Effects of partial patellectomy and reattachment of the patellar tendon on patellofemoral contact areas and pressures.

Marder, Richard A.; Swanson, Todd V.; Sharkey, Neil A.; Duwelius, Paul J.

doi:10.2106/00004623-199301000-00006

Cited by 72 publications

(35 citation statements)

References 15 publications

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“…Finally, the introduction of the pressure sensor into the patellofemoral joint may have altered patellofemoral kinematics. However, the patterns of patellofemoral contact demonstrated in the unbraced knee in this study were similar to those reported by Huberti and Hayes [46][47] and Marder et al [48], who used pressure-sensitive film that had an effective thickness approximately 3 times greater than that of the sensor used in the current study [46][47][48][49]. For all the comparisons in the current study, the pressure sensor was inserted into the joint prior to testing and its placement was not altered during the experiment.…”

Section: Discussionsupporting

confidence: 85%

Effect of bracing on dynamic patellofemoral contact mechanics

Wilson¹,

Mazahery²,

Koh³

et al. 2010

JRRD

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Abstract-Decreases in patellofemoral pain have been demonstrated with bracing; however, the mechanisms of pain reduction remain unclear. Our purpose was to evaluate the hypothesis that patellofemoral bracing decreases peak pressure on the retropatellar surface through an increase in patellofemoral contact area. Nine cadaveric knees were tested during simulated freespeed walking with no brace, a knee sleeve, two different patellar stabilization sleeves, and a wrap-style patellar stabilization brace. Contact area and pressure were measured using a dynamic pressure sensor located in the patellofemoral joint. For the unbraced knee, contact area and peak pressure varied with knee flexion angle, ranging from 0.30 ± 0.3 cm 2 and 1.80 ± 1.7 MPa at full extension to 2.28 ± 0.5 cm 2 and 4.19 ± 1.7 MPa at peak knee flexion. All braces increased contact area, while the wrap-style brace decreased peak pressure (p < 0.001). Sleeve braces compress the quadriceps tendon causing the patella to engage the trochlear groove earlier during knee flexion. The wrap-style brace reduced peak pressure by shifting the location of highest pressure to a region with increased articular cartilage thickness. Sleeve braces may be useful for treatment of patellar subluxation disorders, while wrap-style braces may be effective for treatment of disorders associated with degenerative cartilage changes.

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Section: Discussionsupporting

confidence: 85%

Effect of bracing on dynamic patellofemoral contact mechanics

Wilson¹,

Mazahery²,

Koh³

et al. 2010

JRRD

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“…The site of reattachment of the patellar ligament following partial patellectomy is a controversial area with some67 proposing attachment near the articular surface while others8 advocating attachment near the anterior cortex. We chose to insert the anchors in the center of the proximal remnant as this would have theoretically the least chance of causing the tilt in the patella and also give us a maximum purchase in the cancellous bone (thickest area of the bone).…”

Section: Discussionmentioning

confidence: 99%

Role of suture anchors in management of fractures of inferior pole of patella

Anand

Kumar

Kodikal

2010

IJOO

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Background:The traditional recommendation for displaced comminuted inferior pole fractures is excision of the comminuted pole followed by reattachment of the patellar tendon with transosseous suture. To the best of our knowledge there has been no previous published study mentioning the use of suture anchors for fracture inferior pole of patella. We present a retrospective analysis of five cases of patients doing well at final follow-up of two years.Materials and Methods:Five patients treated at our institute using suture anchors for repair of comminuted inferior pole fractures of patella between January 2007 to March 2007. (range 28 years-55 years). There were three males and two females.Results:The average follow-up was 25 months (range 24 months-26 months). The patients were evaluated for range of motion, strength, patellofemoral scores and any alteration of patellar height. The outcome of the procedure was assessed with use of the patellofemoral scoring system of Noyes et al,5 as adapted by Saltzman et al.6 The final patellofemoral score (maximum 100 points) was 94.6 (range 93-96).Conclusion:We believe it is a novel extended indication of the use of suture anchors and should be in the armament of every trauma surgeon.

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“…Other investigators also have reported the radiographic appearance does not always correlate with the clinical symptoms [5,40]. This may be one of the reasons so many surgical techniques such as débridement [13], microfracture [16], lateral release [1], trephine and drilling [27], isolated lateral facetectomy of the patella [40], transfer of the tibial tubercle [9,10,34], patellectomy [24,25], patellofemoral arthroplasty [3,4], or even TKA [23] are recommended. An assumption is that other structures of the knee, which were not addressed by the current treatment protocol, may have contributed to pain sensation such as the synovial tissue, the patellar fat pad, or the medial or lateral joint capsule.…”

Section: Discussionmentioning

confidence: 99%