Recurrent Patellar Instability: Implications of Preoperative Patellar Crepitation on the Status of the Patellofemoral Articular Cartilage

Luhmann, Scott J.; Smith, Joan; Schootman, Mario; Prasad, Nandan

doi:10.1097/bpo.0000000000001017

Cited by 10 publications

(5 citation statements)

References 14 publications

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“…Mankin's score was larger in the HS group versus the age-matched control group at Week 8 (5 [4.5-7.75] vs. 2.5 [1][2][3][4], p < 0.001), indicating that osteoarthritic changes occurred in the PF joint after 8 weeks of HS.…”

Section: Mankin's Scores Are Shown In Figurementioning

confidence: 93%

“…Patellar instability frequently presents during adolescence, and patellofemoral (PF) symptoms (e.g., pain and instability) are the prelude to a lifelong condition 1 . Luhmann et al reported that PF joint damage was present in 63% of knees treated for patellar instability 2 . In animal models, experimentally induced patellar instability resulted in dysplastic changes in the femoral trochlea 3–6 and arthritic changes in the PF joint 6 .…”

Section: Introductionmentioning

confidence: 99%

“…In addition, histological analysis was performed to determine whether osteoarthritic changes occur in unloaded PF joints. Our hypotheses were as follows: (1) hindlimb unloading alters femur geometry and induces knee joint instability characterized by PF joint malalignments; and (2) joint malalignment alters the intra-articular mechanical environment via patella maltracking, and osteoarthritic changes and synovial inflammation as an index of joint pain occur in the PF joint.…”

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confidence: 99%

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Development of patellofemoral osteoarthritis with knee joint malalignment and lateral patellar dislocation after hindlimb suspension in growing rats

Ozawa,

Ikeda,

Kanehara

et al. 2024

Journal Orthopaedic Research

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Knee malalignment is a risk factor for patellar instability and patellofemoral osteoarthritis (PFOA), but etiologies remain unknown. We investigated the potential effects of decreased weight loading during growth on knee alignments and patellofemoral (PF) joint pathology. Hindlimb suspension (HS) was performed in 4‐week‐old female rats for 2, 4, and 8 weeks (HS groups). Age‐matched rats were used as controls. Three‐dimensional reconstructed images of the knee were obtained using X‐ray computed tomography. Tibial tubercle–trochlear groove (TT–TG) distance, patellar tilt angle, and bisect offset were measured as indices of knee alignment. Histological analysis was also performed to evaluate the changes in cartilage and synovium in the PF joints. At Week 8, TT–TG distance, patella tilt angle, and bisect offset were significantly larger in the HS group than in the control group, respectively, indicating tibial external rotation, outward patellar tilt, and external displacement of the patella. Lateral patellar dislocation was frequently found in the HS group at Week 8 (five of eight knee joints, p < 0.05). Degenerative changes in the cartilage of the trochlear groove were observed at Week 8, and synovial changes such as hypertrophy and synovitis were observed at Weeks 4 and 8. Correlation analyses revealed significant relationships between the Mankin score and bisect offset, and between the OARSI synovitis score and all knee alignments indices. These results suggest that decreased weight loading on the lower extremities in growing rats resulted in knee malalignments characterized by external rotation of tibia and high incidence of lateral patellar dislocation with concomitant PFOA.

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Section: Mankin's Scores Are Shown In Figurementioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Development of patellofemoral osteoarthritis with knee joint malalignment and lateral patellar dislocation after hindlimb suspension in growing rats

Ozawa,

Ikeda,

Kanehara

et al. 2024

Journal Orthopaedic Research

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“…Krepitation Krepitationsphänomene im femoropatellaren Gleitlager sind bei Patienten mit vorderem Knieschmerz häufig nachweisbar und können auf eine Chondropathie bzw. auf eine Synovialitis hindeuten [11,12].…”

Section: Sonstige Klinische Untersuchungenunclassified

Behandlung der Patellainstabilität

Kolb¹,

Willegger²,

Chiari³

et al. 2021

Z Orthop Unfall

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Die Patellainstabilität ist für die PatientenInnen eine belastende Erkrankung mit einer in der orthopädischen Praxis häufig auftretenden Problemstellung. Die Anomalien des patellofemoralen Gelenks, die die Stabilität des Kniescheibenlaufs beeinträchtigen können, sind vielfältig, sodass für eine erfolgreiche Therapie eine strukturierte Analyse essenziell ist. Dieser Beitrag zeigt den Aufbau einer differenzierten Diagnostik und Therapie sowie Beispiele aus der Praxis.

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“… 12 , 13 , 14 However, the incidence of articular cartilage disease after initial and recurrent patellar dislocation remains poorly understood, and there is a paucity of literature comparing the extent of cartilage damage between first-time and recurrent dislocations. 1 , 7 , 15 , 16 , 17 , 18 , 19 , 20 , 21 …”

mentioning

confidence: 99%

Patients With First-Time or Recurrent Patellar Dislocation Have a Similar High Rate and Extent of Articular Cartilage Injury Observed on Magnetic Resonance Imaging

Perez,

Coladonato,

Sonnier

et al. 2024

Arthroscopy, Sports Medicine, and Rehabilitation

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Recurrent Patellar Instability: Implications of Preoperative Patellar Crepitation on the Status of the Patellofemoral Articular Cartilage

Abstract: Level IV.

Cited by 10 publications

References 14 publications

Development of patellofemoral osteoarthritis with knee joint malalignment and lateral patellar dislocation after hindlimb suspension in growing rats

Development of patellofemoral osteoarthritis with knee joint malalignment and lateral patellar dislocation after hindlimb suspension in growing rats

Behandlung der Patellainstabilität

Patients With First-Time or Recurrent Patellar Dislocation Have a Similar High Rate and Extent of Articular Cartilage Injury Observed on Magnetic Resonance Imaging

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