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https://www.readbyqxmd.com/read/27904790/current-concepts-in-the-treatment-of-gross-patellofemoral-instability
#1
Grant Buchanan, LeeAnne Torres, Brian Czarkowski, Charles E Giangarra
: Patellofemoral instability is a painful and commonly recurring condition, which often must be managed surgically. Diagnosis can be aided by the use of a variety of physical exam signs, such as the Q angle, Beighton hypermobility score, glide test, J sign, patellar tilt test, and apprehension test. Imaging modalities including x-ray, CT, and MRI guide both diagnosis and management by revealing trochlear dysplasia, bony malalignment, and ligamentous injury that contribute to instability...
December 2016: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/27842571/medial-patellofemoral-ligament-reconstruction-using-a-bone-groove-and-a-suture-anchor-at-patellar-a-safe-and-firm-fixation-technique-and-3-year-follow-up-study
#2
Hong-De Wang, Jiang-Tao Dong, Shi-Jun Gao
BACKGROUND: Graft fixation is critical to the restoration of the medial patella of femoral ligament function and long-term success. Numerous fixations at the patella have been described, while the complications including patellar fractures, violation of the posterior patella and delay of tendon-to-bone healing remain significant challenges. Here, we describe a safe and firm fixation at the patellar for medial patellofemoral ligament (MPFL) reconstruction and explore the safety angle of drilling the suture anchor at different morphology of the patellar...
November 14, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27810431/clinical-results-after-treatment-for-bidirectional-patellar-subluxation-minimum-2-years-follow-up
#3
Michael Saper, Candice Brady, Robert Zondervan, David Shneider
BACKGROUND: We describe the preliminary clinical results of a patellar stabilization technique to treat bidirectional patellar subluxation (BPS). METHODS: Patients: six patients (one male, five females; mean age 30.2years) underwent this procedure with a minimum of 24months follow-up. Patients were assessed for clinical instability, patellar complications, and need for revision surgery. Patient functional outcomes were evaluated using the criteria of Crosby and Insall and the Kujala Anterior Knee Pain Scale at the time of final follow-up...
December 2016: Knee
https://www.readbyqxmd.com/read/27810430/outcomes-of-surgical-stabilization-in-patients-with-combined-acl-deficiency-and-patellofemoral-instability-a-case-series
#4
Laurie A Hiemstra, Sarah Kerslake, Mark Heard, Gregory Buchko, Mark Lafave
BACKGROUND: The purpose of this study was to assess the disease-specific quality of life, and the objective clinical and functional outcomes of patients with symptomatic ACL deficiency and patellofemoral instability following surgical stabilization of both ligaments. METHODS: Between February 2010 and August 2013, 22 subjects underwent a combined ACL reconstruction and patellofemoral stabilization. The anterior cruciate ligament quality of life questionnaire (ACL-QOL) was completed pre-operatively and two-years post-operatively...
December 2016: Knee
https://www.readbyqxmd.com/read/27796419/results-of-medial-patellofemoral-ligament-reconstruction-compared-with-trochleoplasty-plus-individual-extensor-apparatus-balancing-in-patellar-instability-caused-by-severe-trochlear-dysplasia-a-systematic-review-and-meta-analysis
#5
REVIEW
Peter Balcarek, Stephan Rehn, Nick R Howells, Jonathan D Eldridge, Keisuke Kita, David Dejour, Manfred Nelitz, Ingo J Banke, Delphine Lambrecht, Markus Harden, Tim Friede
PURPOSE: Many studies have reported satisfactory clinical outcomes and low redislocation rates after reconstruction of the medial patellofemoral ligament (MPFL) for the treatment of lateral patellar instability. Despite uncorrected severe trochlear dysplasia (Dejour type B to D) being acknowledged as a major reason for less favourable clinical outcomes and a higher incidence of patellar redislocations after an isolated MPFL reconstruction, the evidence for a deepening trochleoplasty procedure remains scarce in the current literature...
October 27, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27765469/patellar-dislocation-not-the-bees-knees
#6
Martin Duignan, Mary McGibney
BACKGROUND: Patellar dislocations are common, particularly in the adolescent polulation. Registered Advanced Nurse Practitioners are healthcare professionals who can appropriately manage these injuries to minimise the risk of chronicity. METHODS: This is a case study which uses a clinical examplar from the authors practice focusing on the assessment, diagnosis and managment of patellar dislocations. Particular reference is made of the significance of the MPFL. RESULTS: This paper highlights the importance of recognition of appropriate management of patellar dislocations in the ED setting...
October 17, 2016: International Emergency Nursing
https://www.readbyqxmd.com/read/27709116/dynamic-simulation-of-the-effects-of-graft-fixation-errors-during-medial-patellofemoral-ligament-reconstruction
#7
John J Elias, Michael J Kelly, Kathryn E Smith, Kenneth A Gall, Jack Farr
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction is performed to prevent recurrent instability, but errors in femoral fixation can elevate graft tension. HYPOTHESIS: Errors related to femoral fixation will overconstrain the patella and increase medial patellofemoral pressures. STUDY DESIGN: Controlled laboratory study. METHODS: Five knees with patellar instability were represented with computational models...
September 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/27631645/origin-and-insertion-of-the-medial-patellofemoral-ligament-a-systematic-review-of-anatomy
#8
Arash Aframian, Toby O Smith, T Duncan Tennent, Justin Peter Cobb, Caroline Blanca Hing
PURPOSE: The medial patellofemoral ligament (MPFL) is the major medial soft-tissue stabiliser of the patella, originating from the medial femoral condyle and inserting onto the medial patella. The exact position reported in the literature varies. Understanding the true anatomical origin and insertion of the MPFL is critical to successful reconstruction. The purpose of this systematic review was to determine these locations. METHODS: A systematic search of published (AMED, CINAHL, MEDLINE, EMBASE, PubMed and Cochrane Library) and unpublished literature databases was conducted from their inception to the 3 February 2016...
September 8, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27626368/surgical-versus-nonsurgical-treatments-of-acute-primary-patellar-dislocation-with-special-emphasis-on-the-mpfl-injury-patterns
#9
Gang Ji, Shengjie Wang, Xiaomeng Wang, Junhang Liu, Jinghui Niu, Fei Wang
The objective of the present study was to compare the clinical results of the surgical versus nonsurgical treatments of acute primary patellar dislocations with a medial patellofemoral ligament (MPFL) injury in the nonoverlap region with the vastus medialis oblique. In this study, 62 patients with an acute patellar dislocation and a concurrent MPFL injury in the nonoverlap region were randomly divided into two groups based on their birth years (even vs. odd years) and received either surgical or nonsurgical treatment...
September 14, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27600522/biomechanical-and-histological-comparison-between-the-cryopreserved-and-the-lyophilized-gracilis-tendon-allograft-for-mpfl-reconstruction-a-cadaveric-experimental-study
#10
Roberto Negrín, Jaime Duboy, Fernando Olavarría, Mauricio Wainer, Horacio Jimenez, Facundo Las Heras, Nicolas Reyes, Hugo Godoy
BACKGROUND: Medial patellofemoral ligament (MPFL) is the main restrictor of lateral shifting of the patella, contributing by 60 % in the first 20° flexion of the knee. MPFL reconstruction has been performed in order to restore the stability of the patella with good results.Lyophilized Gracilis tendon allograft (LGA) compared to Cryopreserved Gracilis tendon allograft (CGA) has a lower cost, does not require to maintain cooling chain or preparation. The purpose of this study is to compare the histological and biomechanical characteristics of an experimental model of reconstruction of the MPFL in porcine patellas with LGA versus CGA...
December 2016: Journal of Experimental Orthopaedics
https://www.readbyqxmd.com/read/27590642/does-the-utilization-of-allograft-tissue-in-medial-patellofemoral-ligament-reconstruction-in-pediatric-and-adolescent-patients-restore-patellar-stability
#11
Eric Hohn, Nirav K Pandya
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction is one of several surgical procedures used to treat patellofemoral instability. Use of allograft tissue can preserve autogenous tissue and may be preferable in patients with connective tissue disorders or ligamentous laxity. Although there are successful reports in adults, it is unclear if the use of allograft tissue in MPFL reconstruction can restore patellofemoral stability in children and adolescents. QUESTIONS/PURPOSES: (1) Does allograft tissue in MPFL reconstruction in pediatric and adolescent patients restore patellar stability? (2) What complications were associated with allograft MPFL reconstructions in children and adolescents? METHODS: Between June 2012 and August 2015, one surgeon (NKP) performed 26 MPFL reconstructions in 23 patients with gracilis allograft for traumatic patellar instability...
September 2, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27565481/an-evaluation-of-the-effectiveness-of-medial-patellofemoral-ligament-reconstruction-using-an-anatomical-tunnel-site
#12
Kars P Valkering, Aysha Rajeev, Nick Caplan, Wim E Tuinebreijer, Deiary F Kader
PURPOSE: Medial patellofemoral ligament (MPFL) reconstruction for recurrent patellar instability has gained popularity, and anatomical and biomechanical studies have recently altered our operative techniques. The aim of this study was to report the clinical outcome of this new anatomical MPFL reconstructive technique and investigate whether correlating factors could be identified. METHODS: Between 2009 and 2012, a total of 31 consecutive patients underwent MPFL reconstruction using an autologous gracilis graft and anatomical tunnel placement...
August 26, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27544273/patellar-tracking-after-isolated-medial-patellofemoral-ligament-reconstruction-dynamic-evaluation-using-computed-tomography
#13
Riccardo G Gobbi, Marco K Demange, Luiz Francisco Rodrigues de Ávila, José de Arimatéia Batista Araújo Filho, Ramon Alfredo Moreno, Marco Antônio Gutierrez, Marina de Sá Rebelo, Luis Eduardo Passarelli Tírico, José Ricardo Pécora, Gilberto Luis Camanho
PURPOSE: Medial patellofemoral ligament (MPFL) reconstruction offers good clinical results with a very low rate of instability recurrence. However, its in vivo effect on patellar tracking is not clearly known. The aim of this study is to investigate the effects of MPFL reconstruction on patellar tracking using dynamic 320-detector-row CT. METHODS: Ten patients with patellofemoral instability referred to isolated MPFL reconstruction surgery were selected and subjected to dynamic CT before and ≥6 months after surgery...
August 20, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27474384/the-relationship-of-the-femoral-physis-and-the-medial-patellofemoral-ligament-in-children-a-cadaveric-study
#14
Kevin G Shea, Alexandra C Styhl, John C Jacobs, Theodore J Ganley, Matthew D Milewski, Peter C Cannamela, Allen F Anderson, John D Polousky
BACKGROUND: Young athletes sustain patellar dislocations in a variety of sports. The medial patellofemoral ligament (MPFL) is a critical structure that functions as an anatomic checkrein to help prevent lateral patellar dislocation. Reconstruction of this ligament is challenging in patients with open physes because of concerns about iatrogenic damage to the femoral physis. PURPOSE: To evaluate the relationship of the distal femoral physis and the MPFL. STUDY DESIGN: Descriptive laboratory study...
November 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27405577/complications-of-medial-patellofemoral-ligament-reconstruction-using-two-transverse-patellar-tunnels
#15
Loes Schiphouwer, Akkie Rood, Siebren Tigchelaar, Sander Koëter
PURPOSE: The aim of this study was to report the complication rate after a medial patellofemoral ligament (MPFL) reconstruction using transverse patellar tunnels in a retrospective case series performed in a single institution. METHODS: Case series of 179 patients (192 knees) that had an MPFL reconstruction, with or without additional bony realignment procedures, between January 2009 and March 2015. Data were obtained from available patient charts. RESULTS: Thirty-nine complications (20...
July 12, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27386447/acute-patellofemoral-instability-in-children-and-adolescents
#16
Pierluigi Antinolfi, Matteo Bartoli, Giacomo Placella, Andrea Speziali, Valerio Pace, Marco Delcogliano, Claudio Mazzola
Patellofemoral problems are considered to be among the most frequent causes of knee pain in children and adolescents. Correcting bone abnormalities through specific and targeted interventions is mandatory in skeletally immature patients. Medial patellofemoral ligament (MPFL) reconstruction is the preferred procedure, but there are several important precautionary considerations that the surgeon must take into account. It must always be remembered that MPFL rupture is the result, not the cause, of an altered extensor mechanism; therefore, patellar stabilization with MPFL reconstruction is only the first step to be accomplished in the management of an MPFL rupture...
January 2016: Joints
https://www.readbyqxmd.com/read/27372556/a-prospective-randomized-trial-evaluating-two-different-tensioning-techniques-for-medial-patellofemoral-ligament-reconstruction
#17
Huijun Kang, Fei Wang, Jianhui Cao, Xiaohui Liu, Gang Ji
BACKGROUND: In the literature, graft tension was mostly assessed under direct arthroscopy vision for a MPFL reconstruction. The purpose of this study was to prospectively assess the outcomes of MPFL reconstruction with graft tension of self-balance technique in comparison with arthroscopy-view technique. METHODS: Sixty patients with recurrent patellar dislocation were randomly divided into two groups to undergo MPFL reconstruction with graft tension either by the self-balance technique (SB group) or the arthroscopy-view technique (AV group)...
October 2016: Knee
https://www.readbyqxmd.com/read/27354953/soft-tissue-loop-for-medial-patellofemoral-ligament-reconstruction
#18
Mohd Fairudz Bin Mohd Miswan, Mohamed Zubair Mohamed Al-Fayyadh, Teo Seow Hui, Mohamed Razif Bin Mohamed Ali, Wuey Min Ng
A patient with patellar instability frequently presents with anterior knee pain, patellar subluxation, or dislocation. Medial patellofemoral ligament (MPFL) has a key role for normal patella tracking and stability. Reconstruction of the MPFL using a hamstring graft is a commonly used procedure for the treatment of chronic lateral subluxation of patella. Anchor sutures and bony tunnels are used for the patellar attachment of the graft. This can be associated with complications such as patella fracture; besides, it does not produce an anatomical reconstruction for the native MPFL that can alter the direction of tension applied on the patella...
April 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27352088/injury-patterns-of-medial-patellofemoral-ligament-after-acute-lateral-patellar-dislocation-in-children-correlation-analysis-with-anatomical-variants-and-articular-cartilage-lesion-of-the-patella
#19
Guang-Ying Zhang, Lei Zheng, Hao Shi, Bing-Jun Ji, Yan Feng, Hong-Yu Ding
OBJECTIVES: To assess the relationship between injury patterns of medial patellofemoral ligament (MPFL) and anatomical variants and patellar cartilage lesions after acute lateral patellar dislocation (LPD) in children. METHODS: MR images were obtained in 140 children with acute LPD. Images were acquired and evaluated using standardised protocols. RESULTS: Fifty-eight cases of partial MPFL tear and 75 cases of complete MPFL tear were identified...
June 28, 2016: European Radiology
https://www.readbyqxmd.com/read/27348056/pellegrini-stieda-ossification-can-also-involve-the-posterior-attachment-of-the-mpfl
#20
Tatum A McArthur, Michael J Pitt, William P Garth, Carl A Narducci
PURPOSE: To evaluate for development of Pellegrini-Stieda (PS)-type ossification following injury to the posterior attachment of the medial patellofemoral ligament (MPFL). MATERIALS AND METHODS: This retrospective study evaluated 27 patients with acute knee injury with initial radiographs, magnetic resonance imaging within 1 week of injury, and follow-up radiographs assessing for development of PS. RESULTS: Of the 27 patients who developed PS ossification, 7 patients (25...
September 2016: Clinical Imaging
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