keyword
https://read.qxmd.com/read/38488903/incidence-of-patella-baja-and-pseudopatella-baja-in-aseptic-revision-total-knee-arthroplasty
#1
JOURNAL ARTICLE
Dimitrios A Flevas, Marco Brenneis, Allina Nocon, Ioannis Gkiatas, Wali Pirzada, Georgios Tsakotos, Peter K Sculco
INTRODUCTION: There are two variants regarding the low location of the patella in relation to the tibio-femoral joint line: patella baja (PB) and pseudo-patella baja (PPB). The purpose of this study is to investigate the incidence of PB and PPB in a cohort of patients that underwent revision total knee arthroplasty (rTKA) for aseptic reasons and describe any differences in each group's ROM. METHODS: This retrospective study included 114 patients that underwent aseptic revision TKA surgery between 2017 and 2022...
March 15, 2024: Archives of Orthopaedic and Trauma Surgery
https://read.qxmd.com/read/38484922/diverse-factors-affect-measurement-of-patella-alta-trochlear-morphology-and-sagittal-knee-balance-represent-defining-factors-of-patellofemoral-stability
#2
EDITORIAL
Miho J Tanaka
Patella alta is a known risk factor for patellar instability,contributes to increased length changes of the medial patellofemoral complex (MPFC), and is associated with high rates of failure of MPFC reconstruction. Distalization through tibial tuberosity osteotomy (TTO) is a surgical option to address patella alta during patellar stabilization surgery. However, distalization has been shown to have greater complications than other types of TTO, and precise indications through proper assessments of patellar height are needed...
March 12, 2024: Arthroscopy
https://read.qxmd.com/read/38483571/-radiological-diagnostics-of-patellofemoral-instability-and-patellar-dislocation
#3
REVIEW
Sonja Schuldes, Carsten Hackenbroch
Patellofemoral instability (PFI) describes a (sub)luxation of the patella in the patellofemoral joint. Pathophysiologically, PFI is usually due to a nonphysiological movement of the patella, so-called maltracking, either due to acute trauma with injury to the supporting ligamentous apparatus or due to the presence of anatomical risk factors. Radiologically assessable risk factors for maltracking include trochlear dysplasia, patella alta, patellar tilt, lateralization of the tibial tuberosity, torsional deformity and genu valgum...
March 14, 2024: Radiologie (Heidelb)
https://read.qxmd.com/read/38425828/surgical-technique-for-lateral-patellofemoral-ligament-reconstruction-using-bone-tunnels-a-new-method
#4
JOURNAL ARTICLE
M Arora, T Shukla, P M Rathod
Medial patellar instability (lateral patellofemoral ligament tear) is a rare condition which is commonly associated with lateral release for lateral patellar instability. LPFL is a lateral stabilizer of the patellofemoral joint. Reconstruction of LPFL is necessary to provide stability to the patella-femoral joint in patients with instability. We describe a novel technique of trans-osseous reconstruction of LPFL to gain stability and have better graft incorporation. A doubled peroneus longus graft is inserted into the patellar tunnel and secured with an endo button on the anteromedial aspect of the patella; the other end is then inserted into the insertional point on the femur and secured with an interference screw...
March 2024: Indian Journal of Orthopaedics
https://read.qxmd.com/read/38420044/anatomic-risk-factors-for-patellofemoral-joint-instability-an-infographic-as-a-visual-learning-tool
#5
EDITORIAL
Angelo V Vasiliadis, Theodore Troupis, Dimosthenis Chrysikos, Dimitrios Chytas, George Noussios
Patellofemoral instability is a complex pathology with multiple risk factors, which affects mostly young females and may avert them from both activities of daily living and sports participation. Risk factors for instability include patella alta, trochlea dysplasia, abnormal lateral patellar tilt, and increased tibial tuberosity-trochlea groove distance. The knowledge of these anatomical abnormalities is the key to identifying the problem and succeeding in treating the patients.
January 2024: Curēus
https://read.qxmd.com/read/38371997/decreased-effective-patellar-tendon-length-following-distalization-tibial-tubercle-osteotomy-without-patellar-tendon-tenodesis
#6
JOURNAL ARTICLE
Tyler J Uppstrom, Connor F Fletcher, Daniel W Green, Andreas H Gomoll, Sabrina M Strickland
BACKGROUND: Distalization tibial tubercle osteotomy (TTO) is an effective treatment for improving patellar height in patients with patella alta associated with patellofemoral instability and cartilage lesions. The addition of a patellar tendon tenodesis has been suggested; nonetheless, concerns exist regarding possible increased patellofemoral cartilage stresses. PURPOSE: To evaluate pre- and postoperative patellar tendon length and alignment parameters on magnetic resonance imaging (MRI), as well as patient-reported outcome measures (PROMs) after distalization TTO without patellar tendon tenodesis...
February 2024: Orthopaedic Journal of Sports Medicine
https://read.qxmd.com/read/38368533/development-of-patellofemoral-osteoarthritis-with-knee-joint-malalignment-and-lateral-patellar-dislocation-after-hindlimb-suspension-in-growing-rats
#7
JOURNAL ARTICLE
Junya Ozawa, Airi Ikeda, Marina Kanehara, Hideki Moriyama, Akinori Kaneguchi
Knee malalignment is a risk factor for patellar instability and patellofemoral osteoarthritis (PFOA), but etiologies remain unknown. We investigated the potential effects of decreased weight loading during growth on knee alignments and patellofemoral (PF) joint pathology. Hindlimb suspension (HS) was performed in 4-week-old female rats for 2, 4, and 8 weeks (HS groups). Age-matched rats were used as controls. Three-dimensional reconstructed images of the knee were obtained using X-ray computed tomography. Tibial tubercle-trochlear groove (TT-TG) distance, patellar tilt angle, and bisect offset were measured as indices of knee alignment...
February 18, 2024: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://read.qxmd.com/read/38365902/superolateral-hoffa-fat-pad-edema-in-adolescent-competitive-alpine-skiers-temporal-evolution-over-4%C3%A2-years-and-risk-factors
#8
JOURNAL ARTICLE
Georg C Feuerriegel, Adrian A Marth, Stefan Fröhlich, Johannes Scherr, Jörg Spörri, Reto Sutter
OBJECTIVES: To longitudinally assess and correlate the prevalence of superolateral Hoffa fat pad (SHFP) edema with changes in features of the knee extensor mechanism in adolescent competitive alpine skiers over 48 months. METHODS: Competitive alpine skiers were prospectively enrolled in 2018 and underwent bilateral knee MRI at baseline and after 48 months. MRI was assessed for the prevalence of SHFP edema. Features of the knee extensor mechanism were assessed by measuring the trochlear sulcus angle and depth, lateral and medial trochlear inclination, trochlear angle, patella tilt, Insall‒Salvati ratio (ISR), and patellar ligament to lateral trochlear facet (PL-T) distance...
February 16, 2024: Insights Into Imaging
https://read.qxmd.com/read/38365167/femoral-internal-torsion-greater-than-twenty-five-degrees-and-or-external-tibial-torsion-greater-than-thirty-degrees-as-measured-by-computed-tomography-are-threshold-values-for-axial-alignment-correction-in-patellofemoral-instability
#9
REVIEW
Kristen I Barton, Kevin R Boldt, Olawale A Sogbein, Nicholas J Steiner, Gilbert Moatshe, Elizabeth Arendt, Alan Getgood
OBJECTIVES: Patellofemoral instability (PFI) has multiple predisposing anatomic factors including ligamentous hyperlaxity, coronal and axial malalignment, patella alta, trochlea dysplasia, excessive lateral patellar tilt, and excessive lateral Q vector. Yet, few studies have analyzed surgical thresholds for performing axial alignment corrective osteotomies in the treatment of PFI and patella maltracking. The objective of this systematic literature review was to determine if there is a threshold for axial plane alignment that triggers surgical correction for treatment of patellar instability in the published literature...
February 14, 2024: Journal of ISAKOS
https://read.qxmd.com/read/38361079/patella-height-measurements-in-patients-with-patellofemoral-instability-the-power-to-predict-patella-height-indices
#10
JOURNAL ARTICLE
Stephen Picken, Harry Summers, Oday Al-Dadah
INTRODUCTION: Numerous indices for patella height measurement are described in the literature; however, there is not a universally accepted 'gold standard'. Choice of indices varies depending on personal preference and previous experience, making it difficult to compare results between studies. The aims of this study were to assess the correlation between different patella height indices and generate statistically derived formulae that can be used to predict the value of one patella height ratio when another is known...
February 15, 2024: Archives of Orthopaedic and Trauma Surgery
https://read.qxmd.com/read/38349070/clinical-and-radiological-outcomes-after-combined-acl-and-mpfl-reconstruction-versus-isolated-acl-reconstruction-for-acl-injury-with-patellar-instability
#11
JOURNAL ARTICLE
Xiulin Wu, Jiebo Chen, Zipeng Ye, Shikui Dong, Guoming Xie, Song Zhao, Caiqi Xu, Ziyun Li, Junjie Xu, Jinzhong Zhao
BACKGROUND: An anterior cruciate ligament (ACL) injury accompanied by patellar instability (PI) is a topic that has gained orthopaedic surgeons' attention recently. Untreated PI is reportedly associated with worse clinical outcomes after isolated ACL reconstruction (ACLR) in patients after an ACL injury with PI. Nevertheless, the appropriate surgical approach and its long-term therapeutic effects in these patients remain unclear. PURPOSE: (1) To compare the clinical and radiological outcomes between isolated ACLR (iACLR) and combined ACLR and medial patellofemoral ligament reconstruction (cAMR) in patients after an ACL injury with PI and (2) to explore the correlations between these 2 procedures and clinical and radiological outcomes...
February 13, 2024: American Journal of Sports Medicine
https://read.qxmd.com/read/38340969/no-correlation-exists-between-tibial-and-femoral-based-measurements-of-patella-alta-in-a-population-with-chronic-patellofemoral-pain-or-instability-undergoing-patella-distalisation
#12
JOURNAL ARTICLE
Martyn Snow, Nishant Singh, Larissa Rix, Mohammad Haikal
PURPOSE: To investigate if Patellotrochlear index (PTI) predicts patella alta as determined by tibial based methods of Insall Salvati (IS) and Caton Deschamp (CD) in a pathological population (with patellofemoral pain and/or instability). In addition to determining if PTI and Sagittal Patellofemoral engagement (SPE) correlate with trochlea length as determined by Lateral condyle index (LCI). METHODS: Patients with confirmed patella alta (IS/CD ratio > 1.2) undergoing tibial tubercle osteotomy for patellofemoral pain/instability with an available MRI were included...
February 8, 2024: Arthroscopy
https://read.qxmd.com/read/38336307/the-fate-of-unresurfaced-patellae-in-contemporary-total-knee-arthroplasty-early-to-mid-term-results
#13
JOURNAL ARTICLE
Zachary J Gunderson, Taylor G Luster, Evan R Deckard, R Michael Meneghini
BACKGROUND: Leaving the patella unresurfaced in total knee arthroplasty (TKA) has increased significantly over the past decade in the United States, likely due to modern patella-friendly implants, complications with resurfacing, and the knowledge that historical studies were scientifically confounded. This study evaluated revision-free survivorship out to 8.5 years in a cohort of contemporary primary TKAs with patella-friendly femoral components and unresurfaced patellae. METHODS: A total of 1,053 consecutive primary TKAs with unresurfaced patellae were retrospectively reviewed...
February 7, 2024: Journal of Arthroplasty
https://read.qxmd.com/read/38320970/adipocytes-in-synovial-fluid-cytology-an-approach-for-diagnosing-synovial-lipomatosis
#14
Beatriz Agulla, Nùria Vizcaíno, Roser Velarde, Josep Estruch, Elisabet Domínguez, Josep Pastor
A 2-year-old neutered male bullmastiff dog was presented with chronic left hind limb lameness. Physical examination revealed left stifle effusion and medial buttress without cranial tibial thrust. Radiographs showed joint effusion and new bone formation at the patella apex. Magnetic resonance imaging showed increased synovial fluid, widening of the joint space, abnormal infrapatellar fat body and thinning of the cranial cruciate ligament. Synoviocentesis and cytologic evaluation of synovial fluid revealed marked mononuclear inflammation with abundant fatty tissue, suggesting synovial lipomatosis in conjunction with the imaging findings...
February 6, 2024: Veterinary Clinical Pathology
https://read.qxmd.com/read/38314751/patellar-tilt-congruence-angle-and-tibial-tubercle-trochlear-groove-distance-are-correlated-with-positive-j-sign-in-adolescents
#15
JOURNAL ARTICLE
Si Heng Sharon Tan, Yiu Tsun Kwan, Joel Zhao Jie Lee, Lincoln Kai Pheng Yeo, Andrew Kean Seng Lim, James Hoipo Hui
PURPOSE: The J-sign is a clinical evaluation tool that assesses for patellar maltracking and is considered positive if lateral translation of the patella in extension, in the pattern of an inverted J is observed. This study aims to determine the association of clinical J-sign with imaging features noted on dynamic kinematic computed tomography (DKCT). METHODS: A retrospective review was conducted by reviewing the clinical records of all patients aged 18 years or younger who had a CT patellar tracking scan done between 1 January 2005 to 31 December 2016 in a single institution...
February 5, 2024: Physician and Sportsmedicine
https://read.qxmd.com/read/38313861/no-difference-in-pullout-strength-between-a-bio-inductive-implant-and-a-semitendinosus-tendon-graft-in-a-biomechanical-study-of-medial-patellofemoral-ligament-repair-augmentation
#16
JOURNAL ARTICLE
Austin Wetzler, Sean McMillan, Erik Brewer, Aakash Patel, Samuel Handy, Merrick Wetzler
PURPOSE: To compare the pullout strength of a bio-inductive implant (BI) used to augment a medial patellofemoral ligament (MPFL) repair with the pullout strength of semitendinosus graft in a biomechanical cadaveric model. METHODS: Six matched pairs of cadavers (12 knees) were used in the biomechanical testing comparing semitendinosus tendon (Semi-T) versus a BI. The Semi-T was harvested from 1 of the matched pairs. A standard double-bundle technique using 2 sockets in the upper two-thirds of the patella 15 mm apart was performed...
February 2024: Arthroscopy, sports medicine, and rehabilitation
https://read.qxmd.com/read/38270286/tibial-tuberosity-trochlear-groove-distance-is-significantly-decreased-by-medial-closing-wedge-distal-femoral-osteotomy
#17
JOURNAL ARTICLE
Julius Watrinet, Maximilian Joergens, Philipp Blum, Yannick Ehmann, Peter Augat, Fabian Stuby, Steffen Schröter, Joerg Harrer, Julian Fürmetz
PURPOSE: While medial closing wedge distal femoral osteotomy (MCWDFO) has been used to address patella instability combined with valgus malalignment, its impact on patellofemoral parameters remains uncharted. Hence, this study seeks to establish a three-dimensional (3D) planning of MCWDFO and measure its effect on the tibial tubercle - trochlear groove distance (TTTG) through simulation and calculation. METHODS: MCWDFO with a stepwise increment of one-degree varisation (1°-15°) was performed on 3D surface models of 14 lower extremities with valgus malalignment and 24 lower extremities with neutral alignment of the lower limb, resulting in a total of 608 simulations...
January 25, 2024: Knee Surgery, Sports Traumatology, Arthroscopy
https://read.qxmd.com/read/38247939/differences-in-trochlear-morphology-of-a-new-femoral-component-designed-for-kinematic-alignment-from-a-mechanical-alignment-design
#18
JOURNAL ARTICLE
Maury L Hull, Alexander Simileysky, Stephen M Howell
Because kinematic alignment (KA) aligns femoral components in greater valgus and with less external rotation than mechanical alignment (MA), the trochlear groove of an MA design used in KA is medialized, which can lead to complications. Hence, a KA design has emerged. In this study, our primary objective was to quantify differences in trochlear morphology between the KA design and the MA design from which the KA design evolved. The KA and MA designs were aligned in KA on ten 3D femur-cartilage models. Dependent variables describing the morphology of the trochlea along the anterior flange, which extends proximal to the native trochlea, and along the arc length of the native trochlea, were determined, as was flange coverage...
January 8, 2024: Bioengineering
https://read.qxmd.com/read/38246491/mpfl-reconstruction-with-proximal-rather-than-distal-femoral-tunnel-position-leads-to-less-favorable-short-term-results
#19
JOURNAL ARTICLE
Kyoung Ho Yoon, Bi O Jeong, Sung Hyun Hwang, Jin Hyung Kim, Yoon Seok Kim, Hee Sung Lee
BACKGROUND: This study aimed to compare the clinical and radiological outcomes of medial patellofemoral ligament (MPFL) reconstruction (MPFLR) between anatomic femoral tunnel positions: proximal (near adductor tubercle [AT]) and distal (near medial epicondyle [ME]). HYPOTHESIS: MPFLR with the proximal femoral tunnel position has worse clinical and radiological outcomes than those with the distal femoral tunnel position. PATIENTS AND METHODS: Fifty-five patients who underwent isolated MPFLR with proximal or distal femoral tunnels with at least 2 years of follow-up were retrospectively analyzed...
January 19, 2024: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://read.qxmd.com/read/38226056/grade-iii-distal-medial-collateral-ligament-rupture-co-existing-with-transient-lateral-patellar-dislocation
#20
Ruhaid Khurram, Rashed Al-Khudairi, Thomas M Armstrong
Lateral patellar dislocations are the second most common type of traumatic knee injury, accounting for approximately 2-3% of cases, the most common being anterior cruciate ligament (ACL) injury. There are several well-documented anatomical risk factors predisposing to patellofemoral instability for example: patella alta, trochlear dysplasia, ligamentous laxity, and genu valgum. Co-existing medial collateral ligament injury in cases of patellar dislocations in the absence of ACL injury is uncommon and infrequently reported in the literature...
March 2024: Radiology Case Reports
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