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https://www.readbyqxmd.com/read/29349990/-experimentation-of-the-relationship-between-medial-or-lateral-patellar-stabilizer-and-patellofemoral-stabilization
#1
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
https://www.readbyqxmd.com/read/29349002/medial-patellofemoral-ligament-reconstruction-using-dual-patella-docking-technique
#2
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
https://www.readbyqxmd.com/read/29327545/-study-on-therapeutic-effects-of-arthroscopic-repair-on-medial-patellar-retinaculum-acute-injury
#3
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
https://www.readbyqxmd.com/read/29322270/recent-developments-in-evaluation-and-treatment-of-lateral-patellar-instability
#4
REVIEW
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
https://www.readbyqxmd.com/read/29302781/a-new-minimally-invasive-surgical-technique-for-medial-retinaculum-repair-following-traumatic-patellar-dislocation
#5
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
https://www.readbyqxmd.com/read/29300223/osteotomies-in-patello-femoral-instabilities
#6
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
https://www.readbyqxmd.com/read/29299655/medial-patellofemoral-ligament-reconstruction-in-children-do-osseous-abnormalities-matter
#7
Sebastien Pesenti, Matthieu Ollivier, Jean-Charles Escudier, Mathieu Cermolacce, Alexandre Baud, Franck Launay, Jean-Luc Jouve, Elie Choufani
PURPOSE: Management of post-traumatic patellar instability in children with osseous abnormalities is challenging because of the presence of an open physis. The aim of our study was to compare the rate of recurrence after isolated reconstruction of the medial patellofemoral ligament (MPFL) in children with or without osseous abnormalities. METHODS: The medical records of 25 children (27 knees) with recurrent patellar dislocation were reviewed. Each child underwent an isolated reconstruction of the MPFL using a hamstring graft...
January 4, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29298083/clinical-outcomes-after-isolated-medial-patellofemoral-ligament-reconstruction-for-patellar-instability-among-patients-with-trochlear-dysplasia
#8
Joseph N Liu, Jacqueline M Brady, Irene L Kalbian, Sabrina M Strickland, Claire Berdelle Ryan, Joseph T Nguyen, Beth E Shubin Stein
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction has become one of the most common and widely used procedures to regain stability among patients with recurrent lateral patellar dislocation. While recent studies demonstrated low recurrence rates, improved patient-reported outcome measures, and a high rate of return to sports, limited literature explored its effectiveness as an isolated intervention in the context of trochlear dysplasia. PURPOSE: To determine the efficacy of isolated MPFL reconstruction in treating patellar instability in the setting of trochlear dysplasia...
January 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29244659/intra-articular-patellar-dislocation-a-technique-for-closed-reduction-a-case-report-and-review-of-the-literature
#9
Lachlan Wight, Dugal James
CASE: An 87-year-old man fell onto a flexed knee and sustained a closed intra-articular patellar dislocation. A closed reduction was performed under intravenous sedation by flexing the knee to 90°, applying an anterior drawer force to the tibia, and applying pressure to the inferior pole of the patella. The day after reduction, weight-bearing was begun in a hinged brace set at 0° to 90°. Full function was regained by 6 weeks postreduction. CONCLUSION: Intra-articular patellar dislocation may present as an unusual cause of a locked knee...
December 13, 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29239536/-patellar-instability-diagnosis-and-treatment
#10
Trieu Hoai Nam Ngo, Robin Martin
The aim of this paper is to present recent advances in surgical management of patellar instability. Several anatomical factors were reported to promote instability. We propose to classify them in two groups. Extra articular factors are valgus and torsion deformity. Articular factors include trochlea and patella dysplasia, tibial tubercle lateralization and medial patellofemoral ligament (MPFL) insufficiency. Acute patellar dislocations are treated conservatively, with exception for osteochondral and MPFL avulsion fractures that require acute reinsertion...
December 13, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29225329/medial-patellofemoral-ligament-reconstruction-with-semi-patellar-tunnel-fixation-surgical-technique-and-mid-term-follow-up
#11
Jinghui Niu, Qi Qi, Kunpeng Fu, Guman Duan, Chang Liu, Fei Wang
BACKGROUND The present study aimed to describe a new safe and economical technique for medial patellofemoral ligament (MPFL) reconstruction with satisfactory clinical outcomes, and present the results of a four-year follow-up. MATERIAL AND METHODS Thirty-two patients with recurrent patella dislocation, who underwent MPFL reconstruction with two semi-patellar tunnels and hardware-free patellar fixation between 2011 and 2013, were included in the study. Patella stability was tested by an apprehension test preoperatively and at follow-up...
December 11, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29176355/what-is-the-chance-that-a-patella-dislocation-will-happen-a-second-time-update-on-the-natural-history-of-a-first-time-patella-dislocation-in-the-adolescent
#12
Gerd Seitlinger, Hannah N Ladenhauf, Guido Wierer
PURPOSE OF REVIEW: Patellar instability occurs mainly in young patients and shows a high incidence of concomitant cartilage injuries. Recently there has been a strong attempt to identify risk factors and enhance imaging techniques to detect patients with an increased risk for recurrent patella dislocation.We describe current findings on factors associated with recurrent patella dislocation in the adolescent. RECENT FINDINGS: Trochlear dysplasia, patellar height, patellar tilt, tibial tuberosity-trochlear groove distance, skeletal maturity, and history of contralateral patellar dislocation are well known significant risk factors for recurrence in adolescent patients...
November 14, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29167606/results-of-operative-4-in-1-patella-realignment-in-children-with-recurrent-patella-instability
#13
Francesc Malagelada, Ole Rahbek, Cyrus Sahirad, Manoj Ramachandran
Purpose: Recurrent patellar instability is a cause of knee dysfunction, limitation and pain for children. If nonoperative treatment fails to stabilise the patella, operative realignment and stabilisation have been advocated. Operative techniques in the paediatric population must preserve physeal growth while ensuring stability. We aimed to determine the outcome of children and adolescents who underwent a 4-in-1 patellar realignment (lateral release, medial reefing, Insall tube realignment and Roux-Goldthwaite patella ligament transfer)...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29150745/alignment-in-the-transverse-plane-but-not-sagittal-or-coronal-plane-affects-the-risk-of-recurrent-patella-dislocation
#14
Shigeru Takagi, Takashi Sato, Satoshi Watanabe, Osamu Tanifuji, Tomoharu Mochizuki, Go Omori, Naoto Endo
PURPOSE: Abnormalities of lower extremity alignment (LEA) in recurrent patella dislocation (RPD) have been studied mostly by two-dimensional (2D) procedures leaving three-dimensional (3D) factors unknown. This study aimed to three-dimensionally examine risk factors for RPD in lower extremity alignment under the weight-bearing conditions. METHODS: The alignment of 21 limbs in 15 RPD subjects was compared to the alignment of 24 limbs of 12 healthy young control subjects by an our previously reported 2D-3D image-matching technique...
November 17, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29134368/-patellofemoral-instability
#15
S F Fucentese
Patellofemoral instability is an extremely limiting pathology in young and active patients. Anatomical reasons for patellar instability, such as high-riding patella, elevated distance from the tibial tuberosity to trochlear groove (TTTG), trochlear dysplasia, insufficient medial patellofemoral ligament (MPFL) and malpositioning of the axes and torsion can lead to chronic patellofemoral instability and must be thoroughly analyzed. The first dislocation can be treated conservatively, with the exception of an osteochondral defect...
November 13, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/29130878/a-novel-technique-utilizing-a-vastus-lateralis-anchor-in-treatment-of-chronic-patellar-dislocation-after-total-knee-arthroplasty
#16
Allison Mayfield, Vamsi Singaraju, Afshin A Anoushiravani, Zain Sayeed, Jamal K Saleh, Khaled J Saleh
Extensor mechanism complications involving the patella frequently result in total knee arthroplasty (TKA) failure. Postoperative patellar dislocation may be caused by soft tissue imbalance, improper sizing, and position of the prosthesis. This report describes a case of revision TKA requiring several rounds of soft tissue releases in an effort to treat the patient's chronic patellar dislocation. In the process, a novel surgical approach was developed for the surgical management of refractory chronic patellar dislocations...
October 2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29071377/-plate-osteosynthesis-of-patellar-fractures
#17
REVIEW
E C Müller, K-H Frosch
OBJECTIVE: Anatomic reconstruction of the retropatellar articular surface and repair of the extensor mechanism of the knee joint. The osteosynthesis should allow immediate mobilization as part of an early functional postoperative rehabilitation protocol. INDICATIONS: Displaced fractures of the patella, especially multifragment and comminuted fractures with a retropatellar incongruity or dislocation of >2 mm. CONTRAINDICATIONS: Critical local soft tissue because of the risk of postoperative infection...
October 25, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28970976/medial-patellofemoral-ligament-reconstruction-in-a-revision-setting-anchor-and-interference-screw%C3%A2-fixation
#18
Marcio B Ferrari, George Sanchez, Angela Chang, Sami Ferdousian, Matthew T Provencher
Recurrent patellar instability is a common pathology and typically affects younger and more active patients. To prevent complete lateral dislocation of the patella, several osseous and soft-tissue procedures have been previously described, including reconstruction of the medial patellofemoral ligament (MPFL), which has been identified as the primary medial stabilizer of the patella. Several techniques have been reported for reconstruction of the MPFL, sometimes in conjunction with other procedures, with the majority showing success in the treatment and resolution of patellar instability...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28942027/tibial-tubercle-torsion-a-new-factor-of-patellar-instability
#19
V Chassaing, J-M Zeitoun, M Camara, J-L Blin, S Marque, M-D Chancelier
INTRODUCTION: External torsion of the anterior tibial tubercle (TT), defined as external rotation around a craniocaudal axis with respect to the posterior femoral condylar plane, may induce patellar instability. To our knowledge no studies have focused on this parameter. The present study aimed to perform an MRI analysis of TT torsion. The study hypothesis was that TT torsion correlates with patellar instability and with 3 of its components: tibial tubercle-trochlear groove (TT-TG) distance, axial engagement index of the patella (AEI), and patellar tilt...
September 21, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28932876/effective-patellofemoral-joint-stabilization-and-low-complication-rates-using-a-hardware-free-mpfl-reconstruction-technique-with-an-intra-operative-adjustment-of-the-graft-tension
#20
Lars V von Engelhardt, Torsten Fuchs, Pia Weskamp, Joerg Jerosch
PURPOSE: Even if medial patellofemoral ligament (MPFL) reconstruction is a proven method, complications such as implant loosening, patella fractures, recurrent luxations, knee pain or knee stiffness are frequently described. Besides a correct tunnel positioning and implant-specific complications, this might be caused by difficulties with an appropriate graft tensioning. The study presented here is a necessary first step in exploring our technique of a double-limbed, hardware-free MPFL reconstruction, which provides another way to test and adjust the graft tension before permanent fastening...
September 20, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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