Database : MEDLINE
Search on : Patellar and Dislocation [Words]
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[PMID]: 24817023
[Au] Autor:de Oliveira V; de Souza V; Cury R; Camargo OP; Avanzi O; Severino N; Fucs P
[Ad] Address:Orthopaedic and Traumatology, Santa Casa Medical School and Hospitals, São Paulo, Brazil.
[Ti] Title:Medial patellofemoral ligament anatomy: is it a predisposing factor for lateral patellar dislocation?
[So] Source:Int Orthop;38(8):1633-9, 2014 Aug.
[Is] ISSN:1432-5195
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:PURPOSE: Because the medial patellofemoral ligament (MPFL) is the primary restraint to lateral dislocation of the patella, we aimed, in this controlled study, to verify whether the MPFL with different measurements could be considered another predisposing factor for patellar dislocation. METHODS: A group of 100 consecutive individuals without the criteria for patellar dislocation (trochlear dysplasia, patella alta and lateral patellar tilt) was recruited as a control group and underwent magnetic resonance imaging (MRI) study and another group of 50 patients with patellar instability. Femoral condyles, interepicondylar distance, length and thickness of the MPFL were measured. RESULTS: In the control group, the MPFL was 38-60 mm long. Individuals with patellar instability who had no episode of patellar dislocation had a 4.11-mm longer ligament than controls (p = 0.032), while patients with instability with a previous history of dislocation had a 13.54-mm longer MPFL than controls (p < 0.001). Thickness of the MPFL at the patellar insertion was lower in individuals with patellar instability with a history of dislocation (p < 0.001). An instability coefficient (IC) less than 1.3 indicates that the MPFL is insufficient. CONCLUSIONS: Individuals with patellar instability and previous patellar dislocation present with longer MPFL when compared to controls, and an associated IC less than 1.3 can be considered a predisposing factor for patellar dislocation. Treatment of patellar instability is a challenge, and it is difficult to identify what is the predisposing factor. This study has verified the measurements of the MPFL for the first time and presents values of thickness and length that can be considered as indications for surgical reconstruction. LEVEL OF EVIDENCE: III.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1407
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1007/s00264-014-2357-3

  2 / 1296 MEDLINE  
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[PMID]: 24992066
[Au] Autor:Borbas P; Koch PP; Fucentese SF
[Ti] Title:Lateral patellofemoral ligament reconstruction using a free gracilis autograft.
[So] Source:Orthopedics;37(7):e665-8, 2014 Jul.
[Is] ISSN:1938-2367
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Medial patellofemoral instability is a rare, disabling condition that is often associated with the wrong indication for lateral retinacular release or overcorrection with medializing tibial tubercle osteotomy. It is an even less common complication after total knee arthroplasty (TKA). The lateral patellofemoral ligament is an important lateral stabilizer of the patella against medial subluxation or dislocation. Until now, no report in the literature has described lateral patellofemoral ligament reconstruction with a free gracilis tendon autograft. Furthermore, there has not been a single case report of lateral patellofemoral ligament reconstruction after TKA. The authors describe a novel technique for reconstruction of the lateral patellofemoral ligament in a symptomatic medial subluxated patella resulting from TKA and extended lateral release in a 62-year-old patient. The result 1 year postoperatively was deemed successful. Clinically, the patella was stable, with correct tracking, and radiologically the patella was correctly positioned. With a technique similar to that used for the medial patellofemoral ligament, the lateral patellofemoral ligament can be reconstructed with a gracilis tendon autograft to permit stabilization independent of resting scar tissue of the lateral retinaculum. This operation can be performed in a minimally invasive way, without opening the joint, therefore decreasing the risk of joint infection. The authors showed a successful clinical and radiologic outcome 1 year after lateral patellofemoral ligament reconstruction in a patient with medial patellar instability after TKA and lateral release.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1407
[Js] Journal subset:IM
[St] Status:In-Process
[do] DOI:10.3928/01477447-20140626-66

  3 / 1296 MEDLINE  
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[PMID]: 24993410
[Au] Autor:Koh JL; Stewart C
[Ad] Address:Orthopaedic Surgery, NorthShore University HealthSystem, 2650 Ridge Avenue, Walgreen's 2505, Evanston, IL, USA; Department of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago Medicine & Biological Sciences, 5841 S. Maryland Avenue, Rm. P207, MC 3079, Chicago, IL 60637, USA. Electronic address: kohj1@hotmail.com.
[Ti] Title:Patellar instability.
[So] Source:Clin Sports Med;33(3):461-76, 2014 Jul.
[Is] ISSN:1556-228X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Patella instability can cause significant pain and functional limitations. Several factors can predispose to patella instability, such as ligamentous laxity, increased anterior TT-TG distance, patella alta, and trochlear dysplasia. Acquired factors include MPFL injury or abnormal quadriceps function. In many cases, first-time dislocation can successfully be managed with physical therapy and other nonoperative management; however, more than one dislocation significantly increases the chance of recurrence. Surgical management can improve stability, but should be tailored to the injuries and anatomic risk factors for recurrent dislocation. Isolated lateral release is not supported by current literature and increases the risk of iatrogenic medial instability. Medial repair is usually reserved for patients with largely normal anatomy. MPFL reconstruction can successfully stabilize patients with medial soft tissue injury but is a technically demanding procedure with a high complication rate and risks of pain and arthrosis. Tibial tubercle osteotomy can address bony malalignment and also unload certain articular cartilage lesions while improving stability. Trochleoplasty may be indicated in individuals with a severely dysplastic trochlea that cannot otherwise be stabilized. A combination of procedures may be necessary to fully address the multiple factors involved in causing pain, loss of function, and risk of recurrence in patients with patellar instability.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1407
[Js] Journal subset:IM
[St] Status:In-Process

  4 / 1296 MEDLINE  
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[PMID]: 24993408
[Au] Autor:Thomas S; Rupiper D; Stacy GS
[Ad] Address:Department of Radiology, University of Chicago, 5841 South Maryland Avenue, MC 2026, Chicago, IL 60637, USA.
[Ti] Title:Imaging of the patellofemoral joint.
[So] Source:Clin Sports Med;33(3):413-36, 2014 Jul.
[Is] ISSN:1556-228X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:The patellofemoral (PF) joint is a complex articulation, with interplay between the osseous and soft tissue structures to maintain the balance between knee mobility and stability. Disorders of the PF joint can be a source of anterior knee pain (AKP). In this article, radiographic and magnetic resonance imaging of the PF joint are reviewed, including normal anatomy, imaging techniques, and imaging-based measurements. Common imaging findings associated with AKP are reviewed, including symptomatic normal variants, tendinopathy, apophysitis, osteoarthritis, chondromalacia patella, trochlear dysplasia, excessive lateralization of tibial tuberosity, patellar maltracking, patellar dislocation and fractures, anterior bursitis, Morel-Lavallée effusions, and fat pad edema.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1407
[Js] Journal subset:IM
[St] Status:In-Process

  5 / 1296 MEDLINE  
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[PMID]: 23916510
[Au] Autor:Dhinsa BS; Bhamra JS; James C; Dunnet W; Zahn H
[Ad] Address:William Harvey Hospital, Kennington Road, Willesborough, Ashford, Kent, TN24 0LZ UK. Electronic address: bsd14@hotmail.com.
[Ti] Title:Patella fracture after medial patellofemoral ligament reconstruction using suture anchors.
[So] Source:Knee;20(6):605-8, 2013 Dec.
[Is] ISSN:1873-5800
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:The medial patellofemoral ligament (MPFL) acts as a soft tissue restraint to lateral subluxation of the patella, and is frequently damaged following patellar dislocation. A number of techniques for repair or reconstructions of the MPFL have been reported. We report two cases of patellar fracture following MPFL reconstruction utilizing suture anchors and bone tunnels that do not completely traverse the patella. The first case occurred seven months after surgery and the second case was at six weeks following surgery. There have been previous reports of patellar fracture following MPFL reconstruction, particularly when patellar tunnels completely traverse the patella. The authors decided to use suture anchors to reduce the risk of patellar fracture, and they feel that the fractures reported in this paper resulted from surgical error rather than system error. We feel that this is an important learning point when initially using this technique, and should be disseminated to other surgeons who undertake this surgery.
[Mh] MeSH terms primary: Patella/injuries
Patellar Dislocation/surgery
Patellar Ligament/injuries
Reconstructive Surgical Procedures/adverse effects
Suture Anchors/adverse effects
[Mh] MeSH terms secundary: Adult
Arthroscopy/methods
Female
Follow-Up Studies
Humans
Male
Patellar Dislocation/radiography
Patellar Ligament/surgery
Postoperative Complications/physiopathology
Postoperative Complications/radiography
Postoperative Complications/surgery
Reconstructive Surgical Procedures/methods
Reoperation/methods
Risk Assessment
Tomography, X-Ray Computed/methods
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Entry month:1408
[Js] Journal subset:IM
[Da] Date of entry for processing:131113
[St] Status:MEDLINE

  6 / 1296 MEDLINE  
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[PMID]: 23806767
[Au] Autor:Li W; Wang Q; Wang F; Zhang Y; Ma L; Dong J
[Ad] Address:Department of Orthopedics, 3rd Hospital of Hebei Medical University, Shijiazhuang, PR China.
[Ti] Title:Femoral trochlear dysplasia after patellar dislocation in rabbits.
[So] Source:Knee;20(6):485-9, 2013 Dec.
[Is] ISSN:1873-5800
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:BACKGROUND: The aim of this study was to investigate the effects of patellar dislocation on the development of the trochlear groove in rabbits. METHODS: Eighty knees from forty one-month-old white rabbits were divided into three groups (sham surgery, experimental, control). Lateral patellar dislocation was established in the experimental group and the effect on the development of the trochlear groove was compared with that in the sham surgery and control groups. Computed tomography (CT) scans were conducted to measure the angle, width and depth of the trochlear groove one month and six months after surgery. Gross specimen examination, cross-sectional anatomy and histological observation were conducted to investigate the anatomical configuration of the femoral trochlea and the changes in cartilage tissue of the trochlear groove at six months after surgery. RESULTS: At six months after surgery, CT scans showed a significant difference between the sham surgery group and the experimental group in the angle, width and depth of the trochlear groove. There were no significant differences between the sham surgery group and the control group. Gross specimen examination and cross-sectional anatomy indicated low lateral femoral trochlea and reduced height at the trochlear groove in the experimental group. The femoral trochlea was of normal appearance in the other two groups. Histological investigations showed that there were degenerative changes in the cartilage tissue of the femoral trochlea in the experimental group. CONCLUSIONS: Secondary femoral trochlear dysplasia may be caused by patellar dislocation in a normally developing femoral trochlea. Patellar dislocation may be one of the causes of femoral trochlear dysplasia.
[Mh] MeSH terms primary: Bone Diseases, Developmental/etiology
Bone Diseases, Developmental/radiography
Femur Head/radiography
Patellar Dislocation/complications
Patellar Dislocation/radiography
[Mh] MeSH terms secundary: Animals
Biopsy, Needle
Disease Models, Animal
Female
Immunohistochemistry
Male
Patellar Dislocation/surgery
Postoperative Complications/pathology
Rabbits
Random Allocation
Reference Values
Risk Factors
Time Factors
Tomography, X-Ray Computed
[Pt] Publication type:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Entry month:1408
[Js] Journal subset:IM
[Da] Date of entry for processing:131113
[St] Status:MEDLINE

  7 / 1296 MEDLINE  
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[PMID]: 25097585
[Au] Autor:Maslon A; Witonski D; Modrzewski T; Grabicki M; Sibinski M; Grzegorzewski A
[Ad] Address:Clinic of Orthopaedics and Paediatric Orthopaedics, Medical University of Lodz, Poland....
[Ti] Title:Phenomenon of painless knee in recurrent patellar dislocation in children.
[So] Source:Arch Med Sci;10(3):531-6, 2014 Jun 29.
[Is] ISSN:1734-1922
[Cp] Country of publication:Poland
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Cartilage lesion with patellar malalignment may be correlated with pain. Situations in which patients with recurrent patellar dislocation are painless between episodes of luxation can be approached with considerable curiosity. We evaluated the distribution of substance-P and S-100 protein expression in soft tissue of the knee in children with recurrent patellar dislocation, in order to evaluate the distribution of nociceptors and determine tissue origins of this situation. MATERIAL AND METHODS: Samples were collected from the medial and lateral synovial membrane, medial and lateral patellar retinaculum, Hoffa's body, patellar ligament, and quadriceps' aponeurosis in 10 children during the Blauth procedure and 10 adults with idiopathic osteoarthritis during total joint alloplasty. The density of nociceptive fibres was compared in the children and adults using S-100 and substance-P monoclonal antibodies. RESULTS: Statistical differences between groups were demonstrated for S-100 expression in synovial membrane of the medial knee compartment (p < 0.05) and for substance-P expression in the medial patellar retinaculum (p < 0.05) and synovial membrane of the lateral (p < 0.05) and medial (p < 0.05) knee compartment in favour of children. CONCLUSIONS: Lack of pain sensations in patients with recurrent patellar dislocation may be associated with non-increased expression of nerve endings in Hoffa's body. Increased expression of either S-100 protein or substance-P in synovial membrane and the medial retinaculum did not induce pain development in the knee joints of that group of patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1408
[Cu] Class update date: 140808
[Lr] Last revision date:140808
[Da] Date of entry for processing:140806
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.5114/aoms.2014.43747

  8 / 1296 MEDLINE  
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[PMID]: 24045503
[Au] Autor:Beck NA; Patel NM; Ganley TJ
[Ad] Address:aDepartment of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota bDepartment of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York cDivision of Orthopaedic Surgery, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
[Ti] Title:The pediatric knee: current concepts in sports medicine.
[So] Source:J Pediatr Orthop B;23(1):59-66, 2014 Jan.
[Is] ISSN:1473-5865
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:As the popularity and intensity of children's athletics have increased, so has the risk for knee injuries. Fractures of the tibial eminence may be treated operatively or nonoperatively depending on fracture classification, but arthrofibrosis is a potentially significant complication. Anterior cruciate ligament rupture presents treatment challenges as regards the optimal timing and method of reconstruction. A number of novel reconstructive techniques have been developed to minimize risks to the physes in this population. Recent studies have focused on the prognosis, surgical indications, and operative techniques for osteochondritis dissecans in children. A number of authors have also sought to better-define the optimal diagnostic testing and management of patellar dislocation. In this review, we provide an update on current concepts for tibial eminence fractures, anterior cruciate ligament injuries, osteochondritis dissecans of the knee, and patellar dislocation in young athletes.
[Mh] MeSH terms primary: Anterior Cruciate Ligament/injuries
Knee Injuries/epidemiology
Knee Injuries/surgery
Menisci, Tibial/injuries
Osteochondritis Dissecans/diagnosis
[Mh] MeSH terms secundary: Adolescent
Age Distribution
Anterior Cruciate Ligament/surgery
Athletic Injuries/diagnosis
Athletic Injuries/epidemiology
Athletic Injuries/therapy
Child
Female
Follow-Up Studies
Humans
Incidence
Injury Severity Score
Knee Injuries/diagnosis
Male
Menisci, Tibial/surgery
Osteochondritis Dissecans/epidemiology
Osteochondritis Dissecans/therapy
Patellar Dislocation/diagnosis
Patellar Dislocation/epidemiology
Patellar Dislocation/therapy
Pediatrics
Risk Assessment
Sex Distribution
Treatment Outcome
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1408
[Js] Journal subset:IM
[Da] Date of entry for processing:131125
[St] Status:MEDLINE
[do] DOI:10.1097/BPB.0b013e3283655c94

  9 / 1296 MEDLINE  
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[PMID]: 24332616
[Au] Autor:Kim KE; Hsu SL; Woo SL
[Ad] Address:Musculoskeletal Research Center, Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, 405 Center for Bioengineering, 300 Technology Drive, Pittsburgh, PA 15219, United States.
[Ti] Title:Tensile properties of the medial patellofemoral ligament: the effect of specimen orientation.
[So] Source:J Biomech;47(2):592-5, 2014 Jan 22.
[Is] ISSN:1873-2380
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:For recurrent patellar dislocation, reconstruction of the medial patellofemoral ligament (MPFL) with replacement autografts has often been performed but with only little data on the tensile properties of the MPFL to guide graft selection. With its complex anatomy and geometry, these properties are difficult to obtain. In this study, we showed how the orientation of the femur-MPFL-patella complex (FMPC) during uniaxial tensile testing can have a significant effect on its structural properties. Twenty two FMPCs were isolated from porcine stifle joints and randomly assigned to two groups of 11 each. For the first group, the specimens were loaded to failure with the patella oriented 30 degrees away from the direction of the applied load to mimic its orientation in situ, called natural orientation. In the second group, the patella was aligned in the direction of the tensile load, called non-natural orientation. The stiffness for the natural orientation group was 65±13 N/mm, 32% higher than that for the non-natural orientation group (50±17 N/mm; p<0.05). The ultimate loads were 438±128 N and 386±136 N, respectively (p>0.05). Ten out of 11 specimens in the natural orientation group failed at the femoral attachment (the narrowest portion of the MPFL) compared to 6 out of 11 in the non-natural orientation group. Our findings suggest that the specimen orientation that mimics the in-situ loading conditions of the MPFL should be used to obtain more representative data for the structural properties of the FMPC.
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Entry month:1401
[Js] Journal subset:IM
[St] Status:In-Process

  10 / 1296 MEDLINE  
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[PMID]: 25073529
[Au] Autor:Akiyama T; Kanda S; Maeda A; Endo M; Saita K
[Ad] Address:Department of Orthopaedic Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan....
[Ti] Title:Patella dislocation following distal femoral replacement after bone tumour resection.
[So] Source:BMJ Case Rep;2014, 2014.
[Is] ISSN:1757-790X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:We report the case of a 16-year-old girl with patella dislocation following distal femur replacement for a malignant tumour. We performed a medial plication and lateral release procedure to treat her persistent patellar dislocation after distal femur replacement following malignant tumour resection. This treatment improved the patient's gait ability dramatically. A distal femur reconstruction with a total knee arthroplasty (TKA) system for tumour resection is a frequently performed procedure. The reported incidence of patella dislocation following distal femur reconstruction with a TKA is 2.3%. However, treatment procedures for patella dislocation following a distal femur replacement after malignant tumour resection have not been studied extensively. To the best of our knowledge, this is the first English case report about patella dislocation following distal femoral replacement focusing on surgical treatment. Our experience suggests that treatment for patella dislocation following distal femur reconstruction with a TKA should be considered positively.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1407
[Js] Journal subset:IM
[St] Status:In-Data-Review


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