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Arthrosc Sports Med Rehabil 2022 Jun 4;4(3):e1031-e1037. Epub 2022 Apr 4.

Elite Sports Medicine @ Connecticut Children's Medical Center, Farmington, Connecticut, U.S.A.

Purpose: To evaluate whether there is a correlation between the position of the patella and trochlear morphology in patients with and without patellar instability using exclusively MRI measurements.

Methods: MRI scans of knees in patients with patellofemoral instability and knees of patients with an ACL (anterior cruciate ligament) tear as a control group were reviewed. Measurements of patellar position (Canton-Deschamps ratio, Patellar Trochlear Index, and lateral patellar inclination) and trochlear morphology (lateral trochlear inclination and sulcus angle) were obtained from each scan. Read More

Zhongguo Gu Shang 2022 Jun;35(6):532-7

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

Objective: To compare computed tomography (CT) measurement results of external deviation angle of patellar tendon and tibia tubercle-trochlea groove (TT-TG), as well as the diagnostic ability and pathology in recurrent patellar dislocation threshold.

Methods: From January 2015 to March 2020, 46 patients with recurrent patella dislocation and 112 patients with non-patella dislocation were retrospectively analyzed. Forty-six patients with recurrent patella dislocation were divived into 2 groups according to TT-TG value, 11 patients with patellar dislocation with TT-TG≥20 mm(group A), including 7 males and 4 females, aged from 16 to 27 years old with an average of(21. Read More

BMC Musculoskelet Disord 2022 Jun 15;23(1):578. Epub 2022 Jun 15.

Department of Sports Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.

Background: Surgical treatment for recurrent patellar dislocation (RPD) could yield good outcomes. While, unsatisfactory recovery still exists in some cases. For all prognostic factors, serum biomarkers have rarely been investigated. Read More

Knee 2022 Jun 10;37:71-79. Epub 2022 Jun 10.

Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.

Background: We aimed to prospectively investigate the clinical outcomes of medial patellofemoral ligament (MPFL) reconstruction using polyester high-strength suture tape with knotless anchors.

Method: Forty-three patients (65 knees) were followed for at least 1 year postoperatively, with 27 patients (43 knees) followed for 2 years postoperatively. All patients underwent MPFL reconstruction using polyester high-strength suture tape (FiberTape®; Arthrex) with knotless anchors (SwiveLock®; Arthrex). Read More

Cartilage 2022 Apr-Jun;13(2):19476035221102570

Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA.

Objective: The study was performed to evaluate cartilage within the knee following a first-time patellar dislocation, using elevated MRI-based T1ρ relaxation times as an indicator of low proteoglycan concentration. The hypothesis is that MRI-based T1ρ relaxation times for patellofemoral and tibiofemoral cartilage are significantly longer for knees being treated for patellar dislocation than for healthy control knees.

Design: Twenty-one subjects being treated for a first-time, unilateral dislocation of the patella and 16 healthy controls participated in MRI-based T1ρ relaxation time mapping. Read More

Orthop J Sports Med 2022 May 23;10(5):23259671221098748. Epub 2022 May 23.

Foot & Ankle Research and Innovation Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Background: The use of imaging to diagnose patellofemoral instability is often limited by the inability to dynamically load the joint during assessment. Therefore, the diagnosis is typically based on physical examination using the glide test to assess and quantify lateral patellar translation. However, precise quantification with this technique remains difficult. Read More

Injury 2022 Jul 21;53(7):2644-2649. Epub 2022 May 21.

Department of Ultrasonography, Shandong Provincial Qianfoshan Hospital, The First Hospital Affiliated With Shandong First Medical University, Jinan 250014, China. Electronic address:

Objectives: To identify risk factors of acute articular cartilage lesions of the patella and lateral femoral condyle in acute first-time lateral patellar dislocation (LPD).

Methods: Magnetic resonance images were prospectively analyzed in 115 patients in an acute first-time LPD. Factors included gender, skeletal maturity, trochlear dysplasia, patellar height, and tibial tuberosity-trochlear groove (TT-TG) distance. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2022 May;36(5):573-581

Department of Sports Medicine, First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, 650032, P. R. China.

Objective: To establish a three-dimensional finite element analysis model of the knee joint in fresh frozen cadavers, to verify the validity of the model and to simulate the stress distribution characteristics of the patellofemoral joint after combined proximal and distal knee extension rearrangement surgery for recurrent patellar dislocation.

Methods: One male and one female fresh frozen cadavers (4 knees in total), using voluntary body donations, were used to measure the maximum pressure on the patellofemoral articular surface at each passive flexion angle (0°, 30°, 60°, 90°, 120°) of the normal knee joint and the model after combined proximal and distal knee extension rearrangement surgery for recurrent patellar dislocation with tibial tuberosity-trochlear groove distance (TT-TG) value >2.00 cm using pressure-sensitive paper, respectively. Read More

J Orthop Surg Res 2022 May 15;17(1):274. Epub 2022 May 15.

Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China.

Background: Patellar dislocation can cause a series of changes in the trochlear groove and patella. However, the influence of patellar dislocation on the medialis (VM) and vastus lateralis (VL) muscles and whether nerve growth factor (NGF) is beneficial to proprioceptive rehabilitation for patellar dislocation are unknown. The purpose of this study was to investigate the effects on VM and VL after the injection of NGF and early reduction in rabbits for patellar dislocation with electrophysiological and pathological analysis. Read More

J Orthop Surg Res 2022 May 15;17(1):276. Epub 2022 May 15.

Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Ziqiang Road 139, Shijiazhuang, 050051, Hebei, China.

Purpose: To investigate the difference of trochlear width between normal and dysplastic trochlear and to analyze whether the medialization of trochlear groove was correlated with abnormal width of trochlear facets in trochlear dysplasia.

Methods: This study involved CT scans of fifty knees with trochlear dysplasia (TD group) and fifty knees without obvious trochlear dysplasia (Normal group). The linear distance from the medial femoral epicondyle to the various reference points was measured on axial CT images which included the medial edge of medial trochlear facet (dMTE), trochlear groove (dTG), and the lateral edge of lateral trochlear facets (dLTE). Read More

Korean J Radiol 2022 Jun 9;23(6):674-687. Epub 2022 May 9.

Devision of Pediatric Orthopedic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Patellofemoral instability (PFI) is common in pediatric knee injuries. PFI results from loss of balance in the dynamic relationship of the patella in the femoral trochlear groove. Patellar lateral dislocation, which is at the extreme of the PFI, results from medial stabilizer injury and leads to the patella hitting the lateral femoral condyle. Read More

J ISAKOS 2022 02 5;7(1):35-38. Epub 2021 Oct 5.

Department of Orthopaedic Surgery, Sir HN Reliance Foundation Hospital, Mumbai, India. Electronic address:

Medial dislocation of patella has been commonly reported as a complication of the surgical release of the lateral patella-femoral ligament. A traumatic medial eversion-dislocation of the patella has not been earlier reported. We report an unusual case of traumatic medial patellar eversion-dislocation in a young adult patient whose magnetic resonance imaging (MRI) showed a discontinuity in medial and lateral patellar retinacula. Read More

J ISAKOS 2022 02 17;7(1):3-6. Epub 2021 Nov 17.

Department of Orthopedic Surgery, New York University Langone Health, 333 E 38(th) Street, New York, NY 10016, USA.

Objectives: An isolated medial patellofemoral ligament (MPFL) reconstruction (MPFLR) has been demonstrated to be an effective treatment option in the prevention of patellar instability, but there is growing support for performing a tibial tubercle osteotomy (TTO) in patients with an elevated tibial tubercle-trochlear groove distance. The purpose of this study was to evaluate the impact of adding a TTO to MPFLR on patient-reported outcomes.

Methods: A retrospective review of patients who underwent MPFLR with or without TTO with a minimum of 12-month follow-up was performed. Read More

BMC Musculoskelet Disord 2022 May 9;23(1):431. Epub 2022 May 9.

Department of Orthopedic and Trauma Surgery, Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

Background: Open knee fracture-dislocation is a rare orthopedic injury. However, the importance of its correct management could not be overstated. To the best of our knowledge, this is the fifth study reporting a case with simultaneous Hoffa fracture and knee dislocation and the 1 study describing a patient with open plateau fracture-dislocation accompanied with Hoffa fracture, patella fracture, and patellar tendon tear. Read More

Lakartidningen 2022 05 6;119. Epub 2022 May 6.

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Arthrosc Sports Med Rehabil 2022 Apr 20;4(2):e359-e370. Epub 2021 Dec 20.

University of Utah, Department of Orthopaedic Surgery, Salt Lake City, Utah, U.S.A.

Purpose: To evaluate mid-term outcomes after medial patellofemoral ligament (MPFL) reconstruction with and without tape augmentation in the skeletally mature adolescent population.

Methods: All patients under age 18 with recurrent patellar instability treated with surgery at a single institution by a single surgeon from January 2013 through June 2017 were identified by current procedural terminology codes. Inclusion criteria were (1) primary MPFL reconstruction, (2) minimum 3 years' follow-up, (3) skeletal maturity. Read More

Arthrosc Sports Med Rehabil 2022 Apr 8;4(2):e343-e347. Epub 2021 Dec 8.

Rothman Orthopaedic Institute at the Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A.

Purpose: To compare the frequency and severity of articular cartilage injury on longitudinal magnetic resonance imaging (MRI) in patients after their initial dislocation and subsequent recurrent dislocations for those undergoing patellar stabilization surgery.

Methods: Between January 2012 and December 2017, patients undergoing patellar stabilization surgery were retrospectively reviewed. Only patients with an MRI after both the initial dislocation and subsequent dislocation events were included. Read More

Zhongguo Gu Shang 2022 Apr;35(4):345-8

Department of Orthopaedics and Traumatology, Yuncheng County Hospital of TCM, Heze 274700, Shandong, China.

Injury 2022 Jun 30;53(6):1887-1892. Epub 2022 Mar 30.

Gold Coast University Hospital, Australia.

Introduction: Australia is one of the largest surfing nations with over 10% of the population participating; yet there is a paucity of literature analysing the injuries from surfing participation, particularly injuries requiring orthopaedic care. This study retrospectively analyses surfing injuries presenting to a tertiary hospital Emergency Department over a ten-year period with aims of quantifying surfing injuries and investigating injury characteristics requiring orthopaedic input.

Methods: A retrospective clinical audit of presentations to Gold Coast Public Hospital Emergency Departments over a ten-year period was conducted using electronic hospital databases. Read More

Acta Ortop Mex 2021 Sep-Oct;35(5):425-428

Medicina deportiva del Hospital Ángeles Lomas. Ciudad de México. México.

Introduction: Alterations of the patellofemoral joint are one of the most common causes of pain and inflammation as well as joint damage and instability of the knee. Patellofemoral instability is a common multifactorial entity, requiring realignment by proximal, distal, or a combination of techniques. Within the proximal procedures in soft tissues, is the medial patellofemoral ligament plasty (MPFL), which aims to realign the patella medially and restore the anatomy between the quadricipital tendon, patella and tubercle of the tibia. Read More

Am J Sports Med 2022 05 19;50(6):1627-1634. Epub 2022 Apr 19.

Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA.

Background: Previous research supports that distal translation of the tibial tubercle osteotomy (dTTO) for patients with recurrent lateral patellar dislocation (R-LPD) and patella alta is effective for surgical patellar stabilization.

Hypothesis/purpose: The main purpose of this article is to evaluate (1) the results of modifying the surgical threshold and postoperative goal of patellar height measurements for surgical stabilization originated in the "menu à la carte" approach to patellar surgical stabilization and (2) the relationship between the distance distalized in millimeters and postoperative complications. Our hypothesis was that dTTO with medial patellofemoral ligament reconstruction (MPFL-R) will successfully stabilize the patella with improvement in outcome scores and few complications, using a modification of the original menu à la carte as our surgical algorithm. Read More

Am J Sports Med 2022 Jun 19;50(7):1867-1875. Epub 2022 Apr 19.

Unit of Musculoskeletal Surgery, Department of Orthopaedics, Tampere University Hospital, Tampere, Finland.

Background: A traumatic lateral patellar dislocation is a common injury in adolescents and young adults. The majority of first-time dislocations can be treated nonoperatively. Various types of knee braces are used for nonoperative treatment, but evidence on the most preferable bracing method is lacking. Read More

Knee Surg Relat Res 2022 Apr 13;34(1):21. Epub 2022 Apr 13.

Department of Surgery, Central Finland Hospital, Jyväskylä, Finland.

Purpose: We examine the outcomes following operative treatment of intra-articular fracture combined with medial patellofemoral ligament (MPFL) reconstruction after patella dislocation.

Methods: Patients were retrospectively identified from medical records using diagnostic and surgical procedure codes. Radiological anatomical parameters and bony abnormalities of injured knees were assessed from magnetic resonance images (MRI). Read More

Surg Technol Int 2022 May;40:363-367

Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland.

Introduction: The medial patellofemoral ligament (MPFL) is the main restraining force against lateral patellar displacement in the first 20 degrees of knee flexion and is often disrupted following patellar subluxation or dislocation. MPFL reconstruction is commonly performed to restore patellar stability but requires autograft harvest with associated donor site morbidity. The aim of this study was to assess the five-year outcomes of MPFL repair performed with suture tape augmentation. Read More

J Orthop Case Rep 2021 Dec;11(12):57-61

Department of Orthopaedics, All India Institute of Medical Sciences, Patna, Bihar, India.

Introduction: Bicondylar Conjoint Hoffa fractures, where both the fractured femoral condyles joined by the bony bridge at intercondylar notch, are extremely rare with only 7 cases reported so far in the literature. We present a first case of such fracture along with patellar fracture dislocation where a fractured fragment was incarcerated between the femoral condyles.

Case Presentation: 18 years old boy after road side accident presented with knee swelling and pain. Read More

JBJS Rev 2022 04 8;10(4). Epub 2022 Apr 8.

Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, Rhode Island.

»: An osteochondral fracture (OCF) of the patella or the femur is a frequent sequela after an episode of acute patellofemoral instability.

»: Patients commonly present with anterior knee pain after direct trauma to the patella or a noncontact twisting injury.

»: Radiographs and magnetic resonance imaging (MRI) are the most common imaging modalities that are used to diagnose OCFs. Read More

Arthroscopy 2022 04;38(4):1299-1301

An excessively lateral tibial tubercle is a well-accepted risk factor for recurrent patellar dislocation. Generally, it is measured on magnetic resonance imaging as the TT-TG distance (tibial tubercle-trochlear groove distance), and recent meta-analyses have suggested that a value as low as 12.5 mm can be used as the threshold for deciding when to medialize the tibial tubercle. Read More

Knee Surg Sports Traumatol Arthrosc 2022 Mar 31. Epub 2022 Mar 31.

Department of Orthopaedic Surgery, William Beaumont Hospital, Royal Oak, MI, USA.

Purpose: To evaluate the inter-observer and inter-method reliability for patellar height measurements between conventional radiographs (CR) and magnetic resonance imaging (MRI) using one or two slices.

Methods: This was a reliability study, with 60 patients divided in two groups: 30 patients with patellar instability (patella group) and 30 patients with anterior cruciate ligament or meniscus injury (control group). CR and MRI were evaluated by two independent observers. Read More

Int Orthop 2022 Jun 29;46(6):1395-1403. Epub 2022 Mar 29.

Zentrum Für Unfallchirurgie Und Orthopädische Chirurgie, BG Unfallklinik Frankfurt Am Main, Friedberger Landstrasse 430, 60389, Frankfurt am Main, Germany.

Purpose: The treatment of comminuted patellar fractures remains a challenge for orthopedic surgeons. The aim of this study was to assess the clinical, functional, and radiological outcome after treatment of comminuted patellar fractures using an anatomically contoured plating system.

Methods: Between January 2015 and December 2019 (5 years), 29 patients with complex C3 fractures according to AO classification (18 female, 11 male; mean age: 53 years) were treated using an anatomically contoured plating system (patella SuturePlate™, Arthrex®, Naples, USA). Read More

Cureus 2022 Feb 23;14(2):e22516. Epub 2022 Feb 23.

Orthopedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, USA.

Background and objective Primary patellar dislocations can concomitantly involve osteochondral injuries for which prompt recognition is paramount for joint preservation. These injuries can be missed on radiographs, necessitating MRI examinations. In this study, we aimed to identify patient parameters that correlate with occult osteochondral injuries. Read More