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Patellar instability

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https://www.readbyqxmd.com/read/28744079/evaluation-of-patella-alta-using-mri-measurements-in-adolescents
#1
Barış Yılmaz, Guzelali Ozdemir, Evrim Sirin, Esin D Cicek, Burcu S Anıl, Goncagul Bulbun
PURPOSE: To determine whether or not there were any differences in the measurement techniques used by orthopedic and radiology specialists in the evaluation of magnetic resonance (MR) images for the diagnosis of patella alta in adolescents. MATERIALS AND METHODS: Evaluations were performed by three orthopedic specialists (Group I) and three radiology specialists (Group II) regarding the presence of patella alta in 40 adolescents cases using the Insall-Salvati, Caton-Deschamps, Blackburne-Peel, and modified Insall-Salvati indices on MR images obtained to diagnose patellar instability...
April 2017: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/28702749/evaluation-of-different-surgical-methods-in-treating-recurrent-patella-dislocation-after-three-dimensional-reconstruction
#2
Hao Du, Xiao-Xiao Tian, Fa-Qi Guo, Xiang-Ming Li, Tao-Tao Ji, Bin Li, Tong-Sen Li
PURPOSE: Recurrent patella dislocation (RPD) is the most common complication of patellar instability. The effects of different surgical techniques on the outcome of RPD treatments remain unclear. This study was conducted to compare the effects of three surgical techniques in treating RPD by three-dimensional (3D) reconstruction from computed tomography (CT) scans. METHODS: Sixty-eight patients with RPD and no previous surgical treatments who attended our hospital between October 2010 and 2013 were enrolled and randomly assigned into three groups: (1) medial patellofemoral ligament (MPFL) reconstruction and medial patellar retinaculum (MPR) plication group; (2) lateral patellar retinaculum (LPR) release and MPR plication group; and (3) MPFL reconstruction and LPR release group...
July 12, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28696495/robotic-arm-assisted-total-knee-arthroplasty-demonstrated-soft-tissue-protection
#3
Anton Khlopas, Morad Chughtai, Emily L Hampp, Laura Y Scholl, Michael Prieto, Ta-Cheng Chang, Abdullah Abbasi, Manoshi Bhowmik-Stoker, Jason Otto, David J Jacofsky, Michael A Mont
INTRODUCTION: While total knee arthroplasty (TKA) procedures have demonstrated clinical success, occasionally intraoperative complications can occur. Collateral or posterior cruciate ligament injury, instability, extensor mechanism disruption, and tibiofemoral or patellofemoral dislocation are among a few of the intraoperatively driven adverse events prevalently ranked by The Knee Society. Robotic-arm assisted TKA (RATKA) provides a surgeon the ability to three-dimensionally plan a TKA and use intraoperative visual, auditory, and tactile feedback to ensure that only the desired bone cuts are made...
July 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28693590/patella-morphological-alteration-after-patella-instability-in-growing-rabbits
#4
Jinghui Niu, Qi Qi, Yingzhen Niu, Conglei Dong, Zhenyue Dong, Peng Cui, Fei Wang
BACKGROUND: The shape of the patella has been considered to be a predisposing factor resulting in patellar instability, but the effects of abnormal patella position during its development are unclear. The present study evaluated patellar morphological changes after patella instability and evaluated the influence of patellar instability on the patella shape. METHODS: Twenty rabbits that were 2 months old were included in the study. The left knee of each rabbit, defined as the experimental group (N = 20 knees/group), underwent a medial soft tissue restraint release...
July 11, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28678520/return-to-play-guidelines-after-medial-patellofemoral-ligament-surgery-for-recurrent-patellar-instability-a-systematic-review
#5
Saif Zaman, Alex White, Weilong J Shi, Kevin B Freedman, Christopher C Dodson
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction and repair continue to gain acceptance as viable treatment options for recurrent patellar instability in patients who wish to return to sports after surgery. Return-to-play guidelines with objective or subjective criteria for athletes after MPFL surgery, however, have not been uniformly defined. PURPOSE: To determine whether a concise and objective protocol exists that may help athletes return to their sport more safely after MPFL surgery...
June 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28666647/objective-quantification-of-trochlear-dysp-lasia-assessment-of-the-difference-in-morphology-between-control-and-chronic-patellofemoral-instability-patients
#6
Andreas Voss, Sangmin Ryan Shin, Akira M Murakami, Mark P Cote, Andrea Achtnich, Elmar Herbst, Anthony A Schepsis, Cory Edgar
BACKGROUND: Trochlear dysplasia is an important risk factor associated with patellofemoral instability, but it remains difficult to classify with consistency. Currently there is no objective way to quantify the dysplasia. The purpose of this study is to define and quantify objectively the trochlear morphology by volume and length via computed tomography (CT). METHODS: One-hundred control patients (136 knees) were retrospectively reviewed and compared to 36 consecutive patients (72 knees) who were treated surgically for recurrent patellar instability and known trochlear dysplasia based on a lateral radiograph...
June 27, 2017: Knee
https://www.readbyqxmd.com/read/28666038/measuring-malalignment-on-imaging-in-the-treatment-of-patellofemoral-instability
#7
Miho J Tanaka, Andrew J Cosgarea
Assessment of malalignment is an important factor in determining surgical treatment options for patellar instability. Measurement of tibial tubercle-trochlear groove (TT-TG) distance is valuable in planning surgical treatment for patellar instability, because it quantifies a component of malalignment and aids in deciding whether to perform tibial tuberosity osteotomy. In this paper we review how TT-TG distance should be understood in the context of many measurement factors to allow for an individualized procedure that addresses the specific contributors to patellar instability in each patient...
May 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28646869/long-term-outcomes-after-combined-arthroscopic-medial-reefing-and-lateral-release-in-patients-with-recurrent-patellar-instability-a-retrospective-analysis
#8
Dominik Schorn, Sera Yang-Strathoff, Georg Gosheger, Tim Vogler, Sebastian Klingebiel, Carolin Rickert, Dimosthenis Andreou, Dennis Liem
BACKGROUND: There is currently no consensus regarding the optimal surgical treatment method for patients with recurrent patella instability. Our goal was to evaluate the long-term results of combined arthroscopic medial reefing and lateral release, to identify possible risk factors for recurrent dislocations and residual complaints after surgical treatment and to assess functional outcome. METHODS: We performed a retrospective study of 38 patients (43 knees) treated with all-inside technique between 2001 and 2010...
June 24, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28630757/the-patellofemoral-joint-from-dysplasia-to-dislocation
#9
Stefano Zaffagnini, Alberto Grassi, Gianluca Zocco, Michele Attilo Rosa, Cecilia Signorelli, Giulio Maria Marcheggiani Muccioli
Patellofemoral dysplasia is a major predisposing factor for instability of the patellofemoral joint. However, there is no consensus as to whether patellofemoral dysplasia is genetic in origin, caused by imbalanced forces producing maltracking and remodelling of the trochlea during infancy and growth, or due to other unknown and unexplored factors.The biomechanical effects of patellofemoral dysplasia on patellar stability and on surgical procedures have not been fully investigated. Also, different anatomical and demographic risk factors have been suggested, in an attempt to identify the recurrent dislocators...
May 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28628800/increased-internal-femoral-torsion-can-be-regarded-as-a-risk-factor-for-patellar-instability-a-biomechanical-study
#10
Peter Kaiser, Werner Schmoelz, Philip Schoettle, Marit Zwierzina, Christian Heinrichs, Rene Attal
BACKGROUND: Increased internal femoral torsion is regarded as a risk factor for patellar instability. Biomechanical investigations confirming this hypothesis are missing. METHODS: Eight fresh-frozen cadaver knees were tested on a specially designed simulator. Patellar motion and patellofemoral pressure were evaluated for 0°, 10°, and 20° of increased internal and external femoral torsion with native and with transected medial patellofemoral ligaments used to simulate patellar instability...
June 10, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28623415/a-stand-alone-lateral-condyle-elevating-trochlear-osteotomy-leads-to-high-residual-instability-but-no-excessive-increase-in-patellofemoral-osteoarthritis-at-12-year-follow-up
#11
S Tigchelaar, J van Sambeeck, S Koeter, A van Kampen
PURPOSE AND HYPOTHESIS: Trochlear osteotomy is a rarely performed procedure, only indicated in selected cases. Due to its nature, it can potentially lead to cartilage damage and subsequent early osteoarthritis. Satisfactory short-term results from lateral condyle-elevating osteotomy have previously been reported. The long-term effects of this procedure on clinical outcomes, patellar stability and radiological osteoarthritis are reported here. METHODS: Sixteen patients (19 knees) with patellar instability due to trochlear dysplasia were included...
June 16, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28614288/evaluation-of-the-tibial-tubercle-to-posterior-cruciate-ligament-distance-in-a-pediatric-patient-population
#12
Blake Clifton, Dustin L Richter, Dan Tandberg, Matthew Ferguson, Gehron Treme
BACKGROUND: Evaluation of distal extensor mechanism alignment continues to evolve in children with patella instability. Prior studies support the use of the tibial tubercle to trochlear groove (TT-TG) distance but limitations exist for this measurement including: changes in the TT-TG distance with knee flexion, difficulty with finding the deepest part of a dysplastic trochlea, and limitations regarding identification of the site of the anatomic abnormality. The tibial tubercle-posterior cruciate ligament (TT-PCL) distance has been introduced as an alternative measure to address the shortcomings in the TT-TG distance by quantifying the position of the TT independent of the trochlea and with respect to the tibia only...
June 13, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28614283/recurrent-patellar-instability-implications-of-preoperative-patellar-crepitation-on-the-status-of-the-patellofemoral-articular-cartilage
#13
Scott J Luhmann, June C Smith, Mario Schootman, Nandan Prasad
BACKGROUND: The purpose of the study was to quantify the frequency, severity, and location of patellofemoral (PF) articular cartilage changes recurrent patellar instability treated surgically in patients with preoperative clinical patellar crepitation. METHODS: A single-surgeon database was queried for all knees with recurrent patellar instability between 3/2000 and 6/2012 (n=214). Only knees which underwent knee arthroscopy during the surgical treatment were included (n=148)...
June 13, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28601942/anatomic-reconstruction-of-the-medial-patellofemoral-ligament-in-children-and-adolescents-using-a-pedicled-quadriceps-tendon-graft-shows-favourable-results-at-a-minimum-of-2-year-follow-up
#14
Manfred Nelitz, Jens Dreyhaupt, Sean Robert March Williams
PURPOSE: In adults, reconstruction of the medial patellofemoral ligament (MPFL) has shown good results. Treatment for recurrent patellar instability in children and adolescents with open growth plates, however, requires alternative MPFL reconstruction techniques. This study presents the outcomes of a minimally invasive technique for anatomic reconstruction of the MPFL in children using a pedicled superficial quadriceps tendon graft, hardware-free patellar graft attachment, and anatomic femoral fixation that spares the distal femoral physis...
June 10, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28594500/patellofemoral-arthroplasty-an-evolving-science
#15
Jess H Lonner
Patellofemoral arthroplasty (PFA) has long been a clinical option for patients with isolated patellofemoral arthritis. However, a high rate of failure as a result of patellar instability related to component malposition, soft-tissue imbalance, errant surgical techniques, and poor trochlear implant designs contributed to the underutilization of PFA. The evolution of surgical indications, trochlear implant design, component positioning, and soft-tissue balance has led to improved patellar tracking, fewer failures related to patellar instability, and improved functional outcomes...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28593102/rehabilitation-following-medial-patellofemoral-ligament-reconstruction-for-patellar-instability
#16
Robert C Manske, Daniel Prohaska
Patellar instability is a common problem seen by physical therapists, athletic trainers and orthopedic surgeons. Although following an acute dislocation, conservative rehabilitation is usually the first line of defense; refractory cases exist that may require surgical intervention. Substantial progress has been made in the understanding of the medial patellofemoral ligament (MPFL) and its role as the primary stabilizer to lateral patellar displacement. Medial patellofemoral ligament disruption is now considered to be the essential lesion following acute patellar dislocation due to significantly high numbers of ruptures following this injury...
June 2017: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/28585997/diagnosis-and-management-of-traumatic-patellar-instability-in-the-pediatric-patient
#17
Steven F DeFroda, Joseph A Gil, Alex Boulos, Aristides I Cruz
Instability of the patella is a common cause of knee pain and dysfunction in pediatric and adolescent patients and can be due to several factors. Although some patients will recall a specific traumatic event others may not, requiring the diagnosis to be made on the basis of physical examination and imaging. Congenital dislocation and connective tissue disorders should also be considered, even in the setting of trauma. There are radiographic parameters that may identify causes of instability such as trochlear and patellar abnormalities, and magnetic resonance imaging can identify signs of trauma such as bony edema, loose osteochondral fragments, and increased tibial tubercle-trochlear groove distance...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28580253/arthroscopic-patellar-lateral-facetectomy
#18
Marcio B Ferrari, George Sanchez, Jorge Chahla, Gilbert Moatshe, Robert F LaPrade
Isolated patellofemoral osteoarthritis is relatively prevalent, with the lateral facet of the patella being the most commonly affected portion. This pathology can be a result of a patellar maltracking syndrome, patella instability, or idiopathic degenerative changes. A thorough diagnostic work-up with a physical examination and imaging studies are mandatory for a proper diagnosis and to rule out other causes of patellofemoral knee pain. These patients are often treated nonoperatively with exercises for patella mobility, intra-articular injections, braces, patellar tracking, quadriceps balance and strength, and activity modification...
April 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28577210/-distal-femoral-osteotomy-using-a-lateral-opening-wedge-technique
#19
M J Feucht, J Mehl, P Forkel, A B Imhoff, S Hinterwimmer
OBJECTIVE: To shift the weight-bearing axis of the lower limb medially by opening a lateral-based metaphyseal osteotomy at the distal femur. INDICATIONS: Femoral-based valgus malalignment and symptomatic lateral unicompartimental osteoarthritis, lateral hyperpression syndrome, cartilage therapy of the lateral compartment, lateral meniscal replacement/transplantation, medial instability with valgus thrust, reconstruction of the medial collateral ligament, patellar instability and/or maltracking...
June 2, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28567511/trochleoplasty-techniques-provide-good-clinical-results-in-patients-with-trochlear-dysplasia
#20
REVIEW
Umile Giuseppe Longo, Candela Vincenzo, Nicholas Mannering, Mauro Ciuffreda, Giuseppe Salvatore, Alessandra Berton, Vincenzo Denaro
PURPOSE: The aim of this systematic review is to compare the clinical outcomes of patients treated with different trochleoplasty procedures, the rate of complications and recurrence of patellar dislocation. METHODS: A systematic review of the literature was performed, in accord with the PRISMA guidelines. PubMed, MEDLINE, CINAHL, Cochrane, EMBASE and Google Scholar databases were comprehensively searched using the keyword combinations, "Dejour trochleoplasty", "Bereiter Trochleoplasty", "Albee Trochleoplasty", "Recession Trochleoplasty", "Trochlear Dysplasia", "Instability", "Adult", "Clinical Outcome" and "Surgery"...
May 31, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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