Patellar tendon length — the factor in patellar instability?

Neyret, P; Robinson, A. H. N.; Coultre, Bertrand Le; Lapra, C; Chambat, Pierre

doi:10.1016/s0968-0160(01)00136-3

Cited by 167 publications

(123 citation statements)

References 6 publications

Supporting

Mentioning

106

Contrasting

Unclassified

Order By: Relevance

“…Nevertheless, there may be extra benefits associated with use of the additional tenodesis for the treatment of patella alta. For example, patella alta has been shown to result from an elongated patella tendon as opposed to a more-proximal patella tendon insertion [21]. It has been suggested that an elongated patella tendon may be a risk factor for patella instability in the coronal plane [20,21].…”

Section: Discussionmentioning

confidence: 99%

“…For example, patella alta has been shown to result from an elongated patella tendon as opposed to a more-proximal patella tendon insertion [21]. It has been suggested that an elongated patella tendon may be a risk factor for patella instability in the coronal plane [20,21]. Thus, shortening of the patella tendon may provide additional benefits beyond relief of cartilage stress.…”

Section: Discussionmentioning

confidence: 99%

“…1). Neyret et al [21] has suggested the patella tendon tenodesis be performed in addition to the tibial tubercle distalization (referred to as distalization + tenodesis hereafter) to restore the normal length of patella tendon and provide further patella stability (Fig. 1).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Does Patella Tendon Tenodesis Improve Tibial Tubercle Distalization in Treating Patella Alta? A Computational Study

Liao

Yang

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Patellofemoral malalignment associated with patella alta may cause pain and arthritis; because of this, the condition sometimes is treated surgically. Two common procedures are tibial tubercle distalization with or without patellar tendon tenodesis. However, the biomechanical consequences of these interventions for patella alta are not clearly understood. Questions/purposes We evaluated changes in patellofemoral joint contact mechanics after tibial tubercle distalization and tibial tubercle distalization combined with patella tendon tenodesis. Specifically, we asked: (1) Are there biomechanical differences between these two types of procedures? (2) Is there an ideal range to distalize the patella? Methods Subject-specific finite-element models were created for 10 individuals with patella alta (mean InsallSalvati ratio of 1.34 ± 0.05). Input parameters for the finite-element models included subject-specific joint geometry, quadriceps muscle forces, and weightbearing patellofemoral joint kinematics. Virtual operations were conducted to simulate the two procedures. For distalization, the tibial tubercle and patella were displaced distally 4 mm to 20 mm in 4-mm increments based on the original model. At each level of distalization, the patella tendon was attached back to its original insertion to simulate the additional tenodesis procedure. Cartilage stress, contact area, and contact forces were quantified and compared between procedures and distalization levels. Results Distalization and distalization + tenodesis reduced patellofemoral joint stress compared with the baseline of 1.02 ± 0.11 MPa. Distalization led to lower cartilage stress than distalization + tenodesis, and the effect size was relatively large (0.88 ± 0. Conclusions Cartilage stress appears lower using distalization as opposed to distalization + tenodesis in this finite-element analysis simulation. An Insall-Salvati ratio of 0.95 may be an ideal level for distalization; further distalization does not show additional benefits. Clinical Relevance This study suggests that distalization may result in less stress than distalization + tenodesis,

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Does Patella Tendon Tenodesis Improve Tibial Tubercle Distalization in Treating Patella Alta? A Computational Study

Liao

Yang

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Many patients with patellar instability may have generalised ligamentous hyperlaxity or trochlear dysplasia. [31] So reconstruction of MPFL is done with stronger tissue than original tissue to compensate for the underlying predisposing pathology without changing the original position of the patella and its original conformity with its underlying trochlea. [32] [33] Semitendinosus and gracilis tendon are commonly harvested as grafts for reconstructive procedures.…”

Section: Figure 6 Showing Tt-tg Distance In Overlapped Image Of Mrimentioning

confidence: 99%

Reconstruction of Medial Patellofemoral Ligament Through Two Transverse Patellar Tunnel Technique Using Hamstring Autograft

Kumar¹,

Samanta²,

Sil³

2017

jemds

View full text Add to dashboard Cite

show abstract

“…In der klinischen Praxis haben sich für die Auswertung an sagittalen MRT-Bildern der Insall-Salvati-Index und der Canton-Duchamps-Index etabliert, die jeweils eine robuste Reproduzierbarkeit aufweisen [32,33]. Die ursprünglich an konventionellen Seitbildern entwickelten Messtechniken sind mit hoher Übereinstimmung an sagittalen MR-Bildern anwendbar [29,34]. Für die Bestimmung des Insall-Salvati-Index wird der Längs-durchmesser der Patella zur Länge der Patellasehne ins Verhält-nis gesetzt ( • " Abb.…”

unclassified

MRT nach Patellaluxation: Quantifizierung der Risikofaktoren und Beschreibung der Folgeschäden

Diederichs

Scheffler

2013

Fortschr Röntgenstr

View full text Add to dashboard Cite

Zusammenfassung Bei der Patellaluxation handelt es sich um ein Herausspringen der Kniescheibe aus dem trochlearen Gleitlager nach lateral. In der Regel liegen anatomische Risikofaktoren in unterschiedlichem Auspr?gungsgrad vor, die in Zusammenhang mit einer Rotationsbewegung des Beines zu einem Luxationsereignis f?hren. Die im MRT problemlos diagnostizierbaren Kontusions?deme der inferomedialen Patella und des lateralen Femurkondylus sowie die Ruptur des medialen patellofemoralen Ligamentes gelten als typische Zeichen einer k?rzlich stattgehabten Luxation. Allerdings sind auch osteochondrale Begleitverletzungen m?glich, die je nach Ausma? eine Indikation zur fr?hen Refixation darstellen k?nnen. Nach dem Erstereignis folgen durch den instabilen Kapsel-Band-Apparat h?ufig weitere Luxationen, die in Abh?ngigkeit der vorliegenden anatomischen Normvarianten bis hin zu einer chronischen patellofemoralen Instabilit?t f?hren k?nnen. Therapeutisch hat sich ein breites Spektrum aus konservativen und operativen Verfahren durchgesetzt. W?hrend Erstluxationen h?ufig konservativ behandelt werden, orientiert sich das operative Verfahren nach der Zweitluxation am Verletzungsmuster und Auspr?gungsgrad der anatomischen Risikofaktoren. Die relevanten pr?disponierenden Anlagevarianten sind die Trochleadysplasie, die Patella alta und der pathologische Abstand der Tuberositas tibia zum Sulcus trochleae (TT-TG). Insgesamt sollten im radiologischen Befund sowohl die Folgesch?den der Luxation als auch die anatomischen Risikofaktoren quantifiziert werden, da eine individuelle Analyse des zugrunde liegenden Pathomechanismus ausschlaggebend f?r die optimale patientenspezifische Therapie ist.

show abstract

Patellar tendon length — the factor in patellar instability?

Cited by 167 publications

References 6 publications

Does Patella Tendon Tenodesis Improve Tibial Tubercle Distalization in Treating Patella Alta? A Computational Study

Does Patella Tendon Tenodesis Improve Tibial Tubercle Distalization in Treating Patella Alta? A Computational Study

Reconstruction of Medial Patellofemoral Ligament Through Two Transverse Patellar Tunnel Technique Using Hamstring Autograft

MRT nach Patellaluxation: Quantifizierung der Risikofaktoren und Beschreibung der Folgeschäden

Contact Info

Product

Resources

About