Relief of patellofemoral contact stress by anterior displacement of the tibial tubercle. 1979

A B Ferguson, and T D Brown, and F H Fu, and R Rutkowski

Elevation of the patellar tendon by means of displacement of the tibial tubercle has been advocated by Maquet, Ficat and Hungerford, and Murray as an alternative to patellectomy for the treatment of patellofemoral arthralgias. Although tubercle elevation certainly reduces the over-all patellofemoral contact force, its effects on the complex local patterns of contact stress are of more direct significance. In a laboratory series using fresh amputation material, arrays of six miniature contact stress sensors were embedded in the retropatellar cartilage of knees subjected to isometric quadriceps-extension forces. The experimental data revealed that elevation of the patellar tendon generally afforded relief of local contact stress regardless of the joint configuration (zero degrees, 45 degrees, or 90 degrees of flexion), but that its effects were most pronounced at 90 degrees of flexion. Progressive increase in the tendon elevation caused progressive reduction in the contact stress. Most of the contact stress relief was achieved, however, with the first one-half inch of tendon elevation; further elevations to one and one and one-half inches were only marginally useful. In view of the increased superior patellar pole contact associated with distal pole flotation, the results indicate that under most circumstances the optimum amount of elevation of the tibial tubercle is about one-half inch.

UI MeSH Term Description Entries
D007592 Joint Diseases Diseases involving the JOINTS. Arthropathies,Arthropathy,Joint Disease
D008297 Male Males
D008722 Methods A series of steps taken in order to conduct research. Techniques,Methodological Studies,Methodological Study,Procedures,Studies, Methodological,Study, Methodological,Method,Procedure,Technique
D009983 Orthopedic Equipment Nonexpendable items used in the performance of orthopedic surgery and related therapy. They are differentiated from ORTHOTIC DEVICES, apparatus used to prevent or correct deformities in patients. Equipment, Orthopedic,Equipments, Orthopedic,Orthopedic Equipments
D010027 Osteotomy The surgical cutting of a bone. (Dorland, 28th ed) Osteotomies
D010146 Pain An unpleasant sensation induced by noxious stimuli which are detected by NERVE ENDINGS of NOCICEPTIVE NEURONS. Suffering, Physical,Ache,Pain, Burning,Pain, Crushing,Pain, Migratory,Pain, Radiating,Pain, Splitting,Aches,Burning Pain,Burning Pains,Crushing Pain,Crushing Pains,Migratory Pain,Migratory Pains,Pains, Burning,Pains, Crushing,Pains, Migratory,Pains, Radiating,Pains, Splitting,Physical Suffering,Physical Sufferings,Radiating Pain,Radiating Pains,Splitting Pain,Splitting Pains,Sufferings, Physical
D010329 Patella The flat, triangular bone situated at the anterior part of the KNEE. Knee Cap,Kneecap,Knee Caps,Kneecaps,Patellas
D002358 Cartilage, Articular A protective layer of firm, flexible cartilage over the articulating ends of bones. It provides a smooth surface for joint movement, protecting the ends of long bones from wear at points of contact. Articular Cartilage,Articular Cartilages,Cartilages, Articular
D005069 Evaluation Studies as Topic Works about studies that determine the effectiveness or value of processes, personnel, and equipment, or the material on conducting such studies. Critique,Evaluation Indexes,Evaluation Methodology,Evaluation Report,Evaluation Research,Methodology, Evaluation,Pre-Post Tests,Qualitative Evaluation,Quantitative Evaluation,Theoretical Effectiveness,Use-Effectiveness,Critiques,Effectiveness, Theoretical,Evaluation Methodologies,Evaluation Reports,Evaluation, Qualitative,Evaluation, Quantitative,Evaluations, Qualitative,Evaluations, Quantitative,Indexes, Evaluation,Methodologies, Evaluation,Pre Post Tests,Pre-Post Test,Qualitative Evaluations,Quantitative Evaluations,Report, Evaluation,Reports, Evaluation,Research, Evaluation,Test, Pre-Post,Tests, Pre-Post,Use Effectiveness
D005260 Female Females

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