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Trochleoplasty

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https://www.readbyqxmd.com/read/29675504/surgical-treatment-of-objective-patellar-instability-long-term-results
#1
Massimo Berruto, Francesco Mattia Uboldi, Paolo Ferrua, Giovanni Vergottini, Andrea Manunta
Purpose  To evaluate the long-term results of classical "à la carte" surgical treatment of objective patellar instability as proposed by Dejour in 1987. Methods  A multicentric retrospective study was conducted evaluating patients that underwent surgical procedure with a 10-year minimum follow-up (mean 12.7; range, 10-15). Surgical procedures were medial transfer of the tibial tubercle transfer according to Elmslie and Trillat et al in 38 cases, plasty of the vastus medialis obliquus according to Insall in 15 cases, open lateral retinacular release in 13 cases, capsuloplasty in 3 cases, and trochleoplasty in 1 case...
March 2018: Joints
https://www.readbyqxmd.com/read/29552477/sulcus-deepening-trochleoplasty-and-medial-patellofemoral-ligament-reconstruction-for-recurrent-patellar-instability
#2
Michael S Laidlaw, Scott M Feeley, Jeffrey R Ruland, David R Diduch
There are multiple etiologies for recurrent patellar instability. While patella alta, an elevated tibial tubercle trochlear groove distance, and prior lateral patellar dislocations with medial patellofemoral ligament (MPFL) insufficiency have been shown to be risk factors for recurrent patellar instability, trochlear dysplasia can result in a significant impediment to normal patellar tracking. With the adequate identification of risk factors, appropriate surgical treatments can be individually tailored to the patient...
February 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29457385/-current-status-and-expectations-in-the-surgical-treatment-of-recurrent-lateral-patellar-dislocation
#3
Zhi-Dong Zhao, Peng-Cui Li, Xiao-Chun Wei
Up to now, surgical treatment of recurrent lateral patellar dislocation mainly includes: medial patellofemoral ligament reconstruction, tibial tubercle osteotomy, trochleoplasty, lateral retinacular release, derotation osteotomy and so on . Clinical reports show that: the use of a single or combined with several methods have achieved ideal short to mid-term clinical outcomes. However, there is no consolidate criterion concerning the choices of different kinds of surgical ways for the treatment of individual recurrent lateral patellar dislocation...
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29410197/patellofemoral-reconstruction-for-patellar-instability-with-patella-alta-in-middle-aged-patients-clinical-outcomes
#4
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/29349972/-current-therapy-progress-on-the-recurrent-patellar-dislocation
#5
REVIEW
Wan-Quan Cao, Zi-Quan Yang, Gang Wang, Ya-Xun Men, Xiang-Yun Cheng
Patients who suffer from the recurrent patellar dislocation mainly show the recurrent dislocation of patellar, giving way, most patients have the history of trauma or dysplasia of keen joint. Traditional therapies of recurrent patellar dislocation include medical retinaculum placation, lateral retinaculum release, tibial tubercle osteotomy, femoral trochleoplasty etc. In recent years, with the development of anatomical and biomechanical researches on medial patellofemoral ligament(MPFL), more and more experts focus on the role of MPFL played in preventing the patellar dislocation...
March 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29322270/recent-developments-in-evaluation-and-treatment-of-lateral-patellar-instability
#6
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
#7
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/29210022/trochleoplasty-procedures-show-complication-rates-similar-to-other-patellar-stabilizing-procedures
#8
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/29134368/-patellofemoral-instability
#9
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...
January 2018: Der Orthopäde
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
#10
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/28932876/effective-patellofemoral-joint-stabilization-and-low-complication-rates-using-a-hardware-free-mpfl-reconstruction-technique-with-an-intra-operative-adjustment-of-the-graft-tension
#11
Lars V von Engelhardt, Torsten Fuchs, Pia Weskamp, Joerg Jerosch
PURPOSE: Even if medial patellofemoral ligament (MPFL) reconstruction is a proven method, complications such as implant loosening, patella fractures, recurrent luxations, knee pain or knee stiffness are frequently described. Besides a correct tunnel positioning and implant-specific complications, this might be caused by difficulties with an appropriate graft tensioning. The study presented here is a necessary first step in exploring our technique of a double-limbed, hardware-free MPFL reconstruction, which provides another way to test and adjust the graft tension before permanent fastening...
September 20, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28666037/joint-preserving-osteotomies-for-isolated-patellofemoral-osteoarthritis-alternatives-to-arthroplasty
#12
Vicente Sanchis-Alfonso, Jason L Koh
Patellofemoral osteotomies can provide excellent symptomatic relief for selected patients with isolated patellofemoral osteoarthritis (PFOA). Isolated PFOA is a relatively common disorder, seen in 24% of women and 11% of men over the age of 55 years. In up to 89% of these patients, PFOA occurs at the lateral facet of the patella, and is especially amenable to surgical treatment. Particularly in younger patients, joint-preserving osteotomies can provide excellent and reliable relief while delaying the need for partial or joint arthroplasty and subsequent revision...
May 2017: American Journal of Orthopedics
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
#13
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
https://www.readbyqxmd.com/read/28567511/trochleoplasty-techniques-provide-good-clinical-results-in-patients-with-trochlear-dysplasia
#14
REVIEW
Umile Giuseppe Longo, Candela Vincenzo, Nicholas Mannering, Mauro Ciuffreda, Giuseppe Salvatore, Alessandra Berton, Vincenzo Denaro
PURPOSE: The aim of this systematic review is to compare the clinical outcomes of patients treated with different trochleoplasty procedures, the rate of complications and recurrence of patellar dislocation. METHODS: A systematic review of the literature was performed, in accord with the PRISMA guidelines. PubMed, MEDLINE, CINAHL, Cochrane, EMBASE and Google Scholar databases were comprehensively searched using the keyword combinations, "Dejour trochleoplasty", "Bereiter Trochleoplasty", "Albee Trochleoplasty", "Recession Trochleoplasty", "Trochlear Dysplasia", "Instability", "Adult", "Clinical Outcome" and "Surgery"...
May 31, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28510474/increased-magnetic-resonance-imaging-signal-of-the-lateral-patellar-facet-cartilage-a-functional-marker-for-patellar-instability
#15
Anna L Falkowski, Carlo Camathias, Jon A Jacobson, Olaf Magerkurth
BACKGROUND: In the knee joint, predisposition for patellar instability can be assessed by an abnormal Insall-Salvati index, tibial tuberosity-trochlear groove (TTTG) distance, and abnormal shape of patella and trochlea. Given the complex anatomic features of the knee joint with varying positions of the patella during motion, the presence of a single or even a combination of these factors does not inevitably result in patellar instability. After trocheoplasty in patients with trochlear dysplasia, assessment of trochlear cartilage and subchondral bone is limited due to postoperative artifacts...
August 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28459752/patellar-instability-when-is-trochleoplasty-necessary
#16
S Evan Carstensen, Heather M Menzer, David R Diduch
Trochleoplasty is a very effective procedure for correcting trochlear dysplasia and addressing instability of the patella. With an increasing knowledge about the anatomy and biomechanics of the anterior distal femur, a wider array of surgical techniques may be applied to address specific conditions. Patients must be carefully selected to undergo trochleoplasty by use of a thorough history and physical examination as well as basic and advanced imaging. The presence of a "J sign" on physical examination, a history of recurrent instability, patella alta, trochlear dysplasia, and elevated tibial tubercle to trochlear groove are signs and symptoms for which the patient should be evaluated...
June 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28437493/the-role-of-medial-patellofemoral-ligament-repair-and-imbrication
#17
REVIEW
Kyle R Duchman, Matthew J Bollier
Repair, reefing, and advancement of the medial patellofemoral ligament (MPFL) and medial retinacular structures can be performed as an isolated procedure or in conjunction with distal realignment procedures for patients with patellar instability. Although various operative techniques have been described, understanding the appropriate clinical indications and MPFL injury patterns ultimately determines the success or failure of the procedure. MPFL repair is best indicated in the acute setting, particularly if there is a patella- or femoral-based avulsion...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28396049/acquired-femoral-flexion-deformity-due-to-physeal-injury-during-medial-patellofemoral-ligament-reconstruction
#18
Gerd Seitlinger, Philipp Moroder, Christian Fink, Guido Wierer
BACKGROUND: Reconstruction of the medial patellofemoral ligament (MPFL) is the most frequent surgical procedure performed in patients with patellar instability. Recently, concerns regarding physeal injury during femoral tunnel placement for anatomical MPFL reconstruction in children have been discussed. METHODS: This is the first case to report partial posterior physeal growth arrest and subsequent flexion deformity of the distal femur after MPFL reconstruction in a skeletally immature patient...
June 2017: Knee
https://www.readbyqxmd.com/read/28249974/trochleoplasty-with-a-flexible-osteochondral-flap-results-from-an-11-year-series-of-214-cases
#19
A J Metcalfe, D A Clark, M A Kemp, J D Eldridge
AIMS: The Bereiter trochleoplasty has been used in our unit for 12 years to manage recurrent patellar instability in patients with severe trochlea dysplasia. The aim of this study was to document the outcome of a large consecutive cohort of patients who have undergone this operation. PATIENTS AND METHODS: Between June 2002 and August 2013, 214 consecutive trochleoplasties were carried out in 185 patients. There were 133 women and 52 men with a mean age of 21.3 years (14 to 38)...
March 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28178962/the-outcomes-of-the-modified-fulkerson-osteotomy-procedure-to-treat-habitual-patellar-dislocation-associated-with-high-grade-trochlear-dysplasia
#20
Hong Chen, Daohong Zhao, Jingming Xie, Qihui Duan, Jun Zhang, Zhidan Wu, Jia Jiang
BACKGROUND: Habitual patellar dislocation is not common in clinical practice, but it has a deep impact on the patient's lifestyle and movement. There has been no large case-control study on habitual patellar dislocation, and the management of it is still controversial. The aim of this study was to observe the efficacy of the modified Fulkerson procedure on patients with habitual patellar dislocation with high-grade trochlear dysplasia without trochleoplasty and to evaluate the results of this procedure...
February 8, 2017: BMC Musculoskeletal Disorders
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