BOOK
Understanding the Patellofemoral Joint: From Instability to Arthroplasty; An Issue of Clinics in Sports Medicine, E-Book
(2014)
Additional Information
Book Details
Abstract
This issue of Clinics in Sports Medicine will focus on patellofemoral disorders and how they are among the most common clinical conditions managed in the orthopaedic and sports medicine setting. The correct diagnosis at an early stage is essential if subsequent treatment is to be successful and secondary complications are to be avoided. Nonoperative intervention is usually the first form of treatment; however, there is no consensus on the most effective method of treatment.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Understanding the Patellofemoral Joint: From Instability to Arthroplasty\r | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| Contents | vii | ||
| Clinics In Sports Medicine\r | x | ||
| Foreword | xi | ||
| Preface\r | xiii | ||
| Patellofemoral Anatomy and Biomechanics | 389 | ||
| Key points | 389 | ||
| Introduction | 389 | ||
| Epidemiology | 389 | ||
| Spectrum of disease | 390 | ||
| Anatomy | 390 | ||
| Osseous Anatomy of the Patella | 390 | ||
| Osseous Anatomy of the Trochlea | 390 | ||
| Anatomy of patellofemoral soft tissue structures | 393 | ||
| Quadriceps Mechanism | 393 | ||
| Patella Tendon | 393 | ||
| Medial Soft Tissues | 393 | ||
| Lateral Soft Tissues | 394 | ||
| Biomechanics | 395 | ||
| Normal Patella Tracking | 395 | ||
| Measurements of osseous restraint | 396 | ||
| Coronal and Axial Planes | 396 | ||
| Sagittal Plane | 397 | ||
| Abnormal Patella Tracking | 399 | ||
| Summary | 399 | ||
| References | 400 | ||
| Physical Examination of the Patellofemoral Joint | 403 | ||
| Key points | 403 | ||
| Introduction | 403 | ||
| Overview | 404 | ||
| Standing | 405 | ||
| Sitting | 407 | ||
| Supine | 408 | ||
| Summary | 411 | ||
| References | 411 | ||
| Imaging of the Patellofemoral Joint | 413 | ||
| Key points | 413 | ||
| Introduction | 413 | ||
| Imaging of the knee | 413 | ||
| Radiographs | 413 | ||
| Magnetic Resonance Imaging | 414 | ||
| Anatomy | 415 | ||
| Patellar Anatomy and Variants | 415 | ||
| Bipartite Patella | 415 | ||
| Dorsal Defect of the Patella | 415 | ||
| Patellar Cartilage | 415 | ||
| Trochlea | 416 | ||
| Quadriceps Tendon | 417 | ||
| Patellar Tendon | 417 | ||
| Medial Patellar Soft Tissue Restraints | 417 | ||
| Synovial Plicae of the Knee | 418 | ||
| Patellar Tilt | 418 | ||
| Axial radiograph | 419 | ||
| Lateral radiograph | 419 | ||
| MRI | 420 | ||
| Patellar Displacement (Subluxation) | 420 | ||
| Patellar Height | 421 | ||
| MRI | 422 | ||
| Apophysitis | 422 | ||
| Chondromalacia patella and osteoarthritis | 422 | ||
| Trochlear dysplasia | 424 | ||
| Tibial tubercle to trochlear groove distance | 427 | ||
| Patellar sleeve fracture | 428 | ||
| Patellar fractures | 428 | ||
| Patellar dislocation | 429 | ||
| Tendon abnormalities | 430 | ||
| Anterior bursitis | 432 | ||
| Morel-Lavallée Effusion | 433 | ||
| Superolateral Hoffa fat pad edema | 434 | ||
| Quadriceps fat pad edema | 434 | ||
| References | 434 | ||
| Anterior Knee Pain in the Athlete | 437 | ||
| Key points | 437 | ||
| Introduction | 437 | ||
| Symptoms | 437 | ||
| Diagnostic imaging | 438 | ||
| Treatment principles | 439 | ||
| Relative Rest and Activity Modification | 440 | ||
| Methods to Control Inflammation | 441 | ||
| Cryotherapy | 441 | ||
| Anti-inflammatories and analgesics | 441 | ||
| Methods to Stimulate Healing | 441 | ||
| Platelet-rich plasma | 441 | ||
| Hyaluronic acid | 441 | ||
| Other therapies | 442 | ||
| Improving Lower Extremity Biomechanics | 442 | ||
| Patellar taping | 442 | ||
| Patellofemoral bracing | 442 | ||
| Foot orthotics | 443 | ||
| Stretching | 443 | ||
| Strengthening | 444 | ||
| Pathology | 445 | ||
| Patellar Tracking | 445 | ||
| Soft-Tissue Pathology | 445 | ||
| Patellar tendinopathy | 445 | ||
| Bursitis | 445 | ||
| Pediatric patellar tendon abnormalities | 446 | ||
| Iliotibial band syndrome | 446 | ||
| Infrapatellar fat pad syndrome | 447 | ||
| Plica syndrome | 447 | ||
| Cartilage Pathology | 447 | ||
| Bone Pathology | 448 | ||
| Osteochondritis dissecans | 448 | ||
| Stress fractures | 448 | ||
| Trauma | 449 | ||
| Bipartite patella | 449 | ||
| Patellar Instability | 449 | ||
| Neuromuscular Pathology | 450 | ||
| Quadriceps muscles | 450 | ||
| Hip muscles | 450 | ||
| Muscle flexibility | 450 | ||
| Functional testing | 450 | ||
| References | 451 | ||
| Patellar Instability | 461 | ||
| Key points | 461 | ||
| Introduction | 461 | ||
| Anatomy and evaluation of the patellofemoral joint | 462 | ||
| Anatomy | 462 | ||
| Clinical History and Examination | 463 | ||
| Imaging | 463 | ||
| Radiographs | 463 | ||
| Bone Scan | 465 | ||
| CT Scan | 466 | ||
| MRI | 466 | ||
| Treatment | 466 | ||
| Nonoperative Management | 466 | ||
| Surgical Management | 467 | ||
| Arthroscopic and Minimally Invasive Techniques | 467 | ||
| MPFL Reconstruction | 468 | ||
| Tibial tubercle osteotomy | 469 | ||
| Trochleoplasty | 470 | ||
| Summary | 471 | ||
| References | 471 | ||
| Management of Patellofemoral Chondral Injuries | 477 | ||
| Key points | 477 | ||
| Introduction: nature of the problem | 477 | ||
| History | 478 | ||
| Physical examination | 478 | ||
| Indications/contraindications | 479 | ||
| Surgical technique/procedure | 479 | ||
| Complications and management | 487 | ||
| Postoperative care | 487 | ||
| Outcomes | 489 | ||
| Microfracture | 489 | ||
| ACI | 489 | ||
| Osteotomy | 490 | ||
| Osteochondral Autograft/Allograft Transplantation | 491 | ||
| Patellofemoral Arthroplasty | 491 | ||
| Summary | 498 | ||
| References | 498 | ||
| MPFL Reconstruction | 501 | ||
| Key points | 501 | ||
| Introduction | 502 | ||
| Indications | 503 | ||
| Contraindications | 503 | ||
| Surgical technique | 504 | ||
| Preoperative Planning | 504 | ||
| Preparation and Patient Positioning | 504 | ||
| Surgical Approach | 504 | ||
| Graft harvest | 504 | ||
| Patellar preparation | 504 | ||
| Femoral preparation | 505 | ||
| Graft passage | 506 | ||
| Postoperative care | 512 | ||
| Complications and management | 512 | ||
| Outcomes | 512 | ||
| Summary | 513 | ||
| Supplementary data | 513 | ||
| References | 513 | ||
| Distal Realignment | 517 | ||
| Key points | 517 | ||
| Introduction | 517 | ||
| Indications | 518 | ||
| Contraindications | 520 | ||
| Surgical technique | 521 | ||
| History of Distal Realignment Procedures | 521 | ||
| Medialization of the Tibial Tubercle | 522 | ||
| Distalization of the Tibial Tubercle | 522 | ||
| Anteriorization of the Tibial Tubercle | 523 | ||
| Anteromedialization of the Tibial Tubercle | 524 | ||
| Anteromedialization: A Detailed Surgical Technique | 524 | ||
| Complications | 526 | ||
| Postoperative management | 526 | ||
| Outcomes | 526 | ||
| Summary | 527 | ||
| References | 527 | ||
| Trochlear Dysplasia and the Role of Trochleoplasty | 531 | ||
| Key points | 531 | ||
| Introduction | 531 | ||
| Normal trochlear anatomy and biomechanics | 532 | ||
| Anatomy | 532 | ||
| Biomechanics | 532 | ||
| The anatomy and biomechanics of trochlear dysplasia | 533 | ||
| Anatomy | 533 | ||
| Biomechanics | 533 | ||
| Diagnosis of trochlear dysplasia | 533 | ||
| History and Physical Examination | 533 | ||
| Radiographic Evaluation | 534 | ||
| Magnetic Resonance Imaging | 536 | ||
| TT-TG Distance | 536 | ||
| Arthroscopy | 536 | ||
| Natural history | 537 | ||
| Treatment options | 537 | ||
| Indications for a trochleoplasty | 538 | ||
| Sulcus-deepening trochleoplasty and MPFL reconstruction | 538 | ||
| Surgical Procedure | 538 | ||
| Postoperative Rehabilitation | 542 | ||
| Complications | 542 | ||
| Outcomes after trochleoplasty | 542 | ||
| Summary | 542 | ||
| References | 543 | ||
| Patellofemoral Arthroplasty in the Athlete | 547 | ||
| Key points | 547 | ||
| Introduction | 547 | ||
| The patient | 548 | ||
| The implant | 548 | ||
| The patellofemoral preparation | 548 | ||
| Why avoid certain sports | 549 | ||
| Catastrophic Failure | 549 | ||
| Polyethylene Wear | 549 | ||
| Why allow sports | 549 | ||
| Summary: sporting recommendations | 551 | ||
| References | 551 | ||
| Rehabilitation of the Patellofemoral Joint | 553 | ||
| Key points | 553 | ||
| Introduction to rehabilitation approaches for patellofemoral pain syndrome | 553 | ||
| General goals | 554 | ||
| Clinical options for rehabilitation: acute phase | 554 | ||
| Activities | 554 | ||
| Inflammation and swelling | 554 | ||
| Medications | 554 | ||
| Modalities | 555 | ||
| Injections | 555 | ||
| Clinical options for rehabilitation: subacute phase | 557 | ||
| Protection | 557 | ||
| Bracing | 557 | ||
| Taping | 558 | ||
| Physical therapy | 558 | ||
| Manual Medicine | 558 | ||
| Strength | 559 | ||
| Flexibility | 559 | ||
| Stability | 560 | ||
| Activity Progression | 561 | ||
| Shoe type | 561 | ||
| Maintenance phase | 562 | ||
| Reasons for Failure of Conservative Treatment | 562 | ||
| Symptom Chronicity | 562 | ||
| Pain Severity | 562 | ||
| Noncompliance | 562 | ||
| Undiagnosed Conditions | 562 | ||
| Surgical referral | 563 | ||
| References | 563 | ||
| Index | 567 |