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https://www.readbyqxmd.com/read/29752638/avoiding-complications-with-mpfl-reconstruction
#1
REVIEW
Marvin K Smith, Brian C Werner, David R Diduch
PURPOSE OF REVIEW: To discuss the potentially significant complications associated with medial patellofemoral ligament (MPFL) reconstruction. Additionally, to review the most current and relevant literature with an emphasis on avoiding these potential complications. RECENT FINDINGS: Multiple cadaveric studies have characterized the anatomy of the MPFL and the related morphologic abnormalities that contribute to recurrent lateral patellar instability. Such abnormalities include patella alta, excessive tibial tubercle to trochlear grove (TT-TG) distance, trochlear dysplasia, and malalignment...
May 12, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29736872/use-of-tt-pcl-versus-tt-tg
#2
REVIEW
Jacqueline M Brady, Adam S Rosencrans, Beth E Shubin Stein
PURPOSE OF REVIEW: The tibial tubercle-to-trochlear groove (TT-TG) distance and tibial tubercle-to-posterior cruciate ligament (TT-PCL) distance have both been proposed for use in the evaluation of patients with patellofemoral instability. RECENT FINDINGS: While the TT-TG value may be confounded by several factors, including age, gender, body mass index, and varying degrees of knee flexion on cross-sectional imaging, recent literature supports its utility for differentiation of patients with and without patellofemoral instability, and stratification of patients with and without coronal malalignment...
May 8, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29713775/tibial-tuberosity-to-trochlear-groove-distance-and-its-association-with-patellofemoral-osteoarthritis-related-structural-damage-worsening-data-from-the-osteoarthritis-initiative
#3
Arya Haj-Mirzaian, Ali Guermazi, Michael Hakky, Christopher Sereni, Bashir Zikria, Frank W Roemer, Miho J Tanaka, Andrew J Cosgarea, Shadpour Demehri
OBJECTIVES: To determine whether the tibial tuberosity-to-trochlear groove (TT-TG) distance is associated with concurrent patellofemoral joint osteoarthritis (OA)-related structural damage and its worsening on 24-month follow-up magnetic resonance imaging (MRI) in participants in the Osteoarthritis Initiative (OAI). METHODS: Six hundred subjects (one index knee per participant) were assessed. To evaluate patellofemoral OA-related structural damage, baseline and 24-month semiquantitative MRI Osteoarthritis Knee Score (MOAKS) variables for cartilage defects, bone marrow lesions (BMLs), osteophytes, effusion, and synovitis were extracted from available readings...
April 30, 2018: European Radiology
https://www.readbyqxmd.com/read/29653442/examination-under-anesthesia-in-patients-with-recurrent-patellar-dislocation-prognostic-study
#4
Ismail Fathalla, James Holton, Tanweer Ashraf
Surgical management of patellar instability is a matter of wide debate. While some authors believe that isolated medial patellofemoral ligament (MPFL) reconstruction is sufficient, others advocate procedures to treat the underlying pathology, namely, patella alta and trochlear dysplasia. Radiological studies have been traditionally used as a determinant of these pathologies and to determine the need for an additional procedure. The value of examination under anesthesia (EUA) in formulating a treatment plan remains unknown...
April 13, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29502142/knee-size-chart-nomogram-for-evaluation-of-tibial-tuberosity-trochlear-groove-distance-in-knees-with-or-without-history-of-patellofemoral-instability
#5
Jacques Hernigou, Esfandiar Chahidi, Medhi Bouaboula, Eric Moest, Antoine Callewier, Theofylaktos Kyriakydis, Dimitrios Koulalis, Olivier Bath
PURPOSE: Lateralized tibial tubercle is a cause of patellar instability. Before proceeding with reduction of the tibial tubercle-trochlear groove (TT-TG) distance, surgeons prefer to know whether this distance is pathologic. However, the pathological value remains discussed and may vary with the size of the knee. METHODS: We sought to determine variability in the traditional TT-TG distance versus the anthropometric knee size, using dimensions of the distal part of the femur and proximal part of the tibia of 85 CT scans of the knees in two groups of knees, one normal group without history of patellofemoral instability and one pathologic group with history of instability...
March 3, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29410197/patellofemoral-reconstruction-for-patellar-instability-with-patella-alta-in-middle-aged-patients-clinical-outcomes
#6
S Otsuki, Y Okamoto, T Murakami, K Nakagawa, N Okuno, H Wakama, M Neo
INTRODUCTION: Although several surgical treatments for patellar instability with patella alta have been reported, the clinical outcomes and optimal surgical procedures for patellar instability with patella alta in middle-aged patients are still controversial. We hypothesized that optimal surgical procedures for patellar instability with patella alta in middle-aged patients may induce good clinical outcomes with better patellofemoral geometry. MATERIALS AND METHODS: Twelve middle-aged patients with a mean age of 44 years (range: 40-55 years), who presented with patellar instability and patella alta, were treated with a combination of several surgeries, such as medial patellofemoral ligament (MPFL) reconstruction, trochleoplasty, lateral release, and three-dimensional transfer of the tibial tuberosity, based on a surgical algorithm...
April 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29330745/-treatment-of-rotational-malalignment-of-the-lower-leg
#7
REVIEW
P Keppler
BACKGROUND: Rotational malalignment after intramedullary nailing of tibial shaft fractures is not uncommon. In-toeing and out-toeing conditions in children are often the reason for orthopedic and traumatological medical consultation. OBJECTIVE: Evaluation of diagnostic modalities and therapeutic options for rotational malalignment in relationship to the patient's age. Surgical indications and efficacy of specific surgical techniques. MATERIAL AND METHODS: Systematic literature search in the German Institute for Medical Documentation and Information (DIMDI) and MEDLINE and evaluation of the currently published articles...
March 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29298083/clinical-outcomes-after-isolated-medial-patellofemoral-ligament-reconstruction-for-patellar-instability-among-patients-with-trochlear-dysplasia
#8
Joseph N Liu, Jacqueline M Brady, Irene L Kalbian, Sabrina M Strickland, Claire Berdelle Ryan, Joseph T Nguyen, Beth E Shubin Stein
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction has become one of the most common and widely used procedures to regain stability among patients with recurrent lateral patellar dislocation. While recent studies demonstrated low recurrence rates, improved patient-reported outcome measures, and a high rate of return to sports, limited literature explored its effectiveness as an isolated intervention in the context of trochlear dysplasia. PURPOSE: To determine the efficacy of isolated MPFL reconstruction in treating patellar instability in the setting of trochlear dysplasia...
March 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29226423/patellar-tendinopathy-with-intratendinous-alteration-on-mri-may-be-related-to-patellofemoral-dysplasia
#9
P M Tscholl, R M Biedert, F Wanivenhaus, S F Fucentese
Patellar tendinopathy (PT) is a frequent overuse injury of the extensor knee apparatus, whereas as up to 30% of the athletes might suffer from persisting symptoms during their entire career. In the present case-control study, 47 patients (30.8 ± 11.4 years) with PT with intratendinous alteration (PTita) of a minimum of ≥25% of the axial surface on MRI and minimum Blazina score of II (pain during without limiting sports activity) were included; MR images were analyzed for trochlear geometry, patellar height/tilt, and tibial tubercle-trochlear groove distance (TT-TG)...
April 2018: Scandinavian Journal of Medicine & Science in Sports
https://www.readbyqxmd.com/read/29188334/increased-in-vivo-patellofemoral-loading-after-total-knee-arthroplasty-in-resurfaced-patellae
#10
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/29108731/ratio-of-the-tibial-tuberosity-trochlear-groove-distance-to-the-tibial-maximal-mediolateral-axis-a-more-reliable-and-standardized-way-to-measure-the-tibial-tuberosity-trochlear-groove-distance
#11
Pengkai Cao, Yingzhen Niu, Chang Liu, Xiaomeng Wang, Guman Duan, Qinghua Mu, Xintong Luo, Fei Wang
BACKGROUND: Tibial tuberosity-trochlear groove distance(TT-TG) is a measurement to assist in the diagnosis and treatment of patellar instability, however it still has some limitations. Our study was to modify the accepted measurement method and seek a more reliable and standardized method. METHODS: The data of 65 healthy controls and 49 patients with bilateral patellar instability from 2010 to 2016 were collected and analyzed by CT. The TT-TG, tibial maximal mediolateral axis (MML), and their ratio [i...
January 2018: Knee
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...
February 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29094053/measurement-of-tibial-tuberosity-trochlear-groove-offset-distance-by-weightbearing-cone-beam-computed-tomography-scan
#13
John M Marzo, Melissa A Kluczynski, Anthony Notino, Leslie J Bisson
Background: Computed tomography (CT) scans are useful for objectively measuring bone alignment because they show bone detail particularly well, and these scans have been used extensively to assess patellar orientation. The tibial tubercle-trochlear groove (TT-TG) offset distance has been shown to be influenced by knee flexion and weightbearing, yet conventional CT scans are obtained with the subject relaxed, supine, and with the knee in full extension. A new cone-beam CT scanner has been designed to allow for weightbearing images, potentially providing a more physiologically relevant assessment of patellofemoral alignment...
October 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29039139/individualizing-the-tibial-tubercle-to-trochlear-groove-distance-to-patient-specific-anatomy-improves-sensitivity-for-recurrent-instability
#14
Mark J Heidenreich, Thomas L Sanders, Mario Hevesi, Nicholas R Johnson, Isabella T Wu, Christopher L Camp, Diane L Dahm, Aaron J Krych
PURPOSE: An initial episode of patellar instability poses a treatment challenge given the absence of a valid, reproducible, and universally applicable predictor of recurrence. Recently, a series of patellar instability ratios (PIRs) were described. Each ratio consisted of the traditional tibial tubercle to trochlear groove (TT-TG) distance normalized to patient-specific measures. The purpose of this study was to investigate the reliability and validity of these novel measures. METHODS: Eighty-seven patients experiencing a first-time lateral patellar dislocation were identified in a retrospective manner...
October 11, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28942027/tibial-tubercle-torsion-a-new-factor-of-patellar-instability
#15
V Chassaing, J-M Zeitoun, M Camara, J-L Blin, S Marque, M-D Chancelier
INTRODUCTION: External torsion of the anterior tibial tubercle (TT), defined as external rotation around a craniocaudal axis with respect to the posterior femoral condylar plane, may induce patellar instability. To our knowledge no studies have focused on this parameter. The present study aimed to perform an MRI analysis of TT torsion. The study hypothesis was that TT torsion correlates with patellar instability and with 3 of its components: tibial tubercle-trochlear groove (TT-TG) distance, axial engagement index of the patella (AEI), and patellar tilt...
December 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28918500/current-evidence-advocates-use-of-a-new-pathologic-tibial-tubercle-posterior-cruciate-ligament-distance-threshold-in-patients-with-patellar-instability
#16
REVIEW
Nickolas Boutris, Domenica A Delgado, John S Labis, Patrick C McCulloch, David M Lintner, Joshua D Harris
PURPOSE: To determine (1) whether a correlation exists between tibial tubercle-posterior cruciate ligament (TT-PCL) and tibial tubercle-trochlear groove (TT-TG) distances in patellar instability patients; (2) reliability when measuring TT-PCL distance; (3) whether TT-PCL distances measured on MRI are equivalent to those on CT; and (4) whether a correlation exists between TT-PCL distance and number of instability events or recurrence of instability following stabilization surgery. METHODS: A systematic review was performed using PRISMA guidelines...
September 16, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28884099/medial-patellofemoral-ligament-and-medial-patellotibial-ligament-reconstruction-in-children-preliminary-results
#17
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/28735802/correction-of-patellofemoral-malalignment-with-patellofemoral-arthroplasty
#18
Marco Valoroso, Mo Saffarini, Giuseppe La Barbera, Cécile Toanen, Gerjon Hannink, Luca Nover, David H Dejour
BACKGROUND: The goal of patellofemoral arthroplasty (PFA) is to replace damaged cartilage and correct underlying deformities to reduce pain and prevent maltracking. We aimed to determine how PFA modifies patellar height, tilt, and tibial tuberosity-trochlear groove (TT-TG) distance. The hypothesis was that PFA would correct trochlear dysplasia or extensor mechanism malalignment. METHODS: The authors prospectively studied a series of 16 patients (13 women and 3 men) aged 64...
July 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28666038/measuring-malalignment-on-imaging-in-the-treatment-of-patellofemoral-instability
#19
Miho J Tanaka, Andrew J Cosgarea
Assessment of malalignment is an important factor in determining surgical treatment options for patellar instability. Measurement of tibial tubercle-trochlear groove (TT-TG) distance is valuable in planning surgical treatment for patellar instability, because it quantifies a component of malalignment and aids in deciding whether to perform tibial tuberosity osteotomy. In this paper we review how TT-TG distance should be understood in the context of many measurement factors to allow for an individualized procedure that addresses the specific contributors to patellar instability in each patient...
May 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28653182/coronal-femoral-tka-position-significantly-influences-in-vivo-patellar-loading-in-unresurfaced-patellae-after-primary-total-knee-arthroplasty
#20
Omer Slevin, Florian A Schmid, Filippo-Franco Schiapparelli, Helmut Rasch, Felix Amsler, Michael T Hirschmann
PURPOSE: As patellar tracking and loading is influenced by tibial tuberosity and trochlear groove (TT-TG) distance, patellar height, thickness and tilt as well as TKA component position, it was our hypothesis that these parameters significantly correlate with patellar BTU intensity and localization in SPECT/CT. The purpose of the study was to investigate whether TKA component position as well as the height, thickness and tilt of the unresurfaced patella influences the intensity and the distribution pattern of BTU in SPECT/CT...
November 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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