Database : MEDLINE
Search on : Patellar and Dislocation [Words]
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[PMID]: 24755851
[Au] Autor:Saper MG; Shneider DA
[Ad] Address:aDepartment of Osteopathic Surgical Specialties, Michigan State University bMid-Michigan Orthopaedic Institute, East Lansing cDepartment of Orthopaedic Surgery, McLaren Greater Lansing, Lansing, Michigan, USA.
[Ti] Title:Medial patellar subluxation without previous lateral release: a case report.
[So] Source:J Pediatr Orthop B;23(4):350-3, 2014 Jul.
[Is] ISSN:1473-5865
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Medial patellar subluxation (MPS) is normally described following a lateral release. We report on a 14-year-old girl with MPS without previous lateral release. Arthroscopic examination demonstrated MPS at 0 and 30° of flexion, and the patella was tight in flexion on the lateral side. A low lateral release with a tibial tubercle transfer was performed, followed by repair of the lateral release with an iliotibial band flap, and lateral patellofemoral ligament reconstruction. Excellent functional outcome was achieved. This type of patellar instability is often overlooked and a high index of suspicion is needed for appropriate diagnosis and treatment.
[Mh] MeSH terms primary: Patellar Dislocation
[Mh] MeSH terms secundary: Adolescent
Arthroscopy
Female
Humans
Patellar Dislocation/diagnosis
Patellar Dislocation/etiology
Patellar Dislocation/surgery
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1501
[Js] Journal subset:IM
[Da] Date of entry for processing:140526
[St] Status:MEDLINE
[do] DOI:10.1097/BPB.0000000000000054

  2 / 1355 MEDLINE  
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[PMID]: 24473994
[Au] Autor:Samim M; Smitaman E; Lawrence D; Moukaddam H
[Ad] Address:Department of Radiology, Yale University School of Medicine, 333 Cedar Street, PO Box 208042, New Haven, CT, 06520, USA.
[Ti] Title:MRI of anterior knee pain.
[So] Source:Skeletal Radiol;43(7):875-93, 2014 Jul.
[Is] ISSN:1432-2161
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:Anterior knee pain is the most common knee complaint. It may be due to a variety of soft tissue or osseous abnormalities. Knowledge of the radiologic appearance of the abnormalities allows more accurate diagnosis of the cause of the pain including chondral abnormalities, patellar instability and dislocation, femoral trochlear dysplasia, abnormal patellar location, bipartite patella, various tendinopathies, bursal inflammation, traction apophysitis in pediatric and adolescent patients, and miscellaneous diseases including mediopatellar plica syndrome and Hoffa's disease. Radiographs are often obtained to exclude acute osseous abnormalities, such as fractures. Magnetic resonance (MR) imaging offers superior soft tissue contrast resolution and allows for more accurate evaluation of the underlying etiology and therefore may improve treatment and possible surgical planning.
[Mh] MeSH terms primary: Arthralgia/diagnosis
Knee Injuries/pathology
Knee Joint/pathology
Magnetic Resonance Imaging/methods
Osteoarthritis, Knee/pathology
Pain Measurement/methods
Soft Tissue Injuries/pathology
[Mh] MeSH terms secundary: Adolescent
Adult
Arthralgia/etiology
Diagnosis, Differential
Female
Humans
Knee Injuries/complications
Male
Middle Aged
Osteoarthritis, Knee/complications
Soft Tissue Injuries/complications
Young Adult
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1501
[Js] Journal subset:IM
[Da] Date of entry for processing:140521
[St] Status:MEDLINE
[do] DOI:10.1007/s00256-014-1816-7

  3 / 1355 MEDLINE  
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[PMID]: 24359641
[Au] Autor:Van Haver A; Mahieu P; Claessens T; Li H; Pattyn C; Verdonk P; Audenaert EA
[Ad] Address:Department of Mechanics, BioMech, University College Ghent, Valentin Vaerwijckweg 1, 9000 Ghent, Belgium; Department of Production and Construction, Ghent University, 9052 Zwijnaarde, Belgium; Monica Orthopaedic Research Institute (MORE Institute), 2100 Antwerp, Belgium. Electronic address: mvhaver@...
[Ti] Title:A statistical shape model of trochlear dysplasia of the knee.
[So] Source:Knee;21(2):518-23, 2014 Mar.
[Is] ISSN:1873-5800
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:BACKGROUND: Trochlear dysplasia is known as the primary predisposing factor for patellar dislocation. Current methods to describe trochlear dysplasia are mainly qualitative or based on a limited number of discrete measurements. The purpose of this study is to apply statistical shape analysis to take the full geometrical complexity of trochlear dysplasia into account. METHODS: Statistical shape analysis was applied to 20 normal and 20 trochlear dysplastic distal femur models, including the cartilage. RESULTS: This study showed that the trochlea was anteriorized, proximalized and lateralized and that the mediolateral width and the notch width were decreased in the trochlear dysplastic femur compared to the normal femur. The first three principal components of the trochlear dysplastic femurs, accounting for 79.7% of the total variation, were size, sulcus angle and notch width. Automated classification of the trochlear dysplastic and normal femora achieved a sensitivity of 85% and a specificity of 95%. CONCLUSIONS: This study shows that shape analysis is an outstanding method to visualise the location and magnitude of shape abnormalities. Improvement of automated classification and subtyping within the trochlear dysplastic group are expected when larger training sets are used. CLINICAL RELEVANCE: Classification of trochlear dysplasia, especially borderline cases may be facilitated by automated classification. Furthermore, the identification of a decreased notch width in association with an increased sulcus angle can also contribute to the diagnosis of trochlear dysplasia.
[Mh] MeSH terms primary: Femur/abnormalities
Femur/radiography
Imaging, Three-Dimensional
Models, Statistical
[Mh] MeSH terms secundary: Adolescent
Adult
Cartilage, Articular/radiography
Case-Control Studies
Discriminant Analysis
Female
Humans
Image Processing, Computer-Assisted
Male
Middle Aged
Multidetector Computed Tomography
Patellofemoral Joint/abnormalities
Patellofemoral Joint/radiography
Principal Component Analysis
Young Adult
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Entry month:1501
[Js] Journal subset:IM
[Da] Date of entry for processing:140407
[St] Status:MEDLINE

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[PMID]: 23306029
[Au] Autor:Kitta Y; Niki Y; Udagawa K; Enomoto H; Toyama Y; Suda Y
[Ad] Address:Department of Orthopaedic Surgery, Keio University, School of Medicine, Japan....
[Ti] Title:Severe valgus deformity of the knee with permanent patellar dislocation associated with melorheostosis: a case report and review of the literature.
[So] Source:Knee;21(2):589-93, 2014 Mar.
[Is] ISSN:1873-5800
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:We present a case of an 8-year-old boy diagnosed with melorheostosis who was suffering from severe genu valgum, permanent dislocation of the patella, knee flexion contracture and leg length shortening. Soft tissue contracture of the limb and subsequent joint deformities were reported to represent clinical manifestations of pediatric melorheostosis. As the epiphyseal plate had not closed, patellar reduction was achieved by soft tissue surgical stabilization, including lateral retinacular release, medial retinaculum plication, and transfer of the lateral half of the patellar tendon. At 4 years postoperatively, as a result of improved limb alignment and knee flexion contracture, the leg length shortening has improved, and the patient does not limp and participates in sports activities. Surgical intervention should be performed as early as possible, because genu valgum and external rotation of the tibia may deteriorate with age, rendering the patellar dislocation irreversible in patients with melorheostosis before epiphyseal closure.
[Mh] MeSH terms primary: Genu Valgum/etiology
Genu Valgum/surgery
Melorheostosis/complications
Patellar Dislocation/etiology
Patellar Dislocation/surgery
[Mh] MeSH terms secundary: Child
Contracture/etiology
Contracture/surgery
Genu Valgum/pathology
Genu Valgum/radiography
Humans
Magnetic Resonance Imaging
Male
Muscle, Skeletal/surgery
Patellar Dislocation/pathology
Patellar Dislocation/radiography
Patellar Ligament/surgery
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Entry month:1501
[Js] Journal subset:IM
[Da] Date of entry for processing:140407
[St] Status:MEDLINE

  5 / 1355 MEDLINE  
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[PMID]: 23159148
[Au] Autor:Jang KM; Lee HS; Wang JH
[Ad] Address:Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
[Ti] Title:Open reduction of irreducible posterolateral rotary knee dislocation without sectioning of incarcerated vastus medialis: a case report with video illustration.
[So] Source:Knee;21(2):582-5, 2014 Mar.
[Is] ISSN:1873-5800
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:Traumatic knee joint dislocations are relatively rare. Most of knee dislocations are reduced by closed manipulation. However occasionally, especially in the case of soft tissue incarceration, closed reduction may not be possible and open reduction is mandatory. This report introduces a case of irreducible posterolateral rotary knee dislocation with interposition of vastus medialis treated through two-staged operations. In this report, we included preoperative magnetic resonance images (MRI), detailed intraoperative descriptions with photographs and video illustration that show the status of an injured knee joint and the effectiveness of the treatment.
[Mh] MeSH terms primary: Muscle, Skeletal/injuries
Patellar Dislocation/surgery
[Mh] MeSH terms secundary: Anterior Cruciate Ligament/injuries
Anterior Cruciate Ligament/surgery
Humans
Lysholm Knee Score
Magnetic Resonance Imaging
Male
Manipulation, Orthopedic/adverse effects
Medial Collateral Ligament, Knee/injuries
Medial Collateral Ligament, Knee/surgery
Middle Aged
Posterior Cruciate Ligament/injuries
Posterior Cruciate Ligament/surgery
Rupture/surgery
Skiing/injuries
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Em] Entry month:1501
[Js] Journal subset:IM
[Da] Date of entry for processing:140407
[St] Status:MEDLINE

  6 / 1355 MEDLINE  
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[PMID]: 24578116
[Au] Autor:Ateschrang A; Freude T; Grünwald L; Schäffler A; Stöckle U; Schröter S
[Ad] Address:Klinik für Unfall- und Wiederherstellungschirurgie der Eberhard Karls Universität Tübingen, BG Unfallklinik Tübingen....
[Ti] Title:Patellaluxation: Diagnostik- und Behandlungsalgorithmus unter Berücksichtigung der Torsion. [Patella dislocation: an algorithm for diagnostic and treatment considering the rotation].
[So] Source:Z Orthop Unfall;152(1):59-67, 2014 Feb.
[Is] ISSN:1864-6743
[Cp] Country of publication:Germany
[La] Language:ger
[Ab] Abstract:BACKGROUND: Patella dislocation and re-dislocation are common diseases. Although patella dislocation is frequent, it always poses a challenge concerning diagnostics and therapy. Mixed forms of pathological disorder in the patellofemoral joint make the analysis of the malalignment and the choice of the correct treatment more difficult. MATERIAL AND METHODS: By reviewing the available literature of the last few years and taking into account considerations concerning the malalignment, an overview of the necessary diagnostics can be given. Radiographs and MRI are essential parts of the diagnostics after a traumatic patella dislocation. After re-dislocation, more extensive diagnostics are required to determine all pathological aspects of the malalignment. In this situation, a CT scan for measuring the torsion of the femur and the tibia as well as the TT-TG distance (tibial tubercle - trochlea groove), and the full weight-bearing long leg standing radiograph are part of the fundamental diagnostics. RESULTS: The results that are presented in the literature provide some indications for a successful treatment. In consideration of the thorough analysis of the malalignment, the torsional correction of the femur and/or the tibia gains a new importance in the patellofemoral joint. The presented algorithm for diagnostics and treatment should make the decision for the best treatment easier. CONCLUSION: The proposed algorithm for diagnostics and treatment is only partially founded on evidence-based results. Moreover, it takes into consideration reflections concerning the biomechanics of the patellofemoral joint and the realignment of this joint.
[Mh] MeSH terms primary: Algorithms
Patellar Dislocation/diagnosis
Patellar Dislocation/therapy
Patient-Centered Care/methods
Physical Examination/methods
Range of Motion, Articular
Tomography, X-Ray Computed/methods
[Mh] MeSH terms secundary: Evidence-Based Medicine
Humans
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1501
[Js] Journal subset:IM
[Da] Date of entry for processing:140228
[St] Status:MEDLINE
[do] DOI:10.1055/s-0033-1360303

  7 / 1355 MEDLINE  
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[PMID]: 23989854
[Au] Autor:Leonardi F; Rivera F; Zorzan A; Ali SM
[Ad] Address:Orthopaedic Surgery Departement, SS Annunziata Savigliano Hospital, Azienda Sanitaria Locale CN1, Via Ospedali 14, Savigliano, Cuneo, Italy.
[Ti] Title:Bilateral double osteotomy in severe torsional malalignment syndrome: 16 years follow-up.
[So] Source:J Orthop Traumatol;15(2):131-6, 2014 Jun.
[Is] ISSN:1590-9999
[Cp] Country of publication:Italy
[La] Language:eng
[Ab] Abstract:BACKGROUND: Torsional malalignment syndrome (TMS) is a well defined condition consisting of a combination of femoral antetorsion and tibial lateral torsion. The axis of knee motion is medially rotated. This may lead to patellofemoral malalignment with an increased Q angle and chondromalacia, patellar subluxation and dislocation. Conservative management is recommended in all but the most rare and severest cases. In these cases deformity correction requires osteotomies at two levels per limb. MATERIALS AND METHODS: From 1987 to 2002 in our institution three patients underwent double femoral and tibial osteotomy for TMS bilateral correction (12 osteotomies). All patients were reviewed at mean follow-up of 16 years. RESULTS: At final follow-up no patients reported persistence of knee or hip pain. At clinical examination both lower limbs showed a normal axis and a normal patella anterior position. Pre-operative femoral version measurement showed an average hip internal rotation of 81.5° (range 80°-85°) and average hip external rotation of 27.2° (10°-40°). Thigh-foot angle measurement showed an average value of 38.6° (32°-45°). At final follow-up femoral version measurement showed an average hip internal rotation of 49° (range 45°-55°) and average hip internal rotation of 44.3° (20°-48°) (Figs. 1, 2, 3, 4, 5, 6). Thigh-foot angles measurement showed an average value of 21.6° (18°-24°) outward. CONCLUSION: We recommend a clinical, radiographical and CT scan evaluation of all torsional deformity. In cases of significant deformity, internally rotating the tibia alone is not sufficient. Ipsilateral outward femoral and inward tibial osteotomies are our current recommendation for TMS, both performed at the same surgical setting.
[Mh] MeSH terms primary: Bone Malalignment/surgery
Femur/surgery
Osteotomy/methods
Tibia/surgery
Torsion Abnormality/surgery
[Mh] MeSH terms secundary: Adolescent
Bone Malalignment/radiography
Female
Femur/radiography
Follow-Up Studies
Humans
Retrospective Studies
Syndrome
Tibia/radiography
Torsion Abnormality/radiography
Treatment Outcome
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1501
[Js] Journal subset:IM
[Da] Date of entry for processing:140527
[St] Status:MEDLINE
[do] DOI:10.1007/s10195-013-0260-0

  8 / 1355 MEDLINE  
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[PMID]: 25187383
[Au] Autor:Zhang GY; Zheng L; Ding HY; Li EM; Sun BS; Shi H
[Ad] Address:Department of Ultrasonography, Qianfoshan Hospital, Shandong University, Jinan, 250014, China.
[Ti] Title:Evaluation of medial patellofemoral ligament tears after acute lateral patellar dislocation: comparison of high-frequency ultrasound and MR.
[So] Source:Eur Radiol;25(1):274-81, 2015 Jan.
[Is] ISSN:1432-1084
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:OBJECTIVES: The purpose of this study was to compare the diagnostic performance of high-frequency ultrasound with MR in the evaluation of medial patellofemoral ligament (MPFL) lesions after acute lateral patellar dislocation (LPD). METHODS: High-frequency ultrasound and MR images were prospectively obtained in 97 consecutive patients with acute LPD. Images were acquired using standardised protocols and were independently evaluated by two radiologists. The MPFL was assessed at three sites (patellar insertion, femoral attachment, and mid-substance) for signs of injury. RESULTS: Of a total of 291 sites in 97 MPFLs, 127 showed proven MPFL tear at surgery, including 51 sites of complete tear and 76 sites of partial tear. In a site-based analysis, the sensitivity, specificity, and accuracy of high-frequency ultrasound was 90.8%, 96.3%, and 94.6%, respectively, for partial MPFL tear and 86.3%, 96.3%, and 94%, respectively, for complete tear. For MR, the sensitivity, specificity, and accuracy was 81.6%, 95.7%, and 91.3%, respectively, for partial MPFL tear and 80.4%, 95.7%, and 92.1%, respectively, for complete tear. There was no statistical difference between high-frequency ultrasound and MR in the assessment of partial (P = 0.1, 0.777, 0.155) or complete (P = 0.425, 0.777, 0.449) MPFL lesions. Interobserver agreement was very good for high-frequency ultrasound and good for MR. CONCLUSIONS: Data suggest that high-frequency ultrasound and MR have similar diagnostic performance in the evaluation of MPFL lesions after acute LPD. KEY POINTS: • High-frequency ultrasound and MR were able to detect MPFL lesions after acute lateral patellar dislocation. • High-frequency ultrasound and MR showed similarly high accuracy in diagnosing MPFL lesions. • Interobserver agreement was very good for high-frequency ultrasound and good for MR.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1411
[Js] Journal subset:IM
[St] Status:In-Process
[do] DOI:10.1007/s00330-014-3407-3

  9 / 1355 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.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1411
[Js] Journal subset:IM
[St] Status:In-Process
[do] DOI:10.1007/s00776-014-0612-5

  10 / 1355 MEDLINE  
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[PMID]: 25568426
[Au] Autor:Niedzielski KR; Malecki K; Flont P; Fabis J
[Ad] Address:Polish Mother's Memorial Hospital Research Institute, Clinic of Orthopaedics and Traumatology, Rzgowska 281/289, Lodz 93-338, Poland....
[Ti] Title:The results of an extensive soft-tissue procedure in the treatment of obligatory patellar dislocation in children with ligamentous laxity: a post-operative isokinetic study.
[So] Source:Bone Joint J;97-B(1):129-33, 2015 Jan.
[Is] ISSN:2049-4408
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:In 11 paediatric patients (seven girls and four boys, from 12 to 15 years old) with unilateral obligatory patellar dislocation and ligamentous laxity vastus medialis advancement, lateral release, partial patellar ligament transposition and Galeazzi semitendinosus tenodesis was undertaken to stabilise the patella. The diagnostic criterion for ligamentous laxity was based on the Beighton scale. Outcomes were evaluated radiologically and functionally by measurement of the range of knee movement and isokinetic testing. The evaluation also included the Lysholm knee scale. Follow-up studies took place at a mean of 8.1 years (5 to 15) post-operatively. Normal patellar tracking without any recurrence of dislocation was obtained in ten out of 11 patients. Pain related to vigorous activity was reported by nine patients. Compared with the opposite normal side, the isokinetic tests revealed a statistically significant decrease in the maximal torque values for the affected quadriceps muscle (p = 0.003 and p = 0.004), but no difference between the knee flexors (for angular velocities of 60°/s and 180°/s) (p = 0.858 and p = 0.79). The applied surgical technique generally prevents the recurrence of the disorder in children with habitual patellar dislocation and ligamentous laxity. Quadriceps muscle weakness can be expected to occur post-operatively, Cite this article: Bone Joint J 2015;96-B:129-33.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1501
[Js] Journal subset:AIM; IM
[St] Status:In-Data-Review
[do] DOI:10.1302/0301-620X.97B1.33941


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