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https://www.readbyqxmd.com/read/28932880/double-bundle-anatomical-medial-patellofemoral-ligament-reconstruction-with-lateral-retinaculum-plasty-can-lead-to-good-outcomes-in-patients-with-patellar-dislocation
#1
Yingzhen Niu, Xinmin Wang, Chang Liu, Xiaomeng Wang, Zhenyue Dong, Jinghui Niu, Fei Wang
PURPOSE: To evaluate the clinical outcomes of double-bundle anatomical medial patellofemoral ligament (MPFL) reconstruction combined with lateral retinaculum plasty versus isolated MPFL reconstruction for patellar dislocation. METHODS: From 2011 to 2013, 64 patients underwent either double-bundle anatomical MPFL reconstruction combined with lateral retinaculum plasty (Group A, 32 patients), or isolated MPFL reconstruction (Group B, 32 patients). Clinical evaluations were performed 2 years post-operatively and included determination of the number of patients with patellar redislocation, the patellar tilt angle, lateral patellar shift, subjective symptoms, and functional outcomes as evaluated with the Kujala score and Lysholm score...
September 20, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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
#2
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/28929187/morden-synthetic-material-is-a-safe-and-effective-alterative-for-medial-patellofemoral-ligament-reconstruction
#3
Paul Y F Lee, David Golding, Sam Rozewicz, Amit Chandratreya
PURPOSE: Medial patellofemoral ligament (MPFL) reconstruction is often performed using gracilis autografts, which may be associated with donor site morbidity and complications. The use of a synthetic material can circumvent a harvest operation and has previously been demonstrated to be effective in other types of reconstructive procedures and may be effective in MPFL reconstruction. This study reports the clinical result with the use of a morden ultra-high molecular weight polyethylene with a braided jacket of polyester tape (FT) in MPFL reconstruction compared to using standard autografts...
September 19, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28867290/modified-adductor-sling-technique-a-surgical-therapy-for-patellar-instability-in-skeletally-immature-patients
#4
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
#5
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
#6
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
#7
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/28741155/length-change-patterns-and-shape-of-a-grafted-tendon-after-anatomical-medial-patellofemoral-ligament-reconstruction-differs-from-that-in-a-healthy-knee
#8
Shuji Nakagawa, Yuji Arai, Hiroaki Inoue, Manabu Hino, Yuta Fujii, Shintaro Komaki, Kazuya Ikoma, Keiichiro Ueshima, Hiroyoshi Fujiwara, Toshikazu Kubo
PURPOSE: Recurrent patellar dislocation is currently treated with anatomical reconstruction of the medial patellofemoral ligament (MPFL), and favourable postoperative outcomes have been reported. However, it is uncertain if healthy MPFL function is restored by anatomical reconstruction. The hypothesis in this study was that stabilization of the patella following MPFL reconstruction would be improved compared with that before surgery, but that function of the grafted tendon would differ from that of a healthy MPFL...
July 24, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28706804/tibial-tuberosity-transfer-in-combination-with-medial-patellofemoral-ligament-reconstruction-surgical-technique
#9
Damian Clark, Katie Walmsley, Peter Schranz, Vipul Mandalia
The stability of the patellofemoral joint relies on the tenuous interplay of soft tissue and bony factors. Anatomic risk factors for instability include a shallow trochlea, an abnormally lateral tibial tubercle position, patella alta, hypermobility, or a secondary injury to the medial patellofemoral ligament (MPFL). There is an increasing interest in restoring normal anatomy to achieve stability, and at times more than 1 abnormality exists. This article describes the technique for combining a tibial tuberosity transfer and an MPFL reconstruction...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28702749/evaluation-of-different-surgical-methods-in-treating-recurrent-patella-dislocation-after-three-dimensional-reconstruction
#10
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/28684171/biomechanical-tensile-strength-analysis-for-medial-patellofemoral-ligament-reconstruction
#11
Patrick W Joyner, Jeremy Bruce, Travis S Roth, Frederic Baker Mills, Scott Winnier, Ryan Hess, Luke Wilcox, Aaron Mates, Tim Frerichs, James R Andrews, Charles A Roth
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction is a surgery for acute and chronic dislocating patella. Several surgical techniques have been described. No biomechanical study has compared suture anchors, interference screws, and suspensory cortical fixation for MPFL reconstruction using human gracilis allograft. METHODS: Twelve human cadaver knees were used for the analysis of five MPFL reconstruction techniques on the femur (F) and patella (P): suspensory cortical (SC), interference screw (IS) and suture anchor (SA) fixation (SC-F/SC-P, SC-F/IS-P, SC-F/SA-P, IS-F/SC-P, IS-F/IS-P)...
July 3, 2017: Knee
https://www.readbyqxmd.com/read/28680899/cyclic-testing-of-3-medial-patellofemoral-ligament-reconstruction-techniques
#12
Vishal Mehta, Cassie Mandala, Ahmed Akhter
BACKGROUND: Several techniques are available to secure the graft to the patella during medial patellofemoral ligament (MPFL) reconstruction. The biomechanical properties of these techniques remain unknown. PURPOSE: To compare the biomechanical properties of 3 MPFL patellar fixation techniques: bone tunnels (BT), PushLock anchors (PL), and tenodesis screws (TS). STUDY DESIGN: Controlled laboratory study. METHODS: Forty-five MPFL reconstructions were performed using 3 different reconstruction techniques (BT, PL, and TS)...
June 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28678520/return-to-play-guidelines-after-medial-patellofemoral-ligament-surgery-for-recurrent-patellar-instability-a-systematic-review
#13
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/28666039/ultrasound-guided-percutaneous-repair-of-medial-patellofemoral-ligament-surgical-technique-and-outcomes
#14
Alan M Hirahara, Wyatt J Andersen
A lateral patellar dislocation causes a medial patellofemoral ligament (MPFL) tear that begins affecting patellar biomechanics. Reconstruction is difficult because of the inability to reliably and accurately determine proper placement of sockets. Studies of MPFL anatomy have found significant variability in attachment site locations, which suggests MPFL procedures cannot be used universally and must be approached differently for each patient. Recurrent dislocations result in patellar and trochlear chondral and bony damage...
May 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28662894/medial-patellofemoral-ligament-medial-patellotibial-ligament-and-medial-patellomeniscal-ligament-anatomic-histologic-radiographic-and-biomechanical-study
#15
Betina B Hinckel, Riccardo G Gobbi, Marco K Demange, Cesar Augusto M Pereira, Jose Ricardo Pécora, Renato Jose M Natalino, Luciana Miyahira, Bruno S Kubota, Gilberto Luis Camanho
PURPOSE: To describe the anatomy (quantitative macroscopic and histologic), radiographic parameters of the insertions, and biomechanical characteristics of the medial ligamentous restrictors of the patella (medial patellofemoral ligament [MPFL], medial patellotibial ligament [MPTL], and medial patellomeniscal ligament [MPML]) in cadaveric knees. Because the MPTL and the MPML are not as well known as the MPFL, they were the focus of this study. METHODS: MPFLs, MPTLs, and MPMLs from 9 knees were dissected...
June 26, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28601942/anatomic-reconstruction-of-the-medial-patellofemoral-ligament-in-children-and-adolescents-using-a-pedicled-quadriceps-tendon-graft-shows-favourable-results-at-a-minimum-of-2-year-follow-up
#16
Manfred Nelitz, Jens Dreyhaupt, Sean Robert March Williams
PURPOSE: In adults, reconstruction of the medial patellofemoral ligament (MPFL) has shown good results. Treatment for recurrent patellar instability in children and adolescents with open growth plates, however, requires alternative MPFL reconstruction techniques. This study presents the outcomes of a minimally invasive technique for anatomic reconstruction of the MPFL in children using a pedicled superficial quadriceps tendon graft, hardware-free patellar graft attachment, and anatomic femoral fixation that spares the distal femoral physis...
June 10, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28593102/rehabilitation-following-medial-patellofemoral-ligament-reconstruction-for-patellar-instability
#17
Robert C Manske, Daniel Prohaska
Patellar instability is a common problem seen by physical therapists, athletic trainers and orthopedic surgeons. Although following an acute dislocation, conservative rehabilitation is usually the first line of defense; refractory cases exist that may require surgical intervention. Substantial progress has been made in the understanding of the medial patellofemoral ligament (MPFL) and its role as the primary stabilizer to lateral patellar displacement. Medial patellofemoral ligament disruption is now considered to be the essential lesion following acute patellar dislocation due to significantly high numbers of ruptures following this injury...
June 2017: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/28504748/terahertz-multilevel-phase-fresnel-lenses-fabricated-by-laser-patterning-of-silicon
#18
L Minkevičius, S Indrišiūnas, R Šniaukas, B Voisiat, V Janonis, V Tamošiūnas, I Kašalynas, G Račiukaitis, G Valušis
Multilevel phase Fresnel lenses (MPFLs) with a high numerical aperture for 0.58 THz frequencies were developed. The components based on a monocrystalline silicon wafer are prepared by patterning by a high-speed industrial-scale laser direct writing (LDW) system. Two consistent series of the terahertz-MPFLs with phase quantization levels varying between 2 and the continuous kinoform shape for the focal lengths of 5 and 10 mm were produced employing inherent flexibility of the LDW fabrication process. The focusing performance was studied at the optimal 0...
May 15, 2017: Optics Letters
https://www.readbyqxmd.com/read/28493040/stability-of-capsule-closure-and-postoperative-anterior-knee-pain-after-medial-parapatellar-approach-in-tka
#19
Armin Keshmiri, Fabian Dotzauer, Clemens Baier, Günther Maderbacher, Joachim Grifka, Ernst Sendtner
PURPOSE: Anterior knee pain after total knee arthroplasty (TKA) remains a widely discussed postoperative complication. In contrast to sports traumatology, the role of the dissected medial patellofemoral ligament (MPFL) using a medial parapatellar approach in TKA has not been discussed so far. In the present study, it was hypothesized that the attempted repair of the MPFL in TKA by simple closure of the joint capsule may not be successful in some cases, causing anterior knee pain. Furthermore, it was hypothesized, that the success of repair might be influenced by femoral component rotation...
May 10, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28459754/rehabilitation-after-medial-patellofemoral-ligament-reconstruction
#20
Terrence G McGee, Andrew J Cosgarea, Kevin McLaughlin, Miho Tanaka, Ken Johnson
Patellar instability resulting from subluxation or dislocation is a painful and commonly recurring condition. Retinacular restraints control patellar tracking, limiting the movement of the patella in the trochlear groove. The medial patellofemoral ligament (MPFL) is considered the main soft tissue stabilizer against lateral displacement. Few studies of patellar instability discuss rehabilitation after MPFL reconstruction. In this review, we discuss the phases of rehabilitation after MPFL reconstruction, typical interventions by rehabilitation specialists, and patient-specific guidelines for return to prior level of function...
June 2017: Sports Medicine and Arthroscopy Review
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