Local torsion of distal femur is a risk factor for patellar dislocation

Fan, Chongyi; Niu, Yingzhen; Wang, Fei

doi:10.1186/s13018-023-03646-3

Cited by 3 publications

(1 citation statement)

References 30 publications

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“…Femoral torsion is one of the risk factors of patella dislocation [8,17]. Kaiser et al [14] proposed that an increase of 10°in internal femoral torsion for deficient MPFLs was already an important risk factor for patellar dislocation.…”

Section: Ta B L E 4 Comparison Of Clinical Outcomes (Mpflr)mentioning

confidence: 99%

Decreased femoral trochlea axial orientation corrected by derotational distal femur osteotomy in patients with patellar dislocation yields satisfactory outcomes

Li,

Chen,

Huo

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe femoral trochlea axial orientation has been shown to be a better predictor of patellar dislocation than the femoral anteversion angle. However, no study has investigated the importance of the femoral trochlea axial orientation in the surgical treatment of patellar dislocation. It is aimed to explore the pathological threshold of the femoral trochlea axial orientation and its guiding implications for surgical interventions in the study.MethodsSixty‐four patients with patellar dislocation and 64 controls were included for measurement of the femoral trochlea axial orientation. The ability to predict the patellar dislocation and the pathologic threshold of the femoral trochlea axial orientation were evaluated using the receiver operating characteristic curve. One hundred patients with medial patellofemoral ligament reconstruction and 25 patients with derotational distal femur osteotomy were divided into two groups based on the femoral trochlea axial orientation cut‐off value and their postoperative knee functions, and patellar tilt angles were compared.ResultsThere were significant differences in the femoral trochlea axial orientation (60.8 ± 7.9 vs. 67.8 ± 4.6, p < 0.05) between patients with patellar dislocation and the normal population. The sensitivity and specificity of the femoral trochlea axial orientation were 0.641 and 0.813, respectively, at the femoral trochlea axial orientation smaller than 63.8°. Amongst patients having had isolated medial patellofemoral ligament reconstruction with decreased femoral trochlea axial orientation, knee function was poorer after surgery. The prognosis of patients with the femoral trochlea axial orientation correction in derotational distal femur osteotomy was better than that for patients without correction.ConclusionsThe femoral trochlea axial orientation had good predictive efficiency for patellar dislocation. Isolated medial patellofemoral ligament reconstruction is not sufficiently effective for patients with patellar dislocation and decreased femoral trochlea axial orientation. Patients with a decreased femoral trochlea axial orientation can have better surgical outcomes after correction by derotational distal femur osteotomy.Level of EvidenceLevel III.

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Section: Ta B L E 4 Comparison Of Clinical Outcomes (Mpflr)mentioning

confidence: 99%

Decreased femoral trochlea axial orientation corrected by derotational distal femur osteotomy in patients with patellar dislocation yields satisfactory outcomes

Li,

Chen,

Huo

et al. 2024

Knee surg. sports traumatol. arthrosc.

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The accuracy of multiple regression models for predicting the individual risk of recurrent lateral patellar dislocation

Yu,

Li,

Zhang

et al. 2023

BMC Musculoskelet Disord

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Background Recurrent lateral patellar dislocation (RLPD) poses a significant threat to patients’ quality of life due to knee pain, patellofemoral cartilage damage, and potential traumatic arthritis. Predictive scoring systems have been developed to assess the risk of RLPD; however, their relative accuracy remains uncertain. Purpose To investigate the accuracy of the multiple regression models to predict the individual risk of recurrent LPD. Methods The Patellar Instability probability calculator (PIP), Recurrent Instability of the Patella Score (RIP), and Patellar Instability Severity Score (PIS) scoring rules were measured in 171 patients with a history of patellar dislocation and 171 healthy individuals. Three prediction models were calculated based on the data to predict the risk of recurrent lateral patellar dislocation. The inter-observer and intra-observer reliability of each measurement parameter was evaluated. The predictive capacity of the three-prediction model was investigated using the receiver operating characteristic curve. Results In the case group of 171 patients, PIS accurately predicted recurrent lateral Patella dislocation in 143 patients. RIP was 96, and PIP was 83. The positive predictive values were 92.9%, 64%, and 68% respectively. In the control group of 171 patients, the PIS was validated in 160 patients who would not experience dislocations. RIP was 117, and PIP was 50. The negative predictive values were 85.1%, 60.9%, and 36.2%, respectively. The area under the curve score for the PIS was 0.866, and the RIP was 0.673. the PIP was 0.678. Conclusion RIP and PIP did not work to predict LPD. PIS can accurately predict recurrent lateral patellar dislocation. It can aid doctors in making treatment decisions. Level of evidence Level III, retrospective comparative study.

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Inductive 3D numerical modelling of the tibia bone using MRI to examine von Mises stress and overall deformation

Kokz,

Mohsen,

Nile

et al. 2024

Open Engineering

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As the main load bearer throughout the gait cycle, the tibia is a crucial bone in the lower leg that distributes ground reaction forces with each stride. Comprehending the distribution of stress inside the tibia is essential for both avoiding fractures and developing efficient methods of redistributing load to promote healing and biomechanical correction. The study examined the stress, strain, and deformation encountered by the tibia over a 7-s walking cycle using an ANSYS workbench software, using tibia bone under a period of force applied to the boundary condition at intervals of 0.2 s. The tibia encounters stress levels varying from 0 to 1,400 N, exhibiting a regular pattern that aligns with the loading attributes often associated with traditional walking. The research conducted in this study identified the occurrence of maximum stress levels, measuring 25.45 MPa. Additionally, related peak elastic strains and deformations were observed, measuring 2.19 × 10−3 and 2.43 mm, respectively. The patterns that have been seen indicate that there is an initial contact of the foot with the ground, followed by the bearing of weight and subsequently the toe-off. These observed patterns closely resemble the natural motion of the foot during the act of walking. Temporal fluctuations in elastic strain through the tibia throughout a gait cycle reveal that the strain is mostly cantered at the medial surface of the tibia. Additional investigation into the elastic properties and overall deformations of the tibia yielded valuable observations on prospective areas of interest within the bone’s structure. These findings are of utmost importance for biomechanical assessments and the identification of potential injury hazards in subsequent research endeavours.

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Local torsion of distal femur is a risk factor for patellar dislocation

Cited by 3 publications

References 30 publications

Decreased femoral trochlea axial orientation corrected by derotational distal femur osteotomy in patients with patellar dislocation yields satisfactory outcomes

Decreased femoral trochlea axial orientation corrected by derotational distal femur osteotomy in patients with patellar dislocation yields satisfactory outcomes

The accuracy of multiple regression models for predicting the individual risk of recurrent lateral patellar dislocation

Inductive 3D numerical modelling of the tibia bone using MRI to examine von Mises stress and overall deformation

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