Database : MEDLINE
Search on : Patellar and Dislocation [Words]
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[PMID]: 25936196
[Au] Autor:Tang H; Xu YQ; Zheng TE; Sha Y; Xu XS; Zhao WQ; Cui Y; Zhang XJ; Pu SQ; Li Chuan; Li CX
[Ti] Title:[Anatomical double bundle reconstruction of medial patellofemoral ligament with allograft tendon in the treatment of patellar dislocations].
[So] Source:Zhongguo Gu Shang;28(3):252-5, 2015 Mar.
[Is] ISSN:1003-0034
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:OBJECTIVE: To investigate the clinical therapeutic results of allograft tendon for anatomical reconstruction of medial patellofemoral ligament (MPFL) for the treatment of patellar dislocations. METHODS: From September 2008 to June 2013, 16 patients with patellar dislocation underwent MPFL reconstructions. There were 2 males and 14 females, aged 11 to 27 years old (16 years old on average). Patellar dislocations occurred in 11 left and 5 right knees. The disease course ranged from 3 to 10 years. The frequency of dislocation ranged from 9 to 33 times (19 times on average). Affected knee joints showed patellar instability; the range of action for patella obviously increased. The X-ray films showed patellar dislocation. The preoperative Q angle was (36 ± 9)°, and the congruence angle was (63 ± 18)°. Reconstruction was performed via allograft tendon. Allograft tendon was fixed through the superomedial pole of the patella, and the other end was fixed at the natural MPFL insertion site near the medial femoral condyle with an interference screw in a bone tunnel. All the patients were evaluated postoperatively; Kujala patellofemoral scores, objective knee function, complications, and reoperations were assessed. RESULTS: Primary healing was achieved in all cases. No infection or necrosis and absorption of grafts was observed. All the patients were followed up for an average of 16.4 months (ranged, 10 to 24 months) postoperatively. At the latest follow-up, all the patients had no pain, swelling and patellar instability; neither patella redislocation nor fracture occurred. The X-ray films showed good position of tunnel 6 months after operation, and the congruence angle was (5 ± 9)°, showing statistically significant difference when compared with preoperation (P < 0.05). The postoperative Q angle was (17 ± 8)°, the Kujala knee function score improved significantly from 45.20 ± 9.20 to 89.30 ± 6.40 at the latest follow-up, showing statistically significant difference (P < 0.05). CONCLUSION: MPFL reconstruction improves clinical symptoms. Anatomical MPFL reconstruction is effective for patellar dislocation, and it offers good recovery of the premorbid patella mechanics. The interference screw provides firm fixation. Allograft can avoid the graft harvest site morbidity, but it increases the cost of the surgery.
[Mh] MeSH terms primary: Ligaments, Articular/surgery
Patellar Dislocation/surgery
Patellofemoral Joint/surgery
Reconstructive Surgical Procedures/methods
Tendons/transplantation
[Mh] MeSH terms secundary: Adolescent
Adult
Allografts
Child
Female
Humans
Male
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1506
[Js] Journal subset:IM
[Da] Date of entry for processing:150504
[St] Status:MEDLINE

  2 / 1388 MEDLINE  
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[PMID]: 25924496
[Au] Autor:Zhao G; Liu YJ; Wang JL; Qi W; Qu F; Yuan BT; Wang JT; Shen XZ; Liu Y; Zhu JL
[Ti] Title:[Hamstring tendon transplantation embedding reconstruction of medial patellofemoral ligament for the treatment of recurrent patellar dislocation].
[So] Source:Zhongguo Gu Shang;28(2):141-4, 2015 Feb.
[Is] ISSN:1003-0034
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:OBJECTIVE: To explore the effectiveness of hamstring tendon graft embedding reconstruction of medial patellofemoral ligament for the treatment of recurrent dislocation of the patella. METHODS: From March 2008 to June 2013,67 patients with recurrent dislocation of patella were treated, including 28 males, 39 females with an average age of 22 years ranging from 10 to 42 years old. The clinical manifestations involved knee joint instability,"giving way", sense of patellar dislocation, anterior knee pain. All 67 patients underwent arthroscopic hamstring tendon graft embedding reconstruction of the medial patellofemoral ligament. The curative effect were evaluated by preoperative and postoperative Lysholm score and Q angle changes. RESULTS: All cases were followed up after operation and the mean follow-up time was(27.5±13.4) months(4 to 69 months). Postoperative incision were healed well and no patellar dislocation or subluxation occurred. Lysholm score improved from preoperative 76.35±2.86 to 82.71±2.29 postoperatively; Q angle decreased from preoperative (18.75±2.33)° to postoperative(13.28±1.75)°. CONCLUSION: The method for the reconstruction of medial patellofemoral ligament can provide enough tension, patellar stability.imoroving the function of knee ioint.
[Mh] MeSH terms primary: Patellar Dislocation/surgery
Patellar Ligament/surgery
Patellofemoral Joint/surgery
Reconstructive Surgical Procedures/methods
Tendons/transplantation
[Mh] MeSH terms secundary: Adolescent
Adult
Child
Female
Humans
Male
Recurrence
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1506
[Js] Journal subset:IM
[Da] Date of entry for processing:150430
[St] Status:MEDLINE

  3 / 1388 MEDLINE  
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[PMID]: 25176197
[Au] Autor:Torabi M; Wo S; Vyas D; Costello J
[Ad] Address:UPMC Department of Radiology, 200 Lothrop St., Pittsburgh, PA 15213. Electronic address: mtorabi@wakehealth.org....
[Ti] Title:MRI evaluation and complications of medial patellofemoral ligament reconstruction.
[So] Source:Clin Imaging;39(1):116-27, 2015 Jan-Feb.
[Is] ISSN:1873-4499
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Medial patellofemoral ligament (MPFL) reconstruction is a relatively new surgical technique for the treatment of recurrent patellar instability and dislocation. Radiologic findings following MPFL reconstruction are not well described in the existing literature. Here, we review the anatomy and biomechanics of the MPFL, review imaging findings following double-bundle MPFL reconstruction, and show examples of complications arising from reconstruction.
[Mh] MeSH terms primary: Joint Instability/pathology
Magnetic Resonance Imaging/methods
Patellar Dislocation/pathology
Patellar Ligament/pathology
Reconstructive Surgical Procedures/methods
[Mh] MeSH terms secundary: Humans
Joint Instability/surgery
Patellar Dislocation/surgery
Patellar Ligament/surgery
Reconstructive Surgical Procedures/adverse effects
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1506
[Js] Journal subset:IM
[Da] Date of entry for processing:141216
[St] Status:MEDLINE

  4 / 1388 MEDLINE  
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[PMID]: 25171680
[Au] Autor:Rethlefsen SA; Nguyen DT; Wren TA; Milewski MD; Kay RM
[Ad] Address:*Children's Orthopaedic Center, Children's Hospital †Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA ‡Elite Sports Medicine, Connecticut Children's Medical Center, Farmington, CT.
[Ti] Title:Knee Pain and Patellofemoral Symptoms in Patients With Cerebral Palsy.
[So] Source:J Pediatr Orthop;35(5):519-22, 2015 Jul-Aug.
[Is] ISSN:1539-2570
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Knee pain in cerebral palsy (CP) is associated with increased patellofemoral forces present when walking with flexed knees. In typically developing children, knee pain and patellofemoral dysfunction are associated with obesity, genu valgum, femoral anteversion, and external tibial torsion. These problems are also common in CP, and may contribute to knee problems in this population. The purposes of this study were to define the prevalence of knee pain and patellofemoral dysfunction in children with CP, and to identify physical and gait characteristics (using 3-dimensional gait analysis data) that predispose them to such problems. METHODS: Retrospective review of 121 children with CP, Gross Motor Function Classification System level I to IV, who underwent computerized gait analysis testing. Demographics, range of motion, body mass index and hip, knee, and ankle kinematics were compared between subjects with and without knee pain. RESULTS: Twenty-five of 121 subjects (21%) reported knee pain at the time of testing. Three of 121 subjects (2%) had a history of patellar subluxation/dislocation. Age and sex were significantly related to presence of knee pain. The likelihood of knee pain was almost 5 times higher in females (odds ratio=4.9, [95% confidence interval, 1.8-13.3], P=0.002), with a prevalence of 40% (17/42) in females versus 10% (8/79) in males. The likelihood of knee pain increased with age by approximately 13% per year (odds ratio=1.13, [95% confidence interval, 1.00-1.28], P=0.058). Malignant malalignment syndrome showed a potential relationship to more severe knee pain (P=0.05), which warrants further investigation. Body mass index, pes valgus, and degree of stance knee flexion showed no statistically significant relationships to knee pain (P>0.16). CONCLUSIONS: The prevalence of knee pain in ambulatory patients with CP is approximately 21%. Patellar subluxation (2%) and dislocation are rare in these patients. Knee pain is not always related to crouch, femoral anteversion, external tibial torsion, genu valgum, or pes valgus. Knee pain in these patients is more prevalent in females, and increases with increasing age. LEVEL OF EVIDENCE: Level III-case-control study.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1506
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1097/BPO.0000000000000304

  5 / 1388 MEDLINE  
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[PMID]: 26047005
[Au] Autor:Potini VC; Gehrmann RM
[Ad] Address:Department of Orthopaedics, Rutgers University-New Jersey Medical School, Newark, NJ. potinivc@njms.rutgers.edu.
[Ti] Title:Intra-Articular Dislocation of the Patella With Associated Hoffa Fracture in a Skeletally Immature Patient.
[So] Source:Am J Orthop (Belle Mead NJ);44(6):E195-8, 2015 Jun.
[Is] ISSN:1934-3418
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Since 1887, approximately 50 cases of an intra-articular patellar dislocation have been reported in the worldwide literature. The vast majority of patients required an open reduction of the patella or closed reduction under general anesthesia. This injury has never been reported in association with a coronal shear fracture of the femoral condyle. A 14-year-old boy presented to our institution with his left knee locked in flexion after a direct blow. Radiographs showed the patella rotated on its horizontal axis and lying in a transverse position within the knee joint, as well as a concomitant femoral condyle fracture. After a successful closed reduction of the patella, the patient underwent open reduction and rigid fixation of the femoral condyle fracture with countersunk interfragmentary screws. At 12 months, the patient was ambulating on the left leg and had painless motion of the knee. We present a rare injury pattern in a skeletally immature patient after a direct blow to the knee. By treating the injuries in a sequential manner and providing a stable fixation construct, the patient was able to achieve a satisfactory return to function even after sustaining a considerable injury to the knee.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1506
[Js] Journal subset:IM
[St] Status:In-Data-Review

  6 / 1388 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 3 year 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.
[Mh] MeSH terms primary: Arthroplasty
Ilizarov Technique
Joint Deformities, Acquired/surgery
Knee Dislocation/surgery
Patellar Dislocation/surgery
[Mh] MeSH terms secundary: Adult
Female
Humans
Joint Deformities, Acquired/diagnosis
Joint Deformities, Acquired/etiology
Knee Dislocation/complications
Knee Dislocation/diagnosis
Patellar Dislocation/complications
Patellar Dislocation/diagnosis
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1506
[Js] Journal subset:IM
[Da] Date of entry for processing:140923
[St] Status:MEDLINE

  7 / 1388 MEDLINE  
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[PMID]: 26048770
[Au] Autor:Lubowitz JH
[Ti] Title:Editorial Commentary: Operative Treatment of Primary Patellar Dislocation.
[So] Source:Arthroscopy;31(6):1216, 2015 Jun.
[Is] ISSN:1526-3231
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Systematic review of the literature does not support operative treatment of primary patellar dislocation, as the results of nonoperative treatment are similar. However, surgery is indicated for recurrent patellar dislocation, and in the future, we anticipate that contemporary medial patellofemoral ligament reconstruction outcomes for primary patellar dislocation will prove superior to nonoperative treatment.
[Pt] Publication type:EDITORIAL
[Em] Entry month:1506
[Js] Journal subset:IM
[St] Status:In-Data-Review

  8 / 1388 MEDLINE  
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[PMID]: 25395051
[Au] Autor:Acklin YP; Potocnik P; Sommer C
[Ad] Address:General Surgery, Trauma Unit, Kantonsspital Graubünden, Loëstr. 170, 7000, Chur, Switzerland, yvespascal.acklin@gmail.com.
[Ti] Title:Extended medial approach in posteromedial proximal tibia fracture dislocation.
[So] Source:Oper Orthop Traumatol;27(2):183-90, 2015 Apr.
[Is] ISSN:1439-0981
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:OBJECTIVE: Treatment of posteromedial proximal tibia fracture dislocation (medial Moore type II, Schatzker IV) with a one-incision technique. INDICATIONS: Posteromedial proximal tibia fracture dislocation Moore type II (medial). CONTRAINDICATIONS: All Moore type V fracture patterns requiring a bilateral approach. SURGICAL TECHNIQUE: In supine position, an extended strictly medial incision is performed. It is mandatory to preserve the medial collateral ligament and the pes anserinus. In a first step, the posterolateral impressed zone is reduced directly through the main fracture gap using an image intensifier. The posteromedial main fragment is then reduced and preliminarily fixed with Kirschner wires. A posteromedial buttress plate slid in under the medial ligamentous structures supports this fragment. Anterior subcutaneous dissection revolves the medial boarder of the patellar ligament and a medial arthrotomy is performed. The bony avulsed anterior cruciate ligament (ACL) is reduced and suture fixation follows. POSTOPERATIVE MANAGEMENT: Immediate partial weight bearing is possible. RESULTS: A collective of 26 patients could be evaluated after a median follow-up of 4 years (1-8 years). Median age was 51 years (20-77 years). All fractures healed without secondary displacement or infection. After a median of 4 years, 25 patients showed no to moderate osteoarthritis. One patient showed severe osteoarthritis after 8 years. All patients subjectively judged the clinical result as good to excellent. The average Lysholm score was 95 (75-100) and the average Tegner activity score 5 (3-7).
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1504
[Js] Journal subset:IM
[St] Status:In-Process
[do] DOI:10.1007/s00064-014-0306-3

  9 / 1388 MEDLINE  
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[PMID]: 25807952
[Au] Autor:Allen BJ; Krych AJ; Engasser W; Levy BA; Stuart MJ; Collins MS; Dahm DL
[Ad] Address:Department of Orthopedics, Mayo Clinic, Rochester, Minnesota, USA....
[Ti] Title:Medial patellofemoral ligament tears in the setting of multiligament knee injuries rarely cause patellar instability.
[So] Source:Am J Sports Med;43(6):1386-90, 2015 Jun.
[Is] ISSN:1552-3365
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Multiligament knee injuries (MLKIs) can also involve the medial patellofemoral ligament (MPFL), but there is a paucity of information regarding prevalence and relevance of MPFL involvement in this setting. PURPOSE: (1) To identify the prevalence of MPFL injury in MLKIs, (2) to determine whether an MPFL tear results in symptomatic patellar instability, and (3) to report clinical and functional outcomes of patients with and without MPFL tears after MLKI surgical reconstruction. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: The records of all patients who underwent surgical reconstruction of MLKI (defined as a grade 3 injury of ≥2 ligaments) at a single institution from 2007 to 2010 were reviewed. Age, sex, knee dislocation classification (according to Schenck), and MRI findings were documented. All preoperative MRI scans were reviewed by an experienced musculoskeletal radiologist to determine the presence or absence of MPFL involvement. If an MPFL tear was present, its anatomic location and severity as well as the presence of patellar or lateral femoral condyle bone bruises were documented. Inclusion criteria included (1) MLKI treated at a single institution, (2) presence of MPFL tear on preoperative MRI, and (3) minimum 2-year clinical follow-up. Patellar instability symptoms were assessed with the Kujala Knee Questionnaire. Functional outcomes were measured using the International Knee Documentation Committee (IKDC) score. IKDC scores were compared between patients who sustained MLKIs with and without MPFL tears. There were 21 patients in each group. RESULTS: Over the 4-year study period, 30 of 51 patients (59%) treated surgically for a MLKI had MRI evidence of an MPFL tear. Nine were lost to follow-up, leaving 21 patients for review. There were 13 complete (62%), 5 high-grade partial (24%), and 3 partial (14%) MPFL tears. Sixteen of 21 tears (76%) occurred at the proximal third, with the remainder exhibiting diffuse signal abnormality consistent with tearing throughout the length of the MPFL. The superficial medial collateral ligament was involved in all patients. In no case was the MPFL repaired or reconstructed. At mean follow-up of 3.6 years (range, 2.0-5.7 years), only 1 of 21 patients (5%) complained of patellofemoral instability symptoms whereas 20 of 21 patients (95%) did not experience patellar subluxation or dislocation. No significant difference was found when IKDC scores were compared between patients with and without an MPFL tear (mean ± SD, 65.5 ± 22.9 vs 79.4 ± 16.1; P = .07). CONCLUSION: MPFL tears occur frequently in patients with MLKI but rarely cause instability. In the majority of cases, MPFL tears do not need to be addressed at the time of surgery.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1505
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1177/0363546515576902

  10 / 1388 MEDLINE  
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[PMID]: 25983467
[Au] Autor:Kondreddi V; Yalamanchili RK; Ravi Kiran K
[Ad] Address:Assistant Professor, Department of Orthopaedics, ASRAM Medical College, Eluru, West Godavari, India.
[Ti] Title:Bicondylar Hoffa's fracture with patellar dislocation - a rare case.
[So] Source:J Clin Orthop Trauma;5(1):38-41, 2014 Mar.
[Is] ISSN:0976-5662
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:Bicondylar Hoffa's fractures of the femur is very uncommon. Conjoint bicondylar Hoffa fracture with ipsilateral patellar dislocation, Bicondylar Hoffa's with patellar fracture and extensor mechanism rupture has been described in literature. We report a case of unconjoint bicondylar Hoffa's fracture with lateral patellar dislocation in 17-year-old male patient treated with open reduction and cancellous screw fixation that subsequently healed well with good functional outcome.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1505
[Cu] Class update date: 150525
[Lr] Last revision date:150525
[Da] Date of entry for processing:150518
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.1016/j.jcot.2014.02.001


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