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PubMed2005

[Dislocation of artificial cartilage (SaluCartialge)].

Treament of focal cartilage defects is challenging, and techniques of bone marrow stimulation or cartilage transplantation are not sufficient to reconstitute hyaline cartilage. Preliminary results of artificial cartilage repair are promising, but no long-term results are available. Here, we report on a case of graft dislocation 6 months after artificial cartilage repair (SaluCartilage). We conclude that this method is not fully developed and more long-term results are required.

Arthroplasty, Replacement, Knee↗
PubMed1975

Preliminary experience with a method of quadricepsplasty in recurrent subluxation of the patella.

Nineteen knees were treated for recurrent subluxation or dislocation of the patella by lateral and distal transfer of the vastus medialis with or without release of the lateral retinaculum. Fifty-eight per cent has good or excellent and 42 per cent had poor results after a mean follow-up of twenty-nine months. The factors that predisposed to failure were genu valgum greater than 15 degrees and, to a lesser extent, palpable synovitis associated with symptomatic chondromalacia patellae.

Adolescent↗
PubMed1989

Insall proximal realignment for disorders of the patella.

Proximal realignment with standard lateral retinacular release (Insall operation) was performed on 35 knees with a follow-up time of two to 11 years. The results for chondromalacia patellae were satisfactory to excellent results in 20 of 23 knees (87%) at two years and in eight of 15 knees (55%) at five to 11 years. Satisfactory to excellent results in 11 of 12 knees (92%) were noted for recurrent patellar dislocation. This procedure should be reserved for advanced chondromalacia patellae (Grades III and IV) and recurrent patellar dislocation. Anatomic studies suggest that the pain relief was most likely due to a combination of patellar denervation and restoration of patellar congruence.

Adult↗
PubMed1993

Magnetic resonance imaging of patellofemoral relationships.

Patellofemoral relationships were analyzed in 11 patients (13 knees) with patellar dislocation and 15 asymptomatic subjects (15 knees) at 0 degree and 20 degrees of flexion. The measurements were made from five consecutive axial images through the patellofemoral joint. The six indices measured were lateral patellar tilt (LPT), lateral patellofemoral angle (LPA), lateral patellar displacement (LPD), patella-lateral condyle index (L/PW), congruence angle (CA), and sulcus angle (SA). The reproducibility of the method was evaluated. The difference between the two study groups was more evident at 0 degree than at 20 degrees of knee flexion. Significant differences were noted between measurements made at different levels of the joint, particularly in the controls. Isometric contraction of the quadriceps muscle lateralized and tilted the patella slightly in both groups. L/PW with and without quadriceps muscle contraction, and LPA with reference to the anterior condyles differentiated between the two study groups most clearly. LPT and LPA with reference to the anterior condyles differentiated the study groups better than LPT and LPA with reference to the posterior condyles. The reproducibility was good except for inter-observer comparison of CA and SA. The use of an imaging plane selected at the midpoint of the patellar articular cartilage increases the sensitivity of the measurements, since it takes into account both the height of the patella and the tendency towards lateralization. These results indicate that patellar tilt is best measured with the LPA index and patellar lateralization with the L/PW index at 0 degree knee flexion. This study should always include isometric contraction of the quadriceps muscle.

Adolescent↗
PubMed1982

Rotational knee strain resulting in patellar dislocation. An experimental study in rabbits.

The right lower extremities of 64 young rabbits were immobilized by a plaster spica. The animals developed a gait pattern, which included internal tibial rotation and adduction of the left (unimmobilized) tibia. Twenty-one of the animals developed medial patellar dislocation in the unimmobilized lower extremity. The mechanism of the patellar dislocation in this experimental model was possibly overstretching of the lateral colateral ligament and the lateral side of the joint capsule, associated with medial rotation of the tibia and the tibial tubercle. The direction of patellar pull when gliding inferiorly during knee flexion was shifted medially, resulting in patellar dislocation and secondarily, in formation of an exostosis under the displaced patella. Hip arthrodesis in humans, as a course of rotational instability of the contralateral knee, resembles some aspects of this experimental condition.

Animals↗
PubMed1997

[Dislocation of the femoral component of an unicondylar knee prosthesis. Apropos of a case].

INTRODUCTION: Femoral component dislocation in unicondylar knee arthroplasty is rare. One case is reported. MATERIAL AND METHODS: A 59 years old man required revision of his unicondylar knee arthroplasty for loosening and dislocation of the femoral component 3 years after its insertion. Revision was performed and we found a technical error: distal and posterior femoral cut was too thin, and with components in place, there was a tendancy for the components to "rock" as the knee was flexed. The implants were too tight in flexion. A new unicondylar knee arthroplasty was performed. DISCUSSION: The posterior condylar bone resection should reach at least the thickness of the metal implant. It is better to resect slightly too much of the posterior condyle than too little in order to avoid tightening of the knee in flexion. The femoral component must accurately reproduces the anterior-posterior dimension of the femoral condyle. CONCLUSION: With better selection of patients and surgeons who are more familiar to this type of procedure loosening and dislocation of an unicondylar knee arthroplasty should be avoided.

Arthroplasty, Replacement, Knee↗