Conclusion
There is no substitute for a thorough history and a complete and careful physical examination. The history and physical examination still remain the first step for making an accurate diagnosis of anterior knee pain and patellar instability above any technique of diagnostic image. Imaging studies are a second step and can never replace the former. Surgical indications should not be based only on methods of image diagnosis as there is a poor correlation between clinical and image data. Finally, arthroscopy should be used judiciously and no realignment surgery should be based solely on the arthroscopic analysis of the patellofemoral congruence.
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References
Allen, GM, PG Tauro, and SJ Ostlere. Proximal patellar tendinosis and abnormalities of patellar tracking. Skeletal Radiol 1999; 28: 220–223.
Biedert, RM. Patellofemoral Disorders: Diagnosis and Treatment. John Wiley & Sons, Ltd., 2004.
Carlsson, AM, S Werner, CE Mattlar et al. Personality in patients with long-term patellofemoral pain syndrome. Knee Surg Sports Traumatol Arthrosc 1993; 1: 178–183.
Dejour, H, G Walch, L Nove-Josserand et al. Factors of patellar instability: An anatomic radiographic study. Knee Surg Sports Traumatol Arthrosc 1994; 2: 19–26.
Dye, SF. Reflections on patellofemoral disorders. In Biedert, RM, ed., Patellofemoral Disorders: Diagnosis and Treatment. John Wiley & Sons, Ltd., 2004, pp. 3–17.
Dye, SF, and DA Boll. Radionuclide imaging of the patellofemoral joint in young adults with anterior knee pain. Orthop Clin North Am 1986; 17: 249–262.
Elias, DA, LM White, and DC Fithian. Acute lateral patellar dislocation at MR imaging: Injury patterns of medial patellar soft-tissue restraints and osteochondral injuries of the inferomedial patella. Radiology 2002; 225: 736–743.
Ficat, P, C Ficat, and A Bailleux. External hypertension syndrome of the patella. Its significance in the recognition of arthrosis. Rev Chir Orthop Reparatrice Appar Mot 1975; 61: 39–59.
Fulkerson, JP. The etiology of patellofemoral pain in young, active patients: A prospective study. Clin Orthop 1983; 179: 129–133.
Fulkerson, JP. A clinical test for medial patella tracking. Tech Orthop 1997; 12: 165–169.
Gambardella, RA. Technical pitfalls of patellofemoral surgery. Clin Sports Med 1999; 18: 897–903.
Grelsamer, RP, and J McConnell. The patella: A team approach. Gaithersburg, MD: Aspen, 1998.
Grelsamer, R, and C Weinstein. Patellar tilt: An MRI study. Tenth Congress European Society of Sports Traumatology, Knee Surgery and Arthroscopy, Rome 23–27 April 2002, Book of Abstracts, p. 178.
Hejgaard, N, and CC Arnoldi. Osteotomy of the patella in the patellofemoral pain syndrome: The significance of increased intraosseous pressure during sustained knee flexion. Int Orthop 1987; 8: 189–194.
Jackson, AM. Anterior knee pain. J Bone Joint Surg 2001; 83-B: 937–948.
Johnson, LL. Arthroscopic Surgery: Principles and Practice. St. Louis: C.V. Mosby, 1986.
Johnson, LL, E van Dyk, JR Green et al. Clinical assessment of asymptomatic knees: Comparison of men and women. Arthroscopy 1998; 14: 347–359.
Kantaras, AT, J Selby, and DL Johnson. History and physical examination of the patellofemoral joint with patellar instability. Oper Tech Sports Med 2001; 9: 129–133.
Kawakubo, M, K Fujikawa, and H Matsumoto. Evaluation of patellofemoral joint congruence using three-dimensional computed tomography. Knee 1999; 6: 165–170.
Kijowski, R, D Plagens, SJ Shaeh et al. The effects of rotational deformities of the femur on contact pressure and contact area in the patellofemoral joint and on strain in the medial patellofemoral ligament. Presented at the Annual Meeting of the International Patellofemoral Study Group, Napa Valley, San Francisco, USA, September 1999.
Lorberboym, M, DB Ami, D Zin et al. Incremental diagnostic value of 99mTc methylene diphosphonate bone SPECT in patients with patellofemoral pain disorders. Nucl Med Commun 2003; 24: 403–410.
Merchant, AC. Radiography of the patellofemoral joint. Oper Tech Sports Med 1999; 7: 59–64.
Pidoriano, AJ, RN Weinstein, DA Buuck et al. Correlation of patellar articular lesions with results from anteromedial tibial tubercle transfer. Am J Sports Med 1997; 25: 533–537.
Pidoriano, AJ, and JP Fulkerson. Arthroscopy of the patellofemoral joint. Clin Sports Med 1997; 16: 17–28.
Post, WR. History and physical examination. In Fulkerson, JP, ed., Disorders of the Patellofemoral Joint, 4th ed. Philadelphia: Lippincott Williams & Wilkins, 2004, pp. 43–75.
Runow, A. The dislocating patella: Etiology and prognosis in relation to generalized joint laxity and anatomy of the patellar articulation. Acta Orthop Scand Suppl 1983: 201: 1–53.
Sanchis-Alfonso, V, E Gastaldi-OrquÍn, and V Martinez-SanJuan. Usefulness of computed tomography in evaluating the patellofemoral joint before and after Insall’s realignment: Correlation with short-term clinical results. Am J Knee Surg 1994; 7: 65–72.
Schutzer, SF, GR Ramsby, and JP Fulkerson. Computed tomographic classification of patellofemoral pain patients. Orthop Clin North Am 1986; 17: 235–248.
Shellock, FG, JH Mink, AL Deutsch et al. Patellar tracking abnormalities: Clinical experience with kinematic MR imaging in 130 patients. Radiology 1989; 172: 799–804.
Spencer, JD, KC Hayes, and IJ Alexander. Knee joint effusion and quadriceps inhibition in man. Arch Phys Med Rehabil 1984; 65: 171–177.
Stanitski, CL. Articular hypermobility and chondral injury in patients with acute patellar dislocation. Am J Sports Med 1995; 23: 146–150.
Teitge, RA. Plain patellofemoral radiographs. Oper Tech Sports Med 2001; 9: 134–151.
Thomee, P, R Thomee, and J Karlsson. Patellofemoral pain syndrome: Pain, coping strategies and degree of well-being. Scand J Med Sci Sports 2002; 12: 276–281.
Walsh, WM. Patellofemoral joint. In DeLee, JC, and D Drez, eds., Orthopaedic Sports Medicine: Principles and Practice. Philadelphia: W.B. Saunders, 1994, pp. 1163–1248.
Witonski, D, and B Goraj. Patellar motion analyzed by kinematic and dynamic axial magnetic resonance imaging in patients with anterior knee pain syndrome. Arch Orthop Trauma Surg 1999; 119: 46–49.
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Sanchis-Alfonso, V., Puig-Abbs, C., MartÍnez-Sanjuan, V. (2006). Evaluation of the Patient with Anterior Knee Pain and Patellar Instability. In: Sanchis-Alfonso, V. (eds) Anterior Knee Pain and Patellar Instability. Springer, London. https://doi.org/10.1007/1-84628-143-1_6
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