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Patellofemoral reconstruction

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https://www.readbyqxmd.com/read/28706804/tibial-tuberosity-transfer-in-combination-with-medial-patellofemoral-ligament-reconstruction-surgical-technique
#1
Damian Clark, Katie Walmsley, Peter Schranz, Vipul Mandalia
The stability of the patellofemoral joint relies on the tenuous interplay of soft tissue and bony factors. Anatomic risk factors for instability include a shallow trochlea, an abnormally lateral tibial tubercle position, patella alta, hypermobility, or a secondary injury to the medial patellofemoral ligament (MPFL). There is an increasing interest in restoring normal anatomy to achieve stability, and at times more than 1 abnormality exists. This article describes the technique for combining a tibial tuberosity transfer and an MPFL reconstruction...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28702749/evaluation-of-different-surgical-methods-in-treating-recurrent-patella-dislocation-after-three-dimensional-reconstruction
#2
Hao Du, Xiao-Xiao Tian, Fa-Qi Guo, Xiang-Ming Li, Tao-Tao Ji, Bin Li, Tong-Sen Li
PURPOSE: Recurrent patella dislocation (RPD) is the most common complication of patellar instability. The effects of different surgical techniques on the outcome of RPD treatments remain unclear. This study was conducted to compare the effects of three surgical techniques in treating RPD by three-dimensional (3D) reconstruction from computed tomography (CT) scans. METHODS: Sixty-eight patients with RPD and no previous surgical treatments who attended our hospital between October 2010 and 2013 were enrolled and randomly assigned into three groups: (1) medial patellofemoral ligament (MPFL) reconstruction and medial patellar retinaculum (MPR) plication group; (2) lateral patellar retinaculum (LPR) release and MPR plication group; and (3) MPFL reconstruction and LPR release group...
July 12, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28684171/biomechanical-tensile-strength-analysis-for-medial-patellofemoral-ligament-reconstruction
#3
Patrick W Joyner, Jeremy Bruce, Travis S Roth, Frederic Baker Mills, Scott Winnier, Ryan Hess, Luke Wilcox, Aaron Mates, Tim Frerichs, James R Andrews, Charles A Roth
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction is a surgery for acute and chronic dislocating patella. Several surgical techniques have been described. No biomechanical study has compared suture anchors, interference screws, and suspensory cortical fixation for MPFL reconstruction using human gracilis allograft. METHODS: Twelve human cadaver knees were used for the analysis of five MPFL reconstruction techniques on the femur (F) and patella (P): suspensory cortical (SC), interference screw (IS) and suture anchor (SA) fixation (SC-F/SC-P, SC-F/IS-P, SC-F/SA-P, IS-F/SC-P, IS-F/IS-P)...
July 3, 2017: Knee
https://www.readbyqxmd.com/read/28680899/cyclic-testing-of-3-medial-patellofemoral-ligament-reconstruction-techniques
#4
Vishal Mehta, Cassie Mandala, Ahmed Akhter
BACKGROUND: Several techniques are available to secure the graft to the patella during medial patellofemoral ligament (MPFL) reconstruction. The biomechanical properties of these techniques remain unknown. PURPOSE: To compare the biomechanical properties of 3 MPFL patellar fixation techniques: bone tunnels (BT), PushLock anchors (PL), and tenodesis screws (TS). STUDY DESIGN: Controlled laboratory study. METHODS: Forty-five MPFL reconstructions were performed using 3 different reconstruction techniques (BT, PL, and TS)...
June 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28678520/return-to-play-guidelines-after-medial-patellofemoral-ligament-surgery-for-recurrent-patellar-instability-a-systematic-review
#5
Saif Zaman, Alex White, Weilong J Shi, Kevin B Freedman, Christopher C Dodson
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction and repair continue to gain acceptance as viable treatment options for recurrent patellar instability in patients who wish to return to sports after surgery. Return-to-play guidelines with objective or subjective criteria for athletes after MPFL surgery, however, have not been uniformly defined. PURPOSE: To determine whether a concise and objective protocol exists that may help athletes return to their sport more safely after MPFL surgery...
June 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28666039/ultrasound-guided-percutaneous-repair-of-medial-patellofemoral-ligament-surgical-technique-and-outcomes
#6
Alan M Hirahara, Wyatt J Andersen
A lateral patellar dislocation causes a medial patellofemoral ligament (MPFL) tear that begins affecting patellar biomechanics. Reconstruction is difficult because of the inability to reliably and accurately determine proper placement of sockets. Studies of MPFL anatomy have found significant variability in attachment site locations, which suggests MPFL procedures cannot be used universally and must be approached differently for each patient. Recurrent dislocations result in patellar and trochlear chondral and bony damage...
May 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28662894/medial-patellofemoral-ligament-medial-patellotibial-ligament-and-medial-patellomeniscal-ligament-anatomic-histologic-radiographic-and-biomechanical-study
#7
Betina B Hinckel, Riccardo G Gobbi, Marco K Demange, Cesar Augusto M Pereira, Jose Ricardo Pécora, Renato Jose M Natalino, Luciana Miyahira, Bruno S Kubota, Gilberto Luis Camanho
PURPOSE: To describe the anatomy (quantitative macroscopic and histologic), radiographic parameters of the insertions, and biomechanical characteristics of the medial ligamentous restrictors of the patella (medial patellofemoral ligament [MPFL], medial patellotibial ligament [MPTL], and medial patellomeniscal ligament [MPML]) in cadaveric knees. Because the MPTL and the MPML are not as well known as the MPFL, they were the focus of this study. METHODS: MPFLs, MPTLs, and MPMLs from 9 knees were dissected...
June 26, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28624016/longitudinal-change-in-patellofemoral-cartilage-thickness-cartilage-t2-relaxation-times-and-subchondral-bone-plate-area-in-adolescent-vs-mature-athletes
#8
Adam G Culvenor, Wolfgang Wirth, Susanne Maschek, Heide Boeth, Gerd Diederichs, Georg Duda, Felix Eckstein
OBJECTIVE: Patellofemoral cartilage changes have been evaluated in knee trauma and osteoarthritis; however, little is known about changes in patellar and trochlear cartilage thickness, T2 relaxation-time and subchondral bone plate area (tAB) during growth. Our prospective study aimed to explore longitudinal change in patellofemoral cartilage thickness, T2 and tAB in adolescent athletes, and to compare these data with those of mature (i.e., adult) athletes. MATERIALS AND METHODS: 20 adolescent (age 16±1years) and 20 mature (46±5years) volleyball players were studied over 2-years (10 men and 10 women each group)...
July 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28614283/recurrent-patellar-instability-implications-of-preoperative-patellar-crepitation-on-the-status-of-the-patellofemoral-articular-cartilage
#9
Scott J Luhmann, June C Smith, Mario Schootman, Nandan Prasad
BACKGROUND: The purpose of the study was to quantify the frequency, severity, and location of patellofemoral (PF) articular cartilage changes recurrent patellar instability treated surgically in patients with preoperative clinical patellar crepitation. METHODS: A single-surgeon database was queried for all knees with recurrent patellar instability between 3/2000 and 6/2012 (n=214). Only knees which underwent knee arthroscopy during the surgical treatment were included (n=148)...
June 13, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28601942/anatomic-reconstruction-of-the-medial-patellofemoral-ligament-in-children-and-adolescents-using-a-pedicled-quadriceps-tendon-graft-shows-favourable-results-at-a-minimum-of-2-year-follow-up
#10
Manfred Nelitz, Jens Dreyhaupt, Sean Robert March Williams
PURPOSE: In adults, reconstruction of the medial patellofemoral ligament (MPFL) has shown good results. Treatment for recurrent patellar instability in children and adolescents with open growth plates, however, requires alternative MPFL reconstruction techniques. This study presents the outcomes of a minimally invasive technique for anatomic reconstruction of the MPFL in children using a pedicled superficial quadriceps tendon graft, hardware-free patellar graft attachment, and anatomic femoral fixation that spares the distal femoral physis...
June 10, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28593102/rehabilitation-following-medial-patellofemoral-ligament-reconstruction-for-patellar-instability
#11
Robert C Manske, Daniel Prohaska
Patellar instability is a common problem seen by physical therapists, athletic trainers and orthopedic surgeons. Although following an acute dislocation, conservative rehabilitation is usually the first line of defense; refractory cases exist that may require surgical intervention. Substantial progress has been made in the understanding of the medial patellofemoral ligament (MPFL) and its role as the primary stabilizer to lateral patellar displacement. Medial patellofemoral ligament disruption is now considered to be the essential lesion following acute patellar dislocation due to significantly high numbers of ruptures following this injury...
June 2017: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/28585997/diagnosis-and-management-of-traumatic-patellar-instability-in-the-pediatric-patient
#12
Steven F DeFroda, Joseph A Gil, Alex Boulos, Aristides I Cruz
Instability of the patella is a common cause of knee pain and dysfunction in pediatric and adolescent patients and can be due to several factors. Although some patients will recall a specific traumatic event others may not, requiring the diagnosis to be made on the basis of physical examination and imaging. Congenital dislocation and connective tissue disorders should also be considered, even in the setting of trauma. There are radiographic parameters that may identify causes of instability such as trochlear and patellar abnormalities, and magnetic resonance imaging can identify signs of trauma such as bony edema, loose osteochondral fragments, and increased tibial tubercle-trochlear groove distance...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28508959/surgical-treatment-of-patellar-instability-clinical-and-radiological-outcome-after-medial-patellofemoral-ligament-reconstruction-and-tibial-tuberosity-medialisation
#13
Stefan Lobner, Christine Krauss, Frank Reichwein, Thilo Patzer, Wolfgang Nebelung, Arne J Venjakob
INTRODUCTION: The aim of this retrospective study was to analyse clinical and radiological outcome after medial patellofemoral ligament reconstruction (MPFLR) and tibial tuberosity medialisation (TTM) in patients with recurrent patellar instability. MATERIALS AND METHODS: Thirty-five patients were included between 2008 and 2012. According to defined criteria such as tibial tuberosity-trochlear groove (TTTG) distance, hyperpression on the lateral patella facet and lateral retropatellar cartilage damage either MPFLR (group A) or TTM (group B) was performed: 18 patients underwent TTM, the other 17 patients underwent MPFLR...
May 16, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28488001/lateral-displacement-sulcus-angle-and-trochlear-angle-are-associated-with-early-patellofemoral-osteoarthritis-following-anterior-cruciate-ligament-reconstruction
#14
Erin M Macri, Adam G Culvenor, Hayden G Morris, Timothy S Whitehead, Trevor G Russell, Karim M Khan, Kay M Crossley
PURPOSE: Patellofemoral osteoarthritis (PFOA) occurs in approximately half of anterior cruciate ligament (ACL)-injured knees within 10-15 years of trauma. Risk factors for post-traumatic PFOA are poorly understood. Patellofemoral alignment and trochlear morphology may be associated with PFOA following ACL reconstruction (ACLR), and understanding these relationships, particularly early in the post-surgical time period, may guide effective early intervention strategies. In this study, patellofemoral alignment and trochlear morphology were investigated in relation to radiographic features of early PFOA 1-year post-ACLR...
May 9, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28459754/rehabilitation-after-medial-patellofemoral-ligament-reconstruction
#15
Terrence G McGee, Andrew J Cosgarea, Kevin McLaughlin, Miho Tanaka, Ken Johnson
Patellar instability resulting from subluxation or dislocation is a painful and commonly recurring condition. Retinacular restraints control patellar tracking, limiting the movement of the patella in the trochlear groove. The medial patellofemoral ligament (MPFL) is considered the main soft tissue stabilizer against lateral displacement. Few studies of patellar instability discuss rehabilitation after MPFL reconstruction. In this review, we discuss the phases of rehabilitation after MPFL reconstruction, typical interventions by rehabilitation specialists, and patient-specific guidelines for return to prior level of function...
June 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28459753/surgical-options-for-patellar-stabilization-in-the-skeletally-immature-patient
#16
Jack Andrish
The surgical management of children and youth with patellar instability can be a challenging exercise. It is possible to identify the various pathoanatomies that coexist with and predispose to patellar instability and in so doing, it is possible to address some, but not all, of these pathoanatomies as part of the surgical management. Although reconstruction of the medial patellofemoral ligament has become a mainstay of treatment, it is not without potential complications. Understanding the importance of surgical technique as it relates to the unique anatomies involved is crucial...
June 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28459747/biomechanical-analysis-of-tibial-tuberosity-medialization-and-medial-patellofemoral-ligament-reconstruction
#17
John J Elias, Bradley W Smith, Blake T Daney
Biomechanical studies are commonly performed to evaluate the influence of medial patellofemoral ligament (MPFL) reconstruction and tibial tuberosity medialization on patellar tracking and patellofemoral contact pressures. The most common method is in vitro simulation of knee function, but computational simulation of knee function and computational reconstruction of in vivo motion can also be utilized. The current review of the biomechanical literature indicates that MPFL reconstruction and tibial tuberosity medialization reduce lateral patellar tracking...
June 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28457794/partial-quadriceps-tendon-transfer-for-revision-medial-patellofemoral-ligament-reconstruction-a-new-surgical-technique
#18
Joan Leal-Blanquet, Eduard Alentorn-Geli, Raúl Torres-Claramunt, Joan Carles Monllau
Medial patellofemoral ligament (MPFL) reconstruction for patellofemoral instability is a common procedure. Although MPFL reconstruction is a successful procedure in terms of return to normal life or sports, revision cases are challenging due to previous holes into the patella or implants placed in the anatomical femoral insertion site. In this technical note, the use of a partial quadriceps tendon transfer to the adductor magnus tendon is presented as a good solution for revision cases to avoid the use of implants, bone drilling, use of allografts, or two-stage surgical procedures...
April 27, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28456817/erratum-to-medial-patellofemoral-ligament-mpfl-reconstruction-in-combination-with-a-modified-grammont-technique-leads-to-favorable-mid-term-results-in-adolescents-with-recurrent-patellofemoral-dislocations
#19
Helmut Wegmann, Christoph Würnschimmel, Tanja Kraus, Georg Singer, Robert Eberl, Holger Till, Matthias Sperl
No abstract text is available yet for this article.
April 29, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28454998/finite-element-analysis-of-the-biomechanical-effects-of-3-posterolateral-corner-reconstruction-techniques-for-the-knee-joint
#20
Kyoung-Tak Kang, Yong-Gon Koh, Juhyun Son, Sung-Jae Kim, Sungryul Choi, Moonki Jung, Sung-Hwan Kim
PURPOSE: To compare the forces exerted on the cruciate ligaments and the contact stresses on the tibiofemoral (TF) and patellofemoral (PF) joints with respect to 3 different tibial- and fibular-based posterolateral corner (PLC) reconstructions under dynamic loading conditions. METHODS: A subject-specific finite element knee model was developed by using 3-dimensional anatomic data from motion captures in gait and squat activities, including in vivo knee joint kinematics and muscle forces for the single subject...
April 25, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
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