Database : MEDLINE Search on : Patellar and Dislocation [Words] References found : 1183 [refine] Displaying: 1 .. 10   in format [Detailed]

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[PMID]: 23646444 [Au] Autor: Gadek A; Liszka H; Ciszek E [Ad] Address: Szpital CenterMed w Krakowie. drartur@gazeta.pl [Ti] Title: Korekcja nawykowych zwichniec i niestabilnosci rzepki zmodyfikowana metoda Elmslie-Trillat. [The modified Elmslie-Trillat procedure for the treatment of recurrent patellar dislocation and instability]. [So] Source: Przegl Lek;69(11):1186-8, 2012. [Is] ISSN: 0033-2240 [Cp] Country of publication: Poland [La] Language: pol [Ab] Abstract: UNLABELLED: Habitual patella dislocation and instability in the absence of effective conservative treatment requires surgery. Surgical procedures can be divided into bone, soft tissue and mixed methods. In many studies the authors emphasize the good results of Elmslie-Trillat procedure. METHODS: In 2005-2008, we operated 20 patients by modified Elmslie-Trillat procedure but 2 patients were excluded from the study because of lack of control after surgery. We modified surgical technique by type of tibial tuberosity osteotomy and reconstruction of soft tissues. RESULTS: We used a subjective clinical evaluation (evaluation of Q angle, patella traction in the dynamic tests) and the Tegner and Lysholm scale. In the Tegner scale, we obtained an average improvement of 3.4 points (from 0 to 8), and in Lysholm scale average of 46.7 points (from 14 points to 65 points). CONCLUSIONS: Correction of recurrent patellar dislocation and instability by a modified Elmslie-Trillat method is effective and good results are obtained. Only the appropriate selection of surgical procedure depending on the cause of disease provides a permanent cure. [Pt] Publication type: ENGLISH ABSTRACT; JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Process

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[PMID]: 23371425 [Au] Autor: Wang CH; Ma LF; Zhou JW; Ji G; Wang HY; Wang F; Wang J [Ad] Address: Joint Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China. 9112qwa@163.com [Ti] Title: Double-bundle anatomical versus single-bundle isometric medial patellofemoral ligament reconstruction for patellar dislocation. [So] Source: Int Orthop;37(4):617-24, 2013 Apr. [Is] ISSN: 1432-5195 [Cp] Country of publication: Germany [La] Language: eng [Ab] Abstract: PURPOSE: The purpose of this study was to evaluate reconstruction of the medial patellofemoral ligament (MPFL) using the double-bundle anatomical or single-bundle isometric procedure with respect to the patients' clinical outcomes. METHODS: In this retrospective study, we evaluated the clinical outcome of double-bundle anatomical versus single-bundle isometric reconstruction of the MPFL for patellar dislocation patients. Sixty-three patients were included in this study from August 2004 to January 2008. From August 2004 to September 2006, MPFL reconstruction using a single-bundle isometric technique was performed in 21 patients (26 knees). Since October 2006, the double-bundle anatomical reconstruction of the MPFL has been used as the routine surgical procedure. It was performed in 37 patients (44 knees). Fifty-eight patients (70 knees) could be followed up. According to the different techniques, we divided the patients into two groups: group D with double-bundle anatomical reconstruction (37 patients) and group S with single-bundle isometric reconstruction (21 patients). Clinical evaluation consisted of the number with a patellar re-dislocation, patellar apprehension sign, Kujala score, subjective questionnaire score, the patella lateral shift rate and patellar tilt angle measured by cross-sectional CT scan. RESULTS: According to the Kujala score and the subjective questionnaire score, the outcome of the double-bundle group was better than the outcome of the single-bundle group especially in the long-term. Patellar re-dislocation occurred in three patients in the group S, while no re-dislocation occurred in the group D. In total, 26.9 % of group S was considered to have patellar instability, compared to 4.54 % of the group D. After operation, the patellar tilt angle (PTA) and the patella lateral shift rate (PLSR) were restored to the normal range, with statistical significance (P < 0.05) compared to the preoperative state. CONCLUSION: Single- and double-bundle reconstruction of the MPFL can both effectively restore patella stability and improve knee function. However, outcomes in the follow-up period showed that the double-bundle surgery procedure was much better than in single-bundle surgery. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1303 [Js] Journal subset: IM [St] Status: In-Process [do] DOI: 10.1007/s00264-013-1788-6

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[PMID]: 23242381 [Au] Autor: Panni AS; Vasso M; Cerciello S [Ti] Title: Acute patellar dislocation. What to do? [So] Source: Knee Surg Sports Traumatol Arthrosc;21(2):275-8, 2013 Feb. [Is] ISSN: 1433-7347 [Cp] Country of publication: Germany [La] Language: eng [Ab] Abstract: Acute patellar dislocation is a common knee injury that occurs most often in adolescents, frequently associated with sporting and physical activities. Patellar re-dislocation after the first episode appears to depend primarily on the medial patellofemoral ligament injury which represents the primary ligamentous restraint, providing about 50-60 % of the restraining force against lateral patellar displacement. Clinically, up to 94-100 % of patients suffer from medial patellofemoral ligament rupture after first-time patellar dislocation. Controversy regarding how patients with first patellar dislocation should be managed still exists. Though most authors have reported good results with the conservative treatment after a first-time dislocation, several circumstances may warrant surgical intervention. A surgical approach would be necessary in the presence of severe cartilage damage or a relevant disruption of the medial stabilizers with subluxation of the patella. In these cases, the repair/reconstruction of medial stabilizers should follow the treatment of the chondral injury. Medial patellofemoral ligament reconstruction may be a more reliable method of stabilizing the patella than its repair, which has limitations related to the medial patellofemoral ligament injury location. Nowadays, there is no evidence available where osseous abnormalities should be addressed in addition to restoring the medial patellofemoral ligament. [Mh] MeSH terms primary: Athletic Injuries/surgery Patellar Dislocation/surgery [Mh] MeSH terms secundary: Adolescent Athletic Injuries/complications Athletic Injuries/diagnosis Child Female Humans Joint Instability/etiology Ligaments/injuries Male Patella/injuries Patellar Dislocation/complications Patellar Dislocation/diagnosis Recurrence Rupture [Pt] Publication type: EDITORIAL [Em] Entry month: 1305 [Js] Journal subset: IM [Da] Date of entry for processing: 130121 [St] Status: MEDLINE [do] DOI: 10.1007/s00167-012-2347-1

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[PMID]: 23124628 [Au] Autor: Arendt EA; Dejour D [Ad] Address: Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Av., Suite R200, Minneapolis, MN 55454, USA. arend001@umn.edu [Ti] Title: Patella instability: building bridges across the ocean a historic review. [So] Source: Knee Surg Sports Traumatol Arthrosc;21(2):279-93, 2013 Feb. [Is] ISSN: 1433-7347 [Cp] Country of publication: Germany [La] Language: eng [Ab] Abstract: The diagnosis of and treatment for musculoskeletal disease and injuries have seen an explosion of new knowledge. More precise imaging, correlative injury anatomy, more focused physical examination features, among others, have led this upsurge of current insight. Crucial to this knowledge revolution is the expansion of international knowledge, which is aided by an adoption of a universal scientific language, electronic transfer of information, and personal communication of surgeons and scientists across national boundaries. One area where this is particularly evident is in our knowledge and treatment for patellofemoral disorders. This article will review the developments in the management of patellar dislocations by tracing their historical roots. This is not meant to be a comprehensive review, but rather to give current readers a "historical memory" upon which to judge and interpret our present-day bridge of knowledge. Level of evidence V. [Mh] MeSH terms primary: Cartilage Diseases/history Joint Instability/history Patellar Dislocation/history Patellofemoral Joint/radiography [Mh] MeSH terms secundary: Cartilage Diseases/radiography Europe History, 20th Century History, 21st Century Humans Internationality Joint Instability/radiography Knee Joint Patella/radiography Patellar Dislocation/radiography Patellar Dislocation/surgery Patellofemoral Joint/injuries United States [Pt] Publication type: HISTORICAL ARTICLE; JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [Da] Date of entry for processing: 130121 [St] Status: MEDLINE [do] DOI: 10.1007/s00167-012-2274-1

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[PMID]: 22552614 [Au] Autor: Kang HJ; Wang F; Chen BC; Zhang YZ; Ma L [Ad] Address: Department of Orthopaedic Surgery, Shijiazhuang No.1 Hospital, Shijiazhuang, Hebei, 050011, China. [Ti] Title: Non-surgical treatment for acute patellar dislocation with special emphasis on the MPFL injury patterns. [So] Source: Knee Surg Sports Traumatol Arthrosc;21(2):325-31, 2013 Feb. [Is] ISSN: 1433-7347 [Cp] Country of publication: Germany [La] Language: eng [Ab] Abstract: PURPOSE: The objective of present study was to propose a new classification for acute MPFL injury, which can help choose optimal treatment method for certain injury type. METHODS: Eighty-five patients with acute patellar dislocation treated non-surgically were retrospectively reviewed. They were assigned into two groups according to the newly introduced classification scheme, which classified MPFL injury into three types: injury in overlap region, injury in non-overlap region and combined injury of both regions. For study purpose, patients with combined injury were not included. Of 85 patients, 33 were in the overlap-region group (Group 1) and 52 in the non-overlap-region group (Group 2). Clinical patellar instability rate and patellofemoral score were measured and recorded at 2-year follow-up. RESULTS: The patellar instability rate was 15.2 % in Group 1 and 38.5 % in Group 2, with statistically significant difference between the two groups (P = 0.022). The mean visual analogue scale for Group 1 and Group 2 was 15.6 points and 28.3 points, respectively (P = 0.026). The mean Kujala score was 91.1 points and 82.6 points (P = 0.009), with a good or excellent subjective result recorded for 27 of 33 patients (81.8 %) in Group 1 compared with 30 of 52 patients (57.7 %) in Group 2 (P = 0.021). CONCLUSIONS: Non-surgical treatment achieves better clinical outcomes with respect to a lower patellar instability rate and better subjective function for the overlap-region injury of MPFL than for the non-overlap-region injury, and can be considered as treatment of choice for overlap-region injury of MPFL. The optimal choice for the non-overlap-region injury still requires further researches. LEVEL OF EVIDENCE: Therapeutic, Level IV. [Mh] MeSH terms primary: Knee Injuries/classification Knee Injuries/therapy Ligaments, Articular/injuries Patellar Dislocation/classification Patellar Dislocation/therapy Patellofemoral Joint/injuries [Mh] MeSH terms secundary: Adolescent Adult Female Humans Joint Instability/diagnosis Joint Instability/etiology Joint Instability/therapy Knee Injuries/diagnosis Male Patellar Dislocation/diagnosis Retrospective Studies Young Adult [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [Da] Date of entry for processing: 130121 [St] Status: MEDLINE [do] DOI: 10.1007/s00167-012-2020-8

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[PMID]: 23524153 [Au] Autor: Kang H; Cao J; Yu D; Zheng Z; Wang F [Ad] Address: Huijun Kang, Department of Orthopaedic Surgery, Shijiazhuang No. 1 Hospital, No. 36 Fanxi Road, Shijiazhuang, 050011, Hebei, China. doctorkanghj@yeah.net. [Ti] Title: Comparison of 2 different techniques for anatomic reconstruction of the medial patellofemoral ligament: a prospective randomized study. [So] Source: Am J Sports Med;41(5):1013-21, 2013 May. [Is] ISSN: 1552-3365 [Cp] Country of publication: United States [La] Language: eng [Ab] Abstract: BACKGROUND: The comparative clinical outcome of anatomic reconstruction of the medial patellofemoral ligament (MPFL) between the Y-graft technique and C-graft technique for chronic patellar instability is unknown. HYPOTHESIS: Anatomic reconstruction of the MPFL with a Y-graft technique (a Y-shaped graft: femoral fixation first with separate tensioning of the 2 bundles) would yield better clinical results than a C-graft procedure (a C-shaped graft: patellar fixation first with simultaneous tensioning of both bundles) for chronic patellar instability. STUDY DESIGN: Randomized controlled trial; Level of evidence, 2. METHODS: Ninety patients with symptomatic chronic patellar dislocations or instability were randomly divided into 2 groups to undergo double-bundle MPFL reconstruction either with the Y-graft technique or C-graft technique. Follow-ups were performed at 3, 6, 12, and 24 months postoperatively. The patellar stability was evaluated with the apprehension test at follow-up. The patellofemoral morphological characteristics were evaluated on axial computed tomography (CT) scans at 30° of knee flexion, and knee function was evaluated using the Lysholm and Kujala scores preoperatively and at 24 months postoperatively. RESULTS: Forty patients in the Y-graft group and 42 patients in the C-graft group were followed for 24 months. No recurrent dislocation or subluxation was reported in either group. On CT scans, congruence angle, patellar tilt angle, lateral patellar angle, and lateral displacement were restored to the normal range. The mean postoperative Lysholm scores for the Y-graft group and C-graft group were 92.3 ± 3.9 and 88.4 ± 6.8, respectively (P = .001). The mean postoperative Kujala scores were 95.9 ± 4.7 and 91.3 ± 9.7 for the Y-graft group and C-graft group, respectively (P = .001), with a good or excellent rate of 97.5% in the Y-graft group compared with 83.3% in the C-graft group (P = .031). CONCLUSION: With no patellar redislocations reported, the Y-graft technique for the double-bundle anatomic MPFL reconstruction achieved statistically better knee function than the C-graft procedure at a minimum 2-year follow-up. However, the increase was less than the minimal clinically important difference, and further research is required to demonstrate its meaningful clinical improvement. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review [do] DOI: 10.1177/0363546513480468

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[PMID]: 23467555 [Au] Autor: Nelitz M; Dreyhaupt J; Lippacher S [Ad] Address: Manfred Nelitz, Orthopaedic Specialty Clinic, MVZ Oberstdorf, Trettachstrasse 16, 87561 Oberstdorf, Germany. manfred.nelitz@mvz-oberstdorf.de. [Ti] Title: Combined Trochleoplasty and Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Dislocations in Severe Trochlear Dysplasia: A Minimum 2-Year Follow-up Study. [So] Source: Am J Sports Med;41(5):1005-12, 2013 May. [Is] ISSN: 1552-3365 [Cp] Country of publication: United States [La] Language: eng [Ab] Abstract: BACKGROUND: Trochlear dysplasia is an important etiological factor for the development of patellofemoral instability. Because a dislocation of the patella as a result of trochlear dysplasia results in a traumatic disruption of the medial patellofemoral ligament (MPFL), a combined trochleoplasty and patellofemoral ligament reconstruction appears to be the most appropriate procedure to treat patients with severe trochlear dysplasia. HYPOTHESIS: Combined trochleoplasty and anatomic reconstruction of the MPFL will prevent redislocations of the patella and will lead to improved knee function. STUDY DESIGN: Case series; Level of evidence, 3. METHODS: Twenty-three consecutive patients (26 knees) with patellofemoral instability and severe trochlear dysplasia underwent combined trochleoplasty and anatomic reconstruction of the MPFL. Preoperative radiographic examination included anteroposterior and lateral views to assess patella alta. Magnetic resonance imaging was performed to evaluate trochlear dysplasia and the tibial tubercle-trochlear groove (TT-TG) distance. Evaluations included the detection of cartilage injuries, preoperative and postoperative physical examinations, and scores for the visual analog scale (VAS), Kujala knee function, International Knee Documentation Committee (IKDC), activity rating scale (ARS), and Tegner activity scale. RESULTS: The mean age at the time of operation was 19.2 years (range, 15.4-23.6 years). The mean follow-up after operation was 2.5 years after surgery (range, 2.0-3.5 years). No recurrent dislocation occurred postoperatively. Kujala scores improved from 79 to 96, IKDC scores from 74 to 90, and VAS scores from 3 to 1. All improvements were highly statistically significant (P < .01). The activity level according to the Tegner activity scale and the ARS decreased but was not statistically significant (P = .06 and P = .21, respectively). There were 95.7% of the patients who were satisfied or very satisfied with the procedure. CONCLUSION: Combined anatomic reconstruction of the MPFL and trochleoplasty reliably improved the stability of the patellofemoral joint in patients with severe trochlear dysplasia and no or mild degenerative changes. In addition, the described procedure showed significant improvement of knee function and good patient satisfaction without any episode of redislocations of the patella. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review [do] DOI: 10.1177/0363546513478579

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[PMID]: 23147616 [Au] Autor: Abbasi D; May MM; Wall EJ; Chan G; Parikh SN [Ad] Address: Department of Orthopaedic Surgery, University of Cincinnati, Cincinnati, OH, USA. [Ti] Title: MRI findings in adolescent patients with acute traumatic knee hemarthrosis. [So] Source: J Pediatr Orthop;32(8):760-4, 2012 Dec. [Is] ISSN: 1539-2570 [Cp] Country of publication: United States [La] Language: eng [Ab] Abstract: BACKGROUND: Physical examination may be inconclusive in adolescents presenting with an acute traumatic knee effusion because of pain and guarding. The purpose of this study was to describe the magnetic resonance imaging (MRI) findings in adolescents with traumatic knee effusions and to compare injuries based on age, sex, and physeal maturity. METHODS: All MRIs using a knee trauma protocol performed at our institution over a 2-year period were evaluated. One hundred thirty-one patients between the ages of 10 to 18 years of age with a clinical history of acute knee trauma and an effusion confirmed on MRI met our study inclusion criteria. They were divided into 2 age groups: 10 to 14 and 15 to 18 years old. Pathology was confirmed using clinical history, MRI, and any available surgical reports. RESULTS: Of the 131 patients with an acute knee effusion, there were 59 patients in the younger group (10 to 14 y old) and 72 patients in the older group (15 to 18 y old). In the younger group, patellar dislocations (36%), anterior cruciate ligament (ACL) tears (22%), and isolated meniscus tears (15%) were the most common injuries. In the older group, ACL tears (40%), patellar dislocations (28%), and isolated meniscus tears (13%) were the most common injuries. ACL injuries represented 28% of injuries in males and 38% of injuries in females, whereas patellar dislocations represented 28% of injuries in males and 37% of injuries in females. There was a trend toward adolescents with active growth plates sustaining more patellar dislocations and adolescents with closed growth plates sustaining more ACL injuries. Forty-one percent of patients in this study underwent surgery. CONCLUSIONS: Patellar dislocation is a common injury in children who present with a traumatic knee effusion, especially in young adolescents and females. Adolescents presenting with a traumatic knee effusion should undergo MRI because of the high rate of positive findings missed by physical examination and plain radiographs that may warrant surgical repair or reconstruction. LEVEL OF EVIDENCE: Level III. [Mh] MeSH terms primary: Hemarthrosis/diagnosis Knee Injuries/diagnosis Magnetic Resonance Imaging/methods Patellar Dislocation/diagnosis [Mh] MeSH terms secundary: Acute Disease Adolescent Age Factors Anterior Cruciate Ligament/injuries Anterior Cruciate Ligament/pathology Child Female Growth Plate/metabolism Hemarthrosis/pathology Humans Knee Injuries/pathology Knee Joint/pathology Male Menisci, Tibial/injuries Menisci, Tibial/pathology Patellar Dislocation/pathology Retrospective Studies Sex Factors [Pt] Publication type: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Em] Entry month: 1305 [Js] Journal subset: IM [Da] Date of entry for processing: 121113 [St] Status: MEDLINE [do] DOI: 10.1097/BPO.0b013e3182648d45

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[PMID]: 22819143 [Au] Autor: Smith TO; Davies L; Hing CB [Ad] Address: Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK. Electronic address: toby.smith@uea.ac.uk. [Ti] Title: A systematic review to determine the reliability of knee joint position sense assessment measures. [So] Source: Knee;20(3):162-9, 2013 Jun. [Is] ISSN: 1873-5800 [Cp] Country of publication: Netherlands [La] Language: eng [Ab] Abstract: BACKGROUND: The assessment of joint position sense (JPS) is the most widely used measurement of knee proprioceptive capability within the literature. However, it remains unclear what the most reliable method is to assess this. The purpose of this study was to determine the intra- and inter-rater reliability of the various methods used to assess knee JPS. METHODS: A systematic review of published and unpublished literature sources was conducted up to June 2012. All studies principally assessing the reliability (intra- or inter-rater) or reproducibility of a JPS of the knee were included. The methodological quality of each study was reviewed using the Critical Appraisal Skills Programme tool. RESULTS: A total of 18 studies were eligible, assessing the reliability of JPS with 456 knees. The reliability of four methods of JPS has been recorded: position replication using a model, image recorded angulation, electrogoniometry and dynamometry/angular motion chair. Intra-rater reliability was good for the assessment of JPS using photographs and digital images, and replicating knee position using a paper model, this was good but variable when electrogoniometry was used, and moderate but variable when assessed using dynamometry/angle motion chairs. The assessment of JPS by image recorded angulation, electrogoniometry and dynamometry/angular motion chair has demonstrated good inter-rater reliability. CONCLUSIONS: Whilst JPS methods appear to have variable reliability, the four assessment methods should be further assessed with pathological populations such as those following patellar dislocation or anterior cruciate ligament rupture. This will better facilitate the generalisability of JPS assessment methods to inform clinical practice. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1304 [Js] Journal subset: IM [St] Status: In-Data-Review

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[PMID]: 21935619 [Au] Autor: Ebied AM; El-Kholy W [Ad] Address: Department of Orthopaedic Surgery, Faculty of Medicine, Menoufia University, Shebin El Kom, Egypt. ayman_ebied@hotmail.com [Ti] Title: Reconstruction of the medial patello-femoral and patello-tibial ligaments for treatment of patellar instability. [So] Source: Knee Surg Sports Traumatol Arthrosc;20(5):926-32, 2012 May. [Is] ISSN: 1433-7347 [Cp] Country of publication: Germany [La] Language: eng [Ab] Abstract: PURPOSE: The importance of the medial patello-femoral (MPFL) and medial patello-tibial ligaments (MPTL) to the stability of the patella is undoubted. The purpose of this work was to present a technique for the reconstruction of both ligaments and prospectively record its outcome. METHODS: Cadaveric part: the MPFL and MPTL were identified in five knee specimens. Sequential cutting and reattaching of these ligaments were performed to study their effect on patellar stability. CLINICAL PART: In the years between 2005 and 2008, twenty-five knees in twenty-one patients had reconstruction of their MPFL and MPTL using the semitendinosus tendon. In eight of these knees, ligament reconstruction was combined with tibial tubercle osteotomy. The IKDC and Insall's classification of outcome were used for the evaluation of all knees. RESULTS: Cadaveric study revealed that resecting the MPTL increased the lateral translation of the patella up to subluxation at full extension. Intact MPFL avoids full dislocation. Regarding the clinical study, at a minimum 24-months follow-up, all patients reported to have stable patello-femoral joints. There was a significant improvement of the IKDC score 54 ± 2 pre-operatively to 81 ± 2 (Mean ± SD) at 24 months post-operative (P < 0.0003). Nineteen knees scored excellent, five were good and one had fair result. CONCLUSION: A technique for the reconstruction of the MPFL and MPTL that can be performed through minimally invasive approach has been presented and shown to be successful in restoring knee function in cases of traumatic and recurrent patellar dislocation. LEVEL OF EVIDENCE: III. [Mh] MeSH terms primary: Joint Instability/surgery Knee Joint/surgery Patellar Dislocation/surgery Patellar Ligament/surgery Reconstructive Surgical Procedures/methods [Mh] MeSH terms secundary: Cadaver Follow-Up Studies Humans Patellofemoral Joint Prospective Studies [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1304 [Js] Journal subset: IM [Da] Date of entry for processing: 120424 [St] Status: MEDLINE [do] DOI: 10.1007/s00167-011-1659-x

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