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At least 397 records · Page 22Linked to original sources
PubMed2002

The association of Buschke-Ollendorf syndrome and nail-patella syndrome.

Buschke-Ollendorf syndrome and nail-patella syndrome are both rare connective tissue disorders inherited in an autosomal dominant pattern and characterized by cutaneous and bone lesions. We describe a 3-year-old boy and his family who showed clinical features of both Buschke-Ollendorf syndrome and nail-patella syndrome. To our knowledge, this association has not been reported previously, suggesting that these two connective tissue disorders may share the same gene location with different mutations or involve different mutated genes that share downstream segments of their signaling pathways. Furthermore, this young patient is also affected by a chronic idiopathic neutropenia usually not observed in Buschke-Ollendorf syndrome or nail-patella syndrome.

Child, Preschool↗
PubMed1991

Skull, patella and thigh cryptococcosis after a crashing injury of the temporal bone.

An unusual case of triple location (skull, patella and thigh) Cryptococcus neoformans is described. The peculiarity of the case is based on the probability of direct post-traumatic bone inoculation, subsequent seeding from skull to patella, thigh and cerebral spinal fluid (CSF), patella involvement, lack of evidence of lung involvement and lack of predisposing underlying disease. The response to surgery and a combination of amphotericin B and 5-flucytosine administration was favorable without relapse at follow-up after 7-year discontinuation of therapy.

Bone Diseases↗
PubMed1957

The Golgi apparatus in neurons and epithelial cells of the common limpet Patella vulgata.

1. In view of widely diverse views held about the identity and structure of the Golgi apparatus in neurons of Mollusca, particularly gastropods, a study has been made on neurons of the common limpet, Patella vulgata, both by light and electron microscopy. A report is given also of observations made on epithelial cells of Patella by electron microscopy. 2. As revealed by Kolatchev's method, the Golgi apparatus in neurons consists basically of black filaments lying to one side of the nucleus. The filaments generally anastomose to form networks of various complexity. Rarely some cells contain only discrete filaments. Associated with some of the filaments is a weakly osmiophilic substance identified as archoplasm. Kolatchev's method also revealed spheroidal bodies (neutral red bodies, "lipochondria," etc.). 3. It has not been possible to demonstrate the Golgi apparatus using either iron-haematoxylin or Sudan black. 4. Examination of Kolatchev's preparations by electron microscopy has revealed that some of the Golgi filaments consist of chromophilic and chromophobic components. The chromophilic component consists of dense lamellae. 5. After fixation in buffered osmium tetroxide solution and examination by electron microscopy, it has been concluded that (a) the chromophilic component of the Golgi apparatus corresponds to a system of paired membranes (which usually enclose an inner dense substance), (b) the chromophobic component corresponds to a substance lying within small dilations of the paired membrane, and (c) the archoplasm corresponds to numerous small vesicles. 6. The paired membranes branch, anastomose, and can often be traced back to a common source. They are interpreted as lamelliform folds, and occasionally tubular processes, of essentially a single Golgi membrane. In cells containing a Golgi network it is suggested that the membrane extends through the whole of the apparatus in such a way that the substance it encloses may be regarded as being in a continuous phase. 7. Epithelial cells of Patella contain a juxtanuclear Golgi apparatus with an ultrastructure similar to that described for neurons.

Cell Count↗
PubMed1995

Does the Q angle reflect the force on the patella in the frontal plane?

BACKGROUND AND PURPOSE: The quadriceps femoris muscle angle (Q angle) is used to reflect the quadriceps femoris muscle's force on the patella in the frontal plane. We found no studies, however, that validate this assumption. The purpose of this study was to determine whether the Q angle can be used to represent the force on the patella in the frontal plane. SUBJECTS: Seven lower extremities from four male cadavers were dissected and investigated. METHODS: We devised a model in which the line of action of quadriceps femoris muscle's resultant force was calculated in the frontal plane on the seven lower-extremity specimens. We then compared these calculations with the Q angles from the same cadaver specimens. The differences between the measured and calculated Q angles were tested for significance using a paired t test. In addition, we calculated a simple linear regression to test the relationship between the calculated and measured Q angles. RESULTS: Our data showed that the angle for the average resultant force of the quadriceps femoris muscle was 3.90 degrees greater (P = .0003) than the measured Q angles. A significant relationship (r = .919, P = .0035); however, was found between the measured and calculated Q angles. CONCLUSION AND DISCUSSION: The Q angle, as measured in clinical practice, appears to reflect the angle of the resultant quadriceps femoris muscle force. We believe, however, that this measurement is significantly less than the actual quadriceps femoris muscle force vector and underestimates the lateral force on the patella.

Biomechanical Phenomena↗
PubMed1988

Chondromalacia of the patella. Bone imaging correlated with arthroscopic findings.

One hundred adult sports medicine patients with clinical findings suggesting chondromalacia of the patella underwent bone imaging. Of these patients, 50 eventually underwent arthroscopic surgery and the remaining 50 were treated conservatively. The intensity of abnormally increased scintigraphic activity in the patella correlated closely with the grade of chondromalacia observed by the arthroscopist. Bone imaging also was of value in directing the arthroscopist to clinically unsuspected torn menisci. In conclusion, for sports medicine patients with clinical findings suggestive of chondromalacia of the patella, bone imaging contributes to an accurate diagnosis and appropriate surgical planning.

Adult↗
PubMed2004

Traumatic separation of a type I bipartite patella: a report of four knees.

Four knees in three patients with traumatic separation of a Type I bipartite patella are reported. Sudden anterior knee pain and an audible pop occurred at the time of the injury and the patients had aching or dull pain before the traumatic episode. Previous aching or dull pain led us to differentiate this type of injury from a usual transverse fracture. A round fracture line seen on the radiographs also led us to differentiate this type of injury from a stress fracture. Accordingly, the diagnosis of a traumatic separation of a Type I bipartite patella was confirmed. This is the first report of a traumatic separation of a Type I bipartite patella to our knowledge.

Adolescent↗
PubMedDate not supplied

Radiographic abnormalities and clinical symptoms associated with patella alta in ambulatory children with cerebral palsy.

One hundred seventeen randomly selected, skeletally immature, ambulatory children with spastic cerebral palsy were evaluated with clinical examination and lateral radiographs of the knee. Radiographic abnormalities within either the patella or the proximal tibia were present in 21% (41 knees) of the 193 affected knees. The most common radiographic findings were elevation of the tibial tubercle in 34 knees and fragmentation of one pole of the patella in seven knees. Clinical symptoms including pain, swelling, and tenderness were present in 32% of those children with radiographic findings (13 of 41 knees). Patella alta was seen in nearly all children in the study. The radiographic findings appeared to be chronic, were usually asymptomatic, and have required no treatment to date.

Activities of Daily Living↗
PubMed1997

Early complications in the operative treatment of patella fractures.

OBJECTIVE: To identify and review early complications in the operative treatment of patella fractures. DESIGN: Retrospective review. SETTING: Single tertiary care institution with multiple surgeons, including generalists and fellowship trained subspecialists. PATIENTS: A consecutive series of eighty-seven patella fractures over a five year period was reviewed. Patients treated nonoperatively or with partial or total patellectomy were excluded. Minimum follow-up to fracture healing (four months) was available in fifty-one fractures. INTERVENTION: Modified tension band wire fixation was used in forty-nine fractures, whereas two fractures were treated with tension band wires threaded through cannulated screws. OUTCOME MEASURES: Early complications such as loss of reduction or fixation, infection, or soft-tissue problems were evaluated. RESULTS: Displacement of > or = 2 mm before healing was noted in eleven fractures. The displacement could be attributed to technical errors in five cases, and to patient noncompliance with postoperative activity restrictions in another five cases. Two cases of superficial infection were documented. Nine patients with symptomatic hardware required hardware removal. CONCLUSIONS: Twenty-two percent of fractures treated with tension band wiring and early motion displaced > or = 2 mm within the early postoperative period. Technical errors or patient noncompliance were identified as factors. The incidence of early complications in operatively treated patella fractures is higher than previously reported.

Adolescent↗
PubMed1981

Central dislocations of the patella.

The rare traumatic condition of intra-articular dislocation of the patella in a 12-year-old boy is described, suffered in a fall, when he landed in a hole with his knee bent. Closed reduction by manipulation under general anesthesia failed because the upper pole of the patella was locked deeply in te intercondylar space. Operative reduction using a parapatellar incision in which the patella was levered into position without opening the capsule was followed by functional recovery.

Child↗
PubMed1982

Superior dislocation of the patella with interlocking osteophytes.

Superior dislocation of the patella with interlocking osteophytes was only once found roentgenologically documented. Such a dislocation occurs without tendon rupture, and can occur with a hyperextension force. Reduction is easily accomplished by manipulation of the patella without anesthesia. Full active motion is present post-reduction. This entity should not be confused with vertical dislocations of the patella.

Female↗
PubMed1995

Diarrhea-associated hemolytic-uremic syndrome in a child with nail-patella syndrome.

A 5-year-old girl with nail-patella syndrome had diarrhea-associated hemolytic-uremic syndrome. Nail-patella syndrome is associated with a glomerulopathy characterized by the presence of fibrillar collagen within the glomerular basement membrane. Hemolytic-uremic syndrome has also been reported in patients with collagen type III glomerulopathy, a disorder also characterized by the presence of fibrillar collagen within the basement membrane. Patients with nail-patella syndrome or with collagen type III glomerulopathy may be predisposed to hemolytic-uremic syndrome.

Basement Membrane↗
PubMed2002

Nail patella syndrome. A 55-year follow-up of the original description.

The long-term skeletal changes and the lack of significant clinical complaints in a 77-year-old woman with nail patella syndrome are described. Fifty-five years previously she was one of the first reported patients. These early patients came from two families with involvement of multiple individuals with the variable constellation of deformities. We reviewed her skeletal natural history and her family history as it related to nail patella syndrome involvement and treatment, and correlated the original premolecular biology description and subsequent long-term follow-up with the current molecular and genetic concepts of the cause of the variable expression of nail patella syndrome.

Aged↗
PubMed2003

Patella fracture after post total knee replacements.

A retrospective study was done to determine the incidence, clinical function, and complications of treatment in a large series of patella fractures after total knee replacement (TKR). Between 1983 and 1996, 4583 primary AGC TKRs done at our institution. One hundred seventy-seven fractures were identified in 135 patients for a fracture incidence of 3.8%. Twenty-two fractures were vertical and had a stable implant and intact extension mechanism (Type 1). Twenty-one fractures had disruption of the extensor mechanism of less than 1 cm (Type 2A). Seventeen fractures had disruption of the extensor mechanism of 1 cm or more (Type 2B). One hundred fourteen fractures had a loose component and an intact extension mechanism (Type 3). Patients treated nonoperatively generally had no extensor lag and had adequate pain and function scores. Patients treated operatively had a high complication rate. Four of nine patients treated with excision of an extruded patella button developed a deep infection. Both patients treated with open reduction internal fixation (ORIF)had a nonunion develop. Surgery on patients with patella fractures has a high complication rate and should be avoided if possible.

Adolescent↗
PubMed2004

The consequences of not resurfacing the patella.

The decision of whether to resurface the patella during total knee arthroplasty remains controversial. In this study, a meta-analysis of national joint replacement registry data, bilateral total knee replacement studies, selective resurfacing reports, and randomized clinical trials was done Although the evidence seems to support patellar resurfacing, this issue remains inconclusive because of problems generalizing from one implant to another and the short-term nature of available studies. Based on existing data, patellar resurfacing seems reasonable in most total knee replacements. Not resurfacing the patella might be considered in selected younger patients (<60 years) with mild or no patellar arthritis, a well-tracking extensor mechanism, and particularly if a patella-friendly femoral component is used.

Arthroplasty, Replacement, Knee↗
PubMed2006

Case reports: Osteogenic sarcoma of the patella spread to lateral meniscus after arthroscopy.

Our patient presented with a rare lesion, a patella osteogenic sarcoma that spread to the anterior horn of the lateral meniscus via the arthroscope. He was treated arthroscopically for a torn medial meniscus of his right knee. A lesion in the patella was observed and a biopsy specimen was obtained through the arthroscope. The specimen was diagnosed as an osteogenic sarcoma. After 2 weeks of neoadjuvant chemo-therapy, the patient refused additional chemotherapy. Re-section of the knee and allograft arthrodesis were done 4 months after the initial arthroscopy. Pathologic examination of the resected specimen showed osteogenic sarcoma of the patella and a completely separate 1.0-cm nodule of osteogenic sarcoma tissue growing in the anterior horn of the lateral meniscus. The patient died 15 months after knee re-section with multiple pulmonary metastases. We are unaware that such an occurrence of an osteosarcoma spread through an arthroscope has been documented pathologically and reported.

Arthroscopy↗
PubMed2006

Case reports: pathologic fracture of the patella from a gouty tophus.

Fracture of the patella is a relatively common condition seen in patients with trauma. We report one patient with known gout who sustained relatively minor trauma that resulted in a patellar fracture. An intraoperative biopsy confirmed that much of the patella had been replaced with gouty tophus. Gout is a rare cause of patellar fracture, with few documented cases. Postoperative management of patients with patella fractures secondary to gout may be routine with the addition of medical management for the underlying pathologic process.

Fractures, Spontaneous↗
PubMed1998

A comparison of three methods for measuring patella malalignment in children.

This study compared the Insall-Salvati (IS), Blackburne-Peel (BP), and Koshino-Sugimoto (KS) methods for measuring patellar malalignment in children. The IS and BP methods were inaccurate because the traditional landmarks for measurement were absent in the incompletely ossified pediatric knee. The KS method is based on the midpoint of the patella, the distal femoral physis, and the proximal tibial physis. The KS method applied to the extended knee was also inaccurate because of laxity in the patella ligament. However, the KS method applied to the flexed knee was the most accurate method for measuring patella malalignment in children.

Adolescent↗
PubMedDate not supplied

Osteosarcoma of the patella with pulmonary metastases in a dog.

A 6-year-old neutered male Rottweiler was examined for a progressive right pelvic limb lameness. In radiographs of the right stifle, there was an osteolytic lesion with irregular new bone formation along the cranial aspect of the patella consistent with an aggressive bone lesion. In thoracic radiographs, there were multiple soft tissue nodular opacities throughout the lung fields, consistent with pulmonary metastases. Microscopically, fine needle aspirate samples from the right patella contained pleomorphic spindle cells with cytologic features of osteosarcoma. The presence of pulmonary metastases at the time of initial diagnosis in the dog described herein suggests that osteosarcoma of the patella has the potential for similar aggressive biologic behavior as that seen in dogs with appendicular osteosarcoma.

Animals↗