Patellofemoral reconstruction for patellar instability with patella alta in middle-aged patients: Clinical outcomes

Otsuki, Shuhei; Okamoto, Yukiko; Murakami, Tomohiko; Nakagawa, Kosuke; Okuno, Nobuhiro; Wakama, Hitoshi; Neo, Masashi

doi:10.1016/j.otsr.2018.01.003

Cited by 19 publications

(23 citation statements)

References 25 publications

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“…65 Overall, operative intervention has been shown to result in adequate patient outcomes, satisfaction, and postoperative stability. 16,18,58,63,68,88 Improved knowledge about pathologies involving the patellofemoral joint has been a major driving force for tailored management. 90 With the increase in treatment approaches and research on patellar instability, it is imperative to analyze the types and quality of these investigations to determine the driving factors for current and future clinical practice.…”

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confidence: 99%

Assessment and Trends of the Methodological Quality of the Top 50 Most Cited Articles on Patellar Instability

Agarwalla

Yao

Gowd

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Studies with a low level of evidence (LOE) have dominated the top cited research in many areas of orthopaedics. The wide range of treatment options for patellar instability necessitates an investigation to determine the types of studies that drive clinical practice. Purpose: To determine (1) the top 50 most cited articles on patellar instability and (2) the correlation between the number of citations and LOE or methodological quality. Study Design: Cross-sectional study. Methods: The Scopus and Web of Science databases were assessed to determine the top 50 most cited articles on patellar instability between 1985 and 2019. Bibliographic information, number of citations, and LOE were collected. Methodological quality was calculated using the Modified Coleman Methodology Score (MCMS) and the Methodological Index for Non-Randomized Studies (MINORS). Mean citations and mean citation density (citations per year) were correlated with LOE, MCMS, and MINORS scores. Results: Most studies were cadaveric (n = 10; 20.0%), published in the American Journal of Sports Medicine (n = 13; 26.0%), published between 2000 and 2009 (n = 41; 82.0%), and conducted in the United States (n = 17; 34.0%). The mean number of citations and the citation density were 158.61 ± 59.53 (range, 95.5-400.5) and 12.74 ± 5.12, respectively. The mean MCMS and MINORS scores were 59.62 ± 12.58 and 16.24 ± 3.72, respectively. No correlation was seen between mean number of citations or citation density versus LOE. A significant difference was found in the mean LOE of articles published between 1990 and 1999 (5.0 ± 0) versus those published between 2000 and 2009 (3.12 ± 1.38; P = .03) and between 2010 and 2019 (3.00 ± 1.10; P = .01). Conclusion: There was a shift in research from anatomy toward outcomes in patellar instability; however, these articles demonstrated low LOE and methodological quality. Higher quality studies are necessary to establish informed standards of management of patellar instability.

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confidence: 99%

Assessment and Trends of the Methodological Quality of the Top 50 Most Cited Articles on Patellar Instability

Agarwalla

Yao

Gowd

et al. 2021

Orthopaedic Journal of Sports Medicine

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“…The PFJ is a unique and complex structure [5], which is stabilized by a complex multivariate relationship of osseous joint geometry and force vectors generated by the capsuloligamentous stabilizers and quadriceps femoris [6]. Patellar instability (PI) is frequently caused by pathological changes involving PFJ stabilizers, which increase the likelihood of lateral patellar dislocation and early OA [8].…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, PI is related to trochlear dysplasia [8]. Schottle et al demonstrated that trochlear dysplasia of the femur is a predisposing factor for recurrent PI [9].…”

Section: Introductionmentioning

confidence: 99%

Early Patellofemoral Articular Cartilage Degeneration in a Rat Model of Patellar Instability is Associated with Activation of the NF-κB Signaling Pathway

Lin

Kang

Dai

et al. 2021

Preprint

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Background: Patellar instability (PI) often increases the possibility of lateral patellar dislocation and early osteoarthritis. The molecular mechanism of early articular cartilage degeneration during patellofemoral osteoarthritis (PFOA) still requires further investigation. However, it is known that the NF-κB signaling pathway plays an important role in articular cartilage degeneration. The aim of this study was to investigate the relationship between the NF-κB signaling pathway and patellofemoral joint cartilage degeneration. Methods: We established a rat model of PI-induced PFOA. Female 4-week-old Sprague-Dawley rats (n=120) were randomly divided into two groups: the PI (n=60) and control group (n=60). The distal femurs of the PI and control group were isolated and compared 4, 8, and 12 weeks after surgery. The morphological structure of the trochlear cartilage and subchondral bone were evaluated by micro-computed tomography and histology. The expression of NF-κB, matrix metalloproteinase (MMP)-13, collagen X, and TNF-ɑ were evaluated by immunohistochemistry and quantitative polymerase chain reaction. Results: In the PI group, subchondral bone loss and cartilage degeneration were found 4 weeks after surgery. Compared with the control group, the protein and mRNA expression of NF-κB and TNF-ɑ were significantly increased 4, 8, and 12 weeks after surgery in the PI group. In addition, the markers of cartilage degeneration MMP-13 and collagen X were more highly expressed in the PI group compared with the control group at different time points after surgery.Conclusions: This study has demonstrated that early patellofemoral joint cartilage degeneration can be caused by PI in growing rats, accompanied by significant subchondral bone loss and cartilage degeneration. In addition, the degeneration of articular cartilage may be associated with the activation of the NF-κB signaling pathway and can deteriorate with time as a result of PI.

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“…An increased tibial tuberosity-trochlear groove (TTTG) distance measured on CT scan is an important factor for patellar instability and is clinically used for defining the indications for the medialising tibial tubercle osteotomy (TTO) [1][2][3] . It approximates the amount of lateralisation of the patellar tendon insertion by using the apex of the tibial tuberosity as the landmark for the location of the patellar tendon.…”

Section: Introductionmentioning

confidence: 99%

A Comparison of the Reliability of the Patellar TendonTrochlear Groove (PTTG) Distance and the Tibial TuberosityTrochlear Groove (TTTG) Distance Measured on MRI

Gupta

Batta²,

Kataria

et al. 2020

Malays Orthop J

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Introduction: An increased tibial tuberosity-trochlear groove (TTTG) distance is used for deciding a treatment plan in patello-femoral instability (PFI). The centre of the patellar tendon and the chondral trochlear groove can be directly visualised on MRI, and measured, giving the patellar tendontrochlear groove (PTTG) distance. A study was designed to compare the inter-rater and the test-retest reliabilities of PTTG and TTTG measurements in MRI of patients without PFI and in a group with PFI. Materials and Methods:This cross-sectional reliability study was done on archival MRI films of 50 patients without patellar instability and 20 patients with patellar instability. TTTG and PTTG distances were independently measured by two orthopaedic surgeons and two radiologists. A hybrid PTTG measurement with bony landmarks on the femoral side and the patellar tendon landmark on the tibial side, was used to estimate the influence of the differences in the femoral and tibial landmarks on the difference in reliabilities. The intra-class correlation coefficient (ICC) was calculated for all four raters, as well as separately for each rater. Results: The PTTG distance had a higher inter-rater reliability (ICC=0.86, 95% CI=0.79-0.92) compared to the TTTG distance (ICC=0.70, 95% CI=0.59-0.80) in patients without PFI. Similar trends were seen in patients with PFI (0.83 vs 0.66). The inter-rater reliability for the hybrid PTTG distance was found to lie in between the TTTG and PTTG. Conclusions: The MRI-based PTTG distance had better inter-rater reliability compared with the MRI-based TTTG distance.

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Patellofemoral reconstruction for patellar instability with patella alta in middle-aged patients: Clinical outcomes

Abstract: IV. Retrospective case series study.

Cited by 19 publications

References 25 publications

Assessment and Trends of the Methodological Quality of the Top 50 Most Cited Articles on Patellar Instability

Assessment and Trends of the Methodological Quality of the Top 50 Most Cited Articles on Patellar Instability

Early Patellofemoral Articular Cartilage Degeneration in a Rat Model of Patellar Instability is Associated with Activation of the NF-κB Signaling Pathway

A Comparison of the Reliability of the Patellar TendonTrochlear Groove (PTTG) Distance and the Tibial TuberosityTrochlear Groove (TTTG) Distance Measured on MRI

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