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At least 523 records · Page 29Linked to original sources
PubMed1999

Biomechanical experiment and clinical report of modified patellectomy for polar fracture of the patella.

OBJECTIVE: To study the influence of polar patel-lectomy and the site of reanchored the patellar tendon on femoral quadriceps extensing force. METHODS: The experiment was designed by using 5 lower limbs of cadavers for extracorporal biodynamic test. The maximal fixing force of the double stainless steel wire (0.4 mm in diameter) reanchoring the patellar ligament to the patellar cortical edge was measured. Clinically 21 patients with polar fractures were treated by removing the small fragments and reanchoring the patellar ligament to the cortical edge of the patella using the wires. RESULTS: Resection of the lower 1/4 part of the patella and the patellar ligament reanchored to cortical edge of the patella would not increase femoral quadriceps contracting force arm. But if the patellar tendon reanchored near the joint surface, much more extending force would be needed than the former (P<0.001). The maximal fixing force of the wires is 67.4 kg (60.9-72.5 kg). All the patients using this modified procedure gained satisfactory functional recovery. CONCLUSIONS: The modified partial patellecomy is a simple and effective procedure for choice.

Journal Article↗
PubMed2002

[Patella ligament and femoral quadriceps tendon rupture].

OBJECTIVE: To study the diagnosis and treatment of rupture of patella ligament and Femoral quadriceps tendon. METHODS: Twenty-three patients with rupture of the patella ligament and femoral quadriceps tendon were treated from March 1990 to August 2000. They were retrospectively evaluated with regard to patient's age, cause of injuries, characteristics of injuries, symptoms and signs, supplemental checkup, patella position, operative method and time interval from injury to treatment, immobilization, motion of knee, functional recovery etc. RESULTS: They were followed up for 6 years (4 months-11 years) on average. Thirteen of 15 acute injuries after treatment showed excellent results and good results in 2. In 5 old injuries of the extensor mechanism after treatment 2 got excellent results (3 lost to follow-up). CONCLUSION: Excellent or good results could obtain in patients with acute injuries after operation. The results of old injuries are not as good as acute injures, but better results could also achieve after repair.

Adolescent↗
PubMed2003

Patella baja after the modified Coventry-Maquet high tibial osteotomy.

This study assessed the Modified Coventry-Maquet technique for high tibial osteotomy with respect to the incidence of patella baja using the Insall-Salvati index. Twenty-seven high tibial osteotomies performed or supervised by a single surgeon (A.E.G.) between 1996 and 2000 were analyzed. Eight knees were excluded; the remaining 19 were evaluated. Mean patient age at surgery was 49 years, and the mean postoperative Insall-Salvati index was 0.83. This represented an average decrease in patellar height of 15% (P<.000001). The incidence of new-onset postoperative patella baja was 26% (5/19). Tibial posterior slope increased by an average of 4.3 degrees (P<.0001). Mean tibial tuberosity height decreased by an average of 8.9 mm (P<.0001). The mechanical axis was corrected by an average of 11.9 degrees and loss of range of motion postoperatively was negligible. The correlation between tibial slope, tuberosity height, and patellar height was not significant. The modified Coventry-Maquet procedure achieved excellent valgus knee realignment while losing minimal range of motion and avoiding intra-articular fracture and nonunion. This incidence of patella baja was comparable to most, and better than some, published series.

Adult↗
PubMed2005

Non traumatic dislocation of the patella in children: the case for a dysplastic aetiology.

Congenital dislocation of the patella may be a phenotype, which has several genotypes, i.e. it may be congenital or acquired. This hypothesis is suggested with three illustrative case studies. Risk factors predictive of the development of irreducible dislocation of the patella in infancy are suggested. As there is a spectrum of possible aetiologies, 'late' diagnosis and a number of 'risk' factors but a common pathology, the word 'congenital' is not always appropriate. We suggest 'Developmental dysplasia and dislocation of the patella (DDDP)' is a more appropriate term for this rare condition.

Child, Preschool↗
PubMed1993

Microinjection of suc1 transcripts delays the cell cycle clock in Patella vulgata embryos.

The suc1 protein is a cell cycle regulator whose precise function remains to be elucidated. The suc1 cDNA of the mollusk Patella vulgata was cloned and sequenced. It encodes a 9 kD protein showing a strong similarity with its human counterparts and to a lesser extend with its yeast counterparts. The expression of suc1 in maturing oocytes was shown to be tightly cell cycle-regulated. The abundance of the suc1 transcripts is high in prophase- and metaphase-arrested oocytes but drops dramatically upon exit from M-phase, after fertilization. The microinjection of suc1 synthetic messengers into embryonic blastomeres delayed the cell cycle clock, thus disrupting the perfect cell cycle synchrony exhibited by the blastomeres of early Patella embryos. Interestingly, this suc1 delaying effect was significantly reversed when cyclin B messengers were co-injected with suc1 messengers. These results show that Patella embryos offer a quite valuable model to study cell cycle regulation. Moreover, they support the existence of a negative control exerted by suc1 on the cell cycle traverse in a higher eukaryote.

Amino Acid Sequence↗
PubMed1997

Anterior cruciate ligament reconstruction. Bone-patella tendon-bone versus semitendinosus anatomic reconstruction.

In this article, the long term (2-10 years; mean, 4.8 years) followup results of two reconstructive procedures for the anterior cruciate ligament are compared. The bone-patella tendon-bone (with interference fit fixation) was performed on 69 knees, and the semitendinosus anatomic reconstruction was performed on 68 knees, in a population of 76 men and 52 women (age range, 15-60 years; average, 31 years). The patients in the two groups showed no difference in subjective results or activity level and no significant difference to manual testing. The semitendinosus procedure group had a slightly higher KT manual maximum failure rate than the patella tendon group (17% versus 11%). Arthrometric stability did not show deterioration, but patient satisfaction decreased in those patients who had meniscectomies. Both procedures showed satisfactory results during the long term followup. However, if the secondary restraints are compromised, the stiffer bone-patella tendon-bone construct is preferred for reconstruction of the chronic anterior cruciate ligament deficient knee.

Adolescent↗
PubMed1997

[Skeletal anomalies in nail-patella syndrome. Case report and overview].

The nail-patella syndrome (NPS), also known as hereditary onychoosteodysplasia (HOOD), is a hereditary disorder with an autosomal dominant mode of inheritance involving nails, bones and other tissues. It is characterized by onchodysplasia of the finger nails (most prominent on the thumb and index finger) and V-shaped lunulae. Extraosseous manifestations include ocular (glaucoma, microcornea) and renal involvement (proteinuria, nephrotic syndrome). A variety of skeletal anomalies can be observed. We report a 59 year old male with NPS. In addition to dysplastic patellae and elbow joints and the pathognomonic posterior iliacal horns, he had involvement of humerus, radius, ulna. and finger bones, leading to early and painful degenerative changes. Furthermore, microproteinuria was noted. Early diagnosis of NPS is important to prevent early secondary arthrosis and severe renal damage.

Bone Diseases, Developmental↗
PubMed1999

Nail-patella syndrome and IgA nephropathy in a Chinese woman.

Nail-patella syndrome (NPS), also known as hereditary onycho-osteodysplasia, is an autosomal dominant pleiotropic disorder characterized by nailbed dysplasia or hypoplasia, absent or hypoplastic patellae, iliac horns and deformation or luxation of the radial head. Nephropathy is a known serious complication associated with NPS. In this report, we describe an adult Chinese woman with the clinical and radiological features of NPS who presented with the nephrotic syndrome. Renal biopsy disclosed focal segmental glomerulosclerosis on light microscopy, while immunofluorescence revealed predominant staining for IgA in the glomerular mesangium and along some capillary walls. Ultrastructural study confirmed the presence of paramesangial deposits as well as subendothelial collagen fibrils in the glomeruli. The histological findings were those of combined NPS and IgA disease, an association which has rarely been described.

Adult↗
PubMed2003

Nail-patella syndrome: long term evolution.

Nail-patella syndrome is a rare dysplasia characterized by a typical tetrad: hypoplasic nails, hypoplasic or absent patella, radial head dislocation and iliac horns. We review eight patients, four men and four women, aged from 20 to 70 years. The main complaint at consultation was with their knees due to patellar instability and pain. Five of them required surgical treatment due to patellar dislocation and three patients were not treated. The Krogius-Lecène procedure was performed in four patients with a good result following the Insall classification of pain and instability and with an average follow-up of 24 years (range, 18-28 years). Patellectomy was performed in the eldest patient due to femoropatellar arthritis present at first consultation. No patients presented with elbow or nail disorders or with iliac horns.

Adult↗
PubMedDate not supplied

Nail patella syndrome: a review of 44 orthopaedic patients.

Nail patella syndrome is a rare dysplasia with characteristic findings of finger nail abnormalities, hypoplastic patellas, radial head dislocations, and iliac horns. We reviewed the problems and treatment of 44 patients with this syndrome from 13 Shriners Hospital units. The inheritance pattern is autosomal dominant, with foot abnormalities as the chief presenting complaint. All patients were ambulatory. Twenty of the patients underwent knee operations, and 24 underwent operations to correct foot and ankle deformities. Knee extensor realignments and foot posteromedial releases had overall good results. Knee flexion contractures required full posterior capsular releases. Elbow reconstructive procedures were rarely indicated.

Child↗
PubMed1999

Restricted distribution of loss-of-function mutations within the LMX1B genes of nail-patella syndrome patients.

Nail-patella syndrome (NPS) is a pleiotropic condition characterized by dysplasia of the nails, hypoplasia of the patellae, elbow dysplasia, and progressive kidney disease. The syndrome is inherited in an autosomal dominant manner and has been shown to result from mutations in the LIM-homeodomain encoding LMX1B gene. The LMX1B transcription factor plays a role in defining the development of dorsal-specific structures during limb development. To date, a total of 64 point mutations and small deletions or insertions have been reported, concentrated within either the LIM or homeodomains. No NPS mutations have been observed within the carboxy-terminal third of the coding sequence, suggesting that mutations in this region are not inactivating. These findings support the hypothesis that NPS results from a 50% reduction in LMX1B function via a reduction in synthesis, disruption of secondary structure, or failure to bind DNA.

Female↗
PubMed1990

Absence of an osseous patella and other observations in Macropodidae stifle.

The patella is a large sesamoid bone that typically develops in the tendon of insertion of the large extensor muscles of the stifle joint. Although present in almost all species of mammals and birds, it has been found to be absent in the red kangaroo and two wallaby species (family Macropodidae). In its place is a fibrocartilage pad, located in the tendon of the quadriceps femoris muscle. This structure is visible grossly, is palpable, and has the form normally expected of a bony patella. In addition, the femoral trochlea is shallow and asymmetric, and the lateral gastrocnemius sesamoid is unusually prominent. These and other related modifications in the area of the Macropodidae stifle are presented.

Animals↗
PubMed1991

Low level laser treatment of chondromalacia patellae.

A randomized, double blind study of low level laser treatment of chondromalacia of the patella in 40 patients has been undertaken. Chondromalacia was established by arthroscopy and was related to subjective symptoms. Eight treatments were given during five weeks by a physiotherapist with the use of a GAAS pulsed laser, real or sham. Assessment of the location, quality and intensity of pain, and the influence on mood, gait, sleep, work, and sports was made before and after treatment including an eight to twelve week evaluation. No statistical difference was found between real and sham use of low level laser for the symptoms of chondromalacia of the patella.

Adolescent↗
PubMed1992

The patella thinning osteotomy. An experimental study of a new technique for reducing patellofemoral pressure.

The authors describe an original procedure, the patella thinning osteotomy, as an alternative to advancement of the tibial tuberosity or patellectomy in cases of severe anterior knee pain. They present an experimental study on cadaveric knees prior to a clinical trial. This study on 13 knee specimens, using Fujifilm Prescale barosensitive film, shows that thinning of the patella by 7 mm diminishes to a significant degree the patellofemoral contact areas from 16.07% at 60 degrees of flexion to 27.90% at 30 degrees of flexion. Patellofemoral joint reacting forces, measured in 12 knees, also diminish in both medial and lateral surfaces at 30 degrees, 60 degrees and 90 degrees of flexion, the level of statistical significance being over 0.05, except for the lateral surface at 60 degrees of flexion. This technique decompresses the patellofemoral joint, and produces the biological effects found after other osteotomies.

Aged↗
PubMed1991

Case report 639: Malignant fibrous histiocytoma (MFH) of the patella.

Malignant fibrous histiocytoma of bone is a rare skeletal neoplasm, reported in the patella on only a few occasions. We describe an additional case in this bone in an 84-year-old woman. We believe this neoplasm should be considered in the differential diagnosis of malignant tumors of the patella.

Aged↗
PubMed1995

The thickness of the subchondral plate and its correlation with the thickness of the uncalcified articular cartilage in the human patella.

The regional thickness distributions of the subchondral plate and the unmineralized part of the articular cartilage were morphometrically determined in normal human patellae, and the correlation coefficient for each specimen calculated from the paired measurements. For this purpose the patellae were embedded in methyl methacrylate and cut as serial sections, which were assessed with a Vidas image-analyzing system (Kontron). The values obtained were used to reconstruct the individual and average thickness distributions and to calculate the correlation coefficients for each subject. Both the thickness of the subchondral plate and that of the cartilage revealed regular distributions which, however, followed different patterns. Central regions with maximum values from which the thickness decreased concentrically towards the periphery were found in both. However, the distribution patterns of the unmineralized cartilage and the subchondral plate could be clearly distinguished, both by the position of the maxima and by the arrangement of the isocrassids (contour lines of equal thickness). The thicknesses of the two tissues showed a correlation between 0.38 and 0.82 (mean 0.6). We attribute this to their different reactions to the type of stress acting upon them. It appears that the thickness of the subchondral plate is principally determined by stresses acting over a longer period of time with low frequency, whereas the thickness of the articular cartilage seems to be a response to intermittent dynamic stresses of a higher frequency.

Adult↗
PubMed1985

A method for assessing the height of the patella.

In 150 normal subjects the distance (P) between the upper and lower limits of the articular surface of the patella, and the shortest distance (T) between this same lower limit and the tibial plateau, were measured in standard lateral views of the knee in about 30 degrees of flexion. The limits of confidence of the T/P ratio are shown in the Table. The 5% upper limit of normality of this ratio is 1.11 (one-sided). This method of determining the position of the patella is accurate and more simple than those previously described.

Adult↗