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https://www.readbyqxmd.com/read/28801826/brain-activity-changes-in-somatosensory-and-emotion-related-areas-with-medial-patellofemoral-ligament-deficiency
#1
Masaru Kadowaki, Taku Tadenuma, Nobuyuki Kumahashi, Yuji Uchio
BACKGROUND: Patellar instability with medial patellofemoral ligament (MPFL) deficiency is a common sports injury among young people. Although nonoperative and surgical treatment can provide stability of the patella, patients often have anxiety related to the knee. We speculate that neural dysfunction may be related to anxiety in these patients; however, the mechanism in the brain that generates this anxiety remains unknown. QUESTIONS/PURPOSES: (1) How does brain activity in patients with MPFL deficiency change in the areas related to somatic sensation against lateral shift of the patella? (2) How does patella instability, which can lead to continuous fear or apprehension for dislocation, influence brain activity in the areas related to emotion? METHODS: Nineteen patients with MPFL deficiency underwent surgical reconstruction in our hospital from April 2012 to March 2014...
August 11, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28776631/diffuse-pigmented-villonodular-synovitis-as-a-rare-cause-of-graft-failure-following-anterior-cruciate-ligament-reconstruction
#2
Rajiv Rajani, Liliana Ogden, Christopher J Matthews, C Parker Gibbs
This case report describes a 42-year-old woman who was diagnosed with pigmented villonodular synovitis (PVNS) in the knee. The patient had received a bone-patella tendon-bone autograft reconstruction of her anterior cruciate ligament (ACL) 22 years prior to her diagnosis of PVNS. After a traumatic event that tore her ACL graft, she underwent a second surgery to repair the initial reconstruction. However, her pain and joint instability remained unresolved. When radiolucent lesions in her tibia and femur were identified through a radiographic image, the patient was referred to the authors' orthopedic oncology clinic...
August 3, 2017: Orthopedics
https://www.readbyqxmd.com/read/28744079/evaluation-of-patella-alta-using-mri-measurements-in-adolescents
#3
Barış Yılmaz, Guzelali Ozdemir, Evrim Sirin, Esin D Cicek, Burcu S Anıl, Goncagul Bulbun
PURPOSE: To determine whether or not there were any differences in the measurement techniques used by orthopedic and radiology specialists in the evaluation of magnetic resonance (MR) images for the diagnosis of patella alta in adolescents. MATERIALS AND METHODS: Evaluations were performed by three orthopedic specialists (Group I) and three radiology specialists (Group II) regarding the presence of patella alta in 40 adolescents cases using the Insall-Salvati, Caton-Deschamps, Blackburne-Peel, and modified Insall-Salvati indices on MR images obtained to diagnose patellar instability...
April 2017: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/28706804/tibial-tuberosity-transfer-in-combination-with-medial-patellofemoral-ligament-reconstruction-surgical-technique
#4
Damian Clark, Katie Walmsley, Peter Schranz, Vipul Mandalia
The stability of the patellofemoral joint relies on the tenuous interplay of soft tissue and bony factors. Anatomic risk factors for instability include a shallow trochlea, an abnormally lateral tibial tubercle position, patella alta, hypermobility, or a secondary injury to the medial patellofemoral ligament (MPFL). There is an increasing interest in restoring normal anatomy to achieve stability, and at times more than 1 abnormality exists. This article describes the technique for combining a tibial tuberosity transfer and an MPFL reconstruction...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28702749/evaluation-of-different-surgical-methods-in-treating-recurrent-patella-dislocation-after-three-dimensional-reconstruction
#5
Hao Du, Xiao-Xiao Tian, Fa-Qi Guo, Xiang-Ming Li, Tao-Tao Ji, Bin Li, Tong-Sen Li
PURPOSE: Recurrent patella dislocation (RPD) is the most common complication of patellar instability. The effects of different surgical techniques on the outcome of RPD treatments remain unclear. This study was conducted to compare the effects of three surgical techniques in treating RPD by three-dimensional (3D) reconstruction from computed tomography (CT) scans. METHODS: Sixty-eight patients with RPD and no previous surgical treatments who attended our hospital between October 2010 and 2013 were enrolled and randomly assigned into three groups: (1) medial patellofemoral ligament (MPFL) reconstruction and medial patellar retinaculum (MPR) plication group; (2) lateral patellar retinaculum (LPR) release and MPR plication group; and (3) MPFL reconstruction and LPR release group...
July 12, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28696495/robotic-arm-assisted-total-knee-arthroplasty-demonstrated-soft-tissue-protection
#6
Anton Khlopas, Morad Chughtai, Emily L Hampp, Laura Y Scholl, Michael Prieto, Ta-Cheng Chang, Abdullah Abbasi, Manoshi Bhowmik-Stoker, Jason Otto, David J Jacofsky, Michael A Mont
INTRODUCTION: While total knee arthroplasty (TKA) procedures have demonstrated clinical success, occasionally intraoperative complications can occur. Collateral or posterior cruciate ligament injury, instability, extensor mechanism disruption, and tibiofemoral or patellofemoral dislocation are among a few of the intraoperatively driven adverse events prevalently ranked by The Knee Society. Robotic-arm assisted TKA (RATKA) provides a surgeon the ability to three-dimensionally plan a TKA and use intraoperative visual, auditory, and tactile feedback to ensure that only the desired bone cuts are made...
July 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28693590/patella-morphological-alteration-after-patella-instability-in-growing-rabbits
#7
Jinghui Niu, Qi Qi, Yingzhen Niu, Conglei Dong, Zhenyue Dong, Peng Cui, Fei Wang
BACKGROUND: The shape of the patella has been considered to be a predisposing factor resulting in patellar instability, but the effects of abnormal patella position during its development are unclear. The present study evaluated patellar morphological changes after patella instability and evaluated the influence of patellar instability on the patella shape. METHODS: Twenty rabbits that were 2 months old were included in the study. The left knee of each rabbit, defined as the experimental group (N = 20 knees/group), underwent a medial soft tissue restraint release...
July 11, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28646869/long-term-outcomes-after-combined-arthroscopic-medial-reefing-and-lateral-release-in-patients-with-recurrent-patellar-instability-a-retrospective-analysis
#8
Dominik Schorn, Sera Yang-Strathoff, Georg Gosheger, Tim Vogler, Sebastian Klingebiel, Carolin Rickert, Dimosthenis Andreou, Dennis Liem
BACKGROUND: There is currently no consensus regarding the optimal surgical treatment method for patients with recurrent patella instability. Our goal was to evaluate the long-term results of combined arthroscopic medial reefing and lateral release, to identify possible risk factors for recurrent dislocations and residual complaints after surgical treatment and to assess functional outcome. METHODS: We performed a retrospective study of 38 patients (43 knees) treated with all-inside technique between 2001 and 2010...
June 24, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28631024/the-use-of-tibial-tuberosity-trochlear-groove-indices-based-on-joint-size-in-lower-limb-evaluation
#9
Peter Wilhelm Ferlic, Armin Runer, Florian Dirisamer, Peter Balcarek, Johannes Giesinger, Rainer Biedermann, Michael Christian Liebensteiner
PURPOSE: The correlation between tibial tuberosity-trochlear groove distance (TT-TG) and joint size, taking into account several different parameters of knee joint size as well as lower limb dimensions, is evaluated in order to assess whether TT-TG indices should be used in instead of absolute TT-TG values. METHODS: This study comprised a retrospective analysis of knee CT scans, including 36 cases with patellofemoral instability (PFI) and 30 controls. Besides TT-TG, five measures of knee joint size were evaluated in axial CT slices: medio-lateral femur width, antero-posterior lateral condylar height, medio-lateral width of the tibia, width of the patella and the proximal-distal joint size (TT-TE)...
June 19, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28614288/evaluation-of-the-tibial-tubercle-to-posterior-cruciate-ligament-distance-in-a-pediatric-patient-population
#10
Blake Clifton, Dustin L Richter, Dan Tandberg, Matthew Ferguson, Gehron Treme
BACKGROUND: Evaluation of distal extensor mechanism alignment continues to evolve in children with patella instability. Prior studies support the use of the tibial tubercle to trochlear groove (TT-TG) distance but limitations exist for this measurement including: changes in the TT-TG distance with knee flexion, difficulty with finding the deepest part of a dysplastic trochlea, and limitations regarding identification of the site of the anatomic abnormality. The tibial tubercle-posterior cruciate ligament (TT-PCL) distance has been introduced as an alternative measure to address the shortcomings in the TT-TG distance by quantifying the position of the TT independent of the trochlea and with respect to the tibia only...
June 13, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28614283/recurrent-patellar-instability-implications-of-preoperative-patellar-crepitation-on-the-status-of-the-patellofemoral-articular-cartilage
#11
Scott J Luhmann, June C Smith, Mario Schootman, Nandan Prasad
BACKGROUND: The purpose of the study was to quantify the frequency, severity, and location of patellofemoral (PF) articular cartilage changes recurrent patellar instability treated surgically in patients with preoperative clinical patellar crepitation. METHODS: A single-surgeon database was queried for all knees with recurrent patellar instability between 3/2000 and 6/2012 (n=214). Only knees which underwent knee arthroscopy during the surgical treatment were included (n=148)...
June 13, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28601942/anatomic-reconstruction-of-the-medial-patellofemoral-ligament-in-children-and-adolescents-using-a-pedicled-quadriceps-tendon-graft-shows-favourable-results-at-a-minimum-of-2-year-follow-up
#12
Manfred Nelitz, Jens Dreyhaupt, Sean Robert March Williams
PURPOSE: In adults, reconstruction of the medial patellofemoral ligament (MPFL) has shown good results. Treatment for recurrent patellar instability in children and adolescents with open growth plates, however, requires alternative MPFL reconstruction techniques. This study presents the outcomes of a minimally invasive technique for anatomic reconstruction of the MPFL in children using a pedicled superficial quadriceps tendon graft, hardware-free patellar graft attachment, and anatomic femoral fixation that spares the distal femoral physis...
June 10, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28585997/diagnosis-and-management-of-traumatic-patellar-instability-in-the-pediatric-patient
#13
Steven F DeFroda, Joseph A Gil, Alex Boulos, Aristides I Cruz
Instability of the patella is a common cause of knee pain and dysfunction in pediatric and adolescent patients and can be due to several factors. Although some patients will recall a specific traumatic event others may not, requiring the diagnosis to be made on the basis of physical examination and imaging. Congenital dislocation and connective tissue disorders should also be considered, even in the setting of trauma. There are radiographic parameters that may identify causes of instability such as trochlear and patellar abnormalities, and magnetic resonance imaging can identify signs of trauma such as bony edema, loose osteochondral fragments, and increased tibial tubercle-trochlear groove distance...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28580253/arthroscopic-patellar-lateral-facetectomy
#14
Marcio B Ferrari, George Sanchez, Jorge Chahla, Gilbert Moatshe, Robert F LaPrade
Isolated patellofemoral osteoarthritis is relatively prevalent, with the lateral facet of the patella being the most commonly affected portion. This pathology can be a result of a patellar maltracking syndrome, patella instability, or idiopathic degenerative changes. A thorough diagnostic work-up with a physical examination and imaging studies are mandatory for a proper diagnosis and to rule out other causes of patellofemoral knee pain. These patients are often treated nonoperatively with exercises for patella mobility, intra-articular injections, braces, patellar tracking, quadriceps balance and strength, and activity modification...
April 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28510474/increased-magnetic-resonance-imaging-signal-of-the-lateral-patellar-facet-cartilage-a-functional-marker-for-patellar-instability
#15
Anna L Falkowski, Carlo Camathias, Jon A Jacobson, Olaf Magerkurth
BACKGROUND: In the knee joint, predisposition for patellar instability can be assessed by an abnormal Insall-Salvati index, tibial tuberosity-trochlear groove (TTTG) distance, and abnormal shape of patella and trochlea. Given the complex anatomic features of the knee joint with varying positions of the patella during motion, the presence of a single or even a combination of these factors does not inevitably result in patellar instability. After trocheoplasty in patients with trochlear dysplasia, assessment of trochlear cartilage and subchondral bone is limited due to postoperative artifacts...
August 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28508959/surgical-treatment-of-patellar-instability-clinical-and-radiological-outcome-after-medial-patellofemoral-ligament-reconstruction-and-tibial-tuberosity-medialisation
#16
Stefan Lobner, Christine Krauss, Frank Reichwein, Thilo Patzer, Wolfgang Nebelung, Arne J Venjakob
INTRODUCTION: The aim of this retrospective study was to analyse clinical and radiological outcome after medial patellofemoral ligament reconstruction (MPFLR) and tibial tuberosity medialisation (TTM) in patients with recurrent patellar instability. MATERIALS AND METHODS: Thirty-five patients were included between 2008 and 2012. According to defined criteria such as tibial tuberosity-trochlear groove (TTTG) distance, hyperpression on the lateral patella facet and lateral retropatellar cartilage damage either MPFLR (group A) or TTM (group B) was performed: 18 patients underwent TTM, the other 17 patients underwent MPFLR...
May 16, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28502536/results-of-a-modular-revision-system-in-total-knee-arthroplasty
#17
David A Crawford, Keith R Berend, Michael J Morris, Joanne B Adams, Adolph V Lombardi
BACKGROUND: Revision total knee arthroplasty (TKA) poses unique challenges compared with primary TKA such as bone loss, deformity, and ligament instability. Modular component options allow flexibility to deal with these complexities. The purpose of this study was to evaluate midterm outcomes for revision TKA using a modular revision knee system with complete interchangeability and multiple options for augmentation, offset, constraint, and stem extensions. METHODS: A query of our practice registry revealed 257 consented patients (274 knees and 278 TKA) with minimum 2-year follow-up who underwent aseptic revision TKA with a modular system (Vanguard Super Stabilized Knee; Zimmer Biomet, Warsaw, IN) between 2005 and 2013...
April 10, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28463535/risk-factors-and-time-to-recurrent-ipsilateral-and-contralateral-patellar-dislocations
#18
Tyson C Christensen, Diane L Dahm, Aaron J Krych, Rohith Mohan, Ayoosh Pareek, Thomas L Sanders
BACKGROUND: Previous studies have reported variable rates of recurrent lateral patellar instability mainly because of limited cohort sizes. In addition, there is currently a lack of information on contralateral patellar instability. PURPOSE: To evaluate the rate of recurrent ipsilateral patellar dislocations and contralateral patellar dislocations after a first-time lateral patellar dislocation. Additionally, risk factors associated with recurrent dislocations (ipsilateral or contralateral) and time to recurrence were investigated...
May 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28459754/rehabilitation-after-medial-patellofemoral-ligament-reconstruction
#19
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/28459752/patellar-instability-when-is-trochleoplasty-necessary
#20
S Evan Carstensen, Heather M Menzer, David R Diduch
Trochleoplasty is a very effective procedure for correcting trochlear dysplasia and addressing instability of the patella. With an increasing knowledge about the anatomy and biomechanics of the anterior distal femur, a wider array of surgical techniques may be applied to address specific conditions. Patients must be carefully selected to undergo trochleoplasty by use of a thorough history and physical examination as well as basic and advanced imaging. The presence of a "J sign" on physical examination, a history of recurrent instability, patella alta, trochlear dysplasia, and elevated tibial tubercle to trochlear groove are signs and symptoms for which the patient should be evaluated...
June 2017: Sports Medicine and Arthroscopy Review
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