Dr. Shital N Parikh MD (editor) - Patellar Instability: Management Principles and Operative Techniques

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ISBN-13: 978-1-4963-8082-1 | eISBN: 9781496380838

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To my wife, Preeti, for her love, patience, and support

To my children, Ria and Rohan, for allowing me to take precious time away from home

To my parents, Kokila and Navnit, for their blessings and encouragement

SHITAL N. PARIKH

Section Editors

Elizabeth A. Arendt, MD

Professor and Vice Chair
Department of Orthopaedic Surgery
University of Minnesota
Minneapolis, Minnesota

Donald Fithian, MD

Associate Surgeon
Torrey Pines Orthopaedic Medical Group
La Jolla, California

John P. Fulkerson, MD

Clinical Professor
Department of Orthopedic Surgery
School of Medicine, University of Connecticut
Farmington, Connecticut
Partner
Orthopedic Associates of Hartford
Bone and Joint Institute
Hartford, Connecticut

Robert A. Magnussen, MD, MPH

Associate Professor
Sports Medicine Research Institute
Department of Orthopaedics
The Ohio State University
Columbus, Ohio

Shital N. Parikh, MD

Professor of Orthopaedic Surgery
University of Cincinnati College of Medicine
Co-Director
Orthopaedic Sports Center
Cincinnati Childrens Hospital Medical Center
Cincinnati, Ohio

Hui James Hoi Po, MBBS, FRCS, MD

Head of Paediatric Orthopedics
Department of Orthopaedic Surgery
University Orthopaedics, Hand and Reconstructive Microsurgery Cluster
National University Health System (NUHS)
Singapore, Singapore

Beth E. Shubin Stein, MD

Associate Professor
Department of Sports and Shoulder Surgery
Hospital for Special Surgery
New York, New York

Robert A. Teitge, MD

Professor
Department of Orthopaedic Surgery
Wayne State University
Staff Surgeon
Department of Orthopaedic Surgery
Detroit Medical Center
Detroit, Michigan

Foreword

D r Shital Parikh has been a devoted student and a scholar of patellofemoral joint. I applaud him for undertaking this great effort to further advance the understanding of patellofemoral surgery.

Because patellar instability is multifactorial, varied surgical approaches have been recommended to address it. In the 1970s and 1980s, there were predominantly two schools of thought about patellofemoral surgeryboth advocating surgical realignment as treatment for instability and/or pain in many cases. In one, the tibial tubercle was moved medially (as advocated by Drs Elmslie, Trillat, Hauser, Cox, and others). In the other, a major imbrication of the medial patellofemoral retinacular structures was performed (as advocated by Dr John Insall in the United States). Often, surgeons would focus on one or the other approach fairly exclusively, regardless of indications. Extensive lateral releases were often done (often percutaneously, resulting in painful hemarthrosis). In failed cases, the answer might be to remove the patella (patellectomy). Anteriorization of the tibial tubercle was recommended by Dr Maquet as a way to unload the patella, but too often it resulted in complications. Patellofemoral arthroplasties were inconsistent and generally not popular until Dr Allan Merchant and others refined the techniques and designs of implants.

In the United States during the 1980s, patellofemoral surgery was not too popular, mostly because results were unpredictable. Drs Allan Merchant, Bob Teitge, Eric Radin, Scott Dye, and I would often be the only ones available to talk about patellofemoral surgery at US meetingsusually to a small crowd. Fortunately, in Lyon, France, Alfred Trillat, Henri Dejour, and others of the Lyon School were curious about the patellofemoral joint and provided logical approaches to patellofemoral surgery. These were pioneers of modern patellofemoral surgery.

We founded the International Patellofemoral Study Group in 1995 and were quickly joined by about 25 knee surgeons with special interest in the patella. There was a subsequent explosion of new information and academic contributions were made by many orthopedic surgical scholars such as Drs Parikh, Neyret, Dye, Nomura, Espregueira-Mendes, Magnussen, Teitge, Amis, Donell, Mochizuki, Sanchis-Alfonso, Post, Cosgarea, Fithian, Green, Tanaka, Arendt, Dahm, Dejour, Andrish, Biedert, Merchant, Farr, Grelsamer, Shelton, Bicos, Spang, Joseph, Schoettle, Koh, Elias, Servien, Bollier, Hiemstra, Kuroda, Diduch, Sgaglione, Beach, Laprade, Strickland, Almqvist, Albright, Gomoll, Biedert, Edgar, Shubin Stein, Sherman, Munch, Yanke, West, Halbrecht, Silanpaa, Askenberger, Fink, Hinckel, Tompkins, Abdelkafy, Seitlinger, Liebensteiner, Lattermann, and others.