Complex floating knee injuries, comprising complete articular distal femur and proximal tibia fractures, are a significant challenge in Orthopedic Traumatology. Traditional surgical approaches can result in a limited exposure, compromising osteosynthesis, with an extensive soft tissue dissection predisposing to adhesion of the quadriceps and arthrofibrosis. The Patella Osteotomy technique provides unrivaled visualization of the articular surfaces of the knee, with a limited soft tissue dissection to permit the anatomical reconstruction of the articular injury, while minimizing the risk of postsurgical complications and reducing intraoperative fluoroscopy time.
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High-grade trochlear dysplasia increases patellofemoral joint pressure and decreases the knee extension torque, and tibial tubercle anteriorisation does not correct these effects: Biomechanical study in vitro.
Knee Surg Sports Traumatol Arthrosc
December 2024
Mechanical Engineering Department, Biomechanics Group, Imperial College, London, UK.
Purpose: High-grade femoral trochlear dysplasia is associated with anterior knee pain, patellar maltracking, instability and the development of osteoarthritis. Scientific studies have signified the importance of trochlear resection on the knee extensor mechanism, and dysplasia can be addressed by a groove-deepening trochleoplasty. Alternatively, tibial tubercle anteriorisation has been proposed to reduce patellofemoral joint (PFJ) pressure and alleviate pain from osteoarthritis.
View Article and Find Full Text PDFNo secondary osteoarthritis after recession wedge trochleoplasty associated with tibial tubercle osteotomy for treating recurrent patellar dislocation in high-grade dysplasia.
Orthop Traumatol Surg Res
December 2024
Department of Orthopedic and Trauma Surgery, Centre Hospitalier de Versailles, Île-de-France Ouest University, 177 Rue de Versailles, 78150 Le Chesnay, France. Electronic address:
Purpose: To determine in the long-term the rate of osteoarthritis of recession wedge trochleoplasty performed in patients with high-grade trochlear dysplasia and recurrent patellar dislocations. The hypothesis was that the rate of secondary osteoarthritis was low.
Methods: Fifteen consecutive patients (17 knees) undergoing a recession wedge trochleoplasty surgery for recurrent patellar dislocation were retrospectively included.
What's up with patella alta?
Curr Opin Pediatr
February 2025
Hospital for Special Surgery, New York, New York.
Purpose Of Review: Patella alta, which describes an abnormally proximally positioned patella, has become of particular interest as it has been identified as a potential factor in patellofemoral instability (PFI) and other common pediatric orthopedic conditions. The purpose of this review is to describe the condition, measuring techniques, and its association with pediatric orthopedic conditions, and to evaluate methods of correction of patella alta.
Recent Findings: Recent literature has explored the etiology of patella alta by investigating patellar height as age increases, with inconclusive findings as to whether the condition is congenital or acquired over time.
Predictors of Increased Complication Rate Following Tibial Tubercle Osteotomy (TTO).
Knee
December 2024
NYU Langone Health, Department of Orthopedics, Division of Sports Medicine, 333 E 38th St, New York, NY 10016, United States.
Purpose: The purpose of the current study was to define the incidence of minor and major complications following TTO at a tertiary-care institution, with determination of predictive factors related to the occurrence of a major complication.
Study Design: Retrospective case series.
Methods: Patients who underwent TTO from 2011 to 2023 were retrospectively identified.
Impact of the Number of Patellar Dislocations on Outcomes of Isolated Medial Patellofemoral Ligament Reconstruction.
Orthop J Sports Med
December 2024
Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Background: Patellar dislocation is a common knee injury and up to 35% of those who dislocate the patella can develop recurrent patellar instability. In the setting of recurrent instability, medial patellofemoral ligament (MPFL) reconstruction is often performed to restore knee stability. There has been recent interest in patient and surgical factors that influence outcomes of MPFL reconstruction.
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