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Patellofemoral

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https://www.readbyqxmd.com/read/29330745/-treatment-of-rotational-malalignment-of-the-lower-leg
#1
REVIEW
P Keppler
BACKGROUND: Rotational malalignment after intramedullary nailing of tibial shaft fractures is not uncommon. In-toeing and out-toeing conditions in children are often the reason for orthopedic and traumatological medical consultation. OBJECTIVE: Evaluation of diagnostic modalities and therapeutic options for rotational malalignment in relationship to the patient's age. Surgical indications and efficacy of specific surgical techniques. MATERIAL AND METHODS: Systematic literature search in the German Institute for Medical Documentation and Information (DIMDI) and MEDLINE and evaluation of the currently published articles...
January 12, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29327606/the-effects-of-joint-mobilization-on-individuals-with-patellofemoral-pain-a-systematic-review
#2
Dhinu J Jayaseelan, David A Scalzitti, Geoff Palmer, Alex Immerman, Carol A Courtney
OBJECTIVE: To investigate and synthesize the effects of joint mobilization on individuals with patellofemoral pain syndrome. DATA SOURCES: Five electronic databases (CINAHL, the Cochrane Central Register of Controlled Trials, PubMed, Scopus, and SPORTDiscus) were used. REVIEW METHODS: Each database was searched from inception to 1 November 2017. Randomized controlled trials investigating a manual therapy intervention, with or without co-interventions, for persons with patellofemoral pain were included...
January 1, 2018: Clinical Rehabilitation
https://www.readbyqxmd.com/read/29324820/incidence-and-prevalence-of-patellofemoral-pain-a-systematic-review-and-meta-analysis
#3
Benjamin E Smith, James Selfe, Damian Thacker, Paul Hendrick, Marcus Bateman, Fiona Moffatt, Michael Skovdal Rathleff, Toby O Smith, Pip Logan
BACKGROUND: Patellofemoral pain is considered one of the most common forms of knee pain, affecting adults, adolescents, and physically active populations. Inconsistencies in reported incidence and prevalence exist and in relation to the allocation of healthcare and research funding, there is a clear need to accurately understand the epidemiology of patellofemoral pain. METHODS: An electronic database search was conducted, as well as grey literature databases, from inception to June 2017...
2018: PloS One
https://www.readbyqxmd.com/read/29324527/distal-femoral-valgus-and-recurrent-traumatic-patellar-instability-is-an-isolated-varus-producing-distal-femoral-osteotomy-a-treatment-option
#4
Philip L Wilson, Sheena R Black, Henry B Ellis, David A Podeszwa
BACKGROUND: Genu valgum, a risk factor for recurrent patellofemoral instability, can be addressed with a varus producing distal femoral osteotomy (DFO). The purpose of this study is to report 3-year clinical and radiographic outcomes on a series of skeletally mature adolescents with traumatic patellofemoral instability and genu valgum who underwent a varus producing DFO. METHODS: Consecutive patients (n=11) who underwent an isolated DFO for recurrent traumatic patellar instability over a 4-year study period (2009 to 2012) were reviewed...
January 10, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29322904/modular-bicompartmental-knee-arthroplasty-indications-technique-prosthetic-design-and-results
#5
R Kanna
The shifting demographics of patients with localized knee arthritis, including younger, more active patients, is a chief motivation for mounting interest in tissue preserving surgical substitutes for total knee arthroplasty (TKA). Unlinked, modular bi-compartmental knee arthroplasty (MBKA) is an emerging knee-resurfacing approach that provides a conservative alternative to TKA. Arthritis involving both patellofemoral and either medial or lateral tibiofemoral compartments, with no significant deformity or bone deficiency, preserved motion, and intact cruciate ligaments, can be effectively managed with MBKA...
March 2017: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/29322318/total-knee-arthroplasty-with-unexplained-pain-new-insights-from-kinematics
#6
Célia Planckaert, Gabriel Larose, Pierre Ranger, Marc Lacelle, Alexandre Fuentes, Nicola Hagemeister
INTRODUCTION: Up to 20% of total knee arthroplasty patients remain unsatisfied post-surgery, and a large proportion of them report anterior knee pain. This study aims to verify whether patients who experience anterior knee pain after total knee arthroplasty (TKA) will exhibit kinematic characteristics similar to those associated with patellofemoral syndrome, including in the frontal and transverse planes. MATERIALS AND METHODS: Using four different assessment methods [radiological, patient-reported outcome, musculoskeletal assessment with functional performance testing, and a 3D kinematic assessment during gait], the clinical and 3D knee kinematic profiles of three groups were compared: a painful and an asymptomatic TKA group and a healthy control group...
January 10, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29322270/recent-developments-in-evaluation-and-treatment-of-lateral-patellar-instability
#7
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/29320945/the-influence-of-exercise-dosing-on-outcomes-in-patients-with-knee-disorders-a-systematic-review
#8
Jodi L Young, Daniel I Rhon, Joshua A Cleland, Suzanne J Snodgrass
Study Design Systematic review. Background Therapeutic exercise is commonly used to treat individuals with knee disorders, but dosing parameters for optimal outcomes are unclear. Large variations exist in exercise prescription, and research related to specific dosing variables for knee osteoarthritis, patellar tendinopathy and patellofemoral pain syndrome is sparse. Objectives To identify specific doses of exercise related to improved outcomes of pain and function in individuals with common knee disorders, categorized by effect size...
January 10, 2018: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/29312853/deepening-trochleoplasty-combined-with-balanced-medial-patellofemoral-ligament-reconstruction-for-an-adequate-graft-tensioning
#9
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/29305291/medial-patellofemoral-ligament-reconstruction-impact-of-knee-flexion-angle-during-graft-fixation-on-dynamic-patellofemoral-contact-pressure-a-biomechanical-study
#10
Olaf Lorbach, Nikolaus Zumbansen, Matthias Kieb, Turgay Efe, Antonius Pizanis, Dieter Kohn, Alexander Haupert
PURPOSE: Objective evaluation of the optimal graft tension angle to fully restore patellofemoral contact pressure in reconstruction of the medial patellofemoral ligament (MPFL) in comparison to the native knee. METHODS: Twelve cadaveric knee specimens were fixed in a custom-made fixation device. A sensitive pressure film (Tekscan) was fixed in the patellofemoral joint, and patellofemoral contact pressure was assessed during a dynamic flexion movement from 0° to 90°...
January 2, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29304963/editorial-commentary-are-knee-patellofemoral-surgeons-overestimating-their-anteromedialization-measurements
#11
EDITORIAL
Jack Farr
Anteromedialization as originally described by Fulkerson has become an important tool in the armamentarium of patellofemoral surgeons. The goal is to combine the unloading of tibial tubercle anteriorization and the realignment of tubercle medialization. The classic teaching, that the steepest slope of 60° allows approximately 9 mm of medialization with 15 mm of unloading anteriorization, is now challenged, and we may not be achieving the amount of anteriorization as preoperatively planned. Because failure to unload the patellofemoral compartment may adequately compromise surgical outcomes, thorough re-evaluation of anteromedialization measurement is warranted...
January 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29303366/current-clinical-radiological-and-treatment-perspectives-of-patellofemoral-pain-syndrome
#12
Aishwarya Gulati, Christopher McElrath, Vibhor Wadhwa, Jay P Shah, Avneesh Chhabra
Anterior knee pain in active young adults is commonly related to patellofemoral (PF) pain syndrome (PFPS), which can be broadly classified into patellar malalignment and patellar maltracking. PFPS can be caused by a host of miserable malalignments, such as excessive femoral antetorsion, tibial varus / external rotation, knee valgus and pes planus. Radiographic, CT and MRI evaluations are commonly obtained to further elucidate the malalignment and maltracking abnormalities and exclude other related differentials, such as lateral meniscus tear, extensor tendon tear, anterior tenosynovial giant cell tumor and plica syndrome...
January 5, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29302781/a-new-minimally-invasive-surgical-technique-for-medial-retinaculum-repair-following-traumatic-patellar-dislocation
#13
Haim Shtarker, Michael Assaf, Marshall N Deltoff
A new surgical method is introduced offering a less invasive approach to reattach the medial retinaculum following acute patellar dislocation. This retrospective analysis comprised 12 cases of medial retinacular repair in 10 patients. The surgical technique achieved reinforced reattachment of the torn region of the medial retinaculum for improved patellar support and stabilization. During follow-up, no recurrent patellar dislocations occurred, except where one patient reported a subjective feeling of patellar dislocation...
January 4, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29300223/osteotomies-in-patello-femoral-instabilities
#14
David Dejour, Bertrand Le Coultre
Patellar instability is defined by clinical and radiologic criteria. The surgical treatment is aimed at restoring the congruence of the patellofemoral articulation and correcting extensor mechanism malalignment, to prevent recurrence of dislocation. The standard soft-tissue procedures are lateral release and vastus medialis advancement and medial patello femoral ligament plasty. Bony procedures are frequently performed in addition to soft-tissue surgery, to realign the extensor mechanism by means of tibial tubercle medialization, or to correct the patellar index in patella alta...
March 2018: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/29299655/medial-patellofemoral-ligament-reconstruction-in-children-do-osseous-abnormalities-matter
#15
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/29299472/does-a-simple-syringe-applicator-enhance-bone-cement-set-up-time-in-knee-arthroplasty
#16
Nipun Sodhi, Sarah E Dalton, Anton Khlopas, Assem A Sultan, Gannon L Curtis, Matthew A Harb, Qais Naziri, Jared M Newman, John W Barrington, Michael A Mont
Background: The time required for polymethylmethacrylate (PMMA) cement curing or hardening can be modified by a number of variables including the mixing technique, and the temperature and pressure at which the process is taking place. Therefore, the purpose of this study was to evaluate two different methods of PMMA application in terms of set up time. Specifically, we (I) compared the PMMA set up time of cement that remained in the mixing bowl to cement that was placed in a syringe and (II) extrapolated the associated annual cost difference on the national and individual surgeon levels...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29298263/subtubercle-osteotomy-for-medial-compartment-osteoarthritis-of-the-knee-using-ilizarov-technique-survival-analysis-and-clinical-outcomes
#17
Stephen J Warner, Daniel P O'Connor, Mark R Brinker
BACKGROUND: High tibial osteotomy with acute correction and internal fixation can be used to correct malalignment and malorientation and reduce symptoms in patients with medial compartment osteoarthritis of the knee. To address the inadequacies of this technique, we performed a series of subtubercle tibial osteotomy (STO) procedures using circular ring fixation to correct knee varus malalignment and joint malorientation. The purpose of this study was to analyze the ability of this technique to delay subsequent knee arthroplasty and decrease symptoms...
January 3, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29298083/clinical-outcomes-after-isolated-medial-patellofemoral-ligament-reconstruction-for-patellar-instability-among-patients-with-trochlear-dysplasia
#18
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/29291282/anterior-knee-pain-what-muscles-should-i-strengthen
#19
(no author information available yet)
Pain in the front of your knee or under your kneecap is often called patellofemoral pain. The pain may be a nagging ache or an occasional sharp twinge. Because the pain is around the front of your knee, treatment has traditionally focused on the knee itself. However, recent evidence suggests that strengthening your hip muscles can also help by decreasing the stress in your knee. A study published in the January 2018 issue of JOSPT provides new insights and evidence-based suggestions on how to strengthen your entire leg to decrease your knee pain and help you return to full activity...
January 2018: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/29291280/hip-and-knee-exercise-for-patellofemoral-pain-using-the-evidence-to-guide-physical-therapist-practice
#20
(no author information available yet)
The etiology of patellofemoral pain (PFP) is thought to include both local factors (those near the patellofemoral joint and surrounding tissues) and nonlocal factors (those related to the mechanics of the distal and proximal joints). Traditionally, PFP rehabilitation protocols have focused on local factors. Strengthening of the hip may reduce excessive hip adduction and medial rotation during weightbearing activities and so decrease patellofemoral joint stresses. However, while previous studies indicate that including hip strengthening may lessen the intensity of PFP, the effects on strength and activity remain uncertain...
January 2018: Journal of Orthopaedic and Sports Physical Therapy
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