The Prevalence and Combined Prevalences of Anatomic Factors Associated With Recurrent Patellar Dislocation

Steensen, Robert N.; Bentley, Jared C.; Trinh, Thai Q.; Backes, Jeffrey; Wiltfong, Roger E.

doi:10.1177/0363546514563904

Cited by 247 publications

(254 citation statements)

References 28 publications

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“…К ло-кальным статическим факторам относят состояние кости, гиалинового хряща и связок, а к локальным динамическим -мышц, окружающих надколенник. Сре-ди этиологических факторов важную роль играют дисплазия мыщелков бедренной кости и дисплазия надколенника (53-71%), нарушение положения надколенника (patella alta -«высокий» надколенник») и дисплазия четырёхглавой мышцы бедра (60-61%), генерализованная гипермобиль-ность суставов (24%) [47].…”

Section: Etiopathogenic Bases For Patellofemoral Arthritis Developmentunclassified

“…При данном патологическом состоянии проблема с нестабильностью именно КС не является ведущей, поэтому коррекция про-изводится при её необходимости и обосно-ванности [47].…”

Section: Etiopathogenic Bases For Patellofemoral Arthritis Developmentunclassified

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Etiopathogenic bases for patellofemoral arthritis development

Саид

М²,

Akhtyamov

et al. 2018

Kazan Med J

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Patellofemoral arthritis is nowadays an actual issue of traumatology and orthopedics. High prevalence of this pathology around the world (6.9 to 36.1%) is associated with multiple etiological causes, responsible for certain difficulties in diagnosis and complexity of determining an individualized pathogenetic method of treatment. The pathology, often occurring in the young age, is called «delayed or late arthritis», due to the fact that it is often ignored in the early stages of its development. This leads, in the final stages of disease, to manifestation of classic osteoarthritis involving all the structures of the knee joint in the process. The literature review is devoted to the study of etiology, pathogenesis and anatomical features of the development of patellofemoral arthritis. From the clinical point of view, the most important factors, influencing patellofemoral arthritis course, are analyzed. They include mechanisms of the disease, anatomical features of patella, trochlear surface and femoral condyles, which affect the disease course. The article discusses the risk factors of patellofemoral arthritis, such as weakness of vastus muscles of quadriceps femoris, increased knee Q-angle, increased femoral anteversion and tibial rotation, abnormalities of patellar and tibial epicondyles morphology. In addition the study presents some data about dysplasia of the condyles and femoral trochlea and patella, disposition of the patella and dysplasia of the quadriceps. Variations of configuration and position of patella affecting its stability are described and presented. The article also focuses on the influence of internal tibial rotation and femoral anteversion on the development of disease, as well as patellar instability as a multifactorial cause.

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Section: Etiopathogenic Bases For Patellofemoral Arthritis Developmentunclassified

Etiopathogenic bases for patellofemoral arthritis development

Саид

М²,

Akhtyamov

et al. 2018

Kazan Med J

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“…The normal TT:TG distance is 2-9 mm, and it is generally accepted that a figure of >19 mm is pathological [41,42,43]. It is estimated that 42% of patients with PFJI have abnormal TT:TG distance [30]. Although TT:TG distance is regarded by many clinicians as one of the important measurements in assessing patellar instability and deciding about distal realignment procedures, our research has shown that it is not a decisive element in establishing therapeutic choices for instability [43,44].…”

Section: Clinical and Radiologic Assessment Of The Patellamentioning

confidence: 99%

“…The etiology of PFJI is multifactorial as it involves several abnormal anatomical factors such as generalized hypermobility (24%) [29], patella hypermobility (51%) [29], increased femoral anteversion (27%), core, and hip abductor weakness, abnormal knee rotation, trochlea dysplasia (53-71%), abnormal Q angle, patella alta (60-66%) [30], muscle and soft tissue imbalance, external tibial torsion, and foot hyperpronation, which have been identified in patients with recurrent patella dislocation. In a recent magnetic resonance imaging (MRI) based study, 58.3% of patients had multipleanatomic factors associated with recurrent patella dislocation [30] (Figure 3).…”

Section: Introductionmentioning

confidence: 99%

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Patellofemoral Joint Instability: A Review of Current Concepts

Kader¹,

Matar²,

Caplan³

2016

jot

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The patellofemoral joint remains the enigma of orthopedics and sports medicine. Patellar dislocation is a common problem in the younger and athletic population and it is more disabling than cruciate ligament injuries. The pathology is often multifactorial and complex with no one factor being the sole defining etiology. The current management of patella dislocation has been linked with poor patient satisfaction possibly due to a prolonged period of conservative treatment and the general tendency to delay surgical intervention. This review will address the main abnormal anatomical factors contributing to patellar instability, their clinical and radiological diagnoses, and the role of various surgical interventions, including the medial patellofemoral ligament reconstruction in stabilizing the patella.

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Computational analysis of factors contributing to patellar dislocation

Fitzpatrick

Steensen

Tumuluri

et al. 2015

Journal Orthopaedic Research

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Treatment for an initial incidence of patellar dislocation is usually conservative management; however, almost half of patients experience a subsequent, or multiple, dislocation(s). Patients often undergo multiple procedures which fail to treat the underlying anatomic abnormalities. The objective of this study was to evaluate interactions between key predisposing anatomic factors to patellar dislocation and identify combinations of abnormal factors which increase the risk of recurrent lateral dislocation. Four factors associated with lateral patellar dislocation were identified (sulcus angle, Insall-Salvati ratio, tibial tubercle-trochlear groove distance, and femoral anteversion). A finite element model of the patellofemoral joint was developed and parameterized so that a value for each factor could be applied and the model geometry/alignment would be modified accordingly. 100 combinations of the four factors were generated in separate computational simulations and resulting kinematics and forces of the patellofemoral joint were recorded. Sulcus angle was the most impactful factor on constraint. Multiple abnormal factors were generally required to produce the extremes of patellar alignment observed in this analysis. Understanding the underlying anatomic factors, and their effect on joint mechanics, for patients with recurrent lateral patellar dislocation will aid in determining optimal treatment pathways on a patient-specific basis.

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The Prevalence and Combined Prevalences of Anatomic Factors Associated With Recurrent Patellar Dislocation

Cited by 247 publications

References 28 publications

Etiopathogenic bases for patellofemoral arthritis development

Etiopathogenic bases for patellofemoral arthritis development

Patellofemoral Joint Instability: A Review of Current Concepts

Computational analysis of factors contributing to patellar dislocation

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