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https://www.readbyqxmd.com/read/28437505/guidelines-for-treatment-of-lateral-patella-dislocations-in-skeletally-mature-patients
#1
Michael C Liebensteiner, Florian Dirisamer, Peter Balcarek, Philip Schoettle
The incidence of lateral patella dislocations is high, particularly in young females. Beside traumatic cases, many patients present with specific anatomical factors that predispose to lateral patella dislocations (torsional abnormalities of the femur or the tibia, trochlea dysplasia, patella alta, etc). It is of utmost importance to correct those pathologic factors during concomitant procedures as isolated reconstructions of the medial patellofemoral ligament would fail in the presence of severe anatomic risk factors...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28437495/a-practical-guide-to-understanding-and-treating-patellofemoral-pain
#2
John P Fulkerson
There is no shortcut to accurate diagnosis in the patellofemoral pain patient. Most important in the process is a desire and ability to specifically identify the structural and biomechanical origin of pain. This can be elusive and often requires a careful analysis of all factors affecting the patient, including documenting his or her specific history of pain origin and specific treatments to date, and acknowledging the patient's localization of the pain origin. Many patients can pinpoint the site of pain origin when given the time and encouragement to do so...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28437493/the-role-of-medial-patellofemoral-ligament-repair-and-imbrication
#3
Kyle R Duchman, Matthew J Bollier
Repair, reefing, and advancement of the medial patellofemoral ligament (MPFL) and medial retinacular structures can be performed as an isolated procedure or in conjunction with distal realignment procedures for patients with patellar instability. Although various operative techniques have been described, understanding the appropriate clinical indications and MPFL injury patterns ultimately determines the success or failure of the procedure. MPFL repair is best indicated in the acute setting, particularly if there is a patella- or femoral-based avulsion...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28437490/the-diagnosis-and-initial-treatment-of-patellofemoral-disorders
#4
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
https://www.readbyqxmd.com/read/28435557/internal-fixation-of-transverse-patella-fractures-using-cannulated-cancellous-screws-with-anterior-tension-band-wiring
#5
I Khan, M Y Dar, S Rashid, M F Butt
Aims: To evaluate the effectiveness and safety of anterior tension band wiring technique using two cannulated cancellous screws in patients with transverse (AO34-C1) or transverse with mildly comminuted (AO34-C2) patellar fractures. Materials and Methods: This is a prospective study of 25 patients with transverse fracture or transverse fracture with mildly comminuted patella fractures. All the patients were treated with open reduction and internal fixation using two parallel cannulated screws and 18G stainless steel wire as per the tension band principle...
July 2016: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28429403/accuracy-of-computed-tomographic-arthrography-for-assessment-of-articular-cartilage-defects-in-the-ovine-stifle
#6
Fanny Hontoir, Peter Clegg, Vincent Simon, Nathalie Kirschvink, Jean-Francois Nisolle, Jean-Michel Vandeweerd
Articular cartilage defects are one of the features of osteoarthritis in animals and humans. Early detection of cartilage defects is a challenge in clinical veterinary practice and also in translational research studies. An accurate, diagnostic imaging method would be desirable for detecting and following up lesions in specific anatomical regions of the articular surface. The current prospective experimental study aimed to describe the accuracy of computed tomographic arthrography (CTA) for detecting cartilage defects in a common animal model used for osteoarthritis research, the ovine stifle (knee, femoropatellar/femorotibial) joint...
April 20, 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/28419810/the-relationship-of-static-tibial-tubercle-trochlear-groove-measurement-and-dynamic-patellar-tracking
#7
Victor R Carlson, Frances T Sheehan, Aricia Shen, Lawrence Yao, Jennifer N Jackson, Barry P Boden
BACKGROUND: The tibial tubercle to trochlear groove (TT-TG) distance is used for screening patients with a variety of patellofemoral joint disorders to determine who may benefit from patellar medialization using a tibial tubercle osteotomy. Clinically, the TT-TG distance is predominately based on static imaging with the knee in full extension; however, the predictive ability of this measure for dynamic patellar tracking patterns is unknown. PURPOSE: To determine whether the static TT-TG distance can predict dynamic lateral displacement of the patella...
April 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28418810/relationship-of-trochlear-morphology-and-patellofemoral-joint-alignment-to-superolateral-hoffa-fat-pad-edema-on-mr-images-in-individuals-with-or-at-risk-for-osteoarthritis-of-the-knee-the-most-study
#8
Rafael Widjajahakim, Michael Roux, Mohamed Jarraya, Frank W Roemer, Tuhina Neogi, John A Lynch, Cora E Lewis, James C Torner, David T Felson, Ali Guermazi, Joshua J Stefanik
Purpose To determine the relationship of patellofemoral joint alignment and trochlear morphology to superolateral Hoffa fat pad (SHFP) edema on magnetic resonance (MR) images in older adults with or at risk for osteoarthritis of the knee. Materials and Methods Institutional review board approval and written informed consent were obtained from all subjects. The Multicenter Osteoarthritis Study is a prospective cohort study of older adults with or at risk for osteoarthritis of the knee. Subjects were recruited from Birmingham, Alabama, and Iowa City, Iowa...
April 17, 2017: Radiology
https://www.readbyqxmd.com/read/28417444/a-retinaculum-sparing-surgical-approach-preserves-porcine-stifle-joint-cartilage-in-an-experimental-animal-model-of-cartilage-repair
#9
Marcelo B Bonadio, James M Friedman, Mackenzie L Sennett, Robert L Mauck, George R Dodge, Henning Madry
BACKGROUND: This study compares a traditional parapatellar retinaculum-sacrificing arthrotomy to a retinaculum-sparing arthrotomy in a porcine stifle joint as a cartilage repair model. FINDINGS: Surgical exposure of the femoral trochlea of ten Yucatan pigs stifle joint was performed using either a traditional medial parapatellar approach with retinaculum incision and luxation of the patella (n = 5) or a minimally invasive (MIS) approach which spared the patellar retinaculum (n = 5)...
December 2017: Journal of Experimental Orthopaedics
https://www.readbyqxmd.com/read/28417183/patella-height-is-not-altered-by-descending-medial-open-wedge-high-tibial-osteotomy-hto-compared-to-ascending-hto
#10
Matthias Krause, Tobias Claus Drenck, Alexander Korthaus, Achim Preiss, Karl-Heinz Frosch, Ralph Akoto
PURPOSE: The primary purpose of the study was to gain insight into geometric changes of the patellar height (PH) and posterior tibial slope (PTS) after a biplanar ascending medial open-wedge high tibial osteotomy (HTO) compared to biplanar descending medial open-wedge HTO in patients with genu varum. METHODS: Sixty-four patients (mean age 45.2 ± 8.7 years, females n = 24, males n = 40) with varus malalignment and medial gonarthrosis were retrospectively studied...
April 17, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28417049/morphometric-study-of-tensor-of-vastus-intermedius-in-south-indian-population
#11
Raveendranath Veeramani, Dhivyalakshmi Gnanasekaran
Tensor of vastus intermedius is a newly discovered muscle located between vastus lateralis and vastus intermedius. The purpose of this study was to investigate the detailed morphology of tensor of vastus intermedius, specifically to provide data pertaining to the attachments, innervations, variation in the types and its morphometry in South Indian population. The tensor of vastus intermedius was studied in thirty six cadaveric lower limbs using macrodissection techniques. The origin of the muscle was from upper part of intertrochanteric line and anterior part of greater trochanter of femur inserted to medial aspect of upper border of patella...
March 2017: Anatomy & Cell Biology
https://www.readbyqxmd.com/read/28416494/long-term-clinical-course-of-normotensive-preperimetric-glaucoma
#12
Akira Sawada, Yusuke Manabe, Tetsuya Yamamoto, Chisato Nagata
AIMS: To evaluate the long-term clinical course of normotensive preperimetric glaucoma (PPG). METHODS: We retrospectively analysed 130 eyes of 130 patients initially diagnosed as having preperimetric normal tension glaucoma and followed these cases for at least 5 years with reliable visual field (VF) examinations by standard automated perimetry. When the VF defect (VFD) met Anderson-Patella's criteria on three or more consecutive examinations, and consistently met the criteria on subsequent examinations, we concluded that a glaucomatous VFD was present...
April 17, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/28413065/outcome-of-low-profile-mesh-plate-in-management-of-comminuted-displaced-fracture-patella
#13
Mohamed S Singer, Abdelsamie M Halawa, Adel Adawy
PURPOSE: To assess the clinical results of using mesh plate in management of displaced comminuted fracture patella. PATIENTS AND METHODS: Between January 2014 and October 2015, nine patients with closed displaced comminuted fracture patella were fixed using mesh plate and 2mm mini screws. RESULTS: All fractures united after an average of 10 weeks. At final follow-up of an average 19.6 months, average postoperative Lysholm score was 89.1±4...
March 23, 2017: Injury
https://www.readbyqxmd.com/read/28411875/association-between-lateral-patellar-osteoarthrosis-and-knee-morphology-and-alignment-in-young-adults
#14
R Sebro, S Weintraub
AIM: To assess whether patellar and trochlea morphology and patellar alignment are associated with lateral patellar osteoarthrosis/chondrosis (OAC) in young adults. MATERIALS AND METHODS: Magnetic resonance imaging (MRI) images of 183 subjects (81 cases, 102 controls) aged 21-35 years of age were evaluated. Quantitative measurements of patella and trochlea morphology and patellar alignment were obtained. Axial and sagittal MRI images were reviewed to grade the severity of focal cartilage defects along the lateral facet of the patella...
April 12, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28409075/bilateral-patella-dislocation-after-total-knee-arthroplasty-a-report-of-two-cases-and-a-review-of-the-literature
#15
Raju Vaishya, Amit Kumar Agarwal, Sagar Panthi, Vipul Vijay, Abhishek Vaish
Patellar instability is a known but catastrophic complication after total knee arthroplasty (TKA). The occurrence of bilateral dislocation of the patella after TKA is exceedingly rare. It may present as anterior knee pain, and diagnosis can easily be made clinically or by plain radiographs. Early diagnosis with surgical realignment and repair of the extensor mechanism can provide good outcomes after this complication.
March 4, 2017: Curēus
https://www.readbyqxmd.com/read/28408084/semiextended-approach-for-intramedullary-nailing-via-a-patellar-eversion-technique-for-tibial-shaft-fractures-evaluation-of-the-patellofemoral-joint
#16
Tomohiro Yasuda, Shu Obara, Junji Hayashi, Masayuki Arai, Kaoru Sato
Intramedullary nail fixation is a common treatment for tibial-shaft fractures, and it offers a better functional prognosis than other conservative treatments. Currently, the primary approach employed during intramedullary nail insertion is the semiextended position is the suprapatellar approach, which involves a vertical incision of the quadriceps tendon Damage to the patellofemoral joint cartilage has been highlighted as a drawback associated with this approach. To avoid this issue, we perform surgery using the patellar eversion technique and a soft sleeve...
March 25, 2017: Injury
https://www.readbyqxmd.com/read/28400668/nontuberculous-mycobacterial-infection-of-the-musculoskeletal-system-in-immunocompetent-hosts
#17
Manit K Gundavda, Hitendra G Patil, Vikas M Agashe, Rajeev Soman, Camilla Rodriques, Ramesh B Deshpande
BACKGROUND: Nontuberculous mycobacteria (NTM) were considered saprophytic organisms for many years but now are recognized as human pathogens. Although humans are routinely exposed to NTM, the rate of clinical infection is low. Such infections usually occur in the elderly and in patients who are immunocompromised. However, there has been an increasing incidence in recent years of infections in immunocompetent hosts. NTM infections in immunocompetent individuals are secondary to direct inoculation either contamination from surgical procedures or penetrating injuries rather than hematogenous dissemination...
March 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28397004/the-frequency-of-cartilage-lesions-in-non-injured-knees-with-symptomatic-meniscus-tears-results-from-an-arthroscopic-and-nir-near-infrared-spectroscopic-investigation
#18
Gunter Spahn, Holger Plettenberg, Martin Hoffmann, Holm-Torsten Klemm, Christoph Brochhausen-Delius, Gunther O Hofmann
INTRODUCTION: Are symptomatic tear injuries to the menisci of the knee frequently or always associated with cartilage damage to the corresponding articular surfaces and other joint surfaces, respectively? METHODS: A total of 137 patients (medial n = 127; lateral n = 10) underwent a meniscus resection. These patients showed no signs of a clear radiographic arthrosis and no MRI-detectable cartilage lesions > grade II. Traumatic injury was ruled out with a thorough medical history...
April 10, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28391723/the-impact-of-patellar-tendinopathy-on-sports-and-work-performance-in-active-athletes
#19
Astrid J De Vries, Wendy Koolhaas, Johannes Zwerver, Ron L Diercks, Kari Nieuwenhuis, Henk Van Der Worp, Sandra Brouwer, Inge Van Den Akker-Scheek
Greater insight into sports and work performance of athletes with patellar tendinopathy (PT) will help establish the severity of this common overuse injury. Primary aim of this study is to investigate the impact of PT on sports and work performance. Seventy seven active athletes with PT (50 males; age 28.1 ± 8.2 years; Victorian Institute of Sports Assessment Patella 56.4 ± 12.3) participated in this survey. Sports performance, work ability and work productivity were assessed using the Oslo Sports Trauma Research Center overuse injury questionnaire, the single-item Work Ability Index and the Quantity and Quality questionnaire, respectively...
April 10, 2017: Research in Sports Medicine
https://www.readbyqxmd.com/read/28390890/impact-of-soft-tissue-imbalance-on-knee-flexion-angle-after-posterior-stabilized-total-knee-arthroplasty
#20
Sachiyuki Tsukada, Tomoko Fujii, Motohiro Wakui
BACKGROUND: This study was performed to assess the impact of soft tissue imbalance on the knee flexion angle 2 years after posterior stabilized total knee arthroplasty (TKA). METHODS: A total of 329 consecutive varus knees were included to assess the association of knee flexion angle 2 years after TKA with preoperative, intraoperative, and postoperative variables. All intraoperative soft tissue measurements were performed by a single surgeon under spinal anesthesia in a standardized manner including the subvastus approach, reduced patella, and without use of a pneumonic tourniquet...
March 16, 2017: Journal of Arthroplasty
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