Surgical treatment of chronic proximal patellar tendon tears grades 3 and 4 using augmentation with quadriceps tendon-bone graft.

Background: Chronic proximal patellar tendinosis with partial tendon tears represents a multifactorial overuse injury. Several surgical techniques have been described with various outcomes and the return to sports may fail.

Hypothesis: Reconstruction of the proximal patellar tendon with augmentation using a quadriceps tendon-bone (QTB) graft improves knee function in patients presenting with proximal patellar tendinosis and partial tendon tears.

Patellar tendon lengthening and augmentation with quadriceps tendon graft for treatment of severe patella infera.

Background: Patella infera represents a permanent abnormally low position of the patella with three characteristics: distal position of the patella in the femoral trochlea, permanent shortening of the patellar tendon, and decreased distance between the inferior pole of the patella and the articular surface of the tibia. Several surgical techniques have been described to resolve this disabling condition with varying outcomes.

Hypothesis: Lengthening of the shortened patellar tendon with augmentation using a quadriceps tendon graft in combination with excessive intra-articular release improve knee function in patients presenting with severe and permanent patella infera.

Patella Alta: When to Correct and Impact on Other Anatomic Risk Factors for Patellofemoral Instability.

Patella alta is described as abnormally high-riding patella in relation to the femur, the trochlear groove, or the tibia with decreased bony stability. Patella alta represents an important predisposing factor for patellofemoral instability. Different measurement methods are used to define patella alta.

Reflections on Rotational Osteotomies around the Patellofemoral Joint.

Torsional abnormalities of the femur represent a significant risk factor for patellar instability or patellofemoral complaints. Although their clinical implication has been demonstrated, there is still a debate going on about different aspects. These include, especially, the various methods of measurements with a wide range of physiologic values, the indication or clear recommendation for surgical correction, and the site of the rotational osteotomy.

Combined deepening trochleoplasty and supracondylar external rotation osteotomy for recurrent patellar instability in patients with trochlear dysplasia and increased femoral antetorsion.

Background: Deepening trochleoplasty has become a part of surgical management in patients with patellar instability and severe trochlear dysplasia. In addition, increased femoral antetorsion is treated most commonly by proximal femoral external rotation osteotomy.

Hypothesis: Deepening trochleoplasty and supracondylar femoral external rotation osteotomy in combination improve patellar stability and function in patients presenting with recurrent patellar instability due to trochlear dysplasia and increased femoral antetorsion.