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patella dislocation

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
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
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
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
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
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...
February 1, 2018: American Journal of Sports Medicine
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
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
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
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)
Jefferson Brand, Richard Hardy, Paul Westerberg
Lateral patellar dislocations can damage the medial patella femoral ligament. Nonoperative care is preferred but some tears may require a surgical intervention. Patella fractures are considered a risk factor after surgery. The technique described in this Technical Note avoids any bone tunnel drilling, which may eliminate the possibility of a patella fracture. The surgical procedure uses periosteal fibro-osseous tunnels to a double-limbed gracilis graft to reconstruct the upper and lower borders as conventionally used for medial patella femoral ligament reconstruction...
October 2017: Arthroscopy Techniques
Bo Kaewkongnok, Anders Bøvling, Nikolaj Milandt, Celia Møllenborg, Bjarke Viberg, Lars Blønd
BACKGROUND: Immobilization devices such as plaster splints, casts and braces have been used for first time patellar dislocation (FTPD) in order to prevent redislocation. This study evaluates different non-operative immobilization regimes upon rates of redislocation. METHODS: A retrospective cohort study with a study population of 1366 in which 601 subjects under 30years with FTPD were included from three hospitals. Exclusion criteria were osteochondral fracture, ligament injury and subluxation...
January 29, 2018: Knee
Kathryn L Bauer
Osteochondral injuries in pediatric patients may occur as a result of a traumatic injury or secondary to an osteochondritis dissecans (OCD) lesion. Lateral patella dislocation is a common traumatic cause of osteochondral injury that typically occurs at the medial facet of the patella or at the lateral aspect of the distal femur. Multiple theories have been proposed for the cause of an OCD lesion in the knee, including trauma or repetitive microtrauma, local vascular insufficiency, and family history. The most "classic" location for OCD lesions of the knee is the lateral aspect of the medial femoral condyle of the distal femur...
January 30, 2018: Journal of Knee Surgery
D Dammerer, M C Liebensteiner, U M Kujala, K Emmanuel, S Kopf, F Dirisamer, J M Giesinger
INTRODUCTION: The Kujala score is the most frequently used questionnaire for patellofemoral disorders like pain, instability or osteoarthritis. Unfortunately, we are not aware of a validated German version of the Kujala score. The aim of our study was the translation and linguistic validation of the Kujala score in German-speaking patients with patella instability and the assessment of its measurement characteristics. MATERIALS AND METHODS: The German Kujala score was developed in several steps of translation...
January 25, 2018: Archives of Orthopaedic and Trauma Surgery
Xing-Sen Liang, Zheng-Hong Yu, Yi-Kai Li, Ying-Ping Jiang, Xian-Wu Chen, Min Huang
OBJECTIVE: To study the contribution of medial or lateral stabilizer to the stability of the patella, to explore the function and effect of releasing the LPR clinically and to provide a biomechanical basis for the clinical treatment of patellar instability(PI). METHODS: The quadriceps femoris of 6 fresh human cadaver knees were loaded to simulate a normal condition of muscle strength. First the loading force was measured and recorded, which subluxated the patella with the different degrees of knee flexion...
April 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Hassan Azimi, Oke Anakwenze
Medial patellofemoral ligament (MPFL) injuries are common in children and young adults. In patients with recurrent patellar dislocations with normal lower-extremity alignment, anatomic reconstruction of the MPFL has been shown to restore patellar stability. We describe a technique that creates an anatomic reconstruction using a dual docking technique into the patella. Our technique is simple and efficacious for reconstructing the MPFL without implant fixation in the patella, allowing a maximal bone-tendon interface for healing...
December 2017: Arthroscopy Techniques
Min Ren, Ping Zhen, Yu-Jun Fang, Xiao-Long Ren, Chen-Po Dang, Fei-Yi Hou, Shen-Song Li
OBJECTIVE: To accurately define the injury position of medial patellar retinaculum with acute injury under the guiding of high frequency ultrasonography, and to study therapeutic effects of suture operation on medial patellar retinaculum in the injuried position. METHODS: From June 2009 to March 2014, there were 17 patients with acute patellar dislocation, 6 males and 11 females with average age of (16.2±6.2) years old. The duration time of patellar dislocation was 2 weeks...
January 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Alexander Zimmerer, Christian Sobau, Peter Balcarek
Recent years have been characterized by an ongoing increase in knowledge about the different conditions associated with lateral patellar instability. This increase in knowledge provides differentiated approaches to the various pathologies of the patellofemoral joint. Though current guidelines consider medial patellofemoral ligament (MPFL) reconstruction the basic treatment for the unstable patella, medial soft tissue-stabilizing procedures should not be interpreted as stand-alone procedures in every case. The influence of different anatomical factors leading to patellar instability, as well as their impact on clinical outcome measures, is becoming increasingly apparent and deserves further attention...
January 10, 2018: Journal of Experimental Orthopaedics
Haim Shtarker, Michael Assaf, Marshall N Deltoff
A new surgical method is introduced offering a less invasive approach to reattach the medial retinaculum following acute patellar dislocation. This retrospective analysis comprised 12 cases of medial retinacular repair in 10 patients. The surgical technique achieved reinforced reattachment of the torn region of the medial retinaculum for improved patellar support and stabilization. During follow-up, no recurrent patellar dislocations occurred, except where one patient reported a subjective feeling of patellar dislocation...
January 4, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
David Dejour, Bertrand Le Coultre
Patellar instability is defined by clinical and radiologic criteria. The surgical treatment is aimed at restoring the congruence of the patellofemoral articulation and correcting extensor mechanism malalignment, to prevent recurrence of dislocation. The standard soft-tissue procedures are lateral release and vastus medialis advancement and medial patello femoral ligament plasty. Bony procedures are frequently performed in addition to soft-tissue surgery, to realign the extensor mechanism by means of tibial tubercle medialization, or to correct the patellar index in patella alta...
March 2018: Sports Medicine and Arthroscopy Review
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