Patellar mobilization

Abnormal retro patellar stress is believed to contribute to patellofemoral complications after total knee arthroplasty (TKA), but the causal link between TKA and patellofemoral contact stress remains unclear. By reviewing the relevant studies, we found that both TKA implantation and additional patellar resurfacing increase retro patellar pressure. The rotation and size of the femoral component, thickness and position of the patellar component, installation of the tibial component, prosthesis design and soft tissue balance further influence patellofemoral stress...

INTRODUCTION: Medial patellofemoral ligament reconstruction (MPFLR) is used in most patellar instability surgeries, there is controversy on adding a tibial tuberosity osteotomy (TTO). OBJECTIVE: To describe the results of isolated MPFLR in patellar instability according to the Tibial Tuberosity-Trochlear Groove distance (TT-TG). METHODS: Retrospective study of patients with patellar instability with a mature skeleton in one center between 2016 and 2021, using isolated MPFLR...

Mobility impairments associated with musculoskeletal diseases, such as osteoarthritis and degenerative joint disease, affect approximately 200,000 dogs annually and pose a notable challenge to canine health and welfare. Osteoarthritis causes the remodelling of synovial joints, alongside inflammation and impaired mechanical function which can be extremely debilitating. Secondary osteoarthritis commonly affects dogs and can be exacerbated by previous joint abnormalities, such as patellar luxation or cranial cruciate ligament rupture...

BACKGROUND: Influences on anterior knee pain, stair climbing limitations, and function such as rising from sitting are poorly understood in unicompartmental knee arthroplasty (UKA). Original indications for UKA excluded patients who had patello-femoral disease, while more recent studies have expanded the indications to include these patients. This study examined the influence of the patello-femoral joint degeneration on patient-reported outcome measures relating to anterior knee pain and function after UKA...

INTRODUCTION: Interest in anterior cruciate ligament (ACL) repair has been increasing as an alternative to traditional reconstructive techniques and encouraging results have been demonstrated using internal bracing with suture tape augmentation (FiberTape®, Arthrex, Naples, Florida). ACL repair is challenging if the rupture is mid-substance or distal. We describe the case of a hybrid ACL reconstruction with internal brace augmentation. MATERIALS AND METHODS: This retrospective case report documents the rehabilitation process of a 31-year-old professional footballer who had an isolated ACL rupture...

BACKGROUND: Patellofemoral pain syndrome (PFPS) is characterized by peripatellar or retro patellar pain, as a result of changes in the physical and biochemical components of the patellofemoral joint. The main contributory factor is being the excessive load on the patellofemoral joint. The change in the flexibility of lower limb muscles is one of the factors for developing PFPS. OBJECTIVE: To find the association of quadratus lumborum (QL) and lower limb muscles tightness in patients with unilateral PFPS...

[Purpose] Previous studies suggest that the infrapatellar-fat-pad is affected by aging or knee osteoarthritis, and that the infrapatellar-fat-pad in knee osteoarthritis cases may be associated with limited mobility during knee movement. This study aimed to determine changes in the shape and volume of the infrapatellar-fat-pad between 30° and 0° of knee extension in knee osteoarthritis cases and in young, healthy individuals, and to characterize differences in patellar mobility, patellar tendon mobility, and length between the groups...

Today, the number of people affected by gonarthrosis symptoms is increasing proportionally. Total knee arthroplasty (TKA) is a successful intervention that aims to reduce pain and restore knee function. However, studies have shown that active young patients still have limitations in performing activities such as skiing, golfing, surfing, and dancing. Over the last few years, total knee arthroplasty has undergone significant changes. Most of the modern TKA implants are designed to reproduce the normal biomechanics of the knee joint, mimicking the physiological pattern with greater compliance in the medial compartment between the tibial insert and femoral condyle and less congruence on the lateral side...

OBJECTIVES: Although nonsurgical and surgical management of knee arthrofibrosis has been reported in the literature, there is little information on the effect of procedural treatment modalities of refractory arthrofibrosis on clinical outcomes. The purpose of this case report is to describe the intervention of refractory knee arthrofibrosis after anterior cruciate ligament reconstruction and investigate long-term clinical outcomes after procedural intervention. METHODS: A 27-year-old male presented with decreased range of motion (ROM), patellar mobility, strength, and knee joint function following anterior cruciate ligament reconstruction of his left knee...

BACKGROUND: Fibrodysplasia ossificans progressiva (FOP) is an ultrarare genetic disorder with episodic and progressive heterotopic ossification. Tissue trauma is a major risk factor for flareups, heterotopic ossification (HO), and loss of mobility in patients with FOP. The International Clinical Council on FOP generally recommends avoiding surgery in patients with FOP unless the situation is life-threatening, because soft tissue injury can trigger an FOP flareup. Surprisingly little is known about flareups, HO formation, and loss of mobility after fractures of the normotopic (occurring in the normal place, distinct from heterotopic) skeleton when treated nonoperatively in patients with FOP...

BACKGROUND: The relationship between inferior patellar mobility (IPM) and knee flexion angle has yet to be elucidated. This study aimed to develop quantitative IPM measurement methods and clarify the relationship between IPM and knee flexion angle in community-dwelling older females. METHODS: This was a cross-sectional study. Overall, 128 healthy older women (age 65-79 years) were recruited from the community to evaluate the relationship between IPM and knee flexion angle...

OBJECTIVE: This study aimed to investigate the clinical efficacy of closed reduction high-strength sutures combined with Nice knots in treating transverse patella fractures. METHOD: We retrospectively analyzed the clinical data of 28 patients who underwent surgery for transverse patella fractures from January 2019 to January 2020. Twelve cases of the study group were treated with closed reduction high-strength sutures combined with Nice knots, and 16 cases in the control group were treated with tension band wiring...

Patellar complications frequently limit the success of total knee arthroplasty. In addition to the musculoskeletal forces themselves, patellar tendon elastic properties are essential for driving patellar loading. Elastic properties reported in the literature exhibit high variability and appear to differ according to the methodologies used. Specifically in total knee arthroplasty patients, only limited knowledge exists on in vivo elastic properties and their corresponding loads. For the first time, we report stiffness, Young's modulus, and forces of the patellar tendon, derived from four patients with telemetric total knee arthroplasties using a combined imaging and measurement approach...

BACKGROUND: A nerve root anomaly, typified by a conjoined nerve root, is a rare finding. Conjoined nerve root anomalies are easily missed even in preoperative advanced imaging modalities, which can be potentially troublesome during and after surgery. In this report, we present a case of conjoined right L5-S1 nerve root in a patient with lumbar disc herniation, accompanied by spina bifida occulta, which was undiagnosed on preoperative imaging studies. CASE REPORT: A 55-year-old Asian (Japanese) woman presented with low back pain and right leg radiating pain due to lumbar disc herniation at the right L5/S1...

Total knee arthroplasty (TKA) remains a lifesaving procedure for advanced gonarthrosis. However, patella resurfacing (PR) in TKA remains a controversial procedure, leading to extensive discussions amongst orthopedic surgeons, regarding its indications and results. Based on these premises, we present a clinical case of a 70-year-old Caucasian woman admitted for pain, swelling and limitation of left knee joint mobility. Her medical history records an Ahlback stage IV gonarthrosis with simultaneous bilateral TKA surgery performed in different hospital, when two NexGen cemented total prostheses were implanted with patellar resurfacing being performed only on the right side...

BACKGROUND: Mobile bearing (MB) total knee arthroplasty (TKA) may reduce wear and improve patellar tracking, but may increase revision risk due to tibial component design, balance complexity, and bearing dislocation. We utilized the American Joint Replacement Registry (AJRR) to examine risk of revision with MB compared to fixed bearing (FB) designs. METHODS: An analysis of primary TKA in patients over 65 years was performed with AJRR data linked to Centers for Medicare and Medicaid Services data from 2012 to 2019...

In the present study, we aimed to investigate the clinical outcomes of arthroscopic discoid lateral meniscus (DLM) plasty and the adaptive changes in the patellofemoral joint after surgery. From September 2010 to March 2012, 25 patients with DLM injuries who underwent arthroscopic meniscus plasty were enrolled in the prospective study. All patients underwent clinical evaluation before the operation and at the last follow-up, and imaging evaluation was performed by upright magnetic resonance imaging before and 1 month after the operation as well as at the last follow-up...

Introduction: The extensor apparatus of the knee can be thought of a chain that transmits the muscular strength developed by the quadriceps muscles to the proximal tibia. This complex is essential to allow the extension of the tibia over the femur, being essential to provide knee mobility and stability. In case of lesions which irreparably damage the patella, such as a locally aggressive bone tumor, it is necessary to restore both the apparatus' anatomical continuity and its strength...

BACKGROUND: The ability of the quadriceps muscles to extend the knee depends on the moment arm of the knee-extensor mechanism, which is described by the moment arm of the patellar tendon at the knee. The knee-extensor moment may be altered by a change in quadriceps force, a change in the patellar tendon moment arm (PTMA), or both. A change in quadriceps muscle strength after anterior-cruciate-ligament-reconstruction (ACLR) surgery is well documented, however, there is limited knowledge about how this procedure affects the PTMA...

Postoperative scarring is a complication of arthroscopic knee surgery that causes a lack of terminal extension and tissue sliding defects. We present video evidence of tissue sliding before and after ultrasound-guided hydrorelease in a 53-year-old man. The patient presented with pain in the scarred area following arthroscopic knee surgery. His active and passive extension was -5° with restricted patellar mobility. Dynamic ultrasonography revealed scar tissue sliding defects. For ultrasound-guided hydrorelease, a needle (22G, 60 mm) was aimed at a site within 10 mm depth of the hypoechoic change in the scar area below the patella, and saline solution (10 mL) mixed with 1% lidocaine (10 mL) and 10 mg prednisolone was injected...