Patellar Tendon Tenodesis in Association With Tibial Tubercle Distalization for the Treatment of Episodic Patellar Dislocation With Patella Alta
Background: The association between patella alta and episodic patellar dislocation (EPD) has been well described, but its pathophysiology is not completely clear. Patella alta causes decreased contact between the patella and trochlea and decreased resistance to lateral translation of the patella. Ad...
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| Veröffentlicht in: | The American journal of sports medicine 2012-02, Vol.40 (2), p.346-351 |
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| creator | Mayer, Cyril Magnussen, Robert A. Servien, Elvire Demey, Guillaume Jacobi, Matthias Neyret, Philippe Lustig, Sebastien |
| description | Background: The association between patella alta and episodic patellar dislocation (EPD) has been well described, but its pathophysiology is not completely clear. Patella alta causes decreased contact between the patella and trochlea and decreased resistance to lateral translation of the patella. Additionally, increased patellar tendon length may allow pathologically increased coronal plane patellar motion. It may thus be desirable to address the length of the patellar tendon itself rather than just its insertion site.
Hypothesis: Tenodesis of the patellar tendon in association with tibial tubercle distalization in patients with EPD and abnormally long patellar tendons (>52 mm) results in significant reduction in patellar tendon length, prevention of further patellar dislocation, and good knee function at long-term follow-up.
Study Design: Case series; Level of evidence, 4.
Methods: Twenty-seven knees in 22 patients with EPD and patella alta were treated with patellar tendon tenodesis and tibial tubercle distalization. Following tubercle distalization, the patellar tendon was tenodesed into the original location of the tibial tubercle with suture anchors. Changes in patellar tendon length and patellar height were measured radiographically. Any recurrent dislocation was documented, and patients completed an International Knee Documentation Committee (IKDC) subjective form at a mean of 9.6 years (range, 6-14 years) after surgery.
Results: The mean length of the patellar tendon decreased from 56.3 ± 2.7 mm to 44.3 ± 8.6 mm (P < .0001). The Caton-Deschamps index decreased from 1.22 ± 0.17 to 0.95 ± 0.22 (P < .0001), and the Insall-Salvati ratio decreased from 1.42 ± 0.17 to 0.91 ± 0.18 (P < .0001). No patellar dislocations occurred postoperatively. The mean postoperative subjective IKDC score was 75.6 ± 9.5.
Conclusion: Patellar tendon tenodesis and tibial tubercle distalization result in normalization of patellar tendon length, a stable patellofemoral joint, and good long-term knee function in patients with patella alta and EPD. |
| doi_str_mv | 10.1177/0363546511427117 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_923209937</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0363546511427117</sage_id><sourcerecordid>920230283</sourcerecordid><originalsourceid>FETCH-LOGICAL-c425t-ebfe35f3f0efafa9688f751ddba256e8f211ff43896a165122a4d628ca80aa973</originalsourceid><addsrcrecordid>eNqNkU1v1DAQhi0EotvCnROykFBPAX_EjnNclfIhVYJDEMdo4oypq2y82M6h_Ap-Mo52aVElJE4j-X3emfG8hLzg7A3nTfOWSS1VrRXntWjKyyOy4UqJSkqtHpPNKlerfkJOU7phjPFGm6fkRAjOWlWrDfn1BTJOE0Ta4TyGeS1hxOQT9TPdphSsh-yL8M3na9r5wcNEu2XAaCek73zKMPmfB8SFSPM10i4i5B3OmQZHL_c-hdFbejepmKZg_-p6VOh2yvCMPHEwJXx-rGfk6_vL7uJjdfX5w6eL7VVla6FyhYNDqZx0DB04aLUxrlF8HAcQSqNxgnPnamlaDbwcSAioRy2MBcMA2kaekfND330MPxZMud_5ZNc1ZgxL6lshBWtb-T8kE5IJIwv56gF5E5Y4l2-skJFGyLpA7ADZGFKK6Pp99DuItz1n_Zpq_zDVYnl57LsMOxzvDH9iLMDrIwDJwuQizNane07pcjTNC1cduATf8X65fw7-DdEft28</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>920838234</pqid></control><display><type>article</type><title>Patellar Tendon Tenodesis in Association With Tibial Tubercle Distalization for the Treatment of Episodic Patellar Dislocation With Patella Alta</title><source>MEDLINE</source><source>SAGE Complete</source><source>Alma/SFX Local Collection</source><creator>Mayer, Cyril ; Magnussen, Robert A. ; Servien, Elvire ; Demey, Guillaume ; Jacobi, Matthias ; Neyret, Philippe ; Lustig, Sebastien</creator><creatorcontrib>Mayer, Cyril ; Magnussen, Robert A. ; Servien, Elvire ; Demey, Guillaume ; Jacobi, Matthias ; Neyret, Philippe ; Lustig, Sebastien</creatorcontrib><description>Background: The association between patella alta and episodic patellar dislocation (EPD) has been well described, but its pathophysiology is not completely clear. Patella alta causes decreased contact between the patella and trochlea and decreased resistance to lateral translation of the patella. Additionally, increased patellar tendon length may allow pathologically increased coronal plane patellar motion. It may thus be desirable to address the length of the patellar tendon itself rather than just its insertion site.
Hypothesis: Tenodesis of the patellar tendon in association with tibial tubercle distalization in patients with EPD and abnormally long patellar tendons (>52 mm) results in significant reduction in patellar tendon length, prevention of further patellar dislocation, and good knee function at long-term follow-up.
Study Design: Case series; Level of evidence, 4.
Methods: Twenty-seven knees in 22 patients with EPD and patella alta were treated with patellar tendon tenodesis and tibial tubercle distalization. Following tubercle distalization, the patellar tendon was tenodesed into the original location of the tibial tubercle with suture anchors. Changes in patellar tendon length and patellar height were measured radiographically. Any recurrent dislocation was documented, and patients completed an International Knee Documentation Committee (IKDC) subjective form at a mean of 9.6 years (range, 6-14 years) after surgery.
Results: The mean length of the patellar tendon decreased from 56.3 ± 2.7 mm to 44.3 ± 8.6 mm (P < .0001). The Caton-Deschamps index decreased from 1.22 ± 0.17 to 0.95 ± 0.22 (P < .0001), and the Insall-Salvati ratio decreased from 1.42 ± 0.17 to 0.91 ± 0.18 (P < .0001). No patellar dislocations occurred postoperatively. The mean postoperative subjective IKDC score was 75.6 ± 9.5.
Conclusion: Patellar tendon tenodesis and tibial tubercle distalization result in normalization of patellar tendon length, a stable patellofemoral joint, and good long-term knee function in patients with patella alta and EPD.</description><identifier>ISSN: 0363-5465</identifier><identifier>EISSN: 1552-3365</identifier><identifier>DOI: 10.1177/0363546511427117</identifier><identifier>PMID: 22109545</identifier><identifier>CODEN: AJSMDO</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adolescent ; Adult ; Biological and medical sciences ; Diseases of the osteoarticular system ; Female ; Follow-Up Studies ; Humans ; Knee ; Male ; Medical sciences ; Medical treatment ; Patella - abnormalities ; Patella - diagnostic imaging ; Patella - surgery ; Patellar Dislocation - etiology ; Patellar Dislocation - surgery ; Patellar Ligament - abnormalities ; Patellar Ligament - diagnostic imaging ; Patellar Ligament - surgery ; Radiography ; Recurrence ; Sports medicine ; Tendons ; Tenodesis ; Tibia - surgery ; Young Adult</subject><ispartof>The American journal of sports medicine, 2012-02, Vol.40 (2), p.346-351</ispartof><rights>2012 American Orthopaedic Society for Sports Medicine</rights><rights>2015 INIST-CNRS</rights><rights>Copyright Sage Publications Ltd. Feb 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c425t-ebfe35f3f0efafa9688f751ddba256e8f211ff43896a165122a4d628ca80aa973</citedby><cites>FETCH-LOGICAL-c425t-ebfe35f3f0efafa9688f751ddba256e8f211ff43896a165122a4d628ca80aa973</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0363546511427117$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0363546511427117$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21818,27923,27924,43620,43621</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25642561$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22109545$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mayer, Cyril</creatorcontrib><creatorcontrib>Magnussen, Robert A.</creatorcontrib><creatorcontrib>Servien, Elvire</creatorcontrib><creatorcontrib>Demey, Guillaume</creatorcontrib><creatorcontrib>Jacobi, Matthias</creatorcontrib><creatorcontrib>Neyret, Philippe</creatorcontrib><creatorcontrib>Lustig, Sebastien</creatorcontrib><title>Patellar Tendon Tenodesis in Association With Tibial Tubercle Distalization for the Treatment of Episodic Patellar Dislocation With Patella Alta</title><title>The American journal of sports medicine</title><addtitle>Am J Sports Med</addtitle><description>Background: The association between patella alta and episodic patellar dislocation (EPD) has been well described, but its pathophysiology is not completely clear. Patella alta causes decreased contact between the patella and trochlea and decreased resistance to lateral translation of the patella. Additionally, increased patellar tendon length may allow pathologically increased coronal plane patellar motion. It may thus be desirable to address the length of the patellar tendon itself rather than just its insertion site.
Hypothesis: Tenodesis of the patellar tendon in association with tibial tubercle distalization in patients with EPD and abnormally long patellar tendons (>52 mm) results in significant reduction in patellar tendon length, prevention of further patellar dislocation, and good knee function at long-term follow-up.
Study Design: Case series; Level of evidence, 4.
Methods: Twenty-seven knees in 22 patients with EPD and patella alta were treated with patellar tendon tenodesis and tibial tubercle distalization. Following tubercle distalization, the patellar tendon was tenodesed into the original location of the tibial tubercle with suture anchors. Changes in patellar tendon length and patellar height were measured radiographically. Any recurrent dislocation was documented, and patients completed an International Knee Documentation Committee (IKDC) subjective form at a mean of 9.6 years (range, 6-14 years) after surgery.
Results: The mean length of the patellar tendon decreased from 56.3 ± 2.7 mm to 44.3 ± 8.6 mm (P < .0001). The Caton-Deschamps index decreased from 1.22 ± 0.17 to 0.95 ± 0.22 (P < .0001), and the Insall-Salvati ratio decreased from 1.42 ± 0.17 to 0.91 ± 0.18 (P < .0001). No patellar dislocations occurred postoperatively. The mean postoperative subjective IKDC score was 75.6 ± 9.5.
Conclusion: Patellar tendon tenodesis and tibial tubercle distalization result in normalization of patellar tendon length, a stable patellofemoral joint, and good long-term knee function in patients with patella alta and EPD.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Diseases of the osteoarticular system</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Knee</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medical treatment</subject><subject>Patella - abnormalities</subject><subject>Patella - diagnostic imaging</subject><subject>Patella - surgery</subject><subject>Patellar Dislocation - etiology</subject><subject>Patellar Dislocation - surgery</subject><subject>Patellar Ligament - abnormalities</subject><subject>Patellar Ligament - diagnostic imaging</subject><subject>Patellar Ligament - surgery</subject><subject>Radiography</subject><subject>Recurrence</subject><subject>Sports medicine</subject><subject>Tendons</subject><subject>Tenodesis</subject><subject>Tibia - surgery</subject><subject>Young Adult</subject><issn>0363-5465</issn><issn>1552-3365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkU1v1DAQhi0EotvCnROykFBPAX_EjnNclfIhVYJDEMdo4oypq2y82M6h_Ap-Mo52aVElJE4j-X3emfG8hLzg7A3nTfOWSS1VrRXntWjKyyOy4UqJSkqtHpPNKlerfkJOU7phjPFGm6fkRAjOWlWrDfn1BTJOE0Ta4TyGeS1hxOQT9TPdphSsh-yL8M3na9r5wcNEu2XAaCek73zKMPmfB8SFSPM10i4i5B3OmQZHL_c-hdFbejepmKZg_-p6VOh2yvCMPHEwJXx-rGfk6_vL7uJjdfX5w6eL7VVla6FyhYNDqZx0DB04aLUxrlF8HAcQSqNxgnPnamlaDbwcSAioRy2MBcMA2kaekfND330MPxZMud_5ZNc1ZgxL6lshBWtb-T8kE5IJIwv56gF5E5Y4l2-skJFGyLpA7ADZGFKK6Pp99DuItz1n_Zpq_zDVYnl57LsMOxzvDH9iLMDrIwDJwuQizNane07pcjTNC1cduATf8X65fw7-DdEft28</recordid><startdate>20120201</startdate><enddate>20120201</enddate><creator>Mayer, Cyril</creator><creator>Magnussen, Robert A.</creator><creator>Servien, Elvire</creator><creator>Demey, Guillaume</creator><creator>Jacobi, Matthias</creator><creator>Neyret, Philippe</creator><creator>Lustig, Sebastien</creator><general>SAGE Publications</general><general>Sage Publications</general><general>Sage Publications Ltd</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20120201</creationdate><title>Patellar Tendon Tenodesis in Association With Tibial Tubercle Distalization for the Treatment of Episodic Patellar Dislocation With Patella Alta</title><author>Mayer, Cyril ; Magnussen, Robert A. ; Servien, Elvire ; Demey, Guillaume ; Jacobi, Matthias ; Neyret, Philippe ; Lustig, Sebastien</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c425t-ebfe35f3f0efafa9688f751ddba256e8f211ff43896a165122a4d628ca80aa973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Diseases of the osteoarticular system</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Knee</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medical treatment</topic><topic>Patella - abnormalities</topic><topic>Patella - diagnostic imaging</topic><topic>Patella - surgery</topic><topic>Patellar Dislocation - etiology</topic><topic>Patellar Dislocation - surgery</topic><topic>Patellar Ligament - abnormalities</topic><topic>Patellar Ligament - diagnostic imaging</topic><topic>Patellar Ligament - surgery</topic><topic>Radiography</topic><topic>Recurrence</topic><topic>Sports medicine</topic><topic>Tendons</topic><topic>Tenodesis</topic><topic>Tibia - surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mayer, Cyril</creatorcontrib><creatorcontrib>Magnussen, Robert A.</creatorcontrib><creatorcontrib>Servien, Elvire</creatorcontrib><creatorcontrib>Demey, Guillaume</creatorcontrib><creatorcontrib>Jacobi, Matthias</creatorcontrib><creatorcontrib>Neyret, Philippe</creatorcontrib><creatorcontrib>Lustig, Sebastien</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mayer, Cyril</au><au>Magnussen, Robert A.</au><au>Servien, Elvire</au><au>Demey, Guillaume</au><au>Jacobi, Matthias</au><au>Neyret, Philippe</au><au>Lustig, Sebastien</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patellar Tendon Tenodesis in Association With Tibial Tubercle Distalization for the Treatment of Episodic Patellar Dislocation With Patella Alta</atitle><jtitle>The American journal of sports medicine</jtitle><addtitle>Am J Sports Med</addtitle><date>2012-02-01</date><risdate>2012</risdate><volume>40</volume><issue>2</issue><spage>346</spage><epage>351</epage><pages>346-351</pages><issn>0363-5465</issn><eissn>1552-3365</eissn><coden>AJSMDO</coden><abstract>Background: The association between patella alta and episodic patellar dislocation (EPD) has been well described, but its pathophysiology is not completely clear. Patella alta causes decreased contact between the patella and trochlea and decreased resistance to lateral translation of the patella. Additionally, increased patellar tendon length may allow pathologically increased coronal plane patellar motion. It may thus be desirable to address the length of the patellar tendon itself rather than just its insertion site.
Hypothesis: Tenodesis of the patellar tendon in association with tibial tubercle distalization in patients with EPD and abnormally long patellar tendons (>52 mm) results in significant reduction in patellar tendon length, prevention of further patellar dislocation, and good knee function at long-term follow-up.
Study Design: Case series; Level of evidence, 4.
Methods: Twenty-seven knees in 22 patients with EPD and patella alta were treated with patellar tendon tenodesis and tibial tubercle distalization. Following tubercle distalization, the patellar tendon was tenodesed into the original location of the tibial tubercle with suture anchors. Changes in patellar tendon length and patellar height were measured radiographically. Any recurrent dislocation was documented, and patients completed an International Knee Documentation Committee (IKDC) subjective form at a mean of 9.6 years (range, 6-14 years) after surgery.
Results: The mean length of the patellar tendon decreased from 56.3 ± 2.7 mm to 44.3 ± 8.6 mm (P < .0001). The Caton-Deschamps index decreased from 1.22 ± 0.17 to 0.95 ± 0.22 (P < .0001), and the Insall-Salvati ratio decreased from 1.42 ± 0.17 to 0.91 ± 0.18 (P < .0001). No patellar dislocations occurred postoperatively. The mean postoperative subjective IKDC score was 75.6 ± 9.5.
Conclusion: Patellar tendon tenodesis and tibial tubercle distalization result in normalization of patellar tendon length, a stable patellofemoral joint, and good long-term knee function in patients with patella alta and EPD.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>22109545</pmid><doi>10.1177/0363546511427117</doi><tpages>6</tpages></addata></record> |
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| subjects | Adolescent Adult Biological and medical sciences Diseases of the osteoarticular system Female Follow-Up Studies Humans Knee Male Medical sciences Medical treatment Patella - abnormalities Patella - diagnostic imaging Patella - surgery Patellar Dislocation - etiology Patellar Dislocation - surgery Patellar Ligament - abnormalities Patellar Ligament - diagnostic imaging Patellar Ligament - surgery Radiography Recurrence Sports medicine Tendons Tenodesis Tibia - surgery Young Adult |
| title | Patellar Tendon Tenodesis in Association With Tibial Tubercle Distalization for the Treatment of Episodic Patellar Dislocation With Patella Alta |
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