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https://www.readbyqxmd.com/read/28459754/rehabilitation-after-medial-patellofemoral-ligament-reconstruction
#1
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/28459747/biomechanical-analysis-of-tibial-tuberosity-medialization-and-medial-patellofemoral-ligament-reconstruction
#2
John J Elias, Bradley W Smith, Blake T Daney
Biomechanical studies are commonly performed to evaluate the influence of medial patellofemoral ligament (MPFL) reconstruction and tibial tuberosity medialization on patellar tracking and patellofemoral contact pressures. The most common method is in vitro simulation of knee function, but computational simulation of knee function and computational reconstruction of in vivo motion can also be utilized. The current review of the biomechanical literature indicates that MPFL reconstruction and tibial tuberosity medialization reduce lateral patellar tracking...
June 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28457794/partial-quadriceps-tendon-transfer-for-revision-medial-patellofemoral-ligament-reconstruction-a-new-surgical-technique
#3
Joan Leal-Blanquet, Eduard Alentorn-Geli, Raúl Torres-Claramunt, Joan Carles Monllau
Medial patellofemoral ligament (MPFL) reconstruction for patellofemoral instability is a common procedure. Although MPFL reconstruction is a successful procedure in terms of return to normal life or sports, revision cases are challenging due to previous holes into the patella or implants placed in the anatomical femoral insertion site. In this technical note, the use of a partial quadriceps tendon transfer to the adductor magnus tendon is presented as a good solution for revision cases to avoid the use of implants, bone drilling, use of allografts, or two-stage surgical procedures...
April 27, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28456817/erratum-to-medial-patellofemoral-ligament-mpfl-reconstruction-in-combination-with-a-modified-grammont-technique-leads-to-favorable-mid-term-results-in-adolescents-with-recurrent-patellofemoral-dislocations
#4
Helmut Wegmann, Christoph Würnschimmel, Tanja Kraus, Georg Singer, Robert Eberl, Holger Till, Matthias Sperl
No abstract text is available yet for this article.
April 29, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28454185/patella-dislocation-in-children-and-adolescents
#5
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
#6
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
https://www.readbyqxmd.com/read/28437491/correct-positioning-of-the-medial-patellofemoral-ligament-troubleshooting-in-the-operating-room
#7
M Tyrrell Burrus, Brian C Werner, Jourdan M Cancienne, David R Diduch
Medial patellofemoral ligament (MPFL) reconstruction is often required after failed nonoperative management of lateral patellar instability. It is important to properly re-create the native ligament to avoid altering patellofemoral biomechanics. Such alterations can cause knee stiffness, anterior knee pain, and patellofemoral chondrosis. Incorrect femoral location is the most common mistake that affects MPFL graft biomechanics. Authors have described multiple radiographic and anatomical landmarks that assist in determining the appropriate location, and time should be taken to accurately localize this position...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28396049/acquired-femoral-flexion-deformity-due-to-physeal-injury-during-medial-patellofemoral-ligament-reconstruction
#8
Gerd Seitlinger, Philipp Moroder, Christian Fink, Guido Wierer
BACKGROUND: Reconstruction of the medial patellofemoral ligament (MPFL) is the most frequent surgical procedure performed in patients with patellar instability. Recently, concerns regarding physeal injury during femoral tunnel placement for anatomical MPFL reconstruction in children have been discussed. METHODS: This is the first case to report partial posterior physeal growth arrest and subsequent flexion deformity of the distal femur after MPFL reconstruction in a skeletally immature patient...
April 7, 2017: Knee
https://www.readbyqxmd.com/read/28357492/patient-based-outcomes-after-medial-patellofemoral-ligament-reconstruction
#9
Takehiko Matsushita, Shinya Oka, Daisuke Araki, Kyohei Nishida, Toshikazu Tanaka, Noriyuki Kanzaki, Kotaro Nishida, Ryosuke Kuroda
PURPOSE: The purpose of this study was to evaluate subjective outcomes after medial patellofemoral ligament (MPFL) reconstructions. METHODS: Fifty-four knees of 46 patients who received MPFL reconstruction for recurrent patellar dislocations were examined with a minimum follow-up of two years. To assess patient-based outcomes, the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Kujala score were assessed. RESULTS: The mean Kujala score was significantly improved from 64...
March 29, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28297604/biomechanical-evaluation-of-classic-solid-and-all-soft-suture-anchors-for-medial-patellofemoral-ligament-reconstruction
#10
Michael G Saper, Karim Meijer, Scott Winnier, John Popovich, James R Andrews, Charles Roth
BACKGROUND: Multiple techniques for patellar fixation with classic solid suture anchors (SAs) in medial patellofemoral ligament (MPFL) reconstruction have been described. Fixation of the graft to the patella with all-soft suture anchors (ASAs) has not been studied. Purpose/Hypothesis: To evaluate the biomechanical performance of 2 different MPFL patellar fixation techniques: ASA fixation and SA fixation. We hypothesized that the ASA group would show no statistical difference in the ultimate failure load and stiffness compared with the SA group...
March 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28289819/medial-patellotibial-ligament-and-medial-patellomeniscal-ligament-anatomy-imaging-biomechanics-and-clinical-review
#11
REVIEW
Betina Bremer Hinckel, Riccardo Gomes Gobbi, Camila Cohen Kaleka, Gilberto Luis Camanho, Elizabeth A Arendt
PURPOSE: The purpose of this article is to review anatomical, biomechanical, and clinical data of the medial patellotibial ligament (MPTL) and medial patellomeniscal ligament (MPML), as well as studies focusing on the medial patellofemoral ligament (MPFL) but with relevant data about the MPTL and MPML. METHODS: A literature search of articles specifically addressing the MPTL and/or MPML was included along with studies focusing on the MPFL but with relevant data about the MPTL and MPML...
March 13, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28280905/clinical-outcomes-after-revision-surgery-for-medial-patellofemoral-ligament-reconstruction
#12
Andreas Chatterton, Torsten Grønbech Nielsen, Ole Gade Sørensen, Martin Lind
PURPOSE: Medial patellofemoral ligament reconstruction (MPFL-R) is the standard surgical intervention for patella instability. However, limited knowledge exists concerning the causes for failure, and outcome after revision MPFL-R. The purpose of this study is to evaluate the causes of primary MPFL-R failure and clinical outcomes after revision MPFL-R. METHODS: Twenty-three patients (6 males and 17 females) with failed primary MPFL-R underwent isolated revision MPFL-R or combined revision MPFL-R with tibial tuberosity osteotomy (TTO)...
March 9, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28277745/3d-computed-tomography-evaluation-of-morphological-changes-in-the-femoral-tunnel-after-medial-patellofemoral-ligament-reconstruction-with-hamstring-tendon-graft-for-recurrent-patellar-dislocation
#13
Keisuke Kita, Yoshinari Tanaka, Yukiyoshi Toritsuka, Hiroshi Amano, Ryohei Uchida, Yoshiki Shiozaki, Rikio Takao, Shuji Horibe
BACKGROUND: Reconstruction of the medial patellofemoral ligament (MPFL) for recurrent lateral patellar dislocation is gaining popularity. However, the morphological changes in the femoral tunnel after MPFL reconstruction are still not fully documented. PURPOSE: This study used 3-dimensional (3D) computed tomography to evaluate morphological changes in the femoral tunnel after MPFL reconstruction with hamstring tendon graft to investigate factors affecting the phenomenon and to elucidate whether it is associated with clinical outcomes...
March 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28251062/failed-medial-patellofemoral-ligament-reconstruction-causes-and-surgical-strategies
#14
REVIEW
Vicente Sanchis-Alfonso, Erik Montesinos-Berry, Cristina Ramirez-Fuentes, Joan Leal-Blanquet, Pablo E Gelber, Joan Carles Monllau
Patellar instability is a common clinical problem encountered by orthopedic surgeons specializing in the knee. For patients with chronic lateral patellar instability, the standard surgical approach is to stabilize the patella through a medial patellofemoral ligament (MPFL) reconstruction. Foreseeably, an increasing number of revision surgeries of the reconstructed MPFL will be seen in upcoming years. In this paper, the causes of failed MPFL reconstruction are analyzed: (1) incorrect surgical indication or inappropriate surgical technique/patient selection; (2) a technical error; and (3) an incorrect assessment of the concomitant risk factors for instability...
February 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28241086/the-anatomy-of-the-medial-patellofemoral-ligament
#15
Thai Q Trinh, Jason R Ferrel, Jared C Bentley, Robert N Steensen
Recurrent patellar dislocation is observed in many patients treated nonoperatively following primary dislocation. Injury to the medial patellofemoral ligament (MPFL) is reported in the majority of patients following dislocation. There is an increased interest in repair or reconstruction of the MPFL for patients experiencing recurrent instability. The femoral attachment of the MPFL is critical in determining graft behavior following reconstruction. The femoral attachment can be determined by referencing local anatomy, fluoroscopic imaging or on the basis of desired graft-length changes...
February 27, 2017: Orthopedics
https://www.readbyqxmd.com/read/28228051/patellar-complications-in-single-versus-double-tunnel-medial-patellofemoral-ligament-reconstruction
#16
Riazuddin Mohammed, Neil Hunt, A J Gibbon
PURPOSE: Hamstring graft fixation on the patellar side during medial patellofemoral ligament (MPFL) reconstruction is usually with transosseous tunnels and can frequently lead to further problems. The aim of our study was to compare and analyse patellar complications in single patellar tunnel versus double tunnel hamstring graft fixation. METHODS: Twenty-nine knees with MPFL reconstructions (group S) in which the hamstring tendon graft was transfixed using a suspensory fixation method in a single tunnel drilled across the patella were analysed in comparison with 29 knees (group D) with interference fixation of the graft through two tunnels drilled up to a predetermined depth in the patella...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28210789/medial-patellofemoral-ligament-mpfl-reconstruction-in-combination-with-a-modified-grammont-technique-leads-to-favorable-mid-term-results-in-adolescents-with-recurrent-patellofemoral-dislocations
#17
Helmut Wegmann, Christoph Würnschimmel, Tanja Kraus, Georg Singer, Robert Eberl, Holger Till, Matthias Sperl
PURPOSE: The aim of the present study is to present the outcome of a cohort of adolescent patients with trochlear dysplasia and elevated tibial tuberosity trochlear groove (TTTG) distance suffering from recurrent patellar dislocation. Treatment consisted of medial patellofemoral ligament (MPFL) reconstruction and a modified Grammont procedure. METHODS: MRI examinations were obtained pre- and postoperatively. Trochlear dysplasia was classified according to Déjour, and TTTG was measured on MRI...
February 16, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28210659/medial-patellofemoral-ligament-reconstruction-femoral-tunnel-accuracy-relationship-to-disease-specific-quality-of-life
#18
Laurie A Hiemstra, Sarah Kerslake, Mark Lafave
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction is a procedure aimed to reestablish the checkrein to lateral patellar translation in patients with symptomatic patellofemoral instability. Correct femoral tunnel position is thought to be crucial to successful MPFL reconstruction, but the accuracy of this statement in terms of patient outcomes has not been tested. PURPOSE: To assess the accuracy of femoral tunnel placement in an MPFL reconstruction cohort and to determine the correlation between tunnel accuracy and a validated disease-specific, patient-reported quality-of-life outcome measure...
February 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28193295/biomechanical-comparison-of-single-and-double-bundle-medial-patellofemoral-ligament-reconstruction
#19
COMPARATIVE STUDY
Qing Wang, Wenhan Huang, Daozhang Cai, Huayang Huang
BACKGROUND: Recurrent patellar dislocation is common clinically, primarily in adolescents. However, the biomechanical properties of single- and double-bundle medial patellofemoral ligament (MPFL) reconstruction remain poorly understood. METHODS: Six fresh frozen adult cadaveric knee specimens were obtained for this study. Each specimen was fixed at 0° to test the force needed when the patella was laterally shifted 10 mm at a speed of 0.5 mm/s, and the test was repeated three times...
February 13, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28192824/accuracy-and-learning-curve-of-femoral-tunnel-placement-in-medial-patellofemoral-ligament-reconstruction
#20
Laurie Anne Hiemstra, Sarah Kerslake, Catherine L O'Brien, Mark R Lafave
The purpose of this study was to assess the accuracy of femoral tunnel placement in a medial patellofemoral ligament reconstruction (MPFL-R) cohort. The secondary purpose was to establish the evidence of a learning curve to achieve acceptable femoral tunnel placement during MPFL-R. Two surgeons, using lateral radiographs, assessed 73 subjects post-MPFL-R. Femoral tunnel accuracy and direction of tunnel error were measured in relation to Schöttle's point (A-T distance). Interrater reliability (intraclass correlation coefficient 2,k) of these measures was calculated...
February 13, 2017: Journal of Knee Surgery
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