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Patellofemoral reconstruction

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https://www.readbyqxmd.com/read/28297604/biomechanical-evaluation-of-classic-solid-and-all-soft-suture-anchors-for-medial-patellofemoral-ligament-reconstruction
#1
Michael G Saper, Karim Meijer, Scott Winnier, John Popovich, James R Andrews, Charles Roth
BACKGROUND: Multiple techniques for patellar fixation with classic solid suture anchors (SAs) in medial patellofemoral ligament (MPFL) reconstruction have been described. Fixation of the graft to the patella with all-soft suture anchors (ASAs) has not been studied. Purpose/Hypothesis: To evaluate the biomechanical performance of 2 different MPFL patellar fixation techniques: ASA fixation and SA fixation. We hypothesized that the ASA group would show no statistical difference in the ultimate failure load and stiffness compared with the SA group...
March 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28289819/medial-patellotibial-ligament-and-medial-patellomeniscal-ligament-anatomy-imaging-biomechanics-and-clinical-review
#2
REVIEW
Betina Bremer Hinckel, Riccardo Gomes Gobbi, Camila Cohen Kaleka, Gilberto Luis Camanho, Elizabeth A Arendt
PURPOSE: The purpose of this article is to review anatomical, biomechanical, and clinical data of the medial patellotibial ligament (MPTL) and medial patellomeniscal ligament (MPML), as well as studies focusing on the medial patellofemoral ligament (MPFL) but with relevant data about the MPTL and MPML. METHODS: A literature search of articles specifically addressing the MPTL and/or MPML was included along with studies focusing on the MPFL but with relevant data about the MPTL and MPML...
March 13, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28280905/clinical-outcomes-after-revision-surgery-for-medial-patellofemoral-ligament-reconstruction
#3
Andreas Chatterton, Torsten Grønbech Nielsen, Ole Gade Sørensen, Martin Lind
PURPOSE: Medial patellofemoral ligament reconstruction (MPFL-R) is the standard surgical intervention for patella instability. However, limited knowledge exists concerning the causes for failure, and outcome after revision MPFL-R. The purpose of this study is to evaluate the causes of primary MPFL-R failure and clinical outcomes after revision MPFL-R. METHODS: Twenty-three patients (6 males and 17 females) with failed primary MPFL-R underwent isolated revision MPFL-R or combined revision MPFL-R with tibial tuberosity osteotomy (TTO)...
March 9, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28277745/3d-computed-tomography-evaluation-of-morphological-changes-in-the-femoral-tunnel-after-medial-patellofemoral-ligament-reconstruction-with-hamstring-tendon-graft-for-recurrent-patellar-dislocation
#4
Keisuke Kita, Yoshinari Tanaka, Yukiyoshi Toritsuka, Hiroshi Amano, Ryohei Uchida, Yoshiki Shiozaki, Rikio Takao, Shuji Horibe
BACKGROUND: Reconstruction of the medial patellofemoral ligament (MPFL) for recurrent lateral patellar dislocation is gaining popularity. However, the morphological changes in the femoral tunnel after MPFL reconstruction are still not fully documented. PURPOSE: This study used 3-dimensional (3D) computed tomography to evaluate morphological changes in the femoral tunnel after MPFL reconstruction with hamstring tendon graft to investigate factors affecting the phenomenon and to elucidate whether it is associated with clinical outcomes...
March 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28251062/failed-medial-patellofemoral-ligament-reconstruction-causes-and-surgical-strategies
#5
REVIEW
Vicente Sanchis-Alfonso, Erik Montesinos-Berry, Cristina Ramirez-Fuentes, Joan Leal-Blanquet, Pablo E Gelber, Joan Carles Monllau
Patellar instability is a common clinical problem encountered by orthopedic surgeons specializing in the knee. For patients with chronic lateral patellar instability, the standard surgical approach is to stabilize the patella through a medial patellofemoral ligament (MPFL) reconstruction. Foreseeably, an increasing number of revision surgeries of the reconstructed MPFL will be seen in upcoming years. In this paper, the causes of failed MPFL reconstruction are analyzed: (1) incorrect surgical indication or inappropriate surgical technique/patient selection; (2) a technical error; and (3) an incorrect assessment of the concomitant risk factors for instability...
February 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28241086/the-anatomy-of-the-medial-patellofemoral-ligament
#6
Thai Q Trinh, Jason R Ferrel, Jared C Bentley, Robert N Steensen
Recurrent patellar dislocation is observed in many patients treated nonoperatively following primary dislocation. Injury to the medial patellofemoral ligament (MPFL) is reported in the majority of patients following dislocation. There is an increased interest in repair or reconstruction of the MPFL for patients experiencing recurrent instability. The femoral attachment of the MPFL is critical in determining graft behavior following reconstruction. The femoral attachment can be determined by referencing local anatomy, fluoroscopic imaging or on the basis of desired graft-length changes...
February 27, 2017: Orthopedics
https://www.readbyqxmd.com/read/28228051/patellar-complications-in-single-versus-double-tunnel-medial-patellofemoral-ligament-reconstruction
#7
Riazuddin Mohammed, Neil Hunt, A J Gibbon
PURPOSE: Hamstring graft fixation on the patellar side during medial patellofemoral ligament (MPFL) reconstruction is usually with transosseous tunnels and can frequently lead to further problems. The aim of our study was to compare and analyse patellar complications in single patellar tunnel versus double tunnel hamstring graft fixation. METHODS: Twenty-nine knees with MPFL reconstructions (group S) in which the hamstring tendon graft was transfixed using a suspensory fixation method in a single tunnel drilled across the patella were analysed in comparison with 29 knees (group D) with interference fixation of the graft through two tunnels drilled up to a predetermined depth in the patella...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28224070/combined-particulated-juvenile-cartilage-allograft-transplantation-and-medial-patellofemoral-ligament-reconstruction-for-symptomatic-chondral-defects-in-the-setting-of-recurrent-patellar-instability
#8
Armin Arshi, Dean Wang, Kristofer J Jones
Successful management of patellar osteochondral lesions has proved difficult, with unreliable outcomes reported using traditional cartilage repair and restoration procedures. Unique considerations for this type of defect include the multiplanar contours of the articular surface of the patella, high compressive and shear forces with knee range of motion that may disrupt graft healing, and the potential need for concomitant surgery to address patellar malalignment and instability. We describe our preferred method for treatment of a symptomatic chondral defect in the setting of recurrent patellar instability using particulated juvenile articular cartilage allograft transplantation and medial patellofemoral ligament reconstruction with semitendinosus allograft...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28214426/reduced-step-length-reduces-knee-joint-contact-forces-during-running-following-anterior-cruciate-ligament-reconstruction-but-does-not-alter-inter-limb-asymmetry
#9
Collin D Bowersock, Richard W Willy, Paul DeVita, John D Willson
BACKGROUND: Anterior cruciate ligament reconstruction is associated with early onset knee osteoarthritis. Running is a typical activity following this surgery, but elevated knee joint contact forces are thought to contribute to osteoarthritis degenerative processes. It is therefore clinically relevant to identify interventions to reduce contact forces during running among individuals after anterior cruciate ligament reconstruction. The primary purpose of this study was to evaluate the effect of reducing step length during running on patellofemoral and tibiofemoral joint contact forces among people with a history of anterior cruciate ligament reconstruction...
February 10, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28210789/medial-patellofemoral-ligament-mpfl-reconstruction-in-combination-with-a-modified-grammont-technique-leads-to-favorable-mid-term-results-in-adolescents-with-recurrent-patellofemoral-dislocations
#10
Helmut Wegmann, Christoph Würnschimmel, Tanja Kraus, Georg Singer, Robert Eberl, Holger Till, Matthias Sperl
PURPOSE: The aim of the present study is to present the outcome of a cohort of adolescent patients with trochlear dysplasia and elevated tibial tuberosity trochlear groove (TTTG) distance suffering from recurrent patellar dislocation. Treatment consisted of medial patellofemoral ligament (MPFL) reconstruction and a modified Grammont procedure. METHODS: MRI examinations were obtained pre- and postoperatively. Trochlear dysplasia was classified according to Déjour, and TTTG was measured on MRI...
February 16, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28210659/medial-patellofemoral-ligament-reconstruction-femoral-tunnel-accuracy-relationship-to-disease-specific-quality-of-life
#11
Laurie A Hiemstra, Sarah Kerslake, Mark Lafave
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction is a procedure aimed to reestablish the checkrein to lateral patellar translation in patients with symptomatic patellofemoral instability. Correct femoral tunnel position is thought to be crucial to successful MPFL reconstruction, but the accuracy of this statement in terms of patient outcomes has not been tested. PURPOSE: To assess the accuracy of femoral tunnel placement in an MPFL reconstruction cohort and to determine the correlation between tunnel accuracy and a validated disease-specific, patient-reported quality-of-life outcome measure...
February 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28193295/biomechanical-comparison-of-single-and-double-bundle-medial-patellofemoral-ligament-reconstruction
#12
Qing Wang, Wenhan Huang, Daozhang Cai, Huayang Huang
BACKGROUND: Recurrent patellar dislocation is common clinically, primarily in adolescents. However, the biomechanical properties of single- and double-bundle medial patellofemoral ligament (MPFL) reconstruction remain poorly understood. METHODS: Six fresh frozen adult cadaveric knee specimens were obtained for this study. Each specimen was fixed at 0° to test the force needed when the patella was laterally shifted 10 mm at a speed of 0.5 mm/s, and the test was repeated three times...
February 13, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28192824/accuracy-and-learning-curve-of-femoral-tunnel-placement-in-medial-patellofemoral-ligament-reconstruction
#13
Laurie Anne Hiemstra, Sarah Kerslake, Catherine L O'Brien, Mark R Lafave
The purpose of this study was to assess the accuracy of femoral tunnel placement in a medial patellofemoral ligament reconstruction (MPFL-R) cohort. The secondary purpose was to establish the evidence of a learning curve to achieve acceptable femoral tunnel placement during MPFL-R. Two surgeons, using lateral radiographs, assessed 73 subjects post-MPFL-R. Femoral tunnel accuracy and direction of tunnel error were measured in relation to Schöttle's point (A-T distance). Interrater reliability (intraclass correlation coefficient 2,k) of these measures was calculated...
February 13, 2017: Journal of Knee Surgery
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
#14
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
https://www.readbyqxmd.com/read/28149901/reconstruction-of-the-medial-patellofemoral-ligament-reconstruction-for-patients-with-recurrent-patellar-dislocation-review-of-surgical-techniques-and-tips-to-achieve-successful-reconstruction
#15
COMMENT
Giacomo Placella, Valerio Pace, Paul Foster
No abstract text is available yet for this article.
December 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28148656/adolescent-patellar-instability-current-concepts-review
#16
REVIEW
D Clark, A Metcalfe, C Wogan, V Mandalia, J Eldridge
Patellar instability most frequently presents during adolescence. Congenital and infantile dislocation of the patella is a distinct entity from adolescent instability and measurable abnormalities may be present at birth. In the normal patellofemoral joint an increase in quadriceps angle and patellar height are matched by an increase in trochlear depth as the joint matures. Adolescent instability may herald a lifelong condition leading to chronic disability and arthritis. Restoring normal anatomy by trochleoplasty, tibial tubercle transfer or medial patellofemoral ligament (MPFL) reconstruction in the young adult prevents further instability...
February 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28146393/medial-patellofemoral-ligament-reconstruction-combined-with-distal-realignment-for-recurrent-dislocations-of-the-patella
#17
Iswadi Damasena, Murray Blythe, David Wysocki, David Kelly, Peter Annear
BACKGROUND: Tibial tubercle transfer (TTT) and medial patellofemoral ligament (MPFL) reconstruction have both shown, either in isolation or in combination, to provide improved patellofemoral joint (PFJ) stability. There are few studies that provide evidence that this remains true in the long term. PURPOSE: To compare the long-term results of patellar instability after TTT with and without MPFL reconstruction in 2 randomized groups. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1...
February 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28127647/-reconstruction-of-the-medial-patellofemoral-ligament-after-lower-leg-amputation
#18
M Schulz, R Schwesig, H Siekmann, E Esmer, L Irlenbusch
The reconstruction of the medial patellofemoral ligament has been an increasingly popular approach for patellar instability over the last ten years. It is a conglomeration of symptoms with varying degree of severity. For pinpointed surgery planning, magnetic resonance imaging is now the obligate diagnosic tool. Therefore, in the preoperative stage, collateral pathology can be observed.
January 26, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28045869/why-do-patellofemoral-stabilization-procedures-fail-keys-to-success
#19
Nick Caplan, Islam Nassar, Bobby Anand, Deiary F Kader
In recent years, surgical interventions for patellofemoral joint instability have gained popularity, possibly revitalized by the recent advances in our understanding of patellofemoral joint instability and the introduction of a number of new surgical procedures. This rise in surgical intervention has brought about various complications. In this review article, we present the complications that are associated with 5 main surgical procedures to stabilize the patella-medial patellofemoral ligament reconstruction, tibial tubercle osteotomy, trochleoplasty, lateral release/lateral retinacular lengthening, and derotation osteotomies...
March 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28042121/conversion-of-a-unicompartmental-knee-arthroplasty-to-a-total-knee-arthroplasty-can-we-achieve-a-primary-result
#20
REVIEW
E Thienpont
OBJECTIVES: Unicompartmental knee arthroplasty (UKA) is a potential treatment for isolated bone on bone osteoarthritis when limited to a single compartment. The risk for revision of UKA is three times higher than for total knee arthroplasty (TKA). The aim of this review was to discuss the different revision options after UKA failure. MATERIALS AND METHODS: A search was performed for English language articles published between 2006 and 2016. After reviewing titles and abstracts, 105 papers were selected for further analysis...
January 2017: Bone & Joint Journal
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