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Patellofemoral reconstruction

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https://www.readbyqxmd.com/read/29230426/lateral-patellofemoral-ligament-an-anatomic-study
#1
Kalpit N Shah, Steven F DeFroda, James Kristopher Ware, Sarath C Koruprolu, Brett D Owens
Background: Medial instability of the patellofemoral joint is a rare but known phenomenon that may result from an incompetent lateral patellofemoral ligament (LPFL). Surgical reconstruction of the LPFL has been described. However, anatomic details of the ligament have not been the subject of scrutiny. Purpose: To describe the anatomic origin and insertion of the LPFL. Study Design: Descriptive laboratory study. Methods: Ten fresh-frozen, unpaired human cadaveric knees (mean age, 57 years) were dissected to identify the LPFL...
December 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29225329/medial-patellofemoral-ligament-reconstruction-with-semi-patellar-tunnel-fixation-surgical-technique-and-mid-term-follow-up
#2
Jinghui Niu, Qi Qi, Kunpeng Fu, Guman Duan, Chang Liu, Fei Wang
BACKGROUND The present study aimed to describe a new safe and economical technique for medial patellofemoral ligament (MPFL) reconstruction with satisfactory clinical outcomes, and present the results of a four-year follow-up. MATERIAL AND METHODS Thirty-two patients with recurrent patella dislocation, who underwent MPFL reconstruction with two semi-patellar tunnels and hardware-free patellar fixation between 2011 and 2013, were included in the study. Patella stability was tested by an apprehension test preoperatively and at follow-up...
December 11, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29209793/degenerative-changes-after-posterior-cruciate-ligament-reconstruction-are-irrespective-of-posterior-knee-stability-mri-based-long-term-results
#3
Clemens Gwinner, Andreas Weiler, Timm Denecke, Julian M M Rogasch, Heide Boeth, Tobias M Jung
INTRODUCTION: Posterior cruciate ligament reconstruction (PCLR) is advocated to prevent an early onset of osteoarthritis. We hypothesized that posterior instability after PCLR correlates with degenerative changes. MATERIALS AND METHODS: MRIs of 42 (12 female/30 male; 39 ± 9 years) patients were enrolled with a minimum 5-year follow-up (FFU) after PCLR. In addition, 25 contralateral and 15 follow-up MRIs (12 months after baseline) were performed. Degenerative changes were graded using WORMS...
December 6, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29204862/the-trochlear-isometric-point-is-different-in-patients-with-recurrent-patellar-instability-compared-to-controls-a-radiographical-study
#4
Tulio Campos, Akash Soogumbur, Iain R McNamara, Simon T Donell
PURPOSE: The purpose of the study was to investigate the theoretical isometric point based of the curve of the femoral groove and relating it to the origin of the MPFL femoral tunnel on lateral radiograph by comparing a patellar instability cohort with a control cohort. METHODS: From a Patellar Instability database the radiographs of 40 consecutive patients were analysed to define Schöttle's point, and the arc of the circle of the trochlear groove. A comparison population of 20 radiographs from comparable patients with tibiofemoral joint disorders was used as a control...
December 4, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29201929/evaluation-of-the-sch%C3%A3-ttle-technique-in-the-pediatric-knee
#5
Kellen L Huston, Ugochi C Okoroafor, Scott G Kaar, Christa L Wentt, Paul Saluan, Lutul D Farrow
Background: The Schöttle point is commonly used for anatomic femoral tunnel placement during medial patellofemoral ligament (MPFL) reconstruction. This technique has not been previously validated in the skeletally immature patient, in whom femoral tunnel placement may put the distal femoral physis at risk of iatrogenic injury. Hypothesis: Interobserver reliability for femoral tunnel placement will be higher in adult knees compared with pediatric knees. Study Design: Cross-sectional study (diagnosis); Level of evidence, 3...
November 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29201927/radiographic-location-does-not-ensure-a-precise-anatomic-location-of-the-femoral-fixation-site-in-medial-patellofemoral-ligament-reconstruction
#6
Vicente Sanchis-Alfonso, Cristina Ramírez-Fuentes, Erik Montesinos-Berry, Isabel Elía, Luis Martí-Bonmatí
Background: A frequently used method to determine the anatomic femoral fixation point in the operating room during medial patellofemoral ligament (MPFL) reconstruction is the radiographic method. However, the ability of this radiological method to establish an anatomic femoral attachment point might not be as accurate as expected. Purpose: (1) To evaluate the accuracy of the radiological method to locate the anatomic femoral fixation point in MPFL reconstruction surgery and (2) to determine the factors influencing the predictability of this method to obtain this objective...
November 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29188334/increased-in-vivo-patellofemoral-loading-after-total-knee-arthroplasty-in-resurfaced-patellae
#7
Omer Slevin, Florian A Schmid, Filippo Schiapparelli, Helmut Rasch, Michael T Hirschmann
PURPOSE: The primary purpose of the study was to investigate if and how patellar bone tracer uptake (BTU) distribution in SPECT/CT is influenced by patellar resurfacing and the position of femoral and tibial TKA component position. METHODS: A total of 104 knees of 103 consecutive patients who underwent primary TKA were prospectively investigated. Primary patellar resurfacing was done in 40 knees while 64 had a TKA without patellar resurfacing. All patients underwent clinical assessment using the knee society score (KSS) and standardized radiographs and Tc-99m-HDP-SPECT/CT before and 12 and 24 months after TKA...
November 29, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29162949/neuromuscular-electrical-stimulation-for-treatment-of-muscle-impairment-critical-review-and-recommendations-for-clinical-practice
#8
Ethne L Nussbaum, Pamela Houghton, Joseph Anthony, Sandy Rennie, Barbara L Shay, Alison M Hoens
Purpose: In response to requests from physiotherapists for guidance on optimal stimulation of muscle using neuromuscular electrical stimulation (NMES), a review, synthesis, and extraction of key data from the literature was undertaken by six Canadian physical therapy (PT) educators, clinicians, and researchers in the field of electrophysical agents. The objective was to identify commonly treated conditions for which there was a substantial body of literature from which to draw conclusions regarding the effectiveness of NMES...
2017: Physiotherapy Canada. Physiothérapie Canada
https://www.readbyqxmd.com/read/29138916/lateral-retinaculum-plasty-instead-of-lateral-retinacular-release-with-concomitant-medial-patellofemoral-ligament-reconstruction-can-achieve-better-results-for-patellar-dislocation
#9
Chang Liu, Guman Duan, Yingzhen Niu, Pengkai Cao, Kunpeng Fu, Jinghui Niu, Fei Wang
PURPOSE: To elucidate the outcomes of lateral retinaculum plasty versus lateral retinacular release with concomitant medial patellofemoral ligament (MPFL) reconstruction. METHODS: In a prospective study, 59 patients treated at our institution from 2012 to 2014 were included. The 59 patients were randomly divided into two groups. Group I included 27 patients who underwent lateral retinacular release and MPFL reconstruction. Group II included 32 patients who underwent lateral retinaculum plasty and MPFL reconstruction...
November 14, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29134368/-patellofemoral-instability
#10
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...
November 13, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/29128875/allowing-one-quadrant-of-patellar-lateral-translation-during-medial-patellofemoral-ligament-reconstruction-successfully-limits-maltracking-without-overconstraining-the-patella
#11
John J Elias, Kerwyn C Jones, Molly K Lalonde, Joseph N Gabra, S Cyrus Rezvanifar, Andrew J Cosgarea
PURPOSE: Graft tensioning during medial patellofemoral ligament (MPFL) reconstruction typically allows for lateral patellar translation within the trochlear groove. Computational simulation was performed to relate the allowed patellar translation to patellofemoral kinematics and contact pressures. METHODS: Multibody dynamic simulation models were developed to represent nine knees with patellar instability. Dual limb squatting was simulated representing the pre-operative condition and simulated MPFL reconstruction...
November 11, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29100777/anisometry-of-medial-patellofemoral-ligament-reconstruction-in-the-setting-of-increased-tibial-tubercle-trochlear-groove-distance-and-patella-alta
#12
Lauren H Redler, Kathleen N Meyers, Jacqueline M Brady, Elizabeth R Dennis, Joseph T Nguyen, Beth E Shubin Stein
PURPOSE: To assess the impact elevated tibial tubercle-trochlear groove (TT-TG) distance and patella height, as measured by the Caton-Deschamps Index (CDI), have on the isometry of a reconstructed medial patellofemoral ligament (MPFL). METHODS: Nine fresh-frozen cadaveric knees were placed on a custom testing fixture, with a fixed femur and a mobile tibia. A suture fixed to the MPFL origin on the patella and free to move at the Schöttle point on the femur represented a reconstructed MPFL...
October 31, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29100765/effect-of-transosseous-tunnels-on-patella-fracture-risk-after-medial-patellofemoral-ligament-reconstruction-a-cadaveric-study
#13
Nicholas A Bonazza, Gregory S Lewis, Eric Z Lukosius, Evan P Roush, Kevin P Black, Aman Dhawan
PURPOSE: To determine whether (1) tunnels that breach the anterior cortex of the patella result in increased fracture risk and (2) transosseous tunnels drilled across the patella significantly reduce the tensile force needed to fracture the patella. METHODS: Twenty-six fresh-frozen cadaveric human patellas were randomized to 1 of 3 groups: a control group with unmodified patellas, a group with 2 transverse tunnels (TT) that did not breach the anterior cortex, and a group with 2 TT that breached the anterior cortex of the patella (PA)...
October 31, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29099881/patella-alta-sees-you-do-you-see-it
#14
Robert A Magnussen
Numerous anatomic factors have been shown to contribute to patellar instability. Patellar height remains a critical, yet underappreciated contributor to instability that is amenable to surgical correction through the performance of a tibial tubercle distalization osteotomy (TTDO). The indications for a distalizing tibial tubercle osteotomy are not completely clear and depend on multiple factors. One must consider patient factors and physical examination findings in addition to radiographic measures. In general, the addition of a TTDO to medial patellofemoral ligament reconstruction should be considered when the degree of patella alta exceeds a Caton-Deschamps Index (CDI) of 1...
September 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29083227/variation-in-the-medial-patellofemoral-ligament-origin-in-the-skeletally-immature-knee-an-anatomic-study
#15
Kevin G Shea, W Duncan Martinson, Peter C Cannamela, Connor G Richmond, Peter D Fabricant, Allen F Anderson, John D Polousky, Theodore J Ganley
BACKGROUND: The medial patellofemoral ligament (MPFL) is frequently reconstructed to treat recurrent patellar instability. The femoral origin of the MPFL is well described in adults but not in the skeletally immature knee. PURPOSE: To identify a radiographic landmark for the femoral MPFL attachment in the skeletally immature knee and study its relationship to the distal femoral physis. STUDY DESIGN: Descriptive laboratory study. METHODS: Thirty-six cadaveric specimens between 2 and 11 years old were dissected and examined (29 male and 7 female)...
October 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29017801/influence-of-increased-posterior-tibial-slope-in-total-knee-arthroplasty-on-knee-joint-biomechanics-a-computational-simulation-study
#16
Kyoung-Tak Kang, Yong-Gon Koh, Juhyun Son, Oh-Ryong Kwon, Jun-Sang Lee, Sae-Kwang Kwon
BACKGROUND: The reconstructed posterior tibial slope (PTS) plays a significant role in restoring knee kinematics in cruciate-retaining-total knee arthroplasty (TKA). A few studies have reported the effect of the PTS on biomechanics. METHODS: This study investigates the effect of the PTS on tibiofemoral (TF) kinematics, patellofemoral (PF) contact stress, and forces at the quadriceps, posterior cruciate ligament (PCL) and collateral ligament after cruciate-retaining-TKA using computer simulations...
September 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29016187/quantitative-and-qualitative-analysis-of-the-medial-patellar-ligaments-an-anatomic-and-radiographic-study
#17
Bradley M Kruckeberg, Jorge Chahla, Gilbert Moatshe, Mark E Cinque, Kyle J Muckenhirn, Jonathan A Godin, Taylor J Ridley, Alex W Brady, Elizabeth A Arendt, Robert F LaPrade
BACKGROUND: The qualitative and quantitative anatomy of the medial patellar stabilizers has been reported; however, a quantitative analysis of the anatomic and radiographic attachments of all 4 ligaments relative to anatomic and osseous landmarks, as well as to one another, has yet to be performed. PURPOSE: To perform a qualitative and quantitative anatomic and radiographic evaluation of the medial patellofemoral ligament (MPFL), medial patellotibial ligament (MPTL), medial patellomeniscal ligament (MPML), and medial quadriceps tendon femoral ligament (MQTFL) attachment sites, with attention to their relationship to pertinent osseous and soft tissue landmarks...
October 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28989265/technical-considerations-in-revision-anterior-cruciate-ligament-acl-reconstruction-for-operative-techniques-in-orthopaedics
#18
Jeremy M Burnham, Elmar Herbst, Thierry Pauyo, Thomas Pfeiffer, Darren L Johnson, Freddie H Fu, Volker Musahl
As the incidence of anterior cruciate ligament (ACL) reconstruction continues to increase, the rate of revision surgery continues to climb. Revision surgery has inherent challenges that must be addressed in order to achieve successful results. The cause of the primary ACL reconstruction failure should be determined, and careful preoperative planning should be performed to address the cause(s) of failure. Each patient undergoing revision surgery should undergo a thorough history and physical examination, receive full length alignment radiographs, lateral radiographs, 45-degree flexion weight-bearing postero-anterior radiographs, and patellofemoral radiographs...
March 2017: Operative Techniques in Orthopaedics
https://www.readbyqxmd.com/read/28985094/patellar-instability-management-a-survey-of-the-international-patellofemoral-study-group
#19
Joseph N Liu, Michael E Steinhaus, Irene L Kalbian, William R Post, Daniel W Green, Sabrina M Strickland, Beth E Shubin Stein
BACKGROUND: Although patellofemoral instability is among the most prevalent knee disorders, the management of patients with this condition is complex and remains variable, given the lack of long-term, high-level clinical outcome studies to compare various operative and nonoperative modalities. PURPOSE: To discover a consensus within treatment controversies in patellofemoral instability among experienced knee surgeons with a specific interest in the patellofemoral joint...
October 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28979605/medial-patellofemoral-ligament-reconstruction-using-the-hamstring-tendon-for-patellofemoral-joint-instability-in-an-81-year-old-female
#20
Tsuneari Takahashi, Katsushi Takeshita
INTRODUCTION: Chronic patellofemoral instability occurs mainly in adolescent females and can also be induced by medial patellofemoral ligament (MPFL) injury. There are no case reports of MPFL reconstruction for chronic patellofemoral instability due to MPFL injury in aged populations. CASE PRESENTATION: 81-year-old female presented with left knee pain, giving way, and patellar instability while climbing stairs, which continued for 18 months. Patellar apprehension test was positive, and roentgenogram showed lateral patellar subluxation...
2017: Open Orthopaedics Journal
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