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At least 469 records · Page 26Linked to original sources
PubMed1991

Hereditary onycho-osteodysplasia (nail-patella syndrome). A three-generation familial study.

Hereditary onycho-osteodysplasia or nail-patella syndrome is an uncommon familial musculoskeletal condition that is primarily seen initially in orthopaedic clinics. This three-generation familial review identifies three affected family members, one of whom demonstrated spondylolisthesis, a condition not previously associated with nail-patella syndrome. All affected family members demonstrated the typical radial nail dysplasias, hypoplastic patellae, iliac horns, and posterior dislocation of the radial heads. Overgrowth of the medial femoral condyles caused valgus deformities of the knees that necessitated orthotic treatment in the youngest affected family member. Although this syndrome has classic common musculoskeletal anomalies, the lumbar spine should also be carefully examined for the presence of spondylolysis and for signs of potential spondylolisthetic development.

Adult↗
PubMed1991

[A "blocking" loop in the surgical treatment of avulsive fractures of the patella and damage to its ligament].

In the article is presented the improved method of knee joint extension system restoration by means of blocking wire loop, passed through the formed canals: in tibia--one cross canal and in patella--two longitudinal canals. This method has been applied in 6 patients with injuries of proper ligament of patella and in 18--with patella avulsive fractures. Long-term results have been followed with 12 patients. 11 of them achieved complete restoration of knee joint mobility irrespective of the injury nature.

Bone Wires↗
PubMed1991

[MRI evaluation of the patellar articular cartilage in patients with subluxation of the patella].

In patients with subluxation of the patella, injury of the patellar articular cartilage is frequently observed and correct evaluation is important to manage these patients. We examined 11 patients with subluxation of the patella and five normal volunteers. In 12 patellofemoral joints of seven patients with subluxation of the patella, the abnormalities observed on MRI were compared with those on arthroscopy and/or at operation. MRI was performed with a Magnetom 1.5 T (Siemens) using the round surface coil. Pulse sequences were SE (TR 400 ms/TE 19 ms), FLASH (TR 320 ms/TE 15 ms FA 90 degrees and 40 degrees), and SE (TR 2000 ms/TE 26, 70 ms). We analysed MR findings of the 12 abnormal joints and 10 normal joints according to the following classification of abnormalities observed on arthroscopy. (1) normal appearance (n = 3 joints), (2) softening and fibrillation (n = 6), (3) fragmentation (n = 3), and (4) erosion to bone (n = 0). In only one of the six cases with softening and fibrillation observed on arthroscopy, MRI could visualize the thickening of patellar articular cartilage, but in all three cases with fragmentation observed on arthroscopy, MRI could visualize the thin inhomogenous cartilage with irregular surface. The combination of SE (TR 400 ms/TE 19 ms) and FLASH (TR 320 ms/TE 15 ms FA 90 degrees) are extremely effective pulse sequence to detect the abnormalities of patellar articular cartilage. We conclude that MRI is a useful noninvasive method of detecting advanced changes in patellar articular cartilage.

Adolescent↗
PubMed1990

[Idiopathic high patella in adolescents. Apropos of 61 surgical cases].

The patellar height was measured according to the index of Caton and Deschamps. The normal index equals 1, the patella considered as being high with an index of 1.2 or greater. The authors reviewed 50 patients presenting with such an anomaly in patellar height to verify whether this patella alta said to be idiopathic was simply a radiographic sign or represented a true anatomic and clinical entity. 61 knees were hence operated on between 1963 and 1988, 50% of which had a lowering of the tibial tuberosity. In 8 cases, the lowering was performed secondarily, after a failure of the first operation to correct the anomaly. The mean pre-operative index of patellar height was 1.34 and the trochlea appeared indisputably dysplastic in 50 of the 61 cases. The mean age at the time of surgery was 17 years. Medial translation of the tibial tuberosity averaged 9.5 mm and the lowering 7 mm allowing a normalization of the patellar index. 76.8% of patients had a perfect post-operative stability, evaluated as a score of 8 or 9 on the ARPEGE scale. At the completion of this study it appeared that patella alta is rarely an isolated finding and is most often part of a regional patello-femoral dysplasia. Its existence, when responsible for a functional problem, must absolutely be taken into account and treated to obtain a satisfactory result.

Adolescent↗
PubMed1990

Osteochondral fragmentation of the distal aspect of the patella in horses.

A condition characterised by osteochondral fragmentation of the distal aspect of the patella in 15 horses is described. The problem was unilateral in six horses and bilateral in nine. There were eight Quarterhorses, three Thoroughbreds, two American Saddlebreds, one American Paint and one Warmblood-Thoroughbred cross. A previous medial patellar desmotomy had been performed on 12 of the 15 horses. The condition manifested as hindlimb lameness and stiffness ranging from mild to severe. There was fibrous thickening in the stifle area in the 12 cases with a previous medial patellar desmotomy, and synovial effusion in seven of 12 cases. Synovial effusion was present in two of the three cases in which a previous medial patellar desmotomy was not performed. The radiographic changes included bony fragmentation, spurring (with or without an associated subchondral defect), subchondral roughening and subchondral lysis of the distal aspect of the patella. All horses were treated with arthroscopic surgery. The lesions at arthroscopy varied from flaking, fissuring, undermining or fragmentation of the articular cartilage to fragmentation or lysis of the bone at the distal aspect of the patella. The subchondral bone was involved in all cases that had a previous medial patellar desmotomy. Of the 12 horses that had a previous medial patellar desmotomy, eight became sound at their intended use, one was sold in training without problems, one is in early training without problems, one never improved and one is in convalescence. Of the three that did not have a patellar desmotomy, two performed their intended use well but one was unsatisfactory.

Animals↗
PubMed1989

Patella alta in patellofemoral instability.

In a retrospective study of 90 realignment procedures for patellar instability, a high percentage of patella alta was diagnosed based upon the preoperative radiographs: 53% or 48 knees. The LP-LT index, described by Insall and Salvati, averaged 0.80 for this group of patients. Post-operative measurements of this index showed a definite correction of the craniocaudal position of the patella, with a mean increase of 0.10 (0.80 to 0.90). In evaluating the severity of the eliciting trauma, it is suggested that the alta position makes the patella more prone to instability: only 14.5% of the alta knees (n = 48) sustained a significant trauma versus 28.5% in the non-alta population (n = 42). The altaposition, however, had no influence on the final outcome, (at a mean follow-up time of 57 months), after a latero-medial realignment procedure, using a proximal or a combined proximal and distal procedure.

Adolescent↗
PubMed1989

[Behavior of human rib and patella cartilage].

Report is based on compression- and relaxation experiments with 90 rib- and 30 patella cartilage samples of different aged human bodies to evaluate the elastic and viscoelastic response. The results indicate biomechanical similarities and differences between patella-and rib cartilage as well as in the several age groups. In all age group we could obtain that rib cartilage is "stiffer" than patella cartilage and a loosening in capacity of tensional reduction with increasing age.

Adolescent↗
PubMed1988

Patella baja complicating total knee arthroplasty. A report of two cases.

Severe noniatrogenic patella baja is a rare condition. Two cases were seen accompanying severe osteoarthritis of the knee. In both cases, following total knee arthroplasty the patella failed to make contact with the femoral component. The tibial tubercle had to be shifted proximally 2 cm to restore the normal joint mechanics. In one case, dislocation of the patella to gain access to the knee could be achieved only with osteotomy of the tibial tubercle. The technique of tibial tubercle elevation adopted was to raise a long bone flap. This allowed the tibial tubercle to be moved proximally and anchored securely.

Aged↗
PubMed1986

Resurfacing of the patella in young patients.

The results of prosthetic resurfacing of the patella in 15 knees of 14 patients who ranged in age from 18 to 38 years at the time of surgery have been presented. The results were excellent in two knees, good in one knee, fair in eight knees, and poor in four knees. No mechanical failures occurred. The follow-up period ranged from 6 weeks to 8 years. I believe that the use of prosthetic resurfacing of the patella should be limited to patients, regardless of age, who have grade 3 or 4 chondromalacia of the patella and extremely poor quadriceps function. These are patients who have remained grossly symptomatic in spite of continuous conservative and/or surgical treatment for a period of at least 2 years.

Adolescent↗
PubMed1987

Fracture of the patella treated by open reduction and external compressive skeletal fixation.

Open reduction combined with external compressive skeletal fixation was used to treat twenty-seven patients who had a separated fracture of the patella. Fixation was obtained by the use of two compressive clamps applied to stainless-steel pins that were inserted just proximal and distal to the proximal and distal poles of the patella. Range-of-motion exercises for the knee were begun at two weeks and the pins were removed at three to four weeks. All of the fractures healed. Twenty-four patients regained a range of motion that was equal to that of the opposite knee. There was no evidence of chronic osteomyelitis. Osteoarthritis was noted in one patient who refused excision of a portion of the patella.

Adult↗
PubMed1985

Aneurysmal bone cysts of the patella secondary to chondroblastoma. Case reports.

Three cases of aneurysmal bone cysts secondary to chondroblastoma of the patella are described. This association is not particularly uncommon, but its occurrence in the patella is unusual. Treatment consists of curettage and bone grafting; however, if the patella is grossly enlarged or distorted, patellectomy is preferable.

Adolescent↗
PubMed1979

[Treatment of the relapsing dislocation of the patella (author's transl)].

From 1970-1977, twenty-five patients were given surgical treatment for relapsing dislocation of the patella. The mean age of the patients was 22 years. The case material consisted of 18 female and 7 male patients. The average frequency rate of dislocation was three to fifteen times. (Reported from the BB-Accident Hospital Tübingen). The combined surgical method with gracilis muscle restraint described by Krogius, was used in this clinic in view of its traditionally successful application. Additional antepositioning of the patella according to Bandi was effected in intraoperatively discovered retropatellar arthrosis. Relapses of dislocation were reported in two cases. Good postoperative results were obtained in 14 patients, satisfactory results in 5 patients, and an unsatisfactory outcome in three patients. Redislocation was reported twice. Since this disease occurs preferably in juveniles, surgical treatment to prevent further dislocations should be effected well in time to avoid early retropatellar arthrosis. Since dislocations of the patella are frequently adjusted spontaneously without any treatment, critical and detailed anamnesis is imperative in every patient with a distorted knee joint.

Adult↗
PubMed1979

[Partial fractures of the patella (author's transl)].

The authors reviewed the blood supply of the patella necrosis and pseudarthrosis were retained after patella fracture. These complications made the authors better defining the vascular anatomy of the patella region. A poor peripheral blood supply and a special vascular pedicle to the tip are suggested as an factor of these complications.

Adolescent↗
PubMed1982

[Osteo-onychodysplasia (nail-patella syndrome): a case-report (author's transl)].

A case of osteo-onychodysplasia (nail-patella syndrome) is reported. Features of this inherited condition include hypoplastic nails, hypoplastic to absent patellae, subluxation of the patellae, elbow dysplasia, and spurs in the posterior ileum (this last feature was absent in our patient). The nail hypoplasia is the most suggestive abnormality. Patients should be investigated for renal involvement which is a poor prognosis factor. In patients without renal involvement, prognosis is good.

Humans↗
PubMedDate not supplied

[Does Osgood-Schlatter disease modify the position of the patella?].

The Blackburne and Peel method of assessing the position of the patella was applied to 185 knees with Osgood-Schlatter disease in 125 patients. The normal index of 0.80 was confirmed in 73 controlled knees. The average index in the knees with Osgood-Schlatter disease measured 1.01 (patella alta) in boys and 0.91 (normal) in girls. The value increased to 1.06 in boys with radiological evidence of loose ossicls in the tibial tuberosity or the patellar tendon. This finding indicates that the strong pull of the well developed quadriceps muscle in probably the most important aetiological factor in the patella alta associated with Osgood-Schlatter disease.

Adolescent↗
PubMed1982

Stress fracture of the patella following duopatellar total knee arthroplasty with patellar resurfacing.

Stress fracture of the patella can occur with significant frequency following patellar replacement with the duopatellar knee prosthesis. In the first 372 knees with patellar resurfacing, the incidence was 0.7% in rheumatoid arthritis (2 fractures in 286 knees) and 3.5% in osteoarthritis (3 fractures in 86 knees). The incidence may be greater in osteoarthritic patients because they have more function and are generating greater force across the patellofemoral joint. There was an association with osteonecrosis of the patella in at least three cases in which a lateral retinacular release had been performed and the lateral superior genicular artery sacrificed. This vessel should be preserved during a lateral release to save its contribution to the blood supply of both the patella and the lateral skin flap. Initial treatment of the stress fractures can be nonoperative, with surgery necessary only if the patellar prosthesis has become dislodged, or if pain or inadequate active extension persists. If the fracture can not be repaired, patellectomy can yield a good result. To avoid stress fracture, a minimal amount of patellar articular surface should be resected and the peripheral cortex of both the medial and lateral facets preserved. Fewer stress fractures may occur if a smaller fixation lug is used, thereby preserving more patellar bone stock.

Aged↗
PubMed1982

[Patella dislocation with special reference to cartilage damage].

Dislocations of the patella are discussed in the light of their pathogenesis, their possible injury pattern and their consequences. An exemplary case is presented. Especially the injury to the retropatellar cartilage with following chondromalacia--sometimes initiating the development of patellofemoral osteoarthritis--renders the dislocation of the patella a severe injury of the knee region. In case of spontaneous reduction and uncertain history the diagnosis may be difficult. The dislocation of the patella can be suspected if a hemarthrosis is found without an instability of the knee ligaments. The possibilities of an operative repair are described with special regard to the cartilage injury. Importance was layed upon the shape variabilities of the patellofemoral joint predisposing to recurrent dislocation.

Adolescent↗
PubMed1982

Surgical treatment of recurrent subluxation of the patella in athletes.

The authors describe the results obtained in fifteen athletes suffering from recurrent monolateral subluxation of the patella by a new technique which should represent a considerable improvement over existing methods, both in surgical and rehabilitation phases. The treatment consists of: a) a surgical stage comprising extensive lateral mobilisation by section of the lateral capsule and the external alar ligament, extensive manual detachment of the vastus lateralis muscle, and osteotomy performed obliquely to the frontal plane with antero-medial transposition of the tibial tuberosity to realign the extensor apparatus; b) a post-operative stage characterised by immediate mobilisation of the knee without the application of a plaster cast. The aim of this method is to eliminate above all the instability caused by recurrent subluxation of the patella, to cancel out any abnormal stress exerted on the femoral condyle by the patella, to normalize the extensor apparatus, to bring about the regression of any incipient chondromalacic lesions, and to prevent femoro-patellar arthrosis by restoring the anatomical and functional equilibrium of the femoro-patellar joint. The clinical and radiographic results determined by follow up examinations performed between one year and two and a half years after the operation were so satisfactory that the authors extended the method to recurrent subluxations in non-athletes.

Adolescent↗