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Patellar instability

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https://www.readbyqxmd.com/read/29457387/-multi-point-fixation-with-absorbable-cartilage-screws-for-the-treatment-of-osteochondral-fracture-caused-by-patellar-instability
#1
Xu-Hui Zhang, Lei Xia, Gang-Tao Wang, Tan Li
OBJECTIVE: To study clinical effects of multi-point fixation with bioabsorbable cartilage screws for the treatment of osteochondral fracture caused by patellar instability. METHODS: During the period from August 2014 to Steptember 2016, there were 21 patients with osteochondral fracture caused by patellar dislocation, including 7 males and 14 females, ranging in age from 12 to 42 years old, with an average of 27 years old. During the operation, free fractures fragments of cartilage were found with a open surgery, and the patients were treated with fixation by absorbable cartilage screws combined with lateral retinaculum release and medial retinaculum shrinkage...
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29438635/twenty-year-follow-up-study-comparing-operative-versus-nonoperative-treatment-of-anterior-cruciate-ligament-ruptures-in-high-level-athletes
#2
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
https://www.readbyqxmd.com/read/29413194/editorial-commentary-medial-patellofemoral-ligament-reconstruction-for-knee-patellar-instability-when-are-soft-tissue-procedures-not-enough
#3
EDITORIAL
Miho J Tanaka
Medial patellofemoral ligament reconstruction is commonly performed to treat patellofemoral instability by recreating the static soft tissue restraint to lateral patellar translation. Concurrent tibial tuberosity osteotomy can be indicated in the setting of bony malalignment, such as a lateralized tuberosity or patella alta; however, the exact indications for this have been difficult to define due to the multifactorial nature of this problem. Understanding the role of tuberosity lateralization and patella alta on the function of medial patellofemoral ligament grafts can help to identify the interplay of some factors that contribute to patellar stability and improve our understanding of when and how concurrent tibial tuberosity osteotomy may be indicated...
February 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29410197/patellofemoral-reconstruction-for-patellar-instability-with-patella-alta-in-middle-aged-patients-clinical-outcomes
#4
S Otsuki, Y Okamoto, T Murakami, K Nakagawa, N Okuno, H Wakama, M Neo
INTRODUCTION: Although several surgical treatments for patellar instability with patella alta have been reported, the clinical outcomes and optimal surgical procedures for patellar instability with patella alta in middle-aged patients are still controversial. We hypothesized that optimal surgical procedures for patellar instability with patella alta in middle-aged patients may induce good clinical outcomes with better patellofemoral geometry. MATERIALS AND METHODS: Twelve middle-aged patients with a mean age of 44 years (range: 40-55 years), who presented with patellar instability and patella alta, were treated with a combination of several surgeries, such as medial patellofemoral ligament (MPFL) reconstruction, trochleoplasty, lateral release, and three-dimensional transfer of the tibial tuberosity, based on a surgical algorithm...
February 1, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29409075/the-pediatric-patella-normal-development-anatomical-variants-and-malformations-stability-imaging-and-injury-patterns
#5
Ezekiel Maloney, A Luana Stanescu, Anh-Vu Ngo, Marguerite T Parisi, Ramesh S Iyer
We discuss the pediatric patella, with an emphasis on diagnostic imaging. Topics include normal patellar development, anatomical variants and their physiologic significance, genetic syndromes that alter the appearance of the patella, physiology of patellar tracking and stability, patellofemoral instability, and injury patterns and classification. Recognition of appropriate development on imaging prevents diagnostic error and unnecessary evaluation. Knowledge of the pertinent features of syndromes associated with morphological patellar abnormalities can aid in generating a succinct and relevant differential diagnosis...
February 2018: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/29399590/medial-patellofemoral-ligament-reconstruction-reduces-radiographic-measures-of-patella-alta-in-adults
#6
Jarret M Woodmass, Nick R Johnson, Robert A Cates, Aaron J Krych, Michael J Stuart, Diane L Dahm
Background: Patellar height has long been considered a risk factor for patellofemoral instability. However, recent pediatric literature demonstrated a reduction in patellar height measurements following medial patellofemoral ligament (MPFL) reconstruction. Purpose: To assess the mean change in patellar height and the percentage of skeletally mature patients with patellar height ratios reduced to within-normal limits following MPFL reconstruction. Study Design: Case series; Level of evidence, 4...
January 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29372384/validation-of-the-german-version-of-the-kujala-score-in-patients-with-patellofemoral-instability-a-prospective-multi-centre-study
#7
D Dammerer, M C Liebensteiner, U M Kujala, K Emmanuel, S Kopf, F Dirisamer, J M Giesinger
INTRODUCTION: The Kujala score is the most frequently used questionnaire for patellofemoral disorders like pain, instability or osteoarthritis. Unfortunately, we are not aware of a validated German version of the Kujala score. The aim of our study was the translation and linguistic validation of the Kujala score in German-speaking patients with patella instability and the assessment of its measurement characteristics. MATERIALS AND METHODS: The German Kujala score was developed in several steps of translation...
January 25, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29366741/graft-choice-in-isolated-medial-patellofemoral-ligament-reconstruction-a-systematic-review-with-meta-analysis-of-rates-of-recurrent-instability-and-patient-reported-outcomes-for-autograft-allograft-and-synthetic-options
#8
REVIEW
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
https://www.readbyqxmd.com/read/29354460/reconstruction-of-the-medial-patellofemoral-ligament
#9
Juan C Monllau, Juan I Erquicia, Maximiliano Ibañez, Pablo E Gelber, Federico Ibañez, Angel Masferrer-Pino, Xavier Pelfort
Patellar instability has been shown to be associated with different major factors. However, studies have demonstrated that soft tissue reconstructions are adequate enough to reestablish patellar constraint. In recent years, the medial patellofemoral ligament has been recognized as the primary passive restraint for lateral translation of the patella. Their reconstruction has gain popularity as the procedure is quite simple and fast. Although several surgical techniques have been described for their reconstruction, no clear consensus has been reached as to which is best...
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29354438/osteotomy-of-the-tibial-tubercle-for-anteromedialization
#10
Márcio B Ferrari, George Sanchez, Nicholas I Kennedy, Anthony Sanchez, Katrina Schantz, Matthew T Provencher
Patellofemoral instability is a common cause of anterior knee pain, especially in younger and more active patients. Treatment of instability varies considerably depending on the patient's symptoms as well as the cause of the instability. Lateral instability has a particularly broad spectrum of treatment algorithms including patellar taping, arthroscopy, lateral release, medial patellofemoral ligament (MPFL) reconstruction, MPFL repair, and osteotomy of the tibial tubercle for realignment. Acute traumatic lateral dislocation is commonly associated with a tear of the MPFL and, therefore, needs to be addressed...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349990/-experimentation-of-the-relationship-between-medial-or-lateral-patellar-stabilizer-and-patellofemoral-stabilization
#11
Xing-Sen Liang, Zheng-Hong Yu, Yi-Kai Li, Ying-Ping Jiang, Xian-Wu Chen, Min Huang
OBJECTIVE: To study the contribution of medial or lateral stabilizer to the stability of the patella, to explore the function and effect of releasing the LPR clinically and to provide a biomechanical basis for the clinical treatment of patellar instability(PI). METHODS: The quadriceps femoris of 6 fresh human cadaver knees were loaded to simulate a normal condition of muscle strength. First the loading force was measured and recorded, which subluxated the patella with the different degrees of knee flexion...
April 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29349031/modified-elmslie-trillat-procedure-for-distal-realignment-of-patella-tendon
#12
Ricardo Bastos Filho, Alberto Monteiro, Renato Andrade, M J S Fredrick Michael, Nuno Sevivas, Bruno Pereira, André Sarmento, João Espregueira-Mendes
Patellofemoral dysfunction, due to either a patellofemoral malalignment or patellar instability, is a complex and debilitating condition that significantly decreases the knee function. Conservative management may yield significant clinical outcomes; however, when morphologic anomalies are identified, the surgical approach should be employed. Hence, several surgical procedures have been described in the scientific literature aiming the correction of underlying extensor mechanism malalignments. Still, the rate of complications is higher than desirable...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349001/medial-closing-wedge-distal-femoral-osteotomy-with-medial-patellofemoral-ligament-imbrication-for-genu-valgum-with-lateral-patellar-instability
#13
Orlando D Sabbag, Jarret M Woodmass, Isabella T Wu, Aaron J Krych, Michael J Stuart
A varus-producing distal femoral osteotomy (DFO) is an effective technique for the treatment of lateral patellar instability (LPI) in patients with concomitant moderate to severe valgus malalignment. Patellar maltracking and subluxation are corrected via neutralization of some of the laterally directed forces on the patella due to the valgus deformity. This can be accomplished with a distal femoral lateral opening-wedge or medial closing-wedge osteotomy and medial soft tissue stabilization. A medial closing-wedge osteotomy offers the advantages of immediate weight bearing and a single incision in cases requiring patellofemoral soft tissue stabilization...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29339848/habitual-patellar-dislocation-in-children-results-of-surgical-treatment-by-modified-four-in-one-technique
#14
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
https://www.readbyqxmd.com/read/29327545/-study-on-therapeutic-effects-of-arthroscopic-repair-on-medial-patellar-retinaculum-acute-injury
#15
Min Ren, Ping Zhen, Yu-Jun Fang, Xiao-Long Ren, Chen-Po Dang, Fei-Yi Hou, Shen-Song Li
OBJECTIVE: To accurately define the injury position of medial patellar retinaculum with acute injury under the guiding of high frequency ultrasonography, and to study therapeutic effects of suture operation on medial patellar retinaculum in the injuried position. METHODS: From June 2009 to March 2014, there were 17 patients with acute patellar dislocation, 6 males and 11 females with average age of (16.2±6.2) years old. The duration time of patellar dislocation was 2 weeks...
January 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29324527/distal-femoral-valgus-and-recurrent-traumatic-patellar-instability-is-an-isolated-varus-producing-distal-femoral-osteotomy-a-treatment-option
#16
Philip L Wilson, Sheena R Black, Henry B Ellis, David A Podeszwa
BACKGROUND: Genu valgum, a risk factor for recurrent patellofemoral instability, can be addressed with a varus producing distal femoral osteotomy (DFO). The purpose of this study is to report 3-year clinical and radiographic outcomes on a series of skeletally mature adolescents with traumatic patellofemoral instability and genu valgum who underwent a varus producing DFO. METHODS: Consecutive patients (n=11) who underwent an isolated DFO for recurrent traumatic patellar instability over a 4-year study period (2009 to 2012) were reviewed...
January 10, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29322270/recent-developments-in-evaluation-and-treatment-of-lateral-patellar-instability
#17
REVIEW
Alexander Zimmerer, Christian Sobau, Peter Balcarek
Recent years have been characterized by an ongoing increase in knowledge about the different conditions associated with lateral patellar instability. This increase in knowledge provides differentiated approaches to the various pathologies of the patellofemoral joint. Though current guidelines consider medial patellofemoral ligament (MPFL) reconstruction the basic treatment for the unstable patella, medial soft tissue-stabilizing procedures should not be interpreted as stand-alone procedures in every case. The influence of different anatomical factors leading to patellar instability, as well as their impact on clinical outcome measures, is becoming increasingly apparent and deserves further attention...
January 10, 2018: Journal of Experimental Orthopaedics
https://www.readbyqxmd.com/read/29312853/deepening-trochleoplasty-combined-with-balanced-medial-patellofemoral-ligament-reconstruction-for-an-adequate-graft-tensioning
#18
Lars V von Engelhardt, Pia Weskamp, Matthias Lahner, Gunter Spahn, Joerg Jerosch
AIM: To evaluate our modified deepening trochleoplasty combined with a balanced medial patellofemoral ligament (MPFL) reconstruction for soft tissue alignement. METHODS: Thirty-three knees with with recurrent patellar dislocations and a trochlear dysplasia in 30 patients (m/f = 12/21, mean age 24 ± 9 years) underwent a combination of a modified deepening trochleoplasty and a balanced MPFL reconstruction for a medial soft tissue alignement. After a mean follow-up period of 29 ± 23 mo, patients' return to sports, possible complications as well as the clinical outcomes using the Kujala, International Knee Documentation Committee (IKDC) and Lysholm scoring were evaluated...
December 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/29312850/anterolateral-rotatory-instability-in-vivo-correlates-tunnel-position-after-anterior-cruciate-ligament-reconstruction-using-bone-patellar-tendon-bone-graft
#19
Yasutaka Tashiro, Ken Okazaki, Koji Murakami, Hirokazu Matsubara, Kanji Osaki, Yukihide Iwamoto, Yasuharu Nakashima
AIM: To quantitatively assess rotatory and anterior-posterior instability in vivo after anterior cruciate ligament (ACL) reconstruction using bone-patellar tendon-bone (BTB) autografts, and to clarify the influence of tunnel positions on the knee stability. METHODS: Single-bundle ACL reconstruction with BTB autograft was performed on 50 patients with a mean age of 28 years using the trans-tibial (TT) ( n = 20) and trans-portal (TP) ( n = 30) techniques. Femoral and tibial tunnel positions were identified from the high-resolution 3D-CT bone models two weeks after surgery...
December 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/29309452/a-systematic-review-of-21-tibial-tubercle-osteotomy-studies-and-more-than-1000-knees-indications-clinical-outcomes-complications-and-reoperations
#20
Bryan M Saltzman, Allison Rao, Brandon J Erickson, Gregory L Cvetanovich, David Levy, Bernard R Bach, Brian J Cole
Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched the literature for tibial tubercle osteotomy (TTO) studies and systematically reviewed them for indications, clinical outcomes, complications, and reoperations. Therapeutic clinical studies that reported TTO indications, operative findings, and outcomes were included. Quality of each study was assessed with the modified Coleman methodology score (MCMS). Twenty-one studies (976 patients, 1055 knees) were included in the analysis...
November 2017: American Journal of Orthopedics
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