Pie Crust Research Articles

Peningkatan Mutu “Papie-Sue” melaui Pendekatan GMP, SSOP, dan HACCP”

Papie-Sue is a diversification of agricultural and livestock products. Papie-Sue means banana pie with etawa milk. The main raw material for pie crust comes from banana flour, and the raw material for vla comes from etawa goat's milk. In addition, there are variations in flavors from local fruits, namely starfruit and durian. All raw materials and variations in flavors are local products of Bojonegoro. Because this product is processed from fresh ingredients without preservatives, a method is needed to maintain product quality until it reaches consumers. To improve the quality of Papie-Sue, GMP, SSOP, and HACCP are implemented through training and mentoring for the production team. The implementation of a food safety system based on GMP, SSOP, and HACCP can improve product quality by avoiding food contamination both biologically, chemically, and physically. Potential contamination will be identified to carry out prevention processes during the production process. Training participants consist of a production team of 15 people. The implementation of this food safety system is expected to be one way in the process of increasing the scale of the Papie-Sue business at SMKN Ngambon.

Thermal Inactivation of Cells of Salmonella spp. in Pot Pies Prepared With a Beef, Chicken, or Meat Alternative Filling, With and Without Gravy, During Cooking in a Convection Oven

Cooking parameters elaborated in the U.S. Department of Agriculture’s Food Safety and Inspection Service Cooking Guideline for Meat and Poultry Products (Appendix A) were evaluated for inactivation of Salmonella spp. in pot pies. To prepare dough for pot pies, flour, butter, sugar, salt, and water were mixed, portioned into balls (65 or 85 g each), flattened (ca. 13 or 15 cm diameter, ca. 0.5 cm thick), and hand-pressed into pans (ca. 19.4 cm diameter). Next, a 100-g portion of beef, chicken, or a meat alternative, with or without added gravy (55 g of protein and 45 g of gravy), was inoculated with a cocktail of Salmonella spp. (ca. 6.5 or 7.9 log CFU/g of filling) and distributed onto the pie crust. After covering with a 65-g sheet of dough, pies were heat sealed in nylon polyethylene bags and stored at −20 °C for up to 72 h. Frozen pot pies containing a beef or meat alternative filling were cooked in a convection oven to an internal temperature of 57.8 °C (136°F) instantaneous, 62.8 °C (145°F) and held for 4 min, 67.2 °C (153°F) and held for 34 sec, or 71.1 °C (160°F) instantaneous; whereas chicken pot pies were cooked to an internal temperature of 57.8 °C (136°F) instantaneous, 62.8 °C (145°F) and held for 13 min, 67.2 °C (153°F) and held for 96 sec, or 73.9 °C (165°F) instantaneous. Cells of Salmonella spp. were recovered from uncooked or cooked pot pies by stomaching each pie in peptone water and enumerating pathogen levels via direct plating. Cooking delivered Salmonella spp. reductions of ca. 3.6 to ≥6.3 log CFU/g of pot pie. With few exceptions, when pathogen levels decreased to below detection by direct plating (0.5 log CFU/g of pot pie), cells of Salmonella were not recovered by enrichment. In addition, there were minimal differences in the aw and moisture content of the protein filling before and after cooking, suggesting that enclosing a meat, poultry, or meat alternative filling within a dough wrapping maintained moisture in the filling during the cooking process.

Comparative analysis of medial pivot vs. posterior stabilized total knee arthroplasty in patients with valgus deformed osteoarthritic knees: a retrospective cohort study.

Total knee arthroplasty (TKA) is highly effective for end-stage knee osteoarthritis, providing long-term benefits and anticipated increased prevalence. The study compares Medial Pivot TKA's (MP-TKA) historical success for varus deformities with recent findings suggesting comparable outcomes for valgus deformities. Despite prevalent use of Posterior Stabilized TKA (PS-TKA) for valgus deformities, this research explores the unexplored comparative efficacy of MP-TKA vs. PS-TKA in knee osteoarthritis patients with valgus deformity. This single-centrecohort study focused on 57 knees in 53 patients undergoing TKA for knee osteoarthritis with valgus deformity. Conducted between January 2013 and April 2021, the study compared MP-TKA and PS-TKA. Surgeries adhered to a medial parapatellar approach and modified gap technique, with perioperative interventions for pain, bleeding, and swelling. Outcome measurements included knee joint range of motion, radiographic evaluation, patients-reported outcomes, operative time, blood laboratory tests, estimated blood loss, and postoperative adverse events, and analyzed between the two groups. Postoperative hip-knee-ankle angles showed no significant difference between MP-TKA and PS-TKA. The pie crust technique was similarly used in both groups, and deformity correction showed no significant difference. Range of motion and clinical outcomes, measured by WOMAC and JOA scores, were comparable postoperatively. MP-TKA had a shorter surgical duration (p = 0.01), and PS-TKA exhibited higher estimated blood loss (p = 0.01) without significant complications in either group. This pioneering study compares the outcomes of MP TKA and PS TKA in patients with valgus-deformed osteoarthritic knees. Compared to PS TKA, MP TKA shows a prolonged operative duration and increased blood loss, likely due to the requirement for patellar replacement. However, postoperative range of motion and clinical outcomes are similar. Both groups exhibit favorable midterm clinical results, supporting the viability of MP TKA for valgus deformed knees. The study, consistent in surgical approach, highlights MP TKA's effectiveness for valgus deformities.

Plant-based egg washes for use in baked goods: Machine learning and visual parameter analysis.

Pea protein is one potential environmentally sustainable way of recreating the functionality of eggs in coatings for baked goods. These coatings are commonly applied to enhance visual properties of baked goods that consumers desire, especially color and gloss. This project used a simplified pie crust formulation (flour, shortening, and water) as a model baked good system to investigate color and gloss properties of pea protein coatings comprising three pea protein glycerol ratios, prepared at 2pH values, and applied at three different weights, baked for either 15 or 30 min. Pictures were also taken and used to estimate L*, a*, and b* colorimeter values from images using random forest and artificial neural network models developed using SciKit-Learn. Image acquisition was also conducted at different lighting conditions and the results are corrected utilizing a principal component analysis (PCA) weighting approach. Results show that pea protein glycerol solutions are all glossier than egg washes, and the 80%/20% ratio gives the highest glossiness. Furthermore, there are not significant differences in any of the colorimeter values at any concentration when applying 1 g of protein. The artificial neural network model coupled with PCA weighting led to reasonable estimates of color at different lighting conditions. Together, these results offer an alternative for the use of pea protein/glycerol in lieu of egg washes.

Organoleptic Test Analysis of Pie Crust Using Rub-In and Blending Method

This research was motivated by the discovery of different methods for making pies so it needed to be tested to see the quality produced using the rub-ib and blending methods. The aim of the research was to determine the comparison of pie crust quality using the rub-in and blending methods. This type of research is pure experiment using the Independent Sample T-test method. The research was carried out by providing an organoleptic test format to the panelists. The data obtained is then tabulated in table form and a level test is carried out on each variable X1 and X2 to find out whether there is a quality comparison for these variables. The results of the research show that there is no significant influence on the quality of the shape, color, aroma, texture and taste of the pie crust, for the quality of the shape (neat) it has an average value of X1 (2.77) and X2 (3.78), quality shape (uniform) X1 (4.00) and has an average of X1 (3.67) and X2 (3.78), while the average value for texture quality (dry) has an average of (crispy) has an average value of X1 (4.00) and X2 (3.67), finally for taste quality (savory) has an average value of X1 (4.00) and X1 (4.00).

Pembuatan Kulit Pie Berbahan Dasar Tepung Porang

Pie crust made from porang flour is an innovation that utilizes the results of cultivating porang tubers. This research aims to determine: 1) the best sensory test quality of pie crust made from porang flour; 2) nutritional content, namely water, fat, protein, carbohydrate, ash and fiber content; 3) selling price for pie crust made from porang flour per piece weighing 30 gr. The research method used was experimentation by carrying out 3 different treatments to determine the best sensory test. The research method used in this research is experimentation. The data collection technique is through sensory quality testing using instruments with 30 panelists. The data that has been collected is then analyzed using SPSS version 27 single anova test (one way anova). The research results show that; 1) the formula used to make pie crust is made from porang flour using 60% porang flour and 40% wheat flour, with the formulation 210-grams of porang flour, 140-grams of wheat flour, 25-grams of refined sugar, 280-grams of margarine, 1 ½ tsp salt, 85-ml ice water; 2) laboratory test results for the nutritional content of pie crust made from porang flour, namely water content 7.11%, fat 2.96%, protein 6.11%, carbohydrates 67.90%, ash 0.91%, fiber 3.62% ; and 3) The selling price of pie crust made from porang flour per piece weighing 30 grams.

Medial Collateral Ligament Pie-Crusting for Isolated Medial Meniscal Root Repair Is Associated With Improved Clinical Outcomes with Minimum 2-Year Follow-Up

To determine clinical and radiographic outcomes of medial collateral ligament (MCL) pie-crusting during isolated medial meniscal root repair. A retrospective review was conducted between August 2013 and December 2019 in patients undergoing isolated medial meniscal root repair. Outcomes, including International Knee Documentation Committee (IKDC) score, Lysholm score, re-tears, MCL laxity, and conversion to total knee arthroplasty (TKA), were compared between pie crust (PC) and non-pie crust (NPC) cohorts. Other assessments included subjective instability or stiffness, infection, and intra-operative chondromalacia. Additionally, radiographic outcomes were compared to determine progression of medial compartment arthrosis. Final analysis included 97 knees, 45 in the PC, and 52 in the NPC group. IKDC and Lysholm scores were similar between both groups preoperatively and 3 months postoperatively. However, at the 6,12, and 24-month follow up, the PC group had a significantly higher measured IKDC and Lysholm scores than the NPC group. PASS percentages for the IKDC score were significantly higher in the PC group at 6 months, 1 year, and 2 years (96.2%; P= .02) follow-up compared to the NPC group. MCID percentages for the IKDC score were also significantly higher at the 1- and 2-year (100%; P= .05) follow-up in the PC group compared to the NPC group. There was also a significantly higher rate of recurrent medial meniscal root tears in the NPC group (4 [8.9%]) compared to the PC group (0 [P= .03]). No MCL laxity was observed at 6 months follow-up. MCL pie-crusting during isolated medial meniscal root repair can be used as an alternative surgical technique, as it leads to improved clinical and patient outcomes compared to patients who do not undergo MCL pie-crusting in the short term. Additionally, those that underwent MCL pie-crusting had a lower incidence of recurrent tears, and no patients experienced MCL laxity at 6 months. Level III, retrospective cohort/comparative study.

Karakteristik Kimia dan Sensori Kulit Pie Berbahan Dasar Tepung Mocaf (Modified Cassava Flour) dan Tepung Kepala Ikan Lele Dumbo (Clarias gariepinus)

Pie is processed food products consisting of pie crust dough and filling. A good pie crust is crispy and crumbs but not easily to crumble. In this research, pie crust were made using mocaf flour and catfish dumbo head flour. The purpose of this research was to study the effect of mocaf flour and catfish dumbo head flour substitution on physicochemical and sensory pie crust. The method used was analysis of variance (RAL) with one factor that is the ratio betwn mocaf flour and catfish dumbo head flour with four treatment levels, 100:0, 95:5, 90:10, and 85:15. The product analysis included sensory tests (sensory and hedonic quality) and chemical tests (moisture content, protein content, and calcium content). The result showed that pie crust with treatment mocaf 5%: catfish head flour 15% produced a product with good chemical composition and sensory quality.

Pengaruh Perbandingan Puree Biji Buah Nangka (Artocarpus Heterophyllus) Dengan Tepung Terigu Pada Pembuatan Kulit Pie Terhadap Daya Terima Konsumen

This plant has different names and varies depending on the region or region. Jackfruit plant is a plant that belongs to the annual fruit type, and is still related to Malvales and is also included in the ordoUrticales. This study was conducted to find out how the comparison of jackfruit seed pulp (Artocarpus heterophyllus) with wheat flour on pie peel making on consumer acceptability. The research was conducted starting in March 2021 at the Bakery and Bakery Laboratory, Faculty of Engineering, State University of Jakarta. This study used experimental methods. Consumer acceptance tests were conducted on 30 untrained panelists to rate pie crusts for interior color, subtle flavor, buttery flavor, subtle flavor, sweetness, and texture. The results of consumer acceptance obtained by Friedman's test showed that there was no noticeable difference in sweetness, but there was a noticeable difference in the intense color, mash flavor, butter flavor, mash flavor and texture. Then continued with the Tuckey test with a significance value of α = 0.05 and showed that pie skin has a noticeable difference of 10%, 20-30% and a tendency to like pie skin compared to pure jackfruit seeds by 20%. Therefore the recommended treatment in this study was oilcake peel and compared to jackfruit seed puree 20%. The conclusion is that comparing jackfruit seed puree does not affect consumer acceptance of the sweet taste of pie peel.

Pengaruh Perbandingan Puree Biji Buah Nangka (Artocarpus Heterophyllus) Dengan Tepung Terigu Pada Pembuatan Kulit Pie Terhadap Daya Terima Konsumen

This plant has different names and varies depending on the region or region. Jackfruit plant is a plant that belongs to the annual fruit type, and is still related to Malvales and is also included in the ordoUrticales. This study was conducted to find out how the comparison of jackfruit seed pulp (Artocarpus heterophyllus) with wheat flour on pie peel making on consumer acceptability. The research was conducted starting in March 2021 at the Bakery and Bakery Laboratory, Faculty of Engineering, State University of Jakarta. This study used experimental methods. Consumer acceptance tests were conducted on 30 untrained panelists to rate pie crusts for interior color, subtle flavor, buttery flavor, subtle flavor, sweetness, and texture. The results of consumer acceptance obtained by Friedman's test showed that there was no noticeable difference in sweetness, but there was a noticeable difference in the intense color, mash flavor, butter flavor, mash flavor and texture. Then continued with the Tuckey test with a significance value of α = 0.05 and showed that pie skin has a noticeable difference of 10%, 20-30% and a tendency to like pie skin compared to pure jackfruit seeds by 20%. Therefore the recommended treatment in this study was oilcake peel and compared to jackfruit seed puree 20%. The conclusion is that comparing jackfruit seed puree does not affect consumer acceptance of the sweet taste of pie peel.

Science makes pies and avocados better

Easy as pie Expert pie makers transform flour, water, and fat into light, buttery flakes of pastry. The process is simple but difficult to perfect. Adding water to flour creates gluten, a network of wheat proteins that acts as a scaffold maintaining the pie’s structure. But too much gluten renders the crust tough. Matthew Hartings, an American University chemist, author of Chemistry in Your Kitchen , and member of C&EN’s advisory board, says making a good pie crust requires breaking links between gluten proteins with globs of fat. “It helps with the flakiness,” he tells Newscripts. “You’re making tiny little pockets of gluten.” The fat must be globbed. If it spreads out evenly, the dough will be homogeneous and less flaky. That means bakers must be careful not to melt the butter or shortening with their warm hands. Julie Pollock, a chemist at the University of Richmond, says vegetable shortening

Quality Of Pie Skin From Cornflour

West Pasaman is the city with the highest corn production in West Sumatra. High corn production is mostly used for animal feed. The utilization of corn in West Pasaman in processed food is not optimal, even though corn has good nutritional content. Corn has the weakness of perishability, so it needs to be processed into semi-finished products such as flour so that it is resistant to storage and easy to apply to processed foods, such as pies. Pies vary a lot from the filling, so it is necessary to innovate the pie crust. The purpose of this study was to analyze the quality (shape, color, aroma, texture, and taste) of pie crust from corn flour as much as 20%, 30%, and 40%. This type of research is a pure experiment with a completely randomized design method (CRD) and uses primary data obtained from 5 expert panelists through a questionnaire. After the data was obtained, it was tabulated in the form of a table and an Analysis of Variance (ANOVA) was performed. If the analysis of variance shows Fcount Ftable, then it is continued with Duncan's test. The best results were found in X3 treatment with 40% corn flour substitution, therefore it is recommended for further researchers to use 40% corn flour substitution.

Which Fibers of the Medial Collateral Ligament (MCL) Should Be Released in the Pie Crust Technique Applied During Knee Arthroscopy: Superficial MCL or Deep MCL?

BackgroundKnee arthroscopy is the most common surgery performed to treat meniscal injuries. The pie crust (PC) technique is applied during knee arthroscopy to increase joint vision of the medial femorotibial compartment and reduce the risk of iatrogenic damage. Medial collateral ligament (MCL) release is applied in the PC technique. Currently, there are no studies directly comparing the release of the superficial MCL (sMCL) or deep MCL (dMCL) when applied during the PC technique. In this study, we compared the clinical and functional results of the release of the deep and proximal tibial attachment of the superficial fibers of the MCL.MethodologyWe evaluated the results of 67 (27 women and 40 men) patients who underwent the PC technique during knee arthroscopy due to a medial meniscal tear. The patients who underwent the PC technique were divided into two groups according to the release of the deep and superficial fibers of the MCL. All patients were evaluated for pain, functional capacity, and laxity using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Oxford Knee scores. All patients were evaluated with radiographic examinations such as valgus laxity angle and medial tibiofemoral compartment opening height.ResultsThe KOOS and Oxford Knee Scores in both groups showed a statistically significant increase at 12 months postoperatively compared with the preoperative values (p = 0.005, 0.002, 0.002, and 0.01, respectively). No statistically significant difference was found between the groups (p > 0.05). When the valgus laxity angle before the PC technique was compared with the 12-month result after the procedure, no statistically significant difference was noted (p > 0.05). There was no evidence of complications such as chondral injury and saphenous nerve or vein injury among patients in either group.ConclusionsIn this study, we did not observe laxity in the long-term follow-up of the groups in which the superficial or deep fibers of the MCL were released. In our view, the PC technique has similar effects on surgical outcomes regardless of sMCL and dMCL release techniques.

During Arthroscopic Repair of Medial Meniscal Tears: Do Not Be Afraid to Perform "Pie Crust" Technique.

In the absence of effective long-term repair of meniscal injuries, damage to the knee may lead to the development of osteoarthritis. Recent reports have recommended meniscal repair to be undertaken in all cases of meniscal tears. However, the most common complication encountered during repair of the medial meniscus is iatrogenic cartilage and meniscal injury due to its unclear visualization. The aim of this study is to evaluate the long-term clinical and radiological results of the pie-crust (PC) technique performed during the repair of medial meniscal tears. This retrospective study included 86 patients who underwent arthroscopic medial meniscus repair. PC technique was performed if the medial joint width was less than 5 mm. The patient population was divided into two groups as who underwent meniscus repair with PC technique (PC + repair group) or not (repair group). All patients were evaluated clinically (Kujala score, International Knee Documentation Committee (IKDC) subjective score, Lysholm score, and Tegner activity score) and radiologically (medial joint width and valgus laxity angle). When the medial joint width measurements before the PC technique and at the postoperative first and sixth months were compared, it was found to be statistically significant (p < 0.05). However, there was no significant difference between the preoperative and 12-month postoperative joint width measurements (p > 0.05). At the 12-month follow-up, no statistically significant difference was determined for the valgus laxity angle in the PC group compared with preoperative values (p > 0.05). The follow-up Kujala score, IKDC subjective score, Lysholm score, and Tegner activity score were similar between the groups. The clinical scores in both groups were determined to have statistically significant increase at 12-month postoperatively compared with the preoperative values (p < 0.05). The results of this study showed that performing the PC technique prior to medial meniscal tear repair increase the medial joint visualization safely and effectively without permanent valgus laxity.

The Effect Of Subtitution Of Potato Starch On The Pie Crust

This research was motivated by the high production of potatoes in West Sumatra which caused the utilization of potatoes to be less than optimal. Potatoes have a high moisture content so that if they are not properly utilized, they will spoil quickly, efforts can be made to extend the shelf life of potatoes by processing potatoes into starch. Potato flour has excellent nutritional value because it contains high starch (starch) resistance so that it can be processed into pie crusts. This study aims to analyze the effect of substitution of potato starch as much as 15%, 30%, and 45% on the quality of the shape, color, aroma, texture, and taste of the pie crust. This type of pure experimental research with a completely randomized design method. The dependent variable is the quality of the pie crust using primary data sourced from 3 expert panelists by proposing an organoleptic test format. Analysis of data with ANOVA, if Fcount&gt; Ftable then proceed with the Duncan test. The results showed that there was no significant effect of potato starch substitution on the quality of the pie crust (jagged round shape, uniform shape, neat shape, color, crunchy texture, and brittle texture) because Fcount &lt;Ftable, and there was a significant effect of potato flour substitution. on the quality of the pie crust (aroma and taste) because Fcount&gt; Ftable. The best results were found in X1 with 15% substitution of potato starch.

Quality evaluation of functional pie crust enriched with banana peel flour

Pie crust is a popular bakery product that is consumed all around the world. It could be used as a beneficial supplementation source for improving nutritional profile and acceptability in large population from all over the world. Banana peels, which are commonly discarded after eating banana pulp, are causing wastage issues. These are considered as a rich source of dietary fiber and some other valuable nutrients, which can offer a significant role in enhancing the nutritional profile and shelf life of product. Keeping in these applications, this research was planned to study the different levels of banana peel powder on rheological, chemical, physical and sensory properties of pie crusts. For quality evaluation parameters like water holding capacity, farinograph assay, moisture, crude proteins, crude fat, ash, crude fiber and dietary fiber nitrogen free extract was analyzed. Physical properties such as width, thickness, spread factor and sensory parameters was also part study. Data was analyzed by using analysis of variance (ANOVA).

PEMANFAATAN TEPUNG KOMPOSIT PISANG GOROHO (Musa acuminate) DAN UBI JALAR KUNING (Ipomoea batatas. L) SEBAGAI BAHAN BAKU PEMBUATAN CRUST PIE

AbstractThe objectives of this study were to analyze the composition and sensory quality of the crust pie made of composite flour of goroho and yellow sweet potato. This study was conducted in a completely randomized design with 4 different composition ratio of goroho plantain flour to yellow sweet potato flour, i.e., A (80% : 20%), B (70%: 30%), C (60%: 40%), and D (50% : 50%). The results of the study showed that the chemical composition of pie crust were in a range of 2.87% - 4.74% for moisture content, 2.66% - 2.72% for ash content, 32.10% - 32.95% for fat content, 5.90% - 6.06% for protein content, 3.76% - 4.77% for crude fiber, and 50.04% - 55.50% for carbohydrates content. The pie crust made from composite flour 50% goroho : 50% yellow sweet potato was the most preferred by panelists in terms of color, aroma, taste and texture with a value of 3.89 (like).Keywords: pie crust, composite flour, goroho plantain, sweet potato

Effect of freeze-thaw on the texture of gluten-free pie crust dough

Quick frozen food are becoming increasingly popular among consumers in the last decades. During the development of a quick frozen gluten-free pie crust dough product, the aim was to develop a dough that does not suffer any harmful changes after the freeze-thaw process. The texture is one of the most important sensorial properties, and has a great influence on consumer acceptance. Texture Analyser was used to measure the hardness and the brittleness of various doughs. A quick frozen pie crust dough should be easily cut, but non-crumbling after baking. The results showed that the hardness of a dough with 10% more rice flour was bigger than the other dough’s hardness and it became harder after the freeze-thaw process, while the other dough’s hardness have not changed during the process. The first dough was less brittle than the second dough, also before and after the freeze-thaw. In conclusion, the 1st dough is harder, so it is not more easy to cut than the 2nd dough. However, the first dough being less brittle allows cutting with less crumbs. Considering the expectations, in the future the first recipe should be used to make a fast-frozen pie crust dough product.

Objective Measurement of Medial Joint Space Widening with Percutaneous “Pie Crust” Release of Medial Collateral Ligament during Knee Arthroscopy

Knee arthroscopy may be called the most commonly and increasingly performed orthopaedic procedure. Posterior medial compartment visualization may be quite challenging. The aim of the present study is to detect objective measurement of medial joint space widening with percutaneous "pie crust" release of medial collateral ligament (MCL) during knee arthroscopy. We used this technique for all knees that require any intervention in the posteromedial compartment and for tight knees in which adequate visualization of the posteromedial compartment cannot be obtained. Eighteen patients (18 knees) were included in this study. Patients were evaluated clinically with the Lysholm and Tegner scores at the final office visit. Joint balance, valgus instability, pain or tenderness on MCL region, and numbness over the medial side of the joint were also noted. Measurements of medial joint space (mm) were obtained at three different times with perioperative C-arm images: normal, controlled valgus force, and after pie crusting. The median follow-up time was 9 (6-12) months. Final follow-up Lysholm (p < 0.05) and Tegner scores (p < 0.05) increased significantly compared with preoperative scores. At the final follow-up, there was no pain or tenderness over MCL and there were no signs of saphenous nerve or vein injury. Medial joint space values in after pie crusting increased significantly (p < 0.05) compared with neutral position measurements and controlled valgus force application (p < 0.05). Controlled release of the MCL in knees provided ∼2.45 times wider visualization place. Furthermore, pie crusting of MCL is a safe and effective technique that provides enough space for visualization and instrumentation in knees. This is a Level IV study.

Ultrasound-guided injection and the pie crust technique for the treatment of symptomatic bipartite patella.

This study aimed to investigate the results of a new treatment procedure (ultrasound-guided injection and the "pie crust" technique for lengthening of capsular tendon structures) for symptomatic bipartite patella. We retrospectively investigated patient outcomes following the treatment of symptomatic type III bipartite patella with our new technique. Fifteen knees in 14 boys (mean age, 13.0 ± 1.7years) were included. The procedure involved the injection of 1% lidocaine (2mL) and triamcinolone acetonide (5mg) between the patella and fragment. We then punctured 10 sites from one skin puncture to extend lateral capsular tendon structures. The patients were clinically assessed using the Victorian Institute of Sports Assessment (VISA) score before and 1week, 1month, and 3months after the procedure. Patients were also evaluated for complications. The average VISA score was 45.7 ± 4.7 before treatment, 70.6 ± 7.3 at 1week post-treatment, 84.4 ± 16.6 at 1month post-treatment, and 88.6 ± 18.3 at 3months post-treatment. The VISA score improvement from before the procedure to 1week after the procedure was significant (P < 0.01). There were no complications in any of the patients, who returned to sports at a mean of 4.2 ± 2.1weeks after the procedure. However, two patients (three knees) had poor results and could not return to action; thus, they underwent surgical treatment 4months after the ultrasonographic procedure. This novel method is a potential treatment option for the management of symptomatic bipartite patella in outpatient clinics.