Effects of Rotation and Osteotomy Angulation on Patellar Tendon Insertion Position during Circular Tibial Tuberosity Osteotomy

2012 ◽  
Vol 42 (1) ◽  
pp. 51-59 ◽  
Author(s):  
Gian Luca Rovesti ◽  
Nikola Katic ◽  
Boris Dalpozzo ◽  
Francesco Dondi ◽  
Gilles Dupré
Keyword(s):  
Patellar Tendon ◽  
Tibial Tuberosity ◽  
Effects Of Rotation ◽  
Tendon Insertion

scholarly journals Mechanical resistance of the modified stabilization method for the tibial tuberosity advancement technique: ex vivo experimental study in dogs

2008 ◽  
Vol 39 (2) ◽  
pp. 467-472 ◽  
Author(s):  
Bruno Testoni Lins ◽  
Sheila Canevese Rahal ◽  
Mário Jefferson Louzada ◽  
José Carlos Dalmas ◽  
André Luis Selmi
Keyword(s):  
Patellar Tendon ◽  
Ex Vivo ◽  
Test Group ◽  
Tibial Tuberosity ◽  
Osteotomy Site ◽  
Mechanical Resistance ◽  
Stabilization Method ◽  
Titanium Cage ◽  
Hind Limbs ◽  
Tendon Insertion

The present study aimed to evaluate a modification of the stabilization method of the tibial tuberosity advancement technique (TTA), originally described for stabilization of the cranial cruciate deficient stifle. Ten adult mongrel dogs with weights ranging from 25 to 30kg were used. After euthanasia, the hind-limbs were divided into two groups: G1 - test (n=10), and G2 - control (n=10) represented by the contra lateral limb. The test group was submitted to the modified TTA technique, stabilized by one shaft screw in craniocaudal position and a titanium cage inserted at the osteotomy site. The position of the patellar tendon, 90° in relation to the tibial plateau, and the correct position of all implants were confirmed radiographically after surgery. Posteriorly, in both groups, limbs were harvested and tibias collected with their respectively patellar tendon insertion preserved for the mechanical resistance test. The fixation of the tibial tuberosity with a shaft screw and titanium cage resulted in resistance compatible with the normal physiological forces transferred to the hind-limbs during locomotion. The biomechanical tests confirmed the viability of the method performed for the tibial tuberosity fixation and support future clinical trials to validate the technique.

Restoration of tensile properties at tendon insertion to bone by a patellar tendon-tibia autograft: An experimental study with canine infraspinatus

1999 ◽  
Vol 8 (6) ◽  
pp. 628-633 ◽  
Author(s):  
Mitsuhiro Aoki ◽  
Ei-ichi Uchiyama ◽  
Kozo Ohtera ◽  
Sei-ichi Ishii ◽  
Sei-ii Ohtani ◽  
...  
Keyword(s):  
Experimental Study ◽  
Tensile Properties ◽  
Patellar Tendon ◽  
Tendon Insertion

scholarly journals A Knee Size-Independent Parameter for Malalignment of the Distal Patellofemoral Joint in Children

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Ferdinand Wagner ◽  
Günther Maderbacher ◽  
Jan Matussek ◽  
Boris M. Holzapfel ◽  
Birgit Kammer ◽  
...  
Keyword(s):  
Patellar Tendon ◽  
Patellofemoral Joint ◽  
Cruciate Ligament ◽  
Independent Parameter ◽  
Common Finding ◽  
Tibial Tubercle ◽  
Control Group ◽  
Study Cohort ◽  
Tendon Insertion ◽  
Knee Size

Introduction. Patellar instability (PI) is a common finding in children. Current parameters describing patellofemoral joint alignment do not account for knee size. Additionally, most parameters utilize joint-crossing tibiofemoral landmarks and are prone to errors. The aim of the present study was to develop a knee size-independent parameter that is suitable for pediatric or small knees and determines the malpositioning of the distal patellar tendon insertion solely utilizing tibial landmarks. Methods. Sixty-one pediatric knees were included in the study. The tibial tubercle posterior cruciate ligament distance (TTPCL) was measured via magnetic resonance imaging (MRI). The tibial head diameter (THD) was utilized as a parameter for knee size. An index was calculated for the TTPCL and THD (TTPCL/THD). One-hundred adult knees were analyzed to correlate the data with a normalized cohort. Results. The THD was significantly lower in healthy females than in males (69.3 mm ± 0.8 mm vs. 79.1 mm ± 0.7 mm; p<0.001) and therefore was chosen to serve as a knee size parameter. However, no gender differences were found for the TTPCL/THD index in the healthy adult study cohort. The TTPCL/THD was significantly higher in adult PI patients than in the control group (0.301 ± 0.007 vs. 0.270 ± 0.007; p=0.005). This finding was repeated in the PI group when the pediatric cohort was analyzed (0.316 ± 0.008 vs. 0.288 ± 0.010; p=0.033). Conclusion. The TTPCL/THD index represents a novel knee size-independent measure describing malpositioning of the distal patellar tendon insertion determined solely by tibial landmarks.

scholarly journals Bifocal Disruption of the Patellar Tendon with Avulsion of the Tibial Tuberosity: A Case Report

2020 ◽  
Vol 14 (1) ◽  
pp. 120-124
Author(s):  
Takuya Sekiguchi ◽  
Yoshihiro Hagiwara ◽  
Masahito Honda ◽  
Eiji Itoi
Keyword(s):  
Case Report ◽  
Patellar Tendon ◽  
Fibrous Tissue ◽  
Knee Extensor ◽  
Superficial Layer ◽  
Left Knee ◽  
Tibial Tuberosity ◽  
First Case ◽  
Deep Layers ◽  
The Right

Introduction: Bifocal disruption of the knee extensor system is rare. Coincident bifocal proximal and distal disruptions of the patellar tendon are extremely rare in adults. Case Report: A 38-year-old man presented to our clinic with severe right knee pain after falling down the stairs and abruptly bending the right knee. Plain radiographs of this knee showed tibial avulsion and a high riding patella, suggesting underlying Osgood-Schlatter disease, which was also present to a milder degree in the left knee. Magnetic resonance imaging confirmed an avulsion of the tibial tuberosity and showed concomitant avulsion of the patellar tendon without bone marrow edema. Computed tomography showed that the fragment of the tibial tuberosity had a dull-edged margin, and cortical bones were partially exposed. During surgery, the patellar tendon was divided into superficial and deep layers. The superficial layer was peeled from an attachment at the patella, while the deep layer was from the tibia and contained the fragment of the tibial tuberosity. The detached side of the fragment and tibia were coated with dense, fibrous tissue. Surgical repair was performed, with excellent outcomes. Radiographic and intraoperative findings suggested Osgood-Schlatter disease, which might cause avulsion of the tibial tuberosity. Conclusion: This is the first case of the bifocal proximal and distal rupture of the patellar tendon with the avulsion of the tibial tuberosity. Bifocal disruption of the patellar tendon should be considered in patients presenting with avulsion of the tibial tuberosity and suspected Osgood-Schlatter disease.

scholarly journals The Relationship Between Physical Examination and Ultrasonography of Large Entheses of the Achilles Tendon and Patellar Tendon Origin

2019 ◽  
Vol 47 (7) ◽  
pp. 1026-1030 ◽  
Author(s):  
Sibel Zehra Aydin ◽  
Sibel Bakirci ◽  
Esen Kasapoglu ◽  
Concepcion Castillo-Gallego ◽  
Fatıma Arslan Alhussain ◽  
...  
Keyword(s):  
Physical Examination ◽  
Achilles Tendon ◽  
Patellar Tendon ◽  
Anatomical Site ◽  
Plantar Aponeurosis ◽  
The Us ◽  
Doppler Signals ◽  
Us Findings ◽  
Tendon Insertion ◽  
The Relationship

Objective.To investigate the relationship between physical examination (PE) and sonographic features of enthesitis, based on anatomical sites.Methods.The analysis was done using merged raw data of 3 studies on 2298 entheses.Results.Patients with clinical Achilles enthesitis had more abnormalities on ultrasound (US): hypoechogenicity, p < 0.001; thickening, p = 0.001; Doppler signals, p = 0.002; and erosions, p = 0.02. The patellar tendon origin also correlated with PE but distal patellar tendon insertion and plantar aponeurosis were uncoupled from the US.Conclusion.The relationship between clinical and sonographic findings for large entheses is dependent on the anatomical site. For the patellar tendon origin and Achilles entheses, PE is significantly linked to US findings.

scholarly journals Augmentation of ruptured tendon using fresh frozen Achilles tendon allograft in two dogs: a case report

2013 ◽  
Vol 58 (No. 1) ◽  
pp. 50-55
Author(s):  
MR Alam ◽  
WJ Gordon ◽  
SY Heo ◽  
KC Lee ◽  
NS Kim ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Patellar Tendon ◽  
Weight Bearing ◽  
Clinical Signs ◽  
Tibial Tuberosity ◽  
Tendon Allograft ◽  
Fresh Frozen ◽  
The Right ◽  
Suture Failure ◽  
Achilles Tendon Allograft

This article describes two cases of augmentation of ruptured tendon with fresh frozen Achilles tendon allograft (FFATA) in dogs. Case 1 was a two-year-old crossbreed dog (29 kg) that presented with an open wound on the right forelimb and with complete rupture of the flexor carpi ulnaris and superficial digital flexor tendons. Case 2 was a four-year-old crossbreed dog (4 kg) with partial ruptures of the patellar tendon and detachment of the tibial tuberosity in the right hind limb. In both cases, the ends of the ruptured tendon were sutured and apposed after debridement. To minimize suture failure, FFATA (cut to sufficient size) was placed across the primary suture with tension and sutured to the host tendon. In addition, Case 2 received a Krackow suture through a transverse bone tunnel made in the tibia to fix the patellar tendon along with the tibial tuberosity in situ. The surgical areas healed without any evidence of exaggerated inflammatory response or clinical signs consistent with rejection of the allograft. Both the dogs had normal ambulation and weight bearing on the affected limb 12 weeks postoperatively. No postoperative complications were observed during a one-year follow up period except for slight contracture of the carpus and digits of the affected limb in Case 1. Thus, ruptured tendons can be successfully repaired using suture and augmentation with FFCTA. Augmentation with FFATA may provide additional stability, which counters tension on the primary repair and reduces the chance of gap formation or suture failure in case of reconstruction of the damaged tendon in dogs. &nbsp;

scholarly journals INCREASED LIKELIHOOD OF PEDIATRIC RECURRENT PATELLAR DISLOCATIONS BASED ON SEVERITY OF RADIOGRAPHIC MEASURES

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0004
Author(s):  
William Albiero ◽  
Melanie A. Morscher ◽  
John Elias ◽  
Pat Riley ◽  
Mark Adamczyk ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Patellar Tendon ◽  
Logistic Regression Analysis ◽  
Odds Ratio ◽  
Pediatric Patients ◽  
Trochlear Dysplasia ◽  
Tibial Tuberosity ◽  
Control Group ◽  
Trochlear Groove

Background: The etiology for recurrent patellar dislocations in children with patellofemoral instability (PFI) is not always apparent. Radiographic and other imaging measures help guide the clinician. However, the imaging parameters for pathologic pediatric PFI and the significance of these measures based on severity are not clearly defined. This study compares common imaging measures for PFI in a non-pathologic and known patellar dislocation pediatric population and determines the likelihood of symptoms based on the severity of each individual measure. Methods: An IRB-approved retrospective review of knee MRIs and radiographs at a single pediatric institution identified 108 limbs (102 patients) meeting inclusion criteria. Sixty-nine limbs had no known patellar pathology (control group) and 39 had surgery for recurrent patellar dislocations (surgical group). MRI measures included tibial tuberosity-trochlear groove distance (TT-TG), tibial tuberosity-posterior cruciate ligament distance (TT-PCL), and lateral trochlear inclination (LTI). Radiographic measures included the Caton-Deschamps Index (CDI) and Insall-Salvati Index (ISI). These measures are representative of PFI risk factors, specifically patellar tendon malalignment, trochlear dysplasia, and patella alta. Binomial logistic regression was used to relate the anatomical parameters to the probability of PFI. Results: The surgical and control groups were similar in terms of age, height and weight. The logistic regression analysis indicated that the TT-TG (p=0.001) and LTI (p<0.001) were correlated with PFI. The odds ratio (95% confidence interval) was 1.19 (1.07 -1.31) for TT-TG, giving the increased probability of a knee to experience PFI for each 1 mm increase. The odds ratio was 0.85 (0.77-0.93) for LTI, showing a decrease in the probability of instability with each 1° increase. Neither CDI nor ISI measures significantly correlated with probability of PFI (p=0.30 and p=0.18, respectively). The two parameters of TT-TG and LTI accounted for 42% (Nagelkerke R2) of the variance between the control and surgical groups. Conclusion/Significance: Comparing pediatric patients with recurrent patellar dislocations to controls, logistic regression analysis suggests the likelihood of PFI correlates with the severity of specific radiographic measures, specifically those representing the degree of patellar tendon alignment (TT-TG) and trochlear dysplasia (LTI). Knowing this correlation can help guide the treatment of PFI in pediatric patients by providing physicians and families with a continuum on which to base their decisions.

scholarly journals Patellar Tendon Avulsion with Tibial Tuberosity Sleeve Fragment

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Akira Isaka ◽  
Satoshi Ichihara ◽  
Yasuhiro Homma ◽  
Tomohiko Hirose ◽  
Hajime Kajihara
Keyword(s):  
Pediatric Patient ◽  
Patellar Tendon ◽  
Suture Anchor ◽  
Optimal Treatment ◽  
Tibial Tuberosity ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Patient Diagnosis ◽  
Tendon Avulsion

Rupture of the patellar tendon is relatively rare. We report a case of patellar tendon avulsion with a tibial tuberosity sleeve fragment in pediatric patient. In pediatric patient, diagnosis is sometimes difficult due to uncompleted ossification. In the present case, which involved the presence of a small fleck of bone from tibia, we were able to attain a diagnosis using the Koshino-Sugimoto index and MRI and easily determine the optimal treatment with the use of the suture anchor and tension band wiring method.

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