Pub Date : 2023-12-01DOI: 10.1053/S1060-1872(23)00081-3
{"title":"Editorial Board (pick up from previous issue)","authors":"","doi":"10.1053/S1060-1872(23)00081-3","DOIUrl":"10.1053/S1060-1872(23)00081-3","url":null,"abstract":"","PeriodicalId":54678,"journal":{"name":"Operative Techniques in Sports Medicine","volume":"31 4","pages":"Article 151055"},"PeriodicalIF":0.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139373239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.1016/j.otsm.2023.151034
Danielle E. Chipman , Rajul Gupta , Daniel W. Green , Shital N. Parikh
The article describes safe surgical techniques to address patellar instability in children and adolescents. Open physis presents unique technical challenges during surgical treatment in skeletally immature patients. Besides MPFL reconstruction, the article presents physeal-respecting alternatives such as MQTFL reconstruction and adductor sling technique. Concomitant procedures like guided growth and distal procedures like Roux Goldwaith procedure are also described to provide an overview of commonly used techniques in skeletally immature patients with patellar instability.
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{"title":"Pediatric Medial Patellofemoral Ligament Reconstruction and Concomitant Procedures","authors":"Danielle E. Chipman , Rajul Gupta , Daniel W. Green , Shital N. Parikh","doi":"10.1016/j.otsm.2023.151034","DOIUrl":"10.1016/j.otsm.2023.151034","url":null,"abstract":"<div><div><span>The article describes safe surgical techniques to address patellar instability in children and adolescents. Open physis presents unique technical challenges during surgical treatment in skeletally immature patients. Besides </span>MPFL reconstruction<span>, the article presents physeal-respecting alternatives such as MQTFL reconstruction and adductor sling technique. Concomitant procedures like guided growth and distal procedures like Roux Goldwaith procedure are also described to provide an overview of commonly used techniques in skeletally immature patients with patellar instability.</span></div></div>","PeriodicalId":54678,"journal":{"name":"Operative Techniques in Sports Medicine","volume":"31 4","pages":"Article 151034"},"PeriodicalIF":0.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138529530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.1016/j.otsm.2023.151029
Evan T. Zheng , Chris M. Powers , Miho J. Tanaka
The patellofemoral joint experiences substantial physiologic loads with normal daily activity. Anatomic risk factors can place certain patients at risk for patellofemoral pathology including patellar instability. Stability and load capacity of the joint are a result of numerous factors including the unique configuration of osseous and cartilaginous structures, static and dynamic soft tissue stabilizers, and global lower limb alignment. A thorough understanding of the anatomy and biomechanics of the patellofemoral joint is required to identify patient-specific sources of dysfunction and to tailor individualized treatment specific to a given patient's anatomy. Identification and correction of patient specific risk factors must form the basis for successful treatment strategies. Using novel imaging techniques, dissection methods, and technology for biomechanical evaluation, our understanding of the patellofemoral joint has continued to evolve and in turn can help improve patient specific treatment and outcomes in the management of patellar instability.
{"title":"Update on Patellofemoral Anatomy and Biomechanics","authors":"Evan T. Zheng , Chris M. Powers , Miho J. Tanaka","doi":"10.1016/j.otsm.2023.151029","DOIUrl":"10.1016/j.otsm.2023.151029","url":null,"abstract":"<div><div>The patellofemoral joint<span><span> experiences substantial physiologic loads with normal daily activity. Anatomic risk factors can place certain patients at risk for patellofemoral pathology including patellar instability. Stability and load capacity of the joint are a result of numerous factors including the unique configuration of osseous and cartilaginous structures, static and dynamic soft tissue stabilizers, and global lower limb alignment. A thorough understanding of the anatomy and biomechanics of the patellofemoral joint is required to identify patient-specific sources of dysfunction and to tailor individualized treatment specific to a given patient's anatomy. Identification and correction of patient specific risk factors must form the basis for successful treatment strategies. Using novel </span>imaging techniques, dissection methods, and technology for biomechanical evaluation, our understanding of the patellofemoral joint has continued to evolve and in turn can help improve patient specific treatment and outcomes in the management of patellar instability.</span></div></div>","PeriodicalId":54678,"journal":{"name":"Operative Techniques in Sports Medicine","volume":"31 4","pages":"Article 151029"},"PeriodicalIF":0.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138529531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.1016/j.otsm.2023.151038
Matthew Stiebel , Jack Farr , Dror Paley
Valgus lower extremity alignment with excessive femoral anteversion and tibial external torsion (miserable malalignment syndrome) results in patellar maltracking. Sagittal plane deformities (rotational alignment) should be quantified along with typical frontal plane alignment. Femoral and tibial rotation can be assessed with both physical examination and radiographic studies. Derotational osteotomies of both the femur and the tibia can then be used for correction. In this chapter, we attempt to provide guidelines for assessing lower extremity rotation and an understanding of normal femoral and tibial rotational values. We then provide examples of corrective femoral osteotomies and tibial rotational osteotomies.
{"title":"Lower Limb Rotational Malalignment: Derotational Osteotomies of the Femur and Tibia in the Setting of Recurrent Patellar Instability","authors":"Matthew Stiebel , Jack Farr , Dror Paley","doi":"10.1016/j.otsm.2023.151038","DOIUrl":"10.1016/j.otsm.2023.151038","url":null,"abstract":"<div><div><span>Valgus<span> lower extremity alignment with excessive femoral anteversion and tibial external torsion (miserable malalignment syndrome) results in patellar maltracking. Sagittal plane deformities (rotational alignment) should be quantified along with typical frontal plane alignment. Femoral and tibial rotation can be assessed with both physical examination and radiographic studies. Derotational </span></span>osteotomies<span> of both the femur and the tibia<span> can then be used for correction. In this chapter, we attempt to provide guidelines for assessing lower extremity rotation and an understanding of normal femoral and tibial rotational values. We then provide examples of corrective femoral osteotomies<span> and tibial rotational osteotomies.</span></span></span></div></div>","PeriodicalId":54678,"journal":{"name":"Operative Techniques in Sports Medicine","volume":"31 4","pages":"Article 151038"},"PeriodicalIF":0.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138529554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.1016/j.otsm.2023.151033
Natalie K. Kucirek, Drew A. Lansdown
Medial patellofemoral ligament (MPFL) repair is a historically relevant treatment option for patellar instability, though it has been increasingly supplanted by MPFL reconstruction. Although several comparative studies report superior functional outcomes and a lower risk of recurrent patellar dislocation after MPFL reconstruction, MPFL repair may still be a viable treatment for a select group of patients. Patients with normal trochlear morphology, a normal TT-TG distance, lack of patella alta, and older age may be the best candidates for MPFL repair. MPFL repair also appears to be most effective when performed in the acute setting for avulsion-type tears. In an effort to improve repair outcomes, suture tape augmentation of MPFL repair has emerged recently and has shown promising early results. While our practice is typically to perform MPFL reconstruction for patellar instability, MPFL repair in appropriately selected patients may provide good clinical outcomes while avoiding some of the risks associated with reconstruction.
{"title":"Medial Patellofemoral Ligament Repair: Still a Relevant Treatment for Patellar Instability?","authors":"Natalie K. Kucirek, Drew A. Lansdown","doi":"10.1016/j.otsm.2023.151033","DOIUrl":"10.1016/j.otsm.2023.151033","url":null,"abstract":"<div><div><span>Medial patellofemoral ligament (MPFL) repair is a historically relevant treatment option for patellar instability, though it has been increasingly supplanted by MPFL reconstruction. Although several comparative studies report superior functional outcomes and a lower risk of recurrent </span>patellar dislocation<span> after MPFL reconstruction, MPFL repair may still be a viable treatment for a select group of patients. Patients with normal trochlear morphology, a normal TT-TG distance, lack of patella alta, and older age may be the best candidates for MPFL repair. MPFL repair also appears to be most effective when performed in the acute setting for avulsion-type tears. In an effort to improve repair outcomes, suture tape augmentation of MPFL repair has emerged recently and has shown promising early results. While our practice is typically to perform MPFL reconstruction for patellar instability, MPFL repair in appropriately selected patients may provide good clinical outcomes while avoiding some of the risks associated with reconstruction.</span></div></div>","PeriodicalId":54678,"journal":{"name":"Operative Techniques in Sports Medicine","volume":"31 4","pages":"Article 151033"},"PeriodicalIF":0.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138529512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.1016/j.otsm.2023.151039
Chilan B.G. Leite , Logan W. Huff , Giovanna I.S. Medina , Brian J. Cole , Christian Lattermann
Patellofemoral cartilage injuries present a complex challenge due to the unique anatomy and biomechanics of the joint. The daily activities involving the knee, such as weight-bearing, stair ambulation, and squatting, impose high loads on the joint, increasing the risk of cartilage overload and subsequent cartilage injury. Additionally, several anatomical abnormalities, including patellar malalignment, patella alta, and trochlear dysplasia, can influence the behavior of the patellofemoral joint, leading to instability and further elevating the risk of cartilage injuries. Surgical management of patellofemoral cartilage injuries remains a topic of modern debate. The effectiveness and suitability of different techniques depend on individual indications and the characteristics of the cartilage defect. This chapter explores the use of cartilage repair and restoration techniques for patellofemoral cartilage defects. Here, we discuss aspects of the surgical techniques, their outcomes, and provide insights into when staging arthroscopy or concomitant stability surgery should be considered.
{"title":"Cartilage Restoration of the Patellofemoral Joint: Techniques and Outcomes","authors":"Chilan B.G. Leite , Logan W. Huff , Giovanna I.S. Medina , Brian J. Cole , Christian Lattermann","doi":"10.1016/j.otsm.2023.151039","DOIUrl":"10.1016/j.otsm.2023.151039","url":null,"abstract":"<div><div><span>Patellofemoral cartilage injuries<span> present a complex challenge due to the unique anatomy and biomechanics of the joint. The daily activities involving the knee, such as weight-bearing, stair ambulation, and squatting, impose high loads on the joint, increasing the risk of cartilage overload and subsequent cartilage injury. Additionally, several </span></span>anatomical abnormalities<span><span>, including patellar malalignment, patella alta, and trochlear </span>dysplasia<span>, can influence the behavior of the patellofemoral joint<span>, leading to instability and further elevating the risk of cartilage injuries. Surgical management of patellofemoral cartilage injuries remains a topic of modern debate. The effectiveness and suitability of different techniques depend on individual indications and the characteristics of the cartilage defect. This chapter explores the use of cartilage repair and restoration techniques for patellofemoral cartilage defects. Here, we discuss aspects of the surgical techniques, their outcomes, and provide insights into when staging arthroscopy or concomitant stability surgery should be considered.</span></span></span></div></div>","PeriodicalId":54678,"journal":{"name":"Operative Techniques in Sports Medicine","volume":"31 4","pages":"Article 151039"},"PeriodicalIF":0.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138529505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.1016/j.otsm.2023.151036
Benjamin Kerzner , Daniel J. Kaplan , Luc M. Fortier , Zeeshan A. Khan , Johnathon R. McCormick , Betina B. Hinckel , Jorge Chahla
Medial patellar instability is less common than lateral instability and is almost always iatrogenic in nature. The lateral patellofemoral complex, and in particular the lateral patellofemoral ligament, is a major restraint to medial displacement of the patella. When considering surgical intervention, a comprehensive evaluation including understanding of previous procedures and presence of additional risk factors for instability, such as trochlear dysplasia, malalignment, or patella alta must be ruled out. This paper highlights recent anatomic and biomechanical evidence for the treatment of medial patellar instability as well as the pearls and pitfalls for a successful lateral patellofemoral ligament reconstruction.
{"title":"Lateral Patellofemoral Ligament Reconstruction: Anatomy, Biomechanics, Indications, and Surgical Techniques","authors":"Benjamin Kerzner , Daniel J. Kaplan , Luc M. Fortier , Zeeshan A. Khan , Johnathon R. McCormick , Betina B. Hinckel , Jorge Chahla","doi":"10.1016/j.otsm.2023.151036","DOIUrl":"10.1016/j.otsm.2023.151036","url":null,"abstract":"<div><div>Medial patellar instability is less common than lateral instability and is almost always iatrogenic in nature. The lateral patellofemoral complex, and in particular the lateral patellofemoral ligament, is a major restraint to medial displacement of the patella. When considering surgical intervention, a comprehensive evaluation including understanding of previous procedures and presence of additional risk factors for instability, such as trochlear dysplasia, malalignment, or patella alta must be ruled out. This paper highlights recent anatomic and biomechanical evidence for the treatment of medial patellar instability as well as the pearls and pitfalls for a successful lateral patellofemoral ligament reconstruction.</div></div>","PeriodicalId":54678,"journal":{"name":"Operative Techniques in Sports Medicine","volume":"31 4","pages":"Article 151036"},"PeriodicalIF":0.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138529544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.1016/j.otsm.2023.151031
Erik Haneberg, Andrew Phillips, Eric Cotter, Adam B. Yanke
The lateral retinaculum is a complex, layered structure that is the primary constraint to medial translation of the patella. Patients can develop patellar hypercompression syndrome and arthritis of the lateral patellofemoral joint from an overly tight lateral retinaculum. Conservative treatments include physical therapy and bracing but if relief is not achieved, surgical treatment in the form of lateral retinacular lengthening or release may alleviate symptoms. This chapter provides a thorough background of the risks, indications, outcomes, and techniques regarding treatment of the lateral retinaculum.
{"title":"Lateral Lengthening and Lateral Release","authors":"Erik Haneberg, Andrew Phillips, Eric Cotter, Adam B. Yanke","doi":"10.1016/j.otsm.2023.151031","DOIUrl":"10.1016/j.otsm.2023.151031","url":null,"abstract":"<div><div>The lateral retinaculum<span><span> is a complex, layered structure that is the primary constraint to medial translation of the patella. Patients can develop patellar hypercompression syndrome and arthritis of the lateral </span>patellofemoral joint from an overly tight lateral retinaculum. Conservative treatments include physical therapy and bracing but if relief is not achieved, surgical treatment in the form of lateral retinacular lengthening or release may alleviate symptoms. This chapter provides a thorough background of the risks, indications, outcomes, and techniques regarding treatment of the lateral retinaculum.</span></div></div>","PeriodicalId":54678,"journal":{"name":"Operative Techniques in Sports Medicine","volume":"31 4","pages":"Article 151031"},"PeriodicalIF":0.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138529507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1016/j.otsm.2023.151020
Caitlin A. Nicholson
{"title":"Introduction: The Female Athlete","authors":"Caitlin A. Nicholson","doi":"10.1016/j.otsm.2023.151020","DOIUrl":"10.1016/j.otsm.2023.151020","url":null,"abstract":"","PeriodicalId":54678,"journal":{"name":"Operative Techniques in Sports Medicine","volume":"31 3","pages":"Article 151020"},"PeriodicalIF":0.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138509822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1016/j.otsm.2023.151026
Elizabeth M. Pieroth , Alissa Wicklund
The majority of research on sport-related concussions is conducted on male athletes. The paucity of research focused on female athletes creates a challenge in developing protocols for prevention and treatment of female athletes with concussions. This paper reviews the current epidemiology, injury mechanisms and treatment of concussions in female athletes. Theories on sex-based differences in sport-related concussions are presented. Areas for future research are also reviewed.
{"title":"Concussion in Female Athletes","authors":"Elizabeth M. Pieroth , Alissa Wicklund","doi":"10.1016/j.otsm.2023.151026","DOIUrl":"10.1016/j.otsm.2023.151026","url":null,"abstract":"<div><p>The majority of research on sport-related concussions is conducted on male athletes. The paucity of research focused on female athletes creates a challenge in developing protocols for prevention and treatment of female athletes with concussions. This paper reviews the current epidemiology, injury mechanisms and treatment of concussions in female athletes. Theories on sex-based differences in sport-related concussions are presented. Areas for future research are also reviewed.</p></div>","PeriodicalId":54678,"journal":{"name":"Operative Techniques in Sports Medicine","volume":"31 3","pages":"Article 151026"},"PeriodicalIF":0.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138509779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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