Rotational Deformity —When and How to Address Femoral Anteversion and Tibial Torsion
Rotational deformity is a less common cause of patellar instability than trochlear dysplasia and patella alta. In some cases, rotational deformity is the primary bony factor producing the instability and should be corrected surgically. More research is needed on what are normal values for femoral version and tibial torsion, as well as when the axial plane alignment needs to be corrected. Many tools can be used to evaluate the axial plane and surgeons should be familiar with each of them. Understanding the advantages and disadvantages of each site for osteotomy will help the surgeon choose the most appropriate osteotomy. (S...
Source: Clinics in Sports Medicine - November 13, 2021 Category: Sports Medicine Authors: Benjamin Noonan, Trenton Cooper, Michael Chau, Melissa Albersheim, Elizabeth A. Arendt, Marc Tompkins Source Type: research
Genu Valgum Correction and Biplanar Osteotomies
This article explores the role of corrective osteotomy and discusses the various described methods both on the femoral and tibial sides of the joint. A detailed operative technique of medial closing wedge distal femoral osteotomy is included. (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - November 13, 2021 Category: Sports Medicine Authors: Scott Taylor, Alan Getgood Source Type: research
Trochlear Dysplasia
When? Only patients with high-grade trochlear dysplasia types B and D, in which the prominence of the trochlea (supratrochlear spur) is over 5 mm, recurrent patellar dislocation, and maltracking. How? Sulcus deepening trochleoplasty: modifies the trochlear shape with a central groove and oblique medial and lateral facets; decreases the patellofemoral joint reaction force by reducing the trochlear prominence (spur); and reduces the tibial tubercle and the trochlear groove value by a proximal realignment. Pros: This procedure is highly effective in restoring patellofemoral stability and satisfying the patients. Cons: The pat...
Source: Clinics in Sports Medicine - November 13, 2021 Category: Sports Medicine Authors: Edoardo Giovannetti de Sanctis, Guillaume Mesnard, David H. Dejour Source Type: research
Patellar Instability —The Great Imitator
Many diseases in medicine have been dubbed “Great Imitators” to include syphilis and, more recently, Lyme disease. In the orthopedic world, patellar instability can be added to that list. I recently offered to see a young athlete who injured his knee. He was from the high school football team that my partner takes care of. He had an effu sion and was difficult to examine, so I assumed that he had an ACL injury, sent the boy off for an MRI, and arranged for follow-up with him. I later learned that the player actually had a patellar dislocation and had a TT-TG measurement of 25 mm. (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - November 13, 2021 Category: Sports Medicine Authors: Mark D. Miller Tags: Foreword Source Type: research
There Is a Lot Going on with that Knee ….
So often, as we evaluate patients with patella instability, this is the phrase I hear from residents, fellows, and colleagues. There are numerous anatomic risk factors in play, often with several at once. Which are important? Which meet a threshold value to consider correction? Which combinations are most problematic? And how do the “experts” correct the anatomy? Decision making in this arena is critical—probably as much as technique. (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - November 13, 2021 Category: Sports Medicine Authors: David R. Diduch Tags: Preface Source Type: research
Patellofemoral Instability Decision Making and Techniques
CLINICS IN SPORTS MEDICINE (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - November 13, 2021 Category: Sports Medicine Authors: David R. Diduch Source Type: research
Copyright
ELSEVIER (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - November 13, 2021 Category: Sports Medicine Source Type: research
Contributors
MARK D. MILLER, MD (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - November 13, 2021 Category: Sports Medicine Source Type: research
Contents
Mark D. Miller (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - November 13, 2021 Category: Sports Medicine Source Type: research
Forthcoming Issues
Sports Anesthesia (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - November 13, 2021 Category: Sports Medicine Source Type: research
Glenohumeral Joint Instability
The glenohumeral joint is intrinsically predisposed to instability because of the bony anatomy but maintained in alignment by many important structures, including the glenoid labrum, glenohumeral ligaments (GHLs), and muscles and tendons. Trauma and overuse can damage these stabilizers, which may then lead to subluxation or dislocation and eventually recurrent instability. This is most common in the anterior direction, which has several recognizable patterns of injury on advanced imaging, including humeral Hill Sachs deformities, bony Bankart lesion of the anteroinferior glenoid, soft tissue Bankart lesions, Bankart varian...
Source: Clinics in Sports Medicine - September 9, 2021 Category: Sports Medicine Authors: Lauren M. Ladd, Marlee Crews, Nathan A. Maertz Source Type: research
Imaging of Elbow Injuries
Familiarity with throwing mechanics during elbow range of motion allows accurate diagnosis of sports-related elbow injuries, which occur in predictable patterns. In addition, repetitive stress-related injuries are often clinically apparent; however, imaging plays an important role in determining severity as well as associated injuries that may affect clinical management. A detailed understanding of elbow imaging regarding anatomy and mechanism of injury results in prompt and precise treatment. (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - September 9, 2021 Category: Sports Medicine Authors: Lindsay Stratchko, Humberto Rosas Source Type: research
Wrist and Hand Trauma Imaging
Injuries to the wrist and hands occur frequently in athletes from the high forces applied during sporting events. The examples presented illustrate the important role imaging has in the diagnosis of wrist and hand injuries. In addition, different imaging modalities are complementary and various examinations may be needed to help guide the management of wrist and hand traumatic pathology. (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - September 9, 2021 Category: Sports Medicine Authors: Anthony Balzer, Ashish Patel, Andrew Palisch Source Type: research
MRI of the Meniscus
The menisci of the knee are accurately evaluated by MRI. Knowledge of normal anatomy, imaging parameters, imaging appearance of the normal and torn meniscus, and common anatomic variants and pitfalls are essential in obtaining the correct imaging diagnosis. There are multiple imaging signs of meniscal tear, including linear signal intensity extending to an articular surface on at least 2 images, altered meniscal shape, displaced meniscal flap, ghost meniscus, meniscal extrusion, and parameniscal cyst. After surgery, granulation tissue may mimic tear. Diagnosis is improved by comparison to preoperative images, operative not...
Source: Clinics in Sports Medicine - September 9, 2021 Category: Sports Medicine Authors: James Derek Stensby, Lauren Clough Pringle, Julia Crim Source Type: research
Knee Ligament Imaging
This article focuses on preoperative and postoperative imaging of knee ligament injury. Basic topics pertaining to preoperative image modality selection and isolated injury detection are addressed. More advanced areas including ligamentous injury patterns, surgical indications, and postoperative imaging are also discussed. (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - September 9, 2021 Category: Sports Medicine Authors: Andrew G. Geeslin, Diego F. Lemos, Matthew G. Geeslin Source Type: research
