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Patellofemoral reconstruction

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https://www.readbyqxmd.com/read/29017801/influence-of-increased-posterior-tibial-slope-in-total-knee-arthroplasty-on-knee-joint-biomechanics-a-computational-simulation-study
#1
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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28970976/medial-patellofemoral-ligament-reconstruction-in-a-revision-setting-anchor-and-interference-screw%C3%A2-fixation
#6
Marcio B Ferrari, George Sanchez, Angela Chang, Sami Ferdousian, Matthew T Provencher
Recurrent patellar instability is a common pathology and typically affects younger and more active patients. To prevent complete lateral dislocation of the patella, several osseous and soft-tissue procedures have been previously described, including reconstruction of the medial patellofemoral ligament (MPFL), which has been identified as the primary medial stabilizer of the patella. Several techniques have been reported for reconstruction of the MPFL, sometimes in conjunction with other procedures, with the majority showing success in the treatment and resolution of patellar instability...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28969822/editorial-commentary-the-medial-patellar-ligaments-a-step-closer-to-the-knee-surgeon-s-rubik-s-cube-solution
#7
EDITORIAL
Stefano Zaffagnini, Tommaso Roberti di Sarsina
Recent cadaveric research analyzing the medial patellar ligaments and their contribution to patellar stability points out not only the need for reconstruction of the medial patellofemoral ligament, but also the medial tibiofemoral ligament to restore normal patellar stability and biomechanics.
October 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
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
#8
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
#9
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/modern-synthetic-material-is-a-safe-and-effective-alternative-for-medial-patellofemoral-ligament-reconstruction
#10
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 modern 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/28922015/over-the-top-acl-reconstruction-plus-extra-articular-lateral-tenodesis-with-hamstring-tendon-grafts-prospective-evaluation-with-20-year-minimum-follow-up
#11
Stefano Zaffagnini, Giulio Maria Marcheggiani Muccioli, Alberto Grassi, Tommaso Roberti di Sarsina, Federico Raggi, Cecilia Signorelli, Francisco Urrizola, Paolo Spinnato, Eugenio Rimondi, Maurilio Marcacci
BACKGROUND: There are few published studies with very long-term follow-up of combined intra- and extra-articular anterior cruciate ligament (ACL) reconstruction. PURPOSE: To analyze clinical and radiographic outcomes of over-the-top ACL reconstruction plus extra-articular lateral tenodesis with autologous hamstrings at minimum 20-year follow-up. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Of 60 originally eligible patients who underwent over-the-top ACL reconstruction with double-stranded hamstring tendon (leaving intact graft tibial insertions) and extra-articular lateral plasty (performed with the remnant part of tendons), 52 were prospectively evaluated at a minimum 20-year follow-up (mean follow-up, 24 years; 41 men, 11 women; mean age at time of surgery, 25...
September 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28918784/-treatment-of-patellar-instability
#12
Martin Lind, Peter Faunø, Ole Gade Sørensen, Bjarne Mygind-Klavsen
First-time patellar luxation appears typically in teenagers and young adults below the age of 16 years, with a prevalence of 45/100,000/year. This luxation is treated with brief limited mobility in a bandage, and with a complementary physiotherapy if the mobility is influenced afterwards. Risk factors for patellar instability are patellofemoral dysplasia, hyperlaxity, patella alta and valgus malalignment in the knee joint. In case of repeated luxation the treatment is surgical, i.e. reconstruction of the medial patellofemoral ligament recreating the medial patella-stabilizing structures...
September 18, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28914334/the-clinical-and-radiological-results-of-individualized-surgical-treatment-depending-on-pathologic-abnormalities-in-recurrent-patellar-dislocation-low-recurrence-rate-but-unintended-patella-baja
#13
Do Kyung Lee, Joon Ho Wang, Seung Hoon Kang, Jun Ho Kim, Russel Haque, Byung Hoon Lee
PURPOSE: To evaluate the clinical and radiological outcomes and chondral lesion change using individualized surgery for recurrent patellar dislocation. METHODS: A total of 31 knees with recurrent patellar dislocation underwent surgery depending on individual pathologic abnormalities. Pathologic abnormalities including medial laxity, lateral tightness, increased tibial tuberosity (TT)-to-trochlear groove distance (>20 mm), and patella alta (Caton-Deschamps ratio >1...
September 15, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28903010/effect-of-loading-on-in-vivo-tibiofemoral-and-patellofemoral-kinematics-of-healthy-and-acl-reconstructed-knees
#14
Jarred M Kaiser, Michael F Vignos, Richard Kijowski, Geoffrey Baer, Darryl G Thelen
BACKGROUND: Although knees that have undergone anterior cruciate ligament reconstruction (ACLR) often exhibit normal laxity on clinical examination, abnormal kinematic patterns have been observed when the joint is dynamically loaded during whole body activity. This study investigated whether abnormal knee kinematics arise with loading under isolated dynamic movements. HYPOTHESIS: Tibiofemoral and patellofemoral kinematics of ACLR knees will be similar to those of the contralateral uninjured control knee during passive flexion-extension, with bilateral differences emerging when an inertial load is applied...
September 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28884099/medial-patellofemoral-ligament-and-medial-patellotibial-ligament-reconstruction-in-children-preliminary-results
#15
David Sadigursky, Lucas Cortizo Garcia, Maurício Armede, Lucas Rodrigues de Oliveira, Rogério Jamil Fernandes Carneiro, Paulo Oliveira Colavolpe
OBJECTIVE: The aim of this study was to evaluate the reconstruction of the medial patellofemoral ligament associated with the medial patellotibial ligament in skeletally immature patients. METHOD: This is a case series study in patients with patellar instability with open physis. In total, seven patients were evaluated: four males and three females were operated using the proposed technique. Patients with open physis who had more than two episodes of recurring patellar dislocation were included...
June 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28867290/modified-adductor-sling-technique-a-surgical-therapy-for-patellar-instability-in-skeletally-immature-patients
#16
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
#17
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
#18
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
#19
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/28791612/acl-rehabilitation-progression-where-are-we-now
#20
REVIEW
John T Cavanaugh, Matthew Powers
PURPOSE OF REVIEW: With the increase of publications available to the rehabilitation specialist, there is a need to identify a progression to safely progress the patient through their post-operative ACL reconstruction rehabilitation program. Rehabilitation after ACL reconstruction should follow an evidence-based functional progression with graded increase in difficulty in activities. RECENT FINDINGS: Clinicians should be discouraged not to use strict time frames and protocols when treating patients following ACL reconstruction...
August 8, 2017: Current Reviews in Musculoskeletal Medicine
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