Browse
Submit Data
Databases
API
Help

Dataset Information

44 Views

0 Connections

0 Citations

0 Reanalyses

0 Downloads

Omics score: 0

Patellar Tendon Lengthening: Rescue Procedure for Patella Baja.

ABSTRACT: Patella baja is a challenging pathologic condition that causes pain and functional restrictions and can even lead to premature osteoarthritis-even more so in cases of patella infera or cases associated with degeneration of the patellar tendon in which simple conservative treatment frequently is not resolutive. Several surgical options have been described for symptomatic patella baja: excision of the lower third of the patella, lengthening of the patellar tendon, reconstruction of the patellar tendon with allograft, and proximalization of the tibial tubercle. A combination of 2 or more of these treatments may be recommended in cases of significant patella baja. We present a simple and reproducible technique to address patella baja that combines a partial transposition of the tibial tubercle and patellar tendon lengthening using a subperiosteal patellar flap in continuity with the patellar tendon.

SUBMITTER: Perelli S

PROVIDER: S-EPMC6993128 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Json Xml

Publications

Patellar Tendon Lengthening: Rescue Procedure for Patella Baja.

Perelli Simone S Ibañez Maximiliano M Morales-Marin Carlos C Acuña-Avila Gabriel G Espinoza-von Bischhoffshausen Ricardo R Masferrer-Pino Angel A Monllau Juan Carlos JC

Arthroscopy techniques 20191202 1

Patella baja is a challenging pathologic condition that causes pain and functional restrictions and can even lead to premature osteoarthritis-even more so in cases of patella infera or cases associated with degeneration of the patellar tendon in which simple conservative treatment frequently is not resolutive. Several surgical options have been described for symptomatic patella baja: excision of the lower third of the patella, lengthening of the patellar tendon, reconstruction of the patellar te ...[more]

PMID: 32021766

Similar Datasets

Frontal Tendon Lengthening Plasty for Treatment of Structural Patella Baja.

Project description:Patella baja is a severe complication seen after trauma, prolonged immobilization and surgery. Several surgical methods have been described to proximalize the patella without a change in the patella tendon length. Yet, patella tendon shortening and thickening can be regarded as the hallmark pathology. As such, we describe a technique for the lengthening of the patellar tendon to pathoconformly address underlying patella baja. The technique is reproducible and gives the possibility of an early postoperative mobilization to prevent re-baja-a typical complication after patella baja surgery.

| S-EPMC5263852 | biostudies-literature

Patellar Tendon Tenotomy for Treatment of Patella Baja and Extension Deficiency.

Project description:Extension loss due to patella baja is a rare but devastating postoperative complication associated with knee surgery. The most common causes of patella baja are prolonged postoperative immobilization, over-distalization of the patellar tendon during patella-related surgical procedures (i.e., tibial tubercle osteotomy and patellar tendon reconstruction), and inadequate knee range-of-motion exercises postoperatively. Patella baja can cause significant functional limitations owing to knee-related stiffness, pain, and weakness. Arthroscopy with scar tissue debridement is the standard of care for patients with arthrofibrosis in whom conservative treatment has failed. However, when this surgical approach fails, patients with continued patella baja may be candidates for open patellar tendon tenotomy as a salvage procedure.

| S-EPMC6475627 | biostudies-literature

Patellar Tendon Imbrication for Patella Alta.

Project description:Patella alta is a significant contributor to patellar instability. Historically, distalizing tibial tubercle osteotomy has been recommended for this problem; however, complications such as nonunion, fracture and hardware irritation are concerning. Additionally, the procedure cannot be performed on skeletally immature patients without violation of the proximal tibial physis. The authors describe a technique of patellar tendon imbrication that does not involve hardware or osteotomy. This technique allows for reliable correction of patella alta and provides patellar stability without the complications associated with osteotomy.

| S-EPMC8807527 | biostudies-literature

Does patellar eversion in total knee arthroplasty cause patella baja?

Project description:UNLABELLED: Several proponents of minimally invasive surgery-total knee arthroplasty (MIS-TKA) have suggested patellar eversion during a standard exposure of the knee may cause shortening of the patellar tendon and poorer outcomes secondary to acquired patella baja. To explore this suggestion, we retrospectively reviewed 135 consecutive TKAs in 110 patients to ascertain the effect of TKA on the postoperative Insall-Salvati ratio. All surgeries were performed using standard TKA techniques with a midline incision, medial parapatellar arthrotomy, partial excision of the fat pad, and routine eversion of the patella. One patient developed a postoperative patella baja, defined as an Insall-Salvati ratio of less than 0.8. The Knee Society score for knee and function in this patient was 75 and 70, respectively. Five additional patients had a decrease in Insall-Salvati ratio by 10% or more but without patella baja. Mean Knee Society score for knee and function in these five patients was 94 (range, 73-99) and 96 (range, 90-100), respectively, as compared with 93 (range, 37-99) and 94 (range, 40-100) in the remaining 104 patients. Our data suggest the incidence of patella baja is low after TKA despite routine patellar eversion. Furthermore, a 10% or more decrease in the Insall-Salvati ratio without patella baja was not associated with a worse clinical outcome. LEVEL OF EVIDENCE: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

| S-EPMC2565024 | biostudies-other

Patella Baja Revisited: Interposition of a Pedunculated Flap of the Hoffa Fat Pad to Treat Adhesions Between the Tibia and Patellar Tendon and Restore the Functional Length of the Patellar Tendon.

Project description:Adhesions in the deep infrapatellar region may occur as iatrogenic complications (e.g., after bone-patellar tendon-bone grafting), as part of arthrofibrosis or infrapatellar contracture syndrome, or owing to specific diseases such as Osgood-Schlatter disease. Described adhesions may limit the length of the functional portion of the patellar tendon and lead to patella baja with subsequent decreased range of motion and patellofemoral joint overload, with a risk of osteoarthritis development. The patellar tendon length is commonly within normal limits; however, only the free part of the patellar tendon is functionally active. The purpose of this article is to present a quick, simple, and cost-effective technique for the treatment of patella baja due to adhesions in the deep infrapatellar region. This technique consists of the removal of adhesions to free the whole length of the patellar tendon and the interposition of a Hoffa fat pad pedunculated flap between the patellar tendon and tibia to avoid the recurrent formation of adhesions. Only local tissues are used, allowing for the avoidance of donor-site morbidity. The technique restores the functional length of the patellar tendon and thus normalizes patellofemoral kinematics, increases range of motion, alleviates anterior knee pain, and decreases the risk of osteoarthritis development.

| S-EPMC11662865 | biostudies-literature

Patellar Resurfacing Is Not a Risk Factor for Postoperative Patella Baja in Total Knee Arthroplasty.

Project description:BackgroundPatella baja is a known complication of total knee arthroplasty (TKA). There is a limited understanding of the association between patellar resurfacing and the incidence of patella baja. We aimed to compare rates of patella baja between unresurfaced and resurfaced patellas in patients undergoing TKA.MethodsA retrospective review of patients who underwent TKA between October 2009 and January 2020 was performed. Patients were included if they had at least one preoperative radiograph and a 1-year follow-up radiograph. Blackburne-Peel index (BPI) and Insall-Salvati ratios (ISRs) were measured on preoperative and 1-year postoperative radiographs and were used to define patella baja vs pseudopatella baja. Statistical analysis was performed using a linear model analysis of variance and the Fisher's exact test.ResultsThree hundred eighteen TKAs were included, with 176 being resurfaced and 142 unresurfaced patellas. Of the resurfaced group, 4% (7/176) had true patella baja, compared to 5.6% (8/142) of the unresurfaced patellas. Of the resurfaced patellas, 8% (14/176) had pseudopatella baja, compared to 7% (10/142) in the unresurfaced group. Patellar resurfacing was not associated with a higher incidence of patella baja (P = .60) or pseudopatella baja (P = .83). Lower preoperative ISRs (P = .04) and BPIs (0.03) were highly predictive of a higher incidence of patella baja post-TKA.ConclusionsPatellar resurfacing in TKA is not associated with a higher incidence of patella baja in TKA when compared to unresurfaced patellas. Lower preoperative ISRs and BPIs are highly predictive of a higher incidence of postoperative patella baja.

| S-EPMC11231528 | biostudies-literature

Quadriceps Tendon Lengthening for Obligatory (Habitual) Patellar Dislocation in Flexion.

Project description:Obligatory patella dislocation in flexion is an uncommon form of patellar instability, where the patella is located in extension and dislocates with every episode of knee flexion. This results in dramatically altered patellofemoral kinematics and can be extremely debilitating due to extensor strength deficits and lack of knee confidence in flexion. Concomitant pathology, which is often seen, includes a tight lateral retinaculum and a shortened extensor mechanism. Lengthening the extensor mechanism is a critical part of successful patellar stabilization, and has not been well-reported. Herein, we present a technique of quadriceps lengthening for the treatment of obligatory patellar dislocation.

| S-EPMC9520020 | biostudies-literature

Patellar Tendon Shortening for Treatment of Patella Alta in Skeletally Immature Patients With Patellar Instability.

Project description:Aberrant anatomy, such as patella alta, can be a risk factor for recurrent patellar instability or inferior clinical outcomes after medial patellofemoral ligament reconstruction. In patients with significant patella alta (Caton Deschamps Index >1.2), tibial tubercle distalization may be considered to improve outcomes. However, despite patellar instability commonly affecting pediatric patients, a distalization osteotomy is not feasible in this patient population due to the presence of open physes. Our article presents a technique describing an alternative soft-tissue distalization approach whereby patellar height is decreased by shortening the patellar tendon.

| S-EPMC8355506 | biostudies-literature

Chronic Quadriceps Tendon Ruptures: Primary Repair of Quadriceps Via Bioaugmentation and Patellar Tendon Lengthening.

Project description:Quadriceps tendon ruptures are devastating injuries that impair the extensor mechanism of the knee. Complete tears require prompt surgical intervention in order to ensure optimal clinical outcomes. Chronic, neglected ruptures- marked by severe extensor lag, muscular atrophy, and tendon retraction- are difficult to treat. Further, severe patella baja complicates surgical planning. While there is no consensus on optimal treatment for these injuries, many different techniques have been proposed. Unlike many of these approaches, our technique focuses on restoration of patellar height via patellar tendon lengthening. Once patellar height is restored, quadriceps tendon repair can be performed using the native quadriceps tendon. Both the patellar tendon lengthening and the quadriceps tendon repair are augmented with bioinductive implants to ensure optimal healing environments, enabling us to reestablish native extensor mechanism function.

| S-EPMC9353194 | biostudies-literature

Technique for Fixation of Semitendinosus to the Patella in Patellar Tendon Reconstruction.

Project description:Chronic patellar tendon injuries are rare yet challenging to treat. Timing of surgery and graft choices are debatable. Many techniques and methods of fixation have been described with pros and cons. Functional impairment of the extensor mechanism and postoperative complications triggers the quest for finding the ideal technique. In this Technical Note, we use distally based semitendinosus (ST) looped over 2 ETHIBOND sutures. The ETHIBOND is passed through 2 vertical tunnels in the patella and retrieved proximally, docking the ST in a blind tunnel created in the lower pole of the patella. The whip-stitched free ST end is passed through a tunnel behind the tibial tubercle and sutured back to its base. A polyester tape is used to augment the repair in a circumferential manner. Postoperatively full weight bearing is allowed as tolerated in a hinged knee brace locked in extension with only passive range of motion of 0-90° allowed for 6 weeks.

| S-EPMC7768288 | biostudies-literature

OmicsDI is part of the ELIXIR infrastructure

OmicsDI is an Elixir interoperability service. Learn more ›

Tweets

OmicsDI Databases

PRIDE
PeptideAtlas
MassIVE
JPOST Repository
Physiome Model Repository

EGA
EVA
ENA
LINCS
PAXDB
Cell Collective

MetaboLights
Metabolomics Workbench
MetabolomeExpress
GNPS
BioModels
FAIRDOMHub

ArrayExpress
dbGaP
ExpressionAtlas
GEO
NODE

Information

Databases
Help
API
Contact us
Code on GitHub
Terms of use
Submit Data