BACKGROUND Graft fixation is critical to the restoration of the medial patella of femoral ligament function and long-term success. Numerous fixations at the patella have been described, while the complications including patellar fractures, violation of the posterior patella and delay of tendon-to-bone healing remain significant challenges. Here, we describe a safe and firm fixation at the patel...

Conventional operative treatments of patella fractures are frequently associated with implant failure or displacement. Recent biomechanical studies showed that the orientation of the wire loop and the site of the wire twist can affect the fixation strength. The purpose of this study was to compare the clinical outcome of the tension band technique with loops in different orientations and differ...

The patellofemoral joint is intrinsically unstable because the tibial tubercle lies lateral to the long axis of the femur and the quadriceps muscle, and the patella is therefore subject to a laterally directed force. This apparent ‘design fault’ is minimised by the resistance of the lateral lip of the trochlea to lateral movement of the patella during flexion (Brattström 1964). In full extensio...

The current view of skeletal patterning fails to explain the formation of sesamoid bones. These small bones, which facilitate musculoskeletal function, are exceptionally embedded within tendons. Although their structural design has long puzzled researchers, only a limitedmodel for sesamoid bone development has emerged. To date, sesamoids are thought to develop inside tendons in response to mech...

A report on an unusual transverse fracture through the body of the patella in a 13 year old high jumper is presented. The clinic features and treatment of the more usual avulsion injury of the patella is discussed.

We measured longitudinal surface strains on the anterior patella at controlled simulated quadriceps loads, quadriceps angles, and knee flexion angles. We studied both the natural patella and patellas resurfaced with domed, bifaceted, and metal backed polyethylene components. Twelve matched pairs of fresh human cadaver knee specimens were tested. Midanterior longitudinal patellar strains were gr...

We report an extremely rare case of both recurrent lateral patella dislocation and medial patellofemoral instability, following prior operations to correct patella maltracking. Manual translation of the patella revealed medial and lateral instability with a positive apprehension sign. 3-D computer modelling of kinematics based on MRI data demonstrated that the patella deviated laterally at full...

Lateral patellar dislocations can damage the medial patella femoral ligament. Nonoperative care is preferred but some tears may require a surgical intervention. Patella fractures are considered a risk factor after surgery. The technique described in this Technical Note avoids any bone tunnel drilling, which may eliminate the possibility of a patella fracture. The surgical procedure uses periost...