2,625 results match your criteria Patellar Injury and Dislocation


Combined medial patellofemoral and patellotibial reconstruction with soft tissue fixation in recurrent patellar dislocation.

Injury 2020 Jun 17. Epub 2020 Jun 17.

Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, 84084 Baronissi, Italy; Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi D'Aragona, 84131 Salerno, Italy.

Introduction: The medial patellofemoral and patellotibial ligaments (MPFL and MPTL) are the main passive restraints to lateral patellar translation. When nonoperative management of patellofemoral dislocations fails, surgical options can be considered to restore patellofemoral stability. Several reconstruction procedures of the MPFL with semitendinosus, gracilis, quadriceps tendon, and synthetic grafts have been described. Read More

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http://dx.doi.org/10.1016/j.injury.2020.06.028DOI Listing

Conservative versus repair of medial patellofemoral ligament for the treatment of patients with acute primary patellar dislocations: A systematic review and meta-analysis.

J Orthop Surg (Hong Kong) 2020 Jan-Apr;28(2):2309499020932375

Department of Joint Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.

Purpose: The aim of this study was to perform a meta-analysis to compare the effects of repair of medial patellofemoral ligament (MPFL) and conservative treatment in patients with acute primary patellar dislocation (PPD).

Method: The databases we used to search the studies included MEDILINE, EMBASE, and Cochrane registry of controlled clinical trials. Five randomized controlled studies comparing the effects of MPFL repair versus conservative treatment with 300 acute PPD patients were included in the present meta-analysis. Read More

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http://dx.doi.org/10.1177/2309499020932375DOI Listing

Prediction of recurrence based on the patellofemoral morphological profile and demographic factors in first-time and recurrent dislocators.

Int Orthop 2020 Jun 7. Epub 2020 Jun 7.

Ganga Hospital, 313, Mettupalayam Road, Coimbatore, 641043, India.

Introduction: Prediction of recurrence in first-time patellar dislocation is an unsolved mystery. The purpose of our study is to compare patellar instability patients and normal control groups with anatomical risk factors and validation of newer parameters patello-trochlear index (PTI) and tibial tuberosity-posterior cruciate ligament (TT-PCL) and also to find the significant risk factors that help to predict the recurrence of dislocation in first-time dislocators.

Methods: This is a comparison study between 50 normal individuals as a control population (group-1) and 94 patients with patellar instability done between 2013 and 2017. Read More

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http://dx.doi.org/10.1007/s00264-020-04639-1DOI Listing

Editorial Commentary: Repair or Reconstruct? Addressing Medial Patellofemoral Ligament Insufficiency in the Absence of Morphologic Abnormalities.

Authors:
Miho J Tanaka

Arthroscopy 2020 06;36(6):1735-1737

The role of medial patellofemoral ligament (MPFL) repair versus reconstruction in the treatment of patellar instability continues to undergo debate. Repair of the ligament can be technically less demanding with fewer risks of morbidity, whereas reconstruction carries concerns of graft malpositioning or over-tensioning as well as the risk of patellar fracture. Studies directly comparing the 2 procedures in the setting of recurrent patellar instability have consisted of small series or low levels of evidence that inevitably include patients with concurrent morphologic risk factors such as tuberosity malalignment or patella alta, which are known factors that can influence the biomechanical behavior of the MPFL. Read More

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http://dx.doi.org/10.1016/j.arthro.2020.02.040DOI Listing

Hoffa's Fracture with Associated Injuries Around the Knee Joint: An Approach to a Rare Injury.

Cureus 2020 Apr 28;12(4):e7865. Epub 2020 Apr 28.

Orthopedics, Maharishi Markandeshwar (deemed to be University), Ambala, IND.

Fractures of the distal femur typically occur in the axial and sagittal planes. A Hoffa fracture is a coronal plane fracture of the femoral condyle, which accounts for 8.7% to 13% of distal femoral fractures. Read More

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http://dx.doi.org/10.7759/cureus.7865DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7255537PMC

Acute instability of the patella: is magnetic resonance imaging mandatory?

Int Orthop 2020 Jun 2. Epub 2020 Jun 2.

Department of Trauma and Orthopaedics, Wansbeck Hospital, Northumberland, UK.

Purpose: Acute dislocations of the patella represent 2 to 3% of traumatic injuries of the knee. When patients are seen in the emergency department with a dislocated patella clinical diagnosis is often very evident. However, in cases of short-lived subluxation or dislocations that have reduced spontaneously, the diagnosis can be challenging. Read More

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http://dx.doi.org/10.1007/s00264-020-04652-4DOI Listing

Open tibia plateau fracture with intra-osseous dislocation of the patella and quadriceps tendon rupture: a case report.

BMC Surg 2020 May 25;20(1):114. Epub 2020 May 25.

Department of Orthopaedics, The Second Affiliated Hospital of Kunming Medical University, Kunming, China.

Background: Both tibial plateau fractures and extensor apparatus injuries are serious injuries to the knee joint that generally do not occur in the same patient. We report a rare case of open tibial plateau fracture combined with quadriceps tendon rupture and complete displacement of the patella into the tibial plateau fracture.

Case Presentation: The case involved a male who was 19 years old who had been in a motorcycle accident. Read More

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http://dx.doi.org/10.1186/s12893-020-00770-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7249650PMC

Tibial Tubercle-Roman Arch Distance: A New Measurement of Patellar Dislocation and Indication of Tibial Tubercle Osteotomy.

Orthop J Sports Med 2020 Apr 28;8(4):2325967120914872. Epub 2020 Apr 28.

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

Background: The surgical indication for tibial tubercle osteotomy (TTO) has been based on a tibial tubercle-trochlear groove (TT-TG) distance of 20 mm or greater in patients with patellar dislocation. However, the measurement of this parameter is less reliable in patients with trochlear dysplasia.

Hypothesis: The novel measurement of tibial tubercle-Roman arch (TT-RA) distance would be a reliable parameter for identifying the relative position of the tibial tubercle in patients with patellar dislocation, especially those with trochlear dysplasia. Read More

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http://dx.doi.org/10.1177/2325967120914872DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7222266PMC

Which Risk Factors Predict Knee Ligament Injuries in Severely Injured Patients?-Results from an International Multicenter Analysis.

J Clin Med 2020 May 12;9(5). Epub 2020 May 12.

Committee on Emergency Medicine, Intensive Care and Trauma Management (Sektion NIS) of the German Trauma Society (DGU), 10623 Berlin, Germany.

Introduction: Ligament injuries around the knee joint and knee dislocations are rare but potentially complex injuries associated with high-energy trauma. Concomitant neurovascular injuries further affect their long-term clinical outcomes. In contrast to isolated ligamentous knee injuries, epidemiologic data and knowledge on predicting knee injuries in severely injured patients is still limited. Read More

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http://dx.doi.org/10.3390/jcm9051437DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7290858PMC

Medial Patellofemoral Ligament Reconstruction in Skeletally Immature Patients.

JBJS Essent Surg Tech 2020 Jan-Mar;10(1). Epub 2020 Feb 3.

Division of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, NY.

Patellofemoral instability is a common problem affecting children and adolescents, with recurrent instability often requiring surgical intervention. Medial patellofemoral ligament (MPFL) reconstruction has become a mainstay for the treatment of patellofemoral instability because of the biomechanical importance of the MPFL against lateral dislocation as well as the high frequency of MPFL injury following traumatic patellar dislocation. The concern in managing skeletally immature patients is the potential for injury to the distal femoral physis. Read More

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http://dx.doi.org/10.2106/JBJS.ST.18.00110DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161734PMC
February 2020

[A combined method of proximalization of the patella tendon and double boundle reconstruction of medial patellofemoral ligament with adductor magnus tendon autograft for the treatment of habitual dislocation of patella in adolescent].

Zhonghua Yi Xue Za Zhi 2020 Apr;100(15):1169-1174

Department of Pediatric Orthopedics, Beijing Jishuitan Hospital, Beijing 100035, China.

To present the technique and clinic effect of the combined method of proximalization of the patella and double boundle reconstruction of medial patellofemoral ligament (MPFL) with adductor magnus tendon autograft for the treatment of habitual dislocation of patella (HDP) in adolescent. From August 2016 to August 2018, a total of 33 consecutive skeletally immature adolescent patients (37 knees) with HDP were surgically treated in Beijing Jishuitan Hospital and were retrospectively reviewed. Among them, 10 patients (12 knees) with severe quadriceps contracture underwent the index comprehensive procedure. Read More

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http://dx.doi.org/10.3760/cma.j.cn112137-20190908-01986DOI Listing

Technique for Reduction and Fixation of a Hoffa Fracture with Ipsilateral Patella Dislocation from Low-Energy Trauma, a Rare Injury: A Case Report.

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

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http://dx.doi.org/10.2106/JBJS.CC.19.00250DOI Listing

Osteochondral Fracture of Posterior Aspect of Lateral Femoral Condyle After Lateral Patella Dislocation: A Case Report.

JBJS Case Connect 2020 Jan-Mar;10(1):e1800366

Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, South Korea.

Case: A healthy 15-year-old girl presented with osteochondral fracture at the posterior aspect of the lateral femoral condyle (LFC) associated with a right patellar dislocation after a noncontact injury. The patient remained asymptomatic 18 months after the arthroscopically assisted reduction and internal fixation of the osteochondral fracture using bioabsorbable pins and was able to eventually resume her usual activities of daily living.

Conclusions: This is the first report of an osteochondral fracture at the posterior aspect of the LFC after an acute patellar dislocation, successfully treated with arthroscopically assisted reduction and internal fixation using bioabsorbable pins. Read More

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http://dx.doi.org/10.2106/JBJS.CC.18.00366DOI Listing

Treatment of Osteochondral Fracture of the Lateral Femoral Condyle with TWINFIX Ti Suture Anchor "X"-Shaped Internal Fixation under Arthroscopy: A Surgical Technique and Three Cases Report.

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

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http://dx.doi.org/10.1111/os.12632DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7189045PMC

When does the patella dislocate? A systematic review of biomechanical & kinematic studies.

J Orthop 2020 Jul-Aug;20:70-77. Epub 2019 Nov 16.

University College London, London, UK.

Background: Patellar dislocations are a significant injury with the potential for long term problems. Little work has been done on establishing the mechanism by which this injury occurs.

Objectives: To determine the mechanism of injury of a patella dislocation based on the available published literature and compare them to already proposed theories. Read More

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http://dx.doi.org/10.1016/j.jor.2019.11.018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7000435PMC
November 2019

Patellar Instability and Dislocation: Optimizing Surgical Treatment and How to Avoid Complications.

Instr Course Lect 2020 ;69:671-692

Patellar instability is a common problem seen by the orthopedic surgeon. Surgery is indicated in recurrent dislocation to improve patellar tracking and ligamentous restraint in order to decrease risk of recurrence, osteochondral injury, and eventual progression to arthritis. Preoperative imaging studies identify anatomic risk factors that increase risk of patellar dislocation to inform surgical decision making. Read More

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February 2020

Hoffa fracture associated with tibial shaft fracture and multiple ligament avulsion fractures: A case report.

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

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http://dx.doi.org/10.1016/j.tcr.2020.100277DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6970162PMC

Outcomes and Predictors of Popliteal Artery Injury in Pediatric Trauma.

Ann Vasc Surg 2020 Jul 21;66:242-249. Epub 2020 Jan 21.

Department of Trauma Surgery, University of California, Irvine Medical Center, Orange, CA.

Background: Popliteal artery injury (PAI) is a rare occurrence in pediatric patients with significant consequences. Delays in diagnosis lead to severe complications such as lifelong disability and limb loss. We sought to identify outcomes and clinical predictors of PAI in the pediatric trauma population. Read More

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http://dx.doi.org/10.1016/j.avsg.2020.01.079DOI Listing

Clinical Results and MRI Evaluation of Patellar Osteochondral Fracture Fixation following Patellar Dislocation.

Biomed Res Int 2019 17;2019:7943636. Epub 2019 Dec 17.

Clinic of Orthopaedic and Traumatology, Polish Mother's Memorial Hospital Research Institute, 93-338 Łódź, ul. Rzgowska 281/289, Poland.

Aim: The aim of the study was to analyze the clinical results and MRI scans after transpatellar osteochondral fracture fixation following patellar dislocation.

Methods: Our study group comprised 17 patients with patellar dislocation followed by osteochondral fracture of the articular surface of the patella. All patients underwent surgery where the fractured osteochondral fragments of the patella were attached using the transpatellar suture technique. Read More

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http://dx.doi.org/10.1155/2019/7943636DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6942759PMC

The Oswestry-Bristol Classification.

Bone Joint J 2020 Jan;102-B(1):102-107

The Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, UK.

Aims: Trochlear dysplasia is a significant risk factor for patellofemoral instability. The Dejour classification is currently considered the standard for classifying trochlear dysplasia, but numerous studies have reported poor reliability on both plain radiography and MRI. The severity of trochlear dysplasia is important to establish in order to guide surgical management. Read More

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http://dx.doi.org/10.1302/0301-620X.102B1.BJJ-2019-0366.R3DOI Listing
January 2020

Implementation of a Prehospital Patella Dislocation Reduction Protocol.

Prehosp Emerg Care 2020 Jan 29:1-4. Epub 2020 Jan 29.

Acute patella dislocations account for up to 3% of all knee injuries. Prehospital care of patella dislocation often includes knee immobilization and pain management, but in the wilderness environment patella reductions are often performed by basic life support providers. Given the potential benefits of early reduction, the perceived low risk of harm and precedent with which the procedure can be performed, patella reduction was added to the EMT scope of practice in New York State. Read More

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http://dx.doi.org/10.1080/10903127.2019.1704322DOI Listing
January 2020

Risk of knee osteoarthritis after different types of knee injuries in young adults: a population-based cohort study.

Br J Sports Med 2020 Jun 11;54(12):725-730. Epub 2019 Dec 11.

Clinical Sciences Lund, Orthopaedics, Clinical Epidemiology Unit, Lund University, Faculty of Medicine, Lund, Sweden.

Objectives: To estimate the risk of clinically diagnosed knee osteoarthritis (OA) after different types of knee injuries in young adults.

Methods: In a longitudinal cohort study based on population-based healthcare data from Skåne, Sweden, we included all persons aged 25-34 years in 1998-2007 (n=149 288) with and without diagnoses of knee injuries according to International Classification of Diseases (ICD)-10. We estimated the HR of future diagnosed knee OA in injured and uninjured persons using Cox regression, adjusted for potential confounders. Read More

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http://dx.doi.org/10.1136/bjsports-2019-100959DOI Listing

Factors Associated With an Increased Risk of Recurrence After a First-Time Patellar Dislocation: A Systematic Review and Meta-analysis.

Am J Sports Med 2019 Dec 11:363546519888467. Epub 2019 Dec 11.

OrthoSport Victoria Research Unit, Epworth HealthCare, Melbourne, Victoria, Australia.

Background: Recurrent dislocations after a first-time lateral patellar dislocation may occur in more than 50% of patients and can cause long-term disability. Many factors have been suggested to influence the risk of recurrence.

Purpose: To systematically review and quantitatively synthesize the literature for factors associated with an increased risk of recurrence after a first-time patellar dislocation. Read More

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http://dx.doi.org/10.1177/0363546519888467DOI Listing
December 2019

Dynamic Evaluation of Patellofemoral Instability: A Clinical Reality or Just a Research Field? A Literature review.

Orthop Surg 2019 Dec 2;11(6):932-942. Epub 2019 Dec 2.

The ORIQL, Orthopaedic Research Institute of Queensland, Townsville (QLD), Australia.

Patellofemoral instability (PFI) is one of the most disabling conditions in the knee, often affecting young individuals. Despite its not uncommon presentation, the underlying biomechanical features leading to this entity are not entirely understood. The suitability of classic physical examination manoeuvres and imaging tests is a matter of discussion among treating surgeons, and so are the findings provided by these means. Read More

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http://dx.doi.org/10.1111/os.12549DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6904628PMC
December 2019

Lateral patellar maltracking due to trochlear dysplasia: A computational study.

Knee 2019 Dec 28;26(6):1234-1242. Epub 2019 Nov 28.

Department of Research, Cleveland Clinic Akron General, Akron, OH, USA.

Background: The study focuses on the influence of trochlear dysplasia on patellar tracking related to patellar instability.

Methods: Knee extension against gravity and dual-limb squatting were simulated with seven models representing knees being treated for recurrent instability. Trochlear depth was altered to represent lateral trochlear inclination (LTI) values of 6°, 12° and 24°. Read More

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http://dx.doi.org/10.1016/j.knee.2019.11.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6926151PMC
December 2019

[Treatment of a hip and patella luxation in a toy dog].

Schweiz Arch Tierheilkd 2019 Dec;161(12):831-836

Klinik für Kleintierchirurgie, Vetsuisse-Fakultät, Universität Zürich.

Introduction: The present case report describes the surgical treatment of a traumatic craniodorsal luxation of the hip and a concomitant medial congenital luxation of the patella (3rd grade) in an 11-year-old Yorkshire Terrier. First the hip luxation was corrected with a cemented hip prosthesis. The femoral stem was inserted in slight anteversion (15°) with respect to the preoperative condition (5°), this contributed contrasting the medial traction of the femoral quadriceps on the patella, improving patellar luxation from 3rd to 2nd grade. Read More

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http://dx.doi.org/10.17236/sat00239DOI Listing
December 2019

The Pediatric Knee and Proximal Tibia.

Pediatr Clin North Am 2020 02;67(1):153-167

Seaview Orthopaedic & Medical Associates, 1200 Eagle Avenue, Ocean, NJ 07712, USA. Electronic address:

Pediatric knee disorders are various and range from trauma and sports injuries to chronic overuse injuries. Because pediatric patients are different from adults, management of pediatric injuries and general knee disorders is also often different. Primary treatment regimen goals focus on a return to the previous level of function, preservation of anatomy, and decreasing potential long-term effects. Read More

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http://dx.doi.org/10.1016/j.pcl.2019.09.012DOI Listing
February 2020

[Diagnosis and therapy of chronic patellofemoral instability].

Orthopade 2020 Jan;49(1):73-84

Abteilung und Poliklinik für Sportorthopädie, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, 81675, München, Deutschland.

The chronic patellofemoral instability is a multifactorial disease, which is mostly congenital. Luxation of the patella is mainly atraumatic. Sole conservative treatment is often unsuccessful. Read More

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http://dx.doi.org/10.1007/s00132-019-03846-yDOI Listing
January 2020

Psychometric properties of the Norwich Patellar Instability Score in people with recurrent patellar dislocation.

Knee 2019 Dec 23;26(6):1192-1197. Epub 2019 Nov 23.

Department of Trauma and Orthopaedics, St George's Hospital, St George's University Hospitals NHS Foundation Trust, Tooting, London, UK; St George's University of London, Tooting, London, UK.

Background: Patellar dislocations account for two percent of all knee injuries with a 17% chance of re-dislocation. There are few validated scores specific to instability. One of these is the Norwich Patellar Instability Score. Read More

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http://dx.doi.org/10.1016/j.knee.2019.10.021DOI Listing
December 2019

Computational approach to correcting joint instability in patients with recurrent patellar dislocation.

J Orthop Res 2020 04 26;38(4):768-776. Epub 2019 Nov 26.

Mechanical and Biomedical Engineering, Boise State University, Boise, Idaho.

Patellar dislocation is a debilitating injury common in active adolescents and young adults. Conservative treatment after initial dislocation is often recommended, but almost half of these patients continue to suffer from recurrent dislocation. The objective of this study was to compare preoperative patellofemoral joint stability with stability after a series of simulated procedures, including restorative surgery to correct to pre-injury state, generic tibial tubercle osteotomy, patient-specific reconstructive surgery to correct anatomic abnormality, less invasive patient-specific surgery, and equivalent healthy controls. Read More

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http://dx.doi.org/10.1002/jor.24526DOI Listing

Surgical treatment is better than non-surgical treatment for primary patellar dislocation: a meta-analysis of randomized controlled trials.

Arch Orthop Trauma Surg 2020 Feb 14;140(2):219-229. Epub 2019 Nov 14.

Department of Orthopedic Surgery, Hangzhou First People's Hospital, Hangzhou, 310002, China.

Background: At present, the best treatment for primary patellar dislocation (PPD) has not been unified. Moreover, meta-analyses comparing the non-surgical and surgical treatments of PPD are lacking. Thus, we aimed to compare the clinical efficacy of surgical or non-surgical treatment of PPD. Read More

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http://dx.doi.org/10.1007/s00402-019-03308-2DOI Listing
February 2020

Management of the first-time lateral patellar dislocation.

Knee 2019 Dec 11;26(6):1161-1165. Epub 2019 Nov 11.

Department of Trauma and Orthopaedics, Stockport NHS Foundation Trust, Aspen House, Stepping Hill Hospital, Poplar Grove, Stockport SK2 7JE, United Kingdom of Great Britain and Northern Ireland; School of Health and Society, Mary Seacole Building, University of Salford, Frederick Road Campus, Salford M6 6PU, United Kingdom of Great Britain and Northern Ireland.

Background: Little guidance exists on the management of the first-time patellar dislocation. The aim of this article was to review current guidance for management of this condition.

Methods: Recent meta-analyses, systematic reviews and current consensus documents relating to first-time patellar dislocation were sourced. Read More

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http://dx.doi.org/10.1016/j.knee.2019.10.015DOI Listing
December 2019

Refixation of Large Osteochondral Fractures After Patella Dislocation Shows Better Mid- to Long-Term Outcome Compared With Debridement.

Cartilage 2019 Nov 13:1947603519886637. Epub 2019 Nov 13.

Centre for Sports Orthopedics and Special Joint Surgery, Orthopedic Hospital Markgroeningen, Markgroeningen, Germany.

Objective: The purpose of this study was to compare results of osteochondral fractures (OCF) after first-time lateral patella dislocation, when either refixation or debridement was performed in a mid- to long-term follow-up and to analyze redislocation and reintervention rates.

Design: Fifty-three consecutive patients with OCF were included in this retrospective comparative study. Indication for refixation was presence of subchondral bone at the fragment. Read More

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http://dx.doi.org/10.1177/1947603519886637DOI Listing
November 2019

Functional outcome after recurrent patellar dislocation : Comparison of two surgical techniques-Medial patellofemoral ligament reconstruction (MPFL) vs. Elmslie Trillat procedure.

Wien Klin Wochenschr 2019 Dec 11;131(23-24):614-619. Epub 2019 Nov 11.

Department of Orthopedics and Traumatology, Clinical Division of Traumatology, Medical University of Vienna, Vienna, Austria.

Background: There is no final consensus regarding the ideal surgical technique for the treatment of patellar dislocation. The aim of this retrospective pilot study was to describe muscle strength, body composition, self-reported physical performance, and pain in male patients after patellar dislocation treatment with two different surgical techniques: medial patellofemoral ligament (MPFL) reconstruction vs. the Elmslie-Trillat procedure. Read More

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http://dx.doi.org/10.1007/s00508-019-01570-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6908566PMC
December 2019

Medial Patellofemoral Ligament Reconstruction: Indications, Technique, and Outcomes.

Arthroscopy 2019 11;35(11):2970-2972

Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, U.S.A. Electronic address:

The medial patellofemoral ligament is the primary static restraint to lateral patellar translation. It is injured in 96% to 100% of patellar dislocations that affect approximately 6 to 29 of 100,000 patients and is more common in patients younger than 20 years of age. Risk factors for patellar dislocation include patella alta, trochlear dysplasia, genu valgus, increased Q angle, and hyperlaxity. Read More

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http://dx.doi.org/10.1016/j.arthro.2019.09.008DOI Listing
November 2019

Pediatric Management of Recurrent Patellar Instability.

Sports Med Arthrosc Rev 2019 Dec;27(4):171-180

Cincinnati Children's Hospital Medical Center, Cincinnati, OH.

Patellofemoral instability is a common orthopedic condition in children and adolescents, with recurrent instability often requiring surgical intervention. Age, bilateral instability, and various anatomic features such as trochlear dysplasia, patella alta, increased tibial tubercle to trochlear groove distance, and patellar tilt have all been described as risk factors for recurrent patellar instability. Medial patellofemoral ligament reconstruction has become the mainstay of treatment for addressing recurrent patellar instability in skeletally immature patients. Read More

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http://dx.doi.org/10.1097/JSA.0000000000000256DOI Listing
December 2019

When and How I Add Trochleoplasty in the Treatment of Recurrent Patella Instability.

Authors:
John P Fulkerson

Sports Med Arthrosc Rev 2019 Dec;27(4):169-170

Orthopedic Associates of Hartford, P.C., Farmington, CT.

Long experience and recent evidence suggest that trochleoplasty is needed in very few patella stabilization surgeries. As trochleoplasty adds risk, this author recommends it only in patients with high degrees of dysplasia, prominent supratrochlear spurs, ligamentous laxity, and more dramatic J signs. Read More

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http://dx.doi.org/10.1097/JSA.0000000000000261DOI Listing
December 2019

Why and Where to Move the Tibial Tubercle: Indications and Techniques for Tibial Tubercle Osteotomy.

Sports Med Arthrosc Rev 2019 Dec;27(4):154-160

Department of Orthopaedic Surgery, Hospital for Special Surgery.

Patellofemoral disorders including pain and instability are common orthopedic problems, particularly in the adolescent population. Patellofemoral pain is usually anterior, poorly localized, and diffuse. Because of its multifactorial etiology, patellofemoral pain can be clinically challenging to diagnose and manage. Read More

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http://dx.doi.org/10.1097/JSA.0000000000000270DOI Listing
December 2019

Concepts of the Distal Medial Patellar Restraints: Medial Patellotibial Ligament and Medial Patellomeniscal Ligament.

Sports Med Arthrosc Rev 2019 Dec;27(4):143-149

Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN.

The important medial patellar ligamentous restraints to lateral dislocation are the proximal group (the medial quadriceps tendon femoral ligament and the medial patellofemoral ligament) and the distal group [medial patellotibial ligament (MPTL) and medial patellomeniscal ligament (MPML)]. The MPTL patellar insertion is at inferomedial border of patella and tibial insertion is in the anteromedial tibia. The MPML originates in the inferomedial patella, right proximal to the MPTL, inserting in the medial meniscus. Read More

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http://dx.doi.org/10.1097/JSA.0000000000000269DOI Listing
December 2019

An Updated Overview of the Anatomy and Function of the Proximal Medial Patellar Restraints (Medial Patellofemoral Ligament and the Medial Quadriceps Tendon Femoral Ligament).

Sports Med Arthrosc Rev 2019 Dec;27(4):136-142

Orthopedic Associates of Hartford, University of Connecticut School of Medicine, Farmington, CT.

The medial patellofemoral ligament (MPFL) has been widely accepted to function as "the primary static restraint to lateral patellar displacement." However, current growing evidence suggests that there is a complex of medial patellofemoral/tibial ligaments, both proximal [MPFL, and medial quadriceps tendon femoral ligament (MQTFL)], and distal (medial patellotibial ligament and the medial patellomeniscal ligament) which restrain lateral patellar translation at different degrees of knee flexion. Specifically, the MQTFL has gained popularity over the last decade because of pure soft tissue attachments into the extensor mechanism that allow for avoidance of drilling tunnels into the patella during reconstruction. Read More

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http://dx.doi.org/10.1097/JSA.0000000000000252DOI Listing
December 2019
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Treatment of First-time Patellar Dislocations and Evaluation of Risk Factors for Recurrent Patellar Instability.

Sports Med Arthrosc Rev 2019 Dec;27(4):130-135

Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.

Approximately one-third of skeletally mature patients with primary patellar dislocation will experience recurrent patellar instability over time. Because of the multifactorial combination of features contributing to overall stability of the patellofemoral joint, first-time patella dislocation presents a challenge to the treating physician. A detailed patient history, focused physical examination, and appropriate diagnostic imaging are essential for identifying risk factors for recurrent instability. Read More

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http://dx.doi.org/10.1097/JSA.0000000000000239DOI Listing
December 2019

Anteroposterior distance between the tibial tuberosity and trochlear groove in patients with patellar instability.

Knee 2019 Dec 25;26(6):1278-1285. Epub 2019 Oct 25.

Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 5(th) Floor, 601 N Caroline Street, Baltimore, MD 21287, United States.

Background: Our objective was to describe a measurement to assess sagittal tibial tuberosity (TT)-trochlear groove (TG) distance and to compare this between asymptomatic (control) patients and patients with symptomatic patellar instability.

Methods: We compared static CT images of 22 fully extended knees of patients with symptomatic patellar instability with images of 22 asymptomatic knees. TT-TG distance was measured to quantify lateralization of the TT, and anteroposterior TT-TG distance was used to quantify the sagittal distance between these two points. Read More

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http://dx.doi.org/10.1016/j.knee.2019.08.011DOI Listing
December 2019

Treatment of a combined deformity following tibial tubercle ventromedialization with single proximal tibial closing wedge osteotomy.

Eklem Hastalik Cerrahisi 2019 Dec;30(3):316-21

Department of Orthopedics and Traumatology, Medical Faculty of Gazi University, 06500 Beşevler, Ankara, Turkey.

Patellar instability in skeletally immature patients must be approached with concern of potential damage to physes. In this article, we present a case of combined knee deformity consisting of genu recurvatum, genu valgum and patella baja which arose subsequent to a pediatric tibial tubercle ventromedialization. Patient was a female who was 22 years old upon first admission. Read More

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http://dx.doi.org/10.5606/ehc.2019.19002DOI Listing
December 2019

Management of comminuted patellar fracture fixation using modified cerclage wiring.

J Orthop Surg Res 2019 Oct 17;14(1):324. Epub 2019 Oct 17.

Department of Orthopaedic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwuweiqi Road, Jinan, Shandong, People's Republic of China.

Background: Although there are several different kinds of fixation techniques for displaced comminuted patellar fracture, the treatment remains a challenge for orthopaedic surgeons. The purpose of this study is to evaluate the effectiveness and safety of a fixation technique for comminuted patellar fracture fixation using modified cerclage wiring.

Methods: From February 2016 to April 2018, 38 cases of simple unilateral closed comminuted patellar fracture were treated by modified cerclage wiring. Read More

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http://dx.doi.org/10.1186/s13018-019-1385-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6798409PMC
October 2019

Primary Medial Patellofemoral Ligament Repair Versus Reconstruction: Rates and Risk Factors for Instability Recurrence in a Young, Active Patient Population.

Arthroscopy 2019 10;35(10):2909-2915

Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A.. Electronic address:

Purpose: To comparatively evaluate the clinical outcomes and rates of recurrent instability in young patients with primary medial patellofemoral ligament (MPFL) repair or reconstruction, as well as to assess for radiologic risk factors for worse outcomes.

Methods: A retrospective review identified all patients with lateral patellar instability who underwent either MPFL repair and/or imbrication or MPFL reconstruction without any additional osseous procedures between 2008 and 2015 at a single center. Demographic variables and preoperative magnetic resonance imaging were analyzed, and Kujala scores were obtained at a minimum 2-year follow-up. Read More

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http://dx.doi.org/10.1016/j.arthro.2019.05.007DOI Listing
October 2019

Late Repair, One Year After a Knee Twisting Injury, of a Missed Femoral Trochlea Osteochondral Fragment, With Bioabsorbable Nails, in a 14-Year-Old Boy.

J Am Acad Orthop Surg Glob Res Rev 2019 Aug 5;3(8):e040. Epub 2019 Aug 5.

A' Orthopaedic Department, Athens Children's Hospital "P. & A. Kyriakou", Athens, Greece.

The authors report a case of a late repair of a missed, large, osteochondral fracture of the femoral trochlea in a 14-year-old boy due to lateral patellar dislocation after a twisting injury of the knee a year ago. The late-1 year after the knee injury-imaging assessment of the patient regarding radiograph images, CT scan, and MRI was misleading, misinterpreted, and failed to reveal this osteochondral fracture. The free osteochondral fragment was detected during diagnostic arthroscopy. Read More

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http://dx.doi.org/10.5435/JAAOSGlobal-D-18-00040DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6754220PMC
August 2019
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Joint Effusion and Bone Outlines of the Knee: Radiographic/MR Imaging Correlation.

Magn Reson Imaging Clin N Am 2019 Nov 19;27(4):685-699. Epub 2019 Jul 19.

Department of Musculoskeletal Radiology, Lille University Hospital, Rue du Professeur Emile Laine, 59037 Lille CEDEX, France; Lille University School of Medicine, Faculté de Médecine Henri Warembourg, F-59045 Lille CEDEX, France; Service de Radiologie et Imagerie Musculosquelettique, Centre de Consultations et d'Imagerie de l'Appareil Locomoteur (C.C.I.A.L.), Rue du Professeur, Emile Laine, 59037 Lille CEDEX, France.

Knee radiographs are widely used in clinical practice. Many features can be depicted when a systematic analysis of the different views is performed. This article focuses on different types of joint effusion and on the analysis of the bone outlines of the knee, particularly on the lateral view. Read More

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http://dx.doi.org/10.1016/j.mric.2019.06.001DOI Listing
November 2019

Traumatic knee injury patterns in Anatolian folk dancers: a case series and literature review.

Int J Occup Med Environ Health 2019 Oct 13;32(5):585-593. Epub 2019 Sep 13.

Istanbul Bilim University, Istanbul, Turkey (Faculty of Medicine, Department of Orthopedics and Traumatology).

Lower extremities, especially the knee region, are susceptible to traumatic injuries because of long-lasting hard landings and impacts. Most of the injuries described in the literature are associated with ballet. In this review study, the authors tried to present the traumatic knee injury patterns of the Anatolian folk dance. Read More

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http://dx.doi.org/10.13075/ijomeh.1896.01398DOI Listing
October 2019
4 Reads

Superior Dislocation of Patella - A RareClinicalEntity.

J Orthop Case Rep 2019 ;9(2):42-44

Department of Orthopaedics, HBT Medical College and Dr. R.N. Cooper Municipal General Hospital, Mumbai, Maharashtra, India.

Introduction: Superior dislocation of patella is a rare injury. Patient usually presents with painful locking of the knee. The authors describe here a case of 54-year-male, who bumped his right knee on the edge of the bed. Read More

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http://dx.doi.org/10.13107/jocr.2250-0685.1362DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6727440PMC
January 2019
2 Reads