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At least 343 records · Page 19Linked to original sources
PubMed1993

Case report 789: Dorsal defect of the left patella.

Dorsal defect of the patella is an uncommon but well known abnormality. It is believed to be an incidental finding that should not merit further intervention. However, the association of patellofemoral symptoms and a dorsal defect of the patella suggests abnormality of the cartilage overlying the defect. Resection of this area of abnormal cartilage has resulted in relief of symptoms in some patients. A patient who had a dorsal defect of the patella and persistent symptoms had MR imaging. The MR scans showed signal inhomogeneity with streaks of high signal in the cartilage overlying the lesion on both T1-weighted and T2-weighted images. Drilling of the defect relieved his pain.

Adult↗
PubMed1988

Chondroblastoma of the patella.

This study reviews 16 cases of chondroblastoma of the patella which constitute nearly 6% of a large group of chondroblastomas scattered throughout the skeleton. Both radiologic and histologic appearances of chondroblastomas of the patella are indistinguishable from those of chondroblastomas arising in other sites. A reasonable differential diagnosis, including chondromalacia patella, is discussed together with important therapeutic considerations.

Bone Neoplasms↗
PubMed1977

[The lateral tension band--a method of osteosynthesis of patella fractures for immediate carrying capacity (author's transl)].

The tensions caused by means of flexors and tensors on the intact and by various procedures operated fractured patella have been determined. The disadvantages of the cerclage and the eccentric ventral tension band, both of them mainly usual, are exposed. Interfragmentary measurements of pression power in a corpse knee as well as breaking tests with a model patella and first experiences by operation with a new method confirm the reflexions. Principles for a modus of osteosynthesis for fractures of the patella are realized by the lateral tension-band. All loading inclined fragment distractive powers thereby are taken up by production a high-level interfragmentary compression, so that immediate postoperative loading is possible.

Biomechanical Phenomena↗
PubMed1994

Patella partita.

Patella partita is a malformation of the knee cap, generally characterized by one or a few vertical lines of discontinuity in sagittal planes, caused by incomplete ossification within a single ossification center. In other cases, disorder of ossification in frontal planes results in frontal subdivision of the patella. While patella partita is sometimes diagnosed as a coincidental radiographic finding, in other cases, especially in elderly individuals, it is a finding associated with symptoms which require treatment.

Humans↗
PubMed1995

Biodegradable wire fixation in olecranon and patella fractures combined with biodegradable screws or plugs and compared with metallic fixation.

The outcome of olecranon and patella fractures fixed with biodegradable implants (self-reinforced poly-L-lactide wire combined with self-reinforced polyglycolide screw or self-reinforced poly-L-lactide plug) or with metallic implants (tension band wiring, Kirschner wire and metallic cerclage wire) was compared in a prospective, randomized study. Twenty-five olecranon fractures (15 with biodegradable implants and 10 with metallic ones) and 10 patella fractures (6 with biodegradable implants and 4 with metallic ones) were treated. There were no differences between these methods in outcome. Olecranon and patella fractures can be treated using biodegradable implants successfully. The total expenses are lower because a second operation is not needed to remove the implants after fracture consolidation.

Biodegradation, Environmental↗
PubMed1980

Intramedullary pressure of the patella in Chondromalacia.

Degenerative changes in load-bearing joints are often combined with altered intramedullary circulation. This may cause an alteration in intramedullary pressures. It has been said that articular symptoms are connected with a change in intramedullary pressures being high they are suspected to cause pain. In this investigation the intramedullary pressure has been evaluated in chondromalacia and osteoarthrosis of the patella. A comparison has been made with normal patellae. A biopsy needle was drilled into the intramedullary bone of the patella and connected with a registering unit. In a control group an average value of 19 mm Hg was registered. In the condromalacia group the mean intramedullary pressure was 44 mm Hg and in osteoarthrosis 37 mm Hg.

Adolescent↗
PubMed1985

Rotational instability of the patella on radiographic images.

In the period from 1980 to 1981, knee joint radiographs were made in 82 patients following the clinical diagnosis of patellar chondropathy. A total of 119 knee joints with patellar chondropathy and 45 with no specific complaints on the contralateral side, in addition to a control cohort consisting of 28 persons, i.e., 56 knee joints with no complaints, were evaluated. Tangential radiographic images of the patellae enabled us to measure directly the rotation of the patella around the axis perpendicular to its center. It could be established that all healthy patellae underwent medial rotation between 45 and 60 degrees of knee flexion which was maintained up to 90 degrees, whereas the affected knee joints did not rotate.

Adolescent↗
PubMed1986

Lowering of the patella secondary to anterior advancement of the tibial tubercle for the patellofemoral pain syndrome.

From a series of 72 patients treated with anterior advancement of the tibial tubercle for patellofemoral pain syndrome, secondary lowering of the patella was noted in eight. In all eight patients the results were poor following surgery, with severe disabling retro- and peripatellar pain and atrophy of the quadriceps muscle. We describe this complication and illustrate and discuss the biomechanical consequences. The shortening of the patellar ligament and lever arm of the ligament were determined from radiographs of the knee joints before and after surgery. A theoretical analysis was made of the compressive force in the patellofemoral joint in one of these patients. The Insall-Salvati index decreased from 0.88-1.25 (mean 1.07) preoperatively to 0.54-0.78 (mean 0.70) at follow-up, 1.0-2.5 years post-operatively. The lowering of the patella was correlated to a reduction of the lever arm of the patellar ligament in seven patients. The mechanism behind the lowering of the patella is obscure, but the reduced lever arm of the patellar ligament will increase the compressive force in the patellofemoral joint, and this might be one explanation of the poor results. Impaired congruity of the patellofemoral joint, increased tension in the patellar ligament, and increased pressure against the quadriceps tendon are other possible explanations.

Adult↗
PubMed1993

Effect of taping the patella on concentric and eccentric torque and EMG of knee extensor and flexor muscles in patients with patellofemoral pain syndrome.

The acute effect of patella taping on torque and electromyographic (EMG) activity in maximal voluntary concentric and eccentric action of the knee extensor and flexor muscles in patients with patellofemoral pain syndrome was studied in 48 patients (62 knees). The patients (28 female, 20 male) were tested concentrically and eccentrically on a Kin-Com dynamometer with simultaneous EMG recording with the patella untaped and medially or laterally taped. Patients with clinically normal patellar mobility did not improve their quadriceps performance by taping of the patella; after medial taping they decreased their muscle torque during concentric work at 60 degrees/s (P < 0.05) and eccentric work at 180 degrees/s (P < 0.05). After lateral taping they decreased their muscle torque during concentric work at 60 degrees/s (P < 0.05) and eccentric work at both 60 degrees/s (P < 0.01) and 180 degrees/s (P < 0.05). Moreover, these patients also decreased their agonist EMG activity during concentric work at 60 degrees/s (P < 0.05) and 180 degrees/s (P < 0.05) and their antagonist EMG activity during eccentric work at 60 degrees/s (P < 0.01). Patients with a clinical lateral patellar hypermobility increased their knee extensor torque after medial taping at 60 degrees/s during both eccentric work (P < 0.01) and concentric work (P < 0.05). The greatest improvement in quadriceps performance, however, was in patients with a clinical medial patellar hypermobility. They increased their knee extensor torque after lateral taping during eccentric work at both 60 degrees/s (P < 0.001) and 180 degrees/s (P < 0.001) and during concentric work at 60 degrees/s (P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1996

Diagnosis and treatment of stress fracture of the patella in athletes.

Five cases of stress fracture of the patella in athletes are presented. Four of these occurred transversally in the lower part and one longitudinally in the lateral part of the patella. Three of the patients were females (endurance runner, high jumper, and orienteerer) and two males (volleyball and soccer player). The diagnosis was made 2-8 months from the onset of the symptoms. Conservative treatment was successful in only one patient; all others were treated surgically, with good end result. Drilling of the fracture line was performed twice with metal wire cerclage fixation, excision of the lateral fragment was carried out once, and a bone graft with K wires and cerclage compression (tension band) was performed once. In all cases the patellar retinaculum was intact, indicating a stress injury. Stress fracture of the patella is a rare overuse injury, and therefore difficulties and delays in the diagnosis and treatment may occur. In cases with delayed diagnosis we recommend operative treatment.

Adult↗
PubMed1993

Velocity of ultrasound at the patella: influence of age, menopause and estrogen replacement therapy.

Determination of apparent velocity of ultrasound (AVU) in bone has been proposed as a valuable tool for discriminating between normal and osteoporotic women. We have studied the influence of age, menopause and estrogen replacement therapy (ERT) on AVU at the patella in a large sample of pre- and postmenopausal women. Three hundred and eighteen woman aged 40-60 year participated in the study (112 women were premenopausal, 21 were perimenopausal and 185 were postmenopausal of whom 110 had received ERT for a minimum of 1 year). AVU was determined as the mean of four measurements at each patella using a Signet instrument (Osteo-Technology, Framingham, MA). An age-dependent decline in AVU was observed only after menopause (r = -0.33, p = 0.0055); in premenopausal women there was a slight but not significant decrease in AVU with age (r = -0.12, p > 0.05). AVU was significantly lower in postmenopausal women compared with premenopausal women (1882 +/- .84 m/s vs 1961 +/- 73 m/s, p < 0.05). ERT prevented the menopause-related fall in AVU. There was a significant positive correlation between the duration of ERT and AVU measurements. Our findings demonstrate a pronounced influence of estrogens on AVU at the patella, supporting the concept of a protective role of ERT in bone stability. AVU measurements therefore merit further investigation as an inexpensive method for predicting fracture risk that does not expose the subject to radiation.

Adult↗
PubMed1994

The determination of ultrasound velocity in the os calcis, thumb and patella during childhood.

Maximising the accumulation of bone tissue during growth and puberty is one of the most important aims in the prevention of osteoporosis. For prevention studies in children it is necessary to develop methods for skeletal status without radiation. Ultrasonic velocity (speed of sound = SOS) has been proposed as an alternative method. Using a new ultrasonic system (Osteoson K4, Minhorst, Germany), we investigated the reproducibility and age-dependency of SOS in several peripheral bones in 218 children and young adults. Intra-observer (day to day) reproducibility: calcaneus CV = 0.64%, patella CV = 1.18% and thumb CV = 0.43% (n = 25). Inter-observer reproducibility: calcaneus CV = 1.1%, patella CV = 2.48% and thumb CV = 0.62% (n = 16). SOS in thumb and patella increased with age and peaked at 20-25 years. SOS in the calcaneus showed no increase after puberty. Studies in bones from pigs show no dependency of SOS from the thickness of analysed cortical or trabecular bone slices. We conclude that the reproducibility of SOS measurements especially in the thumb is comparable with those of radiation methods. The SOS data in growing, healthy children and the independency from bone dimensions provides more evidence that SOS describes the elastic qualities of the bones.

Adolescent↗
PubMed1987

Dorsal defect of the patella and infection.

Lesions of the patella are relatively rare, although a large variety of etiologies have been reported. To our knowledge this is only the second reported case of a Brodie's abscess of the patella. Its radiologic appearance was identical to that described for the common dorsal defect of the patella.

Abscess↗
PubMed1993

A case report of an Irish family displaying nail-patella syndrome.

This is a case report of an Irish family displaying classical features of Nail-Patella Syndrome--also known as Osteo-onycho Dystrophy--involving four members over three generations. This rare autosomal dominant disorder is well defined with four classical characteristics: dysplasia of finger nails, hypoplastic or absent patellae, hypoplasia of the head of the radius and often the capitulum of the humerus leading to subluxation or dislocation of the radial head and iliac prominences, known as iliac horns which are usually bilateral and symmetrical. Renal dysfunction is also commonly reported. This is the first report of the Nail-Patella Syndrome in an Irish family.

Humans↗
PubMed2000

[Chondroblastoma of the patella with pathological fracture].

Chondroblastoma is a rare benign bone tumor of cartilaginous origin. The typical localization of a chondroblastoma is the epiphysis of long tubular bones--the patella is a very unusual site with an estimated occurrence of 2%. We report a case of a 16-year-old patient with a chondroblastoma of the patella associated with a pathologic fracture. Partial resection of the patella was performed. This is the sixth case in the literature that associates patellar chondroblastoma with fracture.

Adolescent↗
PubMed2006

[Clinical, radiological and arthroscopical aspects in nail patella syndrome. Literature review based on an affected family].

Nail patella syndrome (NPS) is an autosomal dominant hereditary disorder affecting the nails, skeletal system, kidneys, and eyes. Skeletal features include absent or hypoplastic patellae, patella dislocations, elbow abnormalities, talipes and iliac horns on plain films. The existing literature focuses on clinical and radiographic findings in patients with NPS. We also report the case of a 40-year-old male patient and his family affected by NPS and includes clinical, radiographic as well as arthroscopic findings. Arthroscopic findings in this case are characterized by multiple synovial plicae in the knee joint leading to cartilage defects on the corresponding cartilage surfaces. A review of the recent literature suggests that the occurrence of synovial plicae might be related to NPS and might account for at least part of the characteristic symptoms of these patients. Therefore, in cases of unspecific knee pain associated with NPS arthroscopy of the knee joints and plicae resection seems to be recommendable.

Adult↗
PubMed2006

Periosteal transplantation to the rabbit patella.

Autologous periosteal transplantation (without chondrocyte cell transplantation) for treating traumatic articular cartilage defects of the patella gives pain relief in uncontrolled clinical studies. To study the whole transplanted area macroscopically and microscopically, animal studies are motivated. In this pilot study, we reproduce the surgical technique for periosteum transplantation on human patella to a rabbit model. A full-thickness cartilage defect of the whole patella was created in eight adult female rabbits. The defect was treated with autologous periosteal transplantation. After surgery, the rabbits were allowed free activity. This is the difference compared to the treatment in humans, where our group uses CPM for 5 days and non-weight-bearing for 12 weeks. After 21 weeks, there was a diffuse synovitis in all transplanted knees, and in five of eight knees there were signs of osteoarthritis in the patello-femoral joint. Histologically, in three animals, small islands of hyaline cartilage surrounded by fibrocartilage were seen in the transplanted area. In the other five animals, fibrocartilage was the predominant tissue. In contrast to previous experimental studies using a rabbit model, we did not achieve hyaline cartilage resurfacing.

Animals↗
PubMed2001

Ultrasonography: an imaging modality enabling the diagnosis of bipartite patella.

Ultrasound was used to diagnose bipartite patella in seven adolescents with anterior knee pain, and the findings were compared to those from plain radiography and to those of a group of asymptomatic subjects. In all affected individuals the quadriceps and patellar tendons appeared normal on ultrasound. Sonographic examination of the patella demonstrated an irregularity of the bony contour with occurrence of a cleft between the main part of the patellar body and the large superolateral accessory ossicle. The signal detected in the interface between bones was less echogenic than bone reflecting its fibrocartilaginous nature. The correlation with conventional radiography was absolute, as was the inter- and intraobserver reliability. Ultrasound is thus proposed as a simple and reliable imaging modality in bipartite patella. We do not believe that it should replace the initial radiographic, but it can be used to evaluate the contralateral knee for bilaterality and as an adjunct to therapeutic procedures such as local injections to increase the accuracy of treatment.

Adolescent↗