The stability of the patellofemoral joint relies on the tenuous interplay of soft tissue and bony factors. Anatomic risk factors for instability include a shallow trochlea, an abnormally lateral tibial tubercle position, patella alta, hypermobility, or a secondary injury to the medial patellofemoral ligament (MPFL). There is an increasing interest in restoring normal anatomy to achieve stability, and at times more than 1 abnormality exists. This article describes the technique for combining a tibial tuberosity transfer and an MPFL reconstruction. The key features include planning of skin incisions to enable both operations to be undertaken, planning of the screw placement before osteotomy is performed and assessment of the joint through a superolateral portal to assess the need for MPFL reconstruction after tuberosity transfer.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5495215 | PMC |
http://dx.doi.org/10.1016/j.eats.2017.01.003 | DOI Listing |
J Shoulder Elbow Surg
December 2024
Shoulder and Elbow Division, Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA.
Background: Patients undergoing reverse shoulder arthroplasty (RSA) for rotator cuff arthropathy may present with an external rotation (ER) lag due to posterior rotator cuff insufficiency. As a result, the addition of a latissimus dorsi (LD) tendon transfer in combination with RSA has become increasingly utilized. Initial descriptions of LD tendon transfer involved rerouting of the LD tendon posterior to the long head of the triceps tendon.
View Article and Find Full Text PDFArthroscopy
December 2024
Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Faculty of Medicine, Universitas Trisakti, Department of Orthopedic Surgery, St. Carolus Hospital, Jakarta, Indonesia.
Purpose: To evaluate the minimum 12-month clinical and radiological outcomes of combined superior capsular reconstruction (SCR) and lower trapezius transfer (LTT) for posterosuperior irreparable massive rotator cuff tears (IMRCTs).
Methods: Patients with posterosuperior IMRCTs and severe fatty infiltration (Goutallier grades 3 or more) in the infraspinatus who underwent SCR +LTT were retrospectively reviewed. A double-folded fascia lata autograft with one layer of polypropylene mesh inside was used for SCR and an Achilles tendon allograft was used to connect the tendon of lower trapezius to the greater tuberosity.
Cureus
November 2024
Paris Shoulder and Elbow Unit, Institut de la Main, Clinic Jouvenet, Paris, FRA.
Introduction The purpose of this study was to evaluate the feasibility of transferring the pectoralis minor (PM) in its entirety and assess its relationship with the musculocutaneous nerves (MCN) and axillary nerves (AXN). Methods Sixteen fresh transthoracic cadaver specimens were used. After PM transfer, the following measures were obtained: (a) the distance between the coracoid process (CP) and the subscapularis insertion on the lesser tubercle during external, neutral, and internal rotation.
View Article and Find Full Text PDFKnee Surg Relat Res
December 2024
Department of Orthopaedics Surgery, AUVA Trauma Center Klagenfurt, Waidmannsdorferstraße 35, 9020, Klagenfurt Am Wörthersee, Austria.
Background: The aim of this study was to compare the clinical and radiologic results of the arthroscopic and the open trochleoplasty techniques.
Methods: A total of 83 trochleoplasties in 83 patients were performed between 2014 and 2021 in one institution. Surgical indications for trochleoplasty were recurrent patellofemoral instability and a lateral trochlear inclination angle (LTI) ≤ 11˚ and a trochlear depth ≤ 6 mm.
Arthrosc Tech
October 2024
Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri, U.S.A.
Recent attention has turned toward the prevention of acromiohumeral abutment in the treatment of irreparable rotator cuff tears (IRCTs). This can be achieved through tendon transfer with a bridging allograft, superior capsular reconstruction, dermal allograft application to the greater tuberosity (biologic tuberoplasty), bursal acromial reconstruction, or subacromial balloon spacer placement. Recent literature has demonstrated increased graft thickness is associated with improved clinical outcomes after superior capsular reconstruction, suggesting a potential role of a direct bone-to-bone contact between the greater tuberosity and acromion in symptom generation in patients with IRCTs.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!