Database : MEDLINE
Search on : Patellar and Dislocation [Words]
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[PMID]: 26103937
[Au] Autor:Petershofer A; Fingernagel T; Trieb K
[Ad] Address:Klinikum Wels-Grieskirchen, Grieskirchnerstraße 42, 4600, Wels, Österreich, Alexander.petershofer@klinikum-wegr.at.
[Ti] Title:Patellainstabilität bei Patienten mit Trisomie 21 : Alleinige MPFL-Rekonstruktion als neue Indikation. [Patellofemoral instability in trisomy 21 : MPFL-Reconstruction as a single procedure].
[So] Source:Orthopade;44(8):643-6, 2015 Aug.
[Is] ISSN:1433-0431
[Cp] Country of publication:Germany
[La] Language:ger
[Ab] Abstract:BACKGROUND: Patellar instability is a common orthopaedic condition which is often seen in younger individuals. Biomechanical studies have shown that the medial patellofemoral ligament (MPFL) is the most important soft tissue that restrains lateral subluxation of the patella in the beginning of flexion of the knee joint. METHODS: MPFL reconstruction is an effective procedure to treat recurrent patellar dislocation. Double-bundle and single-bundle procedures have been described. If double-bundle reconstruction is not possible, there are good postoperative outcomes with single-bundle procedure as well. DISCUSSION: This is the first report of MPFL reconstruction as a single procedure to treat patellar instability in patients with down syndrome.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1508
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1007/s00132-015-3129-5

  2 / 1407 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-Process

  3 / 1407 MEDLINE  
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[PMID]: 26236115
[Au] Autor:de Freitas GL; Gomes JL; Abdala CC
[Ad] Address:Escola de Medicina, Universidade Federal do Rio Grande do Sul, Rua Ramiro barcelos 2400, Bairro Santa Cecilia, Porto Alegre, RS 90035003, Brazil.
[Ti] Title:Mechanical testing of patellofemoral instability after induced failure of the patellofemoral ligament reconstruction using four differents cadavers grafts.
[So] Source:J Orthop;12(3):130-6, 2015 Sep.
[Is] ISSN:0972-978X
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:PURPOSE: To ascertain whether differences exist in joint instability after experimentally induced failure of medial patellofemoral ligament (MPFL) reconstruction in the cadaver knee with the four graft types most widely used for this procedure, and whether any of these grafts are associated with decreased risk in the event of failure. METHODS: Between March 2011 and March 2012, eight cadavers obtained from the local medical examiner's office were randomly allocated into four groups (four knees each). In each group, a different graft technique was used for MPFL reconstruction. The forces required to induce lateral dislocation of the patella before reconstruction and after experimental failure of surgical reconstruction were recorded. The tested graft techniques were then compared to assess which was associated with the least instability after failed reconstruction. RESULTS: When we compared the groups I (semitendinosus) and II (patellar tendon), the mean differences of the force required to produce a dislocation of the patella before and after the failure were 0.5 N and 12.5 N, respectively (p = 0.028). In comparison between groups I and III (medial third of the quadriceps tendon) the mean differences of the force required to produce dislocation before and after the failure caused were 0.5 N and 22 N, respectively (p < 0.001). In comparison between groups I and IV (Medial third of the quadriceps tendon) we found the mean differences of the force required to produce dislocation before and after the failure caused were 0.5 N and 5 N, respectively (p > 0.999). CONCLUSIONS: There were differences in residual instability after simulated MPFL reconstruction failure depending on graft type. Use of the free semitendinosus graft technique was associated with the least risk of residual instability in case of reconstruction failure.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1508
[Cu] Class update date: 150805
[Lr] Last revision date:150805
[Da] Date of entry for processing:150803
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.1016/j.jor.2015.01.018

  4 / 1407 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-Process
[do] DOI:10.1097/BPO.0000000000000304

  5 / 1407 MEDLINE  
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[PMID]: 26229800
[Au] Autor:Albuquerque RP; Félix Dos Santos Neto J; Albuquerque MI; Giordano V; Pecegueiro do Amaral N
[Ad] Address:Knee Surgery Center, Instituto Nacional de Traumatologia e Ortopedia, Rio de Janeiro, RJ, Brazil....
[Ti] Title:Fixation of an osteochondral fragment after acute patellar dislocation in an immature skeleton.
[So] Source:Rev Bras Ortop;49(2):202-5, 2014 Mar-Apr.
[Is] ISSN:2255-4971
[Cp] Country of publication:Spain
[La] Language:eng
[Ab] Abstract:Fixation of an osteochondral fracture after acute patellar dislocation is an infrequent form of treatment. Likewise, the location of this fragment in the lateral region of the lateral femoral condyle, functioning as a free body, is uncommon. The aim of this study was to present a case of osteochondral fracture of the patella at an unusual site, along with the therapy used and the clinical follow-up.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1508
[Cu] Class update date: 150804
[Lr] Last revision date:150804
[Da] Date of entry for processing:150803
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.1016/j.rboe.2014.03.014

  6 / 1407 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:COMMENT; EDITORIAL
[Em] Entry month:1506
[Js] Journal subset:IM
[St] Status:In-Process

  7 / 1407 MEDLINE  
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[PMID]: 25636989
[Au] Autor:Erickson BJ; Mascarenhas R; Sayegh ET; Saltzman B; Verma NN; Bush-Joseph CA; Cole BJ; Bach BR
[Ad] Address:Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.. Electronic address: berickso.24@gmail.com....
[Ti] Title:Does Operative Treatment of First-Time Patellar Dislocations Lead to Increased Patellofemoral Stability? A Systematic Review of Overlapping Meta-analyses.
[So] Source:Arthroscopy;31(6):1207-15, 2015 Jun.
[Is] ISSN:1526-3231
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: To conduct a systematic review of meta-analyses comparing nonoperative and operative treatment of patellar dislocations to elucidate the cause of the variation and to determine which meta-analysis provides the current best available evidence. METHODS: A systematic review of the literature to identify meta-analyses was performed. Data were extracted for patient outcomes and recurrent dislocations. Meta-analysis quality was assessed using the Oxman-Guyatt and Quality of Reporting of Meta-analyses systems. The Jadad algorithm was then applied to determine which meta-analysis provided the highest level of evidence. RESULTS: Four meta-analyses met the eligibility criteria: 1 Level I evidence, 2 Level II evidence, and 1 Level III evidence. A total of 1,984 patients were included (997 underwent surgery whereas 987 underwent conservative treatment). Three meta-analyses found a lower subsequent patellar dislocation rate in patients managed operatively compared with nonoperatively, whereas one did not find a difference in recurrent dislocation rates between the operative and nonoperative groups. When the results of all the studies were combined, the overall redislocation rate was 29.4% and the rate of recurrent instability episodes was 32.8%. Patients treated operatively had a 24.0% rate of repeat patellar dislocation and a 32.7% rate of recurrent patellar instability, whereas patients treated nonoperatively had a 34.6% rate of repeat patellar dislocation and a 33.0% rate of recurrent instability. In addition, 1 meta-analysis found a significantly higher rate of patellofemoral osteoarthritis in the operative group. No differences in functional outcomes scores were seen between treatments. Two meta-analyses had low Oxman-Guyatt scores (<4), indicative of major flaws. CONCLUSIONS: According to the best available evidence, operative treatment of acute patellar dislocations may result in a lower rate of recurrent dislocations than nonoperative treatment but does not improve functional outcome scores. LEVEL OF EVIDENCE: Level III, systematic review of Level I, II, and II studies.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1506
[Js] Journal subset:IM
[St] Status:In-Process

  8 / 1407 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 12 months (range 6-40 months) after dual tunnel medial patellofemoral ligament reconstruction using a double-looped autologous semitendinosus tendon graft. Median age at the time of initial surgery was 20 years (range 13-43 years). 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.
[Mh] MeSH terms primary: Arthroscopy/methods
Cartilage, Articular/pathology
Patellar Dislocation/surgery
Patellar Ligament/surgery
Patellofemoral Joint/surgery
Reconstructive Surgical Procedures/methods
Second-Look Surgery
[Mh] MeSH terms secundary: Adolescent
Adult
Female
Follow-Up Studies
Humans
Male
Patellar Dislocation/diagnosis
Patellar Dislocation/physiopathology
Patellofemoral Joint/physiopathology
Range of Motion, Articular
Recurrence
Retrospective Studies
Time Factors
Treatment Outcome
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1508
[Js] Journal subset:IM
[Da] Date of entry for processing:141126
[St] Status:MEDLINE
[do] DOI:10.1007/s00776-014-0612-5

  9 / 1407 MEDLINE  
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[PMID]: 24074831
[Au] Autor:Zhang GY; Zheng L; Shi H; Qu SH; Ding HY
[Ad] Address:Department of Ultrasound, Qianfoshan Hospital of Shandong University, Jinan 250014, China.
[Ti] Title:Sonography on injury of the medial patellofemoral ligament after acute traumatic lateral patellar dislocation: Injury patterns and correlation analysis with injury of articular cartilage of the inferomedial patella.
[So] Source:Injury;44(12):1892-8, 2013 Dec.
[Is] ISSN:1879-0267
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:OBJECTIVE: The purpose of this study was to investigate the accuracy of high-frequency ultrasonography in the diagnosis of injuries of medial patellofemoral ligaments (MPFLs), analyse the characteristics of MPFL injury and correlations between injury of the MPFL and articular cartilage of the inferomedial patella in patients with acute traumatic lateral patellar dislocation. METHODS: High-frequency sonographic images of 49 patients with acute traumatic lateral patellar dislocations treated surgically were reviewed. The χ(2) tests were performed for statistical analysis. RESULTS: Twenty-eight cases of complete MPFL tear and 21 cases of partial MPFL tear were identified in operation, with 27 cases of MPFL tear located at their femoral attachment, 21 cases of tear at the patellar attachment and one case of midsubstance tear. The diagnostic accuracy of sonography regarding partial MPFL tear and complete MPFL tear was 89.8% and 89.8%. Among the patients with MPFL tear at the patellar attachment, eight and six cases were concomitant with chondral and osteochondral lesions in the inferomedial patella, respectively, in contrast to nine and six cases in patients with MPFL tear at the femoral attachment, respectively. There was no significant difference between the two locations described above regarding the prevalence rates of chondral or osteochondral lesions of the inferomedial patella (P=0.732, P=0.614). Among the patients with complete MPFL tear, 12 and 10 cases were concomitant with chondral and osteochondral lesions in the inferomedial patella, respectively, while six and two cases were concomitant with partial MPFL tear. There was no significant difference between the two types of injuries discussed above on the prevalence rates of chondral lesions of the inferomedial patella (P=0.305), but the prevalence rate of osteochondral lesions between the two types of injuries discussed above was statistically different (P=0.035). CONCLUSIONS: The MPFL is most easily injured at the femoral attachment, secondly at the patellar attachment. High-frequency ultrasonography is an accurate method in the diagnosis of an MPFL tear. There are neither significant differences on the prevalence rates of chondral or osteochondral lesions of the inferomedial patella between locations of MPFL injuries, nor significant difference on the prevalence rates of chondral lesions between MPFL injury types; but the complete MPFL tear is more often concomitant with inferomedial patellar osteochondral lesions than the partial MPFL tear.
[Mh] MeSH terms primary: Cartilage, Articular/ultrasonography
Joint Instability/ultrasonography
Medial Collateral Ligament, Knee/ultrasonography
Patella/injuries
Patella/ultrasonography
Patellar Dislocation/ultrasonography
[Mh] MeSH terms secundary: Adolescent
Adult
Cartilage, Articular/injuries
Female
Humans
Male
Medial Collateral Ligament, Knee/injuries
Patella/physiopathology
Patellar Dislocation/physiopathology
Reproducibility of Results
Retrospective Studies
Trauma Severity Indices
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1508
[Js] Journal subset:IM
[Da] Date of entry for processing:131104
[St] Status:MEDLINE

  10 / 1407 MEDLINE  
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[PMID]: 24758780
[Au] Autor:Lippacher S; Dreyhaupt J; Williams SR; Reichel H; Nelitz M
[Ad] Address:Department of Orthopaedic Surgery, University of Ulm, Ulm, Germany sabinelippacher@yahoo.de....
[Ti] Title:Reconstruction of the Medial Patellofemoral Ligament: Clinical Outcomes and Return to Sports.
[So] Source:Am J Sports Med;42(7):1661-8, 2014 Jul.
[Is] ISSN:1552-3365
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Recent studies have shown that medial patellofemoral ligament (MPFL) reconstruction using a standardized technique provides significant improvements in all outcome scoring systems, with low complication rates and good patient satisfaction. Although numerous studies have assessed clinical results, there is little published literature investigating return to sporting activities after reconstruction of the MPFL. PURPOSE: To demonstrate postoperative outcomes and the return-to-sports rate a minimum of 2 years after isolated MPFL reconstruction in a young patient cohort. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Between 2007 and 2010, a total of 72 isolated MPFL reconstructions (in 68 patients) were performed for recurrent patellar dislocation. Pre- and postoperative knee assessment included a thorough history of symptoms and a clinical examination consisting of crepitus, range of motion, patellofemoral pain, and patellar apprehension. Knee function was assessed using the Kujala score, International Knee Documentation Committee score, Tegner activity score, visual analog scale (VAS), and Activity Rating Scale (ARS). RESULTS: Of patients who participated in sports preoperatively (62/68 patients), 100% returned to sports after MPFL reconstruction; 53% returned at equal or higher levels, whereas 47% returned at lower levels. Fifty-four of 68 patients (79.4%) rated themselves as very satisfied or satisfied with the results. The median Kujala score improved significantly from 66 to 87.5 and the median International Knee Documentation Committee score from 60 to 79.8. The median VAS for pain score illustrated significant preoperative to postoperative improvement, from 4 to 2. Conversely, patients' activity levels according to the Tegner activity score dropped from 4.5 to 4, and the median Activity Rating Scale score dropped from 6 to 3. There was also a persistent instability rate of 10% as well as a slight loss of knee flexion in 24 of 72 knees. CONCLUSION: Reconstruction of the MPFL is a safe and effective treatment for patellofemoral instability without severe trochlear dysplasia and allows most patients to engage in regular sports activities 2 years postoperatively, at least at a recreational level. However, potential complications, such as persistent instability, pain, and loss of flexion, must be considered.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1508
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1177/0363546514529640


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