Diagnosis and Treatment of Lateral Patellar Compression Syndrome

Saper, Michael G.; Shneider, David A.

doi:10.1016/j.eats.2014.07.004

Cited by 37 publications

(32 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…7,14 Lateral retinaculum release or lengthening is an uncommon procedure for cases with patellar tilting and the clinically diagnosed severe lateral patellar compression syndrome. 7,14,72 The indication for femoral derotation osteotomy is reserved for rare occasions. 7,14 MPFL reconstruction is performed in most of the patients with recurrent patellar dislocations.…”

Section: Current Therapeutic Concepts At Our Institutionmentioning

confidence: 99%

Imaging of Individual Anatomical Risk Factors for Patellar Instability

Dietrich

Fucentese

Pfirrmann

2016

Semin Musculoskelet Radiol

View full text Add to dashboard Cite

This review article presents several pitfalls and limitations of image interpretation of anatomical risk factors for patellar instability. The most important imaging examinations for the work-up of patients with patellar instability are the true lateral radiograph and transverse computed tomography (CT) or MR images of the knee. Primary anatomical risk factors are an insufficient medial patellofemoral ligament (MPFL), patella alta, trochlear dysplasia, increased distance from the tibial tuberosity to the trochlear groove (TTTG), and torsional limb parameters. Limitations of the Caton-Deschamps index are related to the clear identification of the patellar and tibial articular margin. Classification of trochlear dysplasia according to the Dejour system on radiographs and MR images revealed a weak reliability. The comparability of TTTG values obtained on CT and MR images at various flexion angles and different varus alignments of the knee is limited. Thus MRI performed with a dedicated knee coil may underestimate the TTTG distance compared with CT images. Increased lateral patellar tilt is a consequence of primary anatomical risk factors rather than an independent anatomical risk factor for patellar instability. The pretest likelihood of a torn MPFL on MR images is very high after an acute episode of lateral patellar dislocation. Surgical restoration of the patellofemoral joint stability addresses the complex multifactorial biomechanics by a custom-made management such as MPFL reconstruction, sulcus-deepening trochleoplasty, as well as medialization and distalization of the tibial tubercle. Quantification of anatomical risk factors for patellar instability in each person is important for highly individual treatment.

show abstract

Section: Current Therapeutic Concepts At Our Institutionmentioning

confidence: 99%

Imaging of Individual Anatomical Risk Factors for Patellar Instability

Dietrich

Fucentese

Pfirrmann

2016

Semin Musculoskelet Radiol

View full text Add to dashboard Cite

show abstract

“…(1) The obvious hyperplasia and deformation of lateral patella should conduct patelloplasty. (2) The osteophyte of patella trajectory should be removed; (3) Hemostasis using arthroscopic electrocoagulation needs to be thorough to reduce the risk of blood in the joint and accelerate postoperative recovery. (4) The scope of release should be thorough.…”

Section: Discussionmentioning

confidence: 99%

“…Lateral patellar compression syndrome (LPCS) is a disease of musculoskeletal disorder with pathological manifestations of the increased lateral patellofemoral joint pressure, which is caused by the long-term lateral tilt of patella, the adaptive tightening of lateral patella retinaculum (LPR), and the long-term stress imbalance of medial and lateral articular surfaces. The main clinical manifestations are patellofemoral joint pain, abnormal patella trajectory and articular cartilage injury [1,2]. LPCS has become one of the main causes of anterior knee pain [1].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy and experience of arthroscopic lateral patella retinaculum releasing through/outside synovial membrane for the treatment of lateral patellar compression syndrome

Chen

Dong

Xiao

et al. 2020

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background: Arthroscopic closure release includes arthroscopic lateral patella retinaculum releasing (LPRR) either outside synovial membrane (OSM) or through synovial membrane (TSM). At present, there is no research to compare the clinical efficacy of the above two methods for the treatment of lateral patellar compression syndrome (LPCS). So, the goal of this study was to investigate the method and overcome of arthroscopic LPRR either OSM or TSM for the treatment of LPCS. Methods: From September 2014 to December 2017, 125 patients of LPCS underwent arthroscopic LPRR either OSM or TSM combined with joint debridement. In the OSM group, knee joint was cleaned first. The surface of lateral patella retinaculum (LPR) was created the chamber for arthroscopic operation to release LPR. Synovial membrane was retained. In the TSM group, knee joint was cleaned first. Then synovial membrane, joint capsule and LPR, and superficial fascia were gradually incised from the joint cavity to subcutaneous tissue. The synovial membrane was cut open. Before and after surgery, Lysholm score, patella medial shift, Kujala score, VAS score and surgical complications were collected for evaluating clinical overcomes. Results: All patients were followed up for 1.5-5 years. All patients had significant reduction in knee pain and improved function after 1 month and 1 year. The Lysholm score, the distance of patella medial shift, Kujala score, and VAS score in the OSM group and the TSM group were significantly improved in the final follow-up compared with before surgery (All P < 0.001), but these observed targets before surgery and at the last follow-up were compared between the OSM group and the TSM group with no statistical differences. However, the number of occurrences of joint hematoma and adhesion was significantly higher in the TSM group than the OSM group (P = 0.024). Conclusions: Arthroscopic closing LPRR for the treatment of LPCS can effectively improve the function and symptoms of patellofemoral joint with the advantages of small trauma, rapid recovery and less complications. But, the number of occurrences of hemarthrosis and joint adhesion were significantly higher in the TSM group than in the OSM group. Trial registration: The trial registration number (IRCT): IRCT20200205046378N1 and date of registration: February 10, 2020 (retrospectively registered).

show abstract

“…The frontal plane projection angle (FPPA) is a two dimensional measurement often used to assess knee Human Movement, Vol. 19, No 1, 2018 humanmovement.pl kinematics during closed kinetic chain activities [11]. FPPA is related to knee pain severity [12], the prediction of PFP [13], and the interaction between hip abductor isometric torque [14].…”

Section: Introductionmentioning

confidence: 99%

Gluteal activation and increased frontal plane projection angle during a step-down test in young women

Barbosa¹,

Vieira²,

Barbosa³

et al. 2018

Hum Mov.

View full text Add to dashboard Cite

Purpose. To investigate how the activation of gluteus maximus and gluteus medius interacts with different frontal plane projec tion angles (FPPA) in healthy young women presenting dynamic knee valgus in one limb while performing the stepdown test. Methods. The total of 18 young women presenting FPPA > 15° during the stepdown test in one limb (dynamic knee valgus) were assessed. The other limb should present less than 15° for comparisons. The amplitude of muscle activation was assessed through surface electromyography of gluteus medius and gluteus maximus during 8 subsequent weight bearing stepdown tests. Results. FPPA was positively correlated with gluteus maximus activation and with the assessed side showing FPPA > 15°, which also revealed increased activation of gluteus maximus. No differences were noted for gluteus medius. The principal component analysis explained 73% of the variance in 2 components, with gluteus maximus explaining 48% of the variance on the 1st component. Gluteus medius explained 25% on the 2nd component. Conclusions. Gluteus maximus seems to be a major component to explain dynamic knee valgus in women without symptoms of patellofemoral pain, probably owing to weakness and lack of stabilization of other proximal muscles of the hipknee complex during the task.

show abstract

Diagnosis and Treatment of Lateral Patellar Compression Syndrome

Cited by 37 publications

References 21 publications

Imaging of Individual Anatomical Risk Factors for Patellar Instability

Imaging of Individual Anatomical Risk Factors for Patellar Instability

Efficacy and experience of arthroscopic lateral patella retinaculum releasing through/outside synovial membrane for the treatment of lateral patellar compression syndrome

Gluteal activation and increased frontal plane projection angle during a step-down test in young women

Contact Info

Product

Resources

About