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.

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 Outcome and experience of arthroscopic lateral retinacular release combined with lateral patelloplasty in the management of excessive lateral pressure syndrome

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Cheng-Liang Wang ◽  
Ji-Bin Chen ◽  
Te Li
Keyword(s):  
Lateral Pressure ◽  
Arthroscopic Surgery ◽  
Lysholm Score ◽  
Patellar Tilt ◽  
Relieve Pain ◽  
Kujala Score ◽  
Before And After ◽  
Invasive Method ◽  
Lateral Patella

Abstract Background Only a few studies have described the effect of full arthroscopic surgery in treatment of excessive lateral pressure syndrome (ELPS). Therefore, the purpose of this study was to assess the clinical efficacy and experience of total arthroscopic lateral retinacular (LR) release and lateral patelloplasty for the treatment of ELPS. Methods A total of 73 patients (88 knees) with ELPS underwent arthroscopic LR release and lateral patelloplasty. The visual analogue scale (VAS), Kujala score, Lysholm scores, patella medial pushing distance, patellar tilt angle (PTA), and lateral patellofemoral angle (LPFA) were measured and evaluated before and after surgery. Results Follow-up ranged from 12 to 36 months with an average of 24 ± 5.8 months. The VAS was significantly lower at the last follow-up than before surgery (P < 0.01). The patella medial pushing distance, Kujala score, Lysholm score, PTA, and LPFA were significantly higher at the last follow-up than before surgery (P < 0.01, respectively). Years and lateral patella Outerbridge classification at the last follow-up have negative correlation with Kujala score, Lysholm score, Patella medial pushing distance, PTA, and LPFA (P < 0.01, respectively) and have positive correlation with VAS (P < 0.01, respectively). Related complications were not reported. Conclusions Full arthroscopic LR release combined with lateral patelloplasty in the treatment of ELPS is an effective minimally invasive method, which can effectively correct anomalies of force line and skeleton of patella, relieve pain, and restore knee joint motor function with less complications.

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 Medial patellofemoral ligament reconstruction for patellofemoral instability: a new surgical technique

2021 ◽  
Vol 7 (4) ◽  
pp. 843
Author(s):  
Shreekantha K. S. ◽  
Mohammed Usman ◽  
Deepak Malik ◽  
Mahammad Aseem ◽  
Mohammad Gous Mulla
Keyword(s):  
Surgical Technique ◽  
Functional Outcome ◽  
Ligament Reconstruction ◽  
Medial Patellofemoral Ligament ◽  
Patellofemoral Instability ◽  
Lysholm Score ◽  
Mpfl Reconstruction ◽  
Kujala Score ◽  
New Surgical Technique

<p class="abstract"><span lang="EN-US">The purpose of this study was to present new surgical technique for MPFL reconstruction. We also describe its functional outcome, complications, and the advantages of the procedure. This study is a prospective analysis of collected data during the period of august 2018 to January 2020. Ten cases of patients with recurrent symptomatic patellar instability and who underwent isolated MPFL reconstruction were included in the study. Kujala scoring and lysholm scoring was done to assess the functional outcome at follow-up. Post-operative dislocation and apprehension were recorded in each case along with any complication. Pre-operative Kujala score was 36.80 which improved to 89.80 postoperatively at the time follow-up. Pre-operative lysholm score was 36.80 which improved to 92.70 postoperatively at the time follow-up. The improvement in Kujala score and Lysholm score was found to be highly significant (p&lt;0.01). We have done a simple technique where MPFL is reconstructed anatomically to restore kinematics and stability. Consistent good results with early rehabilitation can be obtained using the described technique.</span></p>

scholarly journals Comparison of Clinical Efficacy Between Arthroscopically Assisted Gracilis Autograft With Suture Reinforcement Technique and Transtibial Pull-out Technique in Treating Medial Meniscus Posterior Root Tears

2021 ◽  
Author(s):  
Si Si Nie ◽  
Hongbo Li ◽  
Jianyin He ◽  
Guanxiang Liao ◽  
Xuelei Ke ◽  
...  
Keyword(s):  
Medial Meniscus ◽  
Lysholm Score ◽  
Reconstruction Technique ◽  
Posterior Root ◽  
Vas Score ◽  
Pull Out ◽  
Meniscal Root ◽  
Meniscus Healing ◽  
Ikdc Score

Abstract Background: To compare the short-term efficacy of the transtibial pull-out technique and gracilis autograft with suture reinforcement technique in the treatment of medial meniscus posterior root tears. Methods: A total of 64 patients with medial meniscus posterior root tears received reconstruction of the posterior root of the meniscus attachment point through the tibial tunnel between June 2018 and April 2019 were included in this study, patients were divided into 2 groups (transtibial pull-out technique group: 35 cases; gracilis autograft with suture reinforcement technique group: 29 cases) according to the different posterior meniscus root tear repair methods. Clinical outcomes were evaluated by the visual analogue scale (VAS) and Lysholm score and IKDC score, and the demographics and functional recovery of the knee were compared between the two groups.Results: Intraoperative and postsurgical complications such as infection were not found in the two groups, and there was a statistically significant improvement in the Lysholm score，IKDC score and VAS score (P<0.001; respectively). All the patients were very satisfied with the function of their knee at the last follow-up. However, compared with the transtibial pull-out repair group, the reinforced medial meniscal root reconstruction technique with gracilis autograft group were significant improvement in the meniscus healing rates and Lysholm score, IKDC score and VAS score at the end of follow-up (P<0.05; respectively).Conclusions: Compared with the transtibial pull-out technique, the reinforced medial meniscal root reconstruction technique with gracilis autograft is advantageous for treating these patients because it is a minimally invasive procedure with superior clinical outcome and meniscus healing rates.Levels of Evidence: Ⅲ, Case-control study Retrospective comparative study

Anatomical Medial Patellofemoral Ligament Reconstruction for Recurrent Patella Dislocation: Two-Strand Grafts versus Four-Strand Grafts

2019 ◽  
Author(s):  
Jinghui Niu ◽  
Wei Lin ◽  
Qi Qi ◽  
Jiangfeng Lu ◽  
Yike Dai ◽  
...  
Keyword(s):  
Tilt Angle ◽  
Medial Patellofemoral Ligament ◽  
Lysholm Score ◽  
Mpfl Reconstruction ◽  
Patella Dislocation ◽  
Reconstruction Method ◽  
Patellar Tilt ◽  
Kujala Score ◽  
Patellar Tilt Angle

AbstractThe purpose of this study was to describe two anatomical medial patellofemoral ligament (MPFL) reconstruction methods: reconstruction with two-strand grafts and reconstruction with four-strand grafts and to evaluate the clinical and radiological results. From January 2010 to January 2013, patients who sustained recurrent patella dislocation and met inclusion criteria were included in the study and divided into two groups randomly to undergo MPFL reconstruction either by two-strand grafts (T group) or four-strand grafts (F group). Patients were followed up 1 month, 1 year, 2 years, and 3 years postoperatively. The apprehension test was applied to test patella stability. The Kujala score, Lysholm score, and Crosby–Insall grading were used to evaluate the function of the affected knee. The patellar congruence and patellar tilt angle were used to measure the morphology of the patellofemoral joint. In addition, patients' subjective assessments and complications were recorded. Thirty-eight patients in T group and 38 patients in F group were followed for at least 36 months. The apprehension test was positive in all patients preoperatively but was negative at follow-up. The Kujala score, Lysholm score, patellar congruence angle, and the patellar tilt angle of patients in both groups improved significantly at 36-month follow-up when compared with those assessed preoperatively. However, patients in the F group achieved better clinical results in terms of Kujala score, patellar congruence angle, patellar tilt angle, and Crosby–Insall grading when compared with those in the T group 3 years after the operation. Most patients (92% of patients in the T group and 97% of patients in the F group) were satisfied with the surgery. The anatomical MPFL reconstruction with two-strand grafts or four-strand grafts were both safe techniques for recurrent patella dislocation with satisfactory clinical outcomes. The anatomical fixation with four-strand grafts achieved better clinical and radiographic results in the follow-up, which may be a better reconstruction method.

scholarly journals Early Results of Patients With Recurrent Patellar Instability Treated With MPFL Reconstruction

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0004
Author(s):  
Ömer Naci Ergin ◽  
Mehmet Ekinci ◽  
Fuat Bilgili ◽  
Yücel Bilgin ◽  
Mehmet Aşık
Keyword(s):  
Patellar Dislocation ◽  
Patellar Instability ◽  
Mpfl Reconstruction ◽  
Activity Score ◽  
Vas Score ◽  
Early Results ◽  
Kujala Score ◽  
Patient Reported ◽  
Recurrent Patellar Instability

Introduction: MPFL reconstruction is an evidence-based and successful technique in treating patients with recurrent patellar instability without alignment problems or who have not yet undergone skeletal maturity for distal realignment surgery. Aim: The aim of this study is to report early results of patients who underwent MPFL reconstruction Method: 21 patients with lateral patellar instability who were treated with MPFL reconstruction using hamstring autogrefts in our clinic between 2012 and 2013 were evaluated. Mean age was 18.8 (8-32). Average age of first patellar dislocation was 13 (5-18). Patients’ history of complaints, pre and postoperative knee ROMs, patellofemoral pain scales, and patellofemoral instabilities were evaluated. These evaluations were done using Kujala score, İKDC (International Knee Documentation Committee) score, KOS(Knee Outcome Survey Activities Of Daily Living Score) score, Tegner activity score and VAS score. Results: 86% of our patient reported getting better with the surgery. The mean follow up was 25,2 months.Median Kujala score rose from 71 preop to 96 postop(p<0.05) and median İKDC score rose from 72 to 95(p<0.05). VAS score decreased from 3.4 to 1.2. KOS score was on average 83. Tegner activity score of our patients which was 2.57 preoperatively increased to 4.71. Only one patient had a decreased range of flexion (10 degrees on terminal flexion) and only one patient had persisting recurrent patellar dislocation (%4). The failure to treat this patient was attributed to his concurrent patologies consisting of patella alta, trochlear dysplasia and patellofemoral malalignment. Conclusion: MPFL reconstruction with hamstring autograft for treating patellar instability seems to be an effective surgical option according to early results. For late term results further follow-up is needed.

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