keyword
https://read.qxmd.com/read/38219109/editorial-commentary-absent-extreme-bony-malalignment-medial-patellofemoral-reconstruction-is-a-sufficient-primary-surgery-for-adolescents-with-recurrent-patella-instability
#21
EDITORIAL
Seth Lawrence Sherman, Anna Bartsch
When planning an adolescent's primary surgery for recurrent patella instability, the surgeon must weigh the failure risk of performing medial patellofemoral reconstruction (MPFLR) versus the potential morbidity of adding a concomitant bony procedure, such as tibial tubercle osteotomy (TTO). In this age group, isolated MPFLR is an excellent operation with high clinical success, low failure rates, and favorable complication profile. Patients with high grade J-sign and severe trochlea dysplasia, apprehension into deep flexion, and extremes of bony malalignment, including elevated tibial tubercle-trochlear groove distance may benefit from "doing more" than MPFLR alone...
November 19, 2023: Arthroscopy
https://read.qxmd.com/read/38219108/editorial-commentary-when-managing-patellofemoral-instability-mind-your-ps-and-qs-medial-patellofemoral-ligament-versus-medial-quadriceps-tendon-femoral-ligament-mqtfl-versus-medial-patellofemoral-complex
#22
EDITORIAL
Elizabeth Matzkin
Our understanding of patellar instability and the medial patellofemoral complex (MPFC) has evolved over the past 15 years. Despite advancements and appreciation of the anatomy and biomechanics of the MPFC, the best surgical treatment for recurrent patellar instability has yet to be determined. The goals of medial patellofemoral ligament (MPFL), medial quadriceps tendon femoral ligament (MQTFL), or MPFC reconstructions (with grafts from both the patella and quad to the femur) are to return patients back to activity and avoid complications such as recurrent instability, overconstraint, secondary arthrosis, and potential patellar fracture from surgical drill holes...
November 18, 2023: Arthroscopy
https://read.qxmd.com/read/38204932/comparison-of-failure-rates-at-long-term-follow-up-between-mpfl-repair-and-reconstruction-for-recurrent-lateral-patellar-instability
#23
JOURNAL ARTICLE
Bradley M Kruckeberg, Ryan R Wilbur, Bryant M Song, Abhinav Lamba, Christopher L Camp, Daniel B F Saris, Aaron J Krych, Michael J Stuart
BACKGROUND: The medial patellofemoral ligament (MPFL) is the primary soft tissue restraint to lateral patellar translation and is often disrupted by lateral patellar dislocation. Surgical management for recurrent patellar instability focuses on restoring the MPFL function with repair or reconstruction techniques. Recent studies have favored reconstruction over repair; however, long-term comparative studies are limited. PURPOSE: To compare long-term clinical outcomes, complications, and recurrence rates of isolated MPFL reconstruction and MPFL repair for recurrent lateral patellar instability...
January 2024: Orthopaedic Journal of Sports Medicine
https://read.qxmd.com/read/38193500/management-of-patellar-instability-in-skeletally-immature-patients
#24
REVIEW
Erdem Sahin, Reha Tandogan, Michael Liebensteiner, Guillaume Demey, Asim Kayaalp
Surgical intervention is the treatment of choice for recurrent lateral patellar instability. Surgery should be considered for first time lateral patella dislocations with osteochondral fractures or underlying anatomical risk factors. Primary repair and nonanatomical imbrications/reconstructions have fallen out of favor due to abnormal biomechanics and high rates of recurrence. Anatomical reconstruction of the MPFL using a variety of auto and allograft tissues have yielded good outcomes and low redislocation rates...
January 9, 2024: EFORT Open Reviews
https://read.qxmd.com/read/38181461/longer-term-follow-up-of-outcomes-following-implantation-of-a-modular-rotating-hinge-knee-prosthesis-53-implants-at-mean-7-6%C3%A2-year-follow-up
#25
JOURNAL ARTICLE
David Bruce, Fady Awad, Sam Jonas, Sanjeev Agarwal
BACKGROUND: Rotating hinge knee replacements are becoming more common but have historically had high complication and failure rates. This study is one of the largest to assess the implant survival and patient outcomes of a third-generation rotating hinge knee replacement at a single tertiary orthopaedic centre. METHODS: Data for consecutive operations at our tertiary unit between 2006 to 2020 were assessed with review of electronic patient and radiology records...
January 4, 2024: Knee
https://read.qxmd.com/read/38164681/osteochondritis-dissecans-of-the-knee-associated-with-mechanical-overload
#26
JOURNAL ARTICLE
Goran S van der Weiden, Stijn van Cruchten, Nienke van Egmond, Simon C Mastbergen, Martin Husen, Daniël B F Saris, Roel J H Custers
BACKGROUND: Osteochondritis dissecans (OCD) of the knee is a rare but potentially incapacitating disorder in which subchondral bone detaches, leading to an osteochondral fragment that can become unstable and progress into a loose body. The exact cause is unknown, although several biological and mechanical factors have been described. PURPOSE: To provide insight into epidemiological data of a large cohort of patients affected by OCD of the knee and to identify potential factors contributing to the cause of this disorder...
January 2024: American Journal of Sports Medicine
https://read.qxmd.com/read/38134295/bilateral-patellofemoral-ligament-reconstruction-for-patellar-instability-in-ehlers-danlos-syndrome-a-case-report
#27
JOURNAL ARTICLE
Masanori Wako, Jiro Ichikawa, Kensuke Koyama, Taro Fujimaki, Tetsuo Hagino, Hirotaka Haro
CASE: We report the case of an 11-year-old boy with Ehlers-Danlos syndrome (EDC) who exhibited simultaneous medial and lateral patellar instability. The patient presented with a medial patellar dislocation, and subsequently, the patella became very unstable both medially and laterally. Despite distal realignment, the patellar instability was so significant that he underwent simultaneous reconstruction of the medial and lateral patellofemoral ligament using the semitendinosus tendon, with a good result...
October 1, 2023: JBJS Case Connector
https://read.qxmd.com/read/38132916/the-use-of-synthetic-graft-for-mpfl-reconstruction-surgery-a-systematic-review-of-the-clinical-outcomes
#28
REVIEW
Panayiotis Tanos, Chryssa Neo, Edwin Tong, Andrea Volpin
(1) Background: Acute patella dislocation (APD) is a prevalent knee injury, with rates between 5.8-77.8 per 100,000. APD often results in repeat lateral patella dislocations due to the instability of the medial patellofemoral ligament (MPFL). Non-operative treatments have a 50% recurrence rate. While autologous grafting for MPFL has been favored, surgeons are now exploring synthetic grafts. We aimed to assess the effectiveness of synthetic grafts in MPFL reconstruction surgeries for repeated patellar dislocations; (2) Methods: Our research was based on a thorough search from the National Institute of Health and Clinical Excellence Healthcare Databases, using the Modified Coleman Methodology Score for quality assessment; (3) Results: Six studies met the inclusion criteria...
November 28, 2023: Medical Sciences: Open Access Journal
https://read.qxmd.com/read/38108315/rim-plate-fixation-for-a-rare-fracture-pattern-of-the-lateral-femoral-condyle-a-case-report
#29
JOURNAL ARTICLE
Hanrong Xu, Ding Xu, Yinjiang Lu, Jiong Lin
Osteochondral fractures of the lateral femoral condyle caused by lateral patella dislocation have been rarely reported. The AO/OTA Classification is not suitable for this uncommon injury. Comminution of the anterior cartilage surface of the lateral condyle with bone impaction is challenging to reduce and repair accurately, leading to uncertainty in joint function recovery. The treatment for this rare fracture is not commonly reported. We, herein, report a unique case where the lateral condyle osteochondral fracture occurred alongside patellar dislocation and instability of the patellofemoral joint...
December 18, 2023: Acta Orthopaedica et Traumatologica Turcica
https://read.qxmd.com/read/38106799/patellar-dislocation-masking-a-tibial-post-fracture-an-unusual-complication-of-posterior-stabilized-total-knee-arthroplasty
#30
Aditya Seth, Pranav K Buddhapuram, Arvind Kadwad, Sandeep Boddeda, Ratnakar Vecham, Adarsh Annapareddy, A V Gurava Reddy
Posterior stabilized total knee arthroplasty (TKA) has established itself as a highly effective design for total knee arthroplasty, renowned for its longevity and success. However, a subset of cases, approximately 6-12%, faces early failure, necessitating revision procedures. This case report presents a unique and previously undocumented complication involving a tibial post fracture following hyperflexion of the knee, masked by chronic patellar dislocation. This case highlights the importance of considering polyethylene wear-related failure in cases of instability without an apparent history of trauma...
November 2023: Curēus
https://read.qxmd.com/read/38098902/-knee-ding-a-diagnosis-a-case-of-nail-patella-syndrome
#31
Sosi Dzhugarian, Sevag Hamamah, Amanda Frugoli, Angelica Shepard
Nail Patella Syndrome (NPS) is a rare genetic disorder with pathognomonic signs including dystrophic fingernails, iliac horns, and limb abnormalities, which commonly include hypoplastic development of the patellae, causing patients to experience patellar instability. This resulting patellar instability increases susceptibility to recurrent subluxations or dislocations in NPS patients. Since these anatomical abnormalities are present at birth or in childhood, early recognition may prevent the need for surgical intervention if appropriate preventive measures are taken...
November 2023: Curēus
https://read.qxmd.com/read/38094964/lateral-retinacular-release-for-treatment-of-excessive-lateral-pressure-syndrome-the-capsule-uncut-immaculate-cui-technique
#32
JOURNAL ARTICLE
Li Minghao, Shao Zhenxing, Liu Qiang, Cui Guoqing
Lateral retinacular release of the patella is the main surgical treatment for excessive lateral pressure syndrome. It was first described by Merchant and Mercer in 1974. The main complications of arthroscopic lateral retinacular release are hemarthrosis and medial patellar instability. The main causes of these complications are the disturbance of the synovial membrane of the joint capsule and excessive release of the lateral retinaculum. In this article, we introduce a method for arthroscopic lateral retinacular release that maintains the overall structure of the joint capsule: capsule-uncut immaculate (CUI) lateral retinacular release...
November 2023: Arthroscopy Techniques
https://read.qxmd.com/read/38090941/treatment-of-patellofemoral-instability-and-%C3%A2-chondral-lesions
#33
JOURNAL ARTICLE
Sharif Garra, Zachary I Li, Thomas R Carter, Abigail R Hamilton, J Lee Pace, Laith M Jazrawi
Lateral patellar instability is one of the most common knee disorders among adolescents. Numerous anthropometric features, including trochlear dysplasia, patella alta, high tibial tubercle-to-trochlear groove distance, and coronal and rotational plane malalignment, are considered primary risk factors for patellar dislocation, and the understanding of their complex interplay is continuously evolving. Because of the multifactorial nature of patellar instability, there is a lack of consensus regarding many aspects of surgical intervention...
2024: Instructional Course Lectures
https://read.qxmd.com/read/38057743/anatomic-femoral-tunnel-position-in-medial-patellofemoral-ligament-reconstruction-anterior-versus-posterior
#34
JOURNAL ARTICLE
Kyoung Ho Yoon, Cheol Hee Park, Sung Hyun Hwang, Hyunjae Baek, Hee Sung Lee
BACKGROUND: This study aimed to compare the clinical and radiological outcomes of medial patellofemoral ligament reconstruction (MPFLR) between anatomic femoral tunnel positions at anterior and posterior footprints. METHODS: Fifty-seven patients who underwent MPFLR for patellofemoral instability with anterior or posterior femoral tunnels between 2014 and 2021 with at least 2 years of follow-up were retrospectively analyzed. Based on postoperative images, the femoral tunnel positions anterior to the line connecting the adductor tubercle and medial epicondyle were assigned to the anterior group, group A, and those posterior to the line to the posterior group, group P...
December 6, 2023: BMC Musculoskeletal Disorders
https://read.qxmd.com/read/38057697/the-accuracy-of-multiple-regression-models-for-predicting-the-individual-risk-of-recurrent-lateral-patellar-dislocation
#35
JOURNAL ARTICLE
Jiang Yu, Yijin Li, Kaibo Zhang, Runze Yang, Xiaolong Yang, Meng Gong, Cheng Long, Weili Fu
BACKGROUND: Recurrent lateral patellar dislocation (RLPD) poses a significant threat to patients' quality of life due to knee pain, patellofemoral cartilage damage, and potential traumatic arthritis. Predictive scoring systems have been developed to assess the risk of RLPD; however, their relative accuracy remains uncertain. PURPOSE: To investigate the accuracy of the multiple regression models to predict the individual risk of recurrent LPD. METHODS: The Patellar Instability probability calculator (PIP), Recurrent Instability of the Patella Score (RIP), and Patellar Instability Severity Score (PIS) scoring rules were measured in 171 patients with a history of patellar dislocation and 171 healthy individuals...
December 6, 2023: BMC Musculoskeletal Disorders
https://read.qxmd.com/read/38035602/a-modified-delphi-consensus-statement-on-patellar-instability-part-ii
#36
JOURNAL ARTICLE
Eoghan T Hurley, Seth L Sherman, Jorge Chahla, Safa Gursoy, Michael J Alaia, Miho J Tanaka, J L Pace, Laith M Jazrawi, Andrew J Hughes, Elizabeth A Arendt, Olufemi R Ayeni, Ashley J Bassett, Kevin F Bonner, Christopher L Camp, Kirk A Campbell, Cordelia W Carter, Michael G Ciccotti, Andrew J Cosgarea, David Dejour, Cory M Edgar, Brandon J Erickson, João Espregueira-Mendes, Jack Farr, Lutul D Farrow, Rachel M Frank, Kevin B Freedman, John P Fulkerson, Alan Getgood, Andreas H Gomoll, John A Grant, F W Gwathmey, Fares S Haddad, Laurie A Hiemstra, Betina B Hinckel, Ian Savage-Elliott, Jason L Koh, Aaron J Krych, Robert F LaPrade, Zachary I Li, Catherine A Logan, Guillem Gonzalez-Lomas, Brian J Mannino, Martin Lind, Bogdan A Matache, Elizabeth Matzkin, Bert Mandelbaum, Thomas F McCarthy, Mary Mulcahey, Volker Musahl, Philippe Neyret, Clayton W Nuelle, Sam Oussedik, Peter Verdonk, Scott A Rodeo, Fiachra E Rowan, Matthew J Salzler, Patrick C Schottel, Fintan J Shannon, Andrew J Sheean, Sabrina M Strickland, Brian R Waterman, Jocelyn R Wittstein, Michael Zacchilli, Stefano Zaffagnini
AIMS: The aim of this study was to establish consensus statements on medial patellofemoral ligament (MPFL) reconstruction, anteromedialization tibial tubercle osteotomy, trochleoplasty, and rehabilitation and return to sporting activity in patients with patellar instability, using the modified Delphi process. METHODS: This was the second part of a study dealing with these aspects of management in these patients. As in part I, a total of 60 surgeons from 11 countries contributed to the development of consensus statements based on their expertise in this area...
December 1, 2023: Bone & Joint Journal
https://read.qxmd.com/read/38035601/cementless-metal-backed-patellar-components-in-primary-total-knee-arthroplasty-using-an-implant-of-modern-design
#37
JOURNAL ARTICLE
James F Baker, Arun C Nadar, Alex C Jouflas, Langan S Smith, Shikha Sachdeva, Madhusudhan R Yakkanti, Arthur L Malkani
AIMS: The use of cementless total knee arthroplasty (TKA) components has increased during the past decade. The initial design of cementless metal-backed patellar components had shown high failure rates due to many factors. The aim of this study was to evaluate the clinical results of a second-generation cementless, metal-backed patellar component of a modern design. METHODS: This was a retrospective review of 707 primary TKAs in 590 patients from a single institution, using a cementless, metal-backed patellar component with a mean follow-up of 6...
December 1, 2023: Bone & Joint Journal
https://read.qxmd.com/read/38021800/patellar-dislocation-workup-and-decision-making
#38
REVIEW
Panagiotis V Samelis, Panagiotis Koulouvaris, Olga Savvidou, Andreas Mavrogenis, Vasileios P Samelis, Panayiotis J Papagelopoulos
Acute patellar dislocation (PD) is usually a problem of adolescents and young adults. In most cases, it is a sports-related injury. It is the result of an indirect force on the knee joint, which leads to valgus and external rotation of the tibia relative to the femur. PD is unlikely to occur on a knee with normal patellofemoral joint (PFJ) anatomy. Acute PD consists of an acute injury of the ligamentous medial patellar stabilizers in the background of factors predisposing to patellar instability. These factors are classified into three groups...
October 2023: Curēus
https://read.qxmd.com/read/38008400/stepwise-lengthening-of-quadriceps-extensor-mechanism-for-severe-obligatory-and-fixed-patella-dislocators-four-year-clinical-and-surgical-outcomes
#39
JOURNAL ARTICLE
Sofia Hidalgo Perea, Bridget K Ellsworth, Danielle E Chipman, Emilie Lijesen, Daniel W Green
OBJECTIVES: The purpose of this study was to report clinical and surgical outcomes of medial patellofemoral ligament reconstruction (MPFLR) and concomitant quadriceps lengthening to treat fixed and obligatory patellofemoral instability (PFI) in the pediatric population. METHODS: Patients with obligatory or fixed PFI who underwent simultaneous MPFLR and quadriceps lengthening from 2008 to 2020 were reviewed. Of the 413 records, 24 fit the inclusion criteria. Demographic information, surgical details, associated diagnoses, and outcome measures were collected for each knee...
November 24, 2023: Journal of ISAKOS
https://read.qxmd.com/read/38003061/tibial-plateau-leveling-osteotomy-following-tibial-tuberosity-advancement-cage-removal-a-case-report
#40
Yauheni Zhalniarovich, Marta Mieszkowska, Magdalena Morawska-Kozłowska
The purpose of this case report is to describe the functional and clinical outcome of a tibial plateau leveling osteotomy (TPLO) in a dog with joint instability and persistent lameness following a Tibial Tuberosity Advancement surgery (TTA) Rapid. A six-year-old male Labrador retriever (38 kg) with a tibial plateau angle of 27° and a patella ligament to tibial plateau angle of 102° and persistent lameness lasting six months after TTA Rapid surgery has been examined. During orthopedic examination, the lameness was subjectively graded 3/5 and the positive drawer and tibial compression tests were performed...
November 8, 2023: Animals: An Open Access Journal From MDPI
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