Database : MEDLINE
Search on : Patellar and Dislocation [Words]
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[PMID]: 25298564
[Au] Autor:Soraganvi PC; Narayan Gowda B; Rajagopalakrishnan R; Gavaskar AS
[Ad] Address:Department of Orthopaedics, PES Institute of Medical Science and Research, Kuppam, Chittor District, Andra Pradesh, India....
[Ti] Title:Irreducible, incarcerated vertical dislocation of patella into a Hoffa fracture.
[So] Source:Indian J Orthop;48(5):525-8, 2014 Sep.
[Is] ISSN:0019-5413
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:Rotational dislocations of patella, which involve rotation of the patella around a horizontal or vertical axis are rare. These rotational dislocations of patella are difficult to reduce by close methods. These dislocations can have associated osteochondral and retinacular injury. We report a case of a 20-year-old male who presented with swelling and pain in the right knee following a motor cycle accident. Radiological evaluation using the computed tomography revealed a patellar dislocation with a concomitant Hoffa fracture. Patella was rotated around the vertical axis and was incarcerated into the Hoffa fracture. This is a very rare injury and first of its kind to be reported. The difficulties in diagnosis, mechanism of injury and management have been discussed. We feel closed reduction of such an injury is likely to fail and open reduction is recommended.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1410
[Cu] Class update date: 141011
[Lr] Last revision date:141011
[Da] Date of entry for processing:141009
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.4103/0019-5413.139883

  2 / 1323 MEDLINE  
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[PMID]: 25123919
[Au] Autor:Li J; Li Y; Wei J; Wang J; Gao S; Shen Y
[Ti] Title:A simple technique for reconstruction of medial patellofemoral ligament with bone-fascia tunnel fixation at the medial margin of the patella: a 6-year-minimum follow-up study.
[So] Source:J Orthop Surg Res;9:66, 2014.
[Is] ISSN:1749-799X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction has become an accepted technique to treat patellofemoral instability, and numerous surgical techniques have been described to reconstruct the MPFL. We describe a MPFL reconstruction procedure where bone-fascia tunnel fixation occurs at the medial margin of the patella for recurrent patellar dislocation. OBJECTIVE: MPFL reconstruction is the preferred operative treatment for recurrent patellar dislocation. The purpose of this study was to report a simple technique for reconstruction of medial patellofemoral ligament with bone-fascia tunnel fixation at the medial margin of the patella for recurrent patellar dislocation and to evaluate the results at 6-year-minimum follow-up. METHODS: The study included 65 patients (28 males, 37 females; mean age, 29.4 ± 5.6 years) who underwent MPFL reconstruction using the bone-fascia tunnel fixation at the medial margin of the patella technique and who were followed for a mean duration of 78.5 ± 3.8 months. Objective assessment, Kujala scale, Lysholm score, and Tegner activity score were obtained preoperatively and at the time of final follow-up. RESULTS: There were no patellar complications, including redislocation, in the present study. The congruence angle had significant improvement from 19.2° ± 6.3° before surgery to -6.03° ± 0.50° at the last follow-up. The lateral patellar angle had significant improvement from -6.9° ± 3.5° before surgery to 5.1° ± 2.4° at the last follow-up. The patellar tilt angle had significant improvement from 24.5° ± 5.2° before surgery to 12.30° ± 1.90° at the last follow-up. The Kujala score was significantly increased from 52.9 ± 3.2 points preoperatively to 90.1 ± 5.8 points postoperatively (P < 0.05). The mean Lysholm score was significantly increased from 47.2 ± 5.2 to 92.5 ± 6.2 points postoperatively (P < 0.05). The Tegner activity score improved overall from 3.1 ± 0.6 points to 5.8 ± 0.9 points at follow-up. CONCLUSION: We have done a simple technique where the MPFL is reconstructed safely to avoid patella fracture, anatomically to restore physiological kinematics and stability, and economically to reduce costs with bone-fascia tunnel fixation at the medial margin of the patella.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1409
[Js] Journal subset:IM
[St] Status:In-Process
[do] DOI:10.1186/s13018-014-0066-7

  3 / 1323 MEDLINE  
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[PMID]: 24902510
[Au] Autor:Mansour R; Yoong P; McKean D; Teh JL
[Ad] Address:Department of Radiology, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Windmill Road, Headington, Oxford, UK.
[Ti] Title:The iliotibial band in acute knee trauma: patterns of injury on MR imaging.
[So] Source:Skeletal Radiol;43(10):1369-75, 2014 Oct.
[Is] ISSN:1432-2161
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To delineate the spectrum of knee injuries associated with sprains and tears of the distal iliotibial band (ITB). MATERIALS AND METHODS: A retrospective review of 200 random MRI scans undertaken for acute knee trauma was performed. Scans were excluded if there was a history of injury over 4 weeks from the time of the scan, septic arthritis, inflammatory arthropathy, previous knee surgery, or significant artefact. In each scan, the ITB was scored as normal, minor sprain (grade 1), severe sprain (grade 2), and torn (grade 3). The menisci, ligaments, and tendons of each knee were also assessed. RESULTS: The mean age was 27.4 years (range, 9-69 years) and 71.5% (n = 143) of the patients were male. The ITB was injured in 115 cases (57.5%). The next most common soft tissue structure injured was the anterior cruciate ligament (ACL) in 53.5% of cases (n = 107). Grade 1 ITB injury was seen in 90 of these 115 cases (45%), grade 2 injury in 20 cases, and grade 3 injury in only five cases. There is a significant association between ITB injury and ACL rupture (p < 0.05), as well as acute patellar dislocation (p < 0.05). There were ten cases of significant posterolateral corner injury, and all were associated with ITB injury, including four ITB tears. Only two cases of isolated ITB injury were seen (1%). CONCLUSIONS: ITB injury is common in acute knee trauma and is associated with significant internal derangement of the knee, especially cruciate ligament rupture, posterolateral corner injury, and patellar dislocation.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1408
[Js] Journal subset:IM
[St] Status:In-Process
[do] DOI:10.1007/s00256-014-1918-2

  4 / 1323 MEDLINE  
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[PMID]: 25264063
[Au] Autor:Goto T; Hamada D; Iwame T; Suzue N; Takeuchi M; Egawa H; Sairyo K
[Ad] Address:Department of Orthopedics, Institute of Health Biosciences, the University of Tokushima Graduate School.
[Ti] Title:Medial Patellofemoral Ligament Reconstruction for Patellar Dislocation due to Rupture of the Medial Structures after Total Knee Arthroplasty: A Case Report and Review of the Literature.
[So] Source:J Med Invest;61(3-4):409-12, 2014.
[Is] ISSN:1349-6867
[Cp] Country of publication:Japan
[La] Language:eng
[Ab] Abstract:Patellar dislocation is a well-recognized major complication after total knee arthroplasty (TKA). Treatment of this injury is determined according to the cause of the dislocation. In particular, proximal realignment, distal realignment, and lateral retinaculum release are options if patellar instability is not caused by prosthetic malposition. Here we report a case of patellar dislocation following TKA due to rupture of the medial structures that was treated by medial patellofemoral ligament reconstruction and lateral retinacular release. In addition, we provide a brief review of the related literature. J. Med. Invest. 61: 409-412, August, 2014.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1409
[Js] Journal subset:IM
[St] Status:In-Data-Review

  5 / 1323 MEDLINE  
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[PMID]: 24693771
[Au] Autor:Wang Z; Chen Y; Li A; Long Y
[Ti] Title:[Clinical significance of Q-angle under different conditions in recurrent patellar dislocation].
[So] Source:Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi;28(1):17-20, 2014 Jan.
[Is] ISSN:1002-1892
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:OBJECTIVE: To investigate the clinical significance of Q-angle measuring under different conditions in female recurrent patellar dislocation female patients. METHODS: Between August 2012 and March 2013, 10 female patients (11 knees) with recurrent patellar dislocation were collected as trial group; 20 female patients (20 knees) with simple meniscus injury were collected as control group at the same time. Q-angle was measured in extension, 30 degrees flexion, 30 degrees flexion with manual correction, and surgical correction in the trial group, and only in extension and 30 degrees flexion in the control group. Then the difference value of Q-angle between extension and 30 degrees flexion (Q-angle in extension subtracts Q-angle in 30 flexion) were calculated. Independent sample t-test was used to analyze Q-angle degrees in extension, 30 degrees flexion, and the changed degrees of 2 groups. The Q-angle between manual correction and surgical correction of the trial group was analyzed by paired t-test. RESULTS: The Q-angle in extension, Q-angle in 30 degrees flexion, and difference value of Q-angle between extension and 30 degrees flexion were (17.2 +/- 3.6), (14.3 +/- 3.0), and (2.9 +/- 1.9) degrees in the trial group and were (15.2 +/- 3.4), (14.4 +/- 3.5), and (0.8 +/- 1.7) degrees in the control group. No significant difference was found in Q-angle of extension or Q-angle of 30 degrees flexion between 2 groups (P > 0.05), but the difference value of Q-angle between extension and 30 degrees flexion in the trial group was significantly larger than that in the control group (t = 3.253, P = 0.003). The Q-angle in 30 degrees flexion with manual correction and surgical correction in the trial group was (19.8 +/- 3.4) degrees and (18.9 +/- 3.8) degrees respectively, showing no significant difference (t = 2.193, P = 0.053). CONCLUSION: When a female patient's Q-angle in 30 degrees flexion knee changes obviously compared with Q-angle in extension position, recurrent patellar dislocation should be considered. For female patients with recurrent patellar dislocation, the preoperative Q-angle in 30 degrees flexion with manual correction should be measured, which can help increasing the accuracy of evaluation whether rearrangement should be performed.
[Mh] MeSH terms primary: Anthropometry/methods
Knee Injuries/diagnosis
Knee Joint/physiopathology
Patellar Dislocation/diagnosis
[Mh] MeSH terms secundary: Adolescent
Adult
Arthroscopy
Biomechanical Phenomena
Case-Control Studies
Child
Female
Humans
Joint Instability/diagnosis
Joint Instability/physiopathology
Knee Injuries/physiopathology
Knee Injuries/therapy
Patella/pathology
Patella/physiopathology
Patellar Dislocation/physiopathology
Patellar Dislocation/therapy
Predictive Value of Tests
Range of Motion, Articular
Recurrence
Young Adult
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1409
[Js] Journal subset:IM
[Da] Date of entry for processing:140403
[St] Status:MEDLINE

  6 / 1323 MEDLINE  
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[PMID]: 23412307
[Au] Autor:Zhou JW; Wang CH; Ji G; Ma LF; Wang J; Zhang F; Dong JT; Wang F
[Ad] Address:Department of Orthopedics, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.
[Ti] Title:A minimally invasive medial patellofemoral ligament arthroscopic reconstruction.
[So] Source:Eur J Orthop Surg Traumatol;24(2):225-30, 2014 Feb.
[Is] ISSN:1633-8065
[Cp] Country of publication:France
[La] Language:eng
[Ab] Abstract:The medial patellofemoral ligament reconstruction is recognized as a good choice for patients with recurrent patellar dislocation. Most techniques of the medial patellofemoral ligament reconstruction are open surgeries. Recently, we present a minimally invasive medial patellofemoral ligament arthroscopic reconstruction technique as a possible alternative method for recurrent patellar dislocation. The aim of the study was to describe a safe and effective technique to perform medial patellofemoral ligament reconstruction. The graft was prepared in shape to "Y." Two 5-mm incisions were made in the skin above the medial edge of the patella. Two docking bone tunnels were drilled from medial edge to the center of the patella, mimicking the wide patellar insertion of the medial patellofemoral ligament, and a bone tunnel was made at the femoral insertion site. Two free ends of the graft were fixed into the patellar tunnels by lateral cortical suspension, and the folded end was fixed into the femoral tunnel by bioabsorbable interference screw. Average patellar tilt and the congruence angle were 30.7° ± 7.5° and 52.7° ± 7.3° and were reduced to 12.8° ± 0.9° and 2.3° ± 11.5° after treatment. The Kujala score was increased from 63.0 ± 9.0 to 91.0 ± 7.0. The minimally invasive medial patellofemoral ligament arthroscopic reconstruction in this paper seems to be helpful to increase safe of operation and treatment effect and reduce complications.
[Mh] MeSH terms primary: Femur/surgery
Knee Joint/surgery
Patellar Dislocation/surgery
Patellar Ligament/surgery
Reconstructive Surgical Procedures/methods
Surgical Procedures, Minimally Invasive/methods
[Mh] MeSH terms secundary: Adult
Female
Humans
Joint Instability/prevention & control
Joint Instability/surgery
Male
Treatment Outcome
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1409
[Js] Journal subset:IM
[Da] Date of entry for processing:140127
[St] Status:MEDLINE
[do] DOI:10.1007/s00590-012-1162-1

  7 / 1323 MEDLINE  
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[PMID]: 24458241
[Au] Autor:Hopper GP; Leach WJ; Rooney BP; Walker CR; Blyth MJ
[Ad] Address:Graeme P. Hopper, MBChB, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, Scotland G4 0SF, UK. hopperg@doctors.org.uk.
[Ti] Title:Does degree of trochlear dysplasia and position of femoral tunnel influence outcome after medial patellofemoral ligament reconstruction?
[So] Source:Am J Sports Med;42(3):716-22, 2014 Mar.
[Is] ISSN:1552-3365
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: The medial patellofemoral ligament (MPFL) is the main restraining force against lateral patellar displacement. It is disrupted after patellar subluxation or dislocation. Reconstruction of the MPFL is frequently performed when nonoperative management fails and the patient experiences recurrent patellar dislocation. PURPOSE: To determine the relationship between the degree of trochlear dysplasia and femoral tunnel position and outcome after MPFL reconstruction. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A total of 68 patients (72 knees) with recurrent dislocation of the patella underwent MPFL reconstruction. The mean follow-up was 31.3 months (range, 13-72 months). Clinical and functional outcomes were recorded using the Kujala, Lysholm, and Tegner scores. Postoperative complications, participation in sporting activity, and overall patient satisfaction were determined. Radiographs were analyzed to evaluate congruence angle, lateral patellofemoral angle, patellar height, trochlear dysplasia, trochlear boss height, and position of the femoral tunnel. RESULTS: The mean Kujala, Lysholm, and Tegner scores postoperatively were 76.2, 73.8, and 3.6, respectively (n = 61). The mean congruence angle (n = 30) improved from 22.5° to 1.0° postoperatively (P = .000038), the lateral patellofemoral angle (n = 30) improved from 7.4° to 7.8° postoperatively (P = .048), and the patellar height (n = 46) using the Caton-Deschamps method improved from 1.1 to 1.0 postoperatively (P = .000016). Mild trochlear dysplasia grade A/B was found in 89% of patients (n = 54), and 11% of patients (n = 7) had severe grade C/D dysplasia. The mean distance from the anatomic insertion of the MPFL to the center of the tunnel was 9.3 mm (range, 0.5-28.2 mm), with 71.7% thought to be within 10 mm of the anatomic position defined by Schottle (n = 46). When patients with high-grade trochlear dysplasia were excluded, anatomically placed femoral tunnels demonstrated significantly better clinical scores than did tunnels not placed anatomically (Kujala score, P = .028; Lysholm score, P = .012). A multivariate logistic regression analysis also demonstrated that the distance of the femoral tunnel from the anatomic position predicted clinical outcome (Kujala score, P = .043; Lysholm score, P = .028). All of the patients with severe trochlear dysplasia (n = 7) suffered from recurrent dislocations postoperatively, compared with only 9.3% of patients (n = 5) with mild trochlear dysplasia (P = .0001). Four patients had patellar fractures postoperatively. Of patients with mild dysplasia, 83% were either very satisfied or satisfied with the outcome of their surgery compared with only 57% with severe dysplasia (P = .05). Of patients with mild trochlear dysplasia, 56% returned to sport postoperatively compared with only 43% of patients with severe trochlear dysplasia (P = .526). CONCLUSION: This study demonstrates the importance of restoration of the anatomic insertion point of the MPFL when performing MPFL reconstruction and proposes that this procedure should not be performed in isolation in patients with high-grade trochlear dysplasia.
[Mh] MeSH terms primary: Femur/surgery
Ligaments, Articular/surgery
Osteotomy/methods
Patellar Dislocation/surgery
Patellofemoral Joint/radiography
Patellofemoral Joint/surgery
[Mh] MeSH terms secundary: Adolescent
Adult
Female
Follow-Up Studies
Fractures, Bone/etiology
Humans
Male
Middle Aged
Multivariate Analysis
Patella/injuries
Patellar Dislocation/prevention & control
Patient Satisfaction
Postoperative Complications
Recovery of Function
Recurrence/prevention & control
Retrospective Studies
Tendons/transplantation
Tibia/surgery
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1409
[Js] Journal subset:IM
[Da] Date of entry for processing:140303
[St] Status:MEDLINE
[do] DOI:10.1177/0363546513518413

  8 / 1323 MEDLINE  
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[PMID]: 25047793
[Au] Autor:Ménétrey J; Putman S; Gard S
[Ad] Address:Centre de medicine de l'appareil locomoteur et du sport, Unité d'Orthopédie et Traumatologie du Sport (UOTS), Swiss Olympic Medical Center, Service de chirurgie orthopédique et traumatologie de l'appareil moteur, University Hospital of Geneva (HUG) and Faculty of Medicine, University of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva, Switzerland, Jacques.menetrey@hcuge.ch.
[Ti] Title:Return to sport after patellar dislocation or following surgery for patellofemoral instability.
[So] Source:Knee Surg Sports Traumatol Arthrosc;22(10):2320-6, 2014 Oct.
[Is] ISSN:1433-7347
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:Patellofemoral instability may occur in a young population as a result of injury during sporting activities. This review focuses on return to sport after one episode of dislocation treated no operatively and as well after surgery for chronic patellofemoral instability. With or without surgery, only two-thirds of patients return to sports at the same level as prior to injury. A high-quality rehabilitation programme using specific exercises is the key for a safe return to sporting activities. To achieve this goal, recovery of muscle strength and dynamic stability of the lower limbs is crucial. The focus should be directed to strengthen the quadriceps muscle and pelvic stabilizers, as well as lateral trunk muscle training. Patient education and regularly performed home exercises are other key factors that can lead to a successful return to sports. The criteria for a safe return to sports include the absence of pain, no effusion, a complete range of motion, almost symmetrical strength, and excellent dynamic stability. Level of evidence IV.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1409
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1007/s00167-014-3172-5

  9 / 1323 MEDLINE  
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[PMID]: 25103910
[Au] Autor:Khamaisy S; Haleem AM; Williams RJ; Rozbruch SR
[Ad] Address:Sports Medicine and Shoulder Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY, United States. Electronic address: Khamaisys@hss.edu....
[Ti] Title:Neglected rotatory knee dislocation: A case report.
[So] Source:Knee;21(5):975-8, 2014 Oct.
[Is] ISSN:1873-5800
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:UNLABELLED: We report here a unique case of a 3year neglected rotatory tibiofemoral dislocation associated with a lateral patellar dislocation. The rotational deformity was gradually corrected using a Taylor spatial frame and the patella was realigned by tibial tubercle osteotomy and transfer. The patient also underwent multiple soft tissue releases and quadricepsplasty to improve knee flexion. At nine year follow-up, the patient has good knee range of motion, a congruent knee joint and a good functional result. CLINICAL RELEVANCE: Taylor spatial frame combined with other orthopedic approaches can be a useful tool while dealing with neglected knee dislocations.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1409
[Js] Journal subset:IM
[St] Status:In-Data-Review

  10 / 1323 MEDLINE  
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[PMID]: 23392290
[Au] Autor:Magnussen RA; De Simone V; Lustig S; Neyret P; Flanigan DC
[Ad] Address:Department of Orthopaedic Surgery, Sports Health and Performance Institute, The Ohio State University, Columbus, OH, USA, robert.magnussen@gmail.com.
[Ti] Title:Treatment of patella alta in patients with episodic patellar dislocation: a systematic review.
[So] Source:Knee Surg Sports Traumatol Arthrosc;22(10):2545-50, 2014 Oct.
[Is] ISSN:1433-7347
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:PURPOSE: While there are numerous anatomic contributors to patellar instability, the role of patella alta has been traditionally under-appreciated. The goal of this systematic review is to identify the described techniques for treating patella alta in skeletally mature patients with episodic patellar dislocation (EPD) and review their published results. METHODS: A comprehensive literature review was performed to identify published surgical techniques and their results. Tibial tubercle distalization is the primary described treatment for patellar alta in patients with EPD, and five studies reporting results of this procedure were reviewed. RESULTS: Tibial tubercle distalization was generally successful in normalizing patellar height and preventing recurrent patellar dislocation. Physical examination tests for instability such as patellar apprehension remained positive in 15 to 33 % of patients. Patient-reported outcomes were rarely reported and difficult to interpret given the lack of pre-operative values or comparison groups. CONCLUSION: Tibial tubercle distalization is an effective technique for correction of patellar height and preventing recurrent patellar dislocations. More comparative studies are required to evaluate patient-reported outcomes of this technique, the effect of an associated tubercle medialization, and the results of supplementing distalization with procedures such as MPFL reconstruction. LEVEL OF EVIDENCE: Systematic review of case series, Level IV.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1409
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1007/s00167-013-2445-8


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