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BMC Musculoskelet Disord 2021 May 10;22(1):430. Epub 2021 May 10.

Department of Orthopaedic Surgery, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-Gu, Gyeongki-do, Ansan-si, 15355, Republic of Korea.

Background: Few studies have reported the clinical outcomes of the medial reefing procedure and lateral release with arthroscopic control of medial retinacular tension in patients with recurrent patellar dislocation. The purpose of this study was to investigate the clinical, radiologic outcomes and complications of arthroscopy-controlled medial reefing and lateral release.

Methods: Patients who underwent arthroscopy-controlled medial reefing and lateral release for recurrent patellar dislocation between November 2007 and June 2017 were retrospectively evaluated. Read More

J Orthop Surg Res 2021 May 7;16(1):299. Epub 2021 May 7.

Department of Orthopedics, Fujian Provincial Hospital, Fuzhou, 350000, China.

Objective: To analyze the effect of sacrificing the posterior cruciate ligament (PCL) on the early postoperative outcome of cruciate retaining (CR) highly congruent rotating platform TKA.

Methods: From May 2018 to September 2019, 105 cases of total knee arthroplasty (TKA) with CR highly congruent rotating platform prosthesis were retrospectively analyzed. According to the tension of posterior cruciate ligament, they were divided into sacrifice group (29 cases, 27. Read More

Arthroscopy 2021 May 4. Epub 2021 May 4.

Department of Surgery, Division of Orthopaedic Surgery, McMaster University, Hamilton, ON, Canada. Electronic address:

Purpose: The purpose of this systematic review is to ascertain the reported clinical outcomes and complication profiles of medial patellofemoral ligament (MPFL) reconstruction performed using a superficial "swing-down" quadriceps tendon autograft.

Methods: Three databases (PubMed, EMBASE, and MEDLINE) were searched from January 1, 2000 to April 06, 2020. Keywords used in the search included: "medial patellofemoral ligament" and "reconstruction". Read More

Acta Chir Orthop Traumatol Cech 2021 ;88(2):107-116

Klinika ortopedie a traumatologie pohybového ústrojí a Lékařské fakulty Univerzity Karlovy a Fakultní nemocnice, Plzeň.

PURPOSE OF THE STUDY Acute knee dislocation is a less common injury of the knee joint. It is, however, a serious injury with a high rate of nerve and vascular damage and it is considered a limb threatening injury with long-term functional disability, which can ultimately lead to amputation. Knee dislocations constitute less than 0. Read More

Unfallchirurg 2021 May;124(5):391-406

Klinik für Orthopädie, Unfallchirurgie und Sporttraumatologie, Marienhaus Klinikum Hetzelstift, Stiftstraße 10, 67435, Neustadt an der Weinstraße, Deutschland.

Joint dislocations are always accompanied by rupture of the joint capsule. Depending on the forces exerted on the joint as well as individual bone quality, fractures (dislocation fractures) and injuries to ligaments occur. As blood vessels and nerves can also be damaged, reduction is an urgent measure. Read More

Orthop J Sports Med 2021 Apr 12;9(4):2325967121995803. Epub 2021 Apr 12.

Medical School of Chinese PLA, Beijing, China.

Background: Medial patellofemoral ligament reconstruction (MPFLR) is widely used to treat patellofemoral instability. However, it is still unclear when a concomitant bony procedure is needed.

Purpose: To evaluate the therapeutic efficacy of isolated MPFLR for recurrent patellar lateral dislocation and to identify the prognostic factors for clinical outcomes. Read More

Orthopade 2021 May 4. Epub 2021 May 4.

Dept. für Orthopädie und Traumatologie, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich.

The aim of the intervention presented is a distalization of the tibial tuberosity. It is indicated in patients with symptomatic patella alta, i.e. Read More

Clin Orthop Relat Res 2021 May 4. Epub 2021 May 4.

R. C. Schenck Jr, Department of Orthopaedics & Rehabilitation, The University of New Mexico Health Sciences Center, Albuquerque, NM, USA.

J Orthop Res 2021 Apr 29. Epub 2021 Apr 29.

Center for Orthopaedic Biomechanics, University of Denver, Denver, Colorado, USA.

Dislocation remains the leading indication for revision of total hip arthroplasty (THA). The objective of this study was to use a computational model to compare the overall resistance to both anterior and posterior dislocation for the available THA constructs commonly considered by surgeons attempting to produce a stable joint. Patient-specific musculoskeletal models of THA patients performing activities consistent with anterior and posterior dislocation were developed to calculate joint contact forces and joint positions used for simulations of dislocation in a finite element model of the implanted hip that included an experimentally calibrated hip capsule representation. Read More

Am J Sports Med 2021 Apr 29:3635465211003342. Epub 2021 Apr 29.

Department of Orthopaedics, Rush University Medical Center, Chicago, Illinois, USA.

Background: Medial patellofemoral ligament (MPFL) reconstruction is a common surgical treatment for patients with recurrent patellar instability. A variety of risk factors, such as age, trochlear dysplasia, patella alta, and increased tibial tubercle-trochlear groove (TT-TG) distance, have been identified and may lead to postoperative failure or poor outcomes.

Purpose: While a large number of risk factors have been identified, significant heterogeneity exists in evaluating and reporting these risk factors in the literature. Read More

Orthop J Sports Med 2021 Apr 13;9(4):2325967121991110. Epub 2021 Apr 13.

Investigation performed at Hospital for Special Surgery, New York, New York, USA and Cincinnati Children's Hospital, Cincinnati, Ohio, USA.

Background: Surgical decision making and preoperative planning for children and adolescents with patellofemoral instability rely heavily on a patient's skeletal maturity. To be clinically useful, radiologic assessments of skeletal maturity must demonstrate acceptable interrater reliability and accuracy.

Purpose: The purpose of this study was to examine the interrater reliability among surgeons of varying experience levels and specialty training backgrounds when evaluating the skeletal maturity of the distal femur and proximal tibia of children and adolescents with patellofemoral instability. Read More

Indian J Orthop 2021 Apr 27;55(2):392-396. Epub 2020 Apr 27.

Indian Army Classified Specialist Orthopaedics, New Delhi, India.

Aim: Habitual dislocation of patella is an uncommon pathological condition. Though numerous techniques have been described in the literature for the treatment of patellar dislocations, none of the single procedure is fully effective in the surgical treatment of habitual dislocation of patella. We described our experience with a two in one procedure for habitual dislocation of patella in ten children. Read More

BMJ Case Rep 2021 Apr 26;14(4). Epub 2021 Apr 26.

Department of Trauma & Orthopaedic Surgery, University Hospital Galway, HSE West, Galway, Ireland.

Asian J Surg 2021 Apr 23. Epub 2021 Apr 23.

Department of Orthopaedic Surgery the Affiliated Hospital of Southwest Medical University Luzhou, China. Electronic address:

Recurrent patellar dislocation (RPD) is multifactorial disease, and excessive femoral internal torsion has been considered as an important risk factor for recurrence of patellar dislocation and graft failure after surgery 1 . Satisfactory clinical outcomes depend on correcting of the pathologic abnormalities around the patellofemoral joint and torsional deformity of the lower extremity. At present, conventional isolated medial patellofemoral ligament (MPFL) reconstruction without addressing excessive femoral internal torsion may lead to MPFL graft failure 2,3 , because increased femoral internal torsion can significantly increase a persistently lateralizing force on the patella 4 . Read More

J Pediatr Orthop 2021 Apr 23. Epub 2021 Apr 23.

Department of Orthopedic Surgery, Nationwide Children's Hospital, Columbus, OH.

Purpose: Recurrent instability following a lateral patellar dislocation is a common indication for surgical intervention. Several surgical procedures are described in the literature to address recurrent patellar instability. Medial patellofemoral ligament (MPFL) reconstruction utilizing the quadriceps turndown technique attempts to restore medial stability. Read More

J Emerg Trauma Shock 2020 Oct-Dec;13(4):309-311. Epub 2020 Dec 7.

Department of Orthopedics, AIIMS, Bhubaneswar, Odisha, India.

Ipsilateral hip and knee dislocation (double blow) occurring simultaneously during trauma are rare occurrences that are associated with secondary complications. These are high energy injuries that warrant acute emergency management more so if associated with vascular compromise. We encountered a poly trauma patient having a combined right anterior hip and ipsilateral knee dislocation with vascular occlusion at popliteus level apart from associated segmental radius fracture of the left upper limb. Read More

J ISAKOS 2021 Apr 23. Epub 2021 Apr 23.

Department of Orthopaedics, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia.

Objectives: Recurrent patellar dislocation (RPD) is found most commonly in the juvenile population. While risk factors have been well-established in adults, there remains a paucity in radiographical data to define normal and pathoanatomical juvenile cohorts. The objectives of this paper were to elucidate the differences in the patellofemoral joint between RPD and typically developed (TD) juvenile populations, using MRI measurements, and determine the best independent and combined predictors of RPD. Read More

J Exp Orthop 2021 Apr 20;8(1):31. Epub 2021 Apr 20.

Department, of Orthopaedic Surgery, Spaarne Gasthuis, Spaarnepoort 1, 2134 TM, Hoofddorp, the Netherlands.

Purpose: The 'Spaarne soft tissue procedure', is a 4-in-1 soft tissue procedure that treats recurrent patellar dislocations in the young and active population. The procedure has not yet described elsewhere. The purpose of this study is to analyse the redislocation rate and to evaluate the postoperative knee function and patient satisfaction. Read More

Knee Surg Sports Traumatol Arthrosc 2021 Apr 16. Epub 2021 Apr 16.

Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081, Baronissi, SA, Italy.

Purpose: This study updates the current evidence on the role of allografts versus autografts for medial patellofemoral ligament (MPFL) reconstruction in patients with patellofemoral instability.

Methods: The study was performed according to the PRISMA guidelines. In March 2021, a literature search in the main online databases was performed. Read More

Orthop J Sports Med 2021 Mar 29;9(3):2325967121994203. Epub 2021 Mar 29.

Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Background: Many factors can affect clinical outcomes and complications after a complex multiligament knee injury (MLKI). Certain aspects of the treatment algorithm for MLKI, such as the timing of surgery, remain controversial.

Purpose: To determine the risk factors for common complications after MLKI reconstruction. Read More

Clin J Sport Med 2021 Mar 1. Epub 2021 Mar 1.

Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota; Department of Orthopedic Surgery, Sierra Pacific Orthopedics, Fresno, California; and Department of Orthopedic Surgery, Pan Am Clinic, Winnipeg, MB, Canada.

Objective: To report the injury characteristics, radiographic findings, and long-term outcomes of nonoperative management for posterior shoulder instability (PSI).

Design: A retrospective review of 143 patients with PSI using a large geographic database.

Setting: Single county between January 1994 and July 2012. Read More

Ann Transl Med 2021 Mar;9(6):445

Department of Sports Medicine, Peking University Third Hospital. Institute of Sports Medicine of Peking University. Beijing Key Laboratory of Sports Injuries, Beijing, China.

Background: A well-established reference is lacking for diagnosing lateral patellar compression syndrome (LPCS), and this diagnosis currently depends on clinicians' subjective judgment and several examination results. X-rays are primarily used to diagnose LPCS, but they have low detection rates of patellar tilt using the congruence angle (CA) and patellar tilting angle (PTA).

Methods: We enrolled 87 patients (31 men and 56 women; mean age: 42. Read More

Wien Klin Wochenschr 2021 Apr 13. Epub 2021 Apr 13.

Department of Orthopaedic and Trauma Surgery, Medical University of Vienna, Waehringer Gürtel 18-20, 1090, Vienna, Austria.

Background: Periprosthetic fractures (PPF) of the femur remain challenging, especially in patients with previous multiple revisions. Modular megaprostheses (mMPs) are rarely used in this indication; however, in some cases mMPs seem to be the last chance for limb salvage. We aimed to evaluate the clinical outcome of PPFs of the femur treated by modular mMPs at our institution. Read More

Cureus 2021 Mar 10;13(3):e13801. Epub 2021 Mar 10.

Trauma and Orthopaedics, University Hospitals of Derby and Burton NHS Foundation Trust, Burton-on-Trent, GBR.

Skeletal trauma accounts for 10% to 15% of all childhood injuries, with approximately 15% to 30% of these representing physeal injuries. Talus fractures are rare injuries in children with an estimated prevalence of 0.008% of all childhood fractures. Read More

J Foot Ankle Surg 2021 Mar 18. Epub 2021 Mar 18.

Professor, Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.

Hallux valgus deformity is one of the most common foot and ankle diseases, while brachymetatarsia is a rare foot anomaly with pathological shortening of a metatarsal bone. We present a case of hallux valgus deformity possibly due to second brachymetatarsia. As the hallux valgus was associated with dorsal dislocation of the second toe that made it difficult to evaluate the length of the second toe, the patient was unaware of the second metatarsal shortening until the lengths of the toes compared by manual reposition of the second MTP joint. Read More

JBJS Case Connect 2021 04 9;11(2). Epub 2021 Apr 9.

Department of Orthopaedics & Rehabilitation, Yale School of Medicine, New Haven, Connecticut.

Case: A 29-year-old healthy woman, 19 weeks pregnant, sustained a right posterolateral knee dislocation with multiligamentous injury and a complete occlusive injury to the right popliteal artery yet had adequate distal perfusion. She declined operative management for both the knee dislocation and the arterial injury, and successful collaboration between obstetrical, vascular, and orthopaedic surgical services resulted in limb preservation and restoration of function.

Conclusion: This is a unique case of traumatic complete popliteal artery occlusion with adequate collateral arterial perfusion after a reducible posterolateral knee dislocation in a pregnant patient that resulted in limb preservation with nonoperative management. Read More

Knee Surg Sports Traumatol Arthrosc 2021 Apr 9. Epub 2021 Apr 9.

Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.

Purpose: To determine the differences in anatomic parameters between ipsilateral dislocated knees and contralateral non-dislocated knees in patients with unilateral patellar dislocation and to identify any variations in ipsilateral knees contributing to contralateral anatomic abnormalities.

Methods: A total of 82 patients with unilateral patellar dislocation from 2016 to 2019 were retrospectively evaluated. Bilateral anatomic factors, including the tibial tubercle to trochlear groove (TT-TG) distance, lower limb rotational deformities, trochlear dysplasia, patella tilt, and patellar height, were assessed by CT. Read More

Ther Clin Risk Manag 2021 30;17:275-283. Epub 2021 Mar 30.

Department of Orthopedic Surgery, Charles University, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic.

Background: Spondyloepiphyseal dysplasia is the clinical term applied to a group of rare genetic disorders with primary involvement of the vertebrae and epiphyses, predisposing the afflicted individuals toward the premature development of osteoarthritis. There are few reports concerning joint replacement therapy in these patients, particularly describing the role of total hip arthroplasty. In this report, we describe the anatomical and technical aspects of spondyloepiphyseal dysplasia that must be considered during surgical planning and performance of total knee arthroplasty. Read More

Medicine (Baltimore) 2021 Apr;100(14):e25253

Department of Orthopedics.

Rationale: Hoffa fracture is a rare fracture confined to the coronal-plane involving femoral condyles. This occurs simultaneously with rotational dislocation of the knee joint is extremely rare. Up to now, there is no valid recommendation for the treatment of the Hoffa fracture. Read More

EFORT Open Rev 2021 Feb 1;6(2):107-112. Epub 2021 Feb 1.

Osteoarticular Surgery Research Hospital, La Paz Institute for Health Research - IdiPAZ (La Paz University Hospital - Autonomous University of Madrid), Madrid, Spain.

The number of rotating-hinge total knee arthroplasties (RH-TKAs) is increasing. As a result, the number of complications related to these procedures will also increase.RH-TKAs have the theoretical advantage of reducing bone implant stresses and early aseptic loosening. Read More