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Patella alta

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https://www.readbyqxmd.com/read/28706804/tibial-tuberosity-transfer-in-combination-with-medial-patellofemoral-ligament-reconstruction-surgical-technique
#1
Damian Clark, Katie Walmsley, Peter Schranz, Vipul Mandalia
The stability of the patellofemoral joint relies on the tenuous interplay of soft tissue and bony factors. Anatomic risk factors for instability include a shallow trochlea, an abnormally lateral tibial tubercle position, patella alta, hypermobility, or a secondary injury to the medial patellofemoral ligament (MPFL). There is an increasing interest in restoring normal anatomy to achieve stability, and at times more than 1 abnormality exists. This article describes the technique for combining a tibial tuberosity transfer and an MPFL reconstruction...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28629941/does-patella-lowering-improve-crouch-gait-in-cerebral-palsy-comparative-retrospective-study
#2
Eric Desailly, Camille Thévenin-Lemoine, Nejib Khouri
BACKGROUND: Patellalowering aims to improve quadriceps function as a means of correcting crouch gait in patients with cerebral palsy (PC). Few studies have assessed the effects of patella lowering as a component of multilevel surgery. HYPOTHESIS: Including patella lowering into the components of multilevel surgery is beneficial in patients with crouch gait and patella alta. MATERIAL ET METHODS: In 12 lower limbs with patella alta (Caton-Deschamps index >1...
June 16, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28601942/anatomic-reconstruction-of-the-medial-patellofemoral-ligament-in-children-and-adolescents-using-a-pedicled-quadriceps-tendon-graft-shows-favourable-results-at-a-minimum-of-2-year-follow-up
#3
Manfred Nelitz, Jens Dreyhaupt, Sean Robert March Williams
PURPOSE: In adults, reconstruction of the medial patellofemoral ligament (MPFL) has shown good results. Treatment for recurrent patellar instability in children and adolescents with open growth plates, however, requires alternative MPFL reconstruction techniques. This study presents the outcomes of a minimally invasive technique for anatomic reconstruction of the MPFL in children using a pedicled superficial quadriceps tendon graft, hardware-free patellar graft attachment, and anatomic femoral fixation that spares the distal femoral physis...
June 10, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28569198/determination-of-reference-values-and-frequency-of-occurrence-of-patella-alta-in-german-shepherd-dogs-a-retrospective-study
#4
Anna Łojszczyk-Szczepaniak, Piotr Silmanowicz, Renata Komsta, Zbigniew Osiński
BACKGROUND: Patella alta and patella baja are important conditions underlying a predisposition to many joint diseases, including patellar luxation and patellar chondromalacia of the articular cartilage. The frequencies of patella alta and patella baja have not yet been determined. The objectives of this study were to determine the frequency of patella alta and to determine reference values to the position of the vertical patella according to two modified techniques of the Insall-Salvati method in a group of 65 German shepherd dogs (115 stifle joints)...
May 31, 2017: Acta Veterinaria Scandinavica
https://www.readbyqxmd.com/read/28463535/risk-factors-and-time-to-recurrent-ipsilateral-and-contralateral-patellar-dislocations
#5
Tyson C Christensen, Diane L Dahm, Aaron J Krych, Rohith Mohan, Ayoosh Pareek, Thomas L Sanders
BACKGROUND: Previous studies have reported variable rates of recurrent lateral patellar instability mainly because of limited cohort sizes. In addition, there is currently a lack of information on contralateral patellar instability. PURPOSE: To evaluate the rate of recurrent ipsilateral patellar dislocations and contralateral patellar dislocations after a first-time lateral patellar dislocation. Additionally, risk factors associated with recurrent dislocations (ipsilateral or contralateral) and time to recurrence were investigated...
May 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28459752/patellar-instability-when-is-trochleoplasty-necessary
#6
S Evan Carstensen, Heather M Menzer, David R Diduch
Trochleoplasty is a very effective procedure for correcting trochlear dysplasia and addressing instability of the patella. With an increasing knowledge about the anatomy and biomechanics of the anterior distal femur, a wider array of surgical techniques may be applied to address specific conditions. Patients must be carefully selected to undergo trochleoplasty by use of a thorough history and physical examination as well as basic and advanced imaging. The presence of a "J sign" on physical examination, a history of recurrent instability, patella alta, trochlear dysplasia, and elevated tibial tubercle to trochlear groove are signs and symptoms for which the patient should be evaluated...
June 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28437505/guidelines-for-treatment-of-lateral-patella-dislocations-in-skeletally-mature-patients
#7
Michael C Liebensteiner, Florian Dirisamer, Peter Balcarek, Philip Schoettle
The incidence of lateral patella dislocations is high, particularly in young females. Beside traumatic cases, many patients present with specific anatomical factors that predispose to lateral patella dislocations (torsional abnormalities of the femur or the tibia, trochlea dysplasia, patella alta, etc). It is of utmost importance to correct those pathologic factors during concomitant procedures as isolated reconstructions of the medial patellofemoral ligament would fail in the presence of severe anatomic risk factors...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28437490/the-diagnosis-and-initial-treatment-of-patellofemoral-disorders
#8
Alan C Merchant, John P Fulkerson, Wayne Leadbetter
Our purpose is to provide simple guidelines for the diagnosis and early care of patellofemoral disorders. Any clinician who treats knee problems, including family practitioners, rheumatologists, orthopedic surgeons, or physical therapists, must know how to make the correct diagnosis, or at least a presumptive diagnosis, at the initial visit. This can avoid unneeded and costly tests, ineffective treatment, and even damaging exercises and unnecessary surgery. The diagnosis of patellofemoral disorders is confusing because they can have many causes...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28418810/relationship-of-trochlear-morphology-and-patellofemoral-joint-alignment-to-superolateral-hoffa-fat-pad-edema-on-mr-images-in-individuals-with-or-at-risk-for-osteoarthritis-of-the-knee-the-most-study
#9
Rafael Widjajahakim, Michael Roux, Mohamed Jarraya, Frank W Roemer, Tuhina Neogi, John A Lynch, Cora E Lewis, James C Torner, David T Felson, Ali Guermazi, Joshua J Stefanik
Purpose To determine the relationship of patellofemoral joint alignment and trochlear morphology to superolateral Hoffa fat pad (SHFP) edema on magnetic resonance (MR) images in older adults with or at risk for osteoarthritis of the knee. Materials and Methods Institutional review board approval and written informed consent were obtained from all subjects. The Multicenter Osteoarthritis Study is a prospective cohort study of older adults with or at risk for osteoarthritis of the knee. Subjects were recruited from Birmingham, Alabama, and Iowa City, Iowa...
April 17, 2017: Radiology
https://www.readbyqxmd.com/read/28299386/high-rate-of-recurrent-patellar-dislocation-in-skeletally-immature-patients-a-long-term-population-based-study
#10
Thomas L Sanders, Ayoosh Pareek, Timothy E Hewett, Michael J Stuart, Diane L Dahm, Aaron J Krych
PURPOSE: Patellar dislocation can occur in isolation or be associated with chronic instability. The goals of this study are to describe the rate and factors associated with additional patellar instability events (ipsilateral recurrence and contralateral dislocation), as well as the development of patellofemoral arthritis in patients who are skeletally immature at the time of first patellar dislocation. METHODS: The study included a population-based cohort of 232 skeletally immature patients who experienced a first-time lateral patellar dislocation between 1990 and 2010...
March 15, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28277745/3d-computed-tomography-evaluation-of-morphological-changes-in-the-femoral-tunnel-after-medial-patellofemoral-ligament-reconstruction-with-hamstring-tendon-graft-for-recurrent-patellar-dislocation
#11
Keisuke Kita, Yoshinari Tanaka, Yukiyoshi Toritsuka, Hiroshi Amano, Ryohei Uchida, Yoshiki Shiozaki, Rikio Takao, Shuji Horibe
BACKGROUND: Reconstruction of the medial patellofemoral ligament (MPFL) for recurrent lateral patellar dislocation is gaining popularity. However, the morphological changes in the femoral tunnel after MPFL reconstruction are still not fully documented. PURPOSE: This study used 3-dimensional (3D) computed tomography to evaluate morphological changes in the femoral tunnel after MPFL reconstruction with hamstring tendon graft to investigate factors affecting the phenomenon and to elucidate whether it is associated with clinical outcomes...
June 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28246877/anatomic-patellar-instability-risk-factors-in-primary-lateral-patellar-dislocations-do-not-predict-injury-patterns-an-mri-based-study
#12
Marc A Tompkins, Sara R Rohr, Julie Agel, Elizabeth A Arendt
PURPOSE: The primary goal was to describe the injury patterns in a population of primary (first time) lateral patellar dislocators (LPD) to lend clarity to commonly held notions about injury patterns in this population. METHODS: A prospective study identifying patients presenting with LPD between 2008 and 2012. Inclusion criteria were a history and physical exam consistent with primary LPD, and an MRI consistent with the diagnosis without other significant ligamentous injury...
February 28, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28028569/functional-testing-and-return-to-sport-following-stabilization-surgery-for-recurrent-lateral-patellar-instability-in-competitive-athletes
#13
Aaron J Krych, Michael P O'Malley, Nick R Johnson, Rohith Mohan, Timothy E Hewett, Michael J Stuart, Diane L Dahm
PURPOSE: Medial patellofemoral ligament (MPFL) reconstruction and tibial tubercle osteotomy are commonly used to treat recurrent lateral patellar instability, yet there are limited available data on return to sport (RTS) following these procedures. The purpose of this study is to evaluate patient factors associated with excellent functional outcomes, including successful RTS, following surgical stabilization including MPFL reconstruction in competitive athletes with recurrent lateral patellar instability...
December 27, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27999505/osteochondral-allograft-transplantation-for-femoral-trochlear-dysplasia
#14
Dharmpal V Vansadia, James R Heltsley, Scott Montgomery, Misty Suri, Deryk G Jones
BACKGROUND: The risk factors for patellofemoral joint instability include laxity of medial patellar restraints, abnormal limb geometry, femoral and tibial malrotation, patella alta, and trochlear dysplasia. Femoral trochlear dysplasia is characterized by a hypoplastic or shallow trochlear groove. CASE REPORT: We report the case of a 31-year-old female with trochlear dysplasia and recurrent patella dislocations, laxity of the medial patellofemoral ligament (MPFL), and high-grade chondromalacia of the trochlea and the patella...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27939752/influence-of-patellar-position-on-the-knee-extensor-mechanism-in-normal-and-crouched-walking
#15
Rachel L Lenhart, Scott C E Brandon, Colin R Smith, Tom F Novacheck, Michael H Schwartz, Darryl G Thelen
Patella alta is common in cerebral palsy, especially in patients with crouch gait. Correction of patella alta has been advocated in the treatment of crouch, however the appropriate degree of correction and the implications for knee extensor function remain unclear. Therefore, the goal of this study was to assess the impact of patellar position on quadriceps and patellar tendon forces during normal and crouch gait. To this end, a lower extremity musculoskeletal model with a novel 12 degree of freedom knee joint was used to simulate normal gait in a healthy child, as well as mild (23 deg min knee flexion in stance), moderate (41 deg), and severe (67 deg) crouch gait in three children with cerebral palsy...
January 25, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/27798714/patellar-sleeve-fracture-with-ossification-of-the-patellar-tendon
#16
Derek S Damrow, Scott E Van Valin
Patellar sleeve fractures make up greater than 50% of all patellar fractures. They are essentially only seen in the pediatric population because of the thick periosteum and the distal patellar pole apophysis in this group. These fractures can lead to complications if not treated appropriately and in a timely fashion. Complications of missed or untreated patellar sleeve fractures include patella alta, anterior knee pain, and quadriceps atrophy. These can all result in severe limitations in activity. The authors describe a case of a 16-year-old boy who sustained a patellar sleeve fracture 3 years prior to presentation...
March 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/27652073/patellar-malalignment-a-new-method-on-knee-mri
#17
Hülya Kurtul Yildiz, Elif Evrim Ekin
PURPOSE: The medial patellofemoral ligament (MPFLL)/lateral patellar retinaculum (LPR) ratio were assessed in knees as a means to detect patellar malalignment. We also aimed to evaluate the prevalence of the various types of trochlear dysplasia in patients with patellar malalignment. MATERIALS AND METHODS: After approval of our institutional ethics committee, we conducted a retrospective study that included 450 consecutive patients to evaluate them for the presence of patellar malalignment...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27622149/femoro-patella-vialla-patellofemoral-arthroplasty-an-independent-assessment-of-outcomes-at-minimum-2-year-follow-up
#18
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
https://www.readbyqxmd.com/read/27613760/morphology-and-anatomic-patellar-instability-risk-factors-in-first-time-traumatic-lateral-patellar-dislocations-a-prospective-magnetic-resonance-imaging-study-in-skeletally-immature-children
#19
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...
January 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27577067/does-patella-tendon-tenodesis-improve-tibial-tubercle-distalization-in-treating-patella-alta-a-computational-study
#20
COMPARATIVE STUDY
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
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