Contributors
MARK D. MILLER, MD (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - March 15, 2022 Category: Sports Medicine Source Type: research
Contents
Mark D. Miller (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - March 15, 2022 Category: Sports Medicine Source Type: research
Clinics in Sports Medicine
Sports Cardiology (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - March 15, 2022 Category: Sports Medicine Source Type: research
Myocarditis in the Athlete
Myocarditis is a leading cause of sudden death in athletes. Early data demonstrating increased prevalence of cardiac injury in hospitalized patients with COVID-19 raised concerns for athletes recovered from COVID-19 and the possibility of underlying myocarditis. However, subsequent large registries have provided reassuring data affirming low prevalence of myocarditis in athletes convalesced from COVID-19. Although the clinical significance of subclinical myocarditis detected by cardiac MRI remains uncertain, clinical outcomes have not demonstrated an increase in acute cardiac events in athletes throughout the pandemic. Fut...
Source: Clinics in Sports Medicine - February 16, 2022 Category: Sports Medicine Authors: John D. Symanski, Jason V. Tso, Dermot M. Phelan, Jonathan H. Kim Source Type: research
Myocarditis in the Athlete: a focus on COVID-19 sequelae
Myocarditis is a leading cause of sudden death in athletes. Early data demonstrating increased prevalence of cardiac injury in hospitalized patients with COVID-19 raised concerns for athletes recovered from COVID-19 and the possibility of underlying myocarditis. However, subsequent large registries have provided reassuring data affirming low prevalence of myocarditis in athletes convalesced from COVID-19. While the clinical significance of sub-clinical myocarditis detected by cardiac MRI remains uncertain, clinical outcomes have not demonstrated an increase in acute cardiac events in athletes throughout the pandemic. Futur...
Source: Clinics in Sports Medicine - February 16, 2022 Category: Sports Medicine Authors: John D. Symanski, Jason V. Tso, Dermot M. Phelan, Jonathan H. Kim Source Type: research
Evaluating Patellofemoral Patients
This article reviews the evaluation, physical examination, and interpretation of radiographic imaging of patients with patellofemoral pain as an introduction to subsequent articles in this issue discussing surgical interventions. (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - November 13, 2021 Category: Sports Medicine Authors: Davis L. Rogers, Andrew J. Cosgarea Source Type: research
Patella Alta
Patella alta is described as abnormally high-riding patella in relation to the femur, the trochlear groove, or the tibia with decreased bony stability. Patella alta represents an important predisposing factor for patellofemoral instability. Different measurement methods are used to define patella alta. Despite the clinical importance of patella alta, there is only limited consensus on cutoff values, indications for treatment, and ideal correction. In addition, the impact of patella alta on other risk factors for lateral patellar instability is significant. This must be considered when assessing clinical complaints and choo...
Source: Clinics in Sports Medicine - November 13, 2021 Category: Sports Medicine Authors: Roland M. Biedert Source Type: research
Medial Patellofemoral Ligament Reconstruction
Medial patellofemoral ligament reconstruction is used increasingly to treat patellar instability. A number of different techniques have been described to perform this procedure. In this article, we review common pearls and pitfalls to medial patellofemoral ligament reconstruction, as well as tips for troubleshooting the procedure. A special emphasis is placed on femoral tunnel position and intraoperative adjustments that can be made to improve outcomes. (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - November 13, 2021 Category: Sports Medicine Authors: Gregory Anderson, David R. Diduch Source Type: research
Medial Patellofemoral Ligament Reconstruction with Open Physes
This article focuses on several key points, such as the importance of medial patellofemoral ligament femoral insertions being distal to the growth plate and performing extensive lateral release and quadricep tendon lengthening in cases of obligatory dislocation. Although acknowledging the procedures discussed cannot be considered for all patients, as individuals with open growth plates may require additional operative time, in many cases these techniques yield high rates of success. (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - November 13, 2021 Category: Sports Medicine Authors: Sofia Hidalgo Perea, Sara R. Shannon, Daniel W. Green Source Type: research
Management of Chondral Defects Associated with Patella Instability
Cartilage defects of the patellofemoral joint are commonly found in association with patellar instability owing to abnormal biomechanics. Strategies to address chondral defects of the patellofemoral joint secondary to instability should first address causes of recurrent instability. Most patellofemoral chondral defects associated with instability are less than 2 cm2 and do not generally require intervention beyond chondroplasty. Larger defects of the patella and/or the trochlea can be repaired with osteochondral or surface cartilage repair. (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - November 13, 2021 Category: Sports Medicine Authors: Mark T. Langhans, Sabrina M. Strickland, Andreas H. Gomoll Source Type: research
Medial Patellofemoral Ligament Repair or Medial Advancement
Patellar instability is one of the most prevalent knee disorders, with dislocations occurring in 5 to 43 cases per 10,000 annually. Traumatic patellar dislocation can result in significant morbidity and is associated with patellofemoral chondral injuries and fractures, medial soft tissue disruption, pain, and reduced function, and can lead to patellofemoral osteoarthritis. Chronic and recurrent instability can lead to deformation and incompetence of the medial soft tissue stabilizers. Despite recent gains in understanding the pathoanatomy of this disorder, the management of patients with this condition is complex and remai...
Source: Clinics in Sports Medicine - November 13, 2021 Category: Sports Medicine Authors: Iain R. Murray, Christopher M. LaPrade, William Michael Pullen, Seth L. Sherman Source Type: research
The Lateral Side
The lateral patellofemoral complex is an important stabilizer to medial and lateral displacement of the patella. Soft tissue abnormalities can range from pathologic tightness to laxity, presenting with symptoms related to patellar instability, anterior knee pain, or arthritis. Clinical evaluation should be performed to confirm patellar dislocation, assess the integrity of the lateral and medial soft tissues, and explore other pathoanatomic factors that may need to be addressed. Lateral retinacular lengthening is recommended over lateral release owing to the potential of iatrogenic medial instability with release, and a lat...
Source: Clinics in Sports Medicine - November 13, 2021 Category: Sports Medicine Authors: Navya Dandu, Nicholas A. Trasolini, Steven F. DeFroda, Reem Y. Darwish, Adam B. Yanke Source Type: research
Coronal Malalignment —When and How to Perform a Tibial Tubercle Osteotomy
Coronal malalignment of the patellofemoral joint may contribute to both instability as well as pain and joint overload. The use of distal realignment procedures has evolved to include uniplanar and multiplanar osteotomies, which allows patient-specific treatment. With a careful understanding of the complex pathoanatomy, including osseous, soft tissue, and dynamic muscular factors, an appropriately designed tibial tubercle osteotomy (TTO) is an invaluable tool for the orthopedic surgeon to improve joint biomechanics and off-load articular injuries. Current techniques have improved TTO surgery to limit complications and prod...
Source: Clinics in Sports Medicine - November 13, 2021 Category: Sports Medicine Authors: Elizabeth C. Gardner, David A. Molho, John P. Fulkerson Source Type: research
Putting it all Together
Management of the patient with multiple risk factors for recurrent patellar instability is complex. Surgeons must possess familiarity with the anatomic risk factors that are associated with first time and recurrent instability events and weigh them in the patient ’s individualized surgical “menu” options for surgical patellar stabilization. Addressing individual risk factors, pairing imaging findings with physical examination, and thoughts on prioritizing risk factors to determine which should be prioritized for surgical correction are discussed. (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - November 13, 2021 Category: Sports Medicine Authors: Michaela I. McCarthy, Betina B. Hinckel, Elizabeth A. Arendt, Caitlin C. Chambers Source Type: research
Fixed (Congenital) Patellar Dislocation
Congenital dislocation of the patella is a rare condition characterized by lateral dislocation of the patella that is irreducible without surgical correction. Although there is no clear inheritance pattern, it is associated with several congenital syndromes. Patients often demonstrate flexion contracture, loss of active knee extension, increased tibial external rotation, and absent patella in the trochlea. Treatment requires surgical management and is comprised of lateral release, medial stabilization, quadriceps lengthening, and distal realignment. Results are generally favorable after treatment; persistent flexion contra...
Source: Clinics in Sports Medicine - November 13, 2021 Category: Sports Medicine Authors: Phillip T. Grisdela, Nikolaos Paschos, Miho J. Tanaka Source Type: research
