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https://www.readbyqxmd.com/read/29226423/patellar-tendinopathy-with-intra-tendinous-alteration-on-mri-may-be-related-to-patellofemoral-dysplasia
#1
Philippe M Tscholl, Roland M Biedert, Florian Wanivenhaus, Sandro F Fucentese
Patellar tendinopathy (PT) is a frequent overuse-injury of the extensor knee apparatus whereas as up to 30% of the athletes might suffer from persisting symptoms during their entire career. In the present case-control study, 47 patients (30.8±11.4 years) with PT with intra-tendinous alteration (PTita) of a minimum of ≥ 25% of the axial surface on MRI and minimum Blazina score of II (pain during without limiting sports activity) were included; MR images were analysed for trochlear geometry, patellar height/tilt, and tibial tubercle trochlear groove distance (TT-TG)...
December 11, 2017: Scandinavian Journal of Medicine & Science in Sports
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/29201927/radiographic-location-does-not-ensure-a-precise-anatomic-location-of-the-femoral-fixation-site-in-medial-patellofemoral-ligament-reconstruction
#3
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/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
#4
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/29159672/patellar-tracking-should-be-taken-into-account-when-measuring-radiographic-parameters-for-recurrent-patellar-instability
#5
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/29134368/-patellofemoral-instability
#6
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/29129614/mid-term-clinical-functional-and-radiographic-outcomes-of-105-gender-specific-patellofemoral-arthroplasties-with-or-without-the-association-of-medial-unicompartmental-knee-arthroplasty
#7
Sergio Romagnoli, Matteo Marullo
BACKGROUND: The purpose of this study is to evaluate clinical and radiographic outcomes after gender-specific patellofemoral arthroplasty (PFA) either isolated or combined with unicompartmental knee arthroplasty (UKA). METHODS: A total of 105 PFAs in 85 patients were reviewed: 64 knees had isolated patellofemoral osteoarthritis and received an isolated PFA, and 41 knees with bicompartmental osteoarthritis were treated with medial UKA and PFA. Preoperative and postoperative clinical and functional assessment included knee range of motion, Knee Society Score, University of California Los Angeles Activity Score, Tegner Activity Level Scale, and visual analogue scale pain...
October 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29099881/patella-alta-sees-you-do-you-see-it
#8
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/29095402/mri-and-arthroscopy-correlation-in-the-patellofemoral-joint
#9
Lisa G M Friedman, Melissa S White, Patrick F Carroll, Jeffrey A Macalena, Elizabeth A Arendt, Jutta M Ellermann, Marc Tompkins
The patellofemoral joint is an articulation between the patella and the femoral trochlea, which serves to increase the lever arm of the extensor mechanism. The stability of the patella within the trochlear groove is supported statically by the bony confines of the groove itself, as well as the medial patellofemoral ligament, and dynamically by the vastus musculature. Pathologic changes seen on magnetic resonance imaging (MRI) are frequently well correlated with findings found by arthroscopy at the time of surgery...
December 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/29079908/patellofemoral-dysbalance-and-genua-valga-outcome-after-femoral-varisation-osteotomies
#10
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
https://www.readbyqxmd.com/read/28942225/arthroscopic-deepening-trochleoplasty-for-chronic-anterior-knee-pain-after-previous-failed-conservative-and-arthroscopic-treatment-report-of-two-cases
#11
Lars Blønd
PURPOSE: A proportion of patients having years of chronic anterior knee pain(AKP) that have not responded to non-operative modalities. Trochlear dysplasia have been found to be a cause for AKP. By restoring the anatomy with a trochleoplasty procedure the patellofemoral joint is unloaded. This study is a prospective 2year follow-up study, based on two cases with chronic AKP for several years and having severe trochlear dysplasia and both were successfully treated by arthroscopic deepening trochleoplasty...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28933333/-canine-elbow-humeroulnar-incongruity-measurements-using-computed-tomography
#12
R Snášil, P Proks, A Nečasová, K Michalčáková, A Nečas
PURPOSE OF THE STUDY The purpose of the study is to compare the repeatability and reproducibility of quantitative and subjective evaluation of elbow humeroulnar incongruity (HUI) using computed tomography (CT) on an in vivo canine model. MATERIAL AND METHODS HUI was evaluated on canine (n = 50) elbow joints (n = 100). The computed tomography of elbow joints was performed under intravenous sedation. Multiplanar reconstructions (MPR) were produced. HUI was evaluated on sagittal MPR images subjectively and by measuring the subluxation index (SI)...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28889222/the-predictive-factors-of-secondary-patellar-resurfacing-in-computer-assisted-total-knee-arthroplasty-a-prospective-cohort-study
#13
Florent Franck, Hervé Ouanezar, Alexandre Jacquel, Vincent Pibarot, Julien Wegrzyn
PURPOSE: The decision to resurface the patella during total knee arthroplasty (TKA) remains controversial. This prospective cohort study aimed to evaluate the outcome and survivorship of the native patella in computer-assisted TKA (CAS TKA) implanted for primary knee osteoarthritis, and to determine the predictive factors of secondary patellar resurfacing (SPR). METHODS: A prospective cohort of 273 cementless ultra-congruent mobile-bearing CAS TKA implanted without patellar resurfacing was included in our total joint registry...
September 9, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28867290/modified-adductor-sling-technique-a-surgical-therapy-for-patellar-instability-in-skeletally-immature-patients
#14
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/28828058/arthroscopic-knee-anatomy-in-young-achondroplasia-patients
#15
M Del Pilar Duque Orozco, N C Record, K J Rogers, M B Bober, W G Mackenzie, A Atanda
PURPOSE: Achondroplasia is the most common form of skeletal dysplasia, affecting more than 250 000 individuals worldwide. In these patients, the developing knee undergoes multiple anatomical changes. The purpose of this study was to characterise the intra-articular knee anatomy in children with achondroplasia who underwent knee arthroscopy. METHODS: Records of achondroplasia patients who underwent knee arthroscopy between 2009 and 2014 were reviewed. Demographic data, operative reports, follow-up notes, MRI and arthroscopy images were reviewed...
June 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28735802/correction-of-patellofemoral-malalignment-with-patellofemoral-arthroplasty
#16
Marco Valoroso, Mo Saffarini, Giuseppe La Barbera, Cécile Toanen, Gerjon Hannink, Luca Nover, David H Dejour
BACKGROUND: The goal of patellofemoral arthroplasty (PFA) is to replace damaged cartilage and correct underlying deformities to reduce pain and prevent maltracking. We aimed to determine how PFA modifies patellar height, tilt, and tibial tuberosity-trochlear groove (TT-TG) distance. The hypothesis was that PFA would correct trochlear dysplasia or extensor mechanism malalignment. METHODS: The authors prospectively studied a series of 16 patients (13 women and 3 men) aged 64...
July 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28666647/objective-quantification-of-trochlear-dysplasia-assessment-of-the-difference-in-morphology-between-control-and-chronic-patellofemoral-instability-patients
#17
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/28665533/radiographic-assessment-of-humeroulnar-congruity-in-a-medium-and-a-large-breed-of-dog
#18
Sofia Alves-Pimenta, Bruno Colaço, Armando M Fernandes, Lio Gonçalves, Jorge Colaço, Pedro Melo-Pinto, Mário M Ginja
Elbow joint incongruity is recognized as an important factor in the development, treatment, and prognosis of canine elbow dysplasia. Elbow incongruity has been measured based on radiographic joint space widths, however these values can be affected by the degree of elbow joint flexion. Recent studies have reported radiographic curvature radii as more precise measures of humeroulnar congruity in dogs. The aim of this prospective observational study was to describe radiographic curvature radii measured from flexed and extended elbow radiographs for a sample of dogs representing a medium breed (Portuguese Pointing Dog) and a large breed (Estrela Mountain Dog)...
June 30, 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/28624557/arthroscopic-lateral-retinacular-release-medial-retinacular-plication-and-partial-medial-tibial-tubercle-transfer-for-recurrent-patellar-dislocation
#19
Song Chen, Yiqin Zhou, Qirong Qian, Yuli Wu, Peiliang Fu, Haishan Wu
OBJECTIVE: To assess the efficacy of a therapeutic protocol composed of arthroscopic lateral retinacular release, medial retinacular plication, and partial medial tibial tuberosity transfer for patients with recurrent patellar dislocation. METHOD: 71 patients, 11 males and 60 females and a total of 77 knees, with recurrent dislocation of the patella were enrolled between 1998 and 2012. The average age of the patients was 19.5 years and 67 of them had previous knee trauma history...
August 2017: International Journal of Surgery
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
#20
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
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