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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

Am J Sports Med 2021 03 18;49(4):975-981. Epub 2021 Feb 18.

Department of Health and Physical Education, Mount Royal University, Calgary, Alberta, Canada.

Background: The clinical sign of patellar laxity and the associated symptom of apprehension are mainstays of the physical examination of patellofemoral instability. The apprehension test is widely used as a diagnostic tool and also as an outcome following patellofemoral stabilization surgery. Despite widespread use, the validity, reliability, and responsiveness of the apprehension test have not been established. Read More

J Orthop Case Rep 2020 Oct;10(7):6-10

Department of Orthopedic Sports Medicine, Marshall University, 1600 Medical Center Dr., Huntington, WV 25701, United States.

Addition To Orthopedic Literature: Posterolateral knee dislocations are extremely rare and generally require open reduction; however, we were able to provide closed reduction by reproducing mechanism of injury with a technique described in the literature. This is the second reported case of such accomplishment.

Introduction: Posterolateral knee dislocation is the most common form of "irreducible" knee dislocations. Read More

Rev Bras Ortop (Sao Paulo) 2020 Dec 2;55(6):800-803. Epub 2020 Apr 2.

Serviço de Ortopedia e Traumatologia, Hospital Universitário Cajuru, Curitiba, Brasil.

Intraarticular dislocation of the patella is an uncommon condition, with displacement in the horizontal or vertical plane, which may be associated with total or partial lesion/rupture of the quadriceps tendon, with osteochondral or collateral ligament injury. Risk factors are ligament laxity, patellar hypermobility, high patella, and trochlear dysplasia. This condition is more common in young people and may require blood reduction. Read More

Unfallchirurg 2021 May 16;124(5):407-411. Epub 2020 Oct 16.

Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48147, Münster, Deutschland.

The case of a 56-year-old male patient with locking of the knee in extension without trauma is presented. Patient history, clinical examination and radiographs confirmed a superior dislocation of the patella. Closed reduction led to full weight bearing with free range of motion without further complaints. Read More

J Orthop Case Rep 2020 ;10(2):58-61

Department of Orthopaedic Surgery, Barod Hospital, Indore, Madhya Pradesh, India.

Introduction: Femoral head fractures are a rare pathology most often arising with high-energy traumas and associated with hip dislocations, which gravely compromise the ultimate functional outcome of the hip. Femoral head fractures without dislocation or subluxation are extremely rare injuries.

Case Report: A 23-year-old male who sustained a high-energy trauma due to road traffic accident. Read More

JBJS Case Connect 2020 Jan-Mar;10(1):e0250

Department of Orthopaedic Surgery, Virginia Commonwealth University Health Systems, Richmond, Virginia.

Case: A 25-year-old man sustained a right femur Hoffa fracture with an ipsilateral patella dislocation from a twisting injury to his right knee. He underwent open reduction and internal fixation of the right femur with medial patellofemoral ligament (MPFL) reconstruction with allograft. One year postoperatively, he had returned to full activity and painless range of motion. Read More

Orthop Surg 2020 Apr 11;12(2):679-685. Epub 2020 Mar 11.

Investigation performed at Center for Joint Surgery, Third Affiliated Hospital of Guangxi Medical University, Nanning Second People's Hospital, Nanning, China.

Osteochondral fracture of the lateral femoral condyle is a rare intra-articular injury with or without patellar dislocation. This kind of disease is commonly seen in the knee joint sprain during strenuous activity. At present, open reduction is often used to treat osteochondral fractures. Read More

Arch Orthop Trauma Surg 2020 Jun 21;140(6):769-776. Epub 2020 Feb 21.

Department of Orthopaedics, RWTH Aachen University Clinic, Pauwelsstraße 30, 52074, Aachen, Germany.

Introduction: The MPFL reconstruction is performed either via a single-bundle (SB) or double-bundle (DB) procedure. The purpose of this study is to perform a systematic review comparing SB versus DB graft for recurrent patellofemoral instability, to summarize current evidence, and to clarify the role of both techniques. We focused on clinical scores, physical examination, complications, revision surgeries, and failures. Read More

Am J Sports Med 2020 03 14;48(4):895-900. Epub 2020 Feb 14.

FIFA Medical Center of Excellence, Orthopaedics Surgery and Sports Medicine Department, Croix Rousse Hospital, Civil Hospices of Lyon, Lyon, France.

Background: Reconstruction of the medial patellofemoral ligament (MPFL) is the gold standard treatment for recurrent patellar dislocation. Patella alta has been reported in about half of patients with recurrent patellofemoral instability.

Hypothesis: MPFL reconstruction (MPFLr) has a beneficial role in the correction of patellar height in patients with mild patella alta (Caton-Deschamps index [CDI] between 1. Read More

Eur J Orthop Surg Traumatol 2020 Jul 1;30(5):763-770. Epub 2020 Feb 1.

Department of Orthopaedics, RWTH Aachen University Clinic, Pauwelsstraße 30, 52074, Aachen, Germany.

Introduction: After the first patellar dislocation, most patients report damage of the medio-patellofemoral ligament (MPFL) and surgical reconstruction is required. The purpose of this study is to systematically review current evidence and to clarify the role of the gracilis and semitendinosus tendons as graft for isolated MPFL reconstruction.

Materials And Methods: The present systematic review was conducted according to the PRISMA guidelines. Read More

Trauma Case Rep 2020 Apr 17;26:100277. Epub 2020 Jan 17.

Department of Orthopaedics, The Second Xiangya Hospital, Central South University, Changsha, PR China.

Hoffa fracture combined with tibial shaft fracture and multiple ligament avulsion injuries is extremely rare. Herein, we report a case of medial Hoffa fracture with associated fracture of tibial shaft and avulsion fractures of multiple ligaments secondary to knee dislocation. A 17-year-old female with history of a motorcycle accident was referred to our hospital after knee joint reduction at a regional trauma center. Read More

Zhongguo Gu Shang 2019 08;32(8):772-774

Department of Orthopaedics, Shanxi Provincial People's Hospital, Taiyuan 030012, Shanxi, China;

Rev Bras Ortop (Sao Paulo) 2019 Feb 1;54(1):90-94. Epub 2019 Mar 1.

Departamento de Ortopedia e Traumatologia, Hospital de Cascais Dr. José de Almeida, Cascais, Portugal.

Irreducible patella dislocations are rare and are usually associated with complex mechanisms. The authors report the clinical case of an irreducible lateral patellar dislocation due to an anatomical variant. The authors assisted a 16-year-old patient who presented with a lateral patella dislocation that was impossible to reduce by closed manipulation, even under general anesthesia. Read More

Medicine (Baltimore) 2019 Jun;98(24):e16011

Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China.

Rationale: Upper pole sleeve fractures of the patella are rare in adolescents; however, they are serious injuries that require early diagnosis and treatment.

Patient Concerns: We present a rare case of a 15-year-old girl who suffered a sleeve fracture at the superior pole of the right patella. The patient had a history of dislocation of the patella 2 weeks ago. Read More

J Knee Surg 2020 Oct 23;33(10):998-1003. Epub 2019 May 23.

Department of Physical Medicine, Al-Razi Orthopaedic Hospital, Kuwait City, Kuwait.

Acute traumatic patellar dislocation is a common injury, and spontaneous reduction may occur at the time of injury or may be reduced at the field of the accident by someone. It may be associated with osteochondral fractures and rupture of medial patellar stabilizers leading to recurrent patellar instability. The aim of this prospective study was to evaluate the outcomes of medial patellofemoral (PF) ligament (MPFL) reconstruction in recurrent traumatic patellar dislocation. Read More

BMJ Case Rep 2019 Apr 24;12(4). Epub 2019 Apr 24.

Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India.

Horizontal intra-articular dislocation of the patella is a very rare traumatic entity. We present an unusual case of horizontal intra-articular dislocation in which the patellar articular surface was facing upwards besides having an avulsion of the quadriceps tendon from the superior pole. There was associated posterolateral knee subluxation, which has not been described with intra-articular dislocation of the patella. Read More

J Knee Surg 2019 Aug 1;32(8):710-713. 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

JBJS Case Connect 2019 Jan-Mar;9(1):e2

Department of Orthopedics and Traumatology, Ankara Ataturk Training and Research Hospital, Ankara, Turkey.

Case: Horizontal patellar dislocation is a rare clinical event, and there is no consensus on its management. We describe 2 relatively elderly patients with 2 different types of horizontal patellar dislocation who were successfully treated with closed reduction without general anesthesia.

Conclusion: Appropriate and gently managed closed reduction without general anesthesia may be successful in cases of acute horizontal patellar dislocation, provided there are no osteophytes or an injury that requires surgical treatment. Read More

Unfallchirurg 2019 Jan;122(1):6-16

Unfallchirurgische Abteilung, Landeskrankenhaus Horn, Spitalgasse 10, 3580, Horn, Österreich.

While fractures around the knee are known to be rare, physicians have encountered a rise in the frequency due to the increased participation of children and adolescents in high-impact sports at a younger age. Even if the treatment of fractures in some cases resembles that in adults, the diagnostics and treatment in childhood and adolescence require a hígh level of experience in order avoid possible sequelae and to enable early recognition. Thorough diagnostics using clinical and imaging investigations as well as a precise weighing up of the treatment are essential to minimize differences in leg length and axial malpositioning of the leg. Read More

Am Fam Physician 2018 11;98(10):570-576

West Virginia University School of Medicine-Eastern Campus, Harpers Ferry, WV, USA.

Braces and splints can immobilize and protect joints, reduce pain, decrease swelling, and facilitate healing of acute injuries. They are also used for injury prevention and chronic pain reduction, and to alter the function of a joint. The medial unloading (valgus) knee brace is an option for patients with medial knee osteoarthritis, but evidence of long-term benefit is limited. Read More

Knee Surg Sports Traumatol Arthrosc 2019 Feb 13;27(2):652-658. Epub 2018 Oct 13.

Department of Orthopaedic Sports Medicine, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.

Purpose: Increased femoral antetorsion influences patellofemoral joint kinematics. The aim of this study was to retrospectively evaluate the clinical outcome after derotational osteotomies and combined procedures in patients with patellofemoral instability.

Methods: All patients with derotational osteotomies and combined procedures in patients with patellofemoral instability and increased femoral antetorsion performed between 2007 and 2016 were retrospectively analyzed. Read More

Unfallchirurg 2019 Feb;122(2):95-102

Zentrum für Orthopädie und Unfallchirurgie, Universitätsmedizin der Johannes Gutenberg-Universität, Langenbeckstr. 1, 55131, Mainz, Deutschland.

Intramedullary nailing was originally conceived for the stabilization of shaft fractures of long bones. Due to new nail designs and multiple interlocking possibilities, the spectrum of nailing has significantly increased. Nailing of fractures beyond the isthmus is technically challenging because fractures need to be reduced before the nailing procedure starts. Read More

BMJ Case Rep 2018 Sep 14;2018. Epub 2018 Sep 14.

Trauma and Orthopaedic Department, West Hertfordshire Hospitals NHS Trust, Watford, UK.

We describe the case of a 15-year-old girl who presented to the Accident and Emergency Department with right knee pain and a tense effusion following a twist and fall directly onto her right knee. An MRI scan demonstrated that she had an incarcerated dislocated patella with an associated patella avulsion fracture. This required open reduction. Read More

J Exp Orthop 2018 Sep 10;5(1):34. Epub 2018 Sep 10.

Biomechanics Group, Mechanical Engineering Department, Imperial College London, London, SW7 2AZ, UK.

Background: Vastus Medialis Muscles (VMM) damage has been widely identified following patellar dislocation. Rehabilitation programmes have been suggested to strengthen the VMM and reduce clinical symptoms of pain and instability. This controlled laboratory study investigated the hypothesis that reduced Vastus Medialis Obliquus (VMO) and Vastus Medialis Longus (VML) muscle tension would alter patellar tracking, stability and PFJ contact pressures. Read More

Joints 2018 Jun 22;6(2):80-84. Epub 2018 Jun 22.

Orthopaedic Unit, Casa di Cura "Villa Igea" Hospital, Ancona, Italy.

 The aim of the study was to test the distalization and medialization of the tibial tuberosity (DMTT) for the treatment of patellar instability associated with patella alta, focusing on residual instability and pain.  Twenty-four consecutive patients (26 knees) suffering from patellofemoral instability and patella alta were treated by DMTT. Two groups were identified, which differed for documented history of frank patella dislocation. Read More

Knee Surg Sports Traumatol Arthrosc 2018 Dec 4;26(12):3572-3581. Epub 2018 Jun 4.

Chirurgisch-Traumatologisches Zentrum, Asklepios Klinik St. Georg, Lohmühlenstr. 5, 20099, Hamburg, Germany.

Purpose: Valgus deformities of the lower extremity influence patellofemoral joint kinematics. However, studies examining the clinical outcome after treatment of patellar instability and maltracking due to valgus deformity are rare in recent literature. This study's purpose is to analyze the clinical results after combined distal femoral osteotomy (DFO) for treatment of patellar instability. Read More

Eur J Trauma Emerg Surg 2018 08 7;44(4):637-642. Epub 2018 Mar 7.

Department of General-, Trauma- and Reconstructive Surgery, Munich University Hospital, Nußbaumstr. 20, 80336, Munich, Germany.

Purpose: Joint dislocations occur frequently in prehospital settings. The medical specialities of emergency physicians are heterogeneous. Decision making and the success rates of reduction attempt can vary greatly. Read More

Int Orthop 2018 12 3;42(12):2797-2806. Epub 2018 Mar 3.

Department of Orthopaedic and Traumatology Surgery, Louis Caty hospital, Epicura Baudour, Saint-Ghislain, Belgium.

Purpose: Lateralized tibial tubercle is a cause of patellar instability. Before proceeding with reduction of the tibial tubercle-trochlear groove (TT-TG) distance, surgeons prefer to know whether this distance is pathologic. However, the pathological value remains discussed and may vary with the size of the knee. Read More