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https://www.readbyqxmd.com/read/29410197/patellofemoral-reconstruction-for-patellar-instability-with-patella-alta-in-middle-aged-patients-clinical-outcomes
#1
S Otsuki, Y Okamoto, T Murakami, K Nakagawa, N Okuno, H Wakama, M Neo
INTRODUCTION: Although several surgical treatments for patellar instability with patella alta have been reported, the clinical outcomes and optimal surgical procedures for patellar instability with patella alta in middle-aged patients are still controversial. We hypothesized that optimal surgical procedures for patellar instability with patella alta in middle-aged patients may induce good clinical outcomes with better patellofemoral geometry. MATERIALS AND METHODS: Twelve middle-aged patients with a mean age of 44 years (range: 40-55 years), who presented with patellar instability and patella alta, were treated with a combination of several surgeries, such as medial patellofemoral ligament (MPFL) reconstruction, trochleoplasty, lateral release, and three-dimensional transfer of the tibial tuberosity, based on a surgical algorithm...
February 1, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29395748/does-different-duration-of-non-operative-immobilization-have-an-effect-on-the-redislocation-rate-of-primary-patellar-dislocation-a-retrospective-multicenter-cohort-study
#2
Bo Kaewkongnok, Anders Bøvling, Nikolaj Milandt, Celia Møllenborg, Bjarke Viberg, Lars Blønd
BACKGROUND: Immobilization devices such as plaster splints, casts and braces have been used for first time patellar dislocation (FTPD) in order to prevent redislocation. This study evaluates different non-operative immobilization regimes upon rates of redislocation. METHODS: A retrospective cohort study with a study population of 1366 in which 601 subjects under 30years with FTPD were included from three hospitals. Exclusion criteria were osteochondral fracture, ligament injury and subluxation...
January 29, 2018: Knee
https://www.readbyqxmd.com/read/29322270/recent-developments-in-evaluation-and-treatment-of-lateral-patellar-instability
#3
REVIEW
Alexander Zimmerer, Christian Sobau, Peter Balcarek
Recent years have been characterized by an ongoing increase in knowledge about the different conditions associated with lateral patellar instability. This increase in knowledge provides differentiated approaches to the various pathologies of the patellofemoral joint. Though current guidelines consider medial patellofemoral ligament (MPFL) reconstruction the basic treatment for the unstable patella, medial soft tissue-stabilizing procedures should not be interpreted as stand-alone procedures in every case. The influence of different anatomical factors leading to patellar instability, as well as their impact on clinical outcome measures, is becoming increasingly apparent and deserves further attention...
January 10, 2018: Journal of Experimental Orthopaedics
https://www.readbyqxmd.com/read/29312853/deepening-trochleoplasty-combined-with-balanced-medial-patellofemoral-ligament-reconstruction-for-an-adequate-graft-tensioning
#4
Lars V von Engelhardt, Pia Weskamp, Matthias Lahner, Gunter Spahn, Joerg Jerosch
AIM: To evaluate our modified deepening trochleoplasty combined with a balanced medial patellofemoral ligament (MPFL) reconstruction for soft tissue alignement. METHODS: Thirty-three knees with with recurrent patellar dislocations and a trochlear dysplasia in 30 patients (m/f = 12/21, mean age 24 ± 9 years) underwent a combination of a modified deepening trochleoplasty and a balanced MPFL reconstruction for a medial soft tissue alignement. After a mean follow-up period of 29 ± 23 mo, patients' return to sports, possible complications as well as the clinical outcomes using the Kujala, International Knee Documentation Committee (IKDC) and Lysholm scoring were evaluated...
December 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/29299655/medial-patellofemoral-ligament-reconstruction-in-children-do-osseous-abnormalities-matter
#5
Sebastien Pesenti, Matthieu Ollivier, Jean-Charles Escudier, Mathieu Cermolacce, Alexandre Baud, Franck Launay, Jean-Luc Jouve, Elie Choufani
PURPOSE: Management of post-traumatic patellar instability in children with osseous abnormalities is challenging because of the presence of an open physis. The aim of our study was to compare the rate of recurrence after isolated reconstruction of the medial patellofemoral ligament (MPFL) in children with or without osseous abnormalities. METHODS: The medical records of 25 children (27 knees) with recurrent patellar dislocation were reviewed. Each child underwent an isolated reconstruction of the MPFL using a hamstring graft...
January 4, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29298083/clinical-outcomes-after-isolated-medial-patellofemoral-ligament-reconstruction-for-patellar-instability-among-patients-with-trochlear-dysplasia
#6
Joseph N Liu, Jacqueline M Brady, Irene L Kalbian, Sabrina M Strickland, Claire Berdelle Ryan, Joseph T Nguyen, Beth E Shubin Stein
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction has become one of the most common and widely used procedures to regain stability among patients with recurrent lateral patellar dislocation. While recent studies demonstrated low recurrence rates, improved patient-reported outcome measures, and a high rate of return to sports, limited literature explored its effectiveness as an isolated intervention in the context of trochlear dysplasia. PURPOSE: To determine the efficacy of isolated MPFL reconstruction in treating patellar instability in the setting of trochlear dysplasia...
January 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29285073/the-significance-of-magnetic-resonance-imaging-in-severe-femoral-trochlear-dysplasia-assessment
#7
Ji Shen, Le Qin, Wei-Wu Yao, Mei Li
The clinical diagnosis of femoral trochlear dysplasia primarily relies on imaging. In the past, plain imaging was the major source of diagnosis. The present study investigated the application of magnetic resonance imaging (MRI) in the objective assessment of severe femoral trochlear dysplasia. A retrospective analysis was performed on knee MRIs from 30 normal subjects (30 knees) and 59 patients (61 knees) with severe femoral trochlear dysplasia based on the Dejour morphological classification. Cartilage and subchondral bone landmarks were used to compare a series of measurements between patient and control groups...
December 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29226423/patellar-tendinopathy-with-intra-tendinous-alteration-on-mri-may-be-related-to-patellofemoral-dysplasia
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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...
March 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29099881/patella-alta-sees-you-do-you-see-it
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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