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Results for “Patellar Dislocation”

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At least 433 records · Page 24Linked to original sources
PubMed2005

Total knee replacement for patellofemoral disease.

This study evaluates the technical results and outcomes of total knee replacement (TKR) in a group of patients with isolated patellofemoral disease based on the amount of bone loss and patella subluxation seen at the time of surgery. Thirty-three TKRs in 25 patients comprised the study group. All patients had radiographic evidence of isolated end-stage disease in the patellofemoral joint and had cemented tri-compartmental knee replacements. All patellae could be resurfaced. Average follow-up was 5.2 years (range: 3.8-8.4 years). Average Knee Society Scores was 62 preoperatively and 96 at final follow-up. There was no correlation in outcomes related to either the amount of patellar wear, size of the patella, or amount of subluxation of the patella. Total knee replacement is an effective means of managing end-stage arthritis of the patellofemoral joint.

Aged↗
PubMed2002

Long-term clinical results and radiographic changes in the nonresurfaced patella after total knee arthroplasty: 78 knees followed for mean 12 years.

We evaluated total knee arthroplasty without patellar resurfacing retrospectively in 50 patients (78 knees; 4 men (7 knees) and 46 women (71 knees) having a mean age of 63 (34-78) years and mean weight of 52 (32-72) kg). The preoperative diagnosis was osteoarthrosis in 26 patients (43 knees) and rheumatoid arthritis in 24 (35 knees). The mean follow-up was 12 (9-14) years. Only 3 patients (4 knees) had patellar pain and they all showed patellar subluxation. The latter was found in 13 other knees, all pain-free. We detected no differences between the knees with osteoarthrosis and rheumatoid arthritis concerning the incidence of patellar pain and patellar subluxation. No patient needed revision surgery for patellar problems. We question the need to resurface the patella routinely in total knee arthroplasty if it is congruous and well-aligned.

Adult↗
PubMed2003

Long-term results of low contact stress mobile-bearing total knee replacements.

Five hundred ninety-eight consecutive primary low contact stress total knee replacements were done in 502 patients between 1985 and 1990. Clinical review was available for 495 knees (406 patients), 228 knees with meniscal-bearing prostheses and 267 knees with rotating-platform prostheses. The average followup was 12 years (range, 10-15 years). The average postoperative knee and functional scores were 87 points and 75 points, respectively. The average postoperative range of motion was 110 degrees. Fifty-six knees (11%) required revision for excessive wear of the tibial insert (41), dislocation (10), patellar polyethylene breakage (one), component loosening (one patellar, one tibial), and infection (two). During revision, osteolysis (20 knees), patellar polyethylene failure (33), and femoral component fracture (one) were seen. The overall survivorship was 88.1% at 15 years using Kaplan-Meier analysis. The survival rate was 83% for the meniscal-bearing prostheses and 92.1% for the rotating-platform prostheses. The Low Contact Stress mobile-bearing knee prosthesis has no superiority over that of fixed-bearing knees, especially for the meniscal-bearing design in prevention of polyethylene failure or revision. Based on the results of this study, the use of the LCS meniscal-bearing prosthesis does not appear to be justified.

Adult↗
PubMed2005

Anatomy and malalignment of the patellofemoral joint: its relation to patellofemoral arthrosis.

Patellofemoral joint function involves a complex orchestration of a number of dynamic, static, and neuromuscular factors. I will discuss the components of patellofemoral anatomy and whether the presence of certain anatomic variables may increase the risk of patellofemoral arthrosis. The patellofemoral surgeon is faced with several clinical challenges: the semantics of the language used to discuss these problems, the correlation of clinical symptoms and radiographic imaging to help diagnose a problem, and surgical challenges in optimizing extensor mechanism function.

Femur↗
PubMedDate not supplied

Pre- and postoperative radiographic and computed tomographic evaluation of dogs with medial patellar luxation.

OBJECTIVE: To quantify, using radiographic and computed tomographic (CT) techniques, the effects of surgical procedures most commonly combined to treat dogs with medial patellar luxation (MPL). STUDY DESIGN: Prospective study. METHODS: Six dogs with 8 MPL were studied. Radiographs and CT of the pelvic limbs were obtained before and immediately after soft-tissue reconstruction, trochlear wedge recession, and tibial crest transposition. Radiographic measurements included angle of inclination, Norberg angle, quadriceps angle (QA), anteversion angle, ratio of the length of the patellar tendon (PT) to the length of the patella, and change in patella tendon angle. CT measurements included angle of inclination, Norberg angle, QA, anteversion angle, depth of the femoral trochlear groove, ratio of the middle femoral trochlear groove depth to the patella thickness, and tibial crest alignment. RESULTS: Conformation of the coxofemoral joint was not affected by surgery. Surgical treatment corrected the QA by 33-58%. Trochlear wedge recession was most effective in deepening the proximal trochlea by 103.5%. The ratio of the middle femoral trochlear groove depth to the thickness of the patella postoperatively resulted in 50% coverage of the patella. Tibial crest transposition resulted in caudalization of the PT by 8.5+/-3.0 degrees, with lateralization of the tibial tuberosity of 11.3 degrees. CONCLUSION: The effects of surgery for MPL can be quantified with radiographic and CT measurements. Surgical correction restored the alignment of the quadriceps and adequately deepened the femoral trochlear groove. Tibial crest transposition resulted in caudalization of the patella tendon and lateralization of the tibial tuberosity. CLINICAL RELEVANCE: These pilot data quantified the effects of surgical procedures most commonly combined to treat MPL. We hope to use these measurements to correlate surgical treatment with functional outcome and postoperative occurrence of luxation.

Animals↗
PubMed2006

Complications associated with corrective surgery for patellar luxation in 109 dogs.

OBJECTIVE: To review surgical techniques and postoperative complications associated with correction of patellar luxation in dogs. STUDY DESIGN: Retrospective study. ANIMALS: Dogs (n = 109) with patellar luxation (n = 131). METHODS: Medical records of dogs that had corrective surgery for patellar luxation were reviewed. Signalment, history, grade and direction of patellar luxation, operative technique and clinical outcomes were retrieved. RESULTS: Overall frequency of postoperative complications was 18%. Frequency of major (requiring revision surgery) complications was 13%. Frequency of patellar reluxation was 8%. Frequency of overall, major, and patellar reluxation complications was higher for dogs weighing > or =20 kg compared with those <20 kg. Frequency of overall and major complications was higher for dogs with higher grades of patellar luxation. Femoral trochlear sulcoplasty resulted in lower frequency of patellar reluxation. Tibial tuberosity transposition (TTT) resulted in lower frequency of major complications and patellar reluxation. Retinacular/capsular release resulted in higher frequency of major complications. Patient age, gender, medial versus lateral patellar luxation, left versus right hindlimb, capsular/retinacular imbrication, use of anti-rotational sutures, and whether stifle surgery had been performed previously did not significantly influence frequency of complications. CONCLUSION: TTT and femoral trochlear sulcoplasty minimize the risk of postoperative patellar reluxation and major complications. CLINICAL RELEVANCE: Information derived from this study can be used to estimate the likelihood of postoperative complications for canine patients undergoing corrective surgery for patellar luxation.

Animals↗
PubMed2002

Treatment of temporary upward fixation of the patella in an alpaca by abrasion trochleoplasty and imbrication of the medial retinacular fascia.

A two-year-old female alpaca suddenly became lame on its right hindlimb. Eight days later clinical and radiographic examinations showed that the patella had become temporarily fixed within the supratrochlear notch of the femur. Under general anaesthesia an abrasion trochleoplasty followed by fascial imbrication was carried out. After two weeks in supporting slings, the animal put full weight on the leg, and six months after the surgery it showed no signs of lameness or recurrence of the upward fixation.

Animals↗
PubMed2005

Trochleoplasty in lateral patellar luxation in two calves.

Two Holstein Friesian calves were referred to the Animal Medical Center of Chonbuk National University with severe lameness on the hind limb(s), flexed stifle joint and an inability to walk since birth. Based on the clinical history, clinical findings and radiography of the stifle joint, the cases were diagnosed as grade III lateral patellar luxation (LPL). Trochleoplasty along with medial retinacular reinforcement and lateral release were performed in both calves. The calves recovered 3 to 4 weeks after surgery. Trochleoplasty along with medial retinacular reinforcement and lateral release can be an effective technique for the treatment of LPL in calves.

Animals↗
PubMed2005

The effects of articular, retinacular, or muscular deficiencies on patellofemoral joint stability: a biomechanical study in vitro.

Normal function of the patellofemoral joint is maintained by a complex interaction between soft tissues and articular surfaces. No quantitative data have been found on the relative contributions of these structures to patellar stability. Eight knees were studied using a materials testing machine to displace the patella 10 mm laterally and medially and measure the force required. Patellar stability was tested from 0 degrees to 90 degrees knee flexion with the quadriceps tensed to 175 N. Four conditions were examined: intact, vastus medialis obliquus relaxed, flat lateral condyle, and ruptured medial retinaculae. Abnormal trochlear geometry reduced the lateral stability by 70% at 30 degrees flexion, while relaxation of vastus medialis obliquus caused a 30% reduction. Ruptured medial retinaculae had the largest effect at 0 degrees flexion with 49% reduction. There was no effect on medial stability. There is a complex interaction between these structures, with their contributions to loss of lateral patellar stability varying with knee flexion.

Aged↗
PubMed2006

Clinical signs and results of treatment in cats with patellar luxation: 42 cases (1992-2002).

OBJECTIVE: To describe clinical signs and results of treatment in cats with patellar luxation. DESIGN: Retrospective case series. ANIMALS: 42 cats in which patellar luxation had been diagnosed on the basis of results of palpation of the stifle joints. PROCEDURES: Degree of luxation was graded on a scale from 1 to 4, and severity of lameness was graded on a scale from 0 to 5. Radiographs of stifle joints were evaluated for signs of osteoarthritis. Long-term function was classified as poor, fair, good, or excellent. RESULTS: 34 cats had bilateral luxation and 8 had unilateral luxation. Only 7 (17%) cats had a history of trauma. Mean age of the cats was 3.3 years, and mean weight was 4.26 kg (9.4 lb); 26 (62%) were domestic shorthairs. Seventy-three of the 76 (95%) affected joints had medial patellar luxation. Luxation grades could be assigned to 65 joints, with grade 2 (30 joints) and 3 (22 joints) luxation being most common. Lameness grades could be assigned to 73 joints, with grade 1 lameness (27 joints) most common. Outcome was excellent for 8 of 17 joints treated without surgery and for 23 of 35 joints treated surgically. Complications attributable to surgery were reported in 8 cats. CONCLUSIONS AND CLINICAL RELEVANCE: Patellar luxation should be considered as a cause of hind limb lameness in cats. Low-grade luxation can be associated with lameness of the same severity as high-grade luxation. Surgical correction of patellar luxation in cats with grade 2 or 3 lameness can result in a favorable outcome.

Animals↗
PubMedDate not supplied

Arthroscopic release of the medial femoropatellar ligament for canine medial patellar luxation.

Five dogs of varying breeds and ages were presented for evaluation of medial patellar luxation that was unresponsive to conservative treatment. Arthroscopy of each affected stifle was performed, and adequacy of the femoral trochlea and patellar tracking in the trochlea were assessed. Medial femoropatellar ligament release was then performed using a bipolar radiofrequency electrosurgical system with or without a tibial tuberosity transposition. The procedure resulted in good to excellent outcomes for four dogs and a fair outcome for a fifth dog.

Animals↗
PubMed2003

Evaluation of patients presenting with knee pain: Part II. Differential diagnosis.

Knee pain is a common presenting complaint with many possible causes. An awareness of certain patterns can help the family physician identify the underlying cause more efficiently. Teenage girls and young women are more likely to have patellar tracking problems such as patellar subluxation and patellofemoral pain syndrome, whereas teenage boys and young men are more likely to have knee extensor mechanism problems such as tibial apophysitis (Osgood-Schlatter lesion) and patellar tendonitis. Referred pain resulting from hip joint pathology, such as slipped capital femoral epiphysis, also may cause knee pain. Active patients are more likely to have acute ligamentous sprains and overuse injuries such as pes anserine bursitis and medial plica syndrome. Trauma may result in acute ligamentous rupture or fracture, leading to acute knee joint swelling and hemarthrosis. Septic arthritis may develop in patients of any age, but crystal-induced inflammatory arthropathy is more likely in adults. Osteoarthritis of the knee joint is common in older adults.

Adolescent↗
PubMed2006

[Simple diagnostics of patellofemoral instability point to tailored treatment].

Three patients presented with patellar instability. On physical examination, the first patient, a 20-year-old male soccer player, reported pain at the medial insertion ofthe medial patellofemoral ligament (MPFL) after a traumatic patella luxation. He was successfully treated by MPFL reconstruction. The second patient, an 18-year-old woman, presented with patellofemoral pain. On physical examination, the patella could be luxated laterally over approximately half of its width. Conventional X-rays showed a crossing sign, indicating trochlear dysplasia. She was treated by trochleaplasty. The last patient, a 15-year-old girl, presented with patellofemoral instability. On physical examination, a patella alta could be palpated. She was advised to undergo tuberositas distalisation after her epiphyseal growth plates had closed. Patients with patellofemoral instability must be distinguished from patients with patellofemoral-pain syndrome. Simple physical examination and conventional X-rays usually suffice to make this distinction. The treatment is tailored to the pathology found.

Adolescent↗