Patellar tracking after isolated medial patellofemoral ligament reconstruction: dynamic evaluation using computed tomography

Gobbi, Riccardo Gomes; Demange, Marco Kawamura; Ávila, Luiz Francisco Rodrigues de; Filho, José de Arimatéia Batista Araújo; Moreno, Ramón; Gutierrez, Marco Antônio; Rebelo, M.S.; Tírico, Luis Eduardo Passarelli; Pécora, José Ricardo; Camanho, Gilberto Luís

doi:10.1007/s00167-016-4284-x

Cited by 40 publications

(39 citation statements)

References 45 publications

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“…reported another DKCT study assessing the results of isolated MPFL reconstructions, evaluating various methods to reference and compute anatomical landmarks (Fig. ); another publication presented a similar design with the same purpose.…”

Section: Review Resultsmentioning

confidence: 99%

Dynamic Evaluation of Patellofemoral Instability: A Clinical Reality or Just a Research Field? A Literature review

Rosa

Ewen

Doma

et al. 2019

Orthopaedic Surgery

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Patellofemoral instability (PFI) is one of the most disabling conditions in the knee, often affecting young individuals. Despite its not uncommon presentation, the underlying biomechanical features leading to this entity are not entirely understood. The suitability of classic physical examination manoeuvres and imaging tests is a matter of discussion among treating surgeons, and so are the findings provided by these means. A potential cause for this lack of consensus is the fact that, classically, the diagnostic approach for PFI has relied on statically obtained data. Many authors advocate for the study of this entity in a dynamic scenario, closer to the actual situation in which the instability episodes occur. In this literature review, we have compiled the available data from the last decades regarding dynamic evaluation methods for PFI and related conditions. Several categories are presented, grouping the related techniques and devices: physical examination, imaging modalities (ultrasound (US), magnetic resonance imaging (MRI), computed tomography (CT) and combined methods), arthroscopic evaluation, and others. In conclusion, although a vast number of quality studies are presented, in which comprehensive data about the biomechanics of the patellofemoral joint (PFJ) are described, this evidence has not yet reached clinical practice universally. Most of the data still stays in the research field and is seldom employed to assist a better understanding of the PFI cases and their ideal treatment targets.

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Section: Review Resultsmentioning

confidence: 99%

Dynamic Evaluation of Patellofemoral Instability: A Clinical Reality or Just a Research Field? A Literature review

Rosa

Ewen

Doma

et al. 2019

Orthopaedic Surgery

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“…Up to 38% to 40% of cases were reported having anterior knee pain in those underwent MPFLR [19]. In additional, Gobbi et al [20] suggested patellar shift and tilt correction will not improve signi cantly when performing isolated MPFLR in patients with RPD, while patellar maltracking is regard as a pathoanatomic risk factor for RPD [21,22].…”

Section: Discussionmentioning

confidence: 99%

Closing-wedge Distal Femoral Osteotomy Combined with Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Dislocation with Genu Valgum

Jing¹,

Wang²,

Liu³

et al. 2020

Preprint

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Background: Medial patellofemoral ligament reconstruction (MPFLR) is a well-established procedure for addressing recurrent patellar dislocation (RPD) in young patients. However, for RPD with genu valgum, simultaneous MPFLR and closing-wedge distal femoral osteotomy (CWDFO) may be a promising procedure yet rarely reported. This study’s purpose was to observe and analyse the clinical and imaging findings of CWDFO combined with MPFLR for RPD with genu valgum.Methods: From May 2015 to Apirl 2018, 25 patients with RPD and genu valgum were surgically treated in our department. Anteroposterior long-leg, weight-bearing, lower-extremity radiographs, lateral radiographs and computed tomography (CT) scans of the patellofemoral joint were obtained, and the femorotibial angle (FTA), mechanical lateral distal femoral angle (mLDFA), weight-bearing line rate (WBLR), patellar height, patellar lateral shift (PLS) and tibial tubercle–trochlear groove (TT-TG) distance were analysed. Validated knee scores, such as the Kujala, Lysholm, visual analogue scale (VAS) scores and Tegner socres, were evaluated preoperatively and 2 years postoperatively.Results: 25 patients, with an average age of 19.8 years (14–27), were evaluated. All patients had been able to achieve a better sports level without any problems during the 2-year follow-up period. There has been no recurrence of patellar instability. Compared with preoperation, the FTA, mLDFA, WBLR and PLS showed statistically significant improvement following the procedure (p < 0.001). Meanwhile, no significant differences in the Insall index and TT-TG distance was found. The mean Kujala score, average Lysholm score, VAS score and Tegner socres showed significant improvement postoperatively.Conclusions: CWDFO combined with MPFLR is a suitable treatment for RPD with genu valgum, as it leads to significant improvement in the clinical and imaging findings of the knee in the short term.

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“…40 In more recent reports, the collagen matrix has been replaced with a hyaluronan-based scaffold with decreased pain and increased function reported at 4 and 5 years of follow-up. 41 Augmentation of scaffold and allografts for cartilage repair with BMC has limited, but promising results. In patients treated with a polylactide-coglycolide copolymer augmented with BMC or PRP, the BMC group had improved cartilage maturation with greater fill and MRI T2 values closer to that of normal cartilage at 12 months compared with scaffold alone or scaffold with PRP.…”

Section: Clinical Use Of Bmcmentioning

confidence: 99%

Biological Effects of Bone Marrow Concentrate in Knee Pathologies

et al. 2018

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With our aging population desiring to remain active, the incidence and costs associated with managing knee pain from both acute injury and symptomatic knee osteoarthritis continue to dramatically increase. Current treatment methods fall short with respect to their ability to improve the intra-articular environment and restore normal joint homeostasis. With increasing basic science and clinical evidence showing efficacy, cell-based therapies such as bone marrow concentrate (BMC) hold promise as a nonsurgical joint preserving treatment approach. BMC has inherent advantages over other treatments commonly used for various knee pathologies because it is a point-of-care orthobiologic product that uniquely and simultaneously delivers growth factors, anti-inflammatory proteins, and mesenchymal stem cells. There is increasing evidence for the use of BMC for repair of focal cartilage defects and for the treatment of generalized knee pain. However, continued high-quality studies are necessary for the clinical utility of BMC to be critically assessed with particular attention paid to appropriate patient selection, standardized aspiration, and processing and reporting of both functional and imaging-based outcomes.

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Patellar tracking after isolated medial patellofemoral ligament reconstruction: dynamic evaluation using computed tomography

Abstract: IV.

Cited by 40 publications

References 45 publications

Dynamic Evaluation of Patellofemoral Instability: A Clinical Reality or Just a Research Field? A Literature review

Dynamic Evaluation of Patellofemoral Instability: A Clinical Reality or Just a Research Field? A Literature review

Closing-wedge Distal Femoral Osteotomy Combined with Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Dislocation with Genu Valgum

Biological Effects of Bone Marrow Concentrate in Knee Pathologies

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