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Patellar Apprehension Test

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1. The reversed dynamic patellar apprehension test mimics anatomical complexity in lateral patellar instability. (PubMed)

The reversed dynamic patellar apprehension test mimics anatomical complexity in lateral patellar instability. To develop a dynamic physical examination test that functionally simulates actual patellar instability events and that mimics the range of patellar stabilizer insufficiency in an individual patient.Seventy-eight consecutive patients (male/female 35/43; mean age 22 ± 7 years) with recurrent lateral patellar instability and 35 controls (male/female 16/19; mean age 31 ± 14 years) were (...) prospectively evaluated using the reversed dynamic patellar apprehension test (ReDPAT). Anatomical predisposition was assessed according to Dejour's classification of trochlear dysplasia, tibial tuberosity-trochlear groove distance, tibial tuberosity-posterior cruciate ligament distance, patellar height, and varus/valgus malalignment.The study group had an average of 3.4 ± 1.0 (1-6) anatomical risk factors for lateral patellar dislocation. Severe trochlear dysplasia (84%) and patella alta (49%) were

2018 Knee Surgery, Sports Traumatology, Arthroscopy

2. Patellar Apprehension Test

Patellar Apprehension Test Patellar Apprehension Test Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Patellar Apprehension Test (...) Patellar Apprehension Test Aka: Patellar Apprehension Test II. Indications Evaluation of Evaluation for subluxation Evaluation for dislocation III. Technique Patient lies supine flexed to 30 degrees or in full extension Examiner applies pressure from medial forced laterally by medial pressure Patient tightens quadriceps muscle Positive test is painful Patient may refuse to do this in anticipation of pain Images IV. Interpretation: Positive Test if painful Lateral patellofemoral instability (recent

2018 FP Notebook

3. Patellar Apprehension Test

Patellar Apprehension Test Patellar Apprehension Test Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Patellar Apprehension Test (...) Patellar Apprehension Test Aka: Patellar Apprehension Test II. Indications Evaluation of Evaluation for subluxation Evaluation for dislocation III. Technique Patient lies supine flexed to 30 degrees or in full extension Examiner applies pressure from medial forced laterally by medial pressure Patient tightens quadriceps muscle Positive test is painful Patient may refuse to do this in anticipation of pain Images IV. Interpretation: Positive Test if painful Lateral patellofemoral instability (recent

2015 FP Notebook

4. Medial Patellofemoral Ligament Reconstruction: A Comparison of Single-Bundle Transpatellar Tunnel and Double-Anchor Anatomic Techniques for the Treatment of Recurrent Lateral Patellar Dislocation in Adults. (PubMed)

to the normal range, and no significant difference was found between the 2 groups except for the lesser patellar tilt angle in group B (t = 2.175, P = .030). The clinical examination improved significantly, no patient exhibited a positive apprehension test in either group, and the number of patients with abnormal lateral patellar translation grade and firm end point showed no statistically significant differences between the 2 groups (P > .05). All score systems significantly improved with no significant (...) Medial Patellofemoral Ligament Reconstruction: A Comparison of Single-Bundle Transpatellar Tunnel and Double-Anchor Anatomic Techniques for the Treatment of Recurrent Lateral Patellar Dislocation in Adults. To compare the stability and clinical outcomes of 2 medial patellofemoral ligament reconstruction (MPFLR) techniques for the treatment of recurrent lateral patellar dislocation in adults.Ninety-one patients with recurrent patellar dislocation were randomly divided into 2 groups, undergoing

2019 Arthroscopy

5. Anteromedial Tibial Tubercle Osteotomy Improves Results of Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Instability in Patients With Tibial Tuberosity-Trochlear Groove Distance of 17 to 20 mm. (PubMed)

-trochlear groove (TT-TG) of 17 to 20 mm.From January 2008 to August 2013, patients with RPI and a TT-TG of 17 to 20 mm were divided into 2 groups: TTO+MPFLR or MPFLRa. Subjects were evaluated for J sign classification (1-4+); patellar glide (1-4+); the apprehension test; increased femoral anteversion; the Caton index; trochlear dysplasia; TT-TG; and Kujala, Lysholm, International Knee Documentation Committee (IKDC), and Tegner scores. Kujala improvement was the primary outcome.Forty-two subjects were (...) evaluated, 18 in the TTO+MPFLR group and 24 in the MPFLRa group. Mean follow-up time was 40.86 months (range, 24-60 months). Demographics between the groups were not different. Preoperatively, there was no statistically significant difference between groups regarding J sign classification; patellar glide; the apprehension test; increased femoral anteversion; the Caton index; trochlear dysplasia; TT-TG; and Kujala, Lysholm, IKDC, and Tegner scores. Postoperative J sign classification mean results

2019 Arthroscopy

6. Lateral Patellar Dislocations and Instability ? Post-Operative Management

of the following: ? Hip flexors, extensors, abductors, adductors, internal rotators, external rotators ? Knee flexors and extensors ? Ankle plantarflexors and dorsiflexors (LocalConcensus 2014 [5]) Note: Strength testing of the involved limb is performed as appropriate and with caution initially following surgery (LocalConcensus 2014 [5]). Special Tests Assess medial, superior, and inferior patellar glide as appropriate to examine patellar mobility (LocalConcensus 2014 [5]). Note: Do not assess lateral glide (...) -Operative Management of Lateral Patellar Dislocations and Instability in children and adults aged 8-25 years Guideline 46 Copyright © 2015 Cincinnati Children's Hospital Medical Center; all rights reserved. Page 11 of 38 Goal Expected Outcome ? double leg jumping in place on static surfaces with proper technique 100% of the time for 10 jumps ? Limb Symmetry index of = 85 on all single leg hop tests Cardiovascular Participate in cardiovascular activity without increased pain or adverse event

2015 Cincinnati Children's Hospital Medical Center

7. Medial Patellofemoral Ligament Reconstruction with Semi-Patellar Tunnel Fixation: Surgical Technique and Mid-Term Follow-Up (PubMed)

and hardware-free patellar fixation between 2011 and 2013, were included in the study. Patella stability was tested by an apprehension test preoperatively and at follow-up. Knee function was evaluated using the Kujala score, Lysholm score, and Crosby-Insall grading system. Patellar congruence angle and patellar tilt angle were measured using an axial computed tomography scan. Furthermore, objective feelings of patients and complications were recorded. RESULTS Thirty knees (30 patients) were followed (...) for a minimum of 48 months. The apprehension test was positive in all patients preoperatively, but negative at follow-up. Kujala and Lysholm scores increased from 58.9±9.6 to 92.0±4.8 (p<0.001) and 53.3±5.6 to 91.6±3.5 (p<0.001), respectively, at the last follow-up. Seventeen patients were graded as excellent and 13 were graded as good by the Crosby-Insall grading system. The patellar congruence angle and patellar tilt angle also improved significantly. No patient experienced patellar re-dislocation

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2017 Medical science monitor : international medical journal of experimental and clinical research

8. Lateral Patellar Dislocations and Instability: Conservative Management

Musculoskeletal Function Assessment o PedsQL (Smith 2010a [1b], Smith 2008 [1b], Paxton 2003 [2a], Briggs 2009 [3b], LocalConsensus 2013 [5], Lysholm 2007 [5a]). Note: There is conflicting evidence regarding whether specific outcome measures directly pertaining to patellar instability are clinically meaningful (Smith 2010b [1b]). Nonetheless, studies indicate that the IKDC, Kujala, Fulkerson, Lysholm, and Tegner scales have all been demonstrated to have acceptable test–retest reliability, with a coefficient (...) Lateral Patellar Dislocations and Instability: Conservative Management Evidence-Based Care Guideline for Conservative Management of patellar instability and dislocation in children and adults aged 8-25 Guideline 44 Copyright © 2014 Cincinnati Children's Hospital Medical Center; all rights reserved. Page 1 of 30 James M. Anderson Center for Health Systems Excellence Evidence-Based Care Guideline Conservative Management of Lateral Patellar Dislocations and Instability In children and young adults

2013 Cincinnati Children's Hospital Medical Center

9. Increased Femoral Anteversion Influence Over Surgically Treated Recurrent Patellar Instability Patients. (PubMed)

tubercle (TT)-trochlear groove (TG) ≥ 17 mm who underwent anteromedialization TTO combined with MPFLR were evaluated for J sign, patellar glide, apprehension test, increased FA, Caton index, trochlea dysplasia, TT-TG, Kujala, International Knee Documentation Committee subjective knee evaluation form, and Tegner. Increased FA was determined clinically by a difference of more than 30° between hip internal and external rotation, 70° or more of hip internal rotation, and 30° or more of femoral neck (...) anteversion. A subgroup analysis involving increased FA was made.Forty-eight patients composed the study group. Mean follow-up was 41.5 ± 11.05 months. The J-sign was present in 86% before surgery and none postoperatively (P < .001). All patients had a positive apprehension test or a patellar luxation at the patellar glide test rated as grade 4 before surgery. After surgery, the mean glide was 1.29 ± 0.45 with no apprehension (P < .001). Increased FA was present in 18.7%. Caton index before surgery

2016 Arthroscopy

10. Complications of medial patellofemoral ligament reconstruction using two transverse patellar tunnels. (PubMed)

obtained from available patient charts.Thirty-nine complications (20.3 %) were registered. Twenty-seven of these (14.7 %) were minor. Seven patients (3.6 %) sustained a patellar fracture without adequate trauma. Male gender was a risk factor for patellar fracture (p < 0.001). Sixteen (8.1 %) reported recurrence of instability, of whom 10 (5.1 %) were defined as objective instability (reported dislocation and positive apprehension test).This is largest patient series to date in which the complications (...) Complications of medial patellofemoral ligament reconstruction using two transverse patellar tunnels. The aim of this study was to report the complication rate after a medial patellofemoral ligament (MPFL) reconstruction using transverse patellar tunnels in a retrospective case series performed in a single institution.Case series of 179 patients (192 knees) that had an MPFL reconstruction, with or without additional bony realignment procedures, between January 2009 and March 2015. Data were

2016 Knee Surgery, Sports Traumatology, Arthroscopy

11. Anatomic medial patellofemoral ligament reconstruction using patellar suture anchor fixation for recurrent patellar instability. (PubMed)

. Reconstruction was performed using a hamstring autograft fixed with two suture anchors at native patellar site of the MPFL. No patient had undergone additional medial tibial tuberosity transfer. Clinical scores (Kujala, Lysholm, and Tegner score) and apprehension test were completed preoperatively and at the follow-up. Preoperative and follow-up radiographic assessments included modified Insall-Salvati ratio, congruence angle, and lateral patellofemoral angle.The preoperative Kujala and Lysholm scores were (...) 52.6±12.4 and 49.2±10.7, and at follow-up visits, corresponding values were 90.9±4.5 (p<0.001) and 90.9±5.2 (p<0.001). Tegner score increased from 3.0 (range 1-4) to 5.0 (range 4-7) (p<0.001). The apprehension test was positive in all patients preoperatively, but only positive in one patient at follow-up. All radiographic assessments were significantly improved; modified Insall-Salvati index (from 1.75 to 1.65) (p=0.002), congruence angle (from 6.3° to -7.0°) (p<0.001), and lateral patellofemoral

2014 Knee Surgery, Sports Traumatology, Arthroscopy

12. Reconstruction of medial patellofemoral ligament using quadriceps tendon combined with reconstruction of medial patellotibial ligament using patellar tendon: initial experience (PubMed)

of cases of patients with diagnoses of patellofemoral instability and indications for surgical treatment, who were attended by the Knee Group of HC-IOT, University of São Paulo. The following were evaluated before and after the operation: range of motion (ROM), apprehension test, lateral translation test, patellar inclination test, inverted J sign, subluxation upon extension, pain from compression of the patella and pain from contraction of the quadriceps. After the operation, the patients were asked (...) whether any new episode of dislocation had occurred, what their degree of satisfaction with the surgery was (on a scale from 0 to 10) and whether they would be prepared to go through this operation again.Seven knees were operated, in seven patients, with a mean follow-up of 5.46 months (±2.07). Four patients who presented apprehension before the operation did not show this after the operation. The lateral translation test became normal for all the patients, while the patellar inclination test remained

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2016 Revista brasileira de ortopedia

13. Reconstruction of the medial patellofemoral ligament using autologous graft from quadriceps tendon to treat recurrent patellar dislocation (PubMed)

that required surgical treatment. The functional results from the technique were evaluated using clinical data and the Lysholm questionnaire, one year after the operation.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 (...) Reconstruction of the medial patellofemoral ligament using autologous graft from quadriceps tendon to treat recurrent patellar dislocation 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.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

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2016 Revista brasileira de ortopedia

14. Medial Retinacular Plication Versus Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Instability

after surgery ] A validated international scale that evaluates level of pain Single hop test [ Time Frame: Between two and five years after surgery ] Evaluates limb asymmetry index between operated and nonoperated limbs during a single legged hop for distance Side-to-side hop test [ Time Frame: Between two and five years after surgery ] Evaluates limb asymmetry index between operated and nonoperated limbs performing side to side repetaed hops during 30 seconds Patellar apprehension test [ Time Frame (...) Medial Retinacular Plication Versus Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Instability Medial Retinacular Plication Versus Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Instability - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number

2015 Clinical Trials

15. Trochleoplasty as a Solitary Treatment for Recurrent Patellar Dislocation Results in Good Clinical Outcome in Adolescents. (PubMed)

aged 10 to 20 years. Assessment included J-sign and apprehension test, Kujala and Lysholm scores, patients' subjective assessment and activity level according to the International Knee Documentation Committee questionnaire, and patients' overall satisfaction. The Caton-Deschamps ratio and the lateral condyle index were measured. Pre- versus postoperative values were compared with a paired Wilcoxon signed-rank test. The minimum follow-up was 24 months (33 ± 10.6 months).The Kujala score improved (...) from 71 preoperatively to 92 postoperatively (P < .001) and the Lysholm score from 71 to 95 (P < .001). Patients' subjective assessment improved at the final follow-up as compared with that preoperatively (P < .001). Most patients enhanced their activity (P < .001), and their overall satisfaction increased postoperatively (P < .001). Preoperatively, there was a positive J-sign in 45 knees and a positive apprehension test in 41 knees. Both markers disappeared postoperatively in 39 and 33 knees

2016 American Journal of Sports Medicine

16. Treatment of patella alta in patients with episodic patellar dislocation: a systematic review. (PubMed)

to identify published surgical techniques and their results. Tibial tubercle distalization is the primary described treatment for patellar alta in patients with EPD, and five studies reporting results of this procedure were reviewed.Tibial tubercle distalization was generally successful in normalizing patellar height and preventing recurrent patellar dislocation. Physical examination tests for instability such as patellar apprehension remained positive in 15 to 33% of patients. Patient-reported outcomes (...) Treatment of patella alta in patients with episodic patellar dislocation: a systematic review. While there are numerous anatomic contributors to patellar instability, the role of patella alta has been traditionally under-appreciated. The goal of this systematic review is to identify the described techniques for treating patella alta in skeletally mature patients with episodic patellar dislocation (EPD) and review their published results.A comprehensive literature review was performed

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2014 Knee Surgery, Sports Traumatology, Arthroscopy

17. The development, validation and internal consistency of the Norwich Patellar Instability (NPI) score. (PubMed)

and with the J-sign, patellar mobility, apprehension test, Beighton score, Kujala Patellofemoral Disorder Score and Lysholm Knee Score to evaluate convergent validity. Internal consistency of the 19 items was also calculated.The results indicated a moderate correlation between the NPI score and the Kujala Patellofemoral Disorder Score (rho = -0.66; p < 0.01) and Lysholm Knee Score (rho = -0.54; p = 0.03), suggesting good convergent validity. There was a little correlation between the KOOS and NPI score (...) The development, validation and internal consistency of the Norwich Patellar Instability (NPI) score. No outcome measurements have previously been designed to assess patient-perceived patellar instability. The purposes of this study were to address this limitation and to describe the development and validation of the Norwich Patellar Instability (NPI) scores, a self-administered 19-item questionnaire to assess perceived patellar instability.A previous study assessed activities that aggravated

2014 Knee Surgery, Sports Traumatology, Arthroscopy

18. Patellar Injury and Dislocation (Treatment)

in the surgical group. [ ] Additionally the surgical group had improved functional outcome as measured by the Kujala score. Overall, the investigators evaluated the rates of recurrent dislocations, subluxations, and instability as indicated by a positive patellar apprehension test. [ ] Cootjans et al devised the following surgical algorithm for recurrent patellar dislocations that resulted in a 87% reduction in recurrent dislocations and 66% reduction in instability at 5 year follow up [ ] : A. Immature (...) Patellar Injury and Dislocation (Treatment) Patellar Injury and Dislocation Treatment & Management: Acute Phase, Recovery Phase, Maintenance Phase Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache

2014 eMedicine.com

19. Medial Retinaculum Plasty Versus Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Instability in Adults: A Randomized Controlled Trial. (PubMed)

apprehension test was examined, and redislocation was recorded.Patients were followed up for a mean period of 40 months (range, 24 to 55 months). The measurement results for the congruence angle, patellar tilt angle, and patellar lateral shift decreased significantly from the pretreatment measurements to the normal range at the latest follow-up, without a statistically significant difference between the 2 groups (P > .05). The median Kujala score had significantly improved after surgery. However (...) , no statistically significant difference was found between the 2 groups at the latest follow-up (P > .05). In 6 cases in the MRP group (19%) and 3 in the MPFLR group (9%), we found patellar lateral shift that exceeded 1.5 cm but was less than 2.0 cm with a firm endpoint for the apprehension test, without a significant difference between the 2 groups.This prospective randomized study showed that MPFLR for recurrent patellar instability could achieve good clinical results, with a good congruous patellofemoral

2013 Arthroscopy

20. Midterm Results of Comprehensive Surgical Reconstruction Including Sulcus-Deepening Trochleoplasty in Recurrent Patellar Dislocations With High-Grade Trochlear Dysplasia. (PubMed)

° preoperatively to 141° ± 9° postoperatively, tibial tuberosity-trochlear groove distance decreased significantly (P < .001) from 19 ± 4 mm to 12 ± 5 mm, and patellar tilt decreased significantly (P < .001) from 37° ± 7° to 15° ± 8°. No recurrence was observed, and there was no case of stiffness. Apprehension signs remained positive in 19.3% of the cases, patellar tracking was normal in all cases, and the lateral patellar glide test finding was negative in 96.8%. The mean preoperative International Knee (...) Midterm Results of Comprehensive Surgical Reconstruction Including Sulcus-Deepening Trochleoplasty in Recurrent Patellar Dislocations With High-Grade Trochlear Dysplasia. Trochlear dysplasia is one of the most consistent anatomic factors that can lead to recurrent patellar dislocations. Various trochleoplasty procedures have been described to treat patellar dislocations in high-grade dysplasia by creating a new congruent trochlea.To present the midterm efficacy and outcome of the sulcus

2013 American Journal of Sports Medicine

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