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https://www.readbyqxmd.com/read/28211291/a-biomechanical-analysis-of-tibial-acl-reconstruction-with-graft-length-mismatch
#1
Evan B Gaines, Diana Lau, Qais Naziri, Westley Hayes, Julio J Jauregui, Bhaveen H Kapadia, William P Urban, Bashir A Zikria
INTRODUCTION: The incidence of graft length mismatch (GLM) during anterior cruciate ligament (ACL) reconstruction is reported to be up to 13%, with a rate of 20% when using bone-patellar tendon-bone (BPTB) allografts. Multiple techniques have been described to accommodate for the longer BPTB graft. As no study has compared the biomechanical properties of these methods (with cyclic loading), we evaluated the strength of four different surgical techniques used to accommodate for GLM during ACL reconstruction...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28210789/medial-patellofemoral-ligament-mpfl-reconstruction-in-combination-with-a-modified-grammont-technique-leads-to-favorable-mid-term-results-in-adolescents-with-recurrent-patellofemoral-dislocations
#2
Helmut Wegmann, Christoph Würnschimmel, Tanja Kraus, Georg Singer, Robert Eberl, Holger Till, Matthias Sperl
PURPOSE: The aim of the present study is to present the outcome of a cohort of adolescent patients with trochlear dysplasia and elevated tibial tuberosity trochlear groove (TTTG) distance suffering from recurrent patellar dislocation. Treatment consisted of medial patellofemoral ligament (MPFL) reconstruction and a modified Grammont procedure. METHODS: MRI examinations were obtained pre- and postoperatively. Trochlear dysplasia was classified according to Déjour, and TTTG was measured on MRI...
February 16, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28210659/medial-patellofemoral-ligament-reconstruction-femoral-tunnel-accuracy-relationship-to-disease-specific-quality-of-life
#3
Laurie A Hiemstra, Sarah Kerslake, Mark Lafave
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction is a procedure aimed to reestablish the checkrein to lateral patellar translation in patients with symptomatic patellofemoral instability. Correct femoral tunnel position is thought to be crucial to successful MPFL reconstruction, but the accuracy of this statement in terms of patient outcomes has not been tested. PURPOSE: To assess the accuracy of femoral tunnel placement in an MPFL reconstruction cohort and to determine the correlation between tunnel accuracy and a validated disease-specific, patient-reported quality-of-life outcome measure...
February 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28210658/patellar-maltracking-persists-in-adolescent-females-with-patellofemoral-pain-a-longitudinal-study
#4
Victor R Carlson, Barry P Boden, Aricia Shen, Jennifer N Jackson, Katharine E Alter, Frances T Sheehan
BACKGROUND: Patellofemoral pain is one of the most common conditions seen in sports medicine practices, particularly among adolescent females. However, the natural history of the underlying pathology in patellofemoral pain during puberty remains poorly understood. PURPOSE: The purpose of this longitudinal study is to assess changes in patellar maltracking patterns in subjects with patellofemoral pain as they mature from mid- to late adolescence. STUDY DESIGN: Cohort study; Level of evidence, 3...
February 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28210646/pain-assessment-after-anterior-cruciate-ligament-reconstruction-bone-patellar-tendon-bone-versus-hamstring-tendon-autograft
#5
Kelechi R Okoroha, Robert A Keller, Edward K Jung, Lafi Khalil, Nathan Marshall, Patricia A Kolowich, Vasilios Moutzouros
BACKGROUND: Anterior cruciate ligament (ACL) reconstruction is a common outpatient procedure that is accompanied by significant postoperative pain. PURPOSE: To determine differences in acute pain levels between patients undergoing ACL reconstruction with bone-patellar tendon-bone (BTB) versus hamstring tendon (HS) autograft. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: A total of 70 patients who underwent primary ACL reconstruction using either BTB or HS autografts consented to participate...
December 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28207972/anatomical-study-of-the-inferior-patellar-pole-and-patellar-tendon
#6
M Edama, I Kageyama, M Nakamura, T Kikumoto, E Nakamura, W Ito, T Takabayashi, T Inai, H Onishi
In this study, detailed investigations of the shape of the inferior patellar pole, the site of the patellar tendon attachment, and the length and course of the patellar tendon were performed with the aim of examining the anatomical factors involved in the developmental mechanism of patellar tendinitis.  The investigation examined 100 legs from 50 cadavers. The inferior patellar pole was classified into three types: Pointed, Intermediate, and Blunt. The attachment of the patellar tendon to the inferior patellar pole was classified into two types: an anterior and a posterior...
February 16, 2017: Scandinavian Journal of Medicine & Science in Sports
https://www.readbyqxmd.com/read/28205264/the-influence-of-patellar-tendon-and-muscle-tendon-unit-stiffness-on-quadriceps-explosive-strength-in-man
#7
Garry J Massey, Thomas G Balshaw, Thomas M Maden-Wilkinson, Neale A Tillin, Jonathan P Folland
The influence of musculotendinous tissue stiffness on contractile rate of torque development (RTD) remains opaque. This study examined the relationships between both patellar tendon (PT) and vastus lateralis (VL) muscle-tendon unit (MTU) stiffness, and voluntary and evoked knee extension RTD. Fifty-two healthy untrained males completed duplicate laboratory sessions. Absolute and relative RTD was measured at 50 Nm/25%MVT increments from onset and sequentially during explosive voluntary and evoked octet (supramaximal stimulation: [8 pulses at 300 Hz]) isometric contractions...
February 15, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28205230/forensic-identification-of-bipartite-patella-misdiagnosed-as-patella-fracture
#8
Jingyuan Ma, Fang Shi, Chongya Huang, Shanzhi Gu
Bipartite patella is recognized as a developmental anomaly of ossification. Most of them are asymptomatic and are discovered incidentally. Bipartite patella is sometimes misdiagnosed as a patella fracture, because the x-ray images of both these conditions may appear very similar. In this case, the patient complained of left knee pain after x-ray films revealed a fracture-like line in the left patella. The patient was then diagnosed as having a patella fracture. In China, the injury degree is categorized as serious injury, minor injury, and trivial injury...
February 15, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28205075/hamstring-autograft-versus-patellar-tendon-autograft-for-acl-reconstruction-is-there-a-difference-in-graft-failure-rate-a-meta-analysis-of-47-613-patients
#9
Brian T Samuelsen, Kate E Webster, Nick R Johnson, Timothy E Hewett, Aaron J Krych
BACKGROUND: Bone-patellar tendon-bone (bone-tendon-bone) and four-strand hamstring tendon grafts (hamstring) are the most commonly utilized autografts for primary anterior cruciate ligament (ACL) reconstruction. Existing clinical trials, registry studies, and meta-analyses offer conflicting opinions regarding the most favorable graft choice. QUESTIONS/PURPOSES: Which graft type for ACL reconstruction (bone-tendon-bone or hamstring) has a higher risk of (1) graft rupture and/or (2) graft laxity? METHODS: We performed a meta-analysis of randomized controlled trials (RCTs), prospective cohort studies, and high-quality national registry studies to compare the outcomes of primary ACL reconstruction with bone-tendon-bone autograft or hamstring autograft...
February 15, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28199129/a-focal-defect-at-the-lateral-patellar-retinaculum-on-clinical-knee-mri-and-cadaveric-study-a-normal-variant-or-pathologic-lesion
#10
Ji Su Kim, Seong Jong Yun, Wook Jin, Gou Young Kim, So Young Park, Ji Seon Park, Kyung Nam Ryu
OBJECTIVE: The purpose of this study is to retrospectively investigate the frequency of a focal defect at the lateral patellar retinaculum on knee MRI and to determine the variables that are significantly associated with the defect. MATERIALS AND METHODS: Two radiologists independently reviewed 99 knee MR images for the presence of a focal defect at the lateral patellar retinaculum and categorized patients with concordant results into two groups: a group with the defect (≥ 3 mm; group 1) and a group without the defect (< 3 mm; group 2)...
February 15, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28198391/mcm5-a-new-actor-in-the-link-between-dna-replication-and-meier-gorlin-syndrome
#11
Annalisa Vetro, Salvatore Savasta, Annalisa Russo Raucci, Cristina Cerqua, Geppo Sartori, Ivan Limongelli, Antonella Forlino, Silvia Maruelli, Paola Perucca, Debora Vergani, Giuliano Mazzini, Andrea Mattevi, Lucia Anna Stivala, Leonardo Salviati, Orsetta Zuffardi
Meier-Gorlin syndrome (MGORS) is a rare disorder characterized by primordial dwarfism, microtia, and patellar aplasia/hypoplasia. Recessive mutations in ORC1, ORC4, ORC6, CDT1, CDC6, and CDC45, encoding members of the pre-replication (pre-RC) and pre-initiation (pre-IC) complexes, and heterozygous mutations in GMNN, a regulator of cell-cycle progression and DNA replication, have already been associated with this condition. We performed whole-exome sequencing (WES) in a patient with a clinical diagnosis of MGORS and identified biallelic variants in MCM5...
February 15, 2017: European Journal of Human Genetics: EJHG
https://www.readbyqxmd.com/read/28196392/patellofemoral-osteochondral-allografts-can-we-improve-the-matching-process
#12
Jason R Determann, James E Fleischli, Donald F D'Alessandro, Dana P Piasecki
An important consideration for the successful use of fresh osteochondral allografts for the patellofemoral joint is selection of appropriately sized donor allografts. This is particularly challenging for matching grafts to the patella because of the substantial variability in articular contour that exists. At present, selection of donor patellae is based only on the width of the proximal tibia, with no established means of quantifying basic patellar size, facet configuration, or articular contour. We hypothesized that using a combination of standard radiographic measurements to generate an accurate profile of the recipients native patella would result in a more accurate donor graft...
February 14, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28196029/twelve-year-outcomes-of-an-oxinium-total-knee-replacement-compared-with-the-same-cobalt-chromium-design-an-analysis-of-17-577-prostheses-from-the-australian-orthopaedic-association-national-joint-replacement-registry
#13
Christopher J Vertullo, Peter L Lewis, Stephen Graves, Lan Kelly, Michelle Lorimer, Peter Myers
BACKGROUND: Oxidized zirconium (Oxinium) was introduced as an alternative bearing surface to cobalt-chromium (CoCr) in an attempt to reduce polyethylene wear and decrease aseptic mechanical failure of total knee replacements. While noncomparative reports have been described as promising, we were aware of no short or long-term clinical studies showing the superiority of Oxinium on polyethylene as a bearing surface. Using data from a comprehensive national joint replacement registry, we compared the long-term outcomes after cruciate-retaining total knee arthroplasty (TKA) with an Oxinium femoral component and those with the same prosthetic design but with a CoCr femoral component...
February 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28194391/simultaneous-bilateral-patellar-tendon-rupture
#14
Diogo Lino Moura, José Pedro Marques, Francisco Manuel Lucas, Fernando Pereira Fonseca
Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a short immobilization period and intensive rehabilitation program...
January 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28193295/biomechanical-comparison-of-single-and-double-bundle-medial-patellofemoral-ligament-reconstruction
#15
Qing Wang, Wenhan Huang, Daozhang Cai, Huayang Huang
BACKGROUND: Recurrent patellar dislocation is common clinically, primarily in adolescents. However, the biomechanical properties of single- and double-bundle medial patellofemoral ligament (MPFL) reconstruction remain poorly understood. METHODS: Six fresh frozen adult cadaveric knee specimens were obtained for this study. Each specimen was fixed at 0° to test the force needed when the patella was laterally shifted 10 mm at a speed of 0.5 mm/s, and the test was repeated three times...
February 13, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28192827/the-use-of-mesh-plates-for-difficult-fractures-of-the-patella
#16
David Volgas, Tina K Dreger
Patella fractures present some of the more complicated fracture patterns in orthopaedic trauma care. This is partially due to the small size of the fragments but also the articular nature of each fragment. Fixation methods such as cerclage wiring, excision of smaller fragments, and screw fixation of larger fragments all have their own challenges. Our study examined our Level I trauma center's experience with variable angle locked 2.7 mm titanium plates for treatment of comminuted patella fractures or treatment of patellar nonunion...
February 13, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28185776/tibial-tubercle-osteotomy-a-biomechanical-comparison-of-two-techniques
#17
Christopher J Maugans, Matthew G Scuderi, Frederick W Werner, Stefanos F Haddad, John P Cannizzaro
PURPOSE: The purpose of this study was to determine whether a modified step-cut tibial tubercle osteotomy (Maquet-Fulkerson hybrid) might produce comparable or better results than a standard oblique anteromedialization tibial tubercle osteotomy (Fulkerson type) and thus warrant the surgical need for additional cuts. METHODS: Six pairs of cadaveric knees were evaluated prior to and after tibial tubercle osteotomies. Simulation was done via a shallow knee bend simulator through 20 to 70° of knee flexion for the intact specimens and following the surgical procedures...
February 6, 2017: Knee
https://www.readbyqxmd.com/read/28184358/vertical-patellar-dislocation-reduction-by-the-push-up-and-rotate-method-a-case-report-and-literature-review
#18
Hayat Ahmad Khan, Adil Bashir Shah, Younis Kamal
INTRODUCTION: Patellar dislocation is an emergency. Vertical patellar dislocation is rare, often seen in adolescents and mostly due to sports injuries or high-velocity trauma. Few cases have been reported in the literature. Closed or open reduction under general anesthesia is often needed. We report a case of vertical locked patellar dislocation in a 26-year-old male, which was reduced by a simple closed method under spinal anaesthesia. A literature review regarding the various methods of treatment is also discussed...
November 2016: Trauma Monthly
https://www.readbyqxmd.com/read/28182736/comparison-of-clinical-and-radiological-outcomes-between-opening-wedge-and-closing-wedge-high-tibial-osteotomy-a-comprehensive-meta-analysis
#19
Lingfeng Wu, Jun Lin, Zhicheng Jin, Xiaobin Cai, Weiyang Gao
High tibial osteotomy (HTO) has been widely used for clinical treatment of osteoarthritis of the medial compartment of the knee, and both opening-wedge and closing-wedge HTO are the most commonly used methods. However, it remains unclear which technique has better clinical and radiological outcomes in practice. To systematically evaluate this issue, we conducted a comprehensive meta-analysis by pooling all available data for the opening-wedge HTO and closing-wedge HTO techniques from the electronic databases including PubMed, Embase, Wed of Science and Cochrane Library...
2017: PloS One
https://www.readbyqxmd.com/read/28179061/plateau-patella-angle-an-option-for-the-evaluation-of-patellar-height-in-patients-with-patellar-instability
#20
Marcelo Batista Bonadio, Camilo Partezani Helito, Julio Augusto do Prado Torres, Riccardo Gomes Gobbi, José Ricardo Pécora, Gilberto Luis Camanho, Marco Kawamura Demange
BACKGROUND: Patellar instability is a debilitating disease. An important factor related to recurrent dislocation is patellar height. A new method of patellar height measurement, the plateau-patella angle (PPA), was proposed in 2011. However, to date, there is no study evaluating the use of this method in patients with patellar instability. The aim of this study was to evaluate the PPA in patients with recurrent patellar dislocation. METHODS: This was a retrospective evaluation of the radiographs of 78 knees with patellar instability...
February 5, 2017: Knee
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