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Asia Pac J Sports Med Arthrosc Rehabil Technol 2019 Jul 1;17:5-9. Epub 2019 Apr 1.

Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.

Background: Recently, medial patellofemoral ligament (MPFL) reconstruction has become a common, widely used procedure to treat patellar instability. However, few reports exist on the long-term outcome after MPFL reconstruction. We elucidated the middle- to long-term outcome after MPFL reconstruction with Insall's proximal realignment. Read More

Knee Surg Sports Traumatol Arthrosc 2019 Apr 6. Epub 2019 Apr 6.

Unidad de Hombro y Codo, Hospital Universitario Ramón y Cajal, Cta Colmenar Km 9, 100, 28034, Madrid, Spain.

Purpose: To evaluate the efficacy of the Instability Severity Index Score (ISIS) in predicting an increased recurrence risk after an arthroscopic Bankart repair.

Methods: Retrospective review of a cohort of patients operated in three different centres. The inclusion criteria (recurrent anterior instability [dislocation or subluxation] with or without hyperlaxity, arthroscopic Bankart repair) and the exclusion criteria (concomitant rotator cuff lesion, acute first-time dislocation, surgery after a previous anterior stabilization, surgery for an unstable shoulder without true dislocation or subluxation; multidirectional instability) were those used in the study that defined the ISIS score. Read More

Arthroscopy 2019 Apr;35(4):1138-1140

Our understanding of the medial patellofemoral complex anatomy has evolved significantly over the past several decades, and this has informed our current surgical approach to management of lateral patellar instability. Medial patellofemoral ligament reconstruction remains the gold standard for decreasing the risk of secondary patellar dislocation and returning patients to active physical function. However, concerns about isometry, overconstraint, secondary arthrosis, and surgical-site morbidity remain with femoral socket fixation, particularly when patella alta, rotational malalignment, or hypermobility is present. Read More

Am J Sports Med 2019 Apr 3:363546519831294. Epub 2019 Apr 3.

Department of Orthopaedic Surgery, University Hospital of Saint Étienne, Saint Étienne, France.

Background:: Isolated medial patellofemoral ligament reconstruction (iMPFLR) is increasingly used for the surgical treatment of recurrent patellofemoral instability.

Purpose:: The purpose of this study was to identify the clinical and radiological predictors that can significantly influence the functional outcomes after an iMPFLR.

Study Design:: Case series; Level of evidence, 4. Read More

AJR Am J Roentgenol 2019 Apr 1:1-9. Epub 2019 Apr 1.

5 Department of Pharmacology, Korea University College of Medicine, Seoul, Korea.

Objective: The objective of our study was to assess correlation between patellofemoral incongruency and injury mechanism, recurrence, bilaterality, and cartilage damage in patients with patellofemoral instability (PFI).

Materials And Methods: Ninety-four knee MRI examinations (10 bilateral) of 84 patients with PFI (47 female and 37 male patients; mean age ± SD, 15.0 ± 2. Read More

BMC Musculoskelet Disord 2019 Mar 30;20(1):138. Epub 2019 Mar 30.

Department of Orthopedics, Helsingborg Hospital, Helsingborg, Sweden.

Background: The gracilis tendon is commonly used as an autograft to reconstruct torn tendons or ligaments in many parts of the body. Little is known about the subjective and functional outcome after gracilis tendon harvest. The aim of this study was to evaluate the outcome of the donor leg in patients undergoing such surgery. Read More

Orthop J Sports Med 2019 Mar 21;7(3):2325967119831642. Epub 2019 Mar 21.

Sports Medicine Service, Beijing Jishuitan Hospital, Beijing, China.

Background: A habitual patellar dislocation (HPD) is a rare condition in skeletally mature patients, especially for those with severe quadriceps contracture. Until now, no study has reported the effectiveness of tibial tubercle proximalization to lengthen the extensor mechanism in treating severe HPDs in skeletally mature patients.

Purpose: To describe a novel comprehensive procedure that includes tibial tubercle proximalization, extensive lateral release, tibial tubercle medialization, and medial patellofemoral ligament (MPFL) reconstruction in treating severe HPDs in skeletally mature patients and to report its early clinical outcomes. Read More

Orthop J Sports Med 2019 Mar 15;7(3):2325967119829790. Epub 2019 Mar 15.

ARCUS Sportklinik, Pforzheim, Germany.

Background: The clinical impact of increased torsion on patellar instability and patellofemoral pain syndrome (PFPS) has been suggested by several studies.

Hypothesis: The hypotheses of this study were that (1) torsional malalignment (TM) is characterized by a positive correlation between different malalignment parameters that represent an overall picture of the malalignment syndrome and (2) an increase in overall torsion is the underlying difference between patellar instability and isolated patellofemoral pain.

Study Design: Cohort study; Level of evidence, 3. Read More

Indian J Orthop 2019 Jan-Feb;53(1):122-127

Department of Orthopaedics, Children's Hospital "Bambino Gesù," Rome, Italy.

Background: Patellar instability is a common problem in Down syndrome patients since their childhood. Several treatment have been proposed, but relapses are frequent and not all surgeries are suitable for growing patients. The aim of the present study is to evaluate the clinical and radiographic outcomes of a modified Roux-Goldthwait technique, for the management of patellar instability in children with Down syndrome at minimum 5-year followup. Read More

Arch Orthop Trauma Surg 2019 Mar 22. Epub 2019 Mar 22.

Hospital of Trauma Surgery, University of Munich (LMU), Nussbaumstr. 20, 80336, Munich, Germany.

Introduction: Secondary dislocation due to loss of fixation is the most common complication after plate fixation of proximal humeral fractures. A wide range of different techniques for augmentation has been described to improve the primary and secondary stability. Nevertheless, comparative analyses on the specific advantages and limitations are missing. Read More

Knee Surg Sports Traumatol Arthrosc 2019 Mar 22. Epub 2019 Mar 22.

Orthopaedic and Traumatology Unit, Ospedale Regionale di Lugano, EOC, Via Tesserete 46, 6900, Lugano, Switzerland.

Purpose: Medial patellofemoral ligament (MPFL) surgery combined with trochleoplasty (TP), is often performed to restore the normal patellofemoral biomechanics avoiding recurrent lateral patellar dislocation (LPD) in patients with trochlear dysplasia (TD). However, it is still unclear whether combining TP and MPFL surgery would be more beneficial than performing MPFL surgery on its own. This meta-analysis quantitatively synthesizes and compares published data on the outcomes of recurrent LPD treatment using MPFL surgery without or with TP in patients affected by TD. Read More

Knee Surg Sports Traumatol Arthrosc 2019 Mar 22. Epub 2019 Mar 22.

Institution of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China.

Purpose: Clinical outcomes between reattachment of the superior peroneal retinaculum (SPR) and the bone block procedure were compared in this study to elucidate which procedure was safer and more effective.

Methods: From 2012 to 2016, 25 patients with recurrent peroneal tendon dislocation underwent the bone block procedure (group A), and another 22 patients underwent reattachment of the SPR (group B). American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Ankle Activity Score (AAS), time to return to sports activity, rate of return to sports level, range of motion (ROM) of the ankle, rate of recurrence, and overall patient satisfaction were collected to evaluate outcomes between the two groups. Read More

Traffic Inj Prev 2019 22;20(2):196-203. Epub 2019 Mar 22.

a Univ Lyon, Université Lyon 1, IFSTTAR, UMRESTTE UMR_T 9405 , Lyon , France.

Objective: This study assesses the effectiveness of protective clothing (motorcycle jacket, trousers, gloves, knee-high or ankle boots, back protection) for motorized 2-wheeler (MTW) riders.

Methods: This retrospective observational study used injury data from the Rhône Registry of Road Accident Victims, plus a postal survey conducted in 2016. Seven thousand one hundred forty-eight MTW riders involved in accidents between 2010 and 2014 were identified from the Registry and were invited to complete a questionnaire. Read More

Oper Orthop Traumatol 2019 Apr 18;31(2):127-142. Epub 2019 Mar 18.

Klinik und Poliklinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.

Objective: Complete visualization of the articular surface in comminuted uni- or bicondylar tibial plateau fractures as a prerequisite for anatomical reconstruction to reduce the risk of posttraumatic osteoarthritis.

Indications: Unicondylar lateral or medial as well as bicondylar intra-articular tibial plateau fractures with central and/or dorsal fracture lines; comminuted destruction of the medial or lateral tibial plateau with dislocation of >2 mm.

Contraindications: Critical soft tissue in the approach area, femoral condylar fracture, intraligamentous ruptures of the medial or lateral ligaments or the posterolateral corner. Read More

Knee Surg Sports Traumatol Arthrosc 2019 Mar 16. Epub 2019 Mar 16.

Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.

Purpose: This study aimed to elucidate the primary differences in trochlear morphology between men and women utilizing three-dimensional magnetic resonance image reconstruction of the femoral trochlea.

Methods: Differences in anthropometric femoral trochlea data of 975 patients (825 women, 150 men) were evaluated. The following morphological parameters were measured at three flexion angles (15°, 30°, and 45°) of the femoral trochlea: the sulcus angle, condylar height, and the trochlear groove orientation and mediolateral groove position. Read More

Clin Sports Med 2019 Apr 19;38(2):247-260. Epub 2019 Jan 19.

Department of Orthopaedic Surgery, University of New Mexico, MSC10 5600, 1 University of New Mexico, Albuquerque, NM 87131-0001, USA. Electronic address:

"KDIV ligamentous injuries of the knee are frequently high-energy injuries with significant soft tissue disruption, gross knee instability, and rarely are treated nonoperatively. KDIVs frequently require external fixation, but when presenting in an isolated fashion can be reconstructed in one setting. Five presentations of KDIV injury are described: closed with multitrauma/closed head injury requiring external fixation, irreducible KDIV requiring semi-emergent open reduction and repair, isolated KDIV without arterial injury undergoing 4-ligament reconstruction after regaining motion, KDIV with varus and slight thrust undergoing medial opening osteotomy before ligament reconstruction, and KDIV with failed ligaments requiring revision and posterior tibial tendon transfer. Read More

Clin Sports Med 2019 Apr 19;38(2):215-234. Epub 2019 Jan 19.

Department of Orthopaedic Surgery, Keck Medical Center of the University of Southern California, 1520 San Pablo Street, Suite 2000, Los Angeles, CA 90033, USA.

The multiple ligament injured knee is a complex biomechanical environment. When primary stabilizers fail, secondary stabilizers have an increased role. In addition, loss of primary restraints puts undue stress on the remaining intact structures of the knee. Read More

Clin Sports Med 2019 Apr;38(2):199-213

Orthopaedic Surgery, Pan Am Clinic, University of Manitoba, 75 Poseidon Bay, Winnipeg, Manitoba R3M 3E4, Canada.

In this review, we explore the epidemiology and mechanism of multiligament knee injuries (knee dislocation) and their complications, focusing on the morbidity and mortality associated with concomitant vascular injuries. We discuss the various diagnostic and treatment algorithms in use today and finish the report with a brief case example to outline these principles. Read More

Clin Sports Med 2019 Apr 19;38(2):193-198. Epub 2019 Jan 19.

Geisinger Orthopaedics, 115 Woodbine Lane, Danville, PA 17822-5212, USA. Electronic address:

The multiple ligament injured knee (knee dislocation) is oftentimes part of a multisystem injury complex that can include injuries not only to knee ligaments but also to blood vessels, skin, nerves, bones (fractures), head, and other organ system trauma. These additional injuries can affect surgical timing for knee ligament reconstruction and also affect the results of treatment. This article presents the author's approach and experience to the initial assessment and treatment of the multiple ligament injured (dislocated) knee. Read More

Clin Sports Med 2019 Apr;38(2):183-192

Department of Orthopaedic Surgery, University of Texas Health Science Center at Houston, 6400 Fannin Street, Suite 1700, Houston, TX 77030, USA. Electronic address:

Classification systems should enhance communication between providers, facilitate accurate and consistent reporting in the literature, and guide management. However, current classification systems for MLKIs lack sufficient detail to guide clinical management which limit their prognostic value. The purpose of this chapter is to revisit and consider important features of some of the most impactful classification systems developed in the orthopaedic literature and to propose a classification system for MLKIs that may improve communication among providers, facilitate consistent reporting in the literature, and ultimately foster publication of meaningful clinical data. Read More

Clin Sports Med 2019 Apr;38(2):169-182

Orthopaedic Sports Medicine and Shoulder, Tria Orthopaedic Center, 8100 Northland Drive, Bloomington, MN 55431, USA.

The knee dislocation is a severe, complex injury that can be difficult to treat and is fraught with complications. The first step in a successful reconstruction of a multiple ligamentous knee injury is gaining an accurate and thorough understanding of the pattern of instability imparted by the injury. Evaluation begins with a detailed review of radiographic and advanced imaging studies followed by a thorough physical examination, often done under anesthesia, in conjunction with dynamic fluoroscopy. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2019 03;33(3):312-317

Department of Orthopaedics, the First Affiliated Hospital of University of South China, Hengyang Hunan, 421001, P.R.China.

Objective: To explore the clinical effects of combined operation involving tibial tubercle distalization for the recurrent patellar dislocation with patella alta.

Methods: Between April 2010 and May 2016, 14 cases of recurrent patellar dislocation with patella alta were treated with combined operation involving tibial tubercle distalization. There were 5 males and 9 females with an average age of 18. Read More

Knee Surg Relat Res 2019 Mar;31(1):72-75

Department of Surgery, King Abdulaziz Medical City, Riyadh.

Knee dislocation is one of the rare orthopedic emergencies that require special management with an annual incidence rate of less than 0.02%.Knee dislocations are classified by Kennedy, according to the direction of tibial dislocation in relation to the femur, as anteromedial, posteromedial, anterolateral, and posterolateral. Read More

Knee Surg Sports Traumatol Arthrosc 2019 Mar 13. Epub 2019 Mar 13.

Groupement Hospitalier Nord, Hospices civils de Lyon, Université Lyon, 103 bvd de la Croix Rousse, 69004, Lyon, France.

Unfortunately, the author name was incorrectly published in the original publication as Sébatien Lustig insted of Sébastien Lustig. The author name is corrected here by this Erratum. The original article has been corrected. Read More

Wilderness Environ Med 2019 Mar 8. Epub 2019 Mar 8.

Department of Orthopedic and Trauma Surgery, Klinikum Bamberg, Bamberg, Germany; Department of Emergency Medicine, Section of Wilderness Medicine, University of Colorado School of Medicine, Aurora, CO; Department of Trauma Surgery, Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany.

Introduction: Previous research identified a trend for increasing numbers of injuries sustained while rock climbing. This study investigates whether that trend continued and describes characteristics of climbing injuries.

Methods: The National Electronic Injury Surveillance System registry was searched for rock climbing injuries in US emergency departments in 2008 through 2016 among patients aged ≥7 y. Read More

Acta Orthop Belg 2018 Sep;84(3):257-261

As it is mentioned in the literature, rates of complications and revision are higher in the obese compared to non-obese patients, although obesity does not a contraindication for unicompartmental knee arthroplasty and successful outcomes are achieved. However, there is not any study in the literature comparing the outcomes of fixed and mobile unicompartmental prostheses which are applied in the obese patients. Objective of this study was to compare outcomes of our obese patients who we applied fixed or mobile unicompartmental arthroplasty and followed up for 8 years and over. Read More

Curr Rev Musculoskelet Med 2019 Mar 5. Epub 2019 Mar 5.

Banff Sport Medicine, PO Box 1300, Banff, Alberta, T1L 1B3, Canada.

Purpose Of Review: The purpose of this paper was to review the current psychometric properties of patient-reported outcome measures that are commonly used for patients with patellofemoral instability. This review provides evidence to guide the selection of subjective outcome measures for assessing outcomes in clinical care and research studies.

Recent Findings: At the present time, there are two patient-reported outcome measures that have been designed for, and tested on, large cohorts of patellofemoral instability patients, the Banff Patella Instability Instrument (BPII) and the Norwich Patellar Instability Score (NPI). Read More

J Knee Surg 2019 Mar 1. Epub 2019 Mar 1.

Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, Florida.

Conclusive evidence supporting a clinical difference between posterior-stabilized (PS) and cruciate-retaining (CR) designs in total knee arthroplasty (TKA) does not currently exist, despite both designs being used for decades. Proponents of PS designs that employ a cam-and-post mechanism cite in vivo fluoroscopic data that demonstrate improved posterior rollback; however, optimal rollback has never been correlated to superior clinical outcomes. Recently, anterior-lipped and more conforming CR bearings, such as ultracongruent, medial pivot, and dual-pivot designs, have been used to substitute for the posterior cruciate ligament and obviate the need for the cam-post mechanism of a traditional PS design. Read More

Knee Surg Sports Traumatol Arthrosc 2019 Feb 28. Epub 2019 Feb 28.

Sports Knee Department, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, SY10 7AG, UK.

Purpose: The purpose of this study was to measure the improvement in quality of life (QoL) following isolated anatomical double-bundle medial patellofemoral ligament reconstruction.

Methods: This is a single-centre, prospective study of 56 consecutive patients (57 knees) who underwent isolated MPFL reconstruction between 2014 and 2017. Functional outcome and QoL were assessed with the Kujala score and the EQ-5D-3L questionnaire, respectively. Read More

Bone Joint J 2019 Mar;101-B(3):297-302

Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Suita, Japan.

Aims: The aim of this study was to examine whether hips with unilateral osteoarthritis (OA) secondary to developmental dysplasia of the hip (DDH) have significant asymmetry in femoral length, and to determine potential related factors.

Patients And Methods: We enrolled 90 patients (82 female, eight male) with DDH showing unilateral OA changes, and 43 healthy volunteers (26 female, 17 male) as controls. The mean age was 61. Read More

Knee Surg Sports Traumatol Arthrosc 2019 Feb 27. Epub 2019 Feb 27.

Orthopaedic Department, St. John of God Hospital and University Hospital Geelong, Geelong, Australia.

Purpose: There is a paucity of evidence regarding mid- to long-term clinical outcomes of arthroscopic repair of humeral avulsion of the glenohumeral ligament (HAGL). This study investigated clinical outcomes, return to sport and the frequency of associated shoulder lesions.

Methods: Eighteen patients underwent arthroscopic repair of a HAGL lesion between 2008 and 2015. Read More

Orthop J Sports Med 2019 Feb 15;7(2):2325967119825854. Epub 2019 Feb 15.

University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.

Background: Previous studies have acknowledged the medial patellofemoral ligament (MPFL) as the primary stabilizer of the patella, preventing lateral displacement. MPFL reconstruction (MPFL-R) restores stability and functionality to the patellofemoral joint and has emerged as a preferred treatment option for recurrent lateral patellar instability.

Purpose: To objectively measure biomechanical characteristics of athletes cleared for return to sport after MPFL-R compared with healthy controls. Read More

Cureus 2018 Dec 14;10(12):e3730. Epub 2018 Dec 14.

Orthopaedics, Saint James's Hospital, Dublin, IRL.

Acute traumatic patellar dislocations are encountered with relative frequency, making up 3% of all knee injuries. Typically witnessed in younger patients following sporting injuries, this injury can be debilitating, potentially leading to recurrent dislocation, pain, reduction in activity and patellofemoral osteoarthritis. Management of this injury remains controversial, and as such detailed magnetic resonance imaging (MRI) is increasingly recommended to help illustrate the exact nature of osteochondral and soft tissue injury, with a view to assessing the anatomical sequelae of patellar dislocation as well as the potential of recurrence and dictating the need for either conservative or surgical management in the acute setting. Read More

J Orthop Surg (Hong Kong) 2019 Jan-Apr;27(1):2309499018820698

4 Department of Orthopaedics, Concord Repatriation General Hospital, Concord, New South Wales, Australia.

Introduction:: Medial patellofemoral ligament reconstruction (MPFLR) is regularly combined with a tibial tuberosity transfer (TTT) in cases of recurrent patellar instability with underlying structural deformity. However, these indications for a TTT have recently come into question. This study aimed to assess the traditional indications by comparing the outcomes of isolated and combined MPFLR for the treatment of recurrent lateral patellar dislocation. Read More

Injury 2019 Feb 15. Epub 2019 Feb 15.

Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari, Italy.

Purpose: The purpose of this systematic review was to address the treatment of multiligament knee injuries in three major aspects, specifically (1) surgical versus nonoperative treatment, (2) repair versus reconstruction of injured ligamentous structures, and (3) early versus late surgery of damaged ligaments.

Methods: Two independent reviewers performed a search on PubMed from 1966 to March 2016 using Levy's review as a starting-point, and the same terms "knee dislocation," "multiple ligament-injured knee," and "multiligament knee reconstruction." Study inclusion criteria were (1) levels I to IV evidence, (2) "multiligament" defined as disruption of at least 2 of the 4 major knee ligaments, (3) measures of functional and clinical outcomes, and (4) minimum of 12 months' follow-up, with a mean of at least 24 months. Read More

Scand J Pain 2019 Apr;19(2):375-382

School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, Scotland, UK.

Background and aims Patellofemoral pain (PFP) is a common knee condition causing pain around or behind the kneecap which is exacerbated by certain activities. Traditionally it has been viewed as a self-limiting condition. Recent research proves this is not the case and the evidence for poor long-term outcomes is growing. Read More

Cureus 2018 Dec 8;10(12):e3705. Epub 2018 Dec 8.

Department of Orthopaedics, Jagadguru Jayadeva Murugarajendra Medical College, Davangere, IND.

Acute patellar dislocation is a common condition and is seen in situations that are associated with dance and sports. The intra-articular dislocation of the patella is a rare condition while lateral dislocation is most common. Two types of intra-articular dislocations are described in the literature, horizontal and vertical. Read More

Int Orthop 2019 Feb 15. Epub 2019 Feb 15.

History of Medicine, Anatomy Department, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece.

During the fifth century BC in ancient Greece during the eve of orthopaedics, the Hippocratic School of Medicine diagnosed a series of congenital limb deformities. Congenital dislocation of the arm, elbow, wrist, hip, knee, tarsotibial joint, apex leg, as well as talipes valgus (clubfoot), congenital clavicle fractures, and thumb malfunction were all discussed by Hippocrates and his followers. Ancient Greek medico-philosophers, fond of a "perfect" human body, proposed an immediate non-interventional approach, while archaic orthotics and specialized footwear were suggested. Read More

Knee Surg Sports Traumatol Arthrosc 2019 Feb 14. Epub 2019 Feb 14.

Sporthopaedicum, Straubing and Regensburg, Bahnhofplatz, 27, 94315, Straubing, Germany.

Purpose: Most elbow dislocations can be treated conservatively, with surgery indicated in special circumstances. Surgical options, apart from fracture fixation, range from repair or reconstruction of the damaged ligaments to static external fixation, usually entailing either a long period of immobilization followed by carefully monitored initiation of movement or dynamic external fixation. In general, no consensus regarding surgical treatment has been reached. Read More

Int J Surg Case Rep 2019 31;55:183-186. Epub 2019 Jan 31.

Mayapada Hospital, Jakarta, Indonesia.

Introduction: Recurrent patellar dislocation can lead to articular cartilage injury. We report a 21-year old male with left patella instability and articular cartilage defect.

Presentation Of Case: A 21-year-old male presented with left patellar instability and pain. Read More

Chirurg 2019 Mar;90(3):243-254

Klinik und Poliklinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.

With 1% of all skeletal fractures patellar fractures are rare. The majority of cases are caused by a direct trauma to the flexed knee. The diagnosis is made via the injury mechanism as well as the physical and radiological findings. Read More

J Orthop Case Rep 2018 Sep-Oct;8(5):82-85

Department of Orthopaedic, Henry Ford Hospital, 2799 W. Grand Blvd, Detroit, MI 48202, United States.

Introduction: Dislocations of the proximal tibiofibular joint (PTFJ) are a relatively rare orthopedic injury. They are often repaired with open reduction internal fixation utilizing a transfixation screw. Limited data are available concerning alternative repair methods. Read More

SAGE Open Med Case Rep 2019 11;7:2050313X18823102. Epub 2019 Jan 11.

Department of Orthopedic Surgery, Jichi Medical University, Shimotsuke, Japan.

Knee dislocation with concomitant multiligament injury is a rare and devastating injury. We report the successful repair of a rare case of open knee dislocation with concomitant multiligament injury and patellar tendon rupture of an 18-year-old male due to a motorcycle accident. The patient presented with an open wound running parallel to the knee joint line and patellar tendon rupture with full exposure of the cartilage of the distal femur. Read More

Injury 2019 Jan 17. Epub 2019 Jan 17.

Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany.

Introduction: Patellar dislocation and rupture of the medial patellofemoral ligament (MPFL) are frequently seen in daily orthopedic practice. Besides initial non-surgical treatment, surgery and subsequent rehabilitation are crucial for restoring stability in the femoropatellar joint. This study investigated current rehabilitation strategies after patellar dislocation because knowledge on this topic has been severely limited so far. Read More

Arthroscopy 2019 Mar 29;35(3):845-854.e1. Epub 2019 Jan 29.

Department of Orthopaedics, General Hospital of the People's Liberation Army, Beijing, People's Republic of China.

Purpose: To compare the stability and clinical outcomes of 2 medial patellofemoral ligament reconstruction (MPFLR) techniques for the treatment of recurrent lateral patellar dislocation in adults.

Methods: Ninety-one patients with recurrent patellar dislocation were randomly divided into 2 groups, undergoing either the traditional single-bundle transpatellar tunnel technique (group A) or the double-anchor anatomic reconstruction technique (group B). Preoperatively and at follow-up, the patellar position and rotation were evaluated by computed tomography with the congruence angle, lateral patellar angle, patellar tilt angle, and lateral patellar translation; the subjective symptoms and functional outcomes were evaluated with Kujala, Lysholm, Tegner, and International Knee Documentation Committee subjective scores. Read More

BMJ Case Rep 2019 Jan 29;12(1). Epub 2019 Jan 29.

Alrijne Ziekenhuis Locatie Leiderdorp, Leiderdorp, The Netherlands.

A 37-year-old woman was diagnosed with an isolated proximal tibiofibular joint dislocation (PTJD) after an accident during gymnastic exercise. The dislocation has a low incidence rate and is often missed in the emergency department as physical and radiology signs are subtle. Treatment consists of closed or open reduction and immobilisation. Read More

J Pediatr Orthop 2019 Jan 25. Epub 2019 Jan 25.

Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY.

Introduction: The treatment of a first-time traumatic patella dislocation in children and adolescents remains controversial. Preference-based health utility assessments can provide health-related quality of life information for orthopaedic conditions and their subsequent treatment. The purpose of this study was to determine utilities for pediatric acute traumatic patella dislocation and subsequent treatment health states from both children with patellar dislocation, and their parents. Read More

JBJS Case Connect 2019 Jan-Mar;9(1):e5

University of Kansas Medical Center, Kansas City, Kansas.

Case: We describe the clinical course and treatment of a patient who sustained simultaneous bilateral knee dislocation under low-velocity atraumatic conditions, and provide a review of the literature. Dislocations of the native knee joint are uncommon orthopaedic injuries but they are true emergencies because of the concern for concomitant neurovascular injury; therefore, they may be limb-threatening injuries.

Conclusion: To our knowledge, there are few reports of simultaneous bilateral knee dislocation and no reports of this occurring during weight training. Read More

Int Orthop 2019 Jan 23. Epub 2019 Jan 23.

Service d'Orthopédie-Traumatologie, Hôpital Gabriel Montpied, CHU de Clermont Ferrand BP 69, 63003, Clermont Ferrand Cedex 01, France.

Introduction: Tibiofemoral dislocation is the most serious form of instability following total knee arthroplasty (TKA). It is little reported in the literature, despite severity comparable to that in the native knee. The present systematic review and meta-analysis aimed to identify risk factors and treatment strategies. Read More