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- Comparison of Insall-Salvati Index and Its Modification in Normal Dogs from Four Different Body Weight Groups. [Journal Article]Vet Comp Orthop Traumatol 2019VC
- CONCLUSIONS: The reference intervals for the IS index were 1.04 to 2.16 in the small dogs, 1.19 to 2.27 in the medium dogs, 1.40 to 2.24 in the large dogs and 1.71 to 2.23 in the giant dogs. The reference intervals for the LLcr:PL index were 1.59 to 2.51 in the small dogs, 1.75 to 2.51 in the medium dogs, 1.81 to 2.65 in the large dogs and 1.95 to 2.59 in the giant dogs. Dogs with values exceeding these reference intervals have patella alta and those with values below these intervals have patella baja.
- Chondromalacia Patella among Military Recruits with Anterior Knee Pain: Prevalence and Association with Patellofemoral Malalignment. [Journal Article]Indian J Orthop 2019 Nov-Dec; 53(6):682-688IJ
- CONCLUSIONS: CMP is a common disorder among military recruits with AKP. Patellofemoral malalignment is an important contributory factor in the development of CMP, and the presence of edema in SHFP may be a strong indicator of underlying severe CMP in this population.
- Is Pseudo-Patella Baja Really a Serious Complication of Total Knee Arthroplasty? [Journal Article]J Arthroplasty 2019JA
- CONCLUSIONS: PPB was a relatively common finding, but no significant differences in terms of clinical outcomes were found as compared to patients with postoperative normal patellar height. TPB was infrequent, but these patients had significantly worse clinical outcomes than those with PPB or normal patellar height.
- Primary Medial Patellofemoral Ligament Repair Versus Reconstruction: Rates and Risk Factors for Instability Recurrence in a Young, Active Patient Population. [Journal Article]Arthroscopy 2019; 35(10):2909-2915A
- CONCLUSIONS: MPFL reconstruction may provide improved midterm clinical outcomes and a decreased recurrence rate compared with MPFL repair. Increased patellar height as measured by the CDI may be a risk factor for recurrent patellar instability in patients who undergo isolated MPFL repair.
- Patellar Impingement on Tibial Polyethylene after Primary Total Knee Arthroplasty without Patellar Resurfacing. [Journal Article]J Knee Surg 2019JK
- Patellar impingement on tibial polyethylene (PIP) is one potential complication of total knee arthroplasty (TKA). When PIP occurs, it is often related to inaccurate restoration of the joint line or due to soft-tissue contracture. We investigated the prevalence and etiology of PIP in Asian patients with deeply flexed knees following posterior stabilized (PS)-TKA. We retrospectively reviewed 54 pat…
Patellar impingement on tibial polyethylene (PIP) is one potential complication of total knee arthroplasty (TKA). When PIP occurs, it is often related to inaccurate restoration of the joint line or due to soft-tissue contracture. We investigated the prevalence and etiology of PIP in Asian patients with deeply flexed knees following posterior stabilized (PS)-TKA. We retrospectively reviewed 54 patients (65 knees) with PIP after primary PS-TKAs without patellar resurfacing performed between 2008 and 2011. These patients were compared with a group of 124 patients (130 knees) without PIP matched for age, sex, and body mass index (BMI). The minimum follow-up was 5 years (range, 5-8.1 years). Patients were evaluated by blinded, independent observers using the Oxford knee score, the Waters score, and radiographic parameters. Impingement between the patella and the tibial polyethylene had a mean onset of 13.5 months after PS-TKA. The development of PIP was significantly associated with change in patellar tendon length (odds ratio [OR] = 11.4, 95% confidence interval [CI]: 11.2-11.6%), shorter postoperative patellar tendon length (OR = 2.1, 95% CI: 1.8-2.5%), change in the Insall-Salvati ratio (OR = 0.9, 95% CI: 0.8-1.0%), and joint line elevation (OR = 5.3, 95% CI: 4.8-5.8%) on multiple logistic regression analysis. Our findings reinforce the importance of accurate joint line restoration and the avoidance of iatrogenic injury to the patellar tendon, which can lead to shortening of the patellar tendon. This is a retrospective comparative study and its level of evidence is III.
- Anatomic Magnetic Resonance Imaging Measurements in First-Time Patellar Dislocators by Sex and Age. [Journal Article]J Athl Train 2019; 54(8):901-905JA
- CONCLUSIONS: Patellar height and trochlear morphology did not differ by sex or age among patients whose first-time patellar dislocations resulted in an MPFL tear. In addition, the location of the tear did not appear to vary by sex or age.
- Patellofemoral morphology measurements and their associations with tibiofemoral osteoarthritis-related structural damage: exploratory analysis on the osteoarthritis initiative. [Journal Article]Eur Radiol 2020; 30(1):128-140ER
- CONCLUSIONS: Higher TT-TG distance was associated with concurrent MRI-derived OA-related structural damages and 2-year follow-up worsening only in LTFC. No associations were detected between patellofemoral morphology measurements and MTFC OA progression.• Of all patellofemoral morphology measurements, the only lateralization of the tibial tubercle may be considered as a risk factor for lateral (not medial) tibiofemoral osteoarthritis worsening. • Patellofemoral morphology measurements of patella alta, trochlear dysplasia, patellar tilt, and lateralization of the tibial tubercle are not associated with radiographic and MRI-based medial tibiofemoral osteoarthritis worsening over 2 years. • Using longitudinal MRI data, each millimeter increase of TT-TG distance is associated with a 9% (95% confidence interval, 3-16%) increase in odds of longitudinal cartilage defects in the lateral tibiofemoral (but not medial) compartment over 2 years.
- Anatomic Risk Factors for Focal Cartilage Lesions in the Patella and Trochlea: A Case-Control Study. [Journal Article]Am J Sports Med 2019; 47(10):2444-2453AJ
- CONCLUSIONS: PF anatomic abnormalities are significantly more common in patients with full-thickness PF cartilage lesions. Trochlear dysplasia, patella alta, and excessive lateral patellar tilt are the most common correlated factors, especially in patellar lesions.
- Resurfacing in a Posterior-Stabilized Total Knee Arthroplasty Reduces Patellar Crepitus Complication: A Randomized, Controlled Trial. [Journal Article]J Arthroplasty 2019; 34(9):1969-1974JA
- CONCLUSIONS: Given higher PC incidence and several worse clinical outcomes in the non-PR, we recommend resurfacing during PS-TKA with this knee system to avoid PC development.
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- Patellar height measurements: Insall-Salvati ratio is most reliable method. [Journal Article]Knee Surg Sports Traumatol Arthrosc 2019KS
- CONCLUSIONS: In this study, the Insall-Salvati ratio shows better intra- and inter-observer reliability than the Blackburne-Peel ratio, the Caton-Deschamps ratio and the modified Insall-Salvati ratio on all imaging modalities. Radiography and CT seem to have better reliability than MRI. The patellotrochlear index, however, shows good inter- and intra-observer reliability on MRI. Only for the IS method was there acceptable agreement between CR and MRI. This means that the established Insall-Salvati normal values could be used for MRI as well. This study shows that the most reliable method to measure patella height is the Insall-Salvati ratio measured on conventional radiographs or the patellotrochlear index on MRI.