scholarly journals Use of hyaluronic acid injection after arthroscopic release in lateral patellar compression syndrome with degenerative cartilage changes: randomized control trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sherwan A. Hamawandi
Keyword(s):  
Hyaluronic Acid ◽  
Knee Pain ◽  
Lateral Release ◽  
Arthroscopic Release ◽  
Compression Syndrome ◽  
Kujala Score ◽  
Group A ◽  
Lateral Patellar Compression Syndrome ◽  
Degenerative Cartilage

Abstract Background Degenerative cartilage changes can be seen, in cases of lateral patellar compression syndrome, involving the patellofemoral joint. Hyaluronic acid is a natural component of the synovial fluid and responsible for its elastic features and function of articular surfaces. The aim of this study is to show the effect of intra-articular injection of Hyaluronic acid, after arthroscopic lateral release in lateral patellar compression syndrome, on the functional outcome and knee pain in those patients with degenerative cartilage changes. Method Ninety patients age (30–50) years with lateral patellar compression syndrome and degenerative cartilage changes were divided randomly into 2 groups. Group A was treated by arthroscopic lateral release and received intraarticular injection of Hyaluronic acid 2 weeks after surgery. Group B was treated by arthroscopic lateral release only. Both groups were assessed by Kujala score and visual analogue scale for knee pain preoperatively and re-assessed postoperatively at 3 months, 6 months, 12 months and 24 months. Results There was significant improvement in Kujala score and Visual analogue scale post-operatively in both groups (P-value< 0.001) with better improvement in Kujala score in group A after intra-articular injection of Hyaluronic acid up to 2 year of follow up (P-value = 0.006) as well as better improvement in visual analogue score at 6 months post-operatively (P-value = 0.035). Conclusion Intra-articular injection of Hyaluronic acid after arthroscopic release, in patients with lateral patellar compression syndrome and degenerative cartilage changes, can result in better improvement of knee pain and functional outcome up to 2 years of follow up. Trial registration NCT, NCT04134611. Registered 18 October 2019 -Retrospectively registered.

scholarly journals Use of Hyaluronic Acid Injection after Arthroscopic Release in Lateral Patellar Compression Syndrome with Degenerative Cartilage Changes: Randomized Control Trial

2020 ◽  
Author(s):  
Sherwan Hamawandi
Keyword(s):  
Hyaluronic Acid ◽  
Knee Pain ◽  
Lateral Release ◽  
P Value ◽  
Compression Syndrome ◽  
Kujala Score ◽  
Group A ◽  
Lateral Patellar Compression Syndrome ◽  
Degenerative Cartilage

Abstract BackgroundDegenerative cartilage changes can be seen, in cases of lateral patellar compression syndrome, involving the patellofemoral joint. Hyaluronic acid is a natural component of the synovial fluid and responsible for its elastic features and function of articular surfaces. The aim of this study is to show the effect of intra-articular injection of Hyaluronic acid, after arthroscopic lateral release in lateral patellar compression syndrome, on the functional outcome and knee pain in those patients with degenerative cartilage changes. MethodNinety patients age (30-50) years with lateral patellar compression syndrome and degenerative cartilage changes were divided randomly into 2 groups. Group A was treated by arthroscopic lateral release and received intrarticular injection of Hyaluronic acid 2 weeks after surgery. Group B was treated by arthroscopic lateral release only. Both groups were assessed by Kujala score and visual analogue scale for knee pain preoperatively and re-assessed postoperatively at 3 months, 6 months, 12 months and 24 months.ResultsThere was significant improvement in Kujala score and Visual analogue scale post-operatively in both groups (P-value<0.001) with better improvement in Kujala score in group A after intra-articular injection of Hyaluronic acid up to 2 year of follow up (P-value=0.006) as well as better improvement in visual analogue score at 6 months post-operatively (P-value=0.035)ConclusionIntra-articular injection of Hyaluronic acid after arthroscopic release, in patients with lateral patellar compression syndrome and degenerative cartilage changes, can result in better improvement of knee pain and functional outcome up to 2 years of follow up.Trial registration: NCT, NCT04134611. Registered 18 October 2019 -Retrospectively registered, https://www.clinicaltrials.gov/NCT04134611

scholarly journals Open versus arthroscopic release for lateral patellar compression syndrome: a randomized-controlled trial

2021 ◽  
Author(s):  
Sherwan A. Hamawandi ◽  
Hazhar I. Amin ◽  
Ameer Kadhim Al-Humairi
Keyword(s):  
Functional Outcome ◽  
Patellar Instability ◽  
Controlled Trial ◽  
Lateral Release ◽  
Open Release ◽  
Arthroscopic Release ◽  
Compression Syndrome ◽  
Significant Difference ◽  
Lateral Patellar Compression Syndrome

Abstract Introduction Lateral patellar compression syndrome is one of the causes of anterior knee pain in young adults and resulted from tight lateral patellar retinaculum. The aim of our study is to compare between open and arthroscopic release of lateral patellar compression syndrome in relation of functional outcome, time of surgical procedure, length of hospital stays, intraoperative and postoperative complications as bleeding, infection, recurrence, and patellar instability with 2 years of follow-up. Materials and methods 80 patients, age (21–49 years), were divided randomly into 2 groups (A and B). Group A (40 patients) were treated with open release. Group B (40 patients) were treated by arthroscopic release. All these patients are diagnosed as lateral patellar compression syndrome depending on clinical features and MRI. All patients were assessed by Lysholm knee scoring scale before surgery and at periods of 2, 6 weeks, 6, 12, and 24 months after surgery. Results There is significant difference in functional outcome, measured by Lysholm knee scoring scale, between preoperative and postoperative assessment periods in both groups (P < 0.001). There is significantly better functional outcome at 2 years of follow-up with arthroscopic release (P = 0.018). There is no recurrence in both groups, but there were 4 patients develop medial patellar instability in the group of open release. Conclusion Both open and arthroscopic lateral release for patients with isolated lateral patellar compression syndrome can be effective surgical procedures, but arthroscopic release can achieve better functional outcome. Trial registration: NCT, NCT04130412. Retrospectively registered on 3rd of June, 2020 at ClinicalTrials.gov.

scholarly journals Efficacy and experience of arthroscopic lateral patella retinaculum releasing through/outside synovial membrane for the treatment of lateral patellar compression syndrome

2020 ◽  
Author(s):  
Ji-Bin Chen ◽  
Dong Chen ◽  
Ya-Ping Xiao ◽  
Jian-Zhong Chang ◽  
Te Li
Keyword(s):  
Synovial Membrane ◽  
Lysholm Score ◽  
Compression Syndrome ◽  
Vas Score ◽  
Kujala Score ◽  
Before And After ◽  
Lateral Patella ◽  
Improved Function ◽  
Lateral Patellar Compression Syndrome

Abstract Objective: To investigate the method and effect of arthroscopic lateral patella retinaculum releasing (LPRR) either through or outside synovial membrane for the treatment of lateral patellar compression syndrome (LPCS).Methods: From September 2014 to December 2017, 125 patients with LPCS underwent arthroscopic LPRR either through or outside synovial membrane combined with joint debridement. In the outside synovial membrane (OSM) group, synovial membrane was retained. In the through synovial membrane (TSM) group,The synovial membrane was cut open. Active rehabilitation training was conducted after surgery. Before and after surgery, Lysholm score, patella medial shift, Kujala score, VAS score and surgical complications were evaluated and compared.Results: All patients in this study were followed up for 1.5-5 years. All patients had significant reduction in knee pain and improved function after 1 month and 1 year. The Lysholm score, the distance of patella medial shift, the Kujala score, and the VAS score in the OSM group and the TSM group were significantly improved in the final follow-up compared with before surgery ( P <0.001), but these observed targets before surgery and at the last follow-up between the two groups were compared with no statistical differences. However, the number of occurrences of joint hematoma and adhesion was significantly higher in the TSM group than the OSM group ( P =0.024).Conclusion: Arthroscopic closing LPRR for the treatment of LPCS can effectively improve the function and symptoms of the patellofemoral joint with the advantages of small trauma, rapid recovery and less complications. But, the number of occurrences of hemarthrosis and joint adhesion in the TSM group were significantly higher than those in the OSM group.

Open Versus Arthroscopic Release for Lateral Patellar Compression Syndrome: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Sherwan Hamawandi ◽  
Hazhar Amin ◽  
Ameer Kadhim Al-Humairi
Keyword(s):  
Functional Outcome ◽  
Patellar Instability ◽  
Open Release ◽  
Arthroscopic Release ◽  
Compression Syndrome ◽  
Diagnostic Arthroscopy ◽  
Significant Difference ◽  
Lateral Patellar Compression Syndrome ◽  
Surgical Release

Abstract Background: Lateral patellar compression syndrome is one of the causes of anterior knee pain in young adults and resulted from tight lateral patellar retinaculum, which can be treated by surgical release of tight retinaculum after failure of conservative measures. Surgical release can be done by open or arthroscopic procedures. There was no randomized control trial to compare between these two procedures in considering of functional outcome and complications. The aim of our study is to compare between open and arthroscopic release of lateral patellar compression syndrome in relation of functional outcome, time of surgical procedure, length of hospital stays, intraoperative and postoperative complications as bleeding, infection, recurrence and patellar instability with 2 years of follow up. Methods: 80 patients, age (21-49 years), were divided randomly into 2 groups (A and B). Group A (40 patients) were treated with open release after diagnostic arthroscopy. Group B (40 patients) were treated by arthroscopic release. All these patients are diagnosed as lateral patellar compression syndrome depending on clinical features, MRI and diagnostic arthroscopy and they had failure of conservative measures of quadriceps strengthening and analgesics for 6 months. All patients were assessed by Lysholm knee scoring scale before surgery and at periods of 2 weeks, 6 weeks, 6 months, 12 months and 24 months after surgery. Results: There is significant difference in functional outcome, measured by Lysholm knee scoring scale, between preoperative and postoperative assessment periods in both groups (P<0.001). There is significantly better functional outcome at 2 years of follow up with the arthroscopic release (P=0.018). There is no recurrence in both groups, but there were 4 patients develop medial patellar instability in the group that was treated by open release. There are 2 patients develop hemarthrosis in arthroscopic group and one patient develop superficial wound infection in the group of open release. There is no significant difference in the postoperative complications between two groups. Conclusion: Both open and arthroscopic lateral release for patients with lateral patellar compression syndrome (without instability, limb malalignment or dysplasia) are effective surgical procedures but arthroscopic release can achieve better functional outcome than open release with less risk of development of post-operative patellar instability.Trial registration: NCT, NCT04130412. Registered 15 October 2019 -Retrospectively registered, https://www.clinicaltrials.gov/NCT04130412

scholarly journals Open Versus Arthroscopic Release for Lateral Patellar Compression Syndrome: A Randomized Control Trial

2020 ◽  
Author(s):  
Sherwan Hamawandi ◽  
Hazhar Amin ◽  
Ameer Kadhim Al-Humairi
Keyword(s):  
Functional Outcome ◽  
Patellar Instability ◽  
Open Release ◽  
Arthroscopic Release ◽  
Compression Syndrome ◽  
Diagnostic Arthroscopy ◽  
Significant Difference ◽  
Randomized Control ◽  
Lateral Patellar Compression Syndrome

Abstract Background: Lateral patellar compression syndrome is one of the causes of anterior knee pain in young adults and resulted from tight lateral patellar retinaculum, which can be treated by surgical release of tight retinaculum after failure of conservative measures. Surgical release can be done by open or arthroscopic procedures. There was no randomized control trial to compare between these two procedures in considering of functional outcome and complications. The aim of our study is to compare between open and arthroscopic release of lateral patellar compression syndrome in relation of functional outcome, time of surgical procedure, length of hospital stays, intraoperative and postoperative complications as bleeding, infection, recurrence and patellar instability with 2 years of follow up. Methods: 80 patients, age (21-49 years), were divided randomly into 2 groups (A and B). Group A (40 patients) were treated with open release after diagnostic arthroscopy. Group B (40 patients) were treated by arthroscopic release. All these patients are diagnosed as lateral patellar compression syndrome depending on clinical features, MRI and diagnostic arthroscopy and they had failure of conservative measures of quadriceps strengthening and analgesics for 6 months. All patients were assessed by Lysholm knee scoring scale before surgery and at periods of 2 weeks, 6 weeks, 6 months, 12 months and 24 months after surgery.Results: There is significant difference in functional outcome, measured by Lysholm knee scoring scale, between preoperative and postoperative assessment periods in both groups (P<0.001). There is significantly better functional outcome at 2 years of follow up with the arthroscopic release (P=0.018). There is no recurrence in both groups, but there were 4 patients develop medial patellar instability in the group that was treated by open release. There are 2 patients develop hemarthrosis in arthroscopic group and one patient develop superficial wound infection in the group of open release. There is no significant difference in the postoperative complications between two groups.Conclusion: Both open and arthroscopic lateral release for patients with lateral patellar compression syndrome (without instability, limb malalignment or dysplasia) are effective surgical procedures but arthroscopic release can achieve better functional outcome than open release with less risk of development of post-operative patellar instability.Trial registration: NCT, NCT04130412. Registered 15 October 2019 -Retrospectively registered, https://www.clinicaltrials.gov/NCT04130412

scholarly journals Efficacy and experience of arthroscopic lateral patella retinaculum releasing through/outside synovial membrane for the treatment of lateral patellar compression syndrome

2019 ◽  
Author(s):  
Ji-Bin Chen ◽  
Dong Chen ◽  
Ya-Ping Xiao ◽  
Jian-Zhong Chang ◽  
Te Li
Keyword(s):  
Synovial Membrane ◽  
Lysholm Score ◽  
Good Effect ◽  
Superficial Fascia ◽  
Compression Syndrome ◽  
Vas Score ◽  
Kujala Score ◽  
Lateral Patella ◽  
Lateral Patellar Compression Syndrome

Abstract Objective: To investigate the method and effect of arthroscopic lateral patella retinaculum releasing (LPRR) through/outside synovial membrane for the treatment of lateral patellar compression syndrome (LPCS). Methods: From September 2014 to December 2017, 125 patients with LPCS underwent arthroscopic LPRR through/outside synovial membrane combined with joint debridement. In the outside synovial membrane (OSM) group, the joint was cleaned first. The surface of lateral patella retinaculum (LPR) was created the chamber for arthroscopic operation. The LPR was released under the arthroscopy, and the synovial membrane was retained. In the through synovial membrane (TSM) group, the joint was cleaned first, and the synovial membrane, joint capsule and LPR, and superficial fascia were gradually incised from the joint cavity to the subcutaneous tissue. The synovial membrane was cut open. Active rehabilitation training was conducted after surgery. Before and after surgery, Lysholm score, patella medial shift, Kujala score, VAS score and surgical complications were evaluated and compared. Results: All patients in this study were followed up for 1.5-5 years. All patients had significant reduction in knee pain and improved function after 1 month and 1 year. The final follow-up of the Lysholm score, the distance of patella medial shift, the Kujala score, and the VAS score in the OSM group and the TSM group were significantly improved compared with those before surgery (P<0.001), but these observed targets at the last follow-up and before surgery between the two groups were compared with no statistical differences. In the TSM group, 5 patients had hemarthrosis and 3 cases joint adhesion. There were no postoperative complications in the OSM group. Conclusion: Arthroscopic closing LPRR for the treatment of LPCS can effectively improve the function and symptoms of the patellofemoral joint. It has the advantages of small trauma, good effect and rapid recovery. Among them, the hemarthrosis and joint adhesion in the TSM group were significantly higher than those in the OSM group, and arthroscopic closing LPRR outside synovial membrane was more advantageous.

scholarly journals Effects and safety of platelet-rich plasma (PRP) and hyaluronic acid (HA), alone and in combination, in the treatment of knee osteoarthritis: A systematic review and meta-analysis.

2020 ◽  
Author(s):  
Jinlong Zhao ◽  
Hetao Huang ◽  
Guihong Liang ◽  
Ling-feng Zeng ◽  
Weiyi Yang ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Womac Function ◽  
Lequesne Index

Abstract Background Studies have shown that the combined application of hyaluronic acid (HA) and platelet-rich plasma (PRP) can repair degenerated cartilage and delay the progression of knee osteoarthritis (KOA). The purpose of this study was to explore the efficacy and safety of PRP combined with HA in the treatment of KOA compared with intra-articular injection of PRP or HA alone. Methods The PubMed, Cochrane Library, EMBASE and China National Knowledge Infrastructure (CNKI) databases were searched from inception to December 2019. Two orthopaedic surgeons conducted the literature retrieval and extracted the data. Outcome indicators include the Western Ontario and McMaster Universities Arthritis Index (WOMAC), the Lequesne Index, the visual analogue scale (VAS) for pain, and adverse events (AEs). Results Seven studies (5 randomized controlled trials, 2 cohort studies) with a total of 941 patients were included. In the VAS comparison after 6 months of follow-up, PRP combined with HA was more likely to reduce knee pain than PRP alone (standardized mean difference (SMD): -0.31; 95% confidence interval (CI): -0.55 to -0.06; P=0.01 <0.05). PRP combined with HA for KOA achieved better improvement in WOMAC Function Score (SMD: -0.32; 95% CI: -0.54 to -0.10) and WOMAC Total Score (SMD: -0.42; 95% CI: -0.67 to -0.17) at the 12-month follow-up than the application of PRP alone. In a comparison of Lequesne Index scores at a 6-month follow-up, PRP combined with HA improved knee pain scores more than PRP alone (SMD: -0.42; 95% CI: -0.67 to -0.17). In terms of AEs, PRP combined with HA was not significantly different from PRP or HA alone (P>0.05). Conclusions Compared with intra-articular injection of PRP alone, PRP combined with HA can improve WOMAC Function Scores, WOMAC Total Score, 6-month follow-up VAS ratings, and Lequesne Index scores. However, in terms of the incidence of AEs, PRP combined with HA was not significantly different from PRP or HA alone.

scholarly journals Recurrent Dislocation of the Patella

2014 ◽  
Vol 2 (12_suppl4) ◽  
pp. 2325967114S0025
Author(s):  
Gustavo Benítez
Keyword(s):  
Recurrent Dislocation ◽  
Good Alternative ◽  
Mpfl Reconstruction ◽  
Lateral Release ◽  
Vastus Medialis ◽  
Kujala Score ◽  
Mid Term Results ◽  
Dislocation Of The Patella ◽  
Main Complication

Purpose: To evaluate results of medial patellofemoral ligament (MPFL) reconstruction associated with lateral release and advancement of vastus medialis in recurrent dislocation of the patella. Methods: We retrospectively evaluated 11 patients with a mean follow-up of 19 months. Mean age was 23, mainly women. We did MPFL reconstruction with semitendinosus or gracilis tendon depending on BMI, associated with advancement of vastus medialis and lateral release. Results: Mean Kujala score improved from 46,54 pts. preoperative to 88,36 postoperative. Our main complication was 1 patient with rigid knee, who required movilization under anesthesia and arthroscopic arthrolisis to improve her outcome. Conclusion: The combination of this techniques are a good alternative to treat patients with recurrent patella disclocation, with good short and mid-term results. Biomechanic intra and postop complications of MPFL reconstruction are related to patellar fixation, anatomic positioning of femoral tunnel and knee position of the graft fixation.

scholarly journals Isolated Arthroscopic Lateral Retinacular Release for Lateral Patellar Compression Syndrome

Life ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 295
Author(s):  
Filippo Migliorini ◽  
Christian Lüring ◽  
Jörg Eschweiler ◽  
Alice Baroncini ◽  
Arne Driessen ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Rating Scale ◽  
Cruciate Ligament ◽  
Patellofemoral Instability ◽  
Numeric Rating Scale ◽  
Lateral Retinacular Release ◽  
Compression Syndrome ◽  
The Mean ◽  
Lateral Patellar Compression Syndrome

Introduction: Evidence concerning the role of isolated lateral retinacular release (LRR) for lateral patellar compression syndrome (LPCS) dates back at least three decades. Appropriate indications, execution and outcomes still remain unclear and controversial. The present investigation analyzed the midterm result of isolated and arthroscopic LRR for LPCS in a cohort of patients who underwent such procedure at our institution. Material and methods: Patients undergoing isolated arthroscopic LRR for LPCS were identified retrospectively from our electronic database. All procedures were performed by two experienced surgeons. Patients with bony and/or soft tissues abnormalities, patellofemoral instability, moderate to severe chondral damage were not included. Patients with previous surgeries were not included, as were those who underwent combined interventions. Clinical scores and complications were recorded. Results: 31 patients were recruited in the present investigation. The mean follow-up was 86.0 ± 22.8 months. The mean age of the patients at the index operation was 34.2 ± 13.1 years. A total 55% (17 of 31) were women, and 58% (18 of 31) had involved the right knee. The mean hospitalization length was 3.5 ± 1.4 days. At a mean follow-up of 86.0 ± 22.8 months, the numeric rating scale (NRS) was 1.2 ± 0.8, the Kujala score was 91.3 ± 11.3, the Lysholm score was 93.1 ± 15.0, and the Tegner score was 5.0 ± 1.8. At the latest follow-up, 9 of 31 (29.0%) of patients experienced compilations. One patient (3.2%) had a post-operative hemarthrosis which was managed conservatively. Six patients (19.4%) reported a persistent sensation of instability, without signs of patellar dislocation or subluxation. One patient underwent an arthroscopic meniscectomy, and another patient an anterior cruciate ligament (ACL) reconstruction. Conclusion: isolated arthroscopic lateral retinacular release for lateral patellar compression syndrome is feasible and effective, achieving satisfying results at more than seven years following the procedure.

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