Ultrasound Detection of Patellar Fracture and Evaluation of the Knee Extensor Mechanism in the Emergency Department

Carter, Kiersten; Nesper, A.; Gharahbaghian, Laleh; Perera, Phillips

doi:10.5811/westjem.2016.8.31051

Cited by 11 publications

(3 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Using a high-frequency linear transducer, a patella fracture can be identified as a disturbance in what would usually be a continuous bright line at the meeting point of the bone and soft tissue. A fracture can also be identified with POCUS as a hypoechoic collection, which is often indicative of a hematoma in the fracture space (Carter et al, 2016). Finally, ultrasound identification of lipohemarthrosis (synovial effusion with an echogenic layer of fat above the hypo/anechoic fluid [i.e.…”

Section: )mentioning

confidence: 99%

Patella Fracture Identified Using Point-of-care Ultrasound

et al. 2021

View full text Add to dashboard Cite

A 49-year-old female fell from standing. Her right knee extended into the air. She had acute right knee pain preventing weight-bearing. Her knee was most comfortable fully-extended. She could not flex it due to pain, nor extend it against resistance. Tenderness and a horizontal defect were noted over the anterior knee. Bedside ultrasound demonstrated a horizontally-fractured patella (confirmed on X-ray) with intact femoral and patellar tendons. She was put in a knee immobilizer and underwent surgery, with return to full function and activities. Ultrasound can identify patella fractures and help with early evaluation, management, and specialty referral, as well as ordering more-focused imaging. In one study, POCUS (point-of-care ultrasound) for patella fracture had 95% sensitivity, 63% specificity, 86% positive predictive value, and 83% negative predictive value. The dynamic nature of ultrasound allows a ruptured patella (87% sensitivity) or quadriceps tendon (100% sensitivity) to be excluded with high certainty.

show abstract

Section: )mentioning

confidence: 99%

Patella Fracture Identified Using Point-of-care Ultrasound

et al. 2021

View full text Add to dashboard Cite

show abstract

“…10 Ultrasound has also been found to be accurate and reliable when investigating patellar abnormalities 13 and diagnosing fractures. 14,15 Previous real time US studies on asymptomatic subjects have shown that 20° hip adduction results in lateral displacement of the patella, compared to the neutral position. 9,12 Although the results in these studies were statistically significant, the validity of the US method in assessing patellar position in relation to hip adduction was not reported.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Measurement of Lateral Patellar Displacement: A Cadaveric Validation Study

Kwan

Killingback

Adds³

2022

International Journal of Sports Physical Therapy

View full text Add to dashboard Cite

Background Patellofemoral pain syndrome (PFPS) is one of the most common musculoskeletal complaints seen in outpatient settings. It has been suggested that hip adduction creates loads on the iliotibial band and causes lateral displacement of the patella (patellar tilt), which can lead to uneven patellofemoral joint loading, and hence, cause patellofemoral pain. In previous studies in the literature, ultrasound has been used to measure lateral patellar displacement. However, the method lacks validity data. Purpose/Hypothesis The aim of this study was to validate the use of ultrasound to measure lateral displacement of the patella, by comparing the position of the patella as measured first by ultrasound, and then by direct measurement. Study Design Descriptive Laboratory Study. Methods Nine soft-fixed cadavers were used in this study. The cadavers had been donated for anatomical examination and research under the Human Tissue Act (2004). The distance between the lateral femoral condyle and the lateral edge of the patella were measured by B-mode real-time ultrasound, and then by direct measurement, in two positions, neutral and at 20° hip adduction. Results The mean difference in the patella-to-lateral femoral condyle distance in the neutral position and at 20° adduction was 0.27 cm (ultrasound), and 0.34 cm (direct measurement), respectively. There were no significant differences between the measurements obtained by US and by direct measurement (Pearson correlation= 0.97, p=0.83). Conclusion Ultrasound is a valid and reliable method for measuring patellar position relative to the femoral condyle, and the validity data reported here suggest that it can be used with confidence in clinic to assess lateral patellar displacement. Level of Evidence 3

show abstract

“…The initial management of patellofemoral instability includes physiotherapy and activity therapies, which include: patient education, muscle strength and conditioning, proprioception exercises, lateral releases/ iliotibial band stretches and patellar taping, although there is a lack of quality studies in the literature comparing treatment options [10,14]. The role of surgery in patellofemoral instability is controversial and varies according to the surgeon and center, but the decision is influenced, in a significant part of the surgeries, by the failure of conservative management and clinical or radiological evidence of structural abnormality (lateral tightness, increased Q angle, medial patellofemoral ligament rupture or bone dysplasia) [15,16]. Surgical treatment plays an important role especially for the recurrent dislocator, because of the natural history of the condition and the relatively poor return to normal function.…”

Section: Introductionmentioning

confidence: 99%

Functional outcome and prognostic implications in patellofemoral instability using Elmslie-Trillat and MPFL reconstruction procedures

Iacobescu

Cîrstoiu

Cursaru

et al. 2019

Romanian Journal of Orthopaedic Surgery and Traumatology

View full text Add to dashboard Cite

Introduction. Patellofemoral instability is a troublesome condition that results in significant morbidity, frequently associated with persistent anterior knee pain, long-term osteoarthritis and reduced quality of life.Purpose. The purpose of this study was to describe functional outcomes following surgical treatment of patients who underwent Elmslie-Trillat procedure and reconstruction of medial patellofemoral ligament (MPFL) correlated with Elmslie-Trillat in the treatment of recurrent patellar dislocation and subluxation.Methods. We prospectively followed 23 patients (24 knees) with patellofemoral instability who underwent realignment surgery procedures between 2015 and 2017, 14 knees by the Elmslie-Trillat procedure (Group 1) and 10 knees by Elmslie-Trillat combined with MPFL reconstruction (Group 2). The patients were evaluated pre and postoperatively by clinical examination, knee radiographs, CT scans and functional outcome Kujala score.Results. At a follow up period of 2 years, the apprehension sign remained positive in 6 knees in Group 1, and only one in Group 2. On the skyline radiographs and axial CT scans, stability was significantly better in group 2 than in group 1. The mean Kujala score was 65.2+/ -9.39 points in group 1, and 87.1+/ -6.43 points in group 2, at 2 years evaluation, significantly higher than before surgery. No patient developed osteoarthritis while being followed up.Conclusion. Based on these findings, we were able to conclude that the reconstruction of the MPFL combined with the osteotomy of distal tuberosity is a useful treatment of recurrent patellar dislocation and subluxation. However, further studies are needed to assess the impact of the realignment procedures in the prevention of joint degeneration.

show abstract

Ultrasound Detection of Patellar Fracture and Evaluation of the Knee Extensor Mechanism in the Emergency Department

Cited by 11 publications

References 12 publications

Patella Fracture Identified Using Point-of-care Ultrasound

Patella Fracture Identified Using Point-of-care Ultrasound

Ultrasound Measurement of Lateral Patellar Displacement: A Cadaveric Validation Study

Functional outcome and prognostic implications in patellofemoral instability using Elmslie-Trillat and MPFL reconstruction procedures

Contact Info

Product

Resources

About