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https://www.readbyqxmd.com/read/29789255/combined-tibial-tubercle-osteotomy-and-medial-patellofemoral-ligament-reconstruction-for-recurrent-lateral-patellar-instability-in-patients-with-multiple-anatomic-risk-factors
#1
Melissa M Allen, Aaron J Krych, Nick R Johnson, Rohith Mohan, Michael J Stuart, Diane L Dahm
PURPOSE: To report the outcomes for combined tibial tubercle osteotomy (TTO) and medial patellofemoral ligament (MPFL) reconstruction and assess for potential risk factors for recurrent instability and/or poor outcomes. METHODS: The medical record at our institution was reviewed for patients treated with MPFL reconstruction and TTO for recurrent lateral patellar instability from 1998 to 2014. Preoperative imaging was assessed for trochlear dysplasia according to the Dejour classification (high grade = B, C, D) and the presence of patella alta using the Caton-Deschamps ratio (>1...
May 19, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29752498/arthroscopic-reduction-of-a-locked-patellar-dislocation-a-new-less-invasive-technique
#2
João Teixeira, Carlo Gamba, Jan Ophuis, Geert A Buijze, Gino M M J Kerkhoffs
Patellar dislocation is a condition that is often reduced by itself or through closed manipulation from a trained professional. In this case of a traumatic lateral patellar dislocation, the patella was caught through the rupture in the lateral retinaculum, as is seen in Boutonniere-like lesions. Reduction of the dislocated patella was obtained by arthroscopic reduction.Level of evidence V.
May 11, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29736871/predicting-risk-of-recurrent-patellar-dislocation
#3
REVIEW
Shital N Parikh, Marios G Lykissas, Ioannis Gkiatas
PURPOSE OF REVIEW: Lateral patellar dislocation (LPD) is one of the most common injuries of the knee, especially in a young patient. It is multifactorial with several underlying risk factors. The purpose of this review is to present the most recent data concerning risk factors and their predictive value to estimate recurrent LPD risk. RECENT FINDINGS: Several demographic risk factors (age, skeletal immaturity, sex, bilaterality), mechanism of injury, and anatomic risk factors (trochlear dysplasia, patella alta, excessive tibial tubercle lateralization, increased patellar tilt) have been recognized...
May 7, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29724252/synthetic-versus-autologous-reconstruction-syn-var-of-the-medial-patellofemoral-ligament-a-study-protocol-for-a-randomised-controlled-trial
#4
Adam Tucker, Sam McMahon, Bronwyn McArdle, Bridgeen Rutherford, Danny Acton
BACKGROUND: Recurrent patellar instability incidence is 5.8/100,000 population, and recurrent dislocations are reported in the range of 15-80%. Recurrent instability is multifactorial and can be associated with disorder of limb alignment, osseous development, congruity of the patella in the trochlea and soft tissue static and dynamic constraints. The multifactorial aetiology makes management challenging, and a lack studies in a heterogeneous population with robust clinical outcomes compounds this further...
May 3, 2018: Trials
https://www.readbyqxmd.com/read/29688749/surgical-treatment-with-closing-wedge-distal-femoral-osteotomy-for-recurrent-patellar-dislocation-with-genu-valgum
#5
Kyung Wook Nha, Yoonwon Ha, Seungmin Oh, Vivek P Nikumbha, Sae Kwang Kwon, Woo-Jin Shin, Byung Hoon Lee, Keun Bae Hong
BACKGROUND: Closing-wedge distal femoral osteotomy (CWDFO)-combined with medial reefing and lateral release, if necessary- has been used to treat recurrent patellar dislocation (RPD) with genu valgum. PURPOSE: To evaluate the clinical and radiologic outcomes of surgical treatment with CWDFO for treatment of RPD with genu valgum. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Fourteen consecutive patients (23 knees) with RPD and genu valgum were treated with CWDFO...
April 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29682680/mpfl-in-first-time-dislocators
#6
REVIEW
Beth E Shubin Stein, Simone Gruber, Jacqueline M Brady
PURPOSE OF REVIEW: Historically, the standard of care for patients with an acute patella dislocation has been non-operative with the exception being those with a loose body or osteochondral fracture requiring fixation or removal. RECENT FINDINGS: Recent literature has brought into question this standard of care approach and defined a higher risk subset of first-time dislocators who may benefit from early operative treatment. In addition, these studies suggest that operative treatment not only reduces the risk of recurrence but may improve outcomes overall and specifically in the pediatric population...
April 23, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29653442/examination-under-anesthesia-in-patients-with-recurrent-patellar-dislocation-prognostic-study
#7
Ismail Fathalla, James Holton, Tanweer Ashraf
Surgical management of patellar instability is a matter of wide debate. While some authors believe that isolated medial patellofemoral ligament (MPFL) reconstruction is sufficient, others advocate procedures to treat the underlying pathology, namely, patella alta and trochlear dysplasia. Radiological studies have been traditionally used as a determinant of these pathologies and to determine the need for an additional procedure. The value of examination under anesthesia (EUA) in formulating a treatment plan remains unknown...
April 13, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29644317/a-rare-case-of-hoffa-fracture-combined-with-lateral-patellar-dislocation
#8
Martin C Jordan, Leonie A Bittrich, Kai Fehske, Rainer H Meffert, Hendrik Jansen
The coronal unicondylar fracture of the distal femur (AO 33-B3) is a rare intraarticular injury within the weight bearing area of the knee, initially described by Albert Hoffa in 1904. We report an unusual combination of a Hoffa fracture with lateral patellar dislocation in a young adult. Our patient sustained the injury by a sudden twist of his leg during sports. He presented clinically with knee swelling, dislocation of the patella, and localized tenderness; unable to bare weight. After plane radiograph confirmed the injury, manual reduction of the patella was done by hyperextension of the knee and medialward pressure...
June 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29611163/cadaveric-biomechanical-study-on-medial-retinaculum-its-stabilising-role-for-the-patella-against-lateral-dislocation
#9
Leonidas Mitrogiannis, Alexandra Barbouti, Panagiotis Kanavaros, Georgios Paraskevas, Aikaterini Kitsouli, Georgios Mitrogiannis, Panagiotis Kitsoulis
BACKGROUND: The aim of this study was to analyse the biomechanical role of medial retinaculum, as a stabilising factor against lateral patellar dislocation. MATERIALS AND METHODS: This cadaveric-biomechanical study included the patellae of ten cadaveric knees, which were surgically exposed and the medial retinaculum of each one was located. A stable 24.51N force was applied to the four parts of the quadriceps, and an increasing lateral displacing force was applied to the patella, up to 5mm dislocation...
April 3, 2018: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/29578418/-transosseous-osteosynthesis-of-lower-extremities-bones-fractures-and-quality-of-life-of-patients-in-the-treatment-period
#10
A Dyusupov, A Dyusupov, E Manarbekov, A Bukatov, A Serikbaev
The aim of the study is a comparative analysis of the quality of life in the treatment of fractures of the bones of the lower extremities of various localizations using transosseous and submerged osteosynthesis. We examined 397 patients with injuries of the lower segment of the lower extremity (patellar fractures - 81, multiple bones fractures of the tibia - 84 and fractures of the ankles, accompanied by a dislocation of the foot - 232). Patients were distributed in the subgroups depending on the treatment...
February 2018: Georgian Medical News
https://www.readbyqxmd.com/read/29554966/evaluation-of-the-utility-of-teaching-joint-relocations-using-cadaveric-specimens
#11
John Au, Edward Palmer, Ian Johnson, Mellick Chehade
BACKGROUND: Like other procedural skills, the ability to relocate a joint is an important aspect of junior doctor education. Changes in the approach to teaching and learning from the traditional apprenticeship-style model have made the teaching of practical skills more difficult logistically. Workshops utilising cadaveric specimens offer a solution to this problem. METHODS: One hundred forty-six fourth year medical students were randomly divided into 5 groups. Each group received a different teaching intervention based on ankle, patella and hip relocation...
March 20, 2018: BMC Medical Education
https://www.readbyqxmd.com/read/29552477/sulcus-deepening-trochleoplasty-and-medial-patellofemoral-ligament-reconstruction-for-recurrent-patellar-instability
#12
Michael S Laidlaw, Scott M Feeley, Jeffrey R Ruland, David R Diduch
There are multiple etiologies for recurrent patellar instability. While patella alta, an elevated tibial tubercle trochlear groove distance, and prior lateral patellar dislocations with medial patellofemoral ligament (MPFL) insufficiency have been shown to be risk factors for recurrent patellar instability, trochlear dysplasia can result in a significant impediment to normal patellar tracking. With the adequate identification of risk factors, appropriate surgical treatments can be individually tailored to the patient...
February 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29516125/medical-speciality-medication-or-skills-key-factors-of-prehospital-joint-reduction-a-prospective-multicenter-cohort-study
#13
Georg Siebenbürger, Christian Zeckey, Julian Fürmetz, Wolfgang Böcker, Tobias Helfen
PURPOSE: Joint dislocations occur frequently in prehospital settings. The medical specialities of emergency physicians are heterogeneous. Decision making and the success rates of reduction attempt can vary greatly. The aim of this prospective multicentre study was to identify the factors most crucial for achieving successful prehospital reduction. METHODS: Study was conducted from 05/2012-05/2015 investigating cases of shoulder, patella and ankle joint dislocations in 16 emergency physician rescue stations...
March 7, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29514872/homozygous-chst11-mutation-in-chondrodysplasia-brachydactyly-overriding-digits-clino-symphalangism-and-synpolydactyly
#14
Rana Muhammad Kamran Shabbir, Gökhan Nalbant, Nafees Ahmad, Sajid Malik, Aslıhan Tolun
BACKGROUND: Carbohydrate sulfotransferase 11 (CHST11) is a membrane protein of Golgi that catalyses the transfer of sulfate to position 4 of the N-acetylgalactosamine residues of chondroitin. Chondroitin sulfate is the predominant proteoglycan in cartilage, and its sulfation is important in the developing growth plate of cartilage. A homozygous deletion encompassing part of the gene and the embedded miRNA MIR3922 had been detected in a woman with hand/foot malformation and malignant lymphoproliferative disease...
March 7, 2018: Journal of Medical Genetics
https://www.readbyqxmd.com/read/29492253/case-report-of-a-ruptured-endobutton-used-in-medial-patellofemoral-ligament-reconstruction-causing-patellofemoral-impingement
#15
Raashad Hasan, Wiqqas Jamil
The medial patellofemoral ligament (MPFL) is a key soft tissue stabilizer of the medial patella, with deficiency proven to be a key contributor to patellar dislocation. Reconstruction of this ligament has become a widely employed procedure in managing patients with recurrent patellar dislocation, and is also gaining popularity in the setting of primary dislocation. A wide variety of techniques have been described, differing in the type of graft used, sites for fixation and fixation technique. A number of complications have also been reported in the literature, including post-operative stiffness, apprehension, patellar fracture and recurrence of instability and dislocation...
February 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29466677/analysis-of-graft-length-change-patterns-in-medial-patellofemoral-ligament-reconstruction-via-a-fluoroscopic-guidance-method
#16
Takehiko Matsushita, Daisuke Araki, Yuichi Hoshino, Shinya Oka, Kyohei Nishida, Toshikazu Tanaka, Nobuaki Miyaji, Noriyuki Kanzaki, Kazuyuki Ibaraki, Tomoyuki Matsumoto, Masahiro Kurosaka, Ryosuke Kuroda
BACKGROUND: A fluoroscopic guidance method for medial patellofemoral ligament (MPFL) reconstruction has been widely used to determine the anatomic femoral attachment site. PURPOSE: To examine the graft length change patterns in MPFL reconstruction with a fluoroscopic guidance method. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Forty-four knees of 42 patients who underwent MPFL reconstruction for the treatment of recurrent patellar dislocation were examined prospectively...
April 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29457397/-reconstruction-of-medial-patellofemoral-ligament-with-tightrope-button-fixation-on-the-femoral-side-for-the-treatment-of-traumatic-patellar-dislocation
#17
Yong-Xiang Zuo, Zi-Ping Ma
OBJECTIVE: To explore the operating procedures and therapeutic effects of medial patellofemoral ligament reconstruction with Tightrope(Arthrex, FL, USA) button fixation at lateral femoral cortex. METHODS: From May 2014 to July 2016, 9 patients with traumatic patellar dislocation were treated. There were 5 males and 4 females, ranging in age from 16 to 47 years old, with an average of 23.7 years old. All the patients underment arthroscopic lateral retinaculum release and joint debridement first...
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29457386/-treatment-of-habitual-dislocation-of-patella-with-reconstruction-of-medial-patellofemoral-ligament-combined-with-release-of-lateral-retinaculum-and-medial-transfer-and-advancement-of-tibial-tuberosity-under-arthroscopy
#18
Li-Chuang Wu, Hai-Bo Zhou, Chao Zhang, Lei Chen, Cai-Long Liu
OBJECTIVE: To study clinical effects of triad operation including reconstruction of medial patellofemoral ligament, release of lateral retinaculum, Fulkerson tibial tubercle osteotomy, medial transfer and advancement under arthroscopy for the treatment of habitual dislocation of patella. METHODS: From March 2010 to May 2016, 35 patients with habitual patellar dislocation were treated with the triad operation, including 14 males, 21 females, ranging in age from 18 to 38 years old, with an average of 25...
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29434267/early-changes-of-articular-cartilage-and-subchondral-bone-in-the-dmm-mouse-model-of-osteoarthritis
#19
Hang Fang, Lisi Huang, Ian Welch, Chris Norley, David W Holdsworth, Frank Beier, Daozhang Cai
To examine the early changes of articular cartilage and subchondral bone in the DMM mouse model of osteoarthritis, mice were subjected to DMM or SHAM surgery and sacrificed at 2-, 5- and 10-week post-surgery. Catwalk gait analyses, Micro-Computed Tomography, Toluidine Blue, Picrosirius Red and Tartrate-Resistant Acid Phosphatase (TRAP) staining were used to investigate gait patterns, joint morphology, subchondral bone, cartilage, collagen organization and osteoclasts activity, respectively. Results showed OA progressed over 10-week time-course...
February 12, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29419685/the-adaptive-change-of-patellofemoral-joint-after-arthroscopic-discoid-lateral-meniscus-plasty-an-observational-study
#20
Jiangtao Dong, Hongtao Xu, Guorong Jin, Dongmei Xin, Jian Zhang, Kai Kang, Shijun Gao, Baicheng Chen, Yong Shen
The purpose of this study was to investigate the patellofemoral joint adaptive changes after discoid lateral meniscus (DLM) plasty.Forty-one patients with unilateral complete type DLM tears were included in this study. Demographic variables, including gender, age, body mass index (BMI), injury to operation interval, type of injury, and follow-up time, were recorded. The evolution of physical examination, imaging index, and functional score were analyzed by Chi-squared test, Wilcoxon signed ranks test, and Friedman test...
February 2018: Medicine (Baltimore)
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