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https://www.readbyqxmd.com/read/27904790/current-concepts-in-the-treatment-of-gross-patellofemoral-instability
#1
Grant Buchanan, LeeAnne Torres, Brian Czarkowski, Charles E Giangarra
: Patellofemoral instability is a painful and commonly recurring condition, which often must be managed surgically. Diagnosis can be aided by the use of a variety of physical exam signs, such as the Q angle, Beighton hypermobility score, glide test, J sign, patellar tilt test, and apprehension test. Imaging modalities including x-ray, CT, and MRI guide both diagnosis and management by revealing trochlear dysplasia, bony malalignment, and ligamentous injury that contribute to instability...
December 2016: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/27836693/should-the-position-of-the-patellar-component-replicate-the-vertical-median-ridge-of-the-native-patella
#2
Rae Hyeong Lee, Hae Won Jeong, Jin Kyu Lee, Choong Hyeok Choi
BACKGROUND: In total knee arthroplasty (TKA), the position of the patellar component can affect patellar tracking. However, the patellar component cannot always replicate the original high point of the patella because of anatomical variance. This study investigated whether altering the highest point of the patella can affect outcomes of primary TKA, especially in patients having a patella with a far-medialized median ridge. METHODS: A retrospective review was performed for 177 knees (143 patients) treated with primary TKA between July 2011 and March 2014...
November 8, 2016: Knee
https://www.readbyqxmd.com/read/27818987/total-knee-arthroplasty-with-subvastus-approach-in-patient-with-chronic-post-traumatic-patellar-dislocation
#3
Jader Joel Machado Junqueira, Camilo Partezani Helito, Marcelo Batista Bonadio, Jose Ricardo Pécora, Marco Kawamura Demange
Chronic lateral dislocation of the patella is a rare condition and acquired causes are usually secondary to knee trauma. The neglected chronic dislocation leads to progressive genu valgum and external tibial torsion deformities with subsequent gonarthrosis, which becomes painful and debilitating. There is no consensus regarding treatment of these patients, but total knee arthroplasty (TKA) is a useful therapy in cases of painful symptomatic gonarthrosis. Few reports have shown that subvastus approach and lateral release may be a valid option for TKA, since it allows the correction of valgus deformity and patellar tracking without interrupting vascular blood supply of patella...
September 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/27815014/rotating-platform-versus-fixed-bearing-total-knee-arthroplasty-at-mid-term-follow-up
#4
J Ryan Martin, Taylor R Beahrs, Keith A Fehring, Robert T Trousdale
BACKGROUND: Rotating platform posterior stabilized (RP) total knee arthroplasty (TKA) was initially developed in part to decrease polyethylene wear and to improve patellar tracking. There have been limited studies evaluating the longevity and causes of reoperation or revision for this implant. The following study compares mid-term survival rates and causes for reoperation between fixed bearing (FB) TKAs. METHODS: We identified 11,416 patients who underwent a primary posterior stabilized TKA between 2001 and 2013...
December 2016: Knee
https://www.readbyqxmd.com/read/27709116/dynamic-simulation-of-the-effects-of-graft-fixation-errors-during-medial-patellofemoral-ligament-reconstruction
#5
John J Elias, Michael J Kelly, Kathryn E Smith, Kenneth A Gall, Jack Farr
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction is performed to prevent recurrent instability, but errors in femoral fixation can elevate graft tension. HYPOTHESIS: Errors related to femoral fixation will overconstrain the patella and increase medial patellofemoral pressures. STUDY DESIGN: Controlled laboratory study. METHODS: Five knees with patellar instability were represented with computational models...
September 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/27703948/recurrent-patellar-instabilty-culminating-in-a-vertically-rotated-and-a-locked-patellar-dislocation-a-rare-entity
#6
Devgan A, Rohilla R, Jain A, Mehta H, Singh S
INTRODUCTION: Locked vertical patellar dislocations are rare and pose a therapeutic challenge. This case is more unusual, as the patient was a known case of recurrent patellar dislocation and presented with an atraumatic locked and vertically rotated patellar dislocation. This type of presentation has never been reported in literature to the best of our knowledge. CASE PRESENTATION: A 14-year-old healthy male child with previous history of recurrent lateral dislocation of patella presented to accident & emergency department with complaints of inability to walk or bear weight on his left lower limb after he spontaneously dislocated his patella while running on uneven ground...
April 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/27687176/the-role-of-patelloplasty-in-total-knee-arthroplasty
#7
Simone Cerciello, Jonathan Robin, Sébastien Lustig, Giulio Maccauro, Thomas J Heyse, Philippe Neyret
INTRODUCTION: Anterior knee pain (AKP) is a frequent complication after total knee arthroplasty (TKA). Patelloplasty, defined as reshaping the patella for optimal tracking in the trochlea, has been proposed to reduce the rate of this complication in patellar retaining implants. Aim of this study was to analyze the available literature regarding the outcomes of patelloplasty and to assess its methodological quality. MATERIALS AND METHODS: A comprehensive review of the English literature was performed using the keywords "total knee arthroplasty", "patelloplasty" and "patellaplasty" with no limit regarding the year of publication...
November 2016: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/27544273/patellar-tracking-after-isolated-medial-patellofemoral-ligament-reconstruction-dynamic-evaluation-using-computed-tomography
#8
Riccardo G Gobbi, Marco K Demange, Luiz Francisco Rodrigues de Ávila, José de Arimatéia Batista Araújo Filho, Ramon Alfredo Moreno, Marco Antônio Gutierrez, Marina de Sá Rebelo, Luis Eduardo Passarelli Tírico, José Ricardo Pécora, Gilberto Luis Camanho
PURPOSE: Medial patellofemoral ligament (MPFL) reconstruction offers good clinical results with a very low rate of instability recurrence. However, its in vivo effect on patellar tracking is not clearly known. The aim of this study is to investigate the effects of MPFL reconstruction on patellar tracking using dynamic 320-detector-row CT. METHODS: Ten patients with patellofemoral instability referred to isolated MPFL reconstruction surgery were selected and subjected to dynamic CT before and ≥6 months after surgery...
August 20, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27398788/robotic-total-knee-arthroplasty-surgical-assistant-for-a-customized-normal-kinematic-knee
#9
Kenneth L Urish, Michael Conditt, Martin Roche, Harry E Rubash
Although current total knee arthroplasty (TKA) is considered a highly successful surgical procedure, patients undergoing TKA can still experience substantial functional impairment and increased revision rates as compared with those undergoing total hip arthroplasty. Robotic-assisted surgery has been available clinically for almost 15 years and was developed, in part, to address these concerns. Robotic-assisted surgery aims to improve TKA by enhancing the surgeon's ability to optimize soft tissue balancing, reproduce alignment, and restore normal knee kinematics...
September 1, 2016: Orthopedics
https://www.readbyqxmd.com/read/27395356/morphological-classification-of-the-femoral-trochlear-groove-based-on-a-quantitative-measurement-of-computed-tomographic-models
#10
Shichang Chen, Zhe Du, Mengning Yan, Bing Yue, You Wang
PURPOSE: This study aimed to investigate the natural morphology of the femoral trochlear groove based on quantitative measurement. METHODS: Computed tomographic femur models of 50 male and 50 female healthy Chinese adults (30-60 years) were analysed using three-dimensional software. Coaxial cutting planes (15° increments) rotating about the trochlear groove axis from the proximal to distal point were created, followed by the deepest point of the trochlear groove marked at each cross section...
July 9, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27358051/characterization-of-patellar-maltracking-using-dynamic-kinematic-ct-imaging-in-patients-with-patellar-instability
#11
Miho J Tanaka, John J Elias, Ariel A Williams, Shadpour Demehri, Andrew J Cosgarea
PURPOSE: Little has been reported on the relationship between patellar maltracking and instability. Patellar maltracking has been subjectively described with the "J sign" but is difficult to assess objectively using traditional imaging. Dynamic kinematic computed tomography (DKCT) allows dynamic assessment of the patellofemoral joint. DKCT was used to visualize and quantify patellar maltracking patterns, and severity of maltracking was correlated with the presence or absence of patellar instability symptoms...
June 29, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27357945/-patella-navigation-in-computer-assisted-tka-intraoperative-measurement-of-patellar-kinematics-video-article
#12
H-R Springorum, C Baier, B Craiovan, G Maderbacher, T Renkawitz, J Grifka, A Keshmiri
INTRODUCTION: Patellofemoral maltracking is a relevant problem after total knee arthroplasty (TKA). Patella navigation is a tool that allows real time monitoring of patella tracking. MATERIAL: This video contribution demonstrates the technique of patellofemoral navigation and a possible consequence of intraoperative monitoring. A higher postoperative lateral tilt is addressed with a widening of the lateral retinaculum in a particular manner. CONCLUSION: In selected cases of patellofemoral problems, patella navigation is a helpful tool to evaluate patellofemoral tracking intraoperatively...
July 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27354953/soft-tissue-loop-for-medial-patellofemoral-ligament-reconstruction
#13
Mohd Fairudz Bin Mohd Miswan, Mohamed Zubair Mohamed Al-Fayyadh, Teo Seow Hui, Mohamed Razif Bin Mohamed Ali, Wuey Min Ng
A patient with patellar instability frequently presents with anterior knee pain, patellar subluxation, or dislocation. Medial patellofemoral ligament (MPFL) has a key role for normal patella tracking and stability. Reconstruction of the MPFL using a hamstring graft is a commonly used procedure for the treatment of chronic lateral subluxation of patella. Anchor sutures and bony tunnels are used for the patellar attachment of the graft. This can be associated with complications such as patella fracture; besides, it does not produce an anatomical reconstruction for the native MPFL that can alter the direction of tension applied on the patella...
April 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27299129/atraumatic-extra-articular-patellar-dislocation-with-vertical-axis-rotation-a-case-study
#14
Andrew Higgins, Mahdi Yacine Khalfaoui
INTRODUCTION: Acute patellar dislocation is a common injury usually associated with a significant traumatic mechanism resulting in lateral displacement. Vertical axis rotation following dislocation is a rare variant of this type of injury and can prevent closed reduction in the acute setting. CASE PRESENTATION: A 32-year old gentleman presented with an irreducible patella dislocation following an unusual atraumatic mechanism. Following attempts at closed reduction under sedation and regional nerve block, eventual open reduction and soft tissue reconstruction was required under general anesthetic...
January 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/27284321/treatment-of-patellar-instability-in-a-case-of-hereditary-onycho-osteodysplasia-nail-patella-syndrome-with-medial-patellofemoral-ligament-reconstruction-a-case-report
#15
Yubao Gong, Chen Yang, Yang Liu, Jianguo Liu, Xin Qi
Hereditary onycho-osteodysplasia, also known as nail-patella syndrome (NPS), is a rare genetic disorder that is primarily characterized by poorly developed nails and patella. Patients with NPS frequently suffer from patellar instability that requires surgical management. The present case report describes a 25-year-old man with NPS. The patient presented with left knee pain and was found to have recurrent left patellar dislocation. The knee pain was first reported 1-year after a minor knee trauma incident. Following complete evaluation, a diagnosis of NPS was reached...
June 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27242281/effects-of-tibial-rotation-on-ober-s-test-and-patellar-tracking
#16
Joo-Hee Park, Sun-Young Kang, Sung-Dae Choung, Hye-Seon Jeon, Oh-Yun Kwon
BACKGROUND: The purpose of this study was to investigate the effects of tibial position on ITB flexibility and patellar position. METHODS: A total of 31 asymptomatic subjects (21 males, 10 females) were recruited for this investigation. Adduction angle was measured by Ober's test, and PCD was measured by ultrasonography in three different tibial rotation conditions: N, IR, and ER. RESULTS: Repeated measures ANOVA revealed a significant difference in adduction angle and PCD among three different tibial positions (P<0...
August 2016: Knee
https://www.readbyqxmd.com/read/27216144/total-knee-arthroplasty-using-trochlear-groove-as-guide-for-position-of-femoral-component-in-severe-knee-osteoarthritis
#17
Gangyong Huang, Jun Xia, Siqun Wang, Yibing Wei, Jianguo Wu, Feiyan Chen, Jie Chen, Jingsheng Shi
BACKGROUND: Apart from transepicondylar axis, the native femoral sulcus was also reported to be used as a guide for the femoral component position in total knee arthroplasty (TKA). However, it was not shown in patients with severe knee osteoarthritis. This study was conducted to compare the position of trochlear groove in patients with and without osteoarthritis, and to assess whether trochlear groove could be used as a guide for position of femoral component in TKA for severe knee osteoarthritis...
May 23, 2016: BMC Surgery
https://www.readbyqxmd.com/read/27169720/quantitative-analysis-of-dynamic-patellar-tracking-in-patients-with-lateral-patellar-instability-using-a-simple-video-system
#18
Yuki Fujita, Eiichi Tsuda, Yuji Yamamoto, Takuya Naraoka, Yuka Kimura, Shizuka Sasaki, Yasuyuki Ishibashi
BACKGROUND: As patellar dislocation occurs during activity, it is more important to assess the behavior of the patellofemoral joint under dynamic conditions. The aim of this study was to compare patellar tracking between knees with and without patellar dislocation in patients with an unstable patella and healthy controls using a simple video technique. METHODS: Twenty-three knees with patellar dislocation (dislocated group), 23 contralateral knees without dislocation (non-dislocated group), and 23 healthy knees (control group) were examined...
August 2016: Knee
https://www.readbyqxmd.com/read/27142969/-patellar-bone-deficiency-in-revision-total-knee-arthroplasty
#19
J Kloiber, E Goldenitsch, P Ritschl
BACKGROUND: Patellar bone deficiency in revision total knee arthroplasty (TKA) determines the surgical procedure. Different reconstructive and ablative techniques, dependent on the remaining bone stock, are described. INDICATION: The primary patella implant can be retained in up to 50 % of revision situations. Reasons for replacement are aseptic and septic loosening, implant failure, expanding osteolysis, maltracking of the patella and "metal-backed" prosthesis...
May 2016: Der Orthopäde
https://www.readbyqxmd.com/read/26955174/total-knee-arthroplasty-in-valgus-knees-using-minimally-invasive-medial-subvastus-approach
#20
Nilen Amulak Shah, Nimesh Prakash Jain
BACKGROUND: An ideal approach for valgus knees must provide adequate exposure with minimal complications due to approach per se. Median parapatellar approach is most commonly used approach in TKA including valgus knees. A medial subvastus approach is seldom used for valgus knees and has definite advantages of maintaining extensor mechanism integrity and minimal effect on patellar tracking. The present study was conducted to evaluate outcomes of total knee arthroplasty (TKA) and efficacy of subvastus approach in valgus knees in terms of early functional recovery, limb alignment and complications...
January 2016: Indian Journal of Orthopaedics
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