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https://www.readbyqxmd.com/read/27933343/-conservative-treatment-of-congenital-patellar-dislocation
#1
D Zajonz, E Schumann, M Wojan, M Moche, C-E Heyde
This article presents the rare case of a boy who was born in our hospital with valgus deformity and external rotation of the right lower leg because of congenital patellar dislocation. In the case presented a stable repositioning of the patella could be achieved by redressment with a plaster cast and leg brace. During a 4-year follow-up there were no tendencies towards dislocation during the clinical examination and no dislocation events were documented. In selected cases an attempt at conservative repositioning and retention treatment appears to be worthwhile before surgical treatment is indicated...
December 8, 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27915446/superior-dislocation-of-the-patella-a-pathognomonic-finding-and-review-of-literature
#2
P W van Egmond, M C Vermeulen, C F van Dijke, H C A Graat
A 59-year-old woman with a painful right knee that became locked in extension after a trivial trauma was seen at the emergency room. This was caused by unloaded hyperextension in bed. She was diagnosed with a superior dislocation of the patella. A closed reduction was performed, but a recurrent episode was seen within a week. An arthroscopy was performed, in which the causative osteophytes were removed. In the 12-month follow-up after treatment, no recurrence was seen. A superior dislocation of the patella is caused by patellofemoral osteophytes that interlock...
December 3, 2016: Skeletal Radiology
https://www.readbyqxmd.com/read/27904790/current-concepts-in-the-treatment-of-gross-patellofemoral-instability
#3
Grant Buchanan, LeeAnne Torres, Brian Czarkowski, Charles E Giangarra
: Patellofemoral instability is a painful and commonly recurring condition, which often must be managed surgically. Diagnosis can be aided by the use of a variety of physical exam signs, such as the Q angle, Beighton hypermobility score, glide test, J sign, patellar tilt test, and apprehension test. Imaging modalities including x-ray, CT, and MRI guide both diagnosis and management by revealing trochlear dysplasia, bony malalignment, and ligamentous injury that contribute to instability...
December 2016: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/27894178/comparison-of-radiological-parameters-between-normal-and-patellar-dislocation-groups-in-korean-population-a-rotational-profile-ct-based-study
#4
Jatin Prakash, Jong-Keun Seon, Seong-Hwan Woo, Cheng Jin, Eun-Kyoo Song
Purpose: Patellofemoral instability is a common cause of anterior knee pain in adolescents and young adults. Most normal and pathological values for diagnosing patellofemoral instability are based on Western literature. We conducted this radiological study to determine normal values for different patellofemoral parameters in a Korean population and to evaluate their usefulness in diagnosis. Materials and Methods: We retrospectively reviewed the rotational profile computerized tomography (CT) scans of the patellar dislocation and control groups...
December 1, 2016: Knee Surgery & related Research
https://www.readbyqxmd.com/read/27894010/a-magnetic-resonance-imaging-study-of-abnormalities-of-the-patella-and-patellar-tendon-that-predispose-children-to-acute-patellofemoral-dislocation
#5
Barış Yılmaz, Esin Derin Çiçek, Evrim Şirin, Güzelali Özdemir, Özgün Karakuş, Hasan Hilmi Muratlı
This study compared 20 children hospitalised with acute patellofemoral dislocation with an age-matched healthy control group with no history of knee problems or patellar dislocation. The following morphological parameters were significantly different between the groups: the mean patellar width and length, mean sulcus depth, mean patellar tendon width and total patellar volume. The magnetic resonance imaging findings of this study suggested that structurally smaller than normal patella and patellar tendon volumes are predisposing factors for acute patellofemoral dislocation...
November 17, 2016: Clinical Imaging
https://www.readbyqxmd.com/read/27842571/medial-patellofemoral-ligament-reconstruction-using-a-bone-groove-and-a-suture-anchor-at-patellar-a-safe-and-firm-fixation-technique-and-3-year-follow-up-study
#6
Hong-De Wang, Jiang-Tao Dong, Shi-Jun Gao
BACKGROUND: Graft fixation is critical to the restoration of the medial patella of femoral ligament function and long-term success. Numerous fixations at the patella have been described, while the complications including patellar fractures, violation of the posterior patella and delay of tendon-to-bone healing remain significant challenges. Here, we describe a safe and firm fixation at the patellar for medial patellofemoral ligament (MPFL) reconstruction and explore the safety angle of drilling the suture anchor at different morphology of the patellar...
November 14, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27818987/total-knee-arthroplasty-with-subvastus-approach-in-patient-with-chronic-post-traumatic-patellar-dislocation
#7
Jader Joel Machado Junqueira, Camilo Partezani Helito, Marcelo Batista Bonadio, Jose Ricardo Pécora, Marco Kawamura Demange
Chronic lateral dislocation of the patella is a rare condition and acquired causes are usually secondary to knee trauma. The neglected chronic dislocation leads to progressive genu valgum and external tibial torsion deformities with subsequent gonarthrosis, which becomes painful and debilitating. There is no consensus regarding treatment of these patients, but total knee arthroplasty (TKA) is a useful therapy in cases of painful symptomatic gonarthrosis. Few reports have shown that subvastus approach and lateral release may be a valid option for TKA, since it allows the correction of valgus deformity and patellar tracking without interrupting vascular blood supply of patella...
September 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/27717972/assessment-of-demographic-and-pathoanatomic-risk-factors-in-recurrent-patellofemoral-instability
#8
Laurie Anne Hiemstra, Sarah Kerslake, Mark Lafave
PURPOSE: The WARPS/STAID classification employs clinical assessment of presenting features and anatomic characteristics to identify two distinct subsets of patients within the patellofemoral instability population. The purpose of this study was to further define the specific demographics and the prevalence of risky pathoanatomies in patients classified as either WARPS or STAID presenting with recurrent patellofemoral instability. A secondary purpose was to further validate the WARPS/STAID classification with the Banff Patella Instability Instrument (BPII), the Marx activity scale and the Patellar Instability Severity Score (ISS)...
October 7, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27703948/recurrent-patellar-instabilty-culminating-in-a-vertically-rotated-and-a-locked-patellar-dislocation-a-rare-entity
#9
Devgan A, Rohilla R, Jain A, Mehta H, Singh S
INTRODUCTION: Locked vertical patellar dislocations are rare and pose a therapeutic challenge. This case is more unusual, as the patient was a known case of recurrent patellar dislocation and presented with an atraumatic locked and vertically rotated patellar dislocation. This type of presentation has never been reported in literature to the best of our knowledge. CASE PRESENTATION: A 14-year-old healthy male child with previous history of recurrent lateral dislocation of patella presented to accident & emergency department with complaints of inability to walk or bear weight on his left lower limb after he spontaneously dislocated his patella while running on uneven ground...
April 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/27699726/modified-elmslie-trillat-procedure-for-recurrent-dislocation-of-the-patella
#10
Genya Mitani, Takashi Maeda, Tomonori Takagaki, Kosuke Hamahashi, Kenji Serigano, Yutaka Nakamura, Masato Sato, Joji Mochida
Many groups have reported good to excellent clinical outcomes of the Elmslie-Trillat (ET) procedure for recurrent dislocation of the patella. However, the mean follow-up period of these studies was no more than 5 years. We hypothesized that the long-term postoperative outcomes of the modified ET procedure for recurrent dislocation of the patella would be acceptable compared with those of other procedures. The long-term postoperative outcomes of patients treated with the modified ET procedure were examined. A total of 31 knees in 27 patients with recurrent dislocation of the patella who underwent a modified ET procedure (without medial capsular plication) were evaluated...
October 3, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27650016/-abstracta-woman-with-knee-pain-after-a-fall-in-childhood
#11
J H J van Erp, R W Brouwer
A 32-year-old woman presented with pain in her left knee ever since she had fallen down the stairs as a child and had landed on this knee. On the X-ray we saw two large patella fragments. We made the diagnosis of dislocated and subluxated fracture of the patella without consolidation. The previously missed fracture was treated conservatively.
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27613760/morphology-and-anatomic-patellar-instability-risk-factors-in-first-time-traumatic-lateral-patellar-dislocations-a-prospective-magnetic-resonance-imaging-study-in-skeletally-immature-children
#12
Marie Askenberger, Per-Mats Janarv, Throstur Finnbogason, Elizabeth A Arendt
BACKGROUND: The incidence of primary lateral patellar dislocation (LPD) in children aged 9 to 14 years is 0.6 to 1.2 per 1000. Causation is assumed to be multifactorial, including anatomic variants of the patellofemoral (PF) joint that result in a higher risk of LPD. No publication has compared the morphology of the PF joint and anatomic patellar instability risk factors (APIFs) in a primary LPD population versus controls, defining children by skeletal maturity. PURPOSE: To characterize the PF morphology and APIFs (trochlear dysplasia, abnormal lateral patellar tilt, elevated tibial tubercle-trochlear groove [TT-TG] distance, patella alta) through magnetic resonance imaging (MRI) measurements in skeletally immature children with and without a primary LPD and to identify (potential) distinctive differences between these 2 groups...
September 9, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27590642/does-the-utilization-of-allograft-tissue-in-medial-patellofemoral-ligament-reconstruction-in-pediatric-and-adolescent-patients-restore-patellar-stability
#13
Eric Hohn, Nirav K Pandya
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction is one of several surgical procedures used to treat patellofemoral instability. Use of allograft tissue can preserve autogenous tissue and may be preferable in patients with connective tissue disorders or ligamentous laxity. Although there are successful reports in adults, it is unclear if the use of allograft tissue in MPFL reconstruction can restore patellofemoral stability in children and adolescents. QUESTIONS/PURPOSES: (1) Does allograft tissue in MPFL reconstruction in pediatric and adolescent patients restore patellar stability? (2) What complications were associated with allograft MPFL reconstructions in children and adolescents? METHODS: Between June 2012 and August 2015, one surgeon (NKP) performed 26 MPFL reconstructions in 23 patients with gracilis allograft for traumatic patellar instability...
September 2, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27436719/trochleoplasty-as-a-solitary-treatment-for-recurrent-patellar-dislocation-results-in-good-clinical-outcome-in-adolescents
#14
Carlo Camathias, Katrin Studer, Ata Kiapour, Erich Rutz, Patrick Vavken
BACKGROUND: The essential static patellar stabilizer is a normal-shaped trochlear groove. A dysplastic groove destabilizes the patella. Trochleoplasty approaches this underlying condition and reshapes the trochlea. However, studies have reported on trochleoplasty for revision cases or as accompanied by other interventions. The effect of trochleoplasty alone remains unexplained. PURPOSE: To introduce trochleoplasty as a stand-alone treatment for recurrent patellar dislocation and to compare its pre- to postoperative functional and clinical variables...
July 19, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27405662/load-analysis-of-a-patellofemoral-joint-by-a-quadriceps-muscle
#15
Adam Ciszkiewicz, Józef Knapczyk
PURPOSE: The aim of this paper is to develop a model of the patellofemoral joint by considering the linear displacement along axis of cylindrical joint and to use this model in the analysis of the femur spatial displacements caused by the quadriceps muscle force. METHOD: The linear displacement along the axis of cylindrical joint of the patellofemoral joint is computed using optimization methods - minimization of the difference between the modeled and measured spatial displacements of the femur with respect to the tibia over the full range of the knee flexion...
2016: Acta of Bioengineering and Biomechanics
https://www.readbyqxmd.com/read/27385203/-ligamentous-knee-injuries-in-children-and-adolescents
#16
T C Drenck, R Akoto, N M Meenen, M Heitmann, A Preiss, K- H Frosch
Due to an increase in sporting activities, the number of injuries of the immature knee is continuously increasing. These injuries necessitate a special approach regarding the particular anatomical situation with open growth plates. Three of the most commonly occurring injuries are rupture of the anterior cruciate ligament, patella dislocation and meniscus injuries. The clinical results for conservative treatment of ruptures of the anterior cruciate ligament in the growth phase are inferior to operative treatment...
July 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27374877/epidemiology-of-intra-and-peri-articular-structural-injuries-in-traumatic-knee-joint-hemarthrosis-data-from-1145-consecutive-knees-with-sub-acute-mri
#17
O Olsson, A Isacsson, M Englund, R B Frobell
OBJECTIVE: In patients with traumatic knee distorsion and hemarthrosis, to investigate the panorama of structural injury, as visualized on MRI. DESIGN: Cohort study of 1145 consecutive patients with traumatic knee distorsion who underwent MRI within median 8 days after injury. We present structural injury as visualized on MRI in relation to age, sex and activity at injury. Population based gender specific annual incidences of common structural injuries were calculated...
June 29, 2016: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/27354953/soft-tissue-loop-for-medial-patellofemoral-ligament-reconstruction
#18
Mohd Fairudz Bin Mohd Miswan, Mohamed Zubair Mohamed Al-Fayyadh, Teo Seow Hui, Mohamed Razif Bin Mohamed Ali, Wuey Min Ng
A patient with patellar instability frequently presents with anterior knee pain, patellar subluxation, or dislocation. Medial patellofemoral ligament (MPFL) has a key role for normal patella tracking and stability. Reconstruction of the MPFL using a hamstring graft is a commonly used procedure for the treatment of chronic lateral subluxation of patella. Anchor sutures and bony tunnels are used for the patellar attachment of the graft. This can be associated with complications such as patella fracture; besides, it does not produce an anatomical reconstruction for the native MPFL that can alter the direction of tension applied on the patella...
April 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27354301/treating-patella-fractures-with-a-fixed-angle-patella-plate-a-prospective-observational-study
#19
Michael Wild, Kai Fischer, Florian Hilsenbeck, Mohssen Hakimi, Marcel Betsch
INTRODUCTION: Anterior tension wiring using Kirschner wires (K-wires) is still considered the standard treatment for patella fractures, despite its high complication rate. The objective of this prospective clinical study was to evaluate intra- and perioperative complications as well as the clinical outcome of patients with patella fracture treated with a new developed bilateral, polyaxial, fixed-angle 2.7mm patella plate. PATIENTS AND METHODS: Between 2011 and 2014 all patients with a patella fracture were included in this prospective study and treated with a fixed-angle patella plate...
August 2016: Injury
https://www.readbyqxmd.com/read/27352088/injury-patterns-of-medial-patellofemoral-ligament-after-acute-lateral-patellar-dislocation-in-children-correlation-analysis-with-anatomical-variants-and-articular-cartilage-lesion-of-the-patella
#20
Guang-Ying Zhang, Lei Zheng, Hao Shi, Bing-Jun Ji, Yan Feng, Hong-Yu Ding
OBJECTIVES: To assess the relationship between injury patterns of medial patellofemoral ligament (MPFL) and anatomical variants and patellar cartilage lesions after acute lateral patellar dislocation (LPD) in children. METHODS: MR images were obtained in 140 children with acute LPD. Images were acquired and evaluated using standardised protocols. RESULTS: Fifty-eight cases of partial MPFL tear and 75 cases of complete MPFL tear were identified...
June 28, 2016: European Radiology
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