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Patellar Dislocation

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2. Incidence of second-time lateral patellar dislocation is associated with anatomic factors, age and injury patterns of medial patellofemoral ligament in first-time lateral patellar dislocation: a prospective magnetic resonance imaging study with 5-year fol (PubMed)

Incidence of second-time lateral patellar dislocation is associated with anatomic factors, age and injury patterns of medial patellofemoral ligament in first-time lateral patellar dislocation: a prospective magnetic resonance imaging study with 5-year fol To examine the predictors of the second-time lateral patellar dislocation (LPD) in patients after acute first-time LPD in a 5-year follow-up.Data were collected prospectively from patients after acute first-time LPD with conservative treatment (...) . Factors included sex, age at the first-time LPD, anatomical variants [trochlear dysplasia, patellar height, tibial tuberosity-trochlear groove (TT-TG) distance], and injury patterns of medial patellofemoral ligament (MPFL) in acute first-time LPD. Logistic regression was carried out to identify the independent risk factors for the incidence of the second-time LPD.The incidence rate of a second-time LPD was 35.5% (59 of 166) in the 5-year follow-up. Univariate analysis revealed significant differences

2018 Knee Surgery, Sports Traumatology, Arthroscopy

3. The Correlation between the Injury Patterns of the Medial Patellofemoral Ligament in an Acute First-Time Lateral Patellar Dislocation on MR Imaging and the Incidence of a Second-Time Lateral Patellar Dislocation (Full text)

The Correlation between the Injury Patterns of the Medial Patellofemoral Ligament in an Acute First-Time Lateral Patellar Dislocation on MR Imaging and the Incidence of a Second-Time Lateral Patellar Dislocation To evaluate the correlation between the injury patterns of the medial patellofemoral ligament (MPFL) on magnetic resonance imaging in an acute first-time lateral patellar dislocation (LPD) and incidence of a second-time LPD.Magnetic resonance images were prospectively analyzed in 147 (...) and complete MPFL tear subgroups, respectively. Twenty-five cases (25/65, 38.5%), 11 cases (11/26, 42.3%), and 8 cases (8/47, 17%) were present in the isolated femoral-side MPFL tear (FEM), combined MPFL tear (COM), and isolated patellar-side MPFL tear (PAT) subgroups, respectively. Compared with the partial MPFL tears, complete tears showed higher incidence of a second-time LPD (p = 0.04). The time interval between the two LPDs was shorter in the complete MPFL tear subgroup (24.2 months) than

2018 Korean Journal of Radiology PubMed

4. Operative Repair of Medial Patellofemoral Ligament Injury Versus Knee Brace in Children With an Acute First-Time Traumatic Patellar Dislocation: A Randomized Controlled Trial

Operative Repair of Medial Patellofemoral Ligament Injury Versus Knee Brace in Children With an Acute First-Time Traumatic Patellar Dislocation: A Randomized Controlled Trial A lateral patellar dislocation (LPD) is the most common traumatic knee injury with hemarthrosis in children. The redislocation rate is high. Varying operative and nonoperative treatments have been advocated with no consensus on the best treatment.(1) To evaluate if arthroscopic-assisted repair of the medial patellofemoral (...) ligament (MPFL) in patients with an acute first-time traumatic LPD would reduce the recurrence rate and offer better objective/subjective knee function compared with a knee brace without repair. (2) To study the presence of anatomic patellar instability risk factors (APIFs) and their association with a redislocation.Randomized controlled trial; Level of evidence, 1.This was a prospective series of 74 skeletally immature patients aged 9 to 14 years (38 girls and 36 boys; mean age, 13.1 years

2018 EvidenceUpdates

5. Which Technique Is Better for Treating Patellar Dislocation? A Systematic Review and Meta-analysis

Which Technique Is Better for Treating Patellar Dislocation? A Systematic Review and Meta-analysis To clarify the discrepancy in surgical options and present evidence to treat patellar dislocation by evaluating which of the techniques yields better improvement in stability and functional recovery for patellar dislocation.The MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus electronic databases were searched for relevant articles comparing the outcomes (...) of medial patellofemoral ligament (MPFL) treatment published up until August 2017. Data searching, extraction, analysis, and quality assessment were performed based on The Cochrane Collaboration guidelines. Clinical outcomes were evaluated using various outcome values in various techniques. For results with high heterogeneity, 95% prediction intervals (PIs) were also investigated.Eleven clinical studies were investigated. In patients with primary patellar dislocation, there were no significant

2018 EvidenceUpdates

6. Lower limb muscle strength in adults and children after surgical or non-surgical management of patellar dislocations: a systematic review

Lower limb muscle strength in adults and children after surgical or non-surgical management of patellar dislocations: a systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration

2019 PROSPERO

7. The Norwich Patellar Instability Score: Validity, internal consistency and responsiveness for people conservatively-managed following first-time patellar dislocation. (Full text)

The Norwich Patellar Instability Score: Validity, internal consistency and responsiveness for people conservatively-managed following first-time patellar dislocation. This paper assessed the validity, internal consistency, responsiveness and floor-ceiling effects of the Norwich Patellar Instability (NPI) Score for a cohort of conservatively managed people following first-time patellar dislocation (FTPD).Fifty patients were recruited, providing 130 completed datasets over 12 months. The NPI (...) components account for 70.4% of the variability. Whilst the NPI Score demonstrated a flooring-effect for 13 of the 19 items, no ceiling effect was reported. There was high internal consistency with a Cronbach Alpha value of 0.93 (95% CI: 0.91 to 0.93). The NPI Score was responsive to change over the 12 months period with an effect size of 1.04 from baseline to 12 months post-injury.The NPI Score is a valid tool to assess patellar instability symptoms in people conservatively managed following FTPD.Level

2017 The Knee PubMed

8. Anatomic patellar instability risk factors in primary lateral patellar dislocations do not predict injury patterns: an MRI-based study. (PubMed)

Anatomic patellar instability risk factors in primary lateral patellar dislocations do not predict injury patterns: an MRI-based study. The primary goal was to describe the injury patterns in a population of primary (first time) lateral patellar dislocators (LPD) to lend clarity to commonly held notions about injury patterns in this population.A prospective study identifying patients presenting with LPD between 2008 and 2012. Inclusion criteria were a history and physical exam consistent (...) with primary LPD, and an MRI consistent with the diagnosis without other significant ligamentous injury. On MRI, location of cartilage, medial patellofemoral ligament (MPFL) injury, and bone bruising were noted. Severity was categorized as partial or complete for MPFL and cartilage lesions. Anatomic patellar instability risk factors (patella alta, trochlear dysplasia, increased TT-TG, and lateral patella tilt) were recorded and compared to the injury patterns.This study involved 157 patients; 107 patients

2017 Knee Surgery, Sports Traumatology, Arthroscopy

9. 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)

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 (...) subjective scores. Clinical examinations were also performed, and redislocations or episodes of instability were recorded.Patients were followed up for a mean period of 41.11 ± 7.40 months (range, 29-62 months). At the final point, no recurrent patellar dislocations occurred, except in 4 patients with instability symptoms in group A; however, no significant difference between the 2 groups was seen (χ2 = 2.503, P = .114). The measurement results from computed tomography decreased significantly

2019 Arthroscopy

10. Sporting activity is reduced following medial reefing performed for patellar dislocation : A retrospective case series of 144 patients with a minimum follow-up of 24 months. (Full text)

Sporting activity is reduced following medial reefing performed for patellar dislocation : A retrospective case series of 144 patients with a minimum follow-up of 24 months. Patellar dislocation is common in young and active patients. The purpose of this study was to determine sporting activity following the medial reefing of patellar dislocation.One hundred forty-four patients with objective patellar dislocation were treated between 2004 and 2013. Three groups were analyzed retrospectively (...) groups, a shift from high performance to recreational sports was found.Despite good clinical results, sporting activity was reduced following patellar dislocation treated with medial reefing. Also, a shift from engagement in high- to low-impact sports among the participants was noted.

2019 BMC Musculoskeletal Disorders PubMed

11. Risk Factors and Time to Recurrent Ipsilateral and Contralateral Patellar Dislocations

Risk Factors and Time to Recurrent Ipsilateral and Contralateral Patellar Dislocations Previous studies have reported variable rates of recurrent lateral patellar instability mainly because of limited cohort sizes. In addition, there is currently a lack of information on contralateral patellar instability.To evaluate the rate of recurrent ipsilateral patellar dislocations and contralateral patellar dislocations after a first-time lateral patellar dislocation. Additionally, risk factors (...) associated with recurrent dislocations (ipsilateral or contralateral) and time to recurrence were investigated.Cohort study; Level of evidence, 3.This population-based study included 584 patients with a first-time lateral patellar dislocation occurring between 1990 and 2010. A retrospective review was conducted to gather information about the injury, subsequent dislocations (ipsilateral or contralateral), and structural characteristics including trochlear dysplasia, patella alta, and tibial tubercle

2017 EvidenceUpdates

12. Early functional rehabilitation after patellar dislocation-What procedures are daily routine in orthopedic surgery? (PubMed)

Early functional rehabilitation after patellar dislocation-What procedures are daily routine in orthopedic surgery? Patellar dislocation and rupture of the medial patellofemoral ligament (MPFL) are frequently seen in daily orthopedic practice. Besides initial non-surgical treatment, surgery and subsequent rehabilitation are crucial for restoring stability in the femoropatellar joint. This study investigated current rehabilitation strategies after patellar dislocation because knowledge (...) and surgical treatment after patellar dislocation showed a tendency towards earlier functional rehabilitation after surgical MPFL reconstruction than after conservative treatment. Both surgical and conservative treatment involved initial restrictions in weight bearing, ROM, and use of movement devices and orthosis at the beginning of rehabilitation. The rehab protocols showed a significant earlier full weight bearing after surgical MPFL reconstruction (p > 0.001). Due to the presence of other parameters

2019 Injury

13. Recurrent patellar dislocations: trochleoplasty improves the results of medial patellofemoral ligament surgery only in severe trochlear dysplasia. (PubMed)

Recurrent patellar dislocations: trochleoplasty improves the results of medial patellofemoral ligament surgery only in severe trochlear dysplasia. Medial patellofemoral ligament (MPFL) surgery combined with trochleoplasty (TP), is often performed to restore the normal patellofemoral biomechanics avoiding recurrent lateral patellar dislocation (LPD) in patients with trochlear dysplasia (TD). However, it is still unclear whether combining TP and MPFL surgery would be more beneficial than

2019 Knee Surgery, Sports Traumatology, Arthroscopy

14. Upper pole sleeve fracture of the patella secondary to patellar dislocation: A case report. (PubMed)

Upper pole sleeve fracture of the patella secondary to patellar dislocation: A case report. Upper pole sleeve fractures of the patella are rare in adolescents; however, they are serious injuries that require early diagnosis and treatment.We present a rare case of a 15-year-old girl who suffered a sleeve fracture at the superior pole of the right patella. The patient had a history of dislocation of the patella 2 weeks ago. Physical examination showed tenderness on palpation over the upper pole (...) of the patella and absence of active movement of the knee accompanied by swelling and joint effusion. A plain radiograph showed an avulsed fragment of the superior pole of the patella.Magnetic resonance imaging showed a superior pole patellar avulsion fracture and dysfunction of the knee extensor mechanism.Under general anesthesia, the patient underwent open surgery for reduction of the patellar fracture and reconstruction of the knee extension apparatus through an anterior approach.Six months after

2019 Medicine

15. Surgical versus nonsurgical treatment of primary acute patellar dislocation: A systematic review and meta-analysis. (PubMed)

Surgical versus nonsurgical treatment of primary acute patellar dislocation: A systematic review and meta-analysis. To systematically review the efficacy of surgical versus nonsurgical treatment for acute patellar dislocation.PubMed, Cochrane, and Embase were searched up to February 12, 2019. After removing duplicates, preliminary screening, and reading the full texts, we finally selected 16 articles, including 11 randomized controlled trials and 5 cohort studies. The quality of the enrolled (...) ).For patients with primary acute patellar dislocation, surgical treatment produces a higher mean Kujala score and a lower rate of redislocation than nonsurgical treatment.

2019 Medicine

16. Editorial Commentary: Risk Stratification Is the New "Standard of Care" Following First-Time Patellar Dislocation. (PubMed)

Editorial Commentary: Risk Stratification Is the New "Standard of Care" Following First-Time Patellar Dislocation. The standard of care for a first-time patellar dislocation without loose bodies or osteochondral fracture has been nonoperative treatment. However, studies that show high recurrent instability rates and low levels of return to unlimited activity have opened the door to consider early surgical stabilization in high-risk individuals. Risk stratification models have been developed (...) to identify those at highest risk of recurrent dislocation. Although the decision to operate on patients with a first-time dislocation remains controversial, surgeons should at the very least use readily available information to counsel patients regarding their relative risk of recurrence.Copyright © 2019 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

2019 Arthroscopy

17. High incidence of acute and recurrent patellar dislocations: a retrospective nationwide epidemiological study involving 24.154 primary dislocations. (PubMed)

High incidence of acute and recurrent patellar dislocations: a retrospective nationwide epidemiological study involving 24.154 primary dislocations. The purpose of this study was to investigate the Danish population as a whole from 1994 to 2013 to find the incidence of acute and recurrent patellar dislocation.The study was performed as a descriptive epidemiological study. The Danish National Patient Registry was retrospectively searched from 1994 to 2013 to find the number of acute (...) and recurrent patellar dislocation. National population data were collected from Statistics Denmark.The period 1994-2013 saw a total registration of 24,154 primary patellar dislocations. A mean incidence of 42 (95% CI 37-47) per 100,000 person-years at risk was found, and young females aged 10-17 had the highest incidence of 108 (95% CI 101-116). In a 10-year follow-up, patients were at an overall risk of 22.7% (95% CI 22.2-23.2) of suffering a recurrent dislocation, with young girls aged 10-17 experiencing

2017 Knee Surgery, Sports Traumatology, Arthroscopy

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

Lateral Patellar Dislocations and Instability ? Post-Operative Management Evidence-Based Care Guideline for Post-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 1 of 38 James M. Anderson Center for Health Systems Excellence Evidence-Based Care Guideline Post-Operative Management of Lateral Patellar Dislocations and Instability (...) In children and adults aged 8-25 years 1 Publication Date: January 2015 Target Population Inclusions: Children or young adults: ? With a history of lateral patellar dislocation, subluxation or general instability treated surgically with medial patellofemoral ligament (MPFL) repair, reconstruction, or revision (MPFLR) ? Ages 8-25 years ? Who are skeletally immature or mature Exclusions: Children and young adults: ? With neuro-developmental conditions associated with patellar instability or dislocation (e.g

2015 Cincinnati Children's Hospital Medical Center

19. Inclusion of joint laxity, recurrent patellar dislocation, and short distal ulnae as a feature of Van Den Ende-Gupta syndrome: a case report. (Full text)

Inclusion of joint laxity, recurrent patellar dislocation, and short distal ulnae as a feature of Van Den Ende-Gupta syndrome: a case report. Van Den Ende-Gupta Syndrome (VDEGS) is an extremely rare autosomal recessive syndrome with less than 20 reported families (approximately 40 patients) in the worldwide literature.We have assessed one consanguineous Saudi family with typical features of VDEGS. Two siblings were affected with almost identical features; including blepharophimosis (...) , arachnodactyly, flexion contractures of the elbows, camptodactyly, slender ribs, hooked lateral clavicular ends, and bilateral radial head dislocations. Both patients had several unusual features; including joint laxity, flat feet, recurrent patellar dislocations, and bilateral short distal ulnae. Full sequencing of SCARF2 revealed a homozygous mutation c.773G > A (p. Cys258Tyr) in both affected children. The parents (both with no abnormalities) were heterozygous for the same mutation.Joint laxity, recurrent

2018 BMC Medical Genetics PubMed

20. Short lateral posterior condyle is associated with trochlea dysplasia and patellar dislocation. (PubMed)

Short lateral posterior condyle is associated with trochlea dysplasia and patellar dislocation. Surgeons mainly consider the anterior anatomy of the distal femur in the treatment of patellar instability (PI) with trochlear dysplasia (TD). Through this research, the idea was to analyse the posterior femoral condyle length in TD. The research team posited the presence of morphological differences in the posterior part of the femoral epiphysis in TD compared to a control group. They also (...) , the longer the medial condyle was in the anterior posterior (p = 0.02).This study shows not only an anterior but also a posterior anomaly in PI with TD. There is a correlation between the severity of the anterior deformation and the PCA: in other words, the knee is placed in valgus in flexure which promotes the external dislocation of the patella. This anatomical study could open a field of research on the development of surgical treatments based on the correction of posterior condylar femoral anomalies

2018 Knee Surgery, Sports Traumatology, Arthroscopy

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