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patella instability

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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/29349031/modified-elmslie-trillat-procedure-for-distal-realignment-of-patella-tendon
#2
Ricardo Bastos Filho, Alberto Monteiro, Renato Andrade, M J S Fredrick Michael, Nuno Sevivas, Bruno Pereira, André Sarmento, João Espregueira-Mendes
Patellofemoral dysfunction, due to either a patellofemoral malalignment or patellar instability, is a complex and debilitating condition that significantly decreases the knee function. Conservative management may yield significant clinical outcomes; however, when morphologic anomalies are identified, the surgical approach should be employed. Hence, several surgical procedures have been described in the scientific literature aiming the correction of underlying extensor mechanism malalignments. Still, the rate of complications is higher than desirable...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349001/medial-closing-wedge-distal-femoral-osteotomy-with-medial-patellofemoral-ligament-imbrication-for-genu-valgum-with-lateral-patellar-instability
#3
Orlando D Sabbag, Jarret M Woodmass, Isabella T Wu, Aaron J Krych, Michael J Stuart
A varus-producing distal femoral osteotomy (DFO) is an effective technique for the treatment of lateral patellar instability (LPI) in patients with concomitant moderate to severe valgus malalignment. Patellar maltracking and subluxation are corrected via neutralization of some of the laterally directed forces on the patella due to the valgus deformity. This can be accomplished with a distal femoral lateral opening-wedge or medial closing-wedge osteotomy and medial soft tissue stabilization. A medial closing-wedge osteotomy offers the advantages of immediate weight bearing and a single incision in cases requiring patellofemoral soft tissue stabilization...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29327545/-study-on-therapeutic-effects-of-arthroscopic-repair-on-medial-patellar-retinaculum-acute-injury
#4
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
#5
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/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/29284175/surgical-management-of-simultaneous-anterior-cruciate-ligament-and-patellar-tendon-ruptures-a-systematic-review
#9
Carlos J Meheux, Robert A Jack, Patrick C McCulloch, David M Lintner, Joshua D Harris
This study performs a systematic review to determine (1) if a significant difference exists in return to preinjury activity level between one- and two-stage treatment of combined anterior cruciate ligament (ACL) and patellar tendon (PT) tears; and (2) if a significant difference exists in the number of postoperative complications between the two differing surgical treatment approaches. A systematic review was performed using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and registered on PROSPERO...
December 28, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29273250/clinical-utility-of-continuous-radial-magnetic-resonance-imaging-acquisition-at-3%C3%A2-t-in-real-time-patellofemoral-kinematic-assessment-a-feasibility-study
#10
Christopher J Burke, Daniel Kaplan, Tobias Block, Gregory Chang, Laith Jazrawi, Kirk Campbell, Michael Alaia
PURPOSE: To compare patellar instability with magnetic resonance imaging analysis using continuous real-time radial gradient-echo (GRE) imaging in the assessment of symptomatic patients and asymptomatic subjects. METHODS: Symptomatic patients with suspected patellofemoral maltracking and asymptomatic volunteers were scanned in real time by a radial 2-dimensional GRE sequence at 3 T in axial orientation at the patella level through a range of flexion-extension. The degree of lateral maltracking, as well as the associated tibial tubercle-trochlear groove distance and trochlea depth, was measured...
December 19, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29239536/-patellar-instability-diagnosis-and-treatment
#11
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/29230426/lateral-patellofemoral-ligament-an-anatomic-study
#12
Kalpit N Shah, Steven F DeFroda, James Kristopher Ware, Sarath C Koruprolu, Brett D Owens
Background: Medial instability of the patellofemoral joint is a rare but known phenomenon that may result from an incompetent lateral patellofemoral ligament (LPFL). Surgical reconstruction of the LPFL has been described. However, anatomic details of the ligament have not been the subject of scrutiny. Purpose: To describe the anatomic origin and insertion of the LPFL. Study Design: Descriptive laboratory study. Methods: Ten fresh-frozen, unpaired human cadaveric knees (mean age, 57 years) were dissected to identify the LPFL...
December 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29226423/patellar-tendinopathy-with-intra-tendinous-alteration-on-mri-may-be-related-to-patellofemoral-dysplasia
#13
Philippe M Tscholl, Roland M Biedert, Florian Wanivenhaus, Sandro F Fucentese
Patellar tendinopathy (PT) is a frequent overuse-injury of the extensor knee apparatus whereas as up to 30% of the athletes might suffer from persisting symptoms during their entire career. In the present case-control study, 47 patients (30.8±11.4 years) with PT with intra-tendinous alteration (PTita) of a minimum of ≥ 25% of the axial surface on MRI and minimum Blazina score of II (pain during without limiting sports activity) were included; MR images were analysed for trochlear geometry, patellar height/tilt, and tibial tubercle trochlear groove distance (TT-TG)...
December 11, 2017: Scandinavian Journal of Medicine & Science in Sports
https://www.readbyqxmd.com/read/29195849/cementless-posteriorly-stabilized-total-knee-arthroplasty-seven-year-minimum-follow-up-report
#14
Steven F Harwin, Jay M Levin, Anton Khlopas, Prem N Ramkumar, Nicolas S Piuzzi, Martin Roche, Michael A Mont
BACKGROUND: The purpose of this study is to evaluate (1) implant survivorship; (2) patient outcomes; (3) complications; and to (4) perform a radiographic analysis of cementless posteriorly stabilized total knee arthroplasty (TKA) patients at a minimum of 7-year follow-up. METHODS: Our original cohort was composed of 114 consecutive cementless posteriorly stabilized total knee arthroplasties (110 patients) performed by a single surgeon between 2008 and 2010. Since our original report, 4 (1 bilateral) patients died and 2 were lost to follow-up...
November 16, 2017: Journal of Arthroplasty
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
#15
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
#16
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/29134368/-patellofemoral-instability
#17
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/29128875/allowing-one-quadrant-of-patellar-lateral-translation-during-medial-patellofemoral-ligament-reconstruction-successfully-limits-maltracking-without-overconstraining-the-patella
#18
John J Elias, Kerwyn C Jones, Molly K Lalonde, Joseph N Gabra, S Cyrus Rezvanifar, Andrew J Cosgarea
PURPOSE: Graft tensioning during medial patellofemoral ligament (MPFL) reconstruction typically allows for lateral patellar translation within the trochlear groove. Computational simulation was performed to relate the allowed patellar translation to patellofemoral kinematics and contact pressures. METHODS: Multibody dynamic simulation models were developed to represent nine knees with patellar instability. Dual limb squatting was simulated representing the pre-operative condition and simulated MPFL reconstruction...
November 11, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29100777/anisometry-of-medial-patellofemoral-ligament-reconstruction-in-the-setting-of-increased-tibial-tubercle-trochlear-groove-distance-and-patella-alta
#19
Lauren H Redler, Kathleen N Meyers, Jacqueline M Brady, Elizabeth R Dennis, Joseph T Nguyen, Beth E Shubin Stein
PURPOSE: To assess the impact elevated tibial tubercle-trochlear groove (TT-TG) distance and patella height, as measured by the Caton-Deschamps Index (CDI), have on the isometry of a reconstructed medial patellofemoral ligament (MPFL). METHODS: Nine fresh-frozen cadaveric knees were placed on a custom testing fixture, with a fixed femur and a mobile tibia. A suture fixed to the MPFL origin on the patella and free to move at the Schöttle point on the femur represented a reconstructed MPFL...
October 31, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29099881/patella-alta-sees-you-do-you-see-it
#20
Robert A Magnussen
Numerous anatomic factors have been shown to contribute to patellar instability. Patellar height remains a critical, yet underappreciated contributor to instability that is amenable to surgical correction through the performance of a tibial tubercle distalization osteotomy (TTDO). The indications for a distalizing tibial tubercle osteotomy are not completely clear and depend on multiple factors. One must consider patient factors and physical examination findings in addition to radiographic measures. In general, the addition of a TTDO to medial patellofemoral ligament reconstruction should be considered when the degree of patella alta exceeds a Caton-Deschamps Index (CDI) of 1...
September 2017: American Journal of Orthopedics
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