Database : MEDLINE
Search on : Patellar and Dislocation [Words]
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[PMID]: 27163103
[Au] Autor:Kulkarni S; Shetty AP; Alva KK; Talekar S; Shetty VD
[Ad] Address:Hiranandani Orthopaedic Medical Education (HOME), Dr L. H. Hiranandani Hospital Hillside Avenue Hiranandani Gardens, Powai, Mumbai 400076 India....
[Ti] Title:Patellar instability in Indian population: relevance of tibial tuberosity and trochlear groove distance.
[So] Source:SICOT J;2:14, 2016.
[Is] ISSN:2426-8887
[Cp] Country of publication:France
[La] Language:eng
[Ab] Abstract:INTRODUCTION: The tibial tuberosity to trochlear groove (TTTG) distance in the western population is extensively studied through various modalities such as X-rays, computerised tomography and magnetic resonance imaging. However, to our knowledge there is very little or no literature support to indicate that TTTG distance has been studied in the Indian population. METHODS: We therefore undertook a study to measure the TTTG distance in 100 MRI scans of normal Indian knees. Patients with the following co-morbidities were excluded from the study; ligamentous laxity, patellofemoral instability, mal-alignment and osteoarthritis. We measured TTTG distance on the axial MRI slices using OsiriX software. RESULTS: The mean value for females was found to be 14.07 mm and that for male was found to be 13.34 mm. Our study indicates that the TTTG distance, using MRI scans as measurement modality, in the Indian population is significantly different when compared to the published western data. DISCUSSION: We believe that this study can form the basis for future studies on the relationship between TTTG distance and patellar instability in Indian population.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1605
[Cu] Class update date: 160512
[Lr] Last revision date:160512
[Da] Date of entry for processing:160510
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.1051/sicotj/2016008

  2 / 1524 MEDLINE  
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[PMID]: 26764549
[Au] Autor:Vaishya R; Vijay V; Vaish A
[Ad] Address:Orthopedics and Joint Replacement Surgery, Indraprastha Apollo Hospitals, Sarita Vihar Mathura Road, New Delhi 110076, India.
[Ti] Title:Dislocation of a constrained total knee arthroplasty with patellar tendon rupture after trivial trauma.
[So] Source:Chin J Traumatol;18(4):241-4, 2015.
[Is] ISSN:1008-1275
[Cp] Country of publication:China
[La] Language:eng
[Ab] Abstract:Constrained total knee prostheses are used in knees with severe deformities and insufficiency of collaterals to provide stable and mobile knees. Dislocation after constrained knee prosthesis is an extremely rare and dreaded complication. When dislocation is associated with patellar tendon rupture, the management includes restoration of the extensor apparatus along with a stable knee. Repair of the patellar tendon is challenging due to poor soft tissue coverage in the area and a bulky repair can put tension on the wound closure. Ideal method of restoration of the extensor apparatus is a matter of debate. There are various modalities used ranging from primary end-to-end repair, augmentation by medial gastrocnemius flap, semitendinosus and synthetic implants and allograft tendoachilles. We report a rare case of a posterior dislocation of a constrained total knee arthroplasty in association with patellar tendon rupture due to a minor fall after a few weeks of surgery. The first episode was managed by reposition of the dislocation and V-Y plasty of the quadriceps and primary repair. The second episode of dislocation with re-rupture needed augmentation by semitendinosus along with the insertion of the thicker insert. The management of this complex problem along with the review of literature is discussed in this case report.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1601
[Js] Journal subset:IM
[St] Status:In-Process

  3 / 1524 MEDLINE  
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[PMID]: 27053586
[Au] Autor:Kumahashi N; Kuwata S; Takuwa H; Egusa N; Uchio Y
[Ad] Address:Departments of Orthopaedic Surgery (N.K., S.K., H.T., and Y.U.) and Rehabilitation (N.E.), School of Medicine, Shimane University, Shimane, Japan n-kuma@med.shimane-u.ac.jp....
[Ti] Title:Longitudinal Change of Medial and Lateral Patellar Stiffness After Reconstruction of the Medial Patellofemoral Ligament for Patients with Recurrent Patellar Dislocation.
[So] Source:J Bone Joint Surg Am;98(7):576-83, 2016 Apr 6.
[Is] ISSN:1535-1386
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Longitudinal changes in patellar stiffness following reconstruction of the medial patellofemoral ligament for recurrent patellar dislocation at full extension are unknown. METHODS: Fifteen consecutive patients (three men and twelve women, with a mean age of twenty-two years) with seventeen knees were matched by sex and age to thirty-two reference subjects in this prospective study. The follow-up period was a minimum of twenty-four months. The medial patellofemoral ligament reconstruction used an autograft semitendinosus tendon and an interference screw system with or without lateral release under 10 N of laterally directed force. The medial patellar stiffness and lateral patellar stiffness were measured in 0° of knee extension using the Patella Stability Tester preoperatively; postoperatively at three, six, twelve, and eighteen months; and at the time of the latest follow-up. Before and after the surgical procedure, patients were evaluated for apprehension and Kujala and Lysholm scores; radiographic examinations were performed to evaluate changes, including osteoarthritic changes. RESULTS: The medial stiffness of the affected side before the surgical procedure was significantly lower than the lateral stiffness (p = 0.004) and the stiffness for healthy reference knees (p = 0.004). Medial stiffness three months after the surgical procedure was significantly elevated compared with lateral values (p = 0.027), preoperative values (p < 0.001), and reference group values (p = 0.002); reached the reference level by six months; and was maintained for up to two years. Furthermore, medial stiffness and lateral stiffness were well balanced after six months and this balance was sustained for up to two years postoperatively. No recurrent dislocation occurred during the follow-up period; one patient experienced apprehension. Postoperative radiographic findings and clinical scores were significantly improved at the time of the latest follow-up (p < 0.05). One knee progressed to patellofemoral osteoarthritis. CONCLUSIONS: The value for medial stiffness was significantly improved three months after medial patellofemoral ligament reconstruction compared with the preoperative and lateral values and returned to the reference level by six months. Medial stiffness and lateral stiffness of the patella were well balanced by six months and retained that balance for up to two years, with good clinical results. LEVEL OF EVIDENCE: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1604
[Js] Journal subset:AIM; IM
[St] Status:In-Data-Review
[do] DOI:10.2106/JBJS.15.00605

  4 / 1524 MEDLINE  
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[PMID]: 26935465
[Au] Autor:Weber AE; Nathani A; Dines JS; Allen AA; Shubin-Stein BE; Arendt EA; Bedi A
[Ad] Address:Sports Medicine and Shoulder Service, MedSport, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan....
[Ti] Title:An Algorithmic Approach to the Management of Recurrent Lateral Patellar Dislocation.
[So] Source:J Bone Joint Surg Am;98(5):417-27, 2016 Mar 2.
[Is] ISSN:1535-1386
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:High-level evidence supports nonoperative treatment for first-time lateral acute patellar dislocations. Surgical intervention is often indicated for recurrent dislocations. Recurrent instability is often multifactorial and can be the result of a combination of coronal limb malalignment, patella alta, malrotation secondary to internal femoral or external tibial torsion, a dysplastic trochlea, or disrupted and weakened medial soft tissue, including the medial patellofemoral ligament (MPFL) and the vastus medialis obliquus. MPFL reconstruction requires precise graft placement for restoration of anatomy and minimal graft tension. MPFL reconstruction is safe to perform in skeletally immature patients and in revision surgical settings. Distal realignment procedures should be implemented in recurrent instability associated with patella alta, increased tibial tubercle-trochlear groove distances, and lateral and distal patellar chondrosis. Groove-deepening trochleoplasty for Dejour type-B and type-D dysplasia or a lateral elevation or proximal recession trochleoplasty for Dejour type-C dysplasia may be a component of the treatment algorithm; however, clinical outcome data are lacking. In addition, trochleoplasty is technically challenging and has a risk of substantial complications.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1603
[Js] Journal subset:AIM; IM
[St] Status:In-Data-Review
[do] DOI:10.2106/JBJS.O.00354

  5 / 1524 MEDLINE  
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[PMID]: 26333740
[Au] Autor:Tensho K; Akaoka Y; Shimodaira H; Takanashi S; Ikegami S; Kato H; Saito N
[Ad] Address:Department of Orthopedic Surgery (K.T., Y.A., H.S., S.T., S.I., and H.K.) and Institute for Biomedical Sciences, Interdisciplinary Cluster for Cutting Edge Research (N.S.), Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan. E-mail address for K. Tensho: kten@shins...
[Ti] Title:What Components Comprise the Measurement of the Tibial Tuberosity-Trochlear Groove Distance in a Patellar Dislocation Population?
[So] Source:J Bone Joint Surg Am;97(17):1441-8, 2015 Sep 2.
[Is] ISSN:1535-1386
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: The tibial tuberosity-trochlear groove distance is used as an indicator for medial tibial tubercle transfer; however, to our knowledge, no studies have verified whether this distance is strongly affected by tubercle lateralization at the proximal part of the tibia. We hypothesized that the tibial tuberosity-trochlear groove distance is mainly affected by tibial tubercle lateralization at the proximal part of the tibia. METHODS: Forty-four patients with a history of patellar dislocation and forty-four age and sex-matched controls were analyzed with use of computed tomography. The tibial tuberosity-trochlear groove distance, tibial tubercle lateralization, trochlear groove medialization, and knee rotation were measured and were compared between the patellar dislocation group and the control group. The association between the tibial tuberosity-trochlear groove distance and three other parameters was calculated with use of the Pearson correlation coefficient and partial correlation analysis. RESULTS: There were significant differences in the tibial tuberosity-trochlear groove distance (p < 0.001) and knee rotation (p < 0.001), but there was no difference in the tibial tubercle lateralization (p = 0.13) and trochlear groove medialization (p = 0.08) between the patellar dislocation group and the control group. The tibial tuberosity-trochlear groove distance had no linear correlation with tubercle lateralization (r = 0.21) or groove medialization (r = -0.15); however, knee rotation had a good positive correlation in the patellar dislocation group (r = 0.62). After adjusting for the remaining parameters, knee rotation strongly correlated with the tibial tuberosity-trochlear groove distance (r = 0.69, p < 0.001), whereas tubercle lateralization showed moderate significant correlations in the patellar dislocation group (r = 0.42; p = 0.005). CONCLUSIONS: Because the tibial tuberosity-trochlear groove distance is affected more by knee rotation than by tubercle malposition, its use as an indicator for tibial tubercle transfer may not be appropriate. CLINICAL RELEVANCE: Surgical decisions of tibial tubercle transfer should be made after the careful analysis of several underlying factors of patellar dislocation.
[Mh] MeSH terms primary: Patellar Dislocation/pathology
Tibia/pathology
[Mh] MeSH terms secundary: Adolescent
Adult
Case-Control Studies
Female
Humans
Male
Middle Aged
Patellar Dislocation/radiography
Retrospective Studies
Tibia/radiography
Tomography, X-Ray Computed
Torsion Abnormality/pathology
Torsion Abnormality/radiography
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1511
[Cu] Class update date: 160512
[Lr] Last revision date:160512
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:150903
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.N.01313

  6 / 1524 MEDLINE  
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[PMID]: 25724397
[Au] Autor:Zheng L; Shi H; Feng Y; Sun BS; Ding HY; Zhang GY
[Ad] Address:Department of Radiology, Shandong Provincial Corps Hospital of Chinese People's Armed Police Force, Jinan 250014, Shandong, China....
[Ti] Title:Injury patterns of medial patellofemoral ligament and correlation analysis with articular cartilage lesions of the lateral femoral condyle after acute lateral patellar dislocation in children and adolescents: An MRI evaluation.
[So] Source:Injury;46(6):1137-44, 2015.
[Is] ISSN:1879-0267
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:OBJECTIVES: The purpose of this study was to investigate the injury characteristics of medial patellofemoral ligament (MPFL), and to analyse the correlations between the injury patterns of MPFL and articular cartilage lesions of the lateral femoral condyle in children and adolescents with acute lateral patellar dislocation (LPD). METHODS: Magnetic resonance (MR) images were prospectively obtained in 127 consecutive children and adolescents with acute LPD. Images were acquired using standardised protocols and these were independently evaluated by two radiologists. RESULTS: Fifty-four cases of partial MPFL tear and 69 cases of complete MPFL tear were identified. Injuries occurred at an isolated patellar insertion (PAT) in 47 cases, an isolated femoral attachment (FEM) in 41 cases and an isolated mid-substance (MID) in four cases. More than one site of injury to the MPFL (COM) was identified in 31 cases. The prevalence rate of chondral and osteochondral lesions of the lateral femoral condyle were 23.4% (11/47) and 29.8% (14/47) in the PAT subgroup, 7.3% (3/41) and 9.8% (4/41) in the FEM subgroup and 25.8% (8/31) and 32.3% (10/31) in the COM subgroup, respectively. The PAT and COM subgroups showed significantly higher prevalence rate of chondral and osteochondral lesions in the lateral femoral condyle when compared with the FEM subgroup. The prevalence rate of chondral and osteochondral lesions of the lateral femoral condyle were 17.4% (12/69) and 30.4% (21/69) in the complete MPFL tear subgroup and 20.4% (11/54) and 13% (7/54) in the partial MPFL tear subgroup, respectively. The subgroup of the complete MPFL tear showed significantly higher prevalence rate of osteochondral lesions in the lateral femoral condyle when compared with the subgroup of the partial MPFL tear. CONCLUSIONS: Firstly, the MPFL is most easily injured at the PAT, and secondly at the FEM in children and adolescents after acute LPD. The complete MPFL tear is more often concomitant with osteochondral lesions of the lateral femoral condyle than the partial MPFL tear. The isolated patellar-sided MPFL tear and the combined MPFL tear are more easily concomitant with chondral lesions and osteochondral lesions of the lateral femoral condyle than the isolated femoral-sided MPFL tear.
[Mh] MeSH terms primary: Cartilage, Articular/injuries
Knee Injuries/diagnosis
Ligaments, Articular/injuries
Magnetic Resonance Imaging
Patella/injuries
Patellar Dislocation/diagnosis
[Mh] MeSH terms secundary: Acute Disease
Adolescent
Cartilage, Articular/pathology
Child
China/epidemiology
Female
Humans
Knee Injuries/complications
Knee Injuries/pathology
Ligaments, Articular/pathology
Magnetic Resonance Imaging/methods
Male
Patella/pathology
Patellar Dislocation/etiology
Prevalence
Prospective Studies
Reproducibility of Results
Rupture
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1605
[Js] Journal subset:IM
[Da] Date of entry for processing:150525
[St] Status:MEDLINE

  7 / 1524 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.
[Mh] MeSH terms primary: Arthroplasty, Replacement, Knee/adverse effects
Ligaments, Articular/surgery
Patellar Dislocation/surgery
Patellar Ligament/surgery
Patellofemoral Joint/surgery
[Mh] MeSH terms secundary: Aged
Female
Humans
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Entry month:1605
[Js] Journal subset:IM
[Da] Date of entry for processing:140929
[St] Status:MEDLINE

  8 / 1524 MEDLINE  
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[PMID]: 25892009
[Au] Autor:Ries Z; Bollier M
[Ad] Address:Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
[Ti] Title:Patellofemoral Instability in Active Adolescents.
[So] Source:J Knee Surg;28(4):265-77, 2015 Aug.
[Is] ISSN:1938-2480
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:Patellofemoral instability is a common problem in the adolescent population. Patellar stability depends on a dynamic interplay between bony and soft tissue restraints. Several pathoanatomical factors increase the likelihood of patellar instability: patella alta, trochlear dysplasia, malalignment, and deficient proximal medial restraints. Treatment for first-time patella dislocations is typically nonoperative and includes bracing, early range of motion, and physical therapy. The only absolute indication for early surgery is a large osteochondral fragment that can be fixed. Surgical stabilization is indicated for chronic patellar instability and includes both proximal and distal realignment options. Medial patellofemoral ligament reconstruction is the treatment of choice in most adolescent patients with patella instability. Distal bony realignment procedures are reserved for skeletally mature adolescents.
[Mh] MeSH terms primary: Joint Instability/physiopathology
Patellar Dislocation/therapy
Patellofemoral Joint/physiology
[Mh] MeSH terms secundary: Adolescent
Humans
Joint Instability/etiology
Joint Instability/surgery
Patellar Dislocation/complications
Patellofemoral Joint/surgery
Recurrence
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1605
[Js] Journal subset:IM
[Da] Date of entry for processing:150720
[St] Status:MEDLINE
[do] DOI:10.1055/s-0035-1549017

  9 / 1524 MEDLINE  
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[PMID]: 25633361
[Au] Autor:Lewallen L; McIntosh A; Dahm D
[Ad] Address:Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
[Ti] Title:First-Time Patellofemoral Dislocation: Risk Factors for Recurrent Instability.
[So] Source:J Knee Surg;28(4):303-9, 2015 Aug.
[Is] ISSN:1938-2480
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:Patellofemoral instability is a complex problem, which can be difficult to manage. The purpose of this study was to describe the demographics of patients with a first-time patellofemoral dislocation, and identify risk factors for recurrent instability. This was a single institution, institutional review board-approved, retrospective review of >2,000 patients with a patellar dislocation between 1998 and 2010. Inclusion criteria are as follows: (1) no prior history of patellofemoral subluxation or dislocation of the affected knee; (2) X-rays within 4 weeks of the initial instability episode; and (3) a dislocated patella requiring reduction, or history/findings suggestive of acute patellar dislocation (effusion/hemarthrosis, tenderness along the medial parapatellar structures, and apprehension with lateral patellar translation). Clinical records and radiographs were reviewed. The Caton-Deschamps and Insall-Salvati indices were used to evaluate patella alta. Trochlear dysplasia was assessed using the Dejour classification system. Skeletal maturity was graded based on the distal femoral and proximal tibial physes, using one of the following categories: open, closing, or closed. Three hundred twenty-six knees (312 patients) met the aforementioned criteria. There were 145 females (46.5%) and 167 males (53.5%), with an average age of 19.6 years (range, 9-62 years). Thirty-five patients (10.7%) were treated with surgery after the initial dislocation. All others were initially managed nonoperatively. Of the 291 patients managed nonoperatively, 89 (30.6%) had recurrent instability, 44 (49.4%) of which eventually required surgery. Several risk factors for recurrent instability were identified, including younger age (p < 0.01), immature physes (p < 0.01), sports-related injuries (p < 0.01), patella alta (p = 0.02), and trochlear dysplasia (p < 0.01). Sixty-nine percent of patients with a first-time patellofemoral dislocation will stabilize with conservative treatment. However, patients younger than 25 years with trochlear dysplasia have a 60 to 70% risk of recurrence by 5 years. This information is helpful when counseling patients on their risk for recurrent instability and determining the most appropriate treatment plan. The clinical tool shown in Fig. 4 may be especially useful.
[Mh] MeSH terms primary: Joint Instability/epidemiology
Patellar Dislocation/epidemiology
[Mh] MeSH terms secundary: Adolescent
Adult
Child
Female
Humans
Joint Instability/etiology
Male
Middle Aged
Minnesota/epidemiology
Patellar Dislocation/complications
Recurrence
Retrospective Studies
Risk Factors
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1605
[Js] Journal subset:IM
[Da] Date of entry for processing:150720
[St] Status:MEDLINE
[do] DOI:10.1055/s-0034-1398373

  10 / 1524 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.
[Mh] MeSH terms primary: Joint Instability/surgery
Patellar Ligament/transplantation
Patellofemoral Joint/surgery
Quadriceps Muscle/surgery
Range of Motion, Articular/physiology
Reconstructive Surgical Procedures/methods
[Mh] MeSH terms secundary: Adolescent
Adult
Autografts
Female
Humans
Joint Instability/diagnosis
Joint Instability/physiopathology
Male
Patellofemoral Joint/physiopathology
Prospective Studies
Tomography, X-Ray Computed
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1605
[Js] Journal subset:IM
[Da] Date of entry for processing:151228
[St] Status:MEDLINE


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