Patellar instability.

Abstract:

:Patella instability can cause significant pain and functional limitations. Several factors can predispose to patella instability, such as ligamentous laxity, increased anterior TT-TG distance, patella alta, and trochlear dysplasia. Acquired factors include MPFL injury or abnormal quadriceps function. In many cases, first-time dislocation can successfully be managed with physical therapy and other nonoperative management; however, more than one dislocation significantly increases the chance of recurrence. Surgical management can improve stability, but should be tailored to the injuries and anatomic risk factors for recurrent dislocation. Isolated lateral release is not supported by current literature and increases the risk of iatrogenic medial instability. Medial repair is usually reserved for patients with largely normal anatomy. MPFL reconstruction can successfully stabilize patients with medial soft tissue injury but is a technically demanding procedure with a high complication rate and risks of pain and arthrosis. Tibial tubercle osteotomy can address bony malalignment and also unload certain articular cartilage lesions while improving stability. Trochleoplasty may be indicated in individuals with a severely dysplastic trochlea that cannot otherwise be stabilized. A combination of procedures may be necessary to fully address the multiple factors involved in causing pain, loss of function, and risk of recurrence in patients with patellar instability.

journal_name

Clin Sports Med

authors

Koh JL,Stewart C

doi

10.1016/j.csm.2014.03.011

subject

Has Abstract

pub_date

2014-07-01 00:00:00

pages

461-76

issue

3

eissn

0278-5919

issn

1556-228X

pii

S0278-5919(14)00028-3

journal_volume

33

pub_type

杂志文章,评审
  • Decision making: operative versus nonoperative treatment of acromioclavicular joint injuries.

    abstract::The classification system devised by Allman and Tossy, and revised by Rockwood, defines the extent of injury to the AC joint and helps to guide management of AC joint injuries [1,4,6]. In general, type I and II injuries may be treated nonoperatively with a sling, mainly for comfort, for a short period of time. Once th...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0278-5919(02)00098-4

    authors: Bradley JP,Elkousy H

    更新日期:2003-04-01 00:00:00

  • Epidemiology of hand and wrist injuries in sports.

    abstract::This article addresses the prevalence of various hand and wrist injuries in a variety of sports. Multiple resources and references have been utilized to draw a perception of the types of injuries and the sports with which they are most commonly associated. It is hoped that this article will give the physician a greate...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0278-5919(05)70092-2

    authors: Rettig AC

    更新日期:1998-07-01 00:00:00

  • Overuse injuries.

    abstract::Stress injuries common to running athletes are always associated with a breakdown of the protective mechanisms normally inherent in healthy posture and gait. It is more important to identify and treat these breakdowns of the motor process than the resulting injury itself. Simple motor screening of athletes can identif...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Beck JL,Day RW

    更新日期:1985-07-01 00:00:00

  • Rotatory knee laxity.

    abstract::Evaluation of injured-knee laxity is essential for treatment selection, clinical follow-up, and research. Interest in rotatory knee laxity increased with implementation of anatomic anterior cruciate ligament reconstruction. The pivot shift test represents a link between static testing with 1° of freedom and dynamic te...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.csm.2012.08.005

    authors: Ahldén M,Samuelsson K,Fu FH,Musahl V,Karlsson J

    更新日期:2013-01-01 00:00:00

  • Rehabilitation of rotator cuff tendinopathy.

    abstract::Rehabilitation of the dysfunction that is associated with rotator cuff tendinopathy should be based on the evidence known about the pathoetiology of the tendinopathy, what is known about the extent of the local anatomic injury, the local and distant physiological and biomechanical alterations, and on the knowledge dev...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0278-5919(03)00048-6

    authors: Kibler WB

    更新日期:2003-10-01 00:00:00

  • The National Football Head and Neck Injury Registry: 14-year report on cervical quadriplegia (1971-1984).

    abstract::The specter of catastrophic cervical neurotrauma resulting from athletic participation, although infrequent, has been consistently associated with football, water sports, gymnastics, rugby, and ice hockey. Injury involving intracranial hemorrhage can result in death or permanent neurologic impairment, whereas certain ...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章

    doi:

    authors: Torg JS,Vegso JJ,Sennett B

    更新日期:1987-01-01 00:00:00

  • Imaging of osteochondritis dissecans.

    abstract::Osteochondritis dissecans (OCD) can affect both adults and children, however the imaging characteristics and significance of imaging findings can differ in the juvenile subset with open physes. Radiography and magnetic resonance imaging (MRI) are the primary modalities used to aid in diagnosis, to define a treatment p...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.csm.2013.12.002

    authors: Zbojniewicz AM,Laor T

    更新日期:2014-04-01 00:00:00

  • Open or arthroscopic lateral release. Indications, techniques, and rehabilitation.

    abstract::Careful patient selection, accurate surgical technique, and careful postoperative rehabilitation are all equally important to success in lateral release surgery. Whether the surgery is performed by open or arthroscopic technique, one must release all layers of the retinaculum, spare the vastus lateralis, extend the re...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0278-5919(05)70006-5

    authors: Ford DH,Post WR

    更新日期:1997-01-01 00:00:00

  • The adolescent preparticipation physical examination. Is it helpful?

    abstract::The preparticipation examination (PPE) is a widely practiced method of screening athletes for medical limitations before sports participation. Although the PPE is widely implemented, there is little consistency regarding content or method in providing this important service. This lack of uniformity undermines the over...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0278-5919(05)70227-1

    authors: Metzl JD

    更新日期:2000-10-01 00:00:00

  • Philosophy of the treatment of athletes.

    abstract::There is a proliferation of sports medicine physicians whose training is largely in the management of such athletically debilitating conditions as knee ligament and meniscus tears. Physicians with responsibility for the management of the full spectrum of sports-related conditions, including upper extremity injuries, m...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章

    doi:

    authors: Strickland JW

    更新日期:1995-04-01 00:00:00

  • Revision anterior cruciate ligament surgery.

    abstract::An increasing number of revision ACL reconstructions are being performed each year. Revision ACL surgery is challenging and cannot be approached in the same manner as primary ACL surgery. Successful revision ACL surgery requires a detailed history, a comprehensive physical examination, appropriate radiologic studies, ...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0278-5919(05)70133-2

    authors: Brown CH Jr,Carson EW

    更新日期:1999-01-01 00:00:00

  • Nutrition, exercise, and immune system function.

    abstract::Many components of the immune system exhibit adverse change after prolonged, intense exertion. During this "open window" of impaired immunity (which may last 3-72 h, depending on the immune measure), viruses and bacteria may gain a foothold, increasing the risk for subclinical and clinical infection. The influence of ...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0278-5919(05)70167-8

    authors: Nieman DC

    更新日期:1999-07-01 00:00:00

  • Fundamental Ethical Principles in Sports Medicine.

    abstract::In sports medicine, the practice of ethics presents many unique challenges because of the unusual clinical environment of caring for players within the context of a team whose primary goal is to win. Ethical issues frequently arise because a doctor-patient-team triad often replaces the traditional doctor-patient relat...

    journal_title:Clinics in sports medicine

    pub_type: 历史文章,杂志文章

    doi:10.1016/j.csm.2015.10.004

    authors: Devitt BM

    更新日期:2016-04-01 00:00:00

  • Running and osteoarthritis.

    abstract::The overall health benefits of cardiovascular exercise, such as running, are well established. However, it is also well established that in certain circumstances running can lead to overload injuries of muscle, tendon, and bone. In contrast, it has not been established that running leads to degeneration of articular c...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.csm.2010.03.006

    authors: Willick SE,Hansen PA

    更新日期:2010-07-01 00:00:00

  • Prevention and treatment of elbow injuries in golf.

    abstract::Golf interest is on the increase, resulting in a corresponding increase in golf-related tendon injuries. Injuries are best avoided by a good strength and flexibility program, proper warm-up exercises, and good stroke mechanics. Treatment is directed toward restoring the integrity of the muscle/tendon unit at the elbow...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Kohn HS

    更新日期:1996-01-01 00:00:00

  • Biology of autograft and allograft healing in anterior cruciate ligament reconstruction.

    abstract::The graft-bone attachment site is the weak link in anterior cruciate ligament (ACL) reconstruction surgery because healing is slow and often incomplete. Each of the many graft options for ACL reconstruction surgery has different healing characteristics and potential. Autografts that allow bone-to-bone healing offer th...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.csm.2007.06.007

    authors: Gulotta LV,Rodeo SA

    更新日期:2007-10-01 00:00:00

  • Nerve problems and compartment syndromes in the hand, wrist, and forearm.

    abstract::Most sports-related peripheral neuropathies occurring from the elbow distally are compressive in nature. These result from overuse or overload principles superimposed on normal or variant anatomy. Tensile injury occurs less often and is usually associated with the extremes of the throwing motion, i.e., cocking and fol...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Weinstein SM,Herring SA

    更新日期:1992-01-01 00:00:00

  • Management of the Anterior Cruciate Ligament-Injured Knee in the Skeletally Immature Athlete.

    abstract::Intrasubstance tears of the anterior cruciate ligament (ACL) are being diagnosed with increasing frequency in the skeletally immature. Management options include nonoperative/ early surgical, or delayed surgical reconstruction. Nonoperative/delayed reconstruction results in worse functional outcomes than early reconst...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.csm.2016.08.003

    authors: Anderson CN,Anderson AF

    更新日期:2017-01-01 00:00:00

  • Rehabilitation of the lower extremity.

    abstract::Rehabilitation of the lower extremities has fallen into two basic categories known as open and closed kinetic chain activities. Closed kinetic chain exercises are functional exercises specific to sport movement patterns. Exercises performed with a variety of equipment may be classified as closed kinetic chain. Program...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章

    doi:

    authors: Chu DA

    更新日期:1995-01-01 00:00:00

  • Musculoskeletal injuries in the young tennis player.

    abstract::Tennis is becoming increasingly popular, especially with young athletes. Despite recent advances in epidemiologic research of tennis injuries, there still is a need for more injury research in all of the racquet sports. The data that does exist show that the young athlete is susceptible to injury in these different sp...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0278-5919(05)70237-4

    authors: Kibler WB,Safran MR

    更新日期:2000-10-01 00:00:00

  • Current concepts in imaging the adult hip.

    abstract::Diagnostic imaging plays a key role in the evaluation of adult hip pain. Cornerstone to the initial assessment of hip pain is the plain radiograph. The need for secondary imaging of the hip and choice of imaging modality depends on the clinical presentation, results of the plain radiograph series, and clinical questio...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0278-5919(05)70278-7

    authors: Erb RE

    更新日期:2001-10-01 00:00:00

  • Spinal cord abnormalities in sports.

    abstract::Many types of spinal abnormalities can have an impact on an athlete’s ability to participate in sports. One of the challenges in the current era is distinguishing the clinically relevant lesions from the incidental. Almost without exception, a Chiarimal formation, significant syringomyelia or other cyst compressing th...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.csm.2012.03.008

    authors: Proctor MR,Scott RM

    更新日期:2012-07-01 00:00:00

  • Cardiovascular profiling.

    abstract::As in all other medical evaluations, the evaluation of the cardiovascular system in the competitive athlete or the nonathlete wishing to exercise must begin with a carefully performed history and physical examination. Subsequent studies, including chest radiograph and electrocardiogram, may be waived in certain popula...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Squires RW,Bove AA

    更新日期:1984-01-01 00:00:00

  • The role of the chief ethics officer in a physician's office.

    abstract::The unique role of the chief ethics officer in a sports medicine office is described and guided by the four principles of ethics, as well as the principles and codes of ethics of the American Medical Association, the International Sports Medicine Federation, and the American Academy of Orthopaedic Surgeons. The chief ...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章

    doi:10.1016/j.csm.2004.01.006

    authors: Guten GN,Kohn HS,Zoltan DJ,Black BB,Coran DL,Schneider JA,Pauers W

    更新日期:2004-04-01 00:00:00

  • Elbow Dislocation.

    abstract::This article is a brief overview of the elbow dislocations focusing on updates in treatment and rehabilitation protocols. The fight between obtaining elbow stability without leading to long-term elbow stiffness has been a continued focus in field of sports medicine. This article highlights advances made to help treat ...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.csm.2020.02.009

    authors: Rezaie N,Gupta S,Service BC,Osbahr DC

    更新日期:2020-07-01 00:00:00

  • Arthroscopic Approach to Osteochondral Defects, Impingement, and Instability.

    abstract::Osteochondral defects, impingement, and instability of the ankle are common injuries in athletes. In this article, we review these diagnoses and their treatment options, with a focus on arthroscopic approaches. The treatment options continue to evolve, supported by innovation and outcome studies. In this article, we d...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.csm.2015.06.007

    authors: Walker R,Kunkle WA,Carreira DS

    更新日期:2015-10-01 00:00:00

  • Incorporating Ortho-Biologics into Your Clinical Practice.

    abstract::The decision to incorporate ortho-biologics into a clinical practice will ultimately depend on physicians' preferences and the resources available to their practice. It is important to emphasize that different biologics are used for different pathologies/injuries and in different settings, such as the operating room o...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.csm.2018.08.008

    authors: Murphy CP,Sanchez A,Peebles LA,Provencher MT

    更新日期:2019-01-01 00:00:00

  • Biology of allograft incorporation.

    abstract::The use of implantation of allograft tissue in sports medicine has risen steadily over the last decade. Allograft tissues offer several advantages over autografts, including reduced donor-site morbidity and decreased operative time, and in some instances, no autograft option exists. However, with allografts, there is ...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章

    doi:10.1016/j.csm.2008.10.009

    authors: Eagan MJ,McAllister DR

    更新日期:2009-04-01 00:00:00

  • Treatment algorithm for osteochondritis dissecans of the knee.

    abstract::The authors' preferred treatment algorithm for osteochondritis dissecans (OCD) of the knee is based on skeletal maturity, OCD lesion stability, and OCD lesion salvageability. For unstable yet salvageable OCD lesions, the senior author's preferred treatment is fixation with bone grafting. For unstable and unsalvageable...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.csm.2014.01.002

    authors: Carey JL,Grimm NL

    更新日期:2014-04-01 00:00:00

  • Suicide in athletes: a review and commentary.

    abstract::Not only are athletes at risk for psychiatric illness, but they are at risk of suicide. In an effort to learn more about suicide in athletes and those connected to the sports arena, a review of the medical literature from 1960 to 2000 was conducted through Medline, and a review of the periodical literature from 1980 t...

    journal_title:Clinics in sports medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.csm.2005.06.006

    authors: Baum AL

    更新日期:2005-10-01 00:00:00