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Treatment for patellar tendonitis

Brian R Waterman, William Arroyo, Eric J Cotter, Michael A Zacchilli, E'Stephan J Garcia, Brett D Owens
Background: There remains a debate over whether to retain the index anterior cruciate ligament (ACL) graft in the setting of septic arthritis. Purpose: To evaluate and compare clinical outcomes for the treatment of septic arthritis after ACL reconstruction (ACLR) in those with and without early graft retention. Study Design: Case series; Level of evidence, 4. Methods: The Military Health System was queried for all ACLR procedures performed between 2007 and 2013...
March 2018: Orthopaedic Journal of Sports Medicine
Sergio Barroso Rosa, Zaid Bahho, Kenji Doma, Kaushik Hazratwala, Peter McEwen, Varaguna Manoharan, Brent Matthews, Matthew Wilkinson
INTRODUCTION: Patella alta (PA) is one of the primary correctable risk factors for patellofemoral instability (PFI). Both an accurate diagnosis of PA and a clinically relevant target for correction are necessary for optimal treatment. An ideal test for PA should relate the position of the patella to the femur rather than tibia, should do so with the quadriceps contracted and the patellar tendon under tension and should have good sensitivity and specificity. None of the currently used radiographic tests PA meet these criteria, most of which are based on the position of the patella relative to the tibia with diagnostic cutoffs based on 2 standard deviations from the mean rather than optimal sensitivity and specificity...
March 15, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Brent T Wise, Greg Erens, Aidin Eslam Pour, Thomas L Bradbury, James R Roberson
PURPOSE: Disruption of the extensor mechanism after total knee arthroplasty (TKA) is an infrequent but devastating complication. Presently, limited data exists regarding the optimal treatment and long-term outcomes. METHODS: Patients who underwent reconstruction of their knee extensor mechanism using Achilles tendon allograft following TKA between January 2003 and January 2012 were identified. Sixteen patients with 17 reconstructions (10 patellar tendons, 7 quadriceps tendons) were studied...
March 7, 2018: International Orthopaedics
Michael P Gaspar, Julie E Adams, Ralph C Zohn, Sidney M Jacoby, Randall W Culp, A Lee Osterman, Patrick M Kane
BACKGROUND: The purpose of this study was to report our long-term outcomes following reconstruction of the forearm interosseous membrane (IOM) with bone-patellar tendon-bone (BPTB) graft for treatment of chronic Essex-Lopresti injuries. METHODS: We identified 33 patients who underwent IOM reconstruction with BPTB graft for chronic Essex-Lopresti injuries over a 20-year treatment interval. Twenty male and 13 female patients, with a mean age of 42.1 years (range, 19 to 73 years) and a minimum follow-up interval of 5 years, were included...
March 7, 2018: Journal of Bone and Joint Surgery. American Volume
William T Kent, Trevor J Shelton, Jonathan Eastman
PURPOSE: Floating knee injuries are relatively uncommon injuries. We report the prevalence, location, and severity of heterotopic ossification (HO) around the knee in patients treated with antegrade tibial intramedullary nailing and ipsilateral antegrade versus retrograde femoral intramedullary nailing as well as how the severity of HO around the knee affects knee range of motion (ROM). METHODS: From 2004 to 2014, 26 floating knee injuries were included. Radiographs were reviewed to determine presence, location, and severity of HO...
February 22, 2018: International Orthopaedics
John B Schrock, Trevor J Carver, Matthew J Kraeutler, Eric C McCarty
BACKGROUND: Previous studies have analyzed the treatment patterns used to manage injuries in National Football League (NFL) players. HYPOTHESIS: Treatment patterns for injuries in NFL players will have changed over the study period. STUDY DESIGN: Descriptive epidemiology study. LEVEL OF EVIDENCE: Level 5. METHODS: The head orthopaedic team physicians for all 32 NFL teams were asked to complete a survey containing questions regarding experience as team physician, medical coverage of the team, and treatment preferences for some of the most common injuries occurring in football players...
February 1, 2018: Sports Health
Daan T van Yperen, Max Reijman, Eline M van Es, Sita M A Bierma-Zeinstra, Duncan E Meuffels
BACKGROUND: An anterior cruciate ligament (ACL) rupture has major consequences at midterm follow-up, with an increasing chance of developing an old knee in a young patient. The long-term (≥20 years) effects of the operative and nonoperative treatment of ACL ruptures are still unclear. PURPOSE: To compare the long-term treatment outcomes of operative versus nonoperative treatment of ACL ruptures in high-level athletes. STUDY DESIGN: Cohort study; Level of evidence, 2...
February 1, 2018: American Journal of Sports Medicine
Kengo Harato, Shu Kobayashi, Kazuhiko Udagawa, Yu Iwama, Ko Masumoto, Hiroyuki Enomoto, Yasuo Niki
Although surgical treatment is the gold standard for chronic patellar tendon rupture, the technique of patellar tendon reconstruction is still difficult. Basically, good clinical results of surgical repair for acute patellar tendon rupture have been reported. However, the results of reconstructive surgery for chronic patellar tendon rupture are still inconsistent. Some surgical options have been previously reported. For example, surgeons need to choose between 1- and 2-stage reconstruction. Furthermore, contralateral bone-tendon-bone graft, ipsilateral semitendinosus tendon graft, Achilles tendon allograft, and an artificial ligament have been used to reconstruct the patellar tendon...
October 2017: Arthroscopy Techniques
Chuan-Qiang Shao, Chang-Chun Chen, Chun-Cheng Zhao, Hong-Mei Yang, Yan-Zhong Kang
OBJECTIVE: To investigate surgical method and clinical curative effects of medial patellofemoral ligament (MPFL) reconstruction with great adductor muscular tendon in treating teenagers' recurrent patellar dislocation. METHODS: From May 2012 to September 2014, 19 patients with recurrent dislocation of patellar, including 6 males and 13 females with an average of 16 years old (ranged from 13 to 17 years), the courses of disease ranged from 3 to 18 months(averaged 6 months)...
June 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Lei Tan, Tiejun Wang, Yan-Hui Li, Tianye Yang, Baohui Hao, Dong Zhu, Da-Hui Sun
RATIONALE: Retrograde femoral nailing was one of the most important treatment means for distal femoral shaft fracture. However, studies regarding heterotopic ossification of the patellar tendon after retrograde intramedullary nailing for distal femoral shaft fracture are limited. We herein present a rare complication, namely heterotopic ossification of the patellar tendon, after retrograde intramedullary nailing for displaced femoral shaft fracture. PATIENT CONCERNS: We present a case of 25-year-old male with displaced femoral shaft fracture who was treated by retrograde intramedullary nailing...
November 2017: Medicine (Baltimore)
Ryan J McNeilan, Joshua S Everhart, Patrick K Mescher, Moneer Abouljoud, Robert A Magnussen, David C Flanigan
PURPOSE: To determine whether graft selection or patient age affects the following after isolated medial patellofemoral ligament (MPFL) reconstruction: (1) rates of recurrent instability, (2) rates of postoperative complications (other than instability), and (3) subjective symptom improvement. METHODS: A systematic search identified studies reporting outcomes for isolated MPFL reconstruction. Rates of recurrent instability, subjective Kujala knee function scores, and complications were tabulated...
January 20, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
João Espregueira-Mendes, Renato Andrade, M J S Fredrick Michael, André Sarmento, Nuno Sevivas, Rui Rocha, Ricardo Bastos Filho
Patellar tendon ruptures can lead to significant functional deficiency of the extensor mechanism of the knee. These injuries, because of their inherent nature and associated complications, may require a complex treatment and remains a challenge for orthopaedic surgeons. Current surgical techniques present significant complications, including patellar fracture, damage to patellar articular cartilage, and abnormal patella height. This note describes a surgical technique to provide an additional reinforcement to the patellar tendon repair with a semitendinous autograft, without the necessity to perform any transosseous tunnels at the patella bone...
December 2017: Arthroscopy Techniques
Ravi Mittal, Avtar Singh Balawat, Vikrant Manhas, Amit Roy, Navin Kumar Singh
Background: Habitual patellar dislocation is a rare condition affecting children. The growth plates are open in children and any surgical intervention should take that in to consideration. We are describing a modified four in one technique for habitual patellar dislocation, which is a soft tissue procedure without the use of any implant. Method: In this study we included 6 children (4 females and 2 males) with open growth plates, which were diagnosed with habitual patellar dislocation...
November 2017: Journal of Clinical Orthopaedics and Trauma
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
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
Elizabeth R Boyer, Jean L Stout, Jennifer C Laine, Sarah M Gutknecht, Lucas H Araujo de Oliveira, Meghan E Munger, Michael H Schwartz, Tom F Novacheck
BACKGROUND: We examined long-term outcomes across the domains of the International Classification of Functioning, Disability and Health for 2 groups of participants with cerebral palsy who demonstrated crouch gait at clinical gait analysis. One group underwent a distal femoral extension osteotomy with patellar tendon advancement (DFEO + PTA). The other group received other treatments (non-DFEO + PTA). METHODS: Fifty-one participants returned for a long-term gait analysis, physical examination, energy consumption test, knee radiographs, and questionnaires (median, 13 years post-DFEO + PTA or post-baseline [range, 8 to 21 years])...
January 3, 2018: Journal of Bone and Joint Surgery. American Volume
Trevor J Carver, John B Schrock, Matthew J Kraeutler, Eric C McCarty
BACKGROUND: Previous studies have analyzed the treatment patterns used to manage injuries in National Collegiate Athletic Association (NCAA) Division I football players. HYPOTHESIS: Treatment patterns used to manage injuries in NCAA Division I football players will have changed over the study period. STUDY DESIGN: Descriptive epidemiology study. LEVEL OF EVIDENCE: Level 5. METHODS: The head orthopaedic team physicians for all 128 NCAA Division I football teams were asked to complete a survey containing questions regarding experience as team physician, medical coverage of the team, reimbursement issues, and treatment preferences for some of the most common injuries occurring in football players...
January 1, 2018: Sports Health
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
Ebonie Rio, Craig Purdam, Michael Girdwood, Jill Cook
OBJECTIVE: To investigate the effectiveness of an isometric squat exercise using a portable belt, on patellar tendon pain and function, in athletes during their competitive season. DESIGN: Case series with no requirements to change any aspect of games or training. The object of this pragmatic study was to investigate this intervention in addition to "usual management." A control or sham intervention was considered unacceptable to teams. SETTING: In-season...
November 27, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Per-Henrik Randsborg, Ida Rashida Kahn Bukholm, Rune Bruhn Jakobsen
PURPOSE: To assess the most common reasons for complaints following anterior cruciate ligament (ACL) injuries reported to the Norwegian System of Patient Injury Compensation (NPE), and to view these complaints in light of the ACL reconstructions (ACL-Rs) reported to the Norwegian Knee Ligament Registry (NKLR). METHOD: Data from the NPE and the NKLR were collected for the study period (2005-2015). The age and gender and type of complaint and reason for granted compensation were collected from the NPE, while the graft choice and total number of ACL-R were collected from the NKLR...
February 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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