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Patellar instability

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https://www.readbyqxmd.com/read/29210022/trochleoplasty-procedures-show-complication-rates-similar-to-other-patellar-stabilizing-procedures
#1
Jordy D P van Sambeeck, Sebastiaan A W van de Groes, Nico Verdonschot, Gerjon Hannink
PURPOSE: Trochleoplasty aims to restore patellar stability. Various techniques have been described and almost all authors report successful results. However, the procedure has a significant risk of complications. Purpose of this study was to perform a systematic review and meta-analysis of the available literature to assess the rate of complications after the various techniques used for trochleoplasty procedures. MATERIALS AND METHODS: MEDLINE, EMBASE, Web of Science and Cochrane Library databases were searched...
December 5, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29204862/the-trochlear-isometric-point-is-different-in-patients-with-recurrent-patellar-instability-compared-to-controls-a-radiographical-study
#2
Tulio Campos, Akash Soogumbur, Iain R McNamara, Simon T Donell
PURPOSE: The purpose of the study was to investigate the theoretical isometric point based of the curve of the femoral groove and relating it to the origin of the MPFL femoral tunnel on lateral radiograph by comparing a patellar instability cohort with a control cohort. METHODS: From a Patellar Instability database the radiographs of 40 consecutive patients were analysed to define Schöttle's point, and the arc of the circle of the trochlear groove. A comparison population of 20 radiographs from comparable patients with tibiofemoral joint disorders was used as a control...
December 4, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29202550/the-normal-value-of-tibial-tubercle-trochlear-groove-distance-in-patients-with-normal-knee-examinations-using-mri
#3
Mohammad Sobhanardekani, Mohammad Reza Sobhan, Reza Nafisi Moghadam, Sepehr Nabavinejad, Seid Kazem Razavi Ratki
Patellar instability is a multifactorial common knee pathology that has a high recurrence rate, and the symptoms continue and ultimately predispose the patient to chondromalacia and osteoarthritis. Tibial tuberosity-trochlear groove distance (TTTG) is very important in the assessment of patellofemoral joint instability. The purpose of this study was to report the normal value of TTTG in males and females in different age groups and to assess the reliability of MRI in measuring TTTG. All patients presenting with knee pain and normal examinations of the knee joint, with a normal MRI report, referring to Shahid Sadoughi hospital of Yazd, Iran, from April 2014 to September 2014, were included in the study...
September 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/29201927/radiographic-location-does-not-ensure-a-precise-anatomic-location-of-the-femoral-fixation-site-in-medial-patellofemoral-ligament-reconstruction
#4
Vicente Sanchis-Alfonso, Cristina Ramírez-Fuentes, Erik Montesinos-Berry, Isabel Elía, Luis Martí-Bonmatí
Background: A frequently used method to determine the anatomic femoral fixation point in the operating room during medial patellofemoral ligament (MPFL) reconstruction is the radiographic method. However, the ability of this radiological method to establish an anatomic femoral attachment point might not be as accurate as expected. Purpose: (1) To evaluate the accuracy of the radiological method to locate the anatomic femoral fixation point in MPFL reconstruction surgery and (2) to determine the factors influencing the predictability of this method to obtain this objective...
November 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29195849/cementless-posteriorly-stabilized-total-knee-arthroplasty-seven-year-minimum-follow-up-report
#5
Steven F Harwin, Jay M Levin, Anton Khlopas, Prem N Ramkumar, Nicolas S Piuzzi, Martin Roche, Michael A Mont
BACKGROUND: The purpose of this study is to evaluate (1) implant survivorship; (2) patient outcomes; (3) complications; and to (4) perform a radiographic analysis of cementless posteriorly stabilized total knee arthroplasty (TKA) patients at a minimum of 7-year follow-up. METHODS: Our original cohort was composed of 114 consecutive cementless posteriorly stabilized total knee arthroplasties (110 patients) performed by a single surgeon between 2008 and 2010. Since our original report, 4 (1 bilateral) patients died and 2 were lost to follow-up...
November 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29189538/what-s-new-in-pediatric-sports-conditions-of-the-knee
#6
Aristides I Cruz, Connor G Richmond, Marc A Tompkins, Ann Heyer, Kevin G Shea, Jennifer J Beck
BACKGROUND: Sports injuries are common in pediatric and adolescent patients and the evaluation and treatment of these injuries continues to evolve. The purpose of this review is to provide a comprehensive appraisal of the literature, highlighting recent updates on sports-related knee injuries in the pediatric athlete. We specifically examined literature on tibial spine fractures, osteochondritis dissecans (OCD) of the knee, and patellar instability. Because of the volume of literature on the subject, pediatric, and adolescent anterior cruciate ligament injuries were not included in this review...
November 16, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29176355/what-is-the-chance-that-a-patella-dislocation-will-happen-a-second-time-update-on-the-natural-history-of-a-first-time-patella-dislocation-in-the-adolescent
#7
Gerd Seitlinger, Hannah N Ladenhauf, Guido Wierer
PURPOSE OF REVIEW: Patellar instability occurs mainly in young patients and shows a high incidence of concomitant cartilage injuries. Recently there has been a strong attempt to identify risk factors and enhance imaging techniques to detect patients with an increased risk for recurrent patella dislocation.We describe current findings on factors associated with recurrent patella dislocation in the adolescent. RECENT FINDINGS: Trochlear dysplasia, patellar height, patellar tilt, tibial tuberosity-trochlear groove distance, skeletal maturity, and history of contralateral patellar dislocation are well known significant risk factors for recurrence in adolescent patients...
November 14, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29167606/results-of-operative-4-in-1-patella-realignment-in-children-with-recurrent-patella-instability
#8
Francesc Malagelada, Ole Rahbek, Cyrus Sahirad, Manoj Ramachandran
Purpose: Recurrent patellar instability is a cause of knee dysfunction, limitation and pain for children. If nonoperative treatment fails to stabilise the patella, operative realignment and stabilisation have been advocated. Operative techniques in the paediatric population must preserve physeal growth while ensuring stability. We aimed to determine the outcome of children and adolescents who underwent a 4-in-1 patellar realignment (lateral release, medial reefing, Insall tube realignment and Roux-Goldthwaite patella ligament transfer)...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29159672/patellar-tracking-should-be-taken-into-account-when-measuring-radiographic-parameters-for-recurrent-patellar-instability
#9
Si Heng Sharon Tan, Mazen M Ibrahim, Zhaojie Joel Lee, Yen Kit Michael Chee, James H Hui
PURPOSE: To date, many radiographic parameters on patellar instability have their measurements taken statically, and have not been studied in various degrees of flexion according to the patellar tracking. There are also limited data regarding the use of these parameters in predicting recurrent patellar dislocation. The current study aims to review the radiographic parameters of the patellofemoral joint in different degrees of knee flexion and to correlate them with the presence of recurrent instability...
November 20, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29138919/low-re-rupture-rate-with-bptb-autograft-and-semitendinosus-gracilis-autograft-with-preserved-insertions-in-acl-reconstruction-surgery-in-sports-persons
#10
Ravi Gupta, Munish Sood, Anubhav Malhotra, Gladson David Masih, Anil Kapoor, Mukta Raghav, Mehar Dhillon
PURPOSE: To compare the results of bone-patellar tendon-bone graft (BPTB), semitendinosus-gracilis graft with preserved insertions (STGPI) and semitendinosus-gracilis-free graft (STGF) in terms of graft failure, objective mechanical stability, functional outcome, and return to sports in elite and recreational sports persons. It was hypothesized that the STGPI graft provided superior outcome as compared to the other two grafts. METHODS: Two hundred and forty-nine elite and recreational players who underwent ACL reconstruction surgery, with BPTB graft (N = 80), STGPI graft (N = 85), and STGF graft (N = 84) with a minimum follow-up of 2 years, were assessed using clinical tests, knee arthrometer (KT 1000™), single-leg hop test, Lysholm knee score, Tegner's activity scale, and return to sports...
November 14, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29134368/-patellofemoral-instability
#11
S F Fucentese
Patellofemoral instability is an extremely limiting pathology in young and active patients. Anatomical reasons for patellar instability, such as high-riding patella, elevated distance from the tibial tuberosity to trochlear groove (TTTG), trochlear dysplasia, insufficient medial patellofemoral ligament (MPFL) and malpositioning of the axes and torsion can lead to chronic patellofemoral instability and must be thoroughly analyzed. The first dislocation can be treated conservatively, with the exception of an osteochondral defect...
November 13, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/29132386/primary-single-suture-anchor-re-fixation-of-anterior-cruciate-ligament-proximal-avulsion-tears-leads-to-good-functional-mid-term-results-a-preliminary-study-in-12-patients
#12
Christof Hoffmann, Jan Friederichs, Christian von Rüden, Christian Schaller, Volker Bühren, Christoph Moessmer
BACKGROUND: Current studies demonstrate encouraging short-term results after primary anterior cruciate ligament (ACL) suture anchor repair. However, earlier studies reported deterioration of knee function at 5-year follow-up following good clinical short-term recovery. Therefore, the aim of this study was to evaluate clinical long-term results after primary ACL repair at a minimum 5-year follow-up. METHODS: In a retrospective study, 13 patients were included between 2009 and 2012...
November 13, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29128875/allowing-one-quadrant-of-patellar-lateral-translation-during-medial-patellofemoral-ligament-reconstruction-successfully-limits-maltracking-without-overconstraining-the-patella
#13
John J Elias, Kerwyn C Jones, Molly K Lalonde, Joseph N Gabra, S Cyrus Rezvanifar, Andrew J Cosgarea
PURPOSE: Graft tensioning during medial patellofemoral ligament (MPFL) reconstruction typically allows for lateral patellar translation within the trochlear groove. Computational simulation was performed to relate the allowed patellar translation to patellofemoral kinematics and contact pressures. METHODS: Multibody dynamic simulation models were developed to represent nine knees with patellar instability. Dual limb squatting was simulated representing the pre-operative condition and simulated MPFL reconstruction...
November 11, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29108731/ratio-of-the-tibial-tuberosity-trochlear-groove-distance-to-the-tibial-maximal-mediolateral-axis-a-more-reliable-and-standardized-way-to-measure-the-tibial-tuberosity-trochlear-groove-distance
#14
Pengkai Cao, Yingzhen Niu, Chang Liu, Xiaomeng Wang, Guman Duan, Qinghua Mu, Xintong Luo, Fei Wang
BACKGROUND: Tibial tuberosity-trochlear groove distance(TT-TG) is a measurement to assist in the diagnosis and treatment of patellar instability, however it still has some limitations. Our study was to modify the accepted measurement method and seek a more reliable and standardized method. METHODS: The data of 65 healthy controls and 49 patients with bilateral patellar instability from 2010 to 2016 were collected and analyzed by CT. The TT-TG, tibial maximal mediolateral axis (MML), and their ratio [i...
November 3, 2017: Knee
https://www.readbyqxmd.com/read/29102017/editorial-commentary-measuring-coronal-mal-alignment-for-patients-with-patellar-instability-tibial-tubercle-to-trochlear-groove-versus-tibial-tubercle-to-posterior-cruciate-ligament-distance
#15
EDITORIAL
Andrew J Cosgarea
Excessive lateralization of the tibial tuberosity is one of the anatomic factors that contribute to lateral patellar instability, which we usually correct surgically with tibial tuberosity osteotomy. Traditionally, coronal alignment was determined clinically by measuring the Q angle, which has proven to be unreliable. Radiographic measurements of coronal alignment made using computed tomography and magnetic resonance imaging are more reliable and have become the standard for determining the need for corrective tibial tuberosity osteotomy...
November 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29101982/acr-appropriateness-criteria%C3%A2-imaging-after%C3%A2-total%C3%A2-knee-arthroplasty
#16
Mary G Hochman, Yulia V Melenevsky, Darlene F Metter, Catherine C Roberts, Jenny T Bencardino, R Carter Cassidy, Michael G Fox, Mark J Kransdorf, Douglas N Mintz, Nehal A Shah, Kirstin M Small, Stacy E Smith, Kathy M Tynus, Barbara N Weissman
Total knee arthroplasty (TKA) is the most commonly performed joint replacement procedure in the United States and annual demand for primary TKA is expected to grow by 673% by 2030. The first part provides an overview of imaging modalities (radiographs, CT, MRI, ultrasound, and various nuclear medicine studies) and discusses their usefulness in the imaging evaluation of TKA. The second part focuses on evidence-based imaging and imaging-guided intervention algorithms for the workup of TKA and its complications, including routine follow-up, component wear, periprosthetic infection, aseptic loosening, granulomas/osteolysis, conventional and rotational instability, periprosthetic fracture, patellar complications, and a variety of periprosthetic soft tissue abnormalities...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29099881/patella-alta-sees-you-do-you-see-it
#17
Robert A Magnussen
Numerous anatomic factors have been shown to contribute to patellar instability. Patellar height remains a critical, yet underappreciated contributor to instability that is amenable to surgical correction through the performance of a tibial tubercle distalization osteotomy (TTDO). The indications for a distalizing tibial tubercle osteotomy are not completely clear and depend on multiple factors. One must consider patient factors and physical examination findings in addition to radiographic measures. In general, the addition of a TTDO to medial patellofemoral ligament reconstruction should be considered when the degree of patella alta exceeds a Caton-Deschamps Index (CDI) of 1...
September 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29099880/comparison-of-lateral-retinaculum-release-and-lengthening-in-the-treatment-of-patellofemoral-disorders
#18
Berkay Unal, Betina B Hinckel, Seth L Sherman, Christian Lattermann
For lateral retinaculum (LR) tightness, release or lengthening is the indicated surgical correction. LR release (LRR) or lengthening (LRL) may be a primary treatment for painful lateral compression syndrome or as an adjunct treatment in the setting of patellofemoral instability. Although it is challenging, assessment of the soft-tissue balance between the medial restraint (the medial patellofemoral ligament) and the lateral restraint (the lateral retinaculum) is fundamental to a good outcome. LRR and LRL are effective in the treatment of patellofemoral disorders in which lateral tightness is part of the pathology...
September 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29083227/variation-in-the-medial-patellofemoral-ligament-origin-in-the-skeletally-immature-knee-an-anatomic-study
#19
Kevin G Shea, W Duncan Martinson, Peter C Cannamela, Connor G Richmond, Peter D Fabricant, Allen F Anderson, John D Polousky, Theodore J Ganley
BACKGROUND: The medial patellofemoral ligament (MPFL) is frequently reconstructed to treat recurrent patellar instability. The femoral origin of the MPFL is well described in adults but not in the skeletally immature knee. PURPOSE: To identify a radiographic landmark for the femoral MPFL attachment in the skeletally immature knee and study its relationship to the distal femoral physis. STUDY DESIGN: Descriptive laboratory study. METHODS: Thirty-six cadaveric specimens between 2 and 11 years old were dissected and examined (29 male and 7 female)...
October 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29079908/patellofemoral-dysbalance-and-genua-valga-outcome-after-femoral-varisation-osteotomies
#20
Jörg Dickschas, Felix Ferner, Christoph Lutter, Kolja Gelse, Jörg Harrer, Wolf Strecker
INTRODUCTION: Patellofemoral dysbalance may be caused by trochlear dysplasia, an elevated TTTG distance, femoral or tibial torsional deformities, patella alta, or a genu valgum. The surgical procedure for the treatment of a genu valgum is varisation osteotomy, usually in the femoral aspect. Several authors believe that a genu valgum is one cause of patellofemoral dysbalance, but studies about the outcome of the treatment with a varisation osteotomy are rare. MATERIALS AND METHODS: Nineteen knees in 18 patients, aged on average 28 (16-52) years were investigated in a retrospective study...
October 27, 2017: Archives of Orthopaedic and Trauma Surgery
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