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https://www.readbyqxmd.com/read/28630757/the-patellofemoral-joint-from-dysplasia-to-dislocation
#1
Stefano Zaffagnini, Alberto Grassi, Gianluca Zocco, Michele Attilo Rosa, Cecilia Signorelli, Giulio Maria Marcheggiani Muccioli
Patellofemoral dysplasia is a major predisposing factor for instability of the patellofemoral joint. However, there is no consensus as to whether patellofemoral dysplasia is genetic in origin, caused by imbalanced forces producing maltracking and remodelling of the trochlea during infancy and growth, or due to other unknown and unexplored factors.The biomechanical effects of patellofemoral dysplasia on patellar stability and on surgical procedures have not been fully investigated. Also, different anatomical and demographic risk factors have been suggested, in an attempt to identify the recurrent dislocators...
May 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28624557/arthroscopic-lateral-retinacular-release-medial-retinacular-plication-and-partial-medial-tibial-tubercle-transfer-for-recurrent-patellar-dislocation
#2
Song Chen, Yiqin Zhou, Qirong Qian, Yuli Wu, Peiliang Fu, Haishan Wu
OBJECTIVE: To assess the efficacy of a therapeutic protocol composed of arthroscopic lateral retinacular release, medial retinacular plication, and partial medial tibial tuberosity transfer for patients with recurrent patellar dislocation. METHOD: 71 patients, 11 males and 60 females and a total of 77 knees, with recurrent dislocation of the patella were enrolled between 1998 - 2012. The average age of the patients was 19.5 years and 67 of them had previous knee trauma history...
June 14, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28614283/recurrent-patellar-instability-implications-of-preoperative-patellar-crepitation-on-the-status-of-the-patellofemoral-articular-cartilage
#3
Scott J Luhmann, June C Smith, Mario Schootman, Nandan Prasad
BACKGROUND: The purpose of the study was to quantify the frequency, severity, and location of patellofemoral (PF) articular cartilage changes recurrent patellar instability treated surgically in patients with preoperative clinical patellar crepitation. METHODS: A single-surgeon database was queried for all knees with recurrent patellar instability between 3/2000 and 6/2012 (n=214). Only knees which underwent knee arthroscopy during the surgical treatment were included (n=148)...
June 13, 2017: Journal of Pediatric Orthopedics
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
#4
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/28593102/rehabilitation-following-medial-patellofemoral-ligament-reconstruction-for-patellar-instability
#5
Robert C Manske, Daniel Prohaska
Patellar instability is a common problem seen by physical therapists, athletic trainers and orthopedic surgeons. Although following an acute dislocation, conservative rehabilitation is usually the first line of defense; refractory cases exist that may require surgical intervention. Substantial progress has been made in the understanding of the medial patellofemoral ligament (MPFL) and its role as the primary stabilizer to lateral patellar displacement. Medial patellofemoral ligament disruption is now considered to be the essential lesion following acute patellar dislocation due to significantly high numbers of ruptures following this injury...
June 2017: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/28585997/diagnosis-and-management-of-traumatic-patellar-instability-in-the-pediatric-patient
#6
Steven F DeFroda, Joseph A Gil, Alex Boulos, Aristides I Cruz
Instability of the patella is a common cause of knee pain and dysfunction in pediatric and adolescent patients and can be due to several factors. Although some patients will recall a specific traumatic event others may not, requiring the diagnosis to be made on the basis of physical examination and imaging. Congenital dislocation and connective tissue disorders should also be considered, even in the setting of trauma. There are radiographic parameters that may identify causes of instability such as trochlear and patellar abnormalities, and magnetic resonance imaging can identify signs of trauma such as bony edema, loose osteochondral fragments, and increased tibial tubercle-trochlear groove distance...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28567511/trochleoplasty-techniques-provide-good-clinical-results-in-patients-with-trochlear-dysplasia
#7
REVIEW
Umile Giuseppe Longo, Candela Vincenzo, Nicholas Mannering, Mauro Ciuffreda, Giuseppe Salvatore, Alessandra Berton, Vincenzo Denaro
PURPOSE: The aim of this systematic review is to compare the clinical outcomes of patients treated with different trochleoplasty procedures, the rate of complications and recurrence of patellar dislocation. METHODS: A systematic review of the literature was performed, in accord with the PRISMA guidelines. PubMed, MEDLINE, CINAHL, Cochrane, EMBASE and Google Scholar databases were comprehensively searched using the keyword combinations, "Dejour trochleoplasty", "Bereiter Trochleoplasty", "Albee Trochleoplasty", "Recession Trochleoplasty", "Trochlear Dysplasia", "Instability", "Adult", "Clinical Outcome" and "Surgery"...
May 31, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28554493/statistical-shape-modeling-predicts-patellar-bone-geometry-to-enable-stereo-radiographic-kinematic-tracking
#8
Lowell M Smoger, Kevin B Shelburne, Adam J Cyr, Paul J Rullkoetter, Peter J Laz
Complications in the patellofemoral (PF) joint of patients with total knee replacements include patellar subluxation and dislocation, and remain a cause for revision. Kinematic measurements to assess these complications and evaluate implant designs require the accuracy of dynamic stereo-radiographic systems with 3D-2D registration techniques. While tibiofemoral kinematics are typically derived by tracking metallic implants, PF kinematic measurements are difficult as the patellar implant is radiotransparent and a representation of the resected patella bone requires either pre-surgical imaging and precise implant placement or post-surgical imaging...
May 17, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28541005/a-combined-closing-wedge-distal-femoral-osteotomy-and-medial-reefing-procedure-for-recurrent-patellar-dislocation-with-genu-valgum
#9
Chong Bum Chang, Gautam M Shetty, Jong Seong Lee, Young Chan Kim, Jae Ho Kwon, Kyung Wook Nha
PURPOSE: Recurrent patellar dislocation is often associated with genu valgum. The purpose of this study was to analyze the short-term results of single-incision, closing-wedge distal femoral osteotomy (CWDFO) combined with medial reefing and lateral release for recurrent patellar instability with genu valgum. MATERIALS AND METHODS: Combined CWDFO/medial reefing/lateral release was performed on 10 knees. Clinical evaluation was based on pre- and postoperative Knee Society Score (KSS) and Kujala patellofemoral score...
July 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28538541/surgical-versus-nonsurgical-interventions-for-treating-patellar-dislocation
#10
Lesley Andrews
No abstract text is available yet for this article.
May 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28528349/high-wear-resistance-of-femoral-components-coated-with-titanium-nitride-a-retrieval-analysis
#11
Christian Fabry, Carmen Zietz, Axel Baumann, Reinhard Ehall, Rainer Bader
PURPOSE: The objective of this study was to evaluate the in vivo wear resistance of cobalt-chromium femoral components coated with titanium nitride (TiN). Our null hypothesis was that the surface damage and the thickness of the TiN coating do not correlate with the time in vivo. METHODS: Twenty-five TiN-coated bicondylar femoral retrievals with a mean implantation period of 30.7 ± 11.7 months were subjected to an objective surface damage analysis with a semi-quantitative assessment method...
May 20, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28465849/mobile-bearing-total-knee-arthroplasty-for-valgus-knee-osteoarthritis-with-permanent-patellar-dislocation-a-case-report-and-review-of-the-literature
#12
Kohei Kamada, Tomoyuki Matsumoto, Koji Takayama, Daisuke Araki, Shingo Hashimoto, Shinya Hayashi, Takehiko Matsushita, Ryosuke Kuroda
Permanent patellar dislocation with tibiofemoral joint osteoarthritis is a relatively rare condition. To treat this condition, total knee arthroplasty with proximal or distal realignment of the extensor mechanism has been reported. We report a challenging case of an 80-year-old woman diagnosed with permanent patellar dislocation with tibiofemoral joint osteoarthritis treated by a mobile bearing total knee arthroplasty utilizing navigation system. Lateral retinaculum release was performed to improve patellar tracking; other proximal or distal realignment of the extensor mechanism was not necessary...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28463547/economic-decision-model-for-first-time-traumatic-patellar-dislocations-in-adolescents
#13
Benedict U Nwachukwu, Conan So, William W Schairer, Beth E Shubin-Stein, Sabrina M Strickland, Daniel W Green, Emily R Dodwell
BACKGROUND: The surgical management of traumatic patellar dislocations in adolescents is associated with a lower rate of recurrent dislocations compared with nonoperative care. However, the attendant cost of surgery and the quality-of-life benefit of a surgical treatment strategy are unclear. PURPOSE: To compare the cost-utility of 3 management strategies for acute first-time patellar dislocations in adolescents: (1) nonoperative treatment only, (2) initial nonoperative treatment with surgery only for recurrent dislocations, and (3) immediate surgery...
May 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28463535/risk-factors-and-time-to-recurrent-ipsilateral-and-contralateral-patellar-dislocations
#14
Tyson C Christensen, Thomas L Sanders, Ayoosh Pareek, Rohith Mohan, Diane L Dahm, Aaron J Krych
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/28459754/rehabilitation-after-medial-patellofemoral-ligament-reconstruction
#15
Terrence G McGee, Andrew J Cosgarea, Kevin McLaughlin, Miho Tanaka, Ken Johnson
Patellar instability resulting from subluxation or dislocation is a painful and commonly recurring condition. Retinacular restraints control patellar tracking, limiting the movement of the patella in the trochlear groove. The medial patellofemoral ligament (MPFL) is considered the main soft tissue stabilizer against lateral displacement. Few studies of patellar instability discuss rehabilitation after MPFL reconstruction. In this review, we discuss the phases of rehabilitation after MPFL reconstruction, typical interventions by rehabilitation specialists, and patient-specific guidelines for return to prior level of function...
June 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28459749/nonoperative-treatment-of-patellar-instability
#16
Sameer Dixit, Rajwinder S Deu
The treatment of patellar instability is challenging and typically begins with nonoperative methods. Clinical decisions are made on an individual basis and may vary according to a number of factors. First-time patellar dislocations most commonly occur during sports participation. Initial evaluation, including patient history, physical examination, and appropriate imaging, determines care. Although nonoperative treatment consists primarily of regressive immobilization and physical therapy, there is little evidence to support particular protocols for either...
June 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28459748/diagnosis-and-characterization-of-patellofemoral-instability-review-of-available-imaging-modalities
#17
Arya Haj-Mirzaian, Gaurav K Thawait, Miho J Tanaka, Shadpour Demehri
Patellofemoral instability (PI) is defined as single or multiple episodes of patellar dislocation. Imaging modalities are useful for characterization of patellar malalignment, maltracking, underlying morphologic abnormalities, and stabilizing soft-tissue injuries. Using these findings, orthopedic surgeons can decide when to operate, determine the best operation, and measure degree of correction postoperatively in PI patients. Also, these methods assist with PI diagnosis in some suspicious cases. Magnetic resonance imaging is the preferred method especially in the setting of acute dislocations...
June 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28458846/spontaneous-superior-patellar-dislocation-in-young-age-case-report-and-reduction-technique
#18
Noman Jahangir, Muhammad Umar
Superior patellar dislocation is a very rare pathology, which happens in middle age. We report a case of spontaneous superior patellar dislocation, which occurred at 30 years of age. Differential diagnosis is patellar tendon rupture, which could be reliably excluded by clinical examination and radiographs. Reduction manoeuvres should be tried with diluted intra-articular local anaesthetic for hydrodilatation to gain mechanical advantage. Splinting the knee in gentle flexion is recommended if general anaesthetic is employed...
March 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28454185/patella-dislocation-in-children-and-adolescents
#19
Sven Höhne, Kristina Gerlach, Lars Irlenbusch, Mathias Schulz, Christian Kunze, Rainer Finke
Introduction Patellar dislocation is one of the commonest knee injuries in adolescents. Although treatment usually leads to good results, the influence of anatomical and functional factors on therapeutic strategy has been underestimated, especially in cases of recurrence. Patients and Methods The course of treatment has been analysed in 88 patients with 136 patellar dislocations. The importance of anatomical conditions was studied using X-ray and MRI findings. The treatment results were critically evaluated in comparison with current recommendations...
April 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28451595/medial-patellofemoral-ligament-repair-versus-reconstruction-for-recurrent-patellar-instability-two-year-results-of-an-algorithm-based-approach
#20
Jason L Dragoo, Michael Nguyen, Corey T Gatewood, Jacob D Taunton, Simon Young
BACKGROUND: Patellar instability remains a challenging problem for both the patient and surgeon. Medial patellofemoral ligament (MPFL) repair has historically had poor results, and due to this, there is currently a trend toward reconstruction. PURPOSE/HYPOTHESIS: This study was undertaken to investigate experience with repair versus reconstruction of the MPFL using a multifactorial treatment algorithm approach. Our hypothesis was that there will be no significant difference in outcome scores between patients in the MPFL repair and reconstruction groups...
March 2017: Orthopaedic Journal of Sports Medicine
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