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Patellofemoral reconstruction

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https://www.readbyqxmd.com/read/28045869/why-do-patellofemoral-stabilization-procedures-fail-keys-to-success
#1
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
#2
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
https://www.readbyqxmd.com/read/28028569/functional-testing-and-return-to-sport-following-stabilization-surgery-for-recurrent-lateral-patellar-instability-in-competitive-athletes
#3
Aaron J Krych, Michael P O'Malley, Nick R Johnson, Rohith Mohan, Timothy E Hewett, Michael J Stuart, Diane L Dahm
PURPOSE: Medial patellofemoral ligament (MPFL) reconstruction and tibial tubercle osteotomy are commonly used to treat recurrent lateral patellar instability, yet there are limited available data on return to sport (RTS) following these procedures. The purpose of this study is to evaluate patient factors associated with excellent functional outcomes, including successful RTS, following surgical stabilization including MPFL reconstruction in competitive athletes with recurrent lateral patellar instability...
December 27, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28027463/quantifying-knee-mechanics-during-balance-training-exercises
#4
Lauren C Benson, Thomas G Almonroeder, Kristian M O'Connor
Patellofemoral pain (PFP) is common among runners and those recovering from anterior cruciate ligament reconstruction. Training programs designed to prevent or treat injuries often include balance training, although balance interventions have been reported to coincide with more knee injuries. Knowledge of the effect of balance exercises on knee mechanics may be useful when designing training programs. High knee abduction moment has been implicated in the development of PFP, and imbalance between vastus lateralis (VL) and vastus medialis oblique (VMO) may contribute to patellofemoral stress...
December 24, 2016: Human Movement Science
https://www.readbyqxmd.com/read/28005409/safe-drilling-paths-in-the-distal-femoral-epiphysis-for-pediatric-medial-patellofemoral-ligament-reconstruction
#5
Cynthia V Nguyen, Lutul D Farrow, Raymond W Liu, Allison Gilmore
BACKGROUND: Anatomic surgical reconstruction of the medial patellofemoral ligament (MPFL) has been popularized for the treatment of recurrent patellar instability in the skeletally immature population. Previous anatomic studies have found that the femoral attachment point of the MPFL is very close to the distal femoral physis. PURPOSE: To establish the safe angles for drilling the distal femoral epiphysis for MPFL graft placement. STUDY DESIGN: Descriptive laboratory study...
December 1, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27999505/osteochondral-allograft-transplantation-for-femoral-trochlear-dysplasia
#6
Dharmpal V Vansadia, James R Heltsley, Scott Montgomery, Misty Suri, Deryk G Jones
BACKGROUND: The risk factors for patellofemoral joint instability include laxity of medial patellar restraints, abnormal limb geometry, femoral and tibial malrotation, patella alta, and trochlear dysplasia. Femoral trochlear dysplasia is characterized by a hypoplastic or shallow trochlear groove. CASE REPORT: We report the case of a 31-year-old female with trochlear dysplasia and recurrent patella dislocations, laxity of the medial patellofemoral ligament (MPFL), and high-grade chondromalacia of the trochlea and the patella...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27988165/increased-femoral-anteversion-influence-over-surgically-treated-recurrent-patellar-instability-patients
#7
Carlos Eduardo Franciozi, Luiz Felipe Ambra, Leonardo José Bernardes Albertoni, Pedro Debieux, Fernando Cury Rezende, Mauricio Ayres de Oliveira, Marcio de Castro Ferreira, Marcus Vinícius Malheiros Luzo
PURPOSE: To verify the influence that increased femoral anteversion (FA) has on patients with recurrent patellar instability (RPI) treated by anteromedialization tibial tubercle osteotomy (TTO) combined with medial patellofemoral ligament reconstruction (MPFLR) and to present the midterm outcomes of these patients. METHODS: From January 2008 to August 2013, skeletally mature patients with RPI and tibial tubercle (TT)-trochlear groove (TG) ≥ 17 mm who underwent anteromedialization TTO combined with MPFLR were evaluated for J sign, patellar glide, apprehension test, increased FA, Caton index, trochlea dysplasia, TT-TG, Kujala, International Knee Documentation Committee subjective knee evaluation form, and Tegner...
December 14, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27928547/relationship-of-acl-injury-and-posterior-tibial-slope-with-patient-age-sex-and-race
#8
Alana Waiwaiole, Ajay Gurbani, Kambiz Motamedi, Leanne Seeger, Myung Shin Sim, Patricia Nwajuaku, Sharon L Hame
BACKGROUND: Posterior tibial slope (PTS) has been proposed as a potential risk factor for anterior cruciate ligament (ACL) injury; however, studies that have examined this relationship have provided inconclusive and sometimes contradictory results. Further characterization of this relationship may enable the medical community to identify individuals at greater risk for ACL injury and possibly characterize an anatomic target during surgical reconstruction. PURPOSE: The primary goal was to investigate the relationship between PTS and ACL injury...
November 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/27916577/association-of-fibrosis-in-the-infrapatellar-fat-pad-and-degenerative-cartilage-change-of-patellofemoral-joint-after-anterior-cruciate-ligament-reconstruction
#9
Kyoung Ho Yoon, Dae Hyun Tak, Taeg Su Ko, Sang Eon Park, Juhyun Nam, Sang Hak Lee
BACKGROUND: The purpose of this study was to evaluate the prevalence and risk factor of cartilage degeneration of the patellofemoral joint (PFJ) that was diagnosed by second-look arthroscopy. METHODS: One-hundred and seven patients who underwent ACL reconstruction were evaluated by preoperative MRI, postoperative MRI and second-look arthroscopy. Severity of infrapatellar fat pad (IPFP) fibrosis was evaluated by MRI at an average of 26months after ACL reconstruction...
December 1, 2016: Knee
https://www.readbyqxmd.com/read/27904790/current-concepts-in-the-treatment-of-gross-patellofemoral-instability
#10
Grant Buchanan, LeeAnne Torres, Brian Czarkowski, Charles E Giangarra
: Patellofemoral instability is a painful and commonly recurring condition, which often must be managed surgically. Diagnosis can be aided by the use of a variety of physical exam signs, such as the Q angle, Beighton hypermobility score, glide test, J sign, patellar tilt test, and apprehension test. Imaging modalities including x-ray, CT, and MRI guide both diagnosis and management by revealing trochlear dysplasia, bony malalignment, and ligamentous injury that contribute to instability...
December 2016: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/27842571/medial-patellofemoral-ligament-reconstruction-using-a-bone-groove-and-a-suture-anchor-at-patellar-a-safe-and-firm-fixation-technique-and-3-year-follow-up-study
#11
Hong-De Wang, Jiang-Tao Dong, Shi-Jun Gao
BACKGROUND: Graft fixation is critical to the restoration of the medial patella of femoral ligament function and long-term success. Numerous fixations at the patella have been described, while the complications including patellar fractures, violation of the posterior patella and delay of tendon-to-bone healing remain significant challenges. Here, we describe a safe and firm fixation at the patellar for medial patellofemoral ligament (MPFL) reconstruction and explore the safety angle of drilling the suture anchor at different morphology of the patellar...
November 14, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27811513/patellofemoral-pain-and-instability-in-adolescent-athletes
#12
Matthew Bessette, Paul Saluan
Injuries and disorders of the patellofemoral joint in the adolescent athlete can encompass a wide spectrum of symptomatology and pathology. Anterior knee pain is a common presenting symptom in sports medicine clinics, and can have numerous underlying etiologies. This activity-related pain may be the manifestation of enthesopathy, tendinopathy, fat pad impingement, or numerous other conditions, but is more commonly related to more subtle skeletal and muscular imbalances. Treatment is typically nonoperative in nature, and excellent results are reported with physical therapy...
December 2016: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/27810430/outcomes-of-surgical-stabilization-in-patients-with-combined-acl-deficiency-and-patellofemoral-instability-a-case-series
#13
Laurie A Hiemstra, Sarah Kerslake, Mark Heard, Gregory Buchko, Mark Lafave
BACKGROUND: The purpose of this study was to assess the disease-specific quality of life, and the objective clinical and functional outcomes of patients with symptomatic ACL deficiency and patellofemoral instability following surgical stabilization of both ligaments. METHODS: Between February 2010 and August 2013, 22 subjects underwent a combined ACL reconstruction and patellofemoral stabilization. The anterior cruciate ligament quality of life questionnaire (ACL-QOL) was completed pre-operatively and two-years post-operatively...
December 2016: Knee
https://www.readbyqxmd.com/read/27796419/results-of-medial-patellofemoral-ligament-reconstruction-compared-with-trochleoplasty-plus-individual-extensor-apparatus-balancing-in-patellar-instability-caused-by-severe-trochlear-dysplasia-a-systematic-review-and-meta-analysis
#14
REVIEW
Peter Balcarek, Stephan Rehn, Nick R Howells, Jonathan D Eldridge, Keisuke Kita, David Dejour, Manfred Nelitz, Ingo J Banke, Delphine Lambrecht, Markus Harden, Tim Friede
PURPOSE: Many studies have reported satisfactory clinical outcomes and low redislocation rates after reconstruction of the medial patellofemoral ligament (MPFL) for the treatment of lateral patellar instability. Despite uncorrected severe trochlear dysplasia (Dejour type B to D) being acknowledged as a major reason for less favourable clinical outcomes and a higher incidence of patellar redislocations after an isolated MPFL reconstruction, the evidence for a deepening trochleoplasty procedure remains scarce in the current literature...
October 27, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27755640/relationship-between-posterior-inferior-tibial-slope-and-bilateral-noncontact-acl-injury
#15
Steven T Hendrix, Austin M Barrett, Bopha Chrea, William H Replogle, Josie M Hydrick, Gene R Barrett
Is there a correlation between increased posterior-inferior tibial slope angle and noncontact anterior cruciate ligament (ACL) injury? Does increasing the posterior-inferior tibial slope angle increase the risk of bilateral ACL injury? A computerized relational database (Access 2007; Microsoft Inc, Redmond, Washington) was used to conduct a retrospective review of patients undergoing bilateral or unilateral ACL reconstruction surgery or treatment by a single surgeon between 1995 and 2013. Included in the study were patients with bilateral and unilateral ACL injuries and patellofemoral pain syndrome with no associated ACL deficiency...
October 18, 2016: Orthopedics
https://www.readbyqxmd.com/read/27709116/dynamic-simulation-of-the-effects-of-graft-fixation-errors-during-medial-patellofemoral-ligament-reconstruction
#16
John J Elias, Michael J Kelly, Kathryn E Smith, Kenneth A Gall, Jack Farr
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction is performed to prevent recurrent instability, but errors in femoral fixation can elevate graft tension. HYPOTHESIS: Errors related to femoral fixation will overconstrain the patella and increase medial patellofemoral pressures. STUDY DESIGN: Controlled laboratory study. METHODS: Five knees with patellar instability were represented with computational models...
September 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/27693503/anterior-knee-pain-following-anterior-cruciate-ligament-reconstruction-does-not-increase-the-risk-of-patellofemoral-osteoarthritis-at-15-and-20-year%C3%A2-follow-ups
#17
A G Culvenor, B E Øiestad, I Holm, R B Gunderson, K M Crossley, M A Risberg
OBJECTIVE: To prospectively evaluate the relationship between the presence or persistence of anterior knee pain (AKP) during the first 2-years following anterior cruciate ligament reconstruction (ACLR) and patellofemoral osteoarthritis (PFOA) at 15- and 20-years. DESIGN: This study was ancillary to a long-term prospective cohort study of 221 participants following bone-patellar-tendon-bone ACLR. AKP was assessed at 1- and 2-years post-ACLR using part of the Cincinnati knee score with an additional pain location question (persistence defined as presence at both follow-ups)...
January 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/27682301/outcomes-of-combined-tibial-tuberosity-transfer-and-medial-patellofemoral-ligament-reconstruction-for-recurrent-patellar-instability
#18
G Pemmaraju, J Bassett, R Abbas, G Nagra, S Chugh, E Mughal
Patellofemoral instability is multifactorial and is associated with pathomechanics secondary to anatomical variance. Surgical management of this problem must be tailored to each patient and a thorough clinical and radiological assessment of the anatomical alignment should be carried out pre-operatively. The aim of this study is to assess the role of medial patellofemoral ligament reconstruction combined with tibial tuberosity transfer in patients with increased tibial tuberosity to trochlear groove (TT-TG) distance...
August 2016: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/27637616/corr-insights-%C3%A2-does-the-utilization-of-allograft-tissue-in-medial-patellofemoral-ligament-reconstruction-in-pediatric-and-adolescent-patients-restore-patellar-stability
#19
Peter D Fabricant
No abstract text is available yet for this article.
September 14, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27631645/origin-and-insertion-of-the-medial-patellofemoral-ligament-a-systematic-review-of-anatomy
#20
Arash Aframian, Toby O Smith, T Duncan Tennent, Justin Peter Cobb, Caroline Blanca Hing
PURPOSE: The medial patellofemoral ligament (MPFL) is the major medial soft-tissue stabiliser of the patella, originating from the medial femoral condyle and inserting onto the medial patella. The exact position reported in the literature varies. Understanding the true anatomical origin and insertion of the MPFL is critical to successful reconstruction. The purpose of this systematic review was to determine these locations. METHODS: A systematic search of published (AMED, CINAHL, MEDLINE, EMBASE, PubMed and Cochrane Library) and unpublished literature databases was conducted from their inception to the 3 February 2016...
September 8, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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