patellae (kneecaps) are thought to act as gears, altering the mechanical advantage of knee extensor muscles during running. Similar sesamoids have evolved in the knee extensor tendon independently in birds, but it is unknown if these also affect the mechanical advantage of knee extensors. Here, we examine the mechanics of the patellofemoral joint in the helmeted guineafowl Numida meleagris using a method based on muscle and tendon moment arms taken about the patella's rotation centre around the distal femur...
November 2017: Journal of Zoology: Proceedings of the Zoological Society of London
https://www.readbyqxmd.com/read/29149666/relationship-between-radiographic-patella-alta-pathology-and-walking-dysfunction-in-children-with-bilateral-spastic-cerebral-palsy
#14
Matthias Hösl, Harald Böhm, Michaela Seltmann, Chakravarthy Ugandhar Dussa, Leonhard Döderlein
BACKGROUND: Patella-alta is very common in patients with Cerebral Palsy (CP). While several diagnostic x-ray indices have been developed for patella-alta in general, the specific relationship with walking dysfunction in CP is only partly understood. METHODS: 33 participants with bilateral spastic CP between 4 and 20 years (GMFCS I-II without previous surgery) that underwent 3D gait analysis as well as a radiographic exam within 0.8 (SD 1.2) months were retrospectively included...
November 10, 2017: Gait & Posture
https://www.readbyqxmd.com/read/29146686/specific-force-of-the-vastus-lateralis-in-adults-with-achondroplasia
#15
David Thomas Sims, Gladys L Onambele-Pearson, Adrian Burden, Carl Payton, Christopher I Morse
Achondroplasia is a clinical condition defined by shorter stature and disproportionate limb length. Force production in able-bodied individuals (controls) is proportional to muscle size, but given the disproportionate nature of Achondroplasia, normalising to anatomical cross sectional area (ACSA) is inappropriate. The aim of this study was to assess specific force of the vastus lateralis (VL) in 10 adults with Achondroplasia (22 ±3 yrs) and 18 gender matched controls (22 ±2 yrs). Isometric torque (iMVCτ) of the dominant knee extensors (KE) and in vivo measures of VL muscle architecture, volume, activation and patella tendon moment arm were used to calculate VL physiological CSA (PCSA), fascicle force and specific force in both groups...
November 16, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29130878/a-novel-technique-utilizing-a-vastus-lateralis-anchor-in-treatment-of-chronic-patellar-dislocation-after-total-knee-arthroplasty
#16
Allison Mayfield, Vamsi Singaraju, Afshin A Anoushiravani, Zain Sayeed, Jamal K Saleh, Khaled J Saleh
Extensor mechanism complications involving the patella frequently result in total knee arthroplasty (TKA) failure. Postoperative patellar dislocation may be caused by soft tissue imbalance, improper sizing, and position of the prosthesis. This report describes a case of revision TKA requiring several rounds of soft tissue releases in an effort to treat the patient's chronic patellar dislocation. In the process, a novel surgical approach was developed for the surgical management of refractory chronic patellar dislocations...
October 2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29128877/the-location-of-the-medial-parapatellar-arthrotomy-influences-intraoperative-patella-tracking
#17
Scott R Nodzo, Maximilian Kasparek, Kilian Rueckl, Friedrich Boettner
PURPOSE: The medial parapatellar arthrotomy (MPPA) is a commonly utilized surgical approach; however, the placement of the arthrotomy and its influence on intraoperative patellar tracking has not been evaluated. METHODS: Six knees from three fresh frozen cadavers with transthoracic amputations were operated on. All underwent standard posterior stabilized total knee arthroplasty using a medial parapatellar approach placed at the border of the vastus medialis oblique (VMO)-quadriceps junction...
November 11, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29100765/effect-of-transosseous-tunnels-on-patella-fracture-risk-after-medial-patellofemoral-ligament-reconstruction-a-cadaveric-study
#18
Nicholas A Bonazza, Gregory S Lewis, Eric Z Lukosius, Evan P Roush, Kevin P Black, Aman Dhawan
PURPOSE: To determine whether (1) tunnels that breach the anterior cortex of the patella result in increased fracture risk and (2) transosseous tunnels drilled across the patella significantly reduce the tensile force needed to fracture the patella. METHODS: Twenty-six fresh-frozen cadaveric human patellas were randomized to 1 of 3 groups: a control group with unmodified patellas, a group with 2 transverse tunnels (TT) that did not breach the anterior cortex, and a group with 2 TT that breached the anterior cortex of the patella (PA)...
October 31, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29082055/quadriceps-tendon-rupture-in-an-adolescent-athlete
#19
William A Zuke, Beatrice Go, Alexander E Weber, Brian Forsythe
Quadriceps tendon rupture is an uncommon injury that usually occurs in middle-aged and elderly men with a history of chronic illnesses. We report the case of a 17-year-old healthy adolescent male baseball player who sustained this injury as a result of sudden deceleration in his left knee. He initially reported to the emergency department and then presented to our practice, where he was diagnosed with a quadriceps tendon tear. Preoperatively, he was unable to perform a single straight-leg raise. During surgical repair, the free edge of the quadriceps tendon was mobilized and anchored into the superior pole of the patella, followed by sutures to ensure reinforcement of the quadriceps footprint...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29075841/effects-of-tibial-baseplate-shape-on-rotational-alignment-in-total-knee-arthroplasty-three-dimensional-surgical-simulation-using-osteoarthritis-knees
#20
Yuan Ma, Hideki Mizu-Uchi, Ken Okazaki, Tetsuro Ushio, Koji Murakami, Satoshi Hamai, Yukio Akasaki, Yasuharu Nakashima
INTRODUCTION: Placement of tibial component is expected to fulfill both maximum surface coverage and recommended anterior-posterior (AP) alignment in total knee arthroplasty (TKA). The purpose of this study is to evaluate the effect of the tibial baseplate shape on AP axis. MATERIALS AND METHODS: Virtual surgery of TKA was performed with three-dimensional bone models reconstructed from 77 osteoarthritis varus knees. Two differently designed tibial baseplates, symmetrically and anatomically, were set to the cut surface under posterior slopes of 0°, 3°, and 7°...
October 26, 2017: Archives of Orthopaedic and Trauma Surgery
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