Multiple etiologies may cause anterior knee pain after total knee arthroplasty. While prior studies have addressed component positioning and surgical technique, no series in the literature describes lateral patellofemoral impingement as a source of the pain. Over a 2-year period at our institution, 18 patients with 19 painful total knee arthroplasties were diagnosed with lateral patellofemoral impingement. All underwent revision surgery with either lateral facetectomy or revision of the patellar dome. These patients were followed with Knee Society scores for 1 year. Knee Society scores were significantly improved at 8 weeks, 16 weeks, and 1 year. Lateral patellofemoral impingement should always be considered in the differential diagnosis of the painful total knee arthroplasty. This should be evaluated clinically through direct palpation of the lateral facet, and radiographically with the sunrise view. Lateral facetectomy or patellar revision can be performed with predictably good clinical results.
Community-engaged research can be effective in directly improving justice for individuals and communities, and to guide policies and practices. Given the challenges to accessing some populations of interest, such as with rural victims of crime, community-engaged approaches provide a means to support ethical and culturally competent research that can improve justice in a meaningful way. In this article, we discuss a collaborative research partnership between academic researchers and a victim service agency that sought to connect rural victim advocacy with a data-driven research methodology for improved justice delivery in two communities with differing rural dynamics. Researchers and practitioners can benefit from recognizing the unique, yet varied, victimization experiences within rural communities, and an understanding of this variability among rural victims and contexts can inform justice practice. We provide best practice recommendations from both researcher and practitioner perspectives for the successful implementation of a project that serves victims in the community and through policy. Implications for justice-related policy and practice for rural and American Indian crime victims are discussed.
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