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Patellar instability

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https://www.readbyqxmd.com/read/28210789/medial-patellofemoral-ligament-mpfl-reconstruction-in-combination-with-a-modified-grammont-technique-leads-to-favorable-mid-term-results-in-adolescents-with-recurrent-patellofemoral-dislocations
#1
Helmut Wegmann, Christoph Würnschimmel, Tanja Kraus, Georg Singer, Robert Eberl, Holger Till, Matthias Sperl
PURPOSE: The aim of the present study is to present the outcome of a cohort of adolescent patients with trochlear dysplasia and elevated tibial tuberosity trochlear groove (TTTG) distance suffering from recurrent patellar dislocation. Treatment consisted of medial patellofemoral ligament (MPFL) reconstruction and a modified Grammont procedure. METHODS: MRI examinations were obtained pre- and postoperatively. Trochlear dysplasia was classified according to Déjour, and TTTG was measured on MRI...
February 16, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28210659/medial-patellofemoral-ligament-reconstruction-femoral-tunnel-accuracy-relationship-to-disease-specific-quality-of-life
#2
Laurie A Hiemstra, Sarah Kerslake, Mark Lafave
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction is a procedure aimed to reestablish the checkrein to lateral patellar translation in patients with symptomatic patellofemoral instability. Correct femoral tunnel position is thought to be crucial to successful MPFL reconstruction, but the accuracy of this statement in terms of patient outcomes has not been tested. PURPOSE: To assess the accuracy of femoral tunnel placement in an MPFL reconstruction cohort and to determine the correlation between tunnel accuracy and a validated disease-specific, patient-reported quality-of-life outcome measure...
February 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28179061/plateau-patella-angle-an-option-for-the-evaluation-of-patellar-height-in-patients-with-patellar-instability
#3
Marcelo Batista Bonadio, Camilo Partezani Helito, Julio Augusto do Prado Torres, Riccardo Gomes Gobbi, José Ricardo Pécora, Gilberto Luis Camanho, Marco Kawamura Demange
BACKGROUND: Patellar instability is a debilitating disease. An important factor related to recurrent dislocation is patellar height. A new method of patellar height measurement, the plateau-patella angle (PPA), was proposed in 2011. However, to date, there is no study evaluating the use of this method in patients with patellar instability. The aim of this study was to evaluate the PPA in patients with recurrent patellar dislocation. METHODS: This was a retrospective evaluation of the radiographs of 78 knees with patellar instability...
February 5, 2017: Knee
https://www.readbyqxmd.com/read/28178094/reconstruction-of-symptomatic-congenital-anterior-cruciate-ligament-insufficiency
#4
Brant C Sachleben, Adam Y Nasreddine, Jeffrey J Nepple, Frances A Tepolt, James R Kasser, Mininder S Kocher
BACKGROUND: Hypoplasia or congenital absence of the anterior cruciate ligament (ACL) is a rare disorder occurring in ∼1 in every 6000 births. Although some patients with hypoplasia or agenesis of the ACL may not complain of instability, others desire to participate in more demanding activities that require the stability of a competent ACL. There are limited reports of surgical treatment of this patient population. The purpose of this study was to report ACL reconstruction in a case series of patients with symptomatic congenital ACL deficiency...
February 7, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28177645/conventional-radiographs-and-magnetic-resonance-imaging-for-the-analysis-of-trochlear-dysplasia
#5
Philippe Matthias Tscholl, Florian Wanivenhaus, Sandro F Fucentese
BACKGROUND: Trochlear dysplasia is one of the most important risk factors for recurrent patellar instability. It is defined on true lateral conventional radiographs (CR) and axial magnetic resonance imaging (MRI). The type of trochlear dysplasia is decisive for surgical treatment; however, low agreement between CR and MRI has been reported. PURPOSE: To compare the Dejour classification of trochlear dysplasia on CR and axial MRI using differing levels defined in the literature...
February 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28164055/proximal-tibial-epiphysis-injury-flexion-type-salter-harris-type-1
#6
Pratik Israni, Mangesh Panat
INTRODUCTION: Fractures of the proximal tibial epiphysis rare. It has been estimated that fractures of the upper tibial epiphysis account for 0.5-3.1% of all epiphyseal injuries. Who had no neurovascular deficit, with fixed extension deformity at the left knee was treated early with closed reduction techniques. CASE REPORT: We present a case of a 16-year-old boy who while playing cricket on the road was hit by a car. The patient presented in emergency room with extremely swollen knee and soft tissue swelling (hemarthrosis), he was unable to lift his leg actively due to severe pain because of hamstrings spasm, and he had no wound over his left knee and had no other associated injuries...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28148656/adolescent-patellar-instability-current-concepts-review
#7
REVIEW
D Clark, A Metcalfe, C Wogan, V Mandalia, J Eldridge
Patellar instability most frequently presents during adolescence. Congenital and infantile dislocation of the patella is a distinct entity from adolescent instability and measurable abnormalities may be present at birth. In the normal patellofemoral joint an increase in quadriceps angle and patellar height are matched by an increase in trochlear depth as the joint matures. Adolescent instability may herald a lifelong condition leading to chronic disability and arthritis. Restoring normal anatomy by trochleoplasty, tibial tubercle transfer or medial patellofemoral ligament (MPFL) reconstruction in the young adult prevents further instability...
February 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28146393/medial-patellofemoral-ligament-reconstruction-combined-with-distal-realignment-for-recurrent-dislocations-of-the-patella
#8
Iswadi Damasena, Murray Blythe, David Wysocki, David Kelly, Peter Annear
BACKGROUND: Tibial tubercle transfer (TTT) and medial patellofemoral ligament (MPFL) reconstruction have both shown, either in isolation or in combination, to provide improved patellofemoral joint (PFJ) stability. There are few studies that provide evidence that this remains true in the long term. PURPOSE: To compare the long-term results of patellar instability after TTT with and without MPFL reconstruction in 2 randomized groups. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1...
February 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28127647/-reconstruction-of-the-medial-patellofemoral-ligament-after-lower-leg-amputation
#9
M Schulz, R Schwesig, H Siekmann, E Esmer, L Irlenbusch
The reconstruction of the medial patellofemoral ligament has been an increasingly popular approach for patellar instability over the last ten years. It is a conglomeration of symptoms with varying degree of severity. For pinpointed surgery planning, magnetic resonance imaging is now the obligate diagnosic tool. Therefore, in the preoperative stage, collateral pathology can be observed.
January 26, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28117636/are-metric-parameters-sufficient-alone-in-evaluation-of-the-patellar-instability-new-angular-measuring-parameters
#10
Alper Deveci, Deniz Cankaya, Serdar Yilmaz, Ersin Celen, Bulent Sakman, Murat Bozkurt
PURPOSES: When the evaluation of patellar instability is examined from the aspect of the conical-cylindrical anatomy of the tibia, metric measurement parameters such as the tuberositas tibia (TT)-trochlear groove (TG) and patellar tendon (PT) insertion-trochlear groove (TG) distances are not sufficient. We asked whether defined angular parameters reveal the rotational movement of the tuberositas tibia on the tibia shaft, additional to the metric parameters and there is a correlation between the metric and angular parameters...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28112787/posterior-cortical-axis-a-new-landmark-to-control-femoral-component-rotation-in-total-knee-arthroplasty
#11
Doerte Matziolis, Marius Meiser, Norbert Sieber, Ulf Teichgräber, Georg Matziolis
Rotation errors of the femoral component are held responsible for occurrences such as instability in flexion and midflexion, patellar maltracking, and arthrofibrosis following total knee arthroplasty. However, in many cases, the epicondylar axis cannot be reliably identified due to bone defects or metal artifacts on computed tomography, so alternative landmarks are necessary to evaluate the femoral component rotation. The current study sought to determine the relationship of the posterior cortical bone and the anterior cortical bone in relation to the epicondylar axis...
January 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/28107220/treatment-of-primary-acute-patellar-dislocation-systematic-review-and-quantitative-synthesis-of-the-literature
#12
Umile Giuseppe Longo, Mauro Ciuffreda, Joel Locher, Alessandra Berton, Giuseppe Salvatore, Vincenzo Denaro
PURPOSE: The aim of this study was to evaluate clinical outcomes, rate of redislocation, and complications after conservative or surgical procedures used to treat primary acute patellar dislocation. METHODS: A comprehensive search of PubMed, Medline, CINAHL, Cochrane, Embase, and Google Scholar databases using various combinations of the keywords "patella," "dislocation," "treatment," "acute," "primary" was performed. The following data were extracted: demographics, chondral defects and soft tissue lesions, outcome measurements, type of management, recurrence of instability, and complications...
January 17, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/28089467/the-evolution-of-implant-design-decreases-the-incidence-of-lateral-release-in-primary-total-knee-arthroplasty
#13
Jonathan E Webb, Heidi Y Yang, Jamie E Collins, Elena Losina, Thomas S Thornhill, Jeffrey N Katz
BACKGROUND: Appropriate balancing of the patellofemoral joint (PFJ) using a lateral release can help to prevent patellar instability in total knee arthroplasty (TKA). Contemporary total knee implant designs are characterized by enhanced trochlear geometry more similar to native knee anatomy to minimize instability and reduce utilization of a lateral release. METHODS: We retrospectively reviewed consecutive TKA cases from a single senior surgeon's practice with 3 successive total knee designs: the Press-Fit Condylar (PFC), the Sigma, and the ATTUNE (DePuy, Warsaw, IN)...
December 14, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28056523/the-tibial-tubercle-trochlear-groove-distance-is-greater-in-patients-with-patellofemoral-pain
#14
Victor R Carlson, Barry P Boden, Aricia Shen, Jennifer N Jackson, Lawrence Yao, Frances T Sheehan
BACKGROUND: The distance between the tibial tubercle (TT) and trochlear groove (TT-TG distance) is known to be greater in patients with patellar instability. However, the potential role and prevalence of pathological TT-TG distances in a large cohort of skeletally mature patients with isolated patellofemoral pain (PFP) are not clear. PURPOSE: To determine if the mean TT-TG distance is greater in patients with PFP, who lack a history of patellar dislocations, knee trauma, or osteoarthritis, relative to healthy controls...
December 1, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28050572/comparison-of-a-novel-weightbearing-cone-beam-computed-tomography-scanner-versus-a-conventional-computed-tomography-scanner-for-measuring-patellar-instability
#15
John Marzo, Melissa Kluczynski, Anthony Notino, Leslie Bisson
BACKGROUND: Conventional computed tomography (CT) images are routinely used for diagnosing patellofemoral instability and are obtained with the patient in a supine position, nonweightbearing, with the knee in full extension, and with leg muscles relaxed. A new portable extremity cone beam CT (CBCT) scanner has been developed that may allow for more accurate diagnosis, as imaging can be performed with the patient standing, the knee flexed, and with leg muscles active. PURPOSE/HYPOTHESIS: The purpose of this study was to compare CT measurements of patellar alignment on a prototype scanner versus conventional scanner in patients with known patellar instability...
December 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28029579/patellar-inversion-180-degree-rotation-of-the-patella-around-its-vertical-axis-within-the-intercondylar-notch
#16
Samarth Mittal, Arkesh M, Vivek Shankar, Swapnil Singh, Pankaj Sharma, Ravi Mittal
BACKGROUND: Dislocation of the patella can occur around its vertical as well as horizontal axis. However, near 180 degree rotation of the patella around its vertical axis within the intercondylar notch without its complete dislocation has never been previously reported to the best of our knowledge. We report one such neglected case along with its management. METHODS: The patient underwent open reduction and de-rotation of patella with repair of the medial and lateral patellar retinacula...
October 28, 2016: Knee
https://www.readbyqxmd.com/read/28028569/functional-testing-and-return-to-sport-following-stabilization-surgery-for-recurrent-lateral-patellar-instability-in-competitive-athletes
#17
Aaron J Krych, Michael P O'Malley, Nick R Johnson, Rohith Mohan, Timothy E Hewett, Michael J Stuart, Diane L Dahm
PURPOSE: Medial patellofemoral ligament (MPFL) reconstruction and tibial tubercle osteotomy are commonly used to treat recurrent lateral patellar instability, yet there are limited available data on return to sport (RTS) following these procedures. The purpose of this study is to evaluate patient factors associated with excellent functional outcomes, including successful RTS, following surgical stabilization including MPFL reconstruction in competitive athletes with recurrent lateral patellar instability...
December 27, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28005409/safe-drilling-paths-in-the-distal-femoral-epiphysis-for-pediatric-medial-patellofemoral-ligament-reconstruction
#18
Cynthia V Nguyen, Lutul D Farrow, Raymond W Liu, Allison Gilmore
BACKGROUND: Anatomic surgical reconstruction of the medial patellofemoral ligament (MPFL) has been popularized for the treatment of recurrent patellar instability in the skeletally immature population. Previous anatomic studies have found that the femoral attachment point of the MPFL is very close to the distal femoral physis. PURPOSE: To establish the safe angles for drilling the distal femoral epiphysis for MPFL graft placement. STUDY DESIGN: Descriptive laboratory study...
December 1, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28005405/patellofemoral-arthritis-after-lateral-patellar-dislocation
#19
Thomas L Sanders, Ayoosh Pareek, Nicholas R Johnson, Michael J Stuart, Diane L Dahm, Aaron J Krych
BACKGROUND: The rate of patellofemoral arthritis after lateral patellar dislocation is unknown. Purpose/Hypothesis: The purpose of this study was to compare the risk of patellofemoral arthritis and knee arthroplasty between patients who experienced a lateral patellar dislocation and matched individuals without a patellar dislocation. Additionally, factors predictive of arthritis after patellar dislocation were examined. The hypothesis was that the rate of arthritis is likely higher among patients who experience a patellar dislocation compared with those who do not...
December 1, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27999505/osteochondral-allograft-transplantation-for-femoral-trochlear-dysplasia
#20
Dharmpal V Vansadia, James R Heltsley, Scott Montgomery, Misty Suri, Deryk G Jones
BACKGROUND: The risk factors for patellofemoral joint instability include laxity of medial patellar restraints, abnormal limb geometry, femoral and tibial malrotation, patella alta, and trochlear dysplasia. Femoral trochlear dysplasia is characterized by a hypoplastic or shallow trochlear groove. CASE REPORT: We report the case of a 31-year-old female with trochlear dysplasia and recurrent patella dislocations, laxity of the medial patellofemoral ligament (MPFL), and high-grade chondromalacia of the trochlea and the patella...
2016: Ochsner Journal
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