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A new classification system of patellar instability and patellar maltracking

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A new classification system of patellar instability and patellar maltracking. / Frosch, K-H; Schmeling, A.

in: ARCH ORTHOP TRAUM SU, Jahrgang 136, Nr. 4, 04.2016, S. 485-97.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Frosch, K-H & Schmeling, A 2016, 'A new classification system of patellar instability and patellar maltracking', ARCH ORTHOP TRAUM SU, Jg. 136, Nr. 4, S. 485-97. https://doi.org/10.1007/s00402-015-2381-9

APA

Frosch, K-H., & Schmeling, A. (2016). A new classification system of patellar instability and patellar maltracking. ARCH ORTHOP TRAUM SU, 136(4), 485-97. https://doi.org/10.1007/s00402-015-2381-9

Vancouver

Frosch K-H, Schmeling A. A new classification system of patellar instability and patellar maltracking. ARCH ORTHOP TRAUM SU. 2016 Apr;136(4):485-97. https://doi.org/10.1007/s00402-015-2381-9

Bibtex

@article{c52f4a26d6654a44983f68182c1c78cc,
title = "A new classification system of patellar instability and patellar maltracking",
abstract = "To date there is no classification of patellar dislocations considering clinical and radiological pathologies. As a result many studies mingle the dislocation's underlying pathologies, so that there are no consistent therapy recommendations. It is this article's objective to introduce a patellar dislocation classification based on the current literature to allow for the application of a structured diagnosis and treatment algorithm. The classification is based on instability criteria as well as on clinical and radiological analyses of maltracking and on loss of patellar tracking. There are five types of patellar instability and maltracking. The rare type 1 is a simple (traumatic) patellar dislocation without maltracking and instability with a low risk of redislocation. Type 2 has a high risk of redislocation after primary dislocation; there is no maltracking. Here, a stabilising operation (in most cases MPFL reconstruction) is indicated and sufficient. Type 3 shows both instability and maltracking. Maltracking is mainly caused by: (a) soft tissue contracture, (b) patella alta, (c) pathological tibial tuberosity-trochlea groove distance, (d) valgus deviations and (e) torsional deformities. Stabilisation by means of isolated MPFL reconstruction is not sufficient in these types and additional osseous corrective surgeries are required to achieve physiological patellar tracking and to prevent redislocation. Type 4 features a highly unstable {"}floating patella{"} with complete loss of tracking caused by severe trochlear dysplasia. Therapy of choice is trochleoplasty, and if necessary combined with bony and soft-tissue procedures. Type 5 shows a patellar maltracking without instability. Maltracking can only be fixed by means of corrective osteotomy. The classification is referenced to current literature and each type is introduced by a case example. The resulting treatment consequence is also presented. ",
keywords = "Adult, Algorithms, Decision Support Techniques, Female, Humans, Joint Instability, Male, Patellar Dislocation, Recurrence, Severity of Illness Index, Treatment Outcome, Journal Article",
author = "K-H Frosch and A Schmeling",
year = "2016",
month = apr,
doi = "10.1007/s00402-015-2381-9",
language = "English",
volume = "136",
pages = "485--97",
journal = "ARCH ORTHOP TRAUM SU",
issn = "0936-8051",
publisher = "Springer",
number = "4",

}

RIS

TY - JOUR

T1 - A new classification system of patellar instability and patellar maltracking

AU - Frosch, K-H

AU - Schmeling, A

PY - 2016/4

Y1 - 2016/4

N2 - To date there is no classification of patellar dislocations considering clinical and radiological pathologies. As a result many studies mingle the dislocation's underlying pathologies, so that there are no consistent therapy recommendations. It is this article's objective to introduce a patellar dislocation classification based on the current literature to allow for the application of a structured diagnosis and treatment algorithm. The classification is based on instability criteria as well as on clinical and radiological analyses of maltracking and on loss of patellar tracking. There are five types of patellar instability and maltracking. The rare type 1 is a simple (traumatic) patellar dislocation without maltracking and instability with a low risk of redislocation. Type 2 has a high risk of redislocation after primary dislocation; there is no maltracking. Here, a stabilising operation (in most cases MPFL reconstruction) is indicated and sufficient. Type 3 shows both instability and maltracking. Maltracking is mainly caused by: (a) soft tissue contracture, (b) patella alta, (c) pathological tibial tuberosity-trochlea groove distance, (d) valgus deviations and (e) torsional deformities. Stabilisation by means of isolated MPFL reconstruction is not sufficient in these types and additional osseous corrective surgeries are required to achieve physiological patellar tracking and to prevent redislocation. Type 4 features a highly unstable "floating patella" with complete loss of tracking caused by severe trochlear dysplasia. Therapy of choice is trochleoplasty, and if necessary combined with bony and soft-tissue procedures. Type 5 shows a patellar maltracking without instability. Maltracking can only be fixed by means of corrective osteotomy. The classification is referenced to current literature and each type is introduced by a case example. The resulting treatment consequence is also presented.

AB - To date there is no classification of patellar dislocations considering clinical and radiological pathologies. As a result many studies mingle the dislocation's underlying pathologies, so that there are no consistent therapy recommendations. It is this article's objective to introduce a patellar dislocation classification based on the current literature to allow for the application of a structured diagnosis and treatment algorithm. The classification is based on instability criteria as well as on clinical and radiological analyses of maltracking and on loss of patellar tracking. There are five types of patellar instability and maltracking. The rare type 1 is a simple (traumatic) patellar dislocation without maltracking and instability with a low risk of redislocation. Type 2 has a high risk of redislocation after primary dislocation; there is no maltracking. Here, a stabilising operation (in most cases MPFL reconstruction) is indicated and sufficient. Type 3 shows both instability and maltracking. Maltracking is mainly caused by: (a) soft tissue contracture, (b) patella alta, (c) pathological tibial tuberosity-trochlea groove distance, (d) valgus deviations and (e) torsional deformities. Stabilisation by means of isolated MPFL reconstruction is not sufficient in these types and additional osseous corrective surgeries are required to achieve physiological patellar tracking and to prevent redislocation. Type 4 features a highly unstable "floating patella" with complete loss of tracking caused by severe trochlear dysplasia. Therapy of choice is trochleoplasty, and if necessary combined with bony and soft-tissue procedures. Type 5 shows a patellar maltracking without instability. Maltracking can only be fixed by means of corrective osteotomy. The classification is referenced to current literature and each type is introduced by a case example. The resulting treatment consequence is also presented.

KW - Adult

KW - Algorithms

KW - Decision Support Techniques

KW - Female

KW - Humans

KW - Joint Instability

KW - Male

KW - Patellar Dislocation

KW - Recurrence

KW - Severity of Illness Index

KW - Treatment Outcome

KW - Journal Article

U2 - 10.1007/s00402-015-2381-9

DO - 10.1007/s00402-015-2381-9

M3 - SCORING: Journal article

C2 - 26718353

VL - 136

SP - 485

EP - 497

JO - ARCH ORTHOP TRAUM SU

JF - ARCH ORTHOP TRAUM SU

SN - 0936-8051

IS - 4

ER -