Surgery for patella malalignment
One article on PainSci cites Iliadis 2012: The Complete Guide to Patellofemoral Pain Syndrome
PainSci notes on Iliadis 2012:
This article surveyed the existing research on surgery for PFPS as of 2012.
The authors conclude that the evidence of efficacy is generally poor for most surgical techniques. This may be due to the research being poorly designed and populations studied being poorly described, but other evidence (e.g. Kettunen 2007 and Kettunen 2012) has shown that common surgeries don’t work.
Some techniques might be promising in very specific situations, but a good rationale needs to be developed to justify going ahead with surgery, and better research needs to be produced to support it.
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
Management of patellofemoral joint pathology is challenging as a result of the unique and complex organization of static forces and dynamic factors contributing to its functional capacity. Anterior knee pain is a common musculoskeletal complaint seen daily in the practices of primary care physicians, rheumatologists, and orthopedic surgeons. The key to successful treatment lies not only in the correct diagnosis of a chondral defect, but more importantly, in the accurate identification of associated pathomechanical factors. Appreciating the pathoanatomic basis of the disease and addressing imbalances and anatomical abnormalities should guide treatment.Despite the complexity of the interplay of various components it is essential to attempt to describe patellar malalignement as a clinical entity in order to proceed with appropriate surgical management and successful outcomes. The goals of patellofemoral re- alignment surgery should be to create both a stable environment for optimal extensor mechanism performance and an appropriate load transmission for optimal cartilage wear and joint loading. In the context of this article we will review the operative management of patellofemoral malalignment; the indications for surgery, the different techniques available and the evidence regarding their effectiveness.A large number of procedures have been employed and they have all undergone various modifications over the course of the years. The majority of publications are retrospective series in poorly defined population groups. There are significant methodological inconsistencies and as a result there is lack of strong evidence base for the majority of these procedures.
related content
- “Knee arthroscopy and exercise versus exercise only for chronic patellofemoral pain syndrome: a randomized controlled trial,” Kettunen et al, BMC Med, 2007.
- “Knee arthroscopy and exercise versus exercise only for chronic patellofemoral pain syndrome: 5-year follow-up,” Kettunen et al, British Journal of Sports Medicine, 2012.
- “[Patellofemoral pain: physiotherapy and surgery],” van Linschoten et al, Nederlands tijdschrift voor geneeskunde, 2010.
- “A review of the management of patellofemoral pain syndrome,” Rixe et al, The Physician and Sportsmedicine, 2013.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Cannabidiol (CBD) products for pain: ineffective, expensive, and with potential harms. Moore 2023 J Pain.
- Inciting events associated with lumbar disc herniation. Suri 2010 Spine J.
- Prediction of an extruded fragment in lumbar disc patients from clinical presentations. Pople 1994 Spine (Phila Pa 1976).
- Characteristics of patients with low back and leg pain seeking treatment in primary care: baseline results from the ATLAS cohort study. Konstantinou 2015 BMC Musculoskelet Disord.
- Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial. Kuyken 2022 Evid Based Ment Health.