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Patellofemoral joint

Alison H Chang, Joan S Chmiel, Orit Almagor, Ali Guermazi, Pottumarthi V Prasad, Kirsten C Moisio, Laura Belisle, Yunhui Zhang, Karen Hayes, Leena Sharma
OBJECTIVE: Knee sagittal dynamic joint stiffness (DJS) describes the biomechanical interaction between change in external knee flexion moment and flexion angular excursion during gait. In theory, greater DJS may particularly stress the patellofemoral (PF) compartment and thereby contribute to PF osteoarthritis (OA) worsening. We hypothesized that greater baseline knee sagittal DJS is associated with PF cartilage damage worsening 2 years later. METHODS: Participants all had OA in at least one knee...
October 8, 2016: Osteoarthritis and Cartilage
Jacob Matz, James L Howard, David J Morden, Steven J MacDonald, Matthew G Teeter, Brent A Lanting
BACKGROUND: Patellofemoral joint biomechanics contribute to anterior knee pain, instability, and dysfunction following total knee arthroplasty (TKA). Information about specific factors leading to anterior knee pain and dysfunction is currently limited. Changes in patellofemoral joint offset (PFO) refers to a mismatch between the preoperative and postoperative anteroposterior geometry of the patellofemoral joint. It remains unclear whether these changes lead to adverse outcomes in TKA...
September 14, 2016: Journal of Arthroplasty
Jens Ole Laursen
PURPOSE: The HemiCAP-Wave® implant for the patellofemoral resurfacing treatment of large cartilage lesions and osteoarthritis (OA) was introduced in 2009. The outcome of a prospective cohort study of 18 patients with large trochlea lesions or isolated OA treated with the HemiCAP-Wave® implant is presented with up to a 6-year survival rate, and hypothesised short-to mid-term reduced pain and improved function. METHODS: Indication for treatment with the HemiCAP-Wave® implant was a symptomatic, large cartilage lesion in trochlea demonstrated by MRI or arthroscopy, which was ICRS grades 3-4 and larger than 4 cm(2)...
October 6, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Michael P O'Malley, Ayoosh Pareek, Patrick J Reardon, Michael J Stuart, Aaron J Krych
Coronal limb malalignment is a significant contributor to asymmetric joint wear, gait abnormalities, and the development and progression of degenerative joint disease. Osteotomies about the knee were developed to realign the mechanical axis of the limb to unload the affected compartment. Valgus malalignment is less common than varus malalignment, but can contribute to a variety of clinical conditions, including lateral compartment cartilage defects and arthritis, lateral patellofemoral instability, and medial collateral ligament laxity...
August 2016: Arthroscopy Techniques
Genya Mitani, Takashi Maeda, Tomonori Takagaki, Kosuke Hamahashi, Kenji Serigano, Yutaka Nakamura, Masato Sato, Joji Mochida
Many groups have reported good to excellent clinical outcomes of the Elmslie-Trillat (ET) procedure for recurrent dislocation of the patella. However, the mean follow-up period of these studies was no more than 5 years. We hypothesized that the long-term postoperative outcomes of the modified ET procedure for recurrent dislocation of the patella would be acceptable compared with those of other procedures. The long-term postoperative outcomes of patients treated with the modified ET procedure were examined. A total of 31 knees in 27 patients with recurrent dislocation of the patella who underwent a modified ET procedure (without medial capsular plication) were evaluated...
October 3, 2016: Journal of Knee Surgery
Hiroaki Kanazawa, Yuichiro Maruyama, Katsuo Shitoto, Minoru Yokoyama, Kazuo Kaneko
BACKGROUND: The optimum treatment for isolated patellofemoral joint osteoarthritis (PFJ-OA) remains controversial. The aim of this study was to assess the mid-term clinical results of a modified crosse de hockey procedure for the treatment of isolated PFJ-OA. MATERIALS AND METHODS: We assessed 37 knees in 31 patients treated by a modified crosse de hockey procedure. The mean age was 57.6 years (range, 46-75 years) and mean follow-up was 90.1 months (range, 24-216 months)...
October 3, 2016: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
Simon Décary, Philippe Ouellet, Pascal-André Vendittoli, François Desmeules
Clinicians often rely on physical examination tests to guide them in the diagnostic process of knee disorders. However, reliability of these tests is often overlooked and may influence the consistency of results and overall diagnostic validity. Therefore, the objective of this study was to systematically review evidence on the reliability of physical examination tests for the diagnosis of knee disorders. A structured literature search was conducted in databases up to January 2016. Included studies needed to report reliability measures of at least one physical test for any knee disorder...
September 23, 2016: Manual Therapy
Vincent Ukachukwu, Rachel Duncan, John Belcher, Michelle Marshall, Joshua Stefanik, Kay Crossley, Martin J Thomas, George Peat
Objective To determine the comparative prevalence, associations with selected patient characteristics and clinical outcomes of medial and lateral compartment patellofemoral joint (PFJ) osteoarthritis (OA). Methods Information was collected by questionnaires, clinical assessment and x-rays from 745 eligible community-dwelling symptomatic adults aged ≥50 years. PFJ joint space narrowing (JSN) and osteophytes (OP) were scored from skyline radiographs using the OARSI atlas. Multilevel models were used to assess associations of compartmental PFJOA with age, gender, BMI and varus/valgus malalignment, while median regression was used to examine associations with clinical outcomes (current pain intensity 0-10NRS and WOMAC Function 0-68)...
October 1, 2016: Arthritis Care & Research
S Konan, F S Haddad
AIMS: Medial unicompartmental knee arthroplasty (UKA) is associated with successful outcomes in carefully selected patient cohorts. We hypothesised that severity and location of patellofemoral cartilage lesions significantly influences functional outcome after Oxford medial compartmental knee arthroplasty. PATIENTS AND METHODS: We reviewed 100 consecutive UKAs at minimum eight-year follow-up (96 to 132). A single surgeon performed all procedures. Patients were selected based on clinical and plain radiographic assessment...
October 2016: Bone & Joint Journal
Samia Frioui Mahmoudi, Emna Toulgui, Khalil Ben Jeddou, Mariem Gaddour, Sonia Jemni, Faycel Khachnaoui
OBJECTIVE: The objective of this study is to evaluate the quality of life of patients complaining of knee osteoarthritis. MATERIAL/PATIENTS AND METHODS: This is a descriptive prospective study over a period of three months on knee osteoarthritis outpatients. Demographic and clinical data were collected. An evaluation by a specific quality of life instrument for osteoarthritis of the knee: "The scale of Osteoarthritis of the Lower Limbs and Quality of Life (OAKHQOL)" Version 2...
September 2016: Annals of Physical and Rehabilitation Medicine
Benny Antony, Graeme Jones, Xingzhong Jin, Changhai Ding
Osteoarthritis (OA) mainly affects older populations; however, it is possible that early life factors contribute to the development of OA in later life. The aim of this review is to describe the association between childhood or early adulthood risk factors and knee pain, structural imaging markers and development of knee OA in later life. A narrative overview of the literature synthesising the findings of literature retrieved from searches of computerised databases and manual searches was conducted. We found that only a few studies have explored the long-term effect of childhood or early adulthood risk factors on the markers of joint health that predispose people to OA or joint symptoms...
September 13, 2016: Arthritis Research & Therapy
Mansur Halai, Andrew Ker, Iain Anthony, Graeme Holt, Bryn Jones, Mark Blyth
AIM: To determine outcomes using the Femoro-Patella Vialla (FPV) arthroplasty and if there is an ideal patient for this implant. METHODS: A total of 41 FPV patellofemoral joint replacements were performed in 31 patients (22 females, 9 males, mean age 65 years). Mean follow-up was 3.2 years (minimum 2 years). Radiographs were reviewed preoperatively and postoperatively. We assessed whether gender, age, previous surgery, patella atla or trochlear dysplasia influenced patient satisfaction or patient functional outcome...
August 18, 2016: World Journal of Orthopedics
Marie Askenberger, Per-Mats Janarv, Throstur Finnbogason, Elizabeth A Arendt
BACKGROUND: The incidence of primary lateral patellar dislocation (LPD) in children aged 9 to 14 years is 0.6 to 1.2 per 1000. Causation is assumed to be multifactorial, including anatomic variants of the patellofemoral (PF) joint that result in a higher risk of LPD. No publication has compared the morphology of the PF joint and anatomic patellar instability risk factors (APIFs) in a primary LPD population versus controls, defining children by skeletal maturity. PURPOSE: To characterize the PF morphology and APIFs (trochlear dysplasia, abnormal lateral patellar tilt, elevated tibial tubercle-trochlear groove [TT-TG] distance, patella alta) through magnetic resonance imaging (MRI) measurements in skeletally immature children with and without a primary LPD and to identify (potential) distinctive differences between these 2 groups...
September 9, 2016: American Journal of Sports Medicine
Young Han Lee, Jaemoon Yang, Ha-Kyu Jeong, Jin-Suck Suh
PURPOSE: Biochemical imaging of glycosaminoglycan chemical exchange saturation transfer (gagCEST) could predict the depletion of glycosaminoglycans (GAG) in early osteoarthritis. The purpose of this study was to evaluate the relationship between the magnetization transfer ratio asymmetry (MTRasym) of gagCEST images and visual analog scale (VAS) pain scores in the knee joint. MATERIALS AND METHODS: This retrospective study was approved by the institutional review board...
August 28, 2016: Magnetic Resonance Imaging
Li Yin, Tzu-Chieh Liao, Liu Yang, Christopher M Powers
BACKGROUND: Patellofemoral malalignment associated with patella alta may cause pain and arthritis; because of this, the condition sometimes is treated surgically. Two common procedures are tibial tubercle distalization with or without patellar tendon tenodesis. However, the biomechanical consequences of these interventions for patella alta are not clearly understood. QUESTIONS/PURPOSES: We evaluated changes in patellofemoral joint contact mechanics after tibial tubercle distalization and tibial tubercle distalization combined with patella tendon tenodesis...
November 2016: Clinical Orthopaedics and related Research
Mitch Beckert, Dylan Crebs, Michael Nieto, Yubo Gao, John Albright
AIM: To study patient outcomes after surgical correction for iatrogenic patellar instability. METHODS: This retrospective study looked at 17 patients (19 knees) suffering from disabling medial patellar instability following lateral release surgery. All patients underwent lateral patellofemoral ligament (LPFL) reconstruction by a single surgeon. Assessments in all 19 cases included functional outcome scores, range of motion, and assessment for the presence of apprehension sign of the patella to determine if LPFL reconstruction surgery was successful at restoring patellofemoral stability...
August 16, 2016: World Journal of Clinical Cases
C S N Yeoh, K Y Lam
PURPOSE: To compare the tibial tubercle to trochlear groove (TT-TG) distance and index using magnetic resonance imaging (MRI) between children with onetime and recurrent patellar dislocation. METHODS: Records of first-time acute patellar dislocations from 2007 to 2012 were reviewed. 20 males and 23 females aged 10 to 17 years at presentation were included for measurements of the bony and cartilaginous-tendon TT-TG distance and index. Recurrent patellar dislocation was defined as having more than one episode of dislocation within 2 years of the index injury...
August 2016: Journal of Orthopaedic Surgery
Thomas G Almonroeder, Lauren C Benson
The incidence of patellofemoral pain (PFP) is 2 times greater in females compared with males of similar activity levels; however, the exact reason for this discrepancy remains unclear. Abnormal mechanics of the hip and knee in the sagittal, frontal, and transverse planes have been associated with an increased risk of PFP. The purpose of this study was to compare the mechanics of the lower extremity in males and females during running in order to better understand the reason(s) behind the sex discrepancy in PFP...
August 29, 2016: Journal of Sports Sciences
Antoine Senioris, Mo Saffarini, Said Rahali, Louis Malekpour, Franck Dujardin, Olivier Courage
BACKGROUND: Anterior knee pain (AKP) is observed in total knee arthroplasty (TKA) both with and without patellar resurfacing, and neither patellar denervation nor secondary resurfacing are effective for treating the symptoms. The exact causes for pain remain unclear, though abnormal patellofemoral forces due to patellar malalignment or inadequate implant design can play an important role. The purpose of this study was to arthroscopically evaluate patellofemoral congruence after wound closure following TKA without patellar resurfacing and correlate it to patellar morphology and postoperative pain and function...
August 2016: Annals of Translational Medicine
Adam G Culvenor, Anja Ruhdorfer, Carsten Juhl, Felix Eckstein, Britt Elin Øiestad
OBJECTIVE: To perform a systematic review and meta-analysis on the association between knee extensor strength and the risk of structural, symptomatic, or functional deterioration in individuals with or at risk of knee osteoarthritis (KOA). METHODS: We systematically identified and methodologically appraised all longitudinal studies (≥1-year follow-up) reporting an association between knee extensor strength and structural (tibiofemoral, patellofemoral), symptomatic (self-reported, knee replacement), or functional (subjective, objective) decline in individuals with or at risk of radiographic or symptomatic KOA...
August 26, 2016: Arthritis Care & Research
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