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Patellar mobilization

Nicholas N DePhillipo, Mark E Cinque, Nicholas I Kennedy, Jorge Chahla, Gilbert Moatshe, Robert F LaPrade
Background and Purpose: Early sport specialization (ESS) refers to intense training year round in a specific sport starting at a young age with no or limited participation in other sports. This approach to training is highly controversial; recent literature suggests that this type of specialized training could be a contributing source to overuse injuries in youth athletes. The purpose of this case report was to describe a patellofemoral articular cartilage defect of the knee in a preadolescent skier due to overuse and repetitive microtrauma as a result of ESS...
February 2018: International Journal of Sports Physical Therapy
Guman Duan, Chang Liu, Weiwei Lin, Jiashen Shao, Kunpeng Fu, Yingzhen Niu, Fei Wang
BACKGROUND: A systematic review and meta-analysis was performed to investigate the risks associated with anterior knee pain (AKP) following primary total knee arthroplasty (TKA). METHODS: A computerized search was performed of the following databases: MEDLINE, Embase, and Cochrane Central (published prior to July 2017). A total of 37 studies, which included 1641 cases of AKP and 168,090 TKAs, were included in the meta-analysis. RESULTS: A subgroup analysis revealed that compared with those without the following medical conditions, patients who had an infrapatellar fat pad excision and more than 12 months of follow-up (odds ratio [OR] 12...
January 2, 2018: Journal of Arthroplasty
Federica Rosso, Umberto Cottino, Matteo Olivero, Davide Edoardo Bonasia, Matteo Bruzzone, Roberto Rossi
OBJECTIVE: To evaluate the medium-term outcomes of a posterior-stabilized mobile-bearing total knee arthroplasty (PS-MB-TKA) and the role of different prognostic factors. METHODS: Patients indicated for a primary cemented PS-MB-TKA between 2002 and 2010 were included and prospectively evaluated using the Knee Society Scoring System (KSS) and the Hospital for Special Surgery (HSS) knee scores. The Knee Society Roentgenographic Evaluation form was used for the radiological evaluation...
January 2018: Journal of Orthopaedic Surgery
Elizabeth R Boyer, Jean L Stout, Jennifer C Laine, Sarah M Gutknecht, Lucas H Araujo de Oliveira, Meghan E Munger, Michael H Schwartz, Tom F Novacheck
BACKGROUND: We examined long-term outcomes across the domains of the International Classification of Functioning, Disability and Health for 2 groups of participants with cerebral palsy who demonstrated crouch gait at clinical gait analysis. One group underwent a distal femoral extension osteotomy with patellar tendon advancement (DFEO + PTA). The other group received other treatments (non-DFEO + PTA). METHODS: Fifty-one participants returned for a long-term gait analysis, physical examination, energy consumption test, knee radiographs, and questionnaires (median, 13 years post-DFEO + PTA or post-baseline [range, 8 to 21 years])...
January 3, 2018: Journal of Bone and Joint Surgery. American Volume
Susumu Ota, Kazutoshi Kurokouchi, Shigeo Takahashi, Masaki Yoda, Ryuichiro Yamamoto, Tadahiro Sakai
Patellofemoral cartilage degeneration is a potential complication of anterior cruciate ligament reconstruction (ACLR) surgery. Hypomobility of the patella in the coronal plane is often observed after ACLR. Few studies, however, have examined the relationship between cartilage degeneration in the patellofemoral joint and mobility after ACLR. The present study investigated 1) the coronal mobility of the patella after ACLR, 2) the relationship between patellar mobility and cartilage degeneration of the patellofemoral joint, and 3) the relationship between patellar mobility and knee joint function after ACLR...
November 2017: Nagoya Journal of Medical Science
Naman Wahal, Sahil Gaba, Rajesh Malhotra, Vijay Kumar, Elise C Pegg, Hemant Pandit
BACKGROUND: A small proportion of patients with mobile unicompartmental knee arthroplasty (UKA) report poor functional outcomes in spite of optimal component alignment on postoperative radiographs. The purpose of this study is to assess whether there is a correlation between functional outcome and knee kinematics. METHODS: From a cohort of consecutive cases of 150 Oxford medial UKA, patients with fair/poor functional outcome at 1-year postsurgery (Oxford Knee Score [OKS] < 34, n = 15) were identified and matched for age, gender, preoperative clinical scores, and follow-up period with a cohort of patients with good/excellent outcome (OKS ≥ 34, n = 15)...
October 6, 2017: Journal of Arthroplasty
E C Müller, K-H Frosch
OBJECTIVE: Anatomic reconstruction of the retropatellar articular surface and repair of the extensor mechanism of the knee joint. The osteosynthesis should allow immediate mobilization as part of an early functional postoperative rehabilitation protocol. INDICATIONS: Displaced fractures of the patella, especially multifragment and comminuted fractures with a retropatellar incongruity or dislocation of >2 mm. CONTRAINDICATIONS: Critical local soft tissue because of the risk of postoperative infection...
December 2017: Operative Orthopädie und Traumatologie
Jithin Orville Lobo, Joe Joseph Cherian, Arnav Sahu
INTRODUCTION: Acute concomitant rupture of both anterior cruciate ligament (ACL) and patellar tendon is a rare injury. The diagnosis of either of the injuries may be missed on clinical examination in the emergency room. A high index of suspicion is necessary when active extension is absent, and necessary investigations like ultrasound or magnetic resonance imaging (MRI) should be done to confirm the diagnosis. There are no fixed treatment protocols in these injuries. The options include immediate repair of patellar tendon with either simultaneous or delayed reconstruction of ACL...
May 2017: Journal of Orthopaedic Case Reports
A Rougé, L Perriollat, M Abdellaoui, B Faurie, J Monségu
The presence of a right intraventricular thrombus is a marker of severity of pulmonary embolism (PE), and is associated with high mortality. We report the case of a young patient with a PE postoperative of patellar tendon surgery. The cardiac echocardiography at its admission revealed a voluminous mobile thrombus of 1.7cm diameter located on the pulmonary trunk. Systemic thrombolysis was performed because of respiratory deterioration allowing a rapid disappearance of the thrombus and recovery. Our case emphasizes the value of a complete ultrasound analysis centered on the pulmonary trunk in the case of intermediate-risk PE...
November 2017: Annales de Cardiologie et D'angéiologie
Guo-Chun Zha, Shuo Feng, Xiang-Yang Chen, Kai-Jin Guo
OBJECTIVES: The influence of chondromalacia patellae (CMP) on post-operative anterior knee pain (AKP) following total knee arthroplasty (TKA) remains controversial, and few studies have focused on the relationship between them. The purpose of this study was to determine whether different CMP grades affect the incidence of AKP after TKA without patellar resurfacing. METHODS: We performed a retrospective analysis of prospectively collected data on 290 TKAs with the use of the low contact stress mobile-bearing prosthesis, without patellar resurfacing in 290 patients from February 2009 to January 2013...
October 7, 2017: International Orthopaedics
Wuey Min Ng, Mohamed Zubair Mohamed Al-Fayyadh, Julius Kho, Teo Seow Hui, Mohamed Razif Bin Mohamed Ali
Osteochondral fracture of the patella is a common concomitant injury of the knee, especially in lateral patellar instability, and the importance of early stable fixation with minimal complication and early mobilization should be emphasized. Screws and Kirschner wires both absorbable and nonabsorbable have been the common mode of fixation of these fractures. Nevertheless, these fixation techniques require larger osteochondral fragments and are associated with cartilage abrasion, hardware prominence, synovitis, and foreign body reaction...
August 2017: Arthroscopy Techniques
Susumu Ota, Hiroshi Ohko
BACKGROUND: Sex differences in passive patellar mobility have not been quantitatively evaluated. OBJECTIVE: The present study aimed to: 1) investigate sex differences in absolute and normalized patellar mobility, and 2) verify the relationship between patellar mobility and knee joint laxity. METHODS: Two hundred and five pain-free individuals (205 knees, 103 men, 102 women) participated. Passive lateral and medial patellar displacement was measured using a modified patellofemoral arthrometer and manual pushing method at 0∘ and 30∘ knee flexion angles...
February 6, 2018: Journal of Back and Musculoskeletal Rehabilitation
Madoka Ikemoto-Uezumi, Yasumoto Matsui, Masaki Hasegawa, Remi Fujita, Yasuhide Kanayama, Akiyoshi Uezumi, Tsuyoshi Watanabe, Atsushi Harada, A Robin Poole, Naohiro Hashimoto
Muscle dysfunction is the most important modifiable mediating factor in primary osteoarthritis (OA) because properly contracting muscles are a key absorber of forces acting on a joint. However, the pathological features of disuse muscle atrophy in OA patients have been rarely studied. Vastus medialis muscles of 14 female patients with OA (age range, 69 to 86 years), largely immobile for 1 or more years, were obtained during arthroplastic surgery and analyzed histologically. These were compared with female patients without arthritis, two with patellar fracture and two with patellar subluxation...
December 2017: American Journal of Pathology
Martin Lind, Peter Faunø, Ole Gade Sørensen, Bjarne Mygind-Klavsen
First-time patellar luxation appears typically in teenagers and young adults below the age of 16 years, with a prevalence of 45/100,000/year. This luxation is treated with brief limited mobility in a bandage, and with a complementary physiotherapy if the mobility is influenced afterwards. Risk factors for patellar instability are patellofemoral dysplasia, hyperlaxity, patella alta and valgus malalignment in the knee joint. In case of repeated luxation the treatment is surgical, i.e. reconstruction of the medial patellofemoral ligament recreating the medial patella-stabilizing structures...
September 18, 2017: Ugeskrift for Laeger
Florent Franck, Hervé Ouanezar, Alexandre Jacquel, Vincent Pibarot, Julien Wegrzyn
PURPOSE: The decision to resurface the patella during total knee arthroplasty (TKA) remains controversial. This prospective cohort study aimed to evaluate the outcome and survivorship of the native patella in computer-assisted TKA (CAS TKA) implanted for primary knee osteoarthritis, and to determine the predictive factors of secondary patellar resurfacing (SPR). METHODS: A prospective cohort of 273 cementless ultra-congruent mobile-bearing CAS TKA implanted without patellar resurfacing was included in our total joint registry...
September 9, 2017: International Orthopaedics
Justin S Yang, John P Fulkerson, Elifho Obopilwe, Andreas Voss, Jessica Divenere, Augustus D Mazzocca, Cory M Edgar
PURPOSE: To measure the patellofemoral contact pressure in early flexion after a tibial tubercle distalization osteotomy. METHODS: Ten matched-pair fresh-frozen cadaveric knees were studied. The average Blackburne-Peel ratio of the native knees was 0.91. The knees were placed on a testing rig, with a fixed femur and tibia mobile through 90° of flexion. Individual quadriceps heads and the iliotibial band were separated and loaded with 205 N in anatomic directions using a weighted pulley system...
November 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
Marco Aurélio Nemitalla Added, Caroline Added, Karina Tamy Kasawara, Viviane Perez Rotta, Diego Galace de Freitas
The objective of this study was to observe the immediate effect of a knee brace with a patellar hole versus without a patellar hole on pain perception in patients with knee osteoarthritis. To accomplish this, a double-blind, randomized controlled trial enrolled 108 patients divided into two groups (knee brace with a patellar hole or without a patellar hole). Patients were evaluated by the Visual Analogue Scale (VAS) in order to measure their pain sensation, the Timed Up and Go (TUG) test was used to evaluate their ability to walk, and the 8-m walking test (8MWT) was used to estimate their walking speed...
January 1, 2017: Evaluation & the Health Professions
Shuichi Fujiwara, Takafumi Hiranaka, Yuichi Hida, Shigeru Matsuda, Harunobu Uemoto
INTRODUCTION: Permanent dislocation of the patella (PDP) is a rare condition. In cases of PDP with tibiofemoral arthritis, total knee arthroplasty may be performed through a medial parapatellar approach with patellar realignment. In this article we present two cases of PDP with tibiofemoral osteoarthritis successfully treated via lateral approach TKA without any additional realignment procedure. We performed two total knee arthroplasties for PDP with lateral tibiofemoral arthritis through a lateral approach without any realignment procedure...
2017: International Journal of Surgery Case Reports
Xu Yang, Qinfen Wu, Chin-Hui Lai, Xin Wang
INTRODUCTION: We present a modified tension band technique combined with cable cerclage using Cable Grip System for the treatment of displaced inferior patellar pole fractures and report the knee functional outcome. PATIENTS AND METHODS: The patients who had had operative treatment of a displaced inferior patellar pole fracture (AO/OTA 34-A1) between December 2013 and December 2015 were studied retrospectively. Eleven consecutive patients had had open reduction and internal fixation with the modified technique using Cable Grip System, of whom, five males and six females with an average age of 60...
July 13, 2017: Injury
Sara A Scholtes, Lynnette Khoo-Summers, Katherine J Damico
STUDY DESIGN: Case report. BACKGROUND: Arthrofibrosis is a debilitating condition that results in pain, decreased range of motion, and decreased function. Although surgical management of arthrofibrosis has been well described in the literature, rehabilitation of the arthrofibrotic knee is less well described. CASE DESCRIPTION: A 28-year-old female presented with swelling, pain, and decreased strength, range of motion, patellar mobility, and function following an exploratory arthroscopy of her left knee...
October 2017: Physiotherapy Theory and Practice
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