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At least 631 records · Page 35Linked to original sources
PubMed2006

Comparison of a technique using a new percutaneous osteosynthesis device with conventional open surgery for displaced patella fractures in a randomized controlled trial.

OBJECTIVE: To compare the percutaneous patellar osteosynthesis system (PPOS) technique with open surgery for patella fractures. DESIGN: Randomized controlled trial. SETTING: Referral orthopedic and trauma center. PATIENTS: Fifty-three patients with displaced patellar fractures. INTERVENTION: Stabilization and fixation of patellar fractures with PPOS or open surgery. MAIN OUTCOME MEASUREMENTS: Knee-flexion and -extension angles, pain, surgical time, and assessment of knee function based on the Knee Society Clinical Rating Scale (KSCRS). RESULTS: Comparison of PPOS and open-surgery groups at 4 weeks showed the following: pain, 3.7 +/- 1.6 versus 6.2 +/- 1.4 arbitrary units, P < 0.001; flexion angle, 46 +/- 20.7 versus 12.7 +/- 6.0 degrees, P < 0.001; extension angle, -2.5 versus -3.8 degrees, P < 0.001. At 8 weeks, the following was demonstrated: pain, 1.3 +/- 1.6 versus 4.1 +/- 2.1 arbitrary units, P < 0.001; flexion angle, 87 +/- 17.3 versus 34 +/- 26 degrees, P < 0.001; extension angle, 0 versus -3 degrees, P < 0.001. Surgical time was 35.3 +/- 7.8 versus 66.2 +/- 14.1 minutes, P < 0.001. KSCRS assessment was 84 +/- 4 versus 70 +/- 8, P < 0.001 at 8 weeks; 85 +/- 2 versus 73 +/- 8, P < 0.001 at 12 months; and 85 +/- 1 versus 82 +/- 7, P = 0.246 at 24 months. Frequency of total complications (infections, fragment displacement, and wire-related pain) was significantly lower in the PPOS than in the open-surgery group (P < 0.02). CONCLUSIONS: PPOS for patella fractures was associated with shorter surgical time, less pain, better mobility angles, higher functional score up to 2 years, and a lower incidence of complications than open surgery.

Adolescent↗
PubMedDate not supplied

Osteonecrosis of the patella: diagnostic imaging perspective.

Disability from knee dysfunction has important implications on a patient's performance of simple day-to-day tasks, work-related duties, and leisure activities, including sports. Diagnostic imaging is of fundamental importance in the clinical evaluation of the patient with knee pain. The use of magnetic resonance imaging (MRI) for the assessment of knee pain and dysfunction has increased over the past few years as orthopedic surgeons and radiologists have familiarized themselves with the unique advantages of this modality. Magnetic resonance imaging provides a comprehensive evaluation of a wide spectrum of intra-articular and extra-articular pathologic conditions involving the knee. One of the most common indications for MRI of the knee is osteonecrosis. Osteonecrosis of the patella is unusual, and it is a well-documented cause of knee pain. After a brief overview of the anatomy of the patella, the diagnosis of osteonecrosis at this site by conventional radiography, MRI, and other imaging methods is focused on in this review.

Arthralgia↗
PubMed2006

Application of circular external fixator under arthroscopic control in comminuted patella fractures: technique and early results.

BACKGROUND: Comminuted fractures of the patella are traditionally treated by internal fixation. The modified tension-band technique is widely accepted for internal fixation. The management of comminuted fractures often requires additional K-wire and/or circlage material and wide surgical exposure. Therefore, symptoms and complications related to the stainless steel wire are not uncommon in these cases. We present a new alternative treatment technique for comminuted patellar fractures. METHODS: Five comminuted patellar fractures of four patients were treated by circular external fixator (CEF) under arthroscopic control. The mean patient age was 32.5 (range 24-41) years and mean follow-up was 22 (range 20-28) months. RESULTS: In four cases, union was completed by the sixth week; in the other case, union was completed by the eighth week. The frames were removed after union of the fracture was documented. When the CEF was removed, full knee range of motion was observed full in all patients, and the patients returned to their normal activities of living in a few days. The mean Lysholm score was 94 (range 85-100) after treatment. CONCLUSIONS: CEF application under arthroscopic control can help avoid some complications of the traditional treatment methods, particularly in comminuted fractures of the patella. The most important advantage of this technique is to allow active knee motion in the early postoperative period so patients can return to activity of daily living soon after the implant removal. In addition, arthroscopic examination of the knee joint provides an assessment of any other intra-articular lesions. This technique allows healing of the fracture with low morbidity.

Adult↗
PubMed1998

Treatment of antecubital pterygium in the nail-patella syndrome.

Antecubital pterygium is rare in the nail-patella syndrome but common in the multiple pterygium syndrome and aplasia of the trochlea. It is known that there is the rebound phenomenon after treatment of congenital joint contracture. We describe the poor functional results due to rapid recurrence of the flexion contracture treated with the Ilizarov method for an antecubital pterygium in the nail-patella syndrome.

Child↗
PubMed1982

Chondromalacia of the patella.

One hundred and sixty-three patients who underwent arthroscopic studies of the knee have been reviewed in an attempt to better understand the clinical condition present in chondromalacia of the patella. All patients included in the study were found to have either painful knees, patellar chondromalacia, or both, but no other intraarticular pathology. The difference between true chondromalacia of the patella (which may or may not be symptomatic) and other types of pain in the patello-femoral area is emphasized. Although various types of conservative and operative treatment have been described, the symptoms have frequently been found to resolve spontaneously, especially in young patients.

Adult↗
PubMed1983

Long-term follow-up of the treatment of a family with nail-patella syndrome.

Patients with nail-patella syndrome have deformities of the elbows and knees which can cause bothersome symptoms requiring treatment. We have found in a small series of four patients that quadricepsplasties have been uniformly successful in treating recurrent subluxation or dislocation of the patella at 10-year follow-up. Radial head resection has been effective in relieving minor amounts of pain and eliminating the bump caused by the posteriorly dislocated head. The range of motion of the elbow and forearm has not been improved.

Adolescent↗
PubMedDate not supplied

Lateral longitudinal stress fracture of the patella: report of three cases.

Stress fracture of the patella is a rare occurrence. Two types, longitudinal and transverse, are known. We report three lateral longitudinal fractures of the patella caused by running, Japanese fencing, and long distance walking. Patients returned to physical activities after 2-3 months of conservative treatment.

Athletic Injuries↗
PubMedDate not supplied

Avulsion fractures of the patella.

Forty-seven skeletally immature patients with marginal fractures of the patella were evaluated. We showed that avulsion fractures may affect the superior, inferior, and medial margins of the patella, separating through the subchondral bone along the biomechanically susceptible margin of progressive chondroosseous transformation and expansion of the ossification center. In children, the small size of the osseous fragment may belie the actual size of the more peripheral, radiolucent cartilaginous component. Treatment may be either conservative or operative, depending on the extent of separation of the fragments and the functional capacity of the patellar/quadriceps mechanism.

Adolescent↗
PubMedDate not supplied

Ultrasonography of the unossified patella in young children.

Ultrasonography has become a useful technique to assess the cartilaginous hip of the newborn. We applied this technique and found that it gave useful information in helping to locate the unossified patella in two cases of congenital dislocation of the patella.

Contracture↗
PubMedDate not supplied

Congenital dislocation of the patella and its operative treatment.

Twelve patients with 18 knees whose congenital permanent lateral dislocation of the patella was irreducible by nonoperative means are reported. All knees were operated on according to the same principles, including medial transfer of the patellar tendon. The age of the patients at operation varied between 3 and 19 years. The average follow-up time was greater than 13 years. All patients benefited greatly from the operation. Active knee extension ability was restored in all knees. Some extension deficit remained in two severely dysplastic patients. Congenital subluxation with habitual dislocation of the patella has been successfully treated by the method described.

Adolescent↗
PubMedDate not supplied

Dorsal defect of the patella.

Dorsal defect of the patella is a benign subchondral lesion of unknown etiology, located in the superolateral region of the patella. The lesion presents with a characteristic radiographic appearance consisting of a rounded focus of radiolucency surrounded by a sclerotic margin. Although often an incidental finding on knee radiographs, it occasionally may be symptomatic. It occurs in males and females with equal frequency, is bilateral in up to one third of individuals, and is most frequently found in adolescents. This report describes a series of eight such lesions in five patients.

Adolescent↗
PubMed1992

Acute haematogenous osteomyelitis of the patella revealed by a pathological fracture in multiple myeloma.

A 57-year-old man was followed up for multiple myeloma with no lytic bone lesions. During a septicaema, he presented with a pathological fracture of the patella. Despite a poor haematological status, he received surgical treatment, which allowed diagnosis of haematogenous osteomyelitis of the patella. The outcome was favourable, with a 6-week plaster immobilization after cerclage and 4 months of intravenous antibiotic therapy. This case emphasizes the fact that one well-known cause of bone lesions may lead to an erroneous diagnosis. The successful clinical course suggests that accurate therapeutic management may be discussed in haematological malignancies when intensive-care support is available.

Acute Disease↗
PubMed1978

Familial aplasia or hypoplasia of the patella.

A father with bilateral absence of the patella and his son with pronounced hypoplasia of the patellae are described. A possible relationship between this syndrome and hereditary osteo-onycho-dysplasia is discussed.

Adolescent↗
PubMed1988

Familial recurrent dislocation of patella with autosomal dominant mode of inheritance.

Recurrent dislocation of the patella is considered to be a manifestation of generalized joint laxity. An autosomal dominant mode of inheritance was previously suggested in a few instances; however, male-to-male transmission has not yet been reported. We report a recurrent dislocation of the patella occurring in five generations of one family with male-to-male transmission and without generalized joint laxity.

Female↗
PubMed1975

Chondromalacia of the patella.

Where chondromalacia of the patella is resistant to conservative treatment, and where the existence of a Crooks ridge can be inferred from the clinical or X-ray findings, then an operative search for such a ridge, with trimming both of the ridge and of the affected area of the patella, offers a more promising surgical solution than other minor operative procedures, and a less drastic solution than patellectomy.

Adolescent↗
PubMed1989

Metastasis in a patella: a rare site.

Primary neoplasms of the patella are rare, and metastases of the patella are rarer still. A case is presented of a 64 year old woman whose pain in the left knee, resulting from patellar neoplasms, was subsequently found to result from secondary spread from a renal adenocarcinoma.

Bone Neoplasms↗
PubMed1993

Recurrent patella dislocation treated by closed lateral retinacular release.

This study describes the results of treating selected patients suffering from recurrent dislocation of the patella, with closed lateral retinacular release. Thirty-nine patients were reviewed after a mean follow-up time of 28 months. Thirty patients were substantially improved by the procedure, two patients had sustained a further dislocation. The major complication--haemarthrosis--occurred in four patients. These results compare favourably with those achieved by major realignment procedures. So lateral retinacular release is an effective treatment for selected patients with recurrent patella dislocation, and it offers distinct advantages over other procedures.

Adolescent↗
PubMed1977

Coxofemoral luxation complicated by upward fixation of the patella in the pony.

Two cases of coxofemoral luxation complicated by upward fixation of the patella are described in the pony. Clinical signs included outward rotation of the stifle and foot and inward rotation of the hock with the stifle and hock joints fixed in extension. One case was treated by performing a medial patellar desmotomy with a resultant significant improvement in locomotion. Other cases of hip luxation reported in the literature, some complicated by upward patellar fixation, are reviewed. Hip luxation is principally seen in ponies and it is suggested that upward fixation of the patella occurring in some of these cases is a result of rotation of the limb produced by dislocation of the hip, which alters the normal anatomy and mechanics of the femoro-patellar joint and/or interferes with the normal leverage of the rectus femoris muscle.

Animals↗