Variations in kinematics and function following patellar stabilization including tibial tuberosity realignment

John Joseph Elias, John A. Carrino, Archana Saranathan, Loredana M. Guseila, Miho Tanaka, Andrew J Cosgarea

Research output: Contribution to journalArticle

Abstract

PURPOSE: The current study was performed to characterize the influence of patellar stabilization procedures on patellofemoral and tibiofemoral dynamic motion.

METHODS: Six knees were evaluated pre-operatively and 1 year or longer following stabilization via tibial tuberosity realignment, with simultaneous medial patellofemoral ligament reconstruction performed for five knees. Knees were imaged during extension against gravity using a dynamic CT scanner. Models representing each knee at several positions of extension were reconstructed from the images. Local coordinate systems were created within one femur, patella and tibia for each knee, with shape matching of the bones used to transfer the coordinate axes to the other models. The patellar lateral shift and tilt and tibial external rotation were quantified based on the reference axes and interpolated to flexion angles from 5° to 40°. Pre-operative and post-operative data were compared with the paired t tests.

RESULTS: Surgical realignment significantly decreased the average patellar lateral shift and tilt at low flexion angles. At 5°, surgical realignment decreased the average lateral shift from 15.5 (6.3) to 8.5 (4.7) mm and decreased the average lateral tilt from 20.8 (9.4)° to 13.8 (6.4)°. The changes were statistically significant (p

CONCLUSION: Patellar stabilization including a component of tuberosity realignment reduces patellar lateral shift and tilt at low flexion angles, but the long-term influence of increased tibial external rotation on tibiofemoral function is currently unknown.

LEVEL OF EVIDENCE: Prospective comparative study, Level II.

Original languageEnglish (US)
Pages (from-to)2350-2356
Number of pages7
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Volume22
Issue number10
DOIs
StatePublished - Oct 1 2014

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Biomechanical Phenomena
Knee
Patella
Gravitation
Tibia
Ligaments
Femur
Prospective Studies
Bone and Bones

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Variations in kinematics and function following patellar stabilization including tibial tuberosity realignment. / Elias, John Joseph; Carrino, John A.; Saranathan, Archana; Guseila, Loredana M.; Tanaka, Miho; Cosgarea, Andrew J.

In: Knee Surgery, Sports Traumatology, Arthroscopy, Vol. 22, No. 10, 01.10.2014, p. 2350-2356.

Research output: Contribution to journalArticle

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AU - Carrino, John A.

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AU - Tanaka, Miho

AU - Cosgarea, Andrew J

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N2 - PURPOSE: The current study was performed to characterize the influence of patellar stabilization procedures on patellofemoral and tibiofemoral dynamic motion.METHODS: Six knees were evaluated pre-operatively and 1 year or longer following stabilization via tibial tuberosity realignment, with simultaneous medial patellofemoral ligament reconstruction performed for five knees. Knees were imaged during extension against gravity using a dynamic CT scanner. Models representing each knee at several positions of extension were reconstructed from the images. Local coordinate systems were created within one femur, patella and tibia for each knee, with shape matching of the bones used to transfer the coordinate axes to the other models. The patellar lateral shift and tilt and tibial external rotation were quantified based on the reference axes and interpolated to flexion angles from 5° to 40°. Pre-operative and post-operative data were compared with the paired t tests.RESULTS: Surgical realignment significantly decreased the average patellar lateral shift and tilt at low flexion angles. At 5°, surgical realignment decreased the average lateral shift from 15.5 (6.3) to 8.5 (4.7) mm and decreased the average lateral tilt from 20.8 (9.4)° to 13.8 (6.4)°. The changes were statistically significant (pCONCLUSION: Patellar stabilization including a component of tuberosity realignment reduces patellar lateral shift and tilt at low flexion angles, but the long-term influence of increased tibial external rotation on tibiofemoral function is currently unknown.LEVEL OF EVIDENCE: Prospective comparative study, Level II.

AB - PURPOSE: The current study was performed to characterize the influence of patellar stabilization procedures on patellofemoral and tibiofemoral dynamic motion.METHODS: Six knees were evaluated pre-operatively and 1 year or longer following stabilization via tibial tuberosity realignment, with simultaneous medial patellofemoral ligament reconstruction performed for five knees. Knees were imaged during extension against gravity using a dynamic CT scanner. Models representing each knee at several positions of extension were reconstructed from the images. Local coordinate systems were created within one femur, patella and tibia for each knee, with shape matching of the bones used to transfer the coordinate axes to the other models. The patellar lateral shift and tilt and tibial external rotation were quantified based on the reference axes and interpolated to flexion angles from 5° to 40°. Pre-operative and post-operative data were compared with the paired t tests.RESULTS: Surgical realignment significantly decreased the average patellar lateral shift and tilt at low flexion angles. At 5°, surgical realignment decreased the average lateral shift from 15.5 (6.3) to 8.5 (4.7) mm and decreased the average lateral tilt from 20.8 (9.4)° to 13.8 (6.4)°. The changes were statistically significant (pCONCLUSION: Patellar stabilization including a component of tuberosity realignment reduces patellar lateral shift and tilt at low flexion angles, but the long-term influence of increased tibial external rotation on tibiofemoral function is currently unknown.LEVEL OF EVIDENCE: Prospective comparative study, Level II.

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