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Patellar instability

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https://www.readbyqxmd.com/read/28918784/-treatment-of-patellar-instability
#1
Martin Lind, Peter Faunø, Ole Gade Sørensen, Bjarne Mygind-Klavsen
First-time patellar luxation appears typically in teenagers and young adults below the age of 16 years, with a prevalence of 45/100,000/year. This luxation is treated with brief limited mobility in a bandage, and with a complementary physiotherapy if the mobility is influenced afterwards. Risk factors for patellar instability are patellofemoral dysplasia, hyperlaxity, patella alta and valgus malalignment in the knee joint. In case of repeated luxation the treatment is surgical, i.e. reconstruction of the medial patellofemoral ligament recreating the medial patella-stabilizing structures...
September 18, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28918500/current-evidence-advocates-use-of-a-new-pathologic-tibial-tubercle-posterior-cruciate-ligament-distance-threshold-in-patients-with-patellar-instability
#2
REVIEW
Nickolas Boutris, Domenica A Delgado, John S Labis, Patrick C McCulloch, David M Lintner, Joshua D Harris
PURPOSE: To determine (1) whether a correlation exists between tibial tubercle-posterior cruciate ligament (TT-PCL) and tibial tubercle-trochlear groove (TT-TG) distances in patellar instability patients; (2) reliability when measuring TT-PCL distance; (3) whether TT-PCL distances measured on MRI are equivalent to those on CT; and (4) whether a correlation exists between TT-PCL distance and number of instability events or recurrence of instability following stabilization surgery. METHODS: A systematic review was performed using PRISMA guidelines...
September 16, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28911945/long-term-follow-up-and-survivorship-of-single-radius-posterior-stabilized-total-knee-arthroplasty
#3
Moon Jong Chang, Sangyeon So, Chan-Deok Park, Jai Gon Seo, Young-Wan Moon
BACKGROUND: We sought to determine the 10-year survivorship of single-radius, posterior-stabilized total knee arthroplasty (TKA) in Asian patients. We also aimed to determine whether the long-term clinical and radiographic results differed between patients with and without patellar resurfacing. METHODS: This retrospective study included 148 (115 patients) consecutive single-radius, posterior-stabilized TKAs. Ten-year survivorship analysis was performed using the Kaplan-Meier method with additional surgery for any reason as the end-point...
September 11, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28885967/outcomes-of-medializing-tibial-tubercle-osteotomy-with-medial-reefing-and-vastus-medialis-obliquus-advancement-coupled-with-lateral-retinacular-z-lengthening-for-recurrent-patellar-instability
#4
Patrick Morrissey, Daniel Christensen, Trevor Tompane, Jared Wolfe, Lance LeClere
PURPOSE: Patella-femoral dislocations, although rare, can result in functionally limiting symptoms and limited return to prior activity levels. The purpose of this study is to report outcomes of a three-in-one patellar realignment surgery for treatment of recurrent patellar instability in a young, active duty military population. METHODS: We conducted a retrospective chart review of all patients who underwent our senior author's three-in-one patellar realignment surgery for recurrent patellar instability in the setting of underlying anatomic malalignment...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28884103/lateral-patellar-retinacular-release-changes-over-the-last-ten-years
#5
REVIEW
Leonardo Pini Rosalem Marciano da Fonseca, Ednei Haruo Kawatake, Alberto de Castro Pochini
Lateral retinacular release is a useful resource in knee surgery that can be used for disorders of the extensor mechanism. For many years, it was indiscriminately used in the treatment of the various patellofemoral joint alterations, with conflicting functional results. This study aimed to analyze the changes that have occurred in the indications and clinical effectiveness of lateral retinacular release by reviewing the relevant literature of the past ten years, comparing it to the classic literature on the subject...
June 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28884099/medial-patellofemoral-ligament-and-medial-patellotibial-ligament-reconstruction-in-children-preliminary-results
#6
David Sadigursky, Lucas Cortizo Garcia, Maurício Armede, Lucas Rodrigues de Oliveira, Rogério Jamil Fernandes Carneiro, Paulo Oliveira Colavolpe
OBJECTIVE: The aim of this study was to evaluate the reconstruction of the medial patellofemoral ligament associated with the medial patellotibial ligament in skeletally immature patients. METHOD: This is a case series study in patients with patellar instability with open physis. In total, seven patients were evaluated: four males and three females were operated using the proposed technique. Patients with open physis who had more than two episodes of recurring patellar dislocation were included...
June 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28872404/operative-vs-nonoperative-treatment-after-acute-patellar-dislocation-which-is-more-effective-at-reducing-recurrence-in-adolescents
#7
Julie Fuller, Heidi Hammil, Kelly Pronschinske, Chris Durall
Clinical Scenario: Acute patellar dislocation most commonly affects young, active individuals.(1) Regardless of treatment, patellar dislocation may lead to patellofemoral instability. Two common approaches for treating acute patellar dislocation are surgical stabilization and nonoperative treatment via patellar bracing and exercise.(2) This review was conducted to determine if current best evidence supports one of these treatment approaches over the other for reducing dislocation recurrence in adolescents. Focused Clinical Question: In adolescents with acute patellar dislocation, how does operative stabilization compare with nonoperative treatment for reducing dislocation recurrence?...
September 5, 2017: Journal of Sport Rehabilitation
https://www.readbyqxmd.com/read/28867290/modified-adductor-sling-technique-a-surgical-therapy-for-patellar-instability-in-skeletally-immature-patients
#8
Lena Alm, Matthias Krause, Carolin Mull, Karl-Heinz Frosch, Ralph Akoto
BACKGROUND: Due to open femoral physis the therapy of patellar instability in skeletally immature patients is challenging. We developed a modified surgical technique of the 'Adductor-Sling-Approach' by Sillanpää. The purpose of this study was to evaluate the clinical outcome of the operative technique and to analyse the reasons for failure. METHODS: Thirty 'modified adductor sling' reconstructions in 28 patients were included in the study. From 2010 to 2016 modified adductor sling reconstruction was performed by looping the gracilis or semitendinosus tendon around the adductor magnus tendon and attaching it at the medial facet of the patella...
August 31, 2017: Knee
https://www.readbyqxmd.com/read/28852343/finite-element-analysis-of-patella-alta-a-patellofemoral-instability-model
#9
Nicole A Watson, Kyle R Duchman, Nicole M Grosland, Matthew J Bollier
BACKGROUND: This study aims to provide biomechanical data on the effect of patella height in the setting of medial patellofemoral ligament (MPFL) reconstruction using finite element analysis. The study will also examine patellofemoral joint biomechanics using variable femoral insertion sites for MPFL reconstruction. METHODS: A previously validated finite element knee model was modified to study patella alta and baja by translating the patella a given distance to achieve each patella height ratio...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28845005/-treatment-of-patellofemoral-instability-in-adolescent-by-anatomical-double-bundle-medial-patellofemoral-ligament-reconstruction-with-double-suture-anchor-technique
#10
Weihong Zhu, You Chen, Qi Tang, Lele Liao, Ding Li
To explore the clinical outcomes of anatomical double-bundle medial patellofemoral ligament (MPFL) reconstruction with double suture anchor technique in treating patellofemoral instability in adolescent.
 Methods: Twenty-five young people with patellofemoral instability (25 knees) in our department from January 2013 to December 2014 were enrolled for this study. All patients were performed anatomical double-bundle MPFL reconstruction with arthroscopic-assisted suture anchors technique in the patella, and fixed in the femoral socket with absorbable interference screw...
July 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28801826/brain-activity-changes-in-somatosensory-and-emotion-related-areas-with-medial-patellofemoral-ligament-deficiency
#11
Masaru Kadowaki, Taku Tadenuma, Nobuyuki Kumahashi, Yuji Uchio
BACKGROUND: Patellar instability with medial patellofemoral ligament (MPFL) deficiency is a common sports injury among young people. Although nonoperative and surgical treatment can provide stability of the patella, patients often have anxiety related to the knee. We speculate that neural dysfunction may be related to anxiety in these patients; however, the mechanism in the brain that generates this anxiety remains unknown. QUESTIONS/PURPOSES: (1) How does brain activity in patients with MPFL deficiency change in the areas related to somatic sensation against lateral shift of the patella? (2) How does patella instability, which can lead to continuous fear or apprehension for dislocation, influence brain activity in the areas related to emotion? METHODS: Nineteen patients with MPFL deficiency underwent surgical reconstruction in our hospital from April 2012 to March 2014...
August 11, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28795924/incidence-of-first-time-lateral-patellar-dislocation-a-21-year-population-based-study
#12
Thomas L Sanders, Ayoosh Pareek, Timothy E Hewett, Michael J Stuart, Diane L Dahm, Aaron J Krych
BACKGROUND: First-time lateral patellar dislocation is a common orthopaedic injury. The purposes of this study were to (1) evaluate the incidence of first-time lateral patellar dislocation in a geographically-determined population, (2) report trends over time in the incidence of dislocation, and (3) describe the rate of surgical treatment. HYPOTHESIS: The rate of patellar dislocation is highest among adolescent patients. STUDY DESIGN: Cohort study...
August 1, 2017: Sports Health
https://www.readbyqxmd.com/read/28744079/evaluation-of-patella-alta-using-mri-measurements-in-adolescents
#13
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
#14
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
#15
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
#16
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
#17
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-dysplasia-assessment-of-the-difference-in-morphology-between-control-and-chronic-patellofemoral-instability-patients
#18
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
#19
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
#20
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
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