Database : MEDLINE
Search on : Patellar and Dislocation [Words]
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[PMID]: 26860094
[Au] Autor:Meyers AB; Laor T; Sharafinski M; Zbojniewicz AM
[Ad] Address:Department of Radiology, Children's Hospital of Wisconsin, Medical College of Wisconsin, P.O. Box 1997, MS 721, Milwaukee, WI, 53211-1997, USA. arthurbmeyers@yahoo.com....
[Ti] Title:Imaging assessment of patellar instability and its treatment in children and adolescents.
[So] Source:Pediatr Radiol;46(5):618-36, 2016 May.
[Is] ISSN:1432-1998
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:Transient patellar dislocation is a common entity in children and adolescents, characterized by lateral dislocation of the patella, usually with spontaneous reduction. Many predisposing conditions have been described, including trochlear dysplasia, excessive lateral patellar tilt, patella alta and lateralization of the tibial tuberosity. Associated injuries are bone bruises of the patella and lateral femoral condyle, tears of the medial retinaculum that include the medial patellofemoral ligament (MPFL), tears of the vastus medialis obliquus muscle, injuries of articular cartilage, and intra-articular bodies. Children who are refractory to conservative management, have a large cartilage defect, or are at substantial risk for recurrent dislocations are candidates for surgical procedures to prevent future dislocations. Procedures can include MPFL repair or reconstruction, tibial tubercle repositioning and lateral retinacular release. The purpose of this review is to illustrate the imaging findings of transient patellar dislocation in the acute setting, the normal imaging appearance after surgical intervention, and post-surgical complications.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1604
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1007/s00247-015-3520-8

  2 / 1519 MEDLINE  
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[PMID]: 22321841
[Au] Autor:Li G; Sun XB; Ni JT; Cao L; Zhang KY
[Ad] Address:Department of Orthopedics, First Affiliated Hospital, Xinjiang Medical University, Urumqi 830011, China.
[Ti] Title:[Treatment of instability of patellofemoral joint through athroscopic repair of medial patellofemoral ligament for adolescents with epiphyseal non-closure by allogenic tendon].
[So] Source:Zhonghua Yi Xue Za Zhi;91(35):2468-71, 2011 Sep 20.
[Is] ISSN:0376-2491
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:OBJECTIVE: To explore the efficacy of arthroscopic repair of medial patellofemoral ligament (MPFL) for adolescents with epiphyseal non-closure by allogenic tendon in the treatment of instable patellofemoral joint. METHODS: There were a total of 38 cases including 61 knees with patellofemoral instability from June 2008 to January 2010 at our department. They were diagnosed according to the history of illness, apprehension test and tangential position radiograph in patellofemoral joint. RESULTS: A total of 33 patients with 52 knees were followed up for an average of 12 months (range: 8 - 19). All apprehension tests were negative. No recurrent displacement was found. The pre-operative Lysholm score of 75.5 ± 4.7 increased to 91.1 ± 5.7. There was significant difference. CONCLUSION: Arthroscope-assisted allograft reconstruction of medial patellofemoral ligament tendon is both mini-invasive and reliable for the treatment of epiphyseal non-closure adolescents with traumatic patellofemoral instability.
[Mh] MeSH terms primary: Patellar Dislocation
Patellofemoral Joint
[Mh] MeSH terms secundary: Adolescent
Humans
Ligaments, Articular/surgery
Reconstructive Surgical Procedures
Tendons/transplantation
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1604
[Js] Journal subset:IM
[Da] Date of entry for processing:120210
[St] Status:MEDLINE

  3 / 1519 MEDLINE  
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[PMID]: 26037510
[Au] Autor:Wangdee C; Theyse LF; Hazewinkel HA
[Ad] Address:Chalika Wangdee, DVM, MSc., PhD, Department of Veterinary Surgery, Faculty of Veterinary Science, Chulalongkorn University, 39 Henri Dunant Road, Bangkok 10330, Thailand, Phone: +66 2218 9639, Fax: +66 2252 7007, E-mail: c.wangdee@hotmail.com; chalika.w@chula.ac.th.
[Ti] Title:Proximo-distal patellar position in three small dog breeds with medial patellar luxation.
[So] Source:Vet Comp Orthop Traumatol;28(4):270-3, 2015.
[Is] ISSN:0932-0814
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Medial patellar luxation is thought to be associated with a high proximal position of the patella in the trochlear groove. OBJECTIVE: To determine whether the ratio of patellar ligament length and patellar length (L:P) is influenced by the stifle angle (75°, 96°, 113°, 130°, and 148°) in small dog breeds and to compare the L:P ratio in dogs of three small dog breeds with and without medial patellar luxation. METHODS: A mediolateral radiograph of the stifle joint was used to measure the L:P ratio in the stifle joints of dogs of three small breeds with and without medial patellar luxation. The L:P ratio was evaluated at five stifle angles (75°, 96°, 113°, 130°, and 148°) in 14 cadavers (26 stifle joints) of small dog breeds in order to identify the best stifle angle to measure the L:P ratio. Then the mean ± SD L:P ratio was calculated for normal stifles and stifles with medial patellar luxation grades 1, 2, and 3 in 194 Pomeranians, 74 Chihuahuas, and 41 Toy or Standard Poodles. RESULTS: The L:P ratio was the same for all five stifle angles in the cadavers (p = 0.195). It was also not significantly different in the three breeds (p = 0.135), in normal and medial patellar luxation-affected stifles overall (p = 0.354), and in normal and medial patellar luxation-affected joints within each breed (p = 0.19). CLINICAL SIGNIFICANCE: We conclude that a proximo-distal patellar position is not associated with medial patellar luxation in Pomeranians, Chihuahuas, and Toy or Standard Poodles. Thus a longer patellar ligament length does not play a role in the pathophysiology of medial patellar luxation in these small dog breeds.
[Mh] MeSH terms primary: Dogs/injuries
Patellar Dislocation/veterinary
Stifle/injuries
[Mh] MeSH terms secundary: Animals
Dogs/anatomy & histology
Female
Male
Patella/pathology
Patella/radiography
Patellar Dislocation/etiology
Patellar Dislocation/pathology
Patellar Dislocation/radiography
Species Specificity
Stifle/pathology
Stifle/radiography
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1604
[Js] Journal subset:IM
[Da] Date of entry for processing:150714
[St] Status:MEDLINE
[do] DOI:10.3415/VCOT-15-02-0028

  4 / 1519 MEDLINE  
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[PMID]: 25899793
[Au] Autor:Pugliese LC; Pike FS; Aiken SW
[Ad] Address:Lauren C. Pugliese, DVM, The Ohio State University, College of Veterinary Medicine, 601 Vernon L Tharp Street, Columbus, OH 43210, United States, Phone: +1 614 292 3551, Fax: +1 614 292 1454, E-mail: lpugliesedvm@gmail.com.
[Ti] Title:Distal tibial tuberosity translation using TTA implants for the treatment of patella alta in large breed dogs. Surgical technique and clinical outcome.
[So] Source:Vet Comp Orthop Traumatol;28(4):274-81, 2015.
[Is] ISSN:0932-0814
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Medial patellar luxation frequently occurs in dogs resulting in lameness with increasing incidence in large breed dogs. Patella alta has been defined as a patellar ligament length to patellar length ratio that is greater than two and may predispose to patellar luxation. OBJECTIVE: To describe the surgical technique for stabilization of the distal translation of the tibial tuberosity using tibial tuberosity advancement plates and the clinical outcomes with follow-up for clinical cases of dogs. METHODS: Dogs that were presented with the complaint of patellar luxation and that were concurrently diagnosed with patella alta and were greater than 20 kg in body weight underwent surgery using a tibial tuberosity advancement plate to stabilize the osteotomy. Radiographic assessment of A:PL distance (the ratio of the proximal aspect of the patella to the femoral condyle [A] to the patellar length [PL]), L:P ratio (ratio of the length of the patellar ligament to the diagonal length of the patella), and owner assessment were obtained. RESULTS: Eleven stifles in nine dogs underwent surgical correction with a mean preoperative L:P ratio of 2.47. There were no complications and the lameness resolved clinically. The mean A:PL ratios preoperatively (2.6 ± 0.22) and postoperatively (2.1 ± 0.25) were significantly different (p = 0.0003). All owners were satisfied with the outcome and all dogs had a resolution of lameness with no recurrence of patellar luxation. CLINICAL SIGNIFICANCE: Stabilization of distal translation of the tibial tuberosity using tibial tuberosity advancement implants to correct patella alta in large breed dogs was feasible and resulted in good clinical outcome.
[Mh] MeSH terms primary: Dogs/surgery
Patellar Dislocation/veterinary
Tibia/surgery
[Mh] MeSH terms secundary: Animals
Bone Plates/veterinary
Dogs/injuries
Female
Male
Osteotomy/methods
Osteotomy/veterinary
Patella/radiography
Patella/surgery
Patellar Dislocation/radiography
Patellar Dislocation/surgery
Stifle/radiography
Stifle/surgery
Tibia/radiography
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1604
[Js] Journal subset:IM
[Da] Date of entry for processing:150714
[St] Status:MEDLINE
[do] DOI:10.3415/VCOT-14-05-0075

  5 / 1519 MEDLINE  
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[PMID]: 26837237
[Au] Autor:Ambrozic B; Novak S
[Ad] Address:a Department for Arthroscopy and Sports Medicine , Valdoltra Orthopaedic Hospital , Jadranska cesta 31, SI-6280 Ankaran , Slovenia.
[Ti] Title:The influence of medial patellofemoral ligament reconstruction on clinical results and sports activity level.
[So] Source:Phys Sportsmed;44(2):133-40, 2016 May.
[Is] ISSN:2326-3660
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVES: The aim of this study was to demonstrate postoperative outcomes and return to regular physical and sports activities at average of 6 years after patellar stabilization with medial patellofemoral ligament (MPFL) reconstruction. METHODS: Between November 2006 and January 2010, 31 isolated MPFL reconstructions in 29 patients with recurrent patellar dislocation were performed. Radiographs and magnetic resonance imaging were evaluated preoperatively. Knee function was assessed pre- and postoperative using Kujala score and the patient satisfaction, according to the International Knee Documentation Committee (IKDC) score. Tegner activity score was used for the evaluation of sports activity level. RESULTS: The average follow-up was 6.4±1.2 years. All measured scores increased significantly at follow-up. The average Kujala score increased from 75±10 to 95±10, patient satisfaction according to IKDC score from 6.1±1.4 to 8.7±1.4 and Tegner activity score from 4.4±1.6 to 5.7±1.3. The Tegner activity score after surgery was significantly lower than the score before the patellar dislocation (6.7±1.3). There were no significant differences in Kujala postoperative score between women's and men's group (P=0.25). There was no significant correlation between body mass index and Kujala score postoperatively (P=0.11) and between age at surgery and Kujala scores postoperatively (P=0.56). Patients who were active in sports preoperatively had resumed sports activities in 88.5% after surgery, 69.6% of them returned to the same levels and 30.4% return to the lower levels. CONCLUSION: Patellar stabilization with MPFL reconstruction is a safe and effective treatment method for all patients with patellofemoral instability and allows most patients to return to regular physical and sports activities after surgical intervention. Although sports activity level increased significantly after surgery, the same level of sports activity before the patellar dislocation has not been achieved.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1604
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1080/00913847.2016.1148561

  6 / 1519 MEDLINE  
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[PMID]: 26021832
[Au] Autor:Carnesecchi O; Neri T; Di Iorio A; Farizon F; Philippot R
[Ad] Address:Laboratory of Exercise Physiology (LPE EA 4338), Lyon University, Saint-Etienne, France; Department of Orthopaedic Surgery, University Hospital Center of Saint-Etienne, France. Electronic address: olivier.carnesecchi@gmail.com....
[Ti] Title:Results of anatomic gracilis MPFL reconstruction with precise tensioning.
[So] Source:Knee;22(6):580-4, 2015 Dec.
[Is] ISSN:1873-5800
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:BACKGROUND: The medial patellofemoral ligament (MPFL) is the most commonly injured structure in patients with objective patellar instability. The objective of this study was to prospectively evaluate the clinical and radiographic results of MPFL reconstruction in 50 patients with chronic patellar instability. METHODS: Fifty patients with chronic patellar instability, aged 15-39 years, were included. The MPFL was reconstructed using a free gracilis autograft tendon. Two anchors were used for patellar fixation, and femoral fixation was achieved with an interference screw placed into a tunnel between the adductor tubercle and medial epicondyle. The graft was tensioned to 10 N with the knee in 30° flexion. IKDC and Kujala scores were assessed pre- and post-operatively. Patellar tilt was measured from CT scans with the quadriceps relaxed and contracted, both pre- and post-operatively. RESULTS: The follow-up period was 7 to 44 months (mean: 25 months, SD 10.3). The mean raw IKDC score increased from 51.5 preoperatively to 71.7 at last follow-up, the mean overall IKDC score increased from 38.5 to 61.7 and the Kujala score increased from 48.3 to 82.4. On CT scans, the mean patellar tilt went from 24° to 16.2° with the quadriceps relaxed and 27.7° to 18.1° in contraction. No recurrent dislocation was observed. CONCLUSION: This technique of MPFL reconstruction provided significant improvements in IKDC and Kujala scores and significant reduction in patellar tilt. No recurrent dislocations were observed during the study period.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1512
[Js] Journal subset:IM
[St] Status:In-Process

  7 / 1519 MEDLINE  
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[PMID]: 25764002
[Au] Autor:Yoshvin S; Southern EP; Wang Y
[Ad] Address:Department of Orthopedics, Building No.6, 8th floor, Shanghai Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai Institute of Orthopedics and Traumatology, 197, Ruijin Er Lu, Shanghai, People's Republic of China, Yoshvin@live.com.
[Ti] Title:Surgical treatment of congenital patellar dislocation in skeletally mature patients: surgical technique and case series.
[So] Source:Eur J Orthop Surg Traumatol;25(6):1081-6, 2015 Aug.
[Is] ISSN:1633-8065
[Cp] Country of publication:France
[La] Language:eng
[Ab] Abstract:BACKGROUND: Congenital patellar dislocation is a rarely encountered condition and is readily treated in childhood to prevent lasting disability, knee pain, decreased range of motion and ambulation problems. This condition is very rarely seen in skeletally mature patients, and the treatment of the condition represents a challenge to the orthopedic surgeon. SURGICAL TECHNIQUE AND METHODS: Patients were treated with soft tissue reconstruction and tibial tubercle transfer with or without a prior medial close-wedge distal femoral osteotomy, depending on the degree of valgus deformity. We, then, searched the database of our orthopedics center for cases of congenital patellar dislocation in skeletally mature patients who were surgically treated. We collected a total of five knees and analyzed the cases according to the type of surgery performed and difference between pre- and postoperative functions. RESULTS: Five knees with congenital patellar dislocation were treated. The mean age of the patients was 29.6 years, and mean follow-up time was 4.3 years. Mean preoperative range of motion was 65°, and it increased to a mean of 105.5° after surgical treatment. The mean preoperative Kujala score was 29.2 and increased to 67.2 after surgical treatment. DISCUSSION: Congenital patellar dislocations that are allowed to proceed to adulthood are difficult to treat, and surgical treatment depends on the degree of deformity of the patella and of the knee joint. This study shows that surgical treatment is able to correct the deformity and provide better knee function.
[Mh] MeSH terms primary: Patellar Dislocation/congenital
[Mh] MeSH terms secundary: Adult
Female
Femur/radiography
Femur/surgery
Humans
Knee Joint/physiology
Knee Joint/surgery
Male
Osteotomy/methods
Osteotomy/rehabilitation
Patella/radiography
Patella/surgery
Patellar Dislocation/radiography
Patellar Dislocation/rehabilitation
Patellar Dislocation/surgery
Postoperative Care
Preoperative Care
Range of Motion, Articular/physiology
Tibia/radiography
Tibia/surgery
Tomography, X-Ray Computed
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1604
[Js] Journal subset:IM
[Da] Date of entry for processing:150723
[St] Status:MEDLINE
[do] DOI:10.1007/s00590-015-1619-0

  8 / 1519 MEDLINE  
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[PMID]: 27069888
[Au] Autor:Calapodopulos CJ; Nogueira MC; Eustáquio JM; Calapodopulos Júnior CJ; Rodrigues OA
[Ad] Address:Department of Orthopedics and Traumatology, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, MG, Brazil; Department of Orthopedics and Traumatology, Universidade de Uberaba (UNIUBE), Uberaba, MG, Brazil....
[Ti] Title:Reconstruction of the medial patellofemoral ligament using autologous graft from quadriceps tendon to treat recurrent patellar dislocation.
[So] Source:Rev Bras Ortop;51(2):187-93, 2016 Mar-Apr.
[Is] ISSN:2255-4971
[Cp] Country of publication:Brazil
[La] Language:eng
[Ab] Abstract:OBJECTIVE: The objective of this study was to evaluate the efficacy of the surgical technique using the quadriceps tendon as a graft in static reconstruction of the medial patellofemoral ligament. METHODS: This was a prospective case series study in which the participants were 22 patients with a diagnosis of recurrent patellar dislocation without any other anatomical alterations that required surgical treatment. The functional results from the technique were evaluated using clinical data and the Lysholm questionnaire, one year after the operation. RESULTS: It was observed that the patients were predominantly female (86%) and under 21 years of age (73%), just like in the literature. At the first annual return after the surgery, there was no significant pain on medium efforts, no loss of range of motion and a positive apprehension test. According to the questionnaire used, the results were graded as good. The patients who reported having severe pain on greater effort were involved in employment-related legal disputes. CONCLUSION: This technique showed low morbidity and good functional results over the short term.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1604
[Cu] Class update date: 160415
[Lr] Last revision date:160415
[Da] Date of entry for processing:160412
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.1016/j.rboe.2016.01.012

  9 / 1519 MEDLINE  
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[PMID]: 27077588
[Au] Autor:Dietrich TJ; Fucentese SF; Pfirrmann CW
[Ad] Address:Department of Radiology, Orthopedic University Hospital Balgrist, Faculty of Medicine, University of Zurich, Zurich, Switzerland.
[Ti] Title:Imaging of Individual Anatomical Risk Factors for Patellar Instability.
[So] Source:Semin Musculoskelet Radiol;20(1):65-73, 2016 Feb.
[Is] ISSN:1098-898X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:This review article presents several pitfalls and limitations of image interpretation of anatomical risk factors for patellar instability. The most important imaging examinations for the work-up of patients with patellar instability are the true lateral radiograph and transverse computed tomography (CT) or MR images of the knee. Primary anatomical risk factors are an insufficient medial patellofemoral ligament (MPFL), patella alta, trochlear dysplasia, increased distance from the tibial tuberosity to the trochlear groove (TTTG), and torsional limb parameters.Limitations of the Caton-Deschamps index are related to the clear identification of the patellar and tibial articular margin. Classification of trochlear dysplasia according to the Dejour system on radiographs and MR images revealed a weak reliability. The comparability of TTTG values obtained on CT and MR images at various flexion angles and different varus alignments of the knee is limited. Thus MRI performed with a dedicated knee coil may underestimate the TTTG distance compared with CT images. Increased lateral patellar tilt is a consequence of primary anatomical risk factors rather than an independent anatomical risk factor for patellar instability. The pretest likelihood of a torn MPFL on MR images is very high after an acute episode of lateral patellar dislocation.Surgical restoration of the patellofemoral joint stability addresses the complex multifactorial biomechanics by a custom-made management such as MPFL reconstruction, sulcus-deepening trochleoplasty, as well as medialization and distalization of the tibial tubercle.Quantification of anatomical risk factors for patellar instability in each person is important for highly individual treatment.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1604
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1055/s-0036-1579675

  10 / 1519 MEDLINE  
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[PMID]: 27077065
[Au] Autor:de Andrade MA; de Abreu E Silva GM; Freire MM; Teixeira LE
[Ad] Address:Associate Professor, Department of Locomotor Apparatus, UFMG; Head of Medical Residency, Hospital das Clínicas, UFMG, Minas Gerais, Brazil....
[Ti] Title:SURGICAL TREATMENT OF PATELLOFEMORAL INSTABILITY.
[So] Source:Rev Bras Ortop;44(6):529-32, 2009 Jan.
[Is] ISSN:2255-4971
[Cp] Country of publication:Brazil
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To describe functional outcomes following surgical treatment of patients with patellofemoral instability submitted to patellar realignment. METHODS: This was a retrospective study evaluating 34 operated knees for patellofemoral instability between 1989 and 2004. The patients were evaluated in the late postoperative period when a functional questionnaire was applied. RESULTS: After a mean follow-up time of 6 years and 5 months, the mean score was 82.94 in the surgical group (p=0.00037). The results of this investigation showed pain relief in 97.05% and low rate of recurrent dislocation (5.88%), although lower scores were seen in intense articular activities (squatting, running and jumping). No patient developed osteoarthritis while being followed up. CONCLUSION: The procedure for joint described in this paper was shown to be effective for treating patients with recurrent patellofemoral instability.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1604
[Da] Date of entry for processing:160414
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.1016/S2255-4971(15)30153-1


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