SpringerLink
Log in

Putting It All Together

  • Living reference work entry
  • First Online:
Knee Arthroscopy and Knee Preservation Surgery

Abstract

The patellofemoral joint is complex due to highly variable morphology as well as dynamic factors that can contribute to its dysfunction. Given this, it is key to not only perform a comprehensive assessment of patellofemoral patients but also to subsequently determine which factors are relevant to treatment and which can be successfully managed with purposeful, ongoing nonoperative care. Utilizing a standardized approach for all patients, including simple cases, is crucial in order to understand more complex cases. In this chapter, the aim is to synthesize the previously presented information in creating a workflow from patient assessment to procedural planning, and finishing with case examples highlighting surgical decision-making and how it pertains to concomitant pathology.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Atkin DM, Fithian DC, Marangi KS, et al. Characteristics of patients with primary acute lateral patellar dislocation and their recovery within the first 6 months of injury. Am J Sports Med. 2000;28(4):472–9.

    Article  CAS  PubMed  Google Scholar 

  2. Balcarek P, Oberthür S, Hopfensitz S, et al. Which patellae are likely to redislocate? Knee Surg Sports Traumatol Arthrosc. 2014;22(10):2308–14.

    Article  PubMed  Google Scholar 

  3. Balcarek P, Zimmermann F. Deepening trochleoplasty and medial patellofemoral ligament reconstruction normalize patellotrochlear congruence in severe trochlear dysplasia. Bone Joint J. 2019;101-b(3):325–30.

    Article  CAS  PubMed  Google Scholar 

  4. Beck PR, Thomas AL, Farr J, Lewis PB, Cole BJ. Trochlear contact pressures after anteromedialization of the tibial tubercle. Am J Sports Med. 2005;33(11):1710–5.

    Article  PubMed  Google Scholar 

  5. Brady JM, Rosencrans AS, Shubin Stein BE. Use of TT-PCL versus TT-TG. Curr Rev Musculoskelet Med. 2018;11(2):261–5.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Christensen TC, Sanders TL, Pareek A, et al. Risk factors and time to recurrent ipsilateral and contralateral patellar dislocations. Am J Sports Med. 2017;45(9):2105–10.

    Article  PubMed  Google Scholar 

  7. Elias JJ, Tanaka MJ, Jones KC, Cosgarea AJ. Tibial tuberosity anteriomedialization vs. medial patellofemoral ligament reconstruction for treatment of patellar instability related to malalignment: computational simulation. Clin Biomech (Bristol, Avon). 2020;74:111–7.

    Article  PubMed  Google Scholar 

  8. Franciozi CE, Ambra LF, Albertoni LJB, et al. Anteromedial tibial tubercle osteotomy improves results of medial patellofemoral ligament reconstruction for recurrent patellar instability in patients with tibial tuberosity-trochlear groove distance of 17 to 20 mm. Arthroscopy. 2019;35(2):566–74.

    Article  PubMed  Google Scholar 

  9. Frings J, Krause M, Akoto R, Wohlmuth P, Frosch KH. Combined distal femoral osteotomy (DFO) in genu valgum leads to reliable patellar stabilization and an improvement in knee function. Knee Surg Sports Traumatol Arthrosc. 2018;26(12):3572–81.

    Article  PubMed  Google Scholar 

  10. Hevesi M, Heidenreich MJ, Camp CL, et al. The recurrent instability of the patella score: a statistically based model for prediction of long-term recurrence risk after first-time dislocation. Arthroscopy. 2019;35(2):537–43.

    Article  PubMed  Google Scholar 

  11. Heyworth BE, Carroll KM, Dawson CK, Gill TJ. Open lateral retinacular closure surgery for treatment of anterolateral knee pain and disability after arthroscopic lateral retinacular release. Am J Sports Med. 2012;40(2):376–82.

    Article  PubMed  Google Scholar 

  12. Hiemstra LA, Kerslake S, Loewen M, Lafave M. Effect of trochlear dysplasia on outcomes after isolated soft tissue stabilization for patellar instability. Am J Sports Med. 2016;44(6):1515–23.

    Article  PubMed  Google Scholar 

  13. Imhoff FB, Cotic M, Liska F, et al. Derotational osteotomy at the distal femur is effective to treat patients with patellar instability. Knee Surg Sports Traumatol Arthrosc. 2019;27(2):652–8.

    Article  PubMed  Google Scholar 

  14. Jaquith BP, Parikh SN. Predictors of recurrent patellar instability in children and adolescents after first-time dislocation. J Pediatr Orthop. 2017;37(7):484–90.

    Article  PubMed  Google Scholar 

  15. Lewallen L, McIntosh A, Dahm D. First-time patellofemoral dislocation: risk factors for recurrent instability. J Knee Surg. 2015;28(4):303–9.

    Article  PubMed  Google Scholar 

  16. Liu JN, Brady JM, Kalbian IL, et al. Clinical outcomes after isolated medial patellofemoral ligament reconstruction for patellar instability among patients with trochlear dysplasia. Am J Sports Med. 2018;46(4):883–9.

    Article  PubMed  Google Scholar 

  17. Manjunath AK, Hurley ET, Jazrawi LM, Strauss EJ. Return to play after medial patellofemoral ligament reconstruction: a systematic review. Am J Sports Med. 2021;49(4):1094–100.

    Article  PubMed  Google Scholar 

  18. MDCalc. Recurrent Instability of the Patella (RIP) Score. https://www.mdcalc.com/recurrent-instability-patella-rip-score. Accessed Mar 11, 2022.

  19. Ménétrey J, Putman S, Gard S. Return to sport after patellar dislocation or following surgery for patellofemoral instability. Knee Surg Sports Traumatol Arthrosc. 2014;22(10):2320–6.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Moatshe G, Cinque ME, Kruckeberg BM, Chahla J, LaPrade RF. Medial patellar instability: a systematic review of the literature of outcomes after surgical treatment. Arthroscopy. 2017;33(8):1587–93.

    Article  PubMed  Google Scholar 

  21. Nelitz M, Dreyhaupt J, Lippacher S. Combined trochleoplasty and medial patellofemoral ligament reconstruction for recurrent patellar dislocations in severe trochlear dysplasia: a minimum 2-year follow-up study. Am J Sports Med. 2013;41(5):1005–12.

    Article  PubMed  Google Scholar 

  22. Platt BN, Bowers LC, Magnuson JA, et al. Return to sport after medial patellofemoral ligament reconstruction: a systematic review and meta-analysis. Am J Sports Med. 2022;50(1):282–91.

    Article  PubMed  Google Scholar 

  23. Rue JP, Colton A, Zare SM, et al. Trochlear contact pressures after straight anteriorization of the tibial tuberosity. Am J Sports Med. 2008;36(10):1953–9.

    Article  PubMed  Google Scholar 

  24. Saper M. Lateral patellofemoral ligament reconstruction with a gracilis allograft. Arthrosc Tech. 2018;7(4):e405–10.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Saper MG, Shneider DA. Lateral patellofemoral ligament reconstruction using a quadriceps tendon graft. Arthrosc Tech. 2014;3(4):e445–8.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Seitlinger G, Scheurecker G, Högler R, et al. Tibial tubercle-posterior cruciate ligament distance: a new measurement to define the position of the tibial tubercle in patients with patellar dislocation. Am J Sports Med. 2012;40(5):1119–25.

    Article  PubMed  Google Scholar 

  27. Teitge RA, Torga SR. Lateral patellofemoral ligament reconstruction. Arthroscopy. 2004;20(9):998–1002.

    Article  PubMed  Google Scholar 

  28. van Sambeeck JDP, van de Groes SAW, Verdonschot N, Hannink G. Trochleoplasty procedures show complication rates similar to other patellar-stabilizing procedures. Knee Surg Sports Traumatol Arthrosc. 2018;26(9):2841–57.

    Article  PubMed  Google Scholar 

  29. Wilkens OE, Hannink G, van de Groes SAW. Recurrent patellofemoral instability rates after MPFL reconstruction techniques are in the range of instability rates after other soft tissue realignment techniques. Knee Surg Sports Traumatol Arthrosc. 2020;28(6):1919–31.

    Article  PubMed  Google Scholar 

  30. Wilson PL, Black SR, Ellis HB, Podeszwa DA. Distal femoral valgus and recurrent traumatic patellar instability: is an isolated varus producing distal femoral osteotomy a treatment option? J Pediatr Orthop. 2018;38(3):e162–7.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Mayo Clinic, Rochester, MN, USA

    Mario Hevesi

  2. Houston Methodist Hospital, Houston, TX, USA

    Kevin Credille

  3. OrthoIndy Hospital, Indianapolis, IN, USA

    Jack Farr

  4. Midwest Orthopedics at Rush, Chicago, IL, USA

    Adam B. Yanke

Authors
  1. Mario Hevesi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kevin Credille
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jack Farr
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Adam B. Yanke
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Adam B. Yanke .

Editor information

Editors and Affiliations

  1. Sports Medicine Clinic, Stanford University, Redwood City, CA, USA

    Seth L. Sherman

  2. Midwest Orthopedics, Rush University, Chicago, IL, USA

    Jorge Chahla

  3. Department of Orthopedics, Hospital for Special Surgery, New York, NY, USA

    Scott A. Rodeo

  4. Complex Knee and Sports Medicine Surgeon, Twin Cities Spine Center, Edina, MN, USA

    Robert LaPrade

Section Editor information

  1. Knee Preservation and Cartilage Restoration Center, OrthoIndy, Indianapolis, USA

    Jack Farr

  2. Midwest Orthopedics at Rush, Chicago, IL, USA

    Adam Yanke

Rights and permissions

Reprints and permissions

Copyright information

© 2024 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Hevesi, M., Credille, K., Farr, J., Yanke, A.B. (2024). Putting It All Together. In: Sherman, S.L., Chahla, J., Rodeo, S.A., LaPrade, R. (eds) Knee Arthroscopy and Knee Preservation Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-82869-1_71-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-82869-1_71-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-82869-1

  • Online ISBN: 978-3-030-82869-1

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation