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Knee 2021 Jun 9;31:77-85. Epub 2021 Jun 9.

Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

Soft tissue sarcomas about the patellar tendon necessitate wide resection and thus present a significant reconstructive challenge. This article describes the novel use of a synthetic mesh graft to reconstruct the knee extensor mechanism as a single stage procedure after wide en bloc resection of an extraskeletal myxoid chondrosarcoma (EMC) in a patient with an invasive mass that was intimately associated with her patellar tendon. Read More

Clin J Sport Med 2021 Jun 9. Epub 2021 Jun 9.

Department of Orthopaedics, NU-Hospital Group, Uddevalla/Trollhättan, Sweden; Department of Clinical Sciences Lund, Orthopaedics, Lund University, Lund, Sweden; and Department of Orthopaedics, Helsingborg Hospital, Helsingborg, Sweden.

Objective: Hemarthrosis after knee trauma often indicates serious joint injury. Few studies have evaluated agreement between clinical examination and findings from magnetic resonance imaging (MRI). We aimed to describe the agreement between acute clinical examination and subacute MRI findings after acute knee trauma with hemarthrosis and the importance of the subspecialty of the examiner. Read More

BMJ Case Rep 2021 Jun 11;14(6). Epub 2021 Jun 11.

Radiology, London North West University Healthcare NHS Trust, London, UK.

Patellar tendinopathy is a common cause of knee pain and functional impairment in athletes. It is commonly managed using conservative measures such as physiotherapy, but cases that are refractory to such treatment may require a more invasive approach. Various forms of image-guided injection therapy have been described in the literature. Read More

J Arthroplasty 2021 May 27. Epub 2021 May 27.

Department of Orthopaedics, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.

Background: Patellar crepitus (PC) is a potentially problematic complication after total knee arthroplasty (TKA) more commonly occurring with a posterior-stabilized (PS) prosthesis. Patellar resurfacing has been reported to reduce PC complications; however, no study has compared the PC complication rates between 2 different resurfacing techniques, namely inlay and onlay.

Methods: A prospective, randomized controlled trial was conducted to compare the PC complication between inlay and onlay patellar resurfacing techniques. Read More

Cartilage 2021 Jun 11:19476035211021908. Epub 2021 Jun 11.

Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.

Purpose: To evaluate autologous matrix-induced chondrogenesis (AMIC) for isolated focal retropatellar cartilage lesions and the influence of patellofemoral (PF) anatomy on clinical outcomes at a minimum of 2-year follow-up.

Methods: Twenty-nine consecutive patients (31 knees) who underwent retropatellar AMIC with a mean age of 27.9 ± 11. Read More

Clin Biomech (Bristol, Avon) 2021 Jun 9;87:105406. Epub 2021 Jun 9.

Department of Research, Cleveland Clinic Akron General, 1 Akron General Ave, Akron, OH 44307, United States. Electronic address:

Background: Patella alta reduces articular constraints acting on the patella from the trochlear groove with the knee extended. The current study was performed to address how patella alta alters the influence of tibial tuberosity position and trochlear depth on patellar tracking in patients being treated for patellar instability.

Methods: Fifteen subjects with recurrent patellar instability participated in knee extension within a dynamic CT scanner. Read More

Am J Sports Med 2021 Jun 11:3635465211017145. Epub 2021 Jun 11.

Biomechanics Group, Mechanical Engineering Department, Imperial College London, London, UK.

Background: Biomechanical studies on anterior cruciate ligament (ACL) injuries and reconstructions are based on ACL transection instead of realistic injury trauma.

Purpose: To replicate an ACL injury in vitro and compare the laxity that occurs with that after an isolated ACL transection injury before and after ACL reconstruction.

Study Design: Controlled laboratory study. Read More

J Sport Rehabil 2021 Jun 10:1-6. Epub 2021 Jun 10.

Context: Performance in strength and assessment of patellar tracking is important for patients with arthrofibrosis after anterior cruciate ligament (ACL) reconstruction.

Objective: The study was to examine the difference of patellofemoral kinematics between the affected and the contralateral limb and to evaluate the relationship between knee extensor strength and patellofemoral kinematics in patients with arthrofibrosis after ACL reconstruction.

Design: Cohort study (diagnosis); level of evidence, 3. Read More

JBJS Case Connect 2021 06 10;11(2). Epub 2021 Jun 10.

Division of Orthopedic Trauma Surgery, Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, New York.

Case: A 41-year-old man presented with a transverse patella fracture and proximal patellar tendon avulsion after a fall from standing. Disruption of the extensor mechanism of the knee at multiple points is rare. He was treated operatively for his patella fracture and patellar tendon avulsion but experienced early failure of the patellar tendon fixation requiring reoperation. Read More

Eur J Orthop Surg Traumatol 2021 Jun 10. Epub 2021 Jun 10.

Department of Orthopaedics, Penn State Health Milton S. Hershey Medical Center, 500 University Dr., 414 Hallmark South, Hershey, PA, 17033, USA.

Background: Multiple graft options exist for anterior cruciate ligament (ACL) reconstruction in an adolescent athlete. Patellar tendon harvest can lead to anterior knee pain, while hamstring tendon harvest can affect knee flexion strength and alter mechanics. Allograft is less desirable in pediatric patients due to the higher failure rate and slight risk of disease transmission. Read More

Syst Rev 2021 Jun 9;10(1):173. Epub 2021 Jun 9.

Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.

Background: Current clinical guidelines recommend conservative management including non-pharmacologic therapy prior to considering surgery for knee OA. There is a paucity of clinical trials investigating the use of biomechanical device therapies on those with patellofemoral joint osteoarthritis (PFJOA). The aim was to systematically review the effectiveness of biomechanical devices (bracing, taping, and footwear) in the management of symptomatic PFJOA. Read More

J Orthop Surg Res 2021 Jun 9;16(1):367. Epub 2021 Jun 9.

Department of Orthopaedics, Phramongkutklao Hospital and College of Medicine, Bangkok, 10400, Thailand.

Background: Modified tension band fixation has become commonly used for transverse patella fractures. The conventional stainless steel wire provides sufficient stability but may be associated with complications.

Objective: The study aimed to evaluate the effectiveness of a new modified tension band fixation technique for transverse patella fractures using a nonabsorbable suture. Read More

J Orthop Surg Res 2021 Jun 8;16(1):365. Epub 2021 Jun 8.

Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng-Li Rd., Tainan, Taiwan, Republic of China.

Background: The optimal surgical technique for the fixation of inferior pole patellar fracture remains controversial. The aims of this study were (1) to compare clinical and radiological outcomes following fixation of inferior pole patellar fracture by using tension band wire (TBW) and transosseous reattachment (TOR) without excision of the bony fragment and (2) to determine the risk factors for postoperative radiological loss of reduction.

Methods: For this retrospective cohort study, consecutive patients with inferior pole patellar fracture between January 2010 and December 2017 were recruited. Read More

JBJS Case Connect 2021 06 8;11(2). Epub 2021 Jun 8.

Surgery Service, Department of Veterans Affairs, Cincinnati, Ohio.

Case: A 53-year-old woman presented with a locked knee after an atraumatic hyperextension episode. Imaging showed an anterior tilt of the patella hinging over the superior trochlear margin, consistent with a superior patellar dislocation. The patella spontaneously reduced on an intra-articular injection with 15 mL of lidocaine in normal saline, after which she was able to actively range her knee. Read More

MAGMA 2021 Jun 8. Epub 2021 Jun 8.

School of Rehabilitation Sciences, McMaster University, 1280 Main St. W., Hamilton, ON, L8S 4L8, Canada.

Objectives: Accurate and efficient knee cartilage and bone segmentation are necessary for basic science, clinical trial, and clinical applications. This work tested a multi-stage convolutional neural network framework for MRI image segmentation.

Materials And Methods: Stage 1 of the framework coarsely segments images outputting probabilities of each voxel belonging to the classes of interest: 4 cartilage tissues, 3 bones, 1 background. Read More

J Orthop Surg (Hong Kong) 2021 Sep-Dec;29(3):23094990211015501

Department of Orthopaedics, Melaka-Manipal Medical College, Melaka, Malaysia.

Curr Sports Med Rep 2021 Jun;20(6):298-305

Orthopedic Surgery and Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN.

Abstract: Treatment of musculoskeletal conditions in athletes with extracorporeal shockwave therapy (ESWT) is gaining popularity as greater evidence supports its use. ESWT protocols (describing energy flux density, number of impulses, type of shockwave (focused or radial), number/frequency/duration of treatment session, area of application, and postprocedural therapy protocols) can be adjusted in the clinical setting. Protocols vary across studies, and optimal protocols for most indications are yet to be determined. Read More

Gait Posture 2021 May 27;88:185-191. Epub 2021 May 27.

Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, WI, USA; Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA. Electronic address:

Background: Motion analysis is commonly used to evaluate joint kinetics in children with cerebral palsy who exhibit gait disorders. However, one cannot readily infer muscle-tendon forces from joint kinetics. This study investigates the use of shear wave tensiometry to characterize Achilles and patellar tendon forces during gait. Read More

Am J Sports Med 2021 Jun 7:3635465211013543. Epub 2021 Jun 7.

Division of Orthopedic Surgery, Rady Children's Hospital, San Diego, California, USA.

Background: The management of adolescents with acute first-time patellar dislocation with an associated loose body remains a debated topic. The rate of recurrent dislocation in these patients may be up to 61% if the medial patellofemoral ligament (MPFL) is repaired or not addressed surgically. To our knowledge, a prospective evaluation of MPFL reconstruction for adolescents with acute first-time patellar dislocation with an associated chondral or osteochondral loose body has not been previously performed. Read More

Orthop J Sports Med 2021 May 20;9(5):2325967121993179. Epub 2021 May 20.

Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

Background: Numerous diagnostic imaging measurements related to patellar instability have been evaluated in the literature; however, little has been done to compare these findings across multiple studies.

Purpose: To review the different imaging measurements used to evaluate patellar instability and to assess the prevalence of each measure and its utility in predicting instability. We focused on reliability across imaging modalities and between patients with and without patellar instability. Read More

Clin Orthop Surg 2021 Jun 2;13(2):175-184. Epub 2021 Feb 2.

Department of Orthopaedic Surgery, Kyung Hee University College of Medicine, Seoul, Korea.

Backgroud: One recently developed total knee arthroplasty (TKA) prosthesis was designed to alter the patellofemoral geometry and optimize patellar tracking compared to its predecessor. Despite an expectation that the improved design would contribute to optimal patellofemoral compatibility, its effect has not been confirmed with patellofemoral-specific clinical scoring systems and radiographic parameters. Our purpose was to compare patellofemoral-specific clinical and radiographic results after TKA using a patellofemoral design-modified prosthesis and its predecessor. Read More

Pol J Radiol 2021 24;86:e232-e238. Epub 2021 Apr 24.

Department of Musculoskeletal Imaging, Royal Orthopaedic Hospital, Birmingham, UK.

Introduction: Trochlear dysplasia (TD) is a condition that is characterized by the presence of either a flat or convex trochlear, which impedes the stability of the patellofemoral joint (PFJ). The PFJ function is dependent on many different structures that surround the knee joint. The aim of this study was to analyse all the muscle components around the PFJ and identify whether gross muscle imbalance could contribute to the stability of the patella in TD. Read More

Vet Anaesth Analg 2021 Mar 31. Epub 2021 Mar 31.

Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.

Objectives: To evaluate the use of 0.7 mA as a fixed electrical current to indicate epidural needle placement and to confirm that 0.7 mA is greater than the upper limit of the minimal electrical threshold (MET) for sacrococcygeal epidural needle placement in dogs. Read More

Mol Genet Metab 2021 Jun 1. Epub 2021 Jun 1.

Ospedale Provinciale Madonna del Soccorso, Department of Internal Medicine, San Benedetto del Tronto, Marche, Italy.

Introduction: Musculoskeletal findings in MPS can progress after enzyme replacement. Our aim was to examine synovial recesses, tendons, retinacula and pulleys using ultrasonography for structural and inflammatory changes.

Material And Methods: The wrist, metacarpophalangeal (MCP), proximal and distal interphalangeal (PIP and DIP) joints, the finger flexor tendons and the knee including entheses of quadriceps and patella tendons were assessed clinically. Read More

J ISAKOS 2021 Jun 4. Epub 2021 Jun 4.

OrthoSport Victoria Research Unit, OrthoSport Victoria, Richmond, Victoria, Australia.

Objectives: Recurrent patellar instability following first-time lateral patellar dislocation is associated with a variety of bony, soft tissue and patient-related risk factors. The specific management of recurrent dislocation may vary depending on the presence and combination of these factors as well as the treating physician's interpretation of these. Therefore, this study aimed to determine which factors Australian knee surgeons regard as increasing the risk of recurrence following first-time patellar dislocation and to characterise the surgical decision-making process of these surgeons in the management of lateral patellar instability. Read More

J Strength Cond Res 2021 Jun 2. Epub 2021 Jun 2.

Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, Spain; and Faculty of Humanities and Social Sciences, Comillas Pontifical University, Madrid, Spain.

Abstract: Abián-Vicén, J, Martínez, F, Jiménez, F, and Abián, P. Effects of eccentric single-leg decline squat training performed with different execution times on maximal strength and muscle contraction properties of the knee extensor muscles. J Strength Cond Res XX(X): 000-000, 2021-The eccentric phase of the single-leg decline squat (SLDSe) has been described as a method to maximally load the knee extensor and has been used as an easy and effective rehabilitation exercise for patellar tendinopathy. Read More

Oman J Ophthalmol 2021 Jan-Apr;14(1):60-61. Epub 2021 Feb 27.

Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India.

Ozurdex is one of the most commonly inserted intravitreal steroid implants in cases of posterior uveitis and recalcitrant macular edema in cases of diabetic retinopathy and vascular occlusions. Here we report accidental malpositioning of this implant in patellar fossa. Read More

Bull Hosp Jt Dis (2013) 2021 Jun;79(2):72-77

Background: Graft failure following anterior cruciate ligament reconstruction (ACLR) is a devastating complication. Risk factors such as patient characteristics and tunnel positions are well described. The relationship between graft dimension and failure rates has been investigated mainly in soft tissue grafts. Read More

Oper Orthop Traumatol 2021 Jun 3. Epub 2021 Jun 3.

Department of Orthopedics and Traumatology, Hospital Brandenburg, Brandenburg Medical School "Theodor Fontane", Hochstraße 26, 14776, Brandenburg, Germany.

Objective: Treatment of isolated retropatellar cartilage defects using current gel-type regenerative methods requires settlement of the gel to the underlying subchondral bone under gravity; thus, prone positioned arthroscopy is used.

Indications: Isolated retropatellar contained cartilage defect size >2.5 cm. Read More

Med Sci Sports Exerc 2021 May 28. Epub 2021 May 28.

Dept. Dev. Biology, Stanford University School of Medicine, Stanford, CA Kaiser Permanente Northern California, Division of Research, Oakland, CA Dept. Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA.

Purpose: It is unknown why some athletes develop patellar tendinopathy and others do not, even when accounting for similar workloads between individuals. Genetic differences between these two populations may be a contributing factor. The purpose of this work was to screen the entire genome for genetic markers associated with patellar tendinopathy. Read More