Database : MEDLINE
Search on : Patellar and Dislocation [Words]
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[PMID]: 25187383
[Au] Autor:Zhang GY; Zheng L; Ding HY; Li EM; Sun BS; Shi H
[Ad] Address:Department of Ultrasonography, Qianfoshan Hospital, Shandong University, Jinan, 250014, China.
[Ti] Title:Evaluation of medial patellofemoral ligament tears after acute lateral patellar dislocation: comparison of high-frequency ultrasound and MR.
[So] Source:Eur Radiol;25(1):274-81, 2015 Jan.
[Is] ISSN:1432-1084
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:OBJECTIVES: The purpose of this study was to compare the diagnostic performance of high-frequency ultrasound with MR inthe evaluation ofmedial patellofemoral ligament (MPFL) lesions after acute lateral patellar dislocation (LPD). METHODS: High-frequency ultrasound and MR images were prospectively obtained in 97 consecutive patients with acute LPD. Images were acquired using standardised protocols and were independently evaluated by two radiologists. The MPFL was assessed at three sites (patellar insertion, femoral attachment, and mid-substance) for signs of injury. RESULTS: Of a total of 291 sites in 97 MPFLs, 127 showed proven MPFL tear at surgery, including 51 sites of complete tear and 76 sites of partial tear. In a site-based analysis, the sensitivity, specificity, and accuracy of high-frequencyultrasound was 90.8%, 96.3%, and 94.6%, respectively, for partial MPFL tear and 86.3%, 96.3%, and 94%, respectively, for complete tear. For MR, the sensitivity, specificity, and accuracy was81.6%, 95.7%, and 91.3%, respectively, for partial MPFL tear and 80.4%, 95.7%, and 92.1%, respectively, for complete tear. There was no statistical difference between high-frequency ultrasound and MR in the assessment of partial (P = 0.1, 0.777, 0.155) or complete (P = 0.425, 0.777, 0.449) MPFL lesions. Interobserver agreement was very good for high-frequency ultrasound and good for MR. CONCLUSIONS: Data suggest that high-frequency ultrasound and MR have similar diagnostic performance in the evaluation of MPFL lesions after acute LPD. KEY POINTS: • High-frequency ultrasound and MR were able to detect MPFL lesions after acute lateral patellar dislocation. • High-frequency ultrasound and MR showed similarly high accuracy in diagnosing MPFL lesions. • Interobserver agreement was very good for high-frequency ultrasound and good for MR.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1411
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1007/s00330-014-3407-3

  2 / 1332 MEDLINE  
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[PMID]: 25104603
[Au] Autor:Kita K; Tanaka Y; Toritsuka Y; Yonetani Y; Kanamoto T; Amano H; Nakamura N; Horibe S
[Ad] Address:Department of Sports Orthopaedics, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8025, Japan, keikita@hera.eonet.ne.jp.
[Ti] Title:Patellofemoral chondral status after medial patellofemoral ligament reconstruction using second-look arthroscopy in patients with recurrent patellar dislocation.
[So] Source:J Orthop Sci;19(6):925-32, 2014 Nov.
[Is] ISSN:1436-2023
[Cp] Country of publication:Japan
[La] Language:eng
[Ab] Abstract:BACKGROUND: Most patients with recurrent patellar dislocation show cartilage damage in the patellofemoral joint. Medial patellofemoral ligament reconstruction has become one of the most important surgical techniques for treating recurrent patellar dislocation. However, patellofemoral chondral status after this reconstruction has not been elucidated. The purpose of this study was to investigate the effects of medial patellofemoral ligament reconstruction on articular cartilage in the patellofemoral joint by comparing the arthroscopic chondral status at the time of reconstruction with that at second-look arthroscopy. METHODS: Participants in the present study comprised 31 patients (22 females, 9 males; 32 knees) who underwent second-look arthroscopy at a median of 12months (range 6-40months) after dual tunnel medial patellofemoral ligament reconstruction using a double-looped autologous semitendinosus tendon graft. Median age at the time of initial surgery was 20years (range 13-43years). The patellofemoral joint was divided into six portions, comprising the medial facet of the patella, central ridge, lateral facet of the patella, anterior medial femoral condyle, femoral groove, and anterior lateral femoral condyle. Chondral status in each portion according to the International Cartilage Repair Society classification was retrospectively evaluated at the time of initial surgery and second-look arthroscopy. RESULTS: Before medial patellofemoral ligament reconstruction, chondral lesions were observed in the patellofemoral joint in 31 knees (97%). At the central ridge of the patella, chondral damage was observed in 22 knees (69%) at initial surgery and damaged cartilages showed recovery in 6 knees. No significant difference in the alteration of chondral status was seen for the medial facet, lateral facet of the patella, anterior medial femoral condyle, femoral groove, and anterior lateral femoral condyle. CONCLUSIONS: According to short-term results, the patellofemoral chondral status after medial patellofemoral ligament reconstruction was not altered at second-look arthroscopy in most part of patellofemoral joint. At the central ridge of the patella, significant improvement of the International Cartilage Repair Society grading was observed.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1411
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1007/s00776-014-0612-5

  3 / 1332 MEDLINE  
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[PMID]: 24390042
[Au] Autor:Zheng X; Kang K; Li T; Lu B; Dong J; Gao S
[Ad] Address:Department of Orthopedics, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China, xiaozuo_zheng@163.com.
[Ti] Title:Surgical versus non-surgical management for primary patellar dislocations: an up-to-date meta-analysis.
[So] Source:Eur J Orthop Surg Traumatol;24(8):1513-23, 2014 Dec.
[Is] ISSN:1633-8065
[Cp] Country of publication:France
[La] Language:eng
[Ab] Abstract:The aim of this up-to-date meta-analysis was to compare the effects of surgical versus non-surgical treatment of patients following primary patellar dislocation and to provide the best evidence currently available. A comprehensive literature search was conducted using multiple databases, including Medline, Embase, and Cochrane Registry of Clinical Trials. All databases were searched from the earliest records to May 2013. Eligible studies were selected, and data were extracted by two independent investigators. The primary outcome variable was the frequency of recurrent patellar dislocation. The other outcomes included knee function scores, patient-rated outcomes, and radiographic examination. If appropriate, meta-analysis of these variables was performed. Nine independent trials were found to match the inclusion criteria. The pooled results demonstrated that the incidence of recurrent patellar dislocation and Hughston visual analog scale was significantly lower in the surgical treatment group than that in the non-surgical treatment group (P<0.05). There was no statistically significant difference between the two treatment groups in frequency of subsequent surgical interventions, percentage of excellent or good subjective opinion, Kujala score, pain score on visual analog scale, and severity of patellofemoral joint osteoarthrosis (P>0.05). This up-to-date meta-analysis indicates that surgical treatment was associated with a lower risk of recurrent patellar dislocation, but a lower Hughston VAS than non-surgical treatment for primary patellar dislocation. More large high-quality trials and further studies are needed to overcome the limitations of small sample sizes, and varieties of different surgical procedures or non-surgical management strategies adopted in the included trials.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1411
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1007/s00590-013-1400-1

  4 / 1332 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

  5 / 1332 MEDLINE  
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[PMID]: 24414379
[Au] Autor:Chan CM; King JJ; Farmer KW
[Ad] Address:Department of Orthopaedics and Rehabilitation, University of Florida, 3450 Hull Road, Gainesville, FL, 32607, USA, chancm@ortho.ufl.edu.
[Ti] Title:Fixation of chondral fracture of the weight-bearing area of the lateral femoral condyle in an adolescent.
[So] Source:Knee Surg Sports Traumatol Arthrosc;22(6):1284-7, 2014 Jun.
[Is] ISSN:1433-7347
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:Purely chondral fractures of the distal femur associated with patellar dislocation are uncommon, and treatment varies from fixation to debridement and marrow stimulation techniques. The unusual case reported here involves an adolescent who underwent fixation of a purely chondral fracture involving a large weight-bearing portion of the lateral femoral condyle. Chondral fracture healing was confirmed on follow-up magnetic resonance imaging and arthroscopic examination. This case suggests that fixation of purely chondral fractures can be successful in weight-bearing areas of the knee. Level of evidence V.
[Mh] MeSH terms primary: Femoral Fractures/surgery
Fractures, Cartilage/surgery
Knee Injuries/surgery
Patellar Dislocation/surgery
[Mh] MeSH terms secundary: Adolescent
Female
Femoral Fractures/complications
Femur/surgery
Fracture Healing
Fractures, Cartilage/complications
Humans
Knee Joint/surgery
Magnetic Resonance Imaging
Male
Patellar Dislocation/complications
Weight-Bearing
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1411
[Js] Journal subset:IM
[Da] Date of entry for processing:140521
[St] Status:MEDLINE
[do] DOI:10.1007/s00167-013-2833-0

  6 / 1332 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.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1409
[Js] Journal subset:IM
[St] Status:In-Process

  7 / 1332 MEDLINE  
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[PMID]: 25059336
[Au] Autor:Sillanp PJ; Salonen E; Pihlajamki H; Menp HM
[Ad] Address:Department of Orthopaedic Surgery and Trauma, Tampere University Hospital, Teiskontie 35, 33521, Tampere, Finland, petri.sillanpaa@uta.fi.
[Ti] Title:Medial patellofemoral ligament avulsion injury at the patella: classification and clinical outcome.
[So] Source:Knee Surg Sports Traumatol Arthrosc;22(10):2414-8, 2014 Oct.
[Is] ISSN:1433-7347
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:PURPOSE: To define medial patellofemoral ligament (MPFL) injury characteristics at the patellar attachment and clinical outcome in patients with primary traumatic patellar dislocation and MPFL avulsion injury at the patella. METHODS: Magnetic resonance imaging (MRI) was used to assess patients with primary (first-time) patellar dislocation and MPFL injury at the medial margin of the patella. Fifty-six patients with patellar attachment MPFL injury were enrolled in the study. Thirteen patients underwent surgical fixation of the avulsed MPFL and patellar medial margin osteochondral fracture, and the remaining patellar MPFL injures were treated nonoperatively. Forty-four patients were evaluated clinically at median four (range 1-10) years after patellar dislocation. The follow-up included evaluation of recurrent patellar instability, subjective symptoms, and functional limitations. RESULTS: Three types of patellar MPFL injuries were found; type P0 with ligamentous disruption at the patellar attachment, type P1 with bony avulsion fracture from the medial margin of the patella, and type P2 with bony avulsion involving articular cartilage from the medial facet of the patella. Of the patellar MPFL avulsion injuries that underwent initial surgical fixation, two patients (2/13) reported an unstable patella at follow-up. Fifty-five per cent (17/31) of patellar MPFL avulsion injuries that were treated nonoperatively had recurrent patellar instability (n.s.). The median Kujala score was 90 for patellar avulsion with surgical fixation and 86 for patellar avulsion without surgical fixation (n.s.). CONCLUSION: Patellar attachment MPFL injury showed three different patterns, classified as types P0, P1, and P2. MRI can be used to assess the injury pattern. Patellar MPFL avulsion injuries do not benefit from acute surgical repair compared with nonsurgical treatment. Type P2 patellar MPFL avulsion includes an osteochondral fracture that may require surgical fixation. LEVEL OF EVIDENCE: Prognostic study, Level III.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1409
[Js] Journal subset:IM
[St] Status:In-Process
[do] DOI:10.1007/s00167-014-3174-3

  8 / 1332 MEDLINE  
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[PMID]: 25059335
[Au] Autor:Cerciello S; Lustig S; Costanzo G; Neyret P
[Ad] Address:Albert Trillat Center, Lyon North University Hospital, 103 Grande Rue de la Croix-Rousse, 69004, Lyon, France, simo.red@tiscali.it.
[Ti] Title:Medial retinaculum reefing for the treatment for patellar instability.
[So] Source:Knee Surg Sports Traumatol Arthrosc;22(10):2505-12, 2014 Oct.
[Is] ISSN:1433-7347
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:PURPOSE: Medial structures repair is a well-established approach in the treatment for patellar instability. However, the literature is confusing concerning the indications for surgery, the different surgical techniques and outcomes. The goal of this systematic review was to clarify the indications for medial structures repair and to analyse the results of both arthroscopic and open techniques. METHODS: A comprehensive literature review was performed using the keywords 'patellar instability', 'medial capsule reefing' and 'medial capsule plication' with no limit regarding the year of publication. All the selected articles in Anglo-Saxon language were evaluated with the Coleman methodology score. RESULTS: Seventeen full-text articles were evaluated. Initial cohort included 617 patients. About 569 patients were reviewed at an average FU of 54.6 months (range 2-165 months) after medial structures repair. Average age at the time of surgery was 21.2 years (range 9-65 years). The indications for surgery included both patellar subluxation and dislocation (acute or chronic). Average Kujala score increased from 55 to 84 at the last FU, and in the same way average Lysholm score increased from 41.2 to 80.5, whereas average Tegner score increased from 3 to 5.3 and IKDC score from 47.8 to 75.1. Re-dislocation rate among the series was 6.1%. Average Coleman methodology score was 61.6 (range 17-92). CONCLUSION: From this review, it emerges that medial capsule reefing is a reliable option in the treatment for patellar instability. It can be proposed with good expectations, since the outcomes are positive and stable even at longer FU and complications rates are low. Re-dislocation rate is variable and can occur in up to one-third of patients. However, most of the available studies are case series, and comparison of the series is hard since they widely differ in inclusion criteria and indications, surgical technique and additional procedures, and outcome measures.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1409
[Js] Journal subset:IM
[St] Status:In-Process
[do] DOI:10.1007/s00167-014-3171-6

  9 / 1332 MEDLINE  
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[PMID]: 25047793
[Au] Autor:Mntrey J; Putman S; Gard S
[Ad] Address:Centre de medicine de l'appareil locomoteur et du sport, Unit d'Orthopdie et Traumatologie du Sport (UOTS), Swiss Olympic Medical Center, Service de chirurgie orthopdique 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-Process
[do] DOI:10.1007/s00167-014-3172-5

  10 / 1332 MEDLINE  
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[PMID]: 24781275
[Au] Autor:Becher C; Kley K; Lobenhoffer P; Ezechieli M; Smith T; Ostermeier S
[Ad] Address:Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany, becher.chris@web.de.
[Ti] Title:Dynamic versus static reconstruction of the medial patellofemoral ligament for recurrent lateral patellar dislocation.
[So] Source:Knee Surg Sports Traumatol Arthrosc;22(10):2452-7, 2014 Oct.
[Is] ISSN:1433-7347
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:PURPOSE: To compare clinical and radiological outcomes of static and dynamic medial patellofemoral ligament (MPFL) reconstruction techniques. METHODS: In a retrospective, matched-paired, cohort analysis, 30 patients surgically treated for recurrent lateral patellar dislocation were divided into two groups of 15 patients matched for inclusion and exclusion criteria. The static technique group underwent rigid fixation of the gracilis tendon at the anatomic femoral MPFL insertion and the superomedial border of the patella; the dynamic technique group underwent detachment of the gracilis tendon at the pes anserinus with fixation to the proximal medial patellar margin via tunnel transfer obliquely through the patella. Kujala, Lysholm, and Tegner scores; pain level; and pre- and postoperative radiographic changes of patellar height, patellar tilt, and bisect offset were compared. RESULTS: No significant between-group differences were found in mean Kujala, Tegner, Lysholm, or visual analogue scale scores or radiographic parameters. One case of resubluxation was observed in the dynamic group. All but one patient in each group would have been willing to undergo the procedure again. CONCLUSIONS: Both techniques provided satisfactory short-term outcomes. LEVEL OF EVIDENCE: III.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1409
[Js] Journal subset:IM
[St] Status:In-Process
[do] DOI:10.1007/s00167-014-3020-7


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