Evaluation of patients with persistent symptoms after lateral retinacular release by kinematic magnetic resonance imaging of the patellofemoral joint

Shellock, Frank G.; Mink, Jerrold H.; Deutsch, Andrew L.; Fox, James M.; Ferkel, Richard D.

doi:10.1016/0749-8063(90)90079-s

Cited by 74 publications

(43 citation statements)

References 19 publications

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“…In lieu of this limitation, various forms of imaging (ie, radiographs, computerized tomography, magnetic resonance imaging [MRI], and video fluoroscopy) have been employed to make the diagnosis of patellar malalignment or lateral patellar subluxation. 1,7,15,16 Kinematic magnetic resonance imaging (KMRI) is an imaging method that has been reported to give important diagnostic information concerning the patellofemoral joint. 13,[15][16][17] This technique utilizes a fast spoiled gradient-recalled acquisition in the steady state (spoiled GRASS) pulse sequence that allows rapid imaging during active movement.…”

Section: Discussionmentioning

confidence: 99%

“…1,7,15,16 Kinematic magnetic resonance imaging (KMRI) is an imaging method that has been reported to give important diagnostic information concerning the patellofemoral joint. 13,[15][16][17] This technique utilizes a fast spoiled gradient-recalled acquisition in the steady state (spoiled GRASS) pulse sequence that allows rapid imaging during active movement. 13 The advantage of KMRI over traditional imaging approaches is that the joint can be imaged dynamically (as opposed to incremental passive positioning).…”

Section: Discussionmentioning

confidence: 99%

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Patellofemoral Kinematics During Weight-Bearing and Non-Weight-Bearing Knee Extension in Persons With Lateral Subluxation of the Patella: A Preliminary Study

Powers¹,

Ward²,

Fredericson³

et al. 2003

J Orthop Sports Phys Ther

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300

260

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Study Design: Single-group, repeated-measures design. Objective: To compare patellofemoral joint kinematics during weight-bearing and non-weightbearing knee extension in persons with lateral subluxation of the patella. Background: The only previous study to quantify differences in patellofemoral joint kinematics during weight-bearing and non-weight-bearing tasks was limited in that static loading conditions were utilized. Differences in patellofemoral joint kinematics between weight-bearing and non-weight-bearing conditions have not been quantified during dynamic movement. Methods and Measures: Six females with a diagnosis of patellofemoral pain and lateral subluxation of the patella participated. Using kinematic magnetic resonance imaging, axial images of the patellofemoral joint were obtained as subjects extended their knees from 45° to 0° during non-weight-bearing (5% body weight resistance) and weight-bearing (unilateral squat) conditions. Measurements of patellofemoral joint relationships (medial/lateral patellar displacement and patellar tilt), as well as femur and patella rotations relative to an external reference system (ie, the image field of view), were obtained at 3°increments during knee extension. Results: During non-weight-bearing knee extension, lateral patellar displacement was more pronounced than during the weight-bearing condition between 30°and 12°of knee extension, with statistical significance being reached at 27°, 24°, and 21°. No differences in lateral patellar tilt were observed between conditions (P = .065). During the weight-bearing condition, internal femoral rotation was significantly greater than during the non-weight-bearing condition as the knee extended from 18°to 0°. During the non-weight-bearing condition, the amount of lateral Dr. Powers, 1540 E. Alcazar St. CHP-155, Los Angeles, CA 90089-9006. E-mail: powers@usc.edu. patellar rotation was significantly greater than during the weight-bearing condition throughout the range of motion tested. Conclusions:The results of this study demonstrated that lateral patellar displacement was more pronounced during non-weight-bearing knee extension compared to weight-bearing knee extension in persons with lateral patellar subluxation. In addition, the results of this investigation suggest that the patellofemoral joint kinematics during non-weight-bearing could be characterized as the patella rotating on the femur, while the patellofemoral joint kinematics during the weight-bearing condition could be characterized as the femur rotating underneath the patella. J Orthop Sports Phys Ther 2003;33:677-685.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Patellofemoral Kinematics During Weight-Bearing and Non-Weight-Bearing Knee Extension in Persons With Lateral Subluxation of the Patella: A Preliminary Study

Powers¹,

Ward²,

Fredericson³

et al. 2003

J Orthop Sports Phys Ther

Self Cite

300

260

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show abstract

“…Lateral instability of the patella is a common problem and despite the extensive literature devoted to the topic, the optimal treatment remains contentious [7,9,[11][12][13]18]. Patellofemoral joint stability depends on several factors, such as the balance of the quadriceps muscle forces, the articular geometry of the patella and femur, the retinacular structures, and the direction of the patellar tendon [1,[4][5]8].…”

Section: Introductionmentioning

confidence: 99%

Effects of lateral retinacular release on the lateral stability of the patella

Christoforakis

Bull

Strachan³

et al. 2005

Knee Surg Sports Traumatol Arthrosc

144

111

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The objective of this cadaveric study was to evaluate quantitatively the effects of lateral retinacular release on the lateral stability of the patella.A materials testing machine was used to displace the patella of 7 cadaveric specimens 10 mm laterally while measuring the required force, with 175 N quadriceps tension. The patella was connected via a ball-bearing patellar mounting 10 mm deep to the anterior surface to allow rotations. Patellar force-displacement behaviour was tested from 0º to 60º knee flexion.At 0°, 10° and 20° flexion the mean force required to displace the patella 10 mm laterally was reduced significantly due to lateral retinacular release, by 16 to 19 %. The average force required to displace the patella was also reduced for larger flexion angles, although this was not statistically significant.These findings suggest that lateral retinacular release may not be appropriate in treatment of patellar lateral instability.

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“…La inestabilidad medial secundaria o iatrogénica ha sido reconocida como una entidad nosológica diferenciada, causada por una liberación retinacular externa excesiva [9][10][11][12] . Para que ocurra una inestabilidad medial debe alterarse el estabilizador rotuliano pasivo externo.…”

Section: Eppleyunclassified

“…La RNM mostraba condropatía grado I-II de la faceta externa de la rótu-la derecha. 12 encontraron una incidencia del 40% de subluxaciones en las rótulas contralaterales, no intervenidas, en los pacientes con liberación retinacular externa. Por tanto, la desalineación podría ser bilateral y de ello podemos deducir que la subluxación medial existe antes incluso de realizar la liberación retinacular externa, pero que no es detectada por medios convencionales.…”

Section: Figuraunclassified

Subluxación primaria recidivante medial de rótulas: Revisión a largo plazo de un caso asociado a síndrome de desalineación torsional severa

García-Mata

Hidalgo-Ovejero

2007

Anales Sis San Navarra

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Evaluation of patients with persistent symptoms after lateral retinacular release by kinematic magnetic resonance imaging of the patellofemoral joint

Cited by 74 publications

References 19 publications

Patellofemoral Kinematics During Weight-Bearing and Non-Weight-Bearing Knee Extension in Persons With Lateral Subluxation of the Patella: A Preliminary Study

Patellofemoral Kinematics During Weight-Bearing and Non-Weight-Bearing Knee Extension in Persons With Lateral Subluxation of the Patella: A Preliminary Study

Effects of lateral retinacular release on the lateral stability of the patella

Subluxación primaria recidivante medial de rótulas: Revisión a largo plazo de un caso asociado a síndrome de desalineación torsional severa

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