Database : MEDLINE
Search on : Patellar and Dislocation [Words]
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[PMID]: 27782936
[Au] Autor:Pesenti S; Blondel B; Armaganian G; Parratte S; Bollini G; Launay F; Jouve JL
[Ad] Address:aDepartment of Pediatric Orthopedics, Timone Children's Hospital bDepartment of Orthopedic Surgery, IML, Sainte Marguerite Hospital, Aix-Marseille University, Marseille, France.
[Ti] Title:The lateral wedge augmentation trochleoplasty in a pediatric population: a 5-year follow-up study.
[So] Source:J Pediatr Orthop B;, 2016 Oct 25.
[Is] ISSN:1473-5865
[Cp] Country of publication:United States
[La] Language:ENG
[Ab] Abstract:Patellofemoral instability in children requires surgery when recurrent dislocation occurs. The aim of this study is to report the 5-year clinical and radiographic outcomes following lateral wedge augmentation trochleoplasty of the femoral trochlea. This is a review of 23 (mean age: 12.5 years) patients who underwent surgery for recurrent patellar dislocations related to a flat trochlea. In every case, a lateral wedge augmentation trochleoplasty was performed with preservation of the growth plate. This surgery was consistently associated with a soft tissue procedure. All patients were reviewed for a clinical and radiographic evaluation [computed tomography (CT)-scan]. No case of recurrent patellar dislocation was reported and all patients were satisfied with the procedure; three patients reported anterior knee pain after physical activities. CT scan analysis revealed improvement of the trochlear shape measurements in all cases, but osteoarthritis lesions (narrowing of the lateral patellofemoral compartment) were visible on four CT scans. This trochleoplasty technique augmented by a soft tissue procedure on the extensor apparatus led to acceptable clinical mid-term results in terms of stability for patients with a flat trochlea (grade B according to Dejour classification). However, at the 5-year follow-up, four patients showed signs of osteoarthritis on CT scan evaluation. This warrants serious concern in this young population, and alternative methods should be considered whenever possible.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1610
[Cu] Class update date: 161027
[Lr] Last revision date:161027
[St] Status:Publisher

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[PMID]: 26202017
[Au] Autor:Saccomanno MF; Sircana G; Fodale M; Donati F; Milano G
[Ad] Address:Department of Orthopaedics, Catholic University, "A. Gemelli" University Hospital, Largo A. Gemelli 8, 00168, Rome, Italy.
[Ti] Title:Surgical versus conservative treatment of primary patellar dislocation. A systematic review and meta-analysis.
[So] Source:Int Orthop;40(11):2277-2287, 2016 Nov.
[Is] ISSN:1432-5195
[Cp] Country of publication:Germany
[La] Language:ENG
[Ab] Abstract:PURPOSE: The purpose of this study was to determine the efficacy of surgical and conservative treatment in the prevention of recurrence after primary patellar dislocation. METHODS: Studies were searched on MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and CINHAL from their inception to April 2015. All randomized controlled clinical trials comparing surgical versus conservative treatment after first patellar dislocation were included. Primary outcomes were: recurrent dislocation, subluxation, overall instability and subsequent surgery. Secondary outcomes included imaging, and subjective and objective clinical assessment tools. Methodological quality of the studies was assessed using Cochrane Collaboration's "Risk of Bias" tool. Pooled analyses were reported as risk ratio (RR) using a random effects model. Continuous data were reported as standardized mean difference (SMD) and 95 % confidence intervals (CIs). Heterogeneity was assessed using I². RESULTS: Nine studies were included in the meta-analyses. Methodological quality of the studies was moderate to low. Meta-analyses showed that surgical treatment significantly reduces the redislocation rate (RR = 0.62; 95% CI = 0.39, 0.98, p = 0.04) and provides better results on Hughston VAS score (SMD = -0.32; 95% CI = -0.61, -0.03; p = 0.03) and running (OR = -0.52; 95% CI = 0.31, 0.88; p = 0.01). Conservative treatment showed less occurrence of minor complications (OR = 3.46; 95% CI = 2.08, 5.77; p = 0.01) and better results in the figure-of-8 run test (SMD = 0.42; 95% CI = 0.06, 0.77; p = 0.02) and in the squat down test (SMD = -0.45; 95% CI = -0.81, -0.10; p < 0.00001). No other significant differences could be found. CONCLUSIONS: Based on the available data, surgical treatment of primary patella dislocation significantly reduces the risk of patella redislocation.
[Pt] Publication type:REVIEW; JOURNAL ARTICLE
[Em] Entry month:0157
[Cu] Class update date: 161028
[Lr] Last revision date:161028
[St] Status:In-Data-Review

  3 / 1604 MEDLINE  
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[PMID]: 27506969
[Au] Autor:Khan M; Miller BS
[Ad] Address:Division of Orthopaedics, McMaster University, Hamilton, ON, Canada. moinkhanmd@gmail.com.
[Ti] Title:Cochrane in CORR (®): Surgical Versus Non-surgical Interventions for Treating Patellar Dislocation (Review).
[So] Source:Clin Orthop Relat Res;474(11):2337-2343, 2016 Nov.
[Is] ISSN:0009-921X
[Cp] Country of publication:United States
[La] Language:ENG
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:0168
[Cu] Class update date: 161025
[Lr] Last revision date:161025
[St] Status:In-Data-Review

  4 / 1604 MEDLINE  
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[PMID]: 26897770
[Au] Autor:Frei S; Nuss K
[Ti] Title:Patella-Fixation nach proximal bei 12 Kühen: Eine retrospektive Untersuchung zu Therapie und Langzeitprognose. [Intermittent upward fixation of the patella in 12 cows: A retrospective study of treatment and long-term prognosis].
[So] Source:Schweiz Arch Tierheilkd;157(10):553-8, 2015 Oct.
[Is] ISSN:0036-7281
[Cp] Country of publication:Switzerland
[La] Language:GER
[Ab] Abstract:This retrospective study investigated possible risk factors for intermittent upward fixation of the patella and the outcome of medial patellar desmotomy in 12 cows. All but one young cow had distinctive clinical signs, which usually started in the periparturient period. Medial patellar desmotomy led to normalisation of the stride in 10 cows but did not improve the condition of the young cow. Another cow developed instability and signs of lateral patellar luxation in the affected stifle and was euthanized. The 10 cows that were operated successfully remained in the long term free of symptoms. Medial patellar desmotomy is a suitable treatment for upward patellar fixation in cattle but should be reserved for cows with typical clinical signs. The medial patellar ligament should be cut 4 to 6 cm proximal to its insertion on the tibia to minimise the risk of injury to the middle patellar ligament.
[Mh] MeSH terms primary: Cattle/injuries
Patellar Dislocation/veterinary
Patellar Ligament/surgery
[Mh] MeSH terms secundary: Animals
Cattle/surgery
Female
Lameness, Animal/etiology
Lameness, Animal/surgery
Patellar Dislocation/surgery
Prognosis
Retrospective Studies
Risk Factors
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1603
[Cu] Class update date: 161026
[Lr] Last revision date:161026
[Js] Journal subset:IM
[Da] Date of entry for processing:016222
[St] Status:MEDLINE

  5 / 1604 MEDLINE  
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PubMed Central Full text

[PMID]: 26361442
[Au] Autor:Crebs DT; Anthony CA; McCunniff PT; Nieto MJ; Beckert MW; Albright JP
[Ad] Address:The Department of Orthopaedic Surgery and Rehabilitation, University of Iowa Hospitals and Clinics , 200 Hawkins Drive, 01008 JPP, Iowa City, IA 52242 , USA.
[Ti] Title:Effectiveness of Fulkerson Osteotomy with Femoral Nerve Stimulation for Patients with Severe Femoral Trochlear Dysplasia.
[So] Source:Iowa Orthop J;35:34-41, 2015.
[Is] ISSN:1555-1377
[Cp] Country of publication:United States
[La] Language:ENG
[Ab] Abstract:BACKGROUND: Patients with femoral trochlear dysplasia are at risk for chronic recurrent patellofemoral dislocations, with extreme cases often requiring a surgical procedure. Anteromedialization of the tibial tubercle with intraoperative femoral nerve stimulation and concurrent medial patella-femoral ligament (MPFL) reconstruction is a previously reported method of maximizing patello-femoral congruency. We hypothesize the Fulkerson osteotomy with intraoperative femoral nerve stimulation and concurrent MPFL reconstruction in patients with severe trochlear dysplasia provides equivalent postoperative clinical outcomes to the same procedure in patients with low level trochlear dysplasia. METHODS: 48 knees underwent Fulkerson osteotomy with intraoperative femoral nerve stimulation and concurrent MPFL reconstruction for recurrent lateral patellar dislocations. MRI, surgeon intraoperative assessment, and X-ray were used to assess degrees of trochlear dysplasia; inter-observer and intra-observer error were measured. The knees positive for severe dysplasia on MRI, intraoperative assessment, and X-ray were considered as a comparison cohort to the rest of the study population. We considered postoperative dislocation events and patellar tracking kinematics as outcome measures. Independent student t tests and Fisher exact tests were used to evaluate differences between groups. Significance was set at P<0.05. RESULTS: 11 knees were positive for severe dysplasia (SD) by combined MRI, surgeon intraoperative assessment, and X-ray with the remaining 37 knees categorized as low dysplasia (LD). No patients in either group exhibited apprehension or required re-operation. Mean sulcus angle in the SD group was 175.8 +-2.45 degrees (95% CI 171.0-180.6); the LD group mean sulcus angle was 154.3 +- 0.98 degrees (95% CI 152.4-156.2) (P<.001). Postoperatively there was no significant difference in dislocation events between the SD group (0/11) and the LD group (2/37) (P>0.999). Patellar maltracking decreased in both groups and there were no significant differences in estimates of patellofemoral congruency between the SD (2/11) and LD (8/37) (P>0.999) groups. CONCLUSION: The Fulkerson osteotomy with femoral nerve stimulation aimed at maximizing patellofemoral congruency may be an equally effective procedure for patients with either severe or mild trochlear dysplasia. LEVEL OF EVIDENCE: Level III, Retrospective comparative study.
[Mh] MeSH terms primary: Femoral Nerve
Osteotomy/methods
Patellar Dislocation/therapy
Range of Motion, Articular/physiology
Reconstructive Surgical Procedures/methods
[Mh] MeSH terms secundary: Adolescent
Adult
Cohort Studies
Combined Modality Therapy
Electric Stimulation/methods
Female
Femur/abnormalities
Follow-Up Studies
Humans
Intraoperative Care/methods
Joint Instability/prevention & control
Magnetic Resonance Imaging/methods
Male
Middle Aged
Observer Variation
Patellar Dislocation/diagnosis
Patellar Ligament/surgery
Patellofemoral Joint/surgery
Retrospective Studies
Risk Assessment
Severity of Illness Index
Treatment Outcome
Young Adult
[Pt] Publication type:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Entry month:1606
[Cu] Class update date: 161025
[Lr] Last revision date:161025
[Js] Journal subset:IM
[Da] Date of entry for processing:015912
[St] Status:MEDLINE

  6 / 1604 MEDLINE  
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[PMID]: 27765469
[Au] Autor:Duignan M; McGibney M
[Ad] Address:Emergency Department, Our Lady's Hospital Navan, Co. Meath, Ireland; Honorary Clinical Associate, School of Nursing and Midwifery, RCSI, Ireland. Electronic address: martin.duignan@hse.ie.
[Ti] Title:Patellar dislocation: Not the bees knees.
[So] Source:Int Emerg Nurs;, 2016 Oct 17.
[Is] ISSN:1878-013X
[Cp] Country of publication:England
[La] Language:ENG
[Ab] Abstract:BACKGROUND: Patellar dislocations are common, particularly in the adolescent polulation. Registered Advanced Nurse Practitioners are healthcare professionals who can appropriately manage these injuries to minimise the risk of chronicity. METHODS: This is a case study which uses a clinical examplar from the authors practice focusing on the assessment, diagnosis and managment of patellar dislocations. Particular reference is made of the significance of the MPFL. RESULTS: This paper highlights the importance of recognition of appropriate management of patellar dislocations in the ED setting. Discussion points include the role of the MDT and the role of exercise prescription in the injury management. CONCLUSION: The diagnosis of patellar dislocation is heavily dependant on eliciting a comprehensive history and conducting an appropriate clinical exam. Patient outcomes may be optimised by adopting an MDT approach.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1610
[Cu] Class update date: 161022
[Lr] Last revision date:161022
[St] Status:Publisher

  7 / 1604 MEDLINE  
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[PMID]: 26764549
[Au] Autor:Vaishya R; Vijay V; Vaish A
[Ad] Address:Orthopedics and Joint Replacement Surgery, Indraprastha Apollo Hospitals, Sarita Vihar Mathura Road, New Delhi 110076, India.
[Ti] Title:Dislocation of a constrained total knee arthroplasty with patellar tendon rupture after trivial trauma.
[So] Source:Chin J Traumatol;18(4):241-4, 2015.
[Is] ISSN:1008-1275
[Cp] Country of publication:China
[La] Language:ENG
[Ab] Abstract:Constrained total knee prostheses are used in knees with severe deformities and insufficiency of collaterals to provide stable and mobile knees. Dislocation after constrained knee prosthesis is an extremely rare and dreaded complication. When dislocation is associated with patellar tendon rupture, the management includes restoration of the extensor apparatus along with a stable knee. Repair of the patellar tendon is challenging due to poor soft tissue coverage in the area and a bulky repair can put tension on the wound closure. Ideal method of restoration of the extensor apparatus is a matter of debate. There are various modalities used ranging from primary end-to-end repair, augmentation by medial gastrocnemius flap, semitendinosus and synthetic implants and allograft tendoachilles. We report a rare case of a posterior dislocation of a constrained total knee arthroplasty in association with patellar tendon rupture due to a minor fall after a few weeks of surgery. The first episode was managed by reposition of the dislocation and V-Y plasty of the quadriceps and primary repair. The second episode of dislocation with re-rupture needed augmentation by semitendinosus along with the insertion of the thicker insert. The management of this complex problem along with the review of literature is discussed in this case report.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:0161
[Cu] Class update date: 161020
[Lr] Last revision date:161020
[Js] Journal subset:IM
[St] Status:In-Process

  8 / 1604 MEDLINE  
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[PMID]: 26638694
[Au] Autor:Yasukawa S; Edamura K; Tanegashima K; Seki M; Teshima K; Asano K; Nakayama T; Hayashi K
[Ti] Title:Evaluation of bone deformities of the femur, tibia, and patella in Toy Poodles with medial patellar luxation using computed tomography.
[So] Source:Vet Comp Orthop Traumatol;29(1):29-38, 2016.
[Is] ISSN:0932-0814
[Cp] Country of publication:Germany
[La] Language:ENG
[Ab] Abstract:OBJECTIVES: To evaluate morphological parameters of the femur, tibia, and patella in Toy Poodles with medial patellar luxation (MPL) using three-dimensional (3D) computed tomography (CT) and to compare these parameters between radiography and CT. METHODS: Thirty-five hindlimbs of Toy Poodles were divided into normal and grade 2 and 4 MPL groups. The anatomical and mechanical lateral proximal femoral angle, anatomical and mechanical lateral distal femoral angle (aLDFA, mLDFA), femoral varus angle (FVA), inclination of the femoral head angle, procurvation angle, anteversion angle (AA), frontal angle of the femoral neck, mechanical medial proximal or distal tibial angle, mechanical cranial proximal or distal tibial angle, tibial plateau angle, tibial torsion angle (TTA), Z angle, relative tibial tuberosity width, ratio of the medial distance of tibial tuberosity to the proximal tibial width (MDTT/PTW), patella size, and the patellar ligament length: patellar length (L:P) ratio were evaluated on radiography and 3D CT. RESULTS: The aLDFA, mLDFA, FVA, and TTA were significantly larger and the AA, MDTT/PTW, and patella were significantly smaller in the grade 4 MPL group. There were significant differences in many parameters between imaging tools, and CT was considered less susceptible to potential artefacts and rotational deformities. CLINICAL SIGNIFICANCE: Toy Poodles with grade 4 MPL had significant femoral varus deformity, medial displacement of the tibial tuberosity, internal torsion of the proximal tibia, and hypoplasia of the patella.
[Mh] MeSH terms primary: Dog Diseases/radiography
Femur/radiography
Patella/radiography
Patellar Dislocation/veterinary
Tibia/radiography
Tomography, X-Ray Computed/veterinary
[Mh] MeSH terms secundary: Animals
Dogs
Patellar Dislocation/radiography
Prospective Studies
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1610
[Cu] Class update date: 161019
[Lr] Last revision date:161019
[Js] Journal subset:IM
[Da] Date of entry for processing:016114
[St] Status:MEDLINE
[do] DOI:10.3415/VCOT-15-05-0089

  9 / 1604 MEDLINE  
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[PMID]: 25684639
[Au] Autor:Boot E; Butcher NJ; van Amelsvoort TA; Lang AE; Marras C; Pondal M; Andrade DM; Fung WL; Bassett AS
[Ad] Address:The Dalglish Family Hearts and Minds Clinic for Adults with 22q11.2 Deletion Syndrome, Toronto, Ontario, Canada; Department of Nuclear Medicine, Academic Medical Centre, Amsterdam, The Netherlands; Department of Psychiatry, University Health Network, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
[Ti] Title:Movement disorders and other motor abnormalities in adults with 22q11.2 deletion syndrome.
[So] Source:Am J Med Genet A;167A(3):639-45, 2015 Mar.
[Is] ISSN:1552-4833
[Cp] Country of publication:United States
[La] Language:ENG
[Ab] Abstract:Movement abnormalities are frequently reported in children with 22q11.2 deletion syndrome (22q11.2DS), but knowledge in this area is scarce in the increasing adult population. We report on five individuals illustrative of movement disorders and other motor abnormalities in adults with 22q11.2DS. In addition to an increased susceptibility to neuropsychiatric disorders, seizures, and early-onset Parkinson disease, the underlying brain dysfunction associated with 22q11.2DS may give rise to an increased vulnerability to multiple movement abnormalities, including those influenced by medications. Movement abnormalities may also be secondary to treatable endocrine diseases and congenital musculoskeletal abnormalities. We propose that movement abnormalities may be common in adults with 22q11.2DS and discuss the implications and challenges important to clinical practice.
[Mh] MeSH terms primary: DiGeorge Syndrome/diagnosis
DiGeorge Syndrome/genetics
Movement Disorders/diagnosis
Movement Disorders/etiology
Phenotype
[Mh] MeSH terms secundary: Adult
Clozapine/adverse effects
DiGeorge Syndrome/complications
Diagnosis, Differential
Female
Humans
Male
Middle Aged
Movement Disorders/complications
Myoclonus/chemically induced
Myoclonus/diagnosis
Parkinsonian Disorders
Patellar Dislocation/complications
Patellar Dislocation/diagnosis
Spinal Cord Compression/complications
Spinal Cord Compression/diagnosis
Tremor
Young Adult
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Nm] Name of substance:J60AR2IKIC (Clozapine)
[Em] Entry month:1604
[Cu] Class update date: 161019
[Lr] Last revision date:161019
[Js] Journal subset:IM
[Da] Date of entry for processing:015218
[St] Status:MEDLINE
[do] DOI:10.1002/ajmg.a.36928

  10 / 1604 MEDLINE  
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[PMID]: 25416671
[Au] Autor:Dickschas J; Harrer J; Bayer T; Schwitulla J; Strecker W
[Ad] Address:Klinik für Orthopädie und Unfallchirurgie, Klinikum Bamberg, Buger Strasse 80, 96049, Bamberg, Germany. Joerg.dickschas@sozialstiftung-bamberg.de.
[Ti] Title:Correlation of the tibial tuberosity-trochlear groove distance with the Q-angle.
[So] Source:Knee Surg Sports Traumatol Arthrosc;24(3):915-20, 2016 Mar.
[Is] ISSN:1433-7347
[Cp] Country of publication:Germany
[La] Language:ENG
[Ab] Abstract:PURPOSE: The Q-angle has been used for years to quantify lateralization of the patella. The tibial tuberosity-trochlea groove distance (TT-TG distance) was introduced to analyse patellar tracking. Does a significant correlation exist between these two parameters? Do other significant interrelations exist between the Q-angle/TT-TG distance, torsion of the femur and tibia, the frontal axis, overall leg length, gender, former patellar dislocation, BMI? METHODS: One hundred knees in 55 patients with patellofemoral symptoms were included in a prospective study. All patients underwent clinical examination, including measurement of the Q-angle. A torsional CT was obtained from all patients. RESULTS: The correlation coefficient was 0.33/0.34 (left/right leg), showing that the TT-TG distance tends to rise in direct ratio to a rising Q-angle. Thus, a significant correlation was found (p = 0.017). Femoral and tibial torsion had a positive effect on the TT-TG distance, but showed no significant correlation. Leg length had a significant effect on the TT-TG distance (p = 0.04). The frontal axis had a nonsignificant influence on the Q-angle or TT-TG distance. On average, the Q-angle in women was 2.38° greater than it was in men, but the difference was not significant. CONCLUSION: A significant correlation was noted between the Q-angle and the TT-TG distance. Both depend on various parameters and must be assessed for the analysis of patellofemoral maltracking. The Q-angle did not differ significantly between men and women; thus, the conclusion is that no different ranges need not be used. LEVEL OF EVIDENCE: Diagnostic study, Level III.
[Mh] MeSH terms primary: Femur/radiography
Patella/radiography
Patellofemoral Joint/radiography
Tibia/radiography
[Mh] MeSH terms secundary: Adult
Bone Malalignment/radiography
Female
Humans
Joint Instability/radiography
Knee Joint/radiography
Male
Middle Aged
Patellar Dislocation/radiography
Prospective Studies
Tomography, X-Ray Computed
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1610
[Cu] Class update date: 161019
[Lr] Last revision date:161019
[Js] Journal subset:IM
[Da] Date of entry for processing:016227
[St] Status:MEDLINE
[do] DOI:10.1007/s00167-014-3426-2


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