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Patella mobilization

Goetz A Giessler, Christian Hendrich
Total patellectomy is sometimes unavoidable but usually results in severely impaired function, pain, and instability in the affected knee. Any patellar prosthetic solutions rely on a certain amount of remaining bone and therefore are not applicable after total patellectomy. Traditionally, reconstruction of a neopatella by avascular or allogeneic bone grafts is hampered by mechanical failure, resorption, or infection. We developed a new, 3-stage approach to reconstruct a hybrid patella composed of a revascularized scapula tip transplant fabricated with a prosthetic socket...
December 2016: Plastic and Reconstructive Surgery. Global Open
Valentino F Bruhin, Stefan Preiss, Gian M Salzmann, Laurent P Harder
Patella baja is a severe complication seen after trauma, prolonged immobilization and surgery. Several surgical methods have been described to proximalize the patella without a change in the patella tendon length. Yet, patella tendon shortening and thickening can be regarded as the hallmark pathology. As such, we describe a technique for the lengthening of the patellar tendon to pathoconformly address underlying patella baja. The technique is reproducible and gives the possibility of an early postoperative mobilization to prevent re-baja-a typical complication after patella baja surgery...
December 2016: Arthroscopy Techniques
Nili Steinberg, Shay Tenenbaum, Israel Hershkovitz, Aviva Zeev, Itzhak Siev-Ner
Very little is known about patellofemoral pain syndrome (PPFS) among young dancers. Understanding the mechanism of the injury and implementing a preventative programme are important in order to minimize the risk of PFPS. The aim of the current study is to determine the extent to which factors such as lower extremity and back characteristics are common among dancers with PFPS. The study population included 271 dancers with PFPS and 271 non-injured dancers, aged 10-16 years. All dancers were screened for morphometric profile, dance discipline (h/week), anatomical anomalies (present/absent of scoliosis, genu valgus/varum, etc...
April 2017: Research in Sports Medicine
Karl Grob, Mirjana Manestar, Luis Filgueira, Markus S Kuster, Helen Gilbey, Timothy Ackland
PURPOSE: Although the vastus medialis (VM) is closely associated with the vastus intermedius (VI), there is a lack of data regarding their functional relationship. The purpose of this study was to investigate the anatomical interaction between the VM and VI with regard to their origins, insertions, innervation and function within the extensor apparatus of the knee joint. METHODS: Eighteen human cadaveric lower limbs were investigated using macro-dissection techniques...
January 25, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Sherif Elnikety, Catherine J Pendegrass, Roberta Ferro de Godoy, Charles Holden, Gordon W Blunn
BACKGROUND: In severe injuries with loss of tendon substance a tendon graft or a synthetic substitute is usually used to restore functional length. This is usually associated with donor site morbidity, host tissue reactions and lack of remodelling of the synthetic substitutes, which may result in suboptimal outcome. A biocompatible graft with mechanical and structural properties that replicate those of normal tendon and ligament has so far not been identified. The use of demineralised bone for tendon reattachment onto bone has been shown to be effective in promoting the regeneration of a normal enthesis...
November 17, 2016: BMC Musculoskeletal Disorders
Bevin Lin, Kevin M Moerman, Connor G McMahan, Kenneth A Pasch, Hugh M Herr
OBJECTIVE: The purpose of this manuscript is to compute skin strain data from a flexed biological limb, using portable, inexpensive, and easily-available resources. METHODS: We apply and evaluate this approach on a person with bi-lateral transtibial amputations, imaging left and right residual limbs in extended and flexed knee postures. We map 3D deformations to a flexed biological limb using freeware and a simple point-and-shoot camera. Mean principal strain, maximum shear strain, as well as lines of maximum, minimum, and non-extension are computed from 3D digital models to inform directional mappings of the strain field for an unloaded residual limb...
November 10, 2016: IEEE Transactions on Bio-medical Engineering
Yusuke Osawa, Yasumichi Arai, Yuko Oguma, Takumi Hirata, Yukiko Abe, Koichiro Azuma, Michiyo Takayama, Nobuyoshi Hirose
This study investigated the relationships between muscle echo intensity (EI), physical activity (PA) and functional mobility in 108 Japanese (88-92 years). We measured EI and muscle thickness (MT) at the midpoint of the anterior superior iliac spine and patella using B-mode ultrasound. Light and moderate to vigorous PA (LPA and MVPA) were assessed with a tri-axial accelerometer. Timed up and go (TUG) test was measured for functional mobility. EI, but not MT, was significantly associated with both TUG scores (β=0...
September 6, 2016: Journal of Aging and Physical Activity
Antoine Senioris, Mo Saffarini, Said Rahali, Louis Malekpour, Franck Dujardin, Olivier Courage
BACKGROUND: Anterior knee pain (AKP) is observed in total knee arthroplasty (TKA) both with and without patellar resurfacing, and neither patellar denervation nor secondary resurfacing are effective for treating the symptoms. The exact causes for pain remain unclear, though abnormal patellofemoral forces due to patellar malalignment or inadequate implant design can play an important role. The purpose of this study was to arthroscopically evaluate patellofemoral congruence after wound closure following TKA without patellar resurfacing and correlate it to patellar morphology and postoperative pain and function...
August 2016: Annals of Translational Medicine
S Dahmann, P B Lebo, D Görlich, M V Meyer-Marcotty
OBJECTIVE: Some patients with sacral scars, e. g. those developing after pilonidal sinus surgery, report discomfort when sitting or putting strain on the scars. In order to establish objective criteria for the assessment of this kind of discomfort and for the evaluation of scar quality after various types of surgical interventions, it is of interest to provide a method which enables physicians to assess skin quality in the sacral region. For this purpose, we developed a mechanical, non-invasive, fast and cost-neutral method for the measurement of skin distensibility and mobility...
August 2016: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
Jitendra Nath Pal, Maitreyee Kar, Sunit Hazra, Anindya Basu
INTRODUCTION: Solitary exostosis is common at the metaphysis of long bones, and rarely may it develop in the lower pole of the patella. Usually it stops growing after skeletal maturity unless complicated. When the growth continues after skeletal maturity, other rare possibilities need to be considered such as bizarre parosteal osteochondromatous proliferation (BPOP). Though solitary exostosis is common at the metaphysis of long bones, very rarely it also develops in lower pole of the patella...
October 2015: Journal of Orthopaedic Case Reports
Guzelali Ozdemir, Ibrahim Azboy, Baris Yilmaz
INTRODUCTION: Periprosthetic fractures around the knee after total knee arthroplasty can be seen in the femur, tibia and patella. The tibial fractures are rare cases. Our case with bilateral tibial stress fracture developed after total knee arthroplasty (TKA) is the first of its kind in the literature. PRESENTATION OF CASE: 75-year-old male patient with bilateral knee osteoarthritis had not benefited from conservative treatment methods previously applied. Left TKA was applied...
2016: International Journal of Surgery Case Reports
Jegyun Chon, Bongju Lee, Sangyeop Shin, Gunil Jang, Taehyeon Jeon
BACKGROUND: We investigated the causes of impingement between the patella bone and the bearing post during high flexion in cruciate-substituting total knee arthroplasty and proposed a treatment strategy. METHODS: This prospective cohort study included 218 cases that had undergone cruciate-substituting total knee arthroplasty from February 2014 to January 2015; a single surgeon performed the operation using the same method without patellar resurfacing in all patients...
June 2016: Clinics in Orthopedic Surgery
Dominique C Albrecht, Andreas Ottersbach
The aim of this study was to compare a patient cohort after total knee arthroplasty (TKA) in terms of the revision rate and the functional outcome, with and without patella resurfacing. Sixty-six patients (71 TKAs) were implanted with the mobile-bearing knee prosthesis system e.motion UC (Aesculap AG, Tuttlingen, Germany). These patients were divided into 2 groups, 1 of which received primary patella resurfacing (PPR; 51 TKAs) and 1 of which did not (non-PPR; 20 TKAs), with an average follow-up of 65.6 months (±6...
May 2016: Orthopedics
Diego Costa Astur, Adilio Bernardes, Saulo Castro, Gustavo Gonçalves Arliani, Camila Cohen Kaleka, Nelson Astur, Moisés Cohen
PURPOSE: The aim of the present study was to assess clinical evaluation of patients who underwent autologous osteochondral transplantation of the patella. METHODS: This prospective study assessed outcomes of 20 patients who underwent patellar autologous osteochondral transplantation at four time-points: preoperatively, 3 days, 6 months, and 2 years after surgery. The following outcomes were assessed at each time-point: pain (VAS), gait, swelling, trophic status, muscle strength, patellar mobility, and range of motion...
April 7, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Boonchana Pongcharoen, Chaivet Reutiwarangkoon
In the past, medial osteoarthritis (OA) knee with symptomatic patellofemoral (PF) arthritis has not been recommended for a unicompartmental knee arthroplasty (UKA). However, recent studies have reported that UKA has shown good results in patients with medial OA of the knee, including those with PF arthritis. The purpose of this study is to compare the results between patients with medial OA knees; those with severe arthritis of the lateral facet of the patella and patients without severe arthritis of the lateral facet of the patella following mobile bearing UKA...
2016: SpringerPlus
Pengfei Zan, Zhong Wu, Xiao Yu, Lin Fan, Tianyang Xu, Guodong Li
BACKGROUND: During total knee arthroplasty (TKA), surgical exposure requires mobilization technique of the patella. With this trial, we intended to investigate the effect of patella eversion on clinical outcome measures in simultaneous bilateral TKA. METHODS: We prospectively enrolled 44 patients (88 knees) from April 2008 to June 20l4.One knee was operated with patella eversion (group A) and the other with patella lateral retraction (group B) randomly. Follow-up results, including the operation time, complications, and the time of achieving straight leg raise (SLR) and 90° knee flexion, were recorded...
March 2016: Journal of Arthroplasty
C Konrads, S Reppenhagen, M Hoberg, M Rudert, T Barthel
OBJECTIVE: The development of a stable patellofemoral joint by distal realignment with normal positioning of the patella. INDICATIONS: Patellofemoral instability with increased tibial tubercle to trochlear groove (TT-TG) distance ≥ 20 mm and higher Caton-Deschamps patellar height index ≥ 1.3. CONTRAINDICATIONS: Open epiphyseal and apophyseal plates of the proximal tibia, normal TT-TG distance with normal patellar height, and high-grade chondral lesions of the patellofemoral joint (ICRS grades 3 and 4)...
December 2015: Operative Orthopädie und Traumatologie
T Ibounig, T A Simons
BACKGROUND AND AIMS: Quadriceps and patella tendon ruptures are uncommon injuries often resulting from minor trauma typically consisting of an eccentric contraction of the quadriceps muscle. Since rupture of a healthy tendon is very rare, such injuries usually represent the end stage of a long process of chronic tendon degeneration and overuse. This review aims to give an overview of the current understanding of the pathophysiology, diagnostic principles, and recommended treatment protocols as supported by the literature and institutional experience...
June 2016: Scandinavian Journal of Surgery: SJS
Sanjay Agarwala, Pranshu Agrawal, Anshul Sobti
OBJECTIVE: Fractures of patella constitute 1% of all fractures. Various techniques have been described for internal fixation of patella fractures. Superiority of one technique over the other has long been debated. We reviewed a series of fifty-one patients with transverse or comminuted fractures of patella treated with a novel technique to assess if it had any advantages over the existing methods of fixation. DESIGN: Retrospective. SETTING: A tertiary care centre...
September 2015: Journal of Clinical Orthopaedics and Trauma
Haroon Rehman, Peter Kovacs
BACKGROUND: Several techniques have been described for the primary repair of quadriceps tendon ruptures but there is a paucity of literature on operative management of chronic/recurrent quadriceps tendon ruptures. We describe a novel technique for the revision of quadriceps tendon ruptures which uses hamstring, prolene mesh and autologous conditioned plasma augmentation. METHODS: Our patient was an independently mobile, active 61 year-old man who sustained staggered, bilateral quadriceps tendon ruptures...
December 2015: Knee
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