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Sergio Barroso Rosa, Zaid Bahho, Kenji Doma, Kaushik Hazratwala, Peter McEwen, Varaguna Manoharan, Brent Matthews, Matthew Wilkinson
INTRODUCTION: Patella alta (PA) is one of the primary correctable risk factors for patellofemoral instability (PFI). Both an accurate diagnosis of PA and a clinically relevant target for correction are necessary for optimal treatment. An ideal test for PA should relate the position of the patella to the femur rather than tibia, should do so with the quadriceps contracted and the patellar tendon under tension and should have good sensitivity and specificity. None of the currently used radiographic tests PA meet these criteria, most of which are based on the position of the patella relative to the tibia with diagnostic cutoffs based on 2 standard deviations from the mean rather than optimal sensitivity and specificity...
March 15, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
John J Elias, Kerwyn C Jones, S Cyrus Rezvanifar, Joseph N Gabra, Melanie A Morscher, Andrew J Cosgarea
BACKGROUND: Continued patellar instability can occur following medial patellofemoral ligament (MPFL) reconstruction. Computational simulation of function was used to investigate the influence of the lateral position of the tibial tuberosity, trochlear dysplasia and patella alta on lateral patellar tracking following MPFL reconstruction. METHODS: Multibody dynamic simulation models were developed to represent nine knees being treated for recurrent patellar instability...
March 12, 2018: Knee
Firooz Salami, Julia Wagner, Stefan van Drongelen, Matthias C M Klotz, Thomas Dreher, Sebastian I Wolf, Mirjam Niklasch
AIM: Flexed knee gait can be treated with distal femoral extension osteotomy (DFEO) and additional patellar tendon advancement (PTA) in children with cerebral palsy (CP). This study assesses changes in hamstring muscle tendon length (MTL) and velocity after DFEO (+PTA). METHOD: Nineteen children (mean age 13y [standard deviation 3y] at surgery) with CP and flexed knee gait who were treated with DFEO (15 limbs) or DFEO+PTA (10 limbs) were retrospectively included in this study...
March 14, 2018: Developmental Medicine and Child Neurology
Ryan R Birks, Michael P Kowaleski
OBJECTIVES:  The purpose of this study is to compare the load at failure and mode of failure between (1) tibial plateau levelling osteotomy (TPLO) and combined TPLO and tibial tuberosity transposition (TPLO-TTT) (Phase I) and (2) TPLO-TTT and tibial tuberosity transposition (TTT) (Phase II). METHODS:  Seven pairs of cadaveric tibiae were tested in each of the Phase I (TPLO vs. TPLO-TTT) and Phase II (TPLO-TTT vs. TTT) experiments. One limb of each pair was randomly assigned to one of two groups for each experimental phase...
February 2018: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
Thitaporn Phetkaew, Marissak Kalpravidh, Rampaipat Penchome, Chalika Wangdee
OBJECTIVE:  This article aimed to determine and compare the angular values of the pelvic limb in normal and medial patellar luxation (MPL) stifles in Chihuahuas using radiography and computed tomographic (CT) scan, to identify the relationship between pelvic limb angles and severity of MPL. In addition, radiographic and CT images were compared to determine the more suitable method of limb deformity assessment. METHODS:  Sixty hindlimbs of Chihuahuas were divided into normal and grade 1, 2, 3 and 4 MPL groups...
February 2018: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
Sarah L Pownder, Kei Hayashi, Brian G Caserto, Mary Lou Norman, Hollis G Potter, Matthew F Koff
OBJECTIVES:  The purpose of this study was to evaluate regional differences of canine stifle articular cartilage using the quantitative magnetic resonance imaging (MRI) technique of T2 mapping. METHODS:  Fourteen stifle joints from seven juvenile male Beagle dogs with no evidence or prior history of pelvic limb lameness were imaged ex vivo using standard of care fast spin echo MRI and quantitative T2 mapping protocols. Regions of interest were compared between the femoral, patellar and tibial cartilages, as well as between the lateral and medial femorotibial compartments...
February 2018: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
Seung Hoo Lee, Min Bom Kim, Jae Ang Sim, Do Hwan Han
We report our surgical method used to treat type C distal femur fractures accompanied by patella fractures whereby we approach the articular surface of the femur through the already-fractured patella. We treated 10 patients with type C3 distal femur and patella fractures between May 2013 and April 2015. Because the patella was fractured in all cases, we could approach the articular surface of the distal femur through the transverse gap between the retracted patellar fracture fragments, "transpatellar approach...
February 6, 2018: Journal of Knee Surgery
Idil Kurut Aysin, Ayhan Askin, Berna Dirim Mete, Ece Guvendi, Murat Aysin, Hikmet Kocyigit
Objective: The study aimed to investigate whether there is any association of anterior knee pain and knee function with chondromalacia stage and patellofemoral alignment in patients with anterior knee pain for over a month and with chondromalacia patellae (CMP) detected by magnetic resonance imaging (MRI). Materials and Methods: We reviewed the medical records of 38 patients who underwent a knee MRI examination and were diagnosed with chondromalacia based on the MRI...
February 2018: Eurasian Journal of Medicine
Karim Sabeh, Milad Alam, Samuel Rosas, Shahrose Hussain, Michaela Schneiderbauer
INTRODUCTION: The growing trends of total knee arthroplasty (TKA) foreshadow an inevitable increase in the financial burden on healthcare expenditure estimated to almost nine billion dollars annually. This study aims to demonstrate the potential savings when using all-polyethylene (AP) compared to metal-backed (MB) tibial components and describes the cost variability amongst three major commercially available implants. MATERIALS AND METHODS: The cost of AP versus MB implants was analyzed using a large nationwide database, Emergency Care Research Institute (ECRI)...
March 12, 2018: Surgical Technology International
Sajeesh Kumar Madhurakkat Perikamana, Jinkyu Lee, Taufiq Ahmad, Eun Mi Kim, Hayeon Byun, Sangmin Lee, Heungsoo Shin
Tendon-bone interface tissue is extremely challenging to engineer because it exhibits complex gradients of structure, composition, biologics, and cellular phenotypes. As a step toward engineering these transitional zones, we initially analyzed how different (topographical or biological) cues affect tenogenic differentiation of adipose-derived stem cells (ADSCs). We immobilized platelet-derived growth factor - BB (PDGF-BB) using polydopamine (PD) chemistry on random and aligned nanofibers and investigated ADSC proliferation and tenogenic differentiation...
February 27, 2018: Biomaterials
Shital N Parikh, Neil Rajdev, Qin Sun
BACKGROUND: Femoral trochlear dysplasia is a known risk factor for patellar instability. The growth pattern of the normal trochlea is known, but there have been no studies investigating the growth and development of the dysplastic trochlea. The purpose of this study was to assess the growth pattern of trochlear dysplasia in adolescents. METHODS: In a retrospective analysis, magnetic resonance images of adolescents with patellar instability and trochlear dysplasia were evaluated...
March 8, 2018: Journal of Pediatric Orthopedics
Guang-Ying Zhang, Hong-Xia Zhu, En-Miao Li, Hao Shi, Wei Liu, Lei Zheng, Zheng-Wu Bai, Hong-Yu Ding
Objective: To evaluate the correlation between the injury patterns of the medial patellofemoral ligament (MPFL) on magnetic resonance imaging in an acute first-time lateral patellar dislocation (LPD) and incidence of a second-time LPD. Materials and Methods: Magnetic resonance images were prospectively analyzed in 147 patients after an acute first-time LPD with identical nonoperative management. The injury patterns of MPFL in acute first-time LPDs were grouped by location and severity for the analysis of the incidence of second-time LPD in a 5-year follow-up...
March 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Nili Steinberg, Myriam Stern, Shay Tenenbaum, Alexander Blankstein, Aviva Zeev, Itzhak Siev-Ner
This study aimed at evaluating whether the prevalence of knee injuries and morphological features are different among pre-and-post menarche dancers; Sixty-seven pre-and-post menarche dancers were screened for anthropometric parameters; knee laxity; patella femoral pain syndrome (PFPS), pathologies and anatomical structure of the knees. Both groups showed a high and similar prevalence of PFPS. The post-menarche dancers produced a significantly higher rate of Tanner stages 3-4 (p = .010), greater weight (p < ...
March 8, 2018: Research in Sports Medicine
Brent T Wise, Greg Erens, Aidin Eslam Pour, Thomas L Bradbury, James R Roberson
PURPOSE: Disruption of the extensor mechanism after total knee arthroplasty (TKA) is an infrequent but devastating complication. Presently, limited data exists regarding the optimal treatment and long-term outcomes. METHODS: Patients who underwent reconstruction of their knee extensor mechanism using Achilles tendon allograft following TKA between January 2003 and January 2012 were identified. Sixteen patients with 17 reconstructions (10 patellar tendons, 7 quadriceps tendons) were studied...
March 7, 2018: International Orthopaedics
Lei Zhang, Zhiyao Li
Medial patellofemoral ligament (MPFL) reconstruction is a satisfactory technique for patellar instability, and the anatomical double bundle variant is recommended for better clinical results. However, long-term outcomes are still uncharacterized. This study aimed to assess the effectiveness of double bundle reconstruction of the MPFL for patellar instability by means of established scores. A total of 68 patients with chronic patellar instability who underwent surgery from May 2005 to February 2010 were included prospectively...
March 7, 2018: Journal of Knee Surgery
Michael P Gaspar, Julie E Adams, Ralph C Zohn, Sidney M Jacoby, Randall W Culp, A Lee Osterman, Patrick M Kane
BACKGROUND: The purpose of this study was to report our long-term outcomes following reconstruction of the forearm interosseous membrane (IOM) with bone-patellar tendon-bone (BPTB) graft for treatment of chronic Essex-Lopresti injuries. METHODS: We identified 33 patients who underwent IOM reconstruction with BPTB graft for chronic Essex-Lopresti injuries over a 20-year treatment interval. Twenty male and 13 female patients, with a mean age of 42.1 years (range, 19 to 73 years) and a minimum follow-up interval of 5 years, were included...
March 7, 2018: Journal of Bone and Joint Surgery. American Volume
Melissa A Christino, Frances A Tepolt, Dai Sugimoto, Lyle J Micheli, Mininder S Kocher
BACKGROUND: Revision anterior cruciate ligament (ACL) reconstruction in pediatric patients has not been well studied. The purpose of this study was to assess the demographics, technique, and results of ACL revision surgery in children and adolescents. METHODS: This was a retrospective case series with outcomes assessment of patients 18 years old and younger who underwent revision ACL surgery over a 16-year period at a single institution. Medical records were reviewed for demographics, clinical and operative data, and patients were contacted for outcomes at a minimum of 1 year after revision surgery...
March 5, 2018: Journal of Pediatric Orthopedics
Valentine D Verpaalen, Wendy I Baltzer, Sarah Smith-Ostrin, Jennifer J Warnock, Bernadette Stang, Craig G Ruaux
OBJECTIVE To determine the effects of an omega-3 fatty acid and protein-enriched diet, physical rehabilitation, or both on radiographic findings and markers of synovial inflammation in dogs following tibial plateau leveling osteotomy and arthroscopic surgery for treatment of cranial cruciate ligament disease. DESIGN Randomized, prospective clinical trial. ANIMALS 48 dogs with unilateral cranial cruciate ligament disease. PROCEDURES Dogs were randomly assigned to receive a dry omega-3 fatty acid and protein-enriched dog food formulated to support joint health (test food [TF]), a dry food formulated for adult canine maintenance (control food [CF]), TF plus rehabilitation, or CF plus rehabilitation after surgery...
March 15, 2018: Journal of the American Veterinary Medical Association
Jack Farr
Patellar pain and instability are common presentations to surgeons, yet assessment is more a static art than a dynamic science. In addition to resource-intensive gait laboratory, computed tomography (CT) and magnetic resonance imaging (MRI) have been used to measure patellar tracking. CT has the limitation of radiation and MRI has the limitation of software processing times. With an updated MRI protocol and software, it is now possible to dynamically view patellar tracking. Determining how this will be used to help in the diagnosis and treatment of patients will be the next goal...
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Sung-Jae Kim, Chong Hyuk Choi, Sung-Hwan Kim, Su-Keon Lee, Wonyong Lee, Taeyup Kim, Min Jung
PURPOSE: The present study aimed to compare 2- and 5-year outcomes of ACL reconstruction between patients with and without generalized joint laxity and to perform comparative evaluation between two types of grafts used for ACL reconstruction in patients with generalized joint laxity. METHODS: Two hundred and thirty-seven patients who underwent ACL reconstruction from 2001 to 2008 were included. Patients were classified into two groups according to the presence or the absence of generalized joint laxity, and further subdivided into two subgroups based on the type of graft used: bone-patellar tendon-bone (BPTB) or hamstring...
March 3, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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