News & Activities

Ongoing & Focused

  • Home
    Home This is where you can find all the blog posts throughout the site.
  • Categories
    Categories Displays a list of categories from this blog.
  • Tags
    Tags Displays a list of tags that have been used in the blog.
  • Archives
    Archives Contains a list of blog posts that were created previously.

Activities

Meetings, Conferences and Events 

8th Biennial ISAKOS Congress • Rio De Janeiro, Brazil • May 15-19, 2011

Patellofemoral Research Excellence Award
The Geometry and Function of the Patellofemoral Joint
Farhad Iranpour, United Kingdom

The purpose of this study was to explore the patellofemoral joint in 3 dimensions, looking at its geometry, motion and stability.

Abstract:

Purpose:
The purpose of this study was to explore the patellofemoral joint in 3 dimensions, looking at its geometry, motion and stability. This work aimed to establish a relationship between this joint and the tibio-femoral joint.
 
Method:
CT scans of 40 normal knees were analysed using custom designed 3D imaging software. A frame of reference was defined, the flexion and extension facets were described in terms of spheres, and the offset of the extension facet sphere centres was measured relative to predefined landmarks. The locations and orientations of the groove and the trochlear axis were examined in relation to the conventional axes of the femur. As for the patella the relationships of various patellar dimensions were studied. In the next part of this study, the kinematics and stability of the patellofemoral joint were measured in 14 fresh frozen cadaveric knees using a Polaris tracking system and an Instron material testing machine after physiologically loading the quadriceps muscles. Then the relationship between these measurements and the femoral trochlear geometry was examined.
 
Results:
It was found that the flexion facets of the femoral condyles were spherical. The medial extension facet could be reproducibly described as part of a larger sphere. However, this was not found to be the case laterally. The trochlear groove was circular and positioned laterally in relation to the mechanical, anatomical, and trans-condylar axes of the femur. It was not co- planar with any of the three axes. The trochlear axis was defined as a line joining the centres of two spheres fitted to the trochlear surfaces, lateral and medial to the trochlear groove. When viewed after aligning the femur to this new axis, the trochlear groove appeared more linear than when other axes were used. The thickness of a patella was on average half of its measured width (correlation coefficient 0.89, p<0.001). The path of the centre of the patella was circular and uniplanar from full flexion to approximately 16° flexion, after which it deviated laterally towards full knee extension. This path was perpendicular to a newly-defined trochlear axis. There were significant correlations between the sulcus angle and the medial facet angle with medial stability(r=0.78, p<0.0001).
 
Conclusion:
The knowledge of the shapes of the surfaces and motion of different compartments of the knee joint and their relationships may help to identify and explain the aetiology of knee joint pathologies. It may also be of use in planning and performing joint reconstruction. These relationships also have implications for the design of unicompartmental and total knee replacements and the rules governing their position. 

 

2010 ISAKOS/PFF Travelling Fellows
Click on any image to view Gallery

The Patellofemoral Tavelling Fellowship started in 2005, with Fred Almqvist and Ryosuke Kuroda travelling in 2005, and Elvire Servien and Christina Stukenborg-Colsman in 2007, began under the aegis of the Patellofemoral Foundation, and the selection committee of the Scientific Committee of the ISAKOS. The very first Travelling Fellow was Jason Koh, before ISAKOS was involved. Until this year, only one Travelling Fellow was selected. 

At the 2009 ISAKOS Meeting, in Osaka, Japan, there was the much welcome surprise that three Travelling Fellows were to travel with a Godfather. On this occasion, the Fellowship was to take place in the spring of 2010. The four Patellofemoral Traveling Fellows 2010 made their way to San Francisco from different parts of the world. Dr. Petri Sillanpää from Tampere, Finland and Dr. Philip Schöttle from Zurich, Switzerland met the Godfather, Prof. Nicola Maffulli from London, England, at Heathrow Airport, and proceeded together to San Francisco. Petri and Nicola travelled in economy, and Philip exerted his charm on the check in ladies to get an upgrade to business class. This was a sign of things to come!  

The aim of the Patellofemoral Travelling Fellowship is to promote better understanding and communication regarding patellofemoral pain. A stipend is provided by the Foundation to permit visits to several centres worldwide that offer opportunities to learn about the complexities of patellofemoral pain. This year four surgeons will be given the opportunity to benefit from this fellowship. Philip Schoettle from Germany, Petri Sillanpaa from Finland and Christian Lattermann from the USA will travel with Nicola Maffulli from England acting as their “godfather.”

On April 25th 2009, Ronald Grelsamer, MD and James Gladstone, MD hosted a Patella course at the Mount Sinai Medical Center in New York City. It was standing room only, as over 130 orthopedists, physical therapists and allied health professionals listened to a panel of experts taken mostly from the International Patellofemoral Study Group. These included Vicente Sanchez-Alfonso and Fred Almqvist (who flew in from Spain and Belgium respectively), Rick Cautilli from Philadelphia, Jack Farr (Indianapolis), Wayne Leadbetter from Baltimore, Anthony Schepsis (Boston), as well as Elliot Hershman and Eveline Erni (PT) from New York. John Fulkerson, MD, founder of the International Patellofemoral Study Group and of the Patellofemoral Foundation was the Keynote Speaker. (Submitted by Ronald Grelsamer MD) 

Traveling Fellow Elvire Servien Visits US and South Africa for Further Study
As part of her traveling fellowship, Elvire Servien of Lyon, France visited three different surgeons in two countries on two different continents. Her report is provided below:

In June of 2009, I went to the United States to meet Dr. John Fulkerson of Farmington, CT and Dr. Anthony Schepsis of Boston, MA. I saw different surgeries, including and MPFL procedure and Dr. Fulkerson’s osteotomy. But I also saw many patella-disorders I usually do not see in my practice. Indeed, when experiencing anterior knee pain in France, patients are referred to the physician for a rehabilitation protocol. We went to the lab with Dr. Fulkerson with his fellow and did an MPFL knee dissection on a cadaver. I also saw several antero-medialization osteotomies with a repeat of the anteromedial tibial tubercle transfer with Dr. Schepsis. The second interesting point was a very high rate of patients with previous lateral retinaculum release (two or three recurrent procedures) coming to see a “patella surgeon expert.” With Professor Schepsis, the dynamic CT-scan was a very interesting exam and was performed in order to analyze patello-femoral tracking during flexion.

My second destination was South Africa , where I visited Dr. Spike Erasmus. I saw his technique for MPFL reconstruction and had an extensive discussion with him about MPFL isometry and graft fixation. The fellowship ended with an International PF Study Group meeting and fantastic Sabi Sabi

Newsletter Signup

Signup for Patellofemoral Foundation's eNews
Please wait