NOT ALL PATELLAR DISLOCATIONS ARE THE SAME

A clear understanding of the anatomy and mechanics of the patellofemoral joint is critical when treating a patient that presents with a possible patellar dislocation. The alignment of the patellae should be evaluated to understand where the patellae sit in relation to the trochlea medially and laterally, as well as looking at the height of the patellae, proximal to distal. Physical exam should include assessing for a “J” sign, the patella height and patella tilt and comparing to the opposite knee.

USING A CPM MACHINE: DOES IT MATTER FOLLOWING KNEE SURGERY?

The use of a continuous passive motion (CPM) machine was initiated around 1982 after total knee replacements (TKA) to promote healing to the tissues, but other benefits found from CPM included increased ROM, decrease pain and the need for analgesics, and decreased rate of deep vein thrombosis (DVT). [6, 12, 21, 22] Ritter et al [20] however, found that the use of the CPM lead to a weaker leg, flexion tightness and extension lag along with increased cost with its use.

The Art of the Knee Exam

Our office meets twice a month for research meetings to discuss various topics that relate to treatment of the knee joint, or other topics that may affect our orthopedic practice of treating knee problems/injuries. Last month we discussed chapter 30 out of the book: BareBones by A. Sarmiento.

Treating Patellofemoral Dislocation

Patellofemoral dislocation accounts for fewer than 3% of knee injuries seen by most orthopedic surgeons. Evaluating patellofemoral dislocation and determining whether surgical or non-surgical management is the best treatment for a particular patient is difficult due to anatomical complexity and challenges in determining the cause of the instability.

Effective Treatment for Degenerative Meniscus Tears

Degenerative meniscus tears are the most common reason for knee arthroscopy, yet whether these tears benefit from surgery is controversial, according to an evidence-based, expert consensus statement on the treatment of degenerative meniscus tear published in Arthroscopy: The Journal of Arthroscopic & Related Surgery (February 2020).1 K. Donald Shelbourne, MD, an orthopedic surgeon at Shelbourne Knee Center, was one of 20 international experts who provided input on the consensus statement.