scholarly journals The morphology of patella changed significantly after soft tissue correction for children with recurrent patella dislocation

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Jinghui Niu ◽  
Qi Qi ◽  
Kuo Hao ◽  
Wei Lin ◽  
Kang Piao ◽  
...  
Keyword(s):  
Patellar Dislocation ◽  
Patella Dislocation ◽  
Transverse Diameter ◽  
Recurrent Patellar Dislocation ◽  
Unaffected Side ◽  
Femoral Trochlea ◽  
Affected Side ◽  
Wiberg Index ◽  
Patellar Morphology

Abstract Background Although morphological improvement of femoral trochlea has been investigated in children with patellar dislocation after surgery, whether the patellar shape changed under the same condition is still unknown. The purpose of the study was to investigate the changes of patellar morphology in transverse plane following surgical correction of recurrent patellar dislocation in children. Methods A total of 22 patients with a mean age of 9.9 years (7 to 12) were included. All had unilateral recurrent patellar dislocation. The knees with recurrent patellar dislocation were treated with medial patellar retinaculum plasty and defined as the affected side. The contralateral knees with no symptom of patellar instability were considered as the unaffected side. All patients were treated between October 2014 and August 2018. Axial CT (Computed Tomography) scans were undertaken in all patients to assess the patella morphological characteristics on a particular axial image preoperatively and at the final follow-up. Results There were not significant differences about patellar transverse diameter, thickness and Wiberg angle between affected side and unaffected side before surgery and at the last follow-up respectively (The mean follow-up period: 28.0 ± 3.3 months). However, before surgery, the Wiberg-index in the affected side (0.74 ± 0.06) was significantly different from that in the unaffected side (0.64 ± 0.04). At the last follow-up, the Wiberg-index in the affected side (0.67 ± 0.05) and the unaffected side (0.65 ± 0.04) were not significantly different. Also, in the affected side, the Wiberg-index at the last follow-up was significantly lower than that before surgery (P < 0.05). The Wiberg-index in the unaffected side was not significantly different before surgery and at the last follow-up. Conclusion The patellar morphology can change significantly after surgical procedures in children with patellar recurrent dislocation whose epiphysis is not closed.

scholarly journals The Morphology of Patella changed significantly after Soft Tissue Correction for children with Recurrent Patella Dislocation

2020 ◽  
Author(s):  
Jinghui Niu ◽  
Qi Qi ◽  
Kuo Hao ◽  
Wei Lin ◽  
Kang Piao ◽  
...  
Keyword(s):  
Patellar Dislocation ◽  
Patella Dislocation ◽  
Transverse Diameter ◽  
Recurrent Patellar Dislocation ◽  
Unaffected Side ◽  
Femoral Trochlea ◽  
Affected Side ◽  
Wiberg Index ◽  
Patellar Morphology

Abstract Background: Although morphological improvement of femoral trochlea has been investigated in children with patellar dislocation after surgery, whether the patellar shape changed under the same condition is still unknown. The purpose of the study was to investigate the changes of patellar morphology in transverse plane following surgical correction of recurrent patella dislocation in children.Methods: A total of 22 patients with a mean age of 9.9 years (7 to 12) were included. All had unilateral recurrent patellar dislocation. The knees with recurrent patellar dislocation were treated with medial patellar retinaculum plasty and defined as the affected side. The contralateral knees with no symptom of patellar instability were considered as the unaffected side. All patients were treated between October 2014 and August 2018. Axial CT (Computed Tomography) scans were undertaken in all patients to assess the patella morphological characteristics on a particular axial image preoperatively and at the final follow-up.Results: There were not significant differences about patellar transverse diameter, thickness and Wiberg angle between affected side and unaffected side before surgery and at the last follow-up respectively ( The mean follow-up period: 28.0 ± 3.3 months). However, before surgery, the Wiberg-index in the affected side (0.74 ± 0.06) was significantly different from that in the unaffected side (0.64 ± 0.04). At the last follow-up, the Wiberg-index in the affected side (0.67 ± 0.05) and the unaffected side (0.65 ± 0.04) were not significantly different. Also, in the affected side, the Wiberg-index at the last follow-up was significantly lower than that before surgery (P < 0.05). The Wiberg-index in the unaffected side was not significantly different before surgery and at the last follow-up. Conclusion: The patellar morphology can change significantly after surgical procedures in children with patellar recurrent dislocation whose epiphysis is not closed.

scholarly journals The Morphology of Patella changed significantly after Soft Tissue Correction for children with Recurrent Patella Dislocation

2020 ◽  
Author(s):  
Jinghui Niu ◽  
Qi Qi ◽  
Kuo Hao ◽  
Wei Lin ◽  
Kang Piao ◽  
...  
Keyword(s):  
Patellar Dislocation ◽  
Morphological Characteristics ◽  
Recurrent Dislocation ◽  
Patella Dislocation ◽  
Transverse Diameter ◽  
Unaffected Side ◽  
Femoral Trochlea ◽  
Affected Side ◽  
Wiberg Index

Abstract Background: Although morphological improvement of femoral trochlea has been investigated in children with patellar dislocation after surgery, whether the patellar shape changed under the same condition is still unknown. The purpose of the study was to investigate the changes of patella morphology in transverse plane following surgical correction of recurrent patella dislocation in children.Methods: A total of 22 patients with a mean age of 9.9 years (7 to 12) were included. All had unilateral recurrent patella dislocation. The knees with recurrent patellar dislocation were treated with medial patellar retinaculum plasty and defined as the affected side. The contralateral knees with no symptom of patellar instability were considered as the unaffected side. All patients were treated between October 2014 and August 2018. Axial CT (Computed Tomography) scans were undertaken in all patients to assess the patella morphological characteristics on a particular axial image preoperatively and at the final follow-up.Results: There were not significant differences about patellar transverse diameter, thickness and Wiberg angle between affected side and unaffected side before surgery and at the last follow-up respectively ( The mean follow-up period: 28.0 ± 3.3 months). However, before surgery, the Wiberg-index in the affected side (0.74 ± 0.06) was significantly different from that in the unaffected side (0.64 ± 0.04). At the last follow-up, the Wiberg-index in the affected side (0.67 ± 0.05) and the unaffected side (0.65 ± 0.04) were not significantly different. Also, in the affected side, the Wiberg-index at the last follow-up was significantly lower than that before surgery (P < 0.05). The Wiberg-index in the unaffected side was not significantly different before surgery and at the last follow-up. Conclusion: The patella morphology can change significantly after surgical procedures in children with patellar recurrent dislocation whose epiphysis is not closed.

scholarly journals The Morphology of Patella changed significantly after Soft Tissue Correction for children with Recurrent Patella Dislocation

2020 ◽  
Author(s):  
Jinghui Niu ◽  
Qi Qi ◽  
Kuo Hao ◽  
Wei Lin ◽  
Kang Piao ◽  
...  
Keyword(s):  
Morphological Characteristics ◽  
Recurrent Dislocation ◽  
Patella Dislocation ◽  
Control Group ◽  
Transverse Diameter ◽  
Study Group ◽  
Femoral Trochlea ◽  
Wiberg Index ◽  
And Control

Abstract Background: Although morphological improvement of femoral trochlea has been investigated in children with patella dislocation after surgery, whether the patellar shape changed under the same condition is still unknown. The purpose of the study was to investigate the changes of patella morphology in transverse plane following surgical correction of recurrent patella dislocation in children.Methods: A total of 22 patients with a mean age of 9.9 years (7 to 12) were included. All had unilateral recurrent patella dislocation. The knees with recurrent patella dislocation were treated with medial patellar retinaculum plasty and defined as the study group. The contralateral knees with no symptom of patellar instability were considered as the control group. All patients were treated between October 2014 and August 2018. Axial CT (Computed Tomography) scans were undertaken in all patients to assess the patella morphological characteristics on a particular axial image preoperatively and at the final follow-up.Results: There are not significant differences about patellar transverse diameter, thickness and Wiberg angle between study group and control group before surgery and at the last follow-up respectively ( The mean follow-up period: 28.0 ± 3.3 months). However, before surgery, the Wiberg-index in the study group (0.74 ± 0.06) is significantly different from that in the control group (0.64 ± 0.04). At the last follow-up, the Wiberg-index in the study group (0.67 ± 0.05) and the control group (0.65 ± 0.04) are not significantly different. Also, in the study group, the Wiberg-index at the last follow-up is significantly lower than that before surgery (P ＜ 0.05). The Wiberg-index in the control group is not significantly different before surgery and at the last follow-up. Conclusion: The patella morphology can change significantly after surgical procedures in children (before epiphyseal closure) with patellar recurrent dislocation

Changes in Patellar Morphology Following Soft Tissue Surgical Correction of Recurrent Patellar Dislocation in Children With Low-grade Trochlear Dysplasia

2021 ◽  
Author(s):  
Conglei Dong ◽  
Yanyang Wang ◽  
Chao Zhao ◽  
Jinghui Niu ◽  
Wei lin ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Patellar Dislocation ◽  
Trochlear Dysplasia ◽  
Morphological Characteristics ◽  
Surgical Correction ◽  
Low Grade ◽  
Recurrent Patellar Dislocation ◽  
The Mean ◽  
Patellar Morphology

Abstract Purpose: Studies indicated that patellofemoral joint dysplasia could be caused by patellar dislocation. The purpose of the study was to investigate the changes in patellar morphology following soft tissue surgical correction of recurrent patellar dislocation in children with low-grade trochlear dysplasia.Methods: The prospective study was performed between November 2007 and December 2012. Finally, 25 cases, with the mean age of 8.4 years (range from 7 to 10 years), were admitted to our study. All patients were diagnosed as bilateral recurrent patellar dislocation associated with femoral trochlear dysplasia. The knee that had suffered an injury or dislocated most frequently was treated with medial patellar retinacular plasty (Group S). The contralateral knee, which served as a control was treated conservatively (Group C). Axial CT scans were undertaken in all patients to assess the patellar morphological characteristics on a particular axial image which was established at the point with the greatest patellar width based on measurements preoperatively and at the final follow-up.Results: Preoperatively, there were no statistically significant differences between the patellar morphology in the two groups (P>0.05). Many radiological parameters of patellar morphology were significantly different between the two groups at the final follow-up, including well-known parameters, such as the mean patellar width (Group S, 40.58 mm (SD 1.26); Group C, 36.41 mm (SD 1.17); p < 0.001), the mean patellar thickness (Group S, 11.59 mm (SD 0.74); Group C, 9.38 mm (SD 0.56); p < 0.001) and the mean wiberg index (Group S, 0.54 (SD 0.06); Group C, 0.72 (SD 0.08); p < 0.001). Little known parameters such as the ratio of length of lateral patella to medial patella (Group S, 1.26 (SD 0.17); Group C, 1.69 (SD 0.21); p < 0.001), which is a measurement of facet asymmetry. However, the wiberg angle was not significantly different between the two groups (Group S, 128.63° (SD 9.05); Group C, 125.47° (SD 13.96); p > 0.05) at the final follow-up.Conclusions: The patellar morphology can be significantly improved by early (before epiphyseal closure) soft tissue surgical correction in children with patellar instability associated with low-grade femoral trochlear dysplasia (Dejour A and B).

scholarly journals Changes in patellar morphology following surgical correction of recurrent patellar dislocation in children

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Weifeng Li ◽  
Qian Wang ◽  
Hui Li ◽  
Shunyi Wang
Keyword(s):  
Patellar Dislocation ◽  
Morphological Characteristics ◽  
Surgical Correction ◽  
Ct Scans ◽  
Control Group ◽  
Recurrent Patellar Dislocation ◽  
Radiological Parameters ◽  
Significant Difference ◽  
Patellar Morphology

Abstract Background The aim of this study was to evaluate patellar morphological changes following surgical correction of recurrent patellar dislocation in children. Methods A total of 35 immature children aged 5 to 10 years who suffered from bilateral recurrent patellar dislocation associated with abnormal patella morphology were enrolled in this study. The knees with the most frequent dislocations (treated with medial patellar retinacular plasty) were selected as the study group (SG), and those undergoing conservative treatment for the contralateral knee were selected as the control group (CG). Computed tomography (CT) scans were performed on all children preoperatively and at the last follow-up to evaluate morphological characteristics of the patella. Results All the radiological parameters of the patella showed no significant difference between the two groups preoperatively. At the last follow-up for CT scans, no significant differences were found for the relative patellar width (SG, 54.61%; CG, 52.87%; P = 0.086) and the relative patellar thickness (SG, 26.07%; CG, 25.02%; P = 0.243). The radiological parameters including Wiberg angle (SG, 136.25°; CG, 122.65°; P < 0.001), modified Wiberg index (SG, 1.23; CG, 2.65; P < 0.001), and lateral patellar facet angle (SG, 23.35°; CG, 15.26°; P < 0.001) showed statistical differences between the two groups. Conclusions The patellar morphology can be improved by early surgical correction in children with recurrent patellar dislocation. Therefore, early intervention is of great importance for children diagnosed with recurrent patellar dislocation.

scholarly journals Clinical Outcomes After Medial Patellofemoral Ligament Reconstruction With Suture Fixation of the Gracilis Tendon via Transosseous Tunnels

2020 ◽  
Vol 8 (2) ◽  
pp. 232596711990037
Author(s):  
Hangzhou Zhang ◽  
Mao Ye ◽  
Qingwei Liang
Keyword(s):  
Patellar Dislocation ◽  
Medial Patellofemoral Ligament ◽  
Case Series ◽  
Mpfl Reconstruction ◽  
Suture Fixation ◽  
Recurrent Patellar Dislocation ◽  
Patellar Tilt ◽  
Transosseous Suture ◽  
Patellar Tilt Angle

Background: Several fixation methods have been introduced in medial patellofemoral ligament (MPFL) reconstruction. However, the optimal management of patients with recurrent patellar dislocation remains controversial. Purpose: To present a case series with a minimum 2-year follow-up of 29 patients with recurrent patellar dislocation who underwent a new transosseous suture fixation technique for MPFL reconstruction. Study Design: Case series; Level of evidence, 4. Methods: From January 2014 through February 2016, a total of 29 patients with recurrent patellar dislocation for which the MPFL was reconstructed with transosseous suture patellar fixation were studied. All patients were available for follow-up (mean, 37.52 months; range, 26-48 months). The patellar attachment was fixed by transosseous patellar sutures. The International Knee Documentation Committee (IKDC) subjective knee score, Kujala score, Tegner score, range of motion, congruence angle, patellar tilt angle, and complications were assessed both pre- and postoperatively. Results: No recurrent dislocation was observed in any of the 29 patients for a minimum of 2 years. All outcome scores improved significantly from preoperatively to postoperatively: the average IKDC subjective knee evaluation score from 53 to 87, Kujala from 54 to 90, Lysholm from 50 to 89, and Tegner from 3 to 5 ( P < .001 for all). The congruence angle significantly decreased from 22° preoperatively to –3° postoperatively, and the patellar tilt angle (Merchant) decreased from 23° preoperatively to 5° postoperatively ( P < .001 for both). In total, 25 patients (25/29; 86.21%) were completely pain-free when performing activities of daily living at the last follow-up, and 27 patients (93.1%) rated themselves as very satisfied or satisfied with the results. Conclusion: In patients with chronic recurrent patellar dislocation, transosseous patellar suture fixation for MPFL reconstruction can significantly improve patellar stability and achieve good results at short-term follow-up.

The 3-in-1 Procedure for Recurrent Dislocation of the Patella in Skeletally Immature Children and Adolescents

2009 ◽  
Vol 37 (9) ◽  
pp. 1814-1820 ◽  
Author(s):  
Francesco Oliva ◽  
Mario Ronga ◽  
Umile Giuseppe Longo ◽  
Vittorino Testa ◽  
Giovanni Capasso ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Patellar Dislocation ◽  
Case Series ◽  
Skeletal Maturation ◽  
Isokinetic Strength ◽  
Skeletally Immature ◽  
Recurrent Patellar Dislocation ◽  
Level Of Evidence ◽  
The Mean

Background Recurrent patellar dislocations are common injuries in children and adolescents. The subjective and functional results of soft tissue surgical management in a population that was skeletally immature at the time of surgery have not been reported. Hypothesis The 3-in-1 procedure is an effective treatment for recurrent patellar dislocation in skeletally immature patients. Study Design Case series; Level of evidence, 4. Methods Twenty-five skeletally immature patients (age at operation, 13.5 ± 3.8 years) who were practicing sports and suffering from recurrent unilateral patellar dislocation were included in the study and followed until skeletal maturation. Clinical evaluation included the modified Cincinnati rating system and the Kujala score, anthropometry, plain radiography, and isokinetic dynamometry. Results The average follow-up was 3.8 years (range, 2.5-6 years). The mean modified Cincinnati score increased from 51.7 ± 12.6 preoperatively to 94.3 ± 10.8 (P < .02), while the mean Kujala scores increased from 52.4 ± 12.7 preoperatively to 93.8 ± 14.2 (P < .02). The Insall-Salvati index remained essentially unchanged, being 1.04 ± 0.2 preoperatively and 1.02 ± 0.3 at latest follow-up. Significant differences were found between the operated and the contralateral limb in the various isokinetic strength variables at all angular velocities measured at the latest follow-up (.05 < P < .0042). Conclusion The 3-in-1 procedure is a safe, reliable management option for recurrent patellar dislocation in skeletally immature patients. Side-to-side differences in isokinetic strength and in anthropometric indices persist despite subjective success of the procedure.

scholarly journals Tratamiento quirúrgico de la luxación recidivante de rótula en el niño asociada a displasia patello-femoral./ Surgical treatment of recurrent patellar dislocation in children associated with patello-femoral dysplasia

2014 ◽  
Vol 14 (1) ◽  
pp. 117-128
Author(s):  
Enrique Vergara- amador ◽  
Ricardo Castro
Keyword(s):  
Down Syndrome ◽  
Patellar Dislocation ◽  
Trochlear Dysplasia ◽  
Recurrent Dislocation ◽  
Recurrent Patellar Dislocation ◽  
Femoral Trochlea ◽  
Small Series ◽  
Q Angle ◽  
Proximal Realignment

Objetivo:El objetivo del presente trabajo es mostrar los resultados en una serie cortade pacientes con inestabilidad patelo-femoral o luxación recurrente de rótula en niñosoperados con la técnica de realineamiento proximal. La inestabilidad patelo-femoralse define como una enfermedad en la cual no hay suficiente acople de la rótula con latróclea femoral durante el rango de movimiento de la rodilla. En niños esta inestabilidadpuede deberse a diversos factores anatómicos conduciendo a luxación recurrente dela rótula. Hay cirugías sobre la parte proximal o distal de la rótula.Materiales y mé-todos:tratamos una serie de 10 rodillas en 7 niños, con un realineamiento proximalde la rótula según la técnica de Insall.Resultados:se obtuvieron buenos resultadosen 8 rodillas, sin dolor, sin luxación ni inestabilidad residual, presentando buenaestabilidad y seguridad durante la marcha. Un paciente presento reluxación y otrocon Síndrome de Down, presento con el tiempo una subluxación.Conclusiones:Elrealineamiento proximal en esta serie muestra buenos resultados en pacientes quetenían poca displasia troclear y sin mucha alteración del ángulo Q. Es una técnicano muy usada, que tiene indicación en casos escogidos. Hoy en día con el conceptode la reconstrucción del ligamento patelo- femoral medial, este puede ser usado encombinación con las técnicas de realineamiento proximal. Hay que estar alerta conlos pacientes con síndromes que se acompañan de hiperlaxitud como el S. de Down. Objective: The aim of this paper is to show the results in a small series of patients withpatellofemoral instability or recurrent patellar dislocation in children operated with theproximal realignment technique. Materials and methods: It is a series of 10 knees in7 children, with proximal patela realignment patela using the Insall technique. The mostimportant role of the patela is to increase the quadriceps efficiency. The patelo -femoralinstability is defined as a condition in which there is insufficient coupling of the patelawith the femoral trochlea during the knee range of motion. In children this instabilitymay be due to various anatomical factors leading to recurrent dislocation of the patela.There are surgeries proximal o distal to the patela level. Results: Good results wereobtained on 8 knees, without pain, neither dislocation nor residual instability and havinggood stability and safety during the gait. One patient showed redislocation and anotherpatient with Down syndrome had a subluxation. Conclusions: proximal realignment inthis series shows good results in patients who had little trochlear dysplasia with mildalteration of the Q angle. It is a technique not widely used but has indicated in selectedcases. Today, the patelo - femoral medial ligament reconstruction, can be used incombination with proximal realignment techniques. Patients with collagen problemslike Marfan and Down syndrome usually have redislocation and require some otherprocedures for patelar stabilization.

scholarly journals Non-Anatomic Proximal Realignment for Recurrent Patellar Dislocation Does Not Sufficiently Prevent Redislocation

2012 ◽  
Vol 6 (1) ◽  
pp. 114-117 ◽  
Author(s):  
Turgay Efe ◽  
Julia Seibold ◽  
Markus Geßlein ◽  
Karl Schüttler ◽  
Jan Schmitt ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Patellar Dislocation ◽  
Subjective Assessment ◽  
Clinical Results ◽  
Patient Reported Outcome ◽  
Recurrent Patellar Dislocation ◽  
Term Outcome ◽  
Proximal Realignment ◽  
Patient Reported

Several operative techniques have been described for recurrent patellar dislocation. Clinical results vary depending on the procedure and indication. The present study aimed to evaluate the clinical outcome of Insall’s proximal realignment for recurrent patellar dislocation at mid-term follow-up. Forty-five patients were reviewed with a mean follow-up period of 49 months after having undergone Insall’s procedure. Outcome measures included reports of redislocations, complications, patient-reported outcome scores (Kujala, Tegner activity scale) and subjective assessment. No statistically significant improvements (p < 0.05) in patient-reported outcome measures were noted. Sixteen patients (35%) had poor to fair results using the Kujala score. Subjective assessment revealed that 12 patients (27%) were dissatisfied with the outcome of their surgery and would not undergo the same procedure. Ten patients (22%) had suffered from redislocation at the latest follow-up. In 4 cases (9%), intra-articular knee hematoma occurred which required arthroscopic intervention. The overall mid-term outcome of the present study shows low patient satisfaction. Non-anatomic realignment for recurrent patellar dislocation does not adequately prevent redislocation.

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