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Patella alta

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https://www.readbyqxmd.com/read/27798714/patellar-sleeve-fracture-with-ossification-of-the-patellar-tendon
#1
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...
October 31, 2016: Orthopedics
https://www.readbyqxmd.com/read/27652073/patellar-malalignment-a-new-method-on-knee-mri
#2
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
#3
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
#4
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...
September 9, 2016: 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
#5
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
https://www.readbyqxmd.com/read/27289460/impact-of-the-patella-height-on-the-strain-pattern-of-the-medial-patellofemoral-ligament-after-reconstruction-a-computer-model-based-study
#6
Thomas Tischer, Andreas Geier, Robert Lenz, Christoph Woernle, Rainer Bader
PURPOSE: Medial patellofemoral ligament (MPFL) reconstruction is a key procedure for treating patellofemoral instability. However, controversy exists regarding the correct graft placement in different patellar heights. Therefore, our study aimed to investigate the influence of patellar height on MPFL insertion points. METHODS: Strain patterns of the reconstructed MPFL were calculated using a dynamic musculoskeletal multibody simulation. Numerous patellar (proximal, central, distal) and femoral attachment sites (around the radiological point according to Schöttle) were analysed in the presence of different patella heights [Insall-Salvati (IS) indices 0...
June 11, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27274449/patellofemoral-joint-reconstruction-for-patellar-instability-medial-patellofemoral-ligament-reconstruction-trochleoplasty-and-tibial-tubercle-osteotomy
#7
Chase S Dean, Jorge Chahla, Raphael Serra Cruz, Tyler R Cram, Robert F LaPrade
Recurrent patellar instability can be very debilitating and may require surgical intervention. A thorough workup must be completed in this subset of patients. Risk factors for recurrent instability include patella alta, trochlear dysplasia, an increased tibial tubercle-trochlear groove distance, and insufficiencies in the medial retinacular structures. Necessary treatment of these risk factors, once identified, should be addressed surgically. Patellofemoral reconstruction must be individually tailored to each patient's anatomy and may necessitate medial patellofemoral ligament reconstruction, tibial tubercle osteotomy, or trochleoplasty in any combination or as a standalone procedure...
February 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27274428/physical-therapy-intervention-for-medial-patellofemoral-ligament-reconstruction-after-repeated-lateral-patellar-subluxation-dislocation
#8
Teresa Errigo Vitale, Brianne Mooney, Ashley Vitale, Demitra Apergis, Stephen Wirth, Mark G Grossman
BACKGROUND: The incidence of patellar subluxation or dislocation has been documented up to 43/100,000 with females more prevalent then males. There are many contributing factors involving the hip, knee, and ankle that lead to patellar subluxation. A patellar position of lateral tilt with lateral glide may indicate weakness of the vastus medialis oblique (VMO) and adductors, increased tightness in the iliotibial band, and overpowering of the vastus lateralis. Patella alta can predispose an individual to lateral dislocation due to the patella placement outside of the femoral trochlear groove with a disadvantage of boney stability...
June 2016: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/27200391/position-of-the-patella-among-emirati-adult-knees-is-insall-salvati-ratio-applicable-to-middle-easterners
#9
Saeed Althani, Alisina Shahi, Timothy L Tan, Ali Al-Belooshi
BACKGROUND: Abnormal patellar height is associated with anterior knee pain and several conditions that affect the patellofemoral joint. The aim of this study was to 1) report the incidence of patella alta and patella baja and 2) investigate whether the normal limits of the Insall-Salvati ratio is applicable in adult Middle-Easterners. METHODS: A radiographic review of the lateral radiographs of 736 Middle-Eastern knees were performed. Patellar tendon length (TL) and the patellar length (TP) was digitally measured and the ratios of these measures was used to calculate the Insall-Salvati ratio...
April 2016: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/27135457/biomechanical-assessment-of-patellar-advancement-procedures-for-patella-alta
#10
Adam Seidl, Todd Baldini, Kevin Krughoff, Joshua A Shapiro, Bennie Lindeque, Jason Rhodes, James Carollo
Crouch gait deformity is common in children with cerebral palsy and often is associated with patella alta. Patellar tendon advancement typically is used to correct patella alta and restore normal knee mechanics. The purpose of this study was to determine the mechanical strength of surgical constructs used for fixation during patellar advancement procedures. This study used a cadaveric model to determine which of 3 surgical techniques is biomechanically optimal for patellar tendon advancement in treating patella alta...
May 1, 2016: Orthopedics
https://www.readbyqxmd.com/read/27077588/imaging-of-individual-anatomical-risk-factors-for-patellar-instability
#11
Tobias J Dietrich, Sandro F Fucentese, Christian W A Pfirrmann
This review article presents several pitfalls and limitations of image interpretation of anatomical risk factors for patellar instability. The most important imaging examinations for the work-up of patients with patellar instability are the true lateral radiograph and transverse computed tomography (CT) or MR images of the knee. Primary anatomical risk factors are an insufficient medial patellofemoral ligament (MPFL), patella alta, trochlear dysplasia, increased distance from the tibial tuberosity to the trochlear groove (TTTG), and torsional limb parameters...
February 2016: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/27058648/patellofemoral-instability-in-children-correlation-between-risk-factors-injury-patterns-and-severity-of-cartilage-damage
#12
Hee Kyung Kim, Sahar Shiraj, Chang Ho Kang, Christopher Anton, Dong Hoon Kim, Paul S Horn
OBJECTIVE: The purpose of this study was to compare MRI findings between groups with and without patellofemoral instability and to correlate the MRI findings with the severity of patellar cartilage damage. MATERIALS AND METHODS: Fifty-three children with patellofemoral instability and 53 age- and sex-matched children without patellofemoral instability (15.9 ± 2.4 years) were included. Knee MRI with T2-weighted mapping was performed. On MR images, femoral trochlear dysplasia, patellofemoral malalignment, medial retinaculum injury, and bone marrow edema were documented...
June 2016: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/26960585/superior-dislocation-of-the-patella-in-a-young-woman-without-osteophytes-a-case-report
#13
Tatsunori Kataoka, Norishige Iizawa, Shinro Takai
Superior dislocation of the patella without patellar ligament injury is an extremely rare condition. A review of the English-language literature found only 23 reported cases. In addition, the primary factor for dislocation in most of these cases was considered to be osteophytes in the inferior pole of the patella and the anterior surface of the femoral condyle; only 1 case had no osteophytes. We treated a 19-year-old woman who sustained a painful locking of the left knee after colliding with a friend. Plain radiography and computed tomography showed superior-lateral dislocation of the patella and an interlocking between notches in the inferior pole of the patella and the anterior surface of the femoral condyle...
2016: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/26935465/an-algorithmic-approach-to-the-management-of-recurrent-lateral-patellar-dislocation
#14
REVIEW
Alexander E Weber, Amit Nathani, Joshua S Dines, Answorth A Allen, Beth E Shubin-Stein, Elizabeth A Arendt, Asheesh Bedi
High-level evidence supports nonoperative treatment for first-time lateral acute patellar dislocations. Surgical intervention is often indicated for recurrent dislocations. Recurrent instability is often multifactorial and can be the result of a combination of coronal limb malalignment, patella alta, malrotation secondary to internal femoral or external tibial torsion, a dysplastic trochlea, or disrupted and weakened medial soft tissue, including the medial patellofemoral ligament (MPFL) and the vastus medialis obliquus...
March 2, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/26922799/dynamic-tracking-influenced-by-anatomy-in-patellar-instability
#15
John J Elias, Neil T Soehnlen, Loredana M Guseila, Andrew J Cosgarea
BACKGROUND: The current study was performed to correlate anatomical parameters related to trochlear dysplasia, tibial tuberosity position, and patella alta with in vivo patellar tracking for subjects with recurrent patellar instability. METHODS: Eight subjects with recurrent patellar instability that failed conservative treatment were evaluated using computational reconstruction of in vivo knee motion. Computational models were created from dynamic CT scans of the knee during extension against gravity...
June 2016: Knee
https://www.readbyqxmd.com/read/26900548/semitendinosus-tendon-transfer-associated-with-distal-alignment-for-patella-alta-in-a-patient-with-recurrent-dislocations
#16
Filippo Calderazzi, Andrea Pellegrini, Gianluca Coviello, Giulia Groppi, Francesco Ceccarelli
Patellofemoral instability is characterized by pain during normal daily activities and frequent dislocation events. In the reported case, an adolescent girl, aged 15 years, affected by left patellofemoral instability, underwent surgery with a double technique comprising tibial tubercle distalization and medial patellofemoral ligament reconstruction. In case of patella alta associated with patellofemoral instability, surgical treatment should focus on medial patellofemoral ligament repair and on recurrent instability prevention...
October 2015: Arthroscopy Techniques
https://www.readbyqxmd.com/read/26860094/imaging-assessment-of-patellar-instability-and-its-treatment-in-children-and-adolescents
#17
REVIEW
Arthur B Meyers, Tal Laor, Mark Sharafinski, Andrew M Zbojniewicz
Transient patellar dislocation is a common entity in children and adolescents, characterized by lateral dislocation of the patella, usually with spontaneous reduction. Many predisposing conditions have been described, including trochlear dysplasia, excessive lateral patellar tilt, patella alta and lateralization of the tibial tuberosity. Associated injuries are bone bruises of the patella and lateral femoral condyle, tears of the medial retinaculum that include the medial patellofemoral ligament (MPFL), tears of the vastus medialis obliquus muscle, injuries of articular cartilage, and intra-articular bodies...
May 2016: Pediatric Radiology
https://www.readbyqxmd.com/read/26837641/influence-of-age-on-clinical-outcomes-of-three-dimensional-transfer-of-the-tibial-tuberosity-for-patellar-instability-with-patella-alta
#18
Shuhei Otsuki, Mikio Nakajima, Kenta Fujiwara, Yoshinori Okamoto, Go Iida, Tomohiko Murakami, Masashi Neo
PURPOSE: To evaluate the clinical outcomes of three-dimensional (3D) transfer of the tibial tuberosity for patellar instability with patella alta, with a focus on the influence of age at initial surgery. METHODS: Three-dimensional surgery was performed on 28 knees with a mean follow-up of 46 months. Patients were separated into three groups based on the age at initial surgery: group A, 10 knees and an average age of 16.3 ± 1.8 (14-19) years; group B, 10 knees and an average age of 22...
February 2, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/26792241/radiographic-features-of-acute-patellar-tendon-rupture
#19
Muhammad Ali Fazal, Pradeep Moonot, Fares Haddad
OBJECTIVE: The purpose of our study was to assess soft tissue features of acute patellar tendon rupture on lateral knee radiograph that would facilitate early diagnosis. METHODS: The participants were divided into two groups of 35 patients each. There were 28 men and seven women with a mean age of 46 years in the control group and 26 men and nine women with a mean age of 47 years in the rupture group. The lateral knee radiograph of each patient was evaluated for Insall-Salvati ratio for patella alta, increased density of the infrapatellar fat pad, appearance of the soft tissue margin of the patellar tendon and bony avulsions...
November 2015: Orthopaedic Surgery
https://www.readbyqxmd.com/read/26746043/focal-intratendinous-radiolucency-a-new-radiographic-method-for-diagnosing-patellar-tendon-ruptures
#20
Jonathan P Ng, Derek T Cawley, Suzanne M Beecher, Matthew J Lee, Diane Bergin, Fintan J Shannon
BACKGROUND: Diagnosis of patellar tendon rupture is usually based on clinical history and examination. In equivocal cases, imaging may be required. Lateral radiograph is a simple and cost-effective method for prompt diagnosis. However, no specific radiological sign has been described. Rather than utilising patella alta as an indirect measure of patellar tendon rupture, we hypothesise that a focal intratendinous radiolucency is another reliable and accurate radiological sign for diagnosis...
June 2016: Knee
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