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Quantitative stress radiography of the patella and evaluation of patellar laxity before and after lateral release for recurrent dislocation patella

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aims of the present controlled clinical study were to (1) compare patella laxity determined in the outpatient clinic with that in anaesthetized patients and (2) evaluate patella laxity before and after lateral release.

Method

The study evaluated data on 33 knees from 33 patients (average age 19.7 years) between 2007 and 2011. All patients were diagnosed with recurrent dislocation of the patella. Patellar stability was evaluated in each patient thrice: patellas were first imaged in the outpatient clinic prior to surgery at 45° knee flexion with 20 N stress from the medial to lateral side and from the lateral to medial side; then, at the time of surgery, patella stress images were obtained in the same manner before and after the lateral release procedure. Radiological assessments were performed using the medial stress shift ratio (MSSR) and lateral stress shift ratio (LSSR).

Results

There were no significant differences in the LSSR and MSSR before surgery (outpatient data) and in anaesthetized patients before the lateral release procedure. Furthermore, there was no significant difference in MSSR at the time of surgery before and after the lateral release procedure. However, LSSR increased significantly after the lateral release procedure.

Conclusion

The results of the present study suggest that quantitative patella stress radiography in the outpatient clinic is useful when it comes to investigating laxity of the patella, and that lateral release significantly increases lateral, but not medial, laxity in patients with recurrent patellar dislocation.

Level of evidence

IV.

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Acknowledgments

The authors thank Atsuo Nakamae M.D., Ph.D., Tomoyuki Nakasa M.D, Ph.D, Goki Kamei M.D, Ph.D, Kobun Takazawa M.D, and Akio Eguchi M.D, Hiroshima University, Graduate School of Biomedical Sciences, Department of Orthopaedic Surgery, Hiroshima, Japan, for assistance during this research.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Higashihiroshima Medical Center, 513 Jike, Saijyou-chou, Higashihiroshima, Hiroshima, Japan

    Takuya Niimoto

  2. Department of Physical Therapy and Occupational Therapy Sciences, Graduate School of Health Sciences, Hiroshima University, Hiroshima, Japan

    Masataka Deie

  3. Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan

    Nobuo Adachi, Muhammad Andry Usman & Mitsuo Ochi

Authors
  1. Takuya Niimoto
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  2. Masataka Deie
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  3. Nobuo Adachi
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  4. Muhammad Andry Usman
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  5. Mitsuo Ochi
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Correspondence to Masataka Deie.

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Niimoto, T., Deie, M., Adachi, N. et al. Quantitative stress radiography of the patella and evaluation of patellar laxity before and after lateral release for recurrent dislocation patella. Knee Surg Sports Traumatol Arthrosc 22, 2408–2413 (2014). https://doi.org/10.1007/s00167-014-2930-8

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  • DOI: https://doi.org/10.1007/s00167-014-2930-8

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