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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-10-2014 | Knee

Variations in kinematics and function following patellar stabilization including tibial tuberosity realignment

Authors: John J. Elias, John A. Carrino, Archana Saranathan, Loredana M. Guseila, Miho J. Tanaka, Andrew J. Cosgarea

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 10/2014

Abstract

Purpose

The current study was performed to characterize the influence of patellar stabilization procedures on patellofemoral and tibiofemoral dynamic motion.

Methods

Six knees were evaluated pre-operatively and 1 year or longer following stabilization via tibial tuberosity realignment, with simultaneous medial patellofemoral ligament reconstruction performed for five knees. Knees were imaged during extension against gravity using a dynamic CT scanner. Models representing each knee at several positions of extension were reconstructed from the images. Local coordinate systems were created within one femur, patella and tibia for each knee, with shape matching of the bones used to transfer the coordinate axes to the other models. The patellar lateral shift and tilt and tibial external rotation were quantified based on the reference axes and interpolated to flexion angles from 5° to 40°. Pre-operative and post-operative data were compared with the paired t tests.

Results

Surgical realignment significantly decreased the average patellar lateral shift and tilt at low flexion angles. At 5°, surgical realignment decreased the average lateral shift from 15.5 (6.3) to 8.5 (4.7) mm and decreased the average lateral tilt from 20.8 (9.4)° to 13.8 (6.4)°. The changes were statistically significant (p < 0.05) at 5° and 10° of flexion, as well as 20° for lateral shift. The average tibial external rotation also increased significantly at 30° and 40° following surgery.

Conclusion

Patellar stabilization including a component of tuberosity realignment reduces patellar lateral shift and tilt at low flexion angles, but the long-term influence of increased tibial external rotation on tibiofemoral function is currently unknown.

Level of evidence

Prospective comparative study, Level II.

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Title: Variations in kinematics and function following patellar stabilization including tibial tuberosity realignment
Authors: John J. Elias
John A. Carrino
Archana Saranathan
Loredana M. Guseila
Miho J. Tanaka
Andrew J. Cosgarea
Publication date: 01-10-2014
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 10/2014
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-014-2905-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Variations in kinematics and function following patellar stabilization including tibial tuberosity realignment

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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