Patellofemoral Disorders (eBook)

Roland M. Biedert is the editor of Patellofemoral Disorders: Diagnosis and Treatment, published by Wiley.

Patellofemoral Disorders 3
Contents 9
Foreword 19
Preface 23
Contributors 25
Acknowledgements 27
PART I 29
Reflections on Patellofemoral Disorders 31
Patellofemoral pain: a tissue homeostasis perspective 31
Chondromalacia 32
Malalignment 33
Logical analysis 33
Tissue homeostasis 35
Knee as transmission 38
Therapeutic implications of a tissue homeostasis approach to patellofemoral pain 40
Patellofemoral surgery 43
References 45
PART II 47
1 Anatomy 49
Patellofemoral articulation 49
Lateral side 52
Medial side 53
References 55
Suggested reading 56
2 Cross-sectional Anatomy with Regard to CT and MRI Geometry 57
Osseous anatomy 57
Cryosections and MRI 59
Summary 62
References 62
Suggested reading 63
3 Patellofemoral Joint Biomechanics 65
Geometry and contact areas of the patellofemoral joint 65
Patellar kinematics 68
Patellofemoral joint forces 70
Patellofemoral joint stability 74
Conclusions 79
References 80
4 Pathogenesis of Patellofemoral Pain 83
Physiology of pain 83
Anatomy of pain 85
Pathophysiological mechanisms 86
Clinical implications 89
Summary 94
References 94
Suggested reading 97
5 Physical Examination 99
Standing position 99
Walking 101
Seated position 101
Supine position 103
References 112
Suggested reading 113
6 Radiographs 115
Origin and formation of the patellofemoral joint 115
Analysis of the trochlea 116
Analysis of the patella 120
Position of the anterior tibial tuberosity and the trochlear groove 124
The role of MRI 125
Summary and present concepts 125
Conclusions 127
References 127
7 Computed Tomography Examination 129
Technical equipment 129
Examination techniques 129
Clinical implications 138
Summary 139
References 139
Suggested reading 139
8 Comparison of Radiographs, MRI and CT 141
Conventional radiology 141
Magnetic resonance imaging 141
Computed tomography 146
Conclusion and summary 157
References 158
Suggested reading 159
9 Nonoperative Treatment 161
Nonpharmacological modalities 161
Pharmacological treatment 164
References 166
Suggested reading 168
10 Patellofemoral Joint Replacement 169
Design and surgical considerations 169
Indications 171
Contraindications 171
Results 172
Illustrative case reports 172
Conclusions 173
References 173
PART III CASE STUDIES 175
Case Study 1 Unspecific patellofemoral pain 177
History 178
Comments 178
Course of action 178
Plan 179
Summary 179
References 180
Suggested reading 181
Case Study 2 Specific patellofemoral pain 183
History 184
Comments 184
Course of action 184
Plan 186
Postoperative care and rehabilitation 187
References 187
Suggested reading 187
Case Study 3 Lateral patellar hypercompression, tilt and mild lateral subluxation 189
History 190
Comments 190
Course of action 190
Plan 190
Postoperative care and rehabilitation 191
Summary 193
References 193
Suggested reading 194
Case Study 4 Dynamic lateral patellar subluxation 195
History 196
Comments 196
Course of action 196
Plan 197
Summary 197
References 197
Suggested reading 198
Case Study 5 Lateral patellar subluxation with dynamic reposition 199
History 200
Comments 200
Course of action 200
Plan 201
Postoperative care and rehabilitation 201
Summary 201
References 202
Suggested reading 202
Case Study 6 Lateral patellar subluxation with dynamic impairment and normal trochlea 203
History 204
Comments 204
Course of action 204
Plan 205
Postoperative care and rehabilitation 206
Summary 206
References 207
Case Study 7 Lateral patellar subluxation with dysplastic trochlea 209
History 210
Comments 210
Course of action 210
Plan 211
Postoperative Care and Rehabilitation 213
Summary 213
References 213
Suggested reading 214
Case Study 8 Persistent lateral patellar subluxation with patella alta 215
History 216
Course of action 216
Plan 217
Postperative care and rehabilitation 218
Summary 219
References 219
Case Study 9 Habitual patellar dislocation with severe dysplastic trochlea in adolescents 221
History 222
Comments 222
Course of action 222
Plan 223
Postoperative care and rehabilitation 225
Discussion 226
Summary 226
References 226
Suggested reading 226
Case Study 10 Severe lateral patellar subluxation 227
History 228
Comments 228
Course of action 228
Plan 229
Postoperative care and rehabilitation 230
Summary 230
References 230
Suggested reading 231
Case Study 11 Chronic patellar dislocation in adults 233
History 234
Comments 234
Course of action 234
Plan 235
Postoperative care and rehabilitation 236
Discussion 237
Summary 237
References 237
Case Study 12 Patellar pain and instability due to abnormal skeletal torsion 239
History 240
Comments 240
Course of action 240
Plan 241
Summary 245
References 245
Suggested reading 245
Case Study 13 Acute patellar dislocation in children and adolescents 247
History 248
Comments 248
Course of action 248
Plan 251
Postoperative care and rehabilitation 252
Summary 252
References 253
Suggested reading 253
Case Study 14 Acute patellar dislocation in adults 255
History 256
Comments 256
Course of action 256
Plan 257
Postoperative care and rehabilitation 258
Summary 258
References 258
Suggested reading 259
Case Study 15 Local chondral damage of the trochlea 261
History 262
Comments 262
Course of action 262
Plan 263
Postoperative care and rehabilitation 263
Summary 264
References 264
Suggested reading 264
Case Study 16 Secondary medial patellar instability following lateral retinacular release 265
History 266
Comments 266
Course of action 266
Plan 267
Postoperative care and rehabilitation 268
Summary 268
References 268
Suggested reading 269
Case Study 17 Secondary medial patellar instability following lateral retinacular release documented by gait analysis 271
History 272
Comments 272
Course of action 272
Results 274
Plan 276
Summary 276
References 276
Suggested reading 277
Case Study 18 Secondary distal medial subluxation with osteoarthritis and persisting proximal lateral subluxation 279
History 280
Comments 280
Course of action 280
Plan 281
Postoperative care and rehabilitation 281
Summary 283
References 284
Suggested reading 284
Case Study 19 Secondary medial osteoarthritis with medial subluxation of the patella 285
History 286
Comments 286
Course of action 286
Plan 288
Postoperative care and rehabilitation 291
Summary 291
References 291
Suggested reading 292
Case Study 20 Lateral retinacular over-release 293
History 294
Comments 294
Course of action 294
Plan 295
Postoperative care and rehabilitation 296
Discussion 296
Summary 296
References 296
Suggested reading 296
PART IV 297
Physical Therapy 299
Review of randomized controlled trials 300
Rehabilitation protocols 301
Therapeutic interventions 303
Principles of training and rehabilitation 310
Summary 330
References 330
Suggested reading 334
Glossary 335
Bibliography 345
Index 367

"...an extensive, scientific survey of patellofemoral disorders
and treatments." (E-STREAMS, April 2006)

"...this text provides a good reference for the diagnosis
and treatment of patellofemoral disorders." (Journal of
Orthopaedic & Sports Physical Therapy, September 2005)