The Experts below are selected from a list of 207 Experts worldwide ranked by ideXlab platform
Fernandez J Diaz - One of the best experts on this subject based on the ideXlab platform.
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spontaneous Patella Dislocation in rubinstein taybi syndrome
Knee, 2007Co-Authors: Sanchez J Lazaro, Sanchez S Herraez, Diaz L Gallego, Gamazo E Caballero, Fernandez J DiazAbstract:A patient with Rubinstein Taybi Syndrome ( RTS) was found to have spontaneous Patella Dislocation and spontaneous Patella reduction. Clinical examination revealed ligamentous laxity and reducible Patella. Open reduction and stabilization with semitendinosus tenodesis were done. Surgical treatment should not be put off because of the delay in the ability to walk in addition to the poor psychomotor abilities of children with RTS. This case is of particular interest as it represents an unusual type of Dislocation that has not been reported in the literature so far.
Gerd Seitlinger - One of the best experts on this subject based on the ideXlab platform.
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conservative versus tailored surgical treatment in patients with first time lateral Patella Dislocation a randomized controlled trial
Journal of Orthopaedic Surgery and Research, 2021Co-Authors: Michael Liebensteiner, Alexander Keiler, El R Attal, Peter Balcarek, F Dirisamer, Johannes M Giesinger, Gerd Seitlinger, M Nelitz, Armin Keshmiri, Jannik FringsAbstract:Background Patellar instability has a high incidence and occurs particularly in young and female patients. If the Patella dislocates for the first time, treatment is usually conservative. However, this cautious approach carries the risk of recurrence and of secondary pathologies such as osteochondral fractures. Moreover, there is also risk of continuous symptoms apparent, as recurrent Patella Dislocation is related to patellofemoral osteoarthritis as well. An initial surgical treatment could possibly avoid these consequences of recurrent Patella Dislocation. Methods A prospective, randomized-controlled trial design is applied. Patients with unilateral first-time Patella Dislocation will be considered for participation. Study participants will be randomized to either conservative treatment or to a tailored Patella stabilizing treatment. In the conservative group, patients will use a knee brace and will be prescribed outpatient physical therapy. The surgical treatment will be performed in a tailored manner, addressing the pathologic anatomy that predisposes to Patella Dislocation. The Banff Patellofemoral Instability-Instrument 2.0, recurrence rate, apprehension test, joint degeneration, and the Patella Instability Severity Score will serve as outcome parameters. The main analysis will focus on the difference in change of the scores between the two groups within a 2-year follow-up. Statistical analysis will use linear mixed models. Power analysis was done for the comparison of the two study arms at 2-year follow-up with regard to the BPII Score. A sample size of N = 64 per study arm (128 overall) provides 80% power (alpha = 0.05, two-tailed) to detect a difference of 0.5 standard deviations in a t-test for independent samples. Discussion Although several studies have already dealt with this issue, there is still no consensus on the ideal treatment concept for primary Patellar Dislocation. Moreover, most of these studies show a unified surgical group, which means that all patients were treated with the same surgical procedure. This is regarded as a major limitation as surgical treatment of Patella Dislocation should depend on the patient's anatomic pathologies leading to Patellar instability. To our knowledge, this is the first study investigating whether patients with primary Patella Dislocation are better treated conservatively or operatively with tailored surgery to stabilize the Patella. Trial registration The study will be prospectively registered in the publicly accessible database www.ClinicalTrials.gov .
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what is the chance that a Patella Dislocation will happen a second time update on the natural history of a first time Patella Dislocation in the adolescent
Current Opinion in Pediatrics, 2017Co-Authors: Gerd Seitlinger, Hannah N Ladenhauf, Guido WiererAbstract:Purpose of reviewPatellar instability occurs mainly in young patients and shows a high incidence of concomitant cartilage injuries. Recently there has been a strong attempt to identify risk factors and enhance imaging techniques to detect patients with an increased risk for recurrent Patella disloca
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the position of the tibia tubercle in 0 90 flexion comparing patients with Patella Dislocation to healthy volunteers
Knee Surgery Sports Traumatology Arthroscopy, 2014Co-Authors: Gerd Seitlinger, Georg Scheurecker, Richard Hogler, Luc Labey, Bernardo Innocenti, Siegfried HofmannAbstract:The aim of this study was to measure the tibia tubercle trochlea groove distance (TT–TG) as a function of knee flexion. Our hypothesis was that there is a different pattern in healthy volunteers and patients with Patella instability (PFI). Thirty-six knees of 30 patients with at least one Dislocation of the Patella and 30 knees of 30 healthy volunteers as control group were analysed with magnetic resonance imaging by three different observers. The TT–TG was measured in steps of 15° between 0° and 90° of knee flexion. Furthermore, the alignment of the leg (MA), the femur torsion (FTor) and the tibia torsion (TTor) was calculated. The TT–TG was higher in patients compared to volunteers and in extension compared to flexion. This difference was statistically significant (p < 0.05). Most of the patients with a TT–TG above 20 mm in extension showed a high decrease in flexion to normal values. In some patients, this compensating mechanism fails. MA, FTor and TTor were not different in patients and control group (n.s.). The TT–TG distance is dynamic and decreased significantly during flexion in knees with PFI and healthy volunteers. However, there were a small number of patients in the PFI group where this compensation mechanism did not work. Therefore, the decision to perform a tibia tubercle osteotomy should not be based on one single measurement in extension or 30° of knee flexion. II.
Micael Haugegaard - One of the best experts on this subject based on the ideXlab platform.
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combined arthroscopic deepening trochleoplasty and reconstruction of the medial patellofemoral ligament for patients with recurrent Patella Dislocation and trochlear dysplasia
Knee Surgery Sports Traumatology Arthroscopy, 2014Co-Authors: Lars Blond, Micael HaugegaardAbstract:Purpose Prospectively, a consecutive group of patients troubled by recurrent Patella Dislocation and trochlear dysplasia has been followed after a combined arthroscopic deepening trochleoplasty and reconstruction of the medial patellofemoral ligament. The purpose of this follow-up study is to report the clinical results.
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combined arthroscopic deepening trochleoplasty and reconstruction of the medial patellofemoral ligament for patients with recurrent Patella Dislocation and trochlear dysplasia
Knee Surgery Sports Traumatology Arthroscopy, 2014Co-Authors: Lars Blond, Micael HaugegaardAbstract:Prospectively, a consecutive group of patients troubled by recurrent Patella Dislocation and trochlear dysplasia has been followed after a combined arthroscopic deepening trochleoplasty and reconstruction of the medial patellofemoral ligament. The purpose of this follow-up study is to report the clinical results. Indications for combined arthroscopic deepening trochleoplasty and reconstruction of the medial patellofemoral ligament were two or more Patellar Dislocations with a persistent apprehension sign above 20° of flexion and trochlear dysplasia grade B or more. Prospectively, the Tegner, Kujala and KOOS scores were recorded. Thirty-one consecutive patients (37 knees), 21 women and 10 men, with a median age of 19 (12–39) underwent the procedure. Results were obtained for 29 knees with a minimum of 12-month follow-up (average 29 months; range 12–57). No complications, reDislocations or arthrofibrosis have been recorded. Five patients needed further surgery. The median pre- and postoperative scores (range) are as follows: Kujala 64 (12–90) to 95 (47–100); Tegner 4 (1–6) to 6 (4–9); KOOS score pain 86–94; symptoms 82–86; ADL 91–99; sport 40–86; QDL 25–81. No significant correlation was found with respect to the results and recorded parameters. Significant improvement for all of the scores was observed (p < 0.001). The use of arthroscopic deepening trochleoplasty in combination with reconstruction of the medial patellofemoral ligament was found to be a safe and reproducible procedure. Considering the stability achieved, the knee scores and the patient’s level of satisfaction, the results are encouraging. Prospective consecutive case series, with evaluation of confounding factor. No control group, Level IV.
Sanchez J Lazaro - One of the best experts on this subject based on the ideXlab platform.
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spontaneous Patella Dislocation in rubinstein taybi syndrome
Knee, 2007Co-Authors: Sanchez J Lazaro, Sanchez S Herraez, Diaz L Gallego, Gamazo E Caballero, Fernandez J DiazAbstract:A patient with Rubinstein Taybi Syndrome ( RTS) was found to have spontaneous Patella Dislocation and spontaneous Patella reduction. Clinical examination revealed ligamentous laxity and reducible Patella. Open reduction and stabilization with semitendinosus tenodesis were done. Surgical treatment should not be put off because of the delay in the ability to walk in addition to the poor psychomotor abilities of children with RTS. This case is of particular interest as it represents an unusual type of Dislocation that has not been reported in the literature so far.
Lars Blond - One of the best experts on this subject based on the ideXlab platform.
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combined arthroscopic deepening trochleoplasty and reconstruction of the medial patellofemoral ligament for patients with recurrent Patella Dislocation and trochlear dysplasia
Knee Surgery Sports Traumatology Arthroscopy, 2014Co-Authors: Lars Blond, Micael HaugegaardAbstract:Purpose Prospectively, a consecutive group of patients troubled by recurrent Patella Dislocation and trochlear dysplasia has been followed after a combined arthroscopic deepening trochleoplasty and reconstruction of the medial patellofemoral ligament. The purpose of this follow-up study is to report the clinical results.
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combined arthroscopic deepening trochleoplasty and reconstruction of the medial patellofemoral ligament for patients with recurrent Patella Dislocation and trochlear dysplasia
Knee Surgery Sports Traumatology Arthroscopy, 2014Co-Authors: Lars Blond, Micael HaugegaardAbstract:Prospectively, a consecutive group of patients troubled by recurrent Patella Dislocation and trochlear dysplasia has been followed after a combined arthroscopic deepening trochleoplasty and reconstruction of the medial patellofemoral ligament. The purpose of this follow-up study is to report the clinical results. Indications for combined arthroscopic deepening trochleoplasty and reconstruction of the medial patellofemoral ligament were two or more Patellar Dislocations with a persistent apprehension sign above 20° of flexion and trochlear dysplasia grade B or more. Prospectively, the Tegner, Kujala and KOOS scores were recorded. Thirty-one consecutive patients (37 knees), 21 women and 10 men, with a median age of 19 (12–39) underwent the procedure. Results were obtained for 29 knees with a minimum of 12-month follow-up (average 29 months; range 12–57). No complications, reDislocations or arthrofibrosis have been recorded. Five patients needed further surgery. The median pre- and postoperative scores (range) are as follows: Kujala 64 (12–90) to 95 (47–100); Tegner 4 (1–6) to 6 (4–9); KOOS score pain 86–94; symptoms 82–86; ADL 91–99; sport 40–86; QDL 25–81. No significant correlation was found with respect to the results and recorded parameters. Significant improvement for all of the scores was observed (p < 0.001). The use of arthroscopic deepening trochleoplasty in combination with reconstruction of the medial patellofemoral ligament was found to be a safe and reproducible procedure. Considering the stability achieved, the knee scores and the patient’s level of satisfaction, the results are encouraging. Prospective consecutive case series, with evaluation of confounding factor. No control group, Level IV.