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At least 703 records · Page 39Linked to original sources
PubMed2002

Nail-patella syndrome with renal involvement and antecubital pterygia.

Nail-patella syndrome (NPS) is a rare, autosomal-dominant hereditary disorder characterized by nail dysplasia and multiple osseous abnormalities. Some patients may develop renal function impairment and even end-stage renal disease. We treated a 42-year-old female patient with proteinuria who presented with a web-like structure over the antecubital fossa and hypoplastic patellae. In addition, she had other characteristic findings, including bilateral iliac horn, triangular nail lunulae and hypoplastic radial head. She had impaired renal function, and renal biopsy showed mesangial proliferative glomerulonephritis. Additional cases were found in her family. Her mother had most of the signs of NPS as well as advanced renal failure. Her elder sister had knee abnormalities without the web-like elbow condition. Both daughters also had the characteristic features of NPS. During follow-up 30 months after the initial examination, the patient had stable renal function and mild proteinuria.

Adult↗
PubMed2003

Confirmation of CLIM2/LMX1B interaction by yeast two-hybrid screening and analysis of its involvement in nail-patella syndrome.

Nail-patella syndrome (NPS), an autosomal dominant disorder characterized by nail dysplasia, absent or hypoplastic patellae, iliac horns, and often associated with nephropathy and, less frequently, with open angle glaucoma, is caused by mutations in the LMX1B gene. Inter-familial and intra-familial phenotypic variability raises the question whether modifier genes can be identified to explain differences in the expression and severity of clinical features of NPS. Genes encoding proteins that interact with the LMX1B protein are good candidates and, therefore, methods to search for interactions can be used to this purpose. By the yeast two-hybrid screening we detected the CLIM2 gene as a LMX1B interactor, confirming previous reports which described the same interaction by biochemical methods. Sequencing of the CLIM2 coding region in seven NPS cases in which no LMX1B mutation had been found, did not detect any molecular variant in these patients. Moreover, by genotyping a polymorphic dinucleotide repeat close to the CLIM2 gene in affected members of a large Dutch NPS family with high incidence of nephropathy, we were unable to find a correlation between the presence of a specific allele and the expression of nephropathy. In conclusion, although the results of this study could not provide any proof of CLIM2 involvement in the pathogenesis of NPS or in determination of the clinical phenotype, we suggest that the CLIM2 gene can be considered as a good candidate for further studies on normal and disturbed kidney development associated with NPS or other hereditary glomerulopathies.

DNA Mutational Analysis↗
PubMed1991

[Evaluation of knee joint function after fracture of the patella].

Clinical assessment of the function of the knee joint after surgically and conservatively treated fracture of the patella was carried out. On the basis of C. Ranawat criteria it was found that regardless the method of treatment applied restriction of the joint function was expressed mainly by limited range of motion and by weakening of the knee extensors. The results of surgical and conservative management are similar. The best results of treatment for fracture of the patella were achieved in patients operated with the use of wire loop-cerclage.

Adult↗
PubMed1990

[Resection of the patella and plasty of the knee by the de la Caffiniere method].

The surgical technique of patellectomy with preservation of continuity of the extension apparatus of the knee by the de la Caffinière method and the early results of treatment in 8 operated on patients have been presented. The indications for surgery were: posttraumatic stiffness of the knee in extension in 4 patients, patello-femoral arthrosis with preserved wide range of movement in 3 patients, fresh multi-fragmented fracture of the patella without rupture of the extension apparatus in one patient. The good treatment result was obtained in 6 patients (3 treated for patello-femoral arthrosis, 1 for fresh fracture of the patella, and 2 for stiffness of the knee in extension). The poor results in the other 2 patients operated on or stiffness of the knee in extension were due to large damage of the cartilaginous surface of the condyles and extensive intra- and periarticular adhesions.

Adult↗
PubMed1992

Chondromalacic changes of the patella in rabbits.

Malalignments of the patellofemoral joints were artificially made in eleven rabbits using four different methods in order to generate chondromalacia of the patella. Chondromalacic changes and the location similar to the chondromalacia of the human body were generated in one joint of the patching group. According to the results of our investigation, the most reasonable etiological factor of the chondromalacia is thought to be the expansion of the medial retinaculum and capsule of the knee joint, and chondromalacia patellae may not be a precursor of osteoarthritic changes.

Animals↗
PubMed1992

Osteochondritis dissecans patellae. Is there a genetic predisposition?

The aetiology of Osteochondritis Dissecans Patellae remains controversial. We present a family suffering from the condition in all members of one generation. Clinical data support the hypothesis that the aetiology of the disorder in this family is recurrent subluxation of the patella, the inherited predisposing factor being an abnormality of the mechanics of the knee.

Adolescent↗
PubMed2003

Does harvesting the medial third of the patellar tendon cause lateral shift of the patella after ACL reconstruction?

Many centers do not use the medial third of the patellar tendon as a graft for ACL reconstruction due to the apprehension that there may be post harvest maltracking of the patella towards the lateral side. We undertook a prospective study to evaluate patellar alignment in 30 patients in whom ACL reconstruction was done using the medial third of the patellar tendon. Q-angle assessment was the rough clinical parameter, and the Merchant view, Laurin views, and CT scans were used for radiological assessment. The assessment was done preoperatively and at six months post surgery, and the contralateral normal knees were used as controls. We observed no significant changes in the congruence angle (pre-op -13.86 degrees, postop -12 degrees) or the lateral patellofemoral angles in the pre-operative and postoperative knees as compared to the controls. CT scans were more sensitive for evaluating the congruence angles, and picked up an insignificant abnormal lateralisation of the patella in four cases. None of these patients however had any postoperative symptoms of misalignment. Although medial third graft harvesting did have a 13% change in patellar alignment, this was not statistically significant. Post harvesting local problems are inherent to the procedure, and are independent of the site of harvesting, as they were also seen in cases with no evidence of misalignment.

Adult↗
PubMed2004

Periprosthetic fractures of the tibia and patella in total knee arthroplasty.

Periprosthetic fractures of the tibia and patella associated with total knee arthroplasty are less common than periprosthetic fractures of the distal femur and therefore have been less frequently reported in the literature. Because more total knee replacements are now being performed and implant and patient survival has improved, periprosthetic fractures of the tibia and patella may be recognized more frequently in association with both primary and revision total knee replacement. Several risk factors associated with both types of fractures have been identified, and addressing patient factors, surgical techniques, and implant designs that may contribute to increased risk is an important aspect of management.

Algorithms↗
PubMed2004

Nail-patella syndrome in Saudi Arabia with new features and surgical procedures: the first described study.

The purpose of this study was to reveal the occurrence of nail-patella syndrome (NPS) in Saudi Arabia together with the detection of abnormal attachment of lateral meniscus in the left knee and new surgical procedures applied to the right and left knee, reported for the first time in this study. This was a case study of a 23-year-old young man presenting with bilateral knee pain, giving way and locking since the age of 15 years. Clinically, most of the NPS features were noted, including ocular problems. The complex features affected both knees, especially the previous attempted surgeries for recurrent dislocation of patellae. Deficient ligaments were reconstructed using the Leeds-Keio ligament, starting with the right knee and continuing with the left knee 6 months later. Early and late follow-up showed favorable outcome of surgery revealed as independent ambulation and stable right and left knees. In conclusion, NPS, although rare, presents a complex problem and unexpected surgical outcome, and we recommend this procedure with close follow-up.

Adult↗
PubMedDate not supplied

[The measurement of the tibial tuberosity. Patella groove distanced technique and results (author's transl)].

The line between the summit of the tibial tuberosity and the bottom of the trochlea groove as seen on a radiograph taken with the knee in 30 degrees of flexion and neutral rotation is indicative of the valgus position of the quadriceps mechanism at the moment of engatement of the patella in the groove. The authors stress the technical requirements to obtain the radiograph which permits this measurement. Measurement of a group of normal knees and of two groups of knees presenting with known patello-femoral pathology (lateral patello-femoral arthrosis and current dislocation of the patella) are given. In the study of distrubance of the patello-femoral articulation, this measurement provides information of theoretical and therapeutic interest.

Aged↗
PubMed2004

Patella resurfacing versus nonresurfacing in total knee arthroplasty: results of a randomized controlled clinical trial at a minimum of 10 years' followup.

Patellar resurfacing in total knee arthroplasty remains controversial. This study evaluates the results of resurfacing and nonresurfacing the patella in a randomized controlled, clinical trial at a minimum of 10 years followup. One hundred knees (90 patients) with osteoarthritis were enrolled in a prospective randomized clinical trial using a posterior-cruciate-retaining total knee arthroplasty. Patients were randomized to receive resurfacing or retention of the patella. Evaluations were done preoperatively and yearly, up to a minimum of 10 years (range, 10.1-11.5 years) postoperatively. Disease-specific (Knee Society clinical rating score) and functional (stair climbing, flexion/extension torques, patellar examination) outcomes were measured. Patient satisfaction, anterior knee pain, and patellofemoral questionnaires were completed. Intraoperative grading of the articular cartilage was done. No patients were lost to followup; 45 patients remained alive. Nine revisions (in nine of 90 knees; 10%) were done in seven patients in the nonresurfaced group (15% of knees) and in two patients in the resurfaced group (5% of knees). No significant difference was found between the groups regarding revision rates, Knee Society clinical rating scores, and functional, patient satisfaction, anterior knee pain, patellofemoral, and radiographic outcomes. Intraoperative cartilage quality was not a predictor of outcome. This study currently is the longest followup of a randomized controlled, clinical trial that examines patellar resurfacing in total knee arthroplasty. The results showed no significant difference between the groups for all outcome measures at a minimum of 10 years of followup.

Aged↗
PubMed1992

Tension-band wiring and lag screw fixation of a transverse, comminuted fracture of a patella in a horse.

A transverse, comminuted fracture of the patella was treated surgically by combining tension-band wiring and lag-screw fixation in a horse. Partial patellectomy or smaller detached fragments of the patella was performed. Satisfactory healing of the fracture was evident 10 weeks after surgery, and there were no complications. Implants were not removed. The horse was sound at a trot 4 months after surgery and was used for pleasure riding 8 months later.

Animals↗
PubMedDate not supplied

Clinical evaluation of resurfacing of the patella in posterior-stabilizing total knee replacement.

The authors report their experience in the implantation of 108 posterior-stabilized cemented total knee replacements, where in 43 cases the patella was not resurfaced (group 1) and in 65 in was resurfaced (group 2). The ability to perform daily activities, the subjective function of the patello-femoral joint and the index of patient satisfaction were evaluated by means of a telephone interview; furthermore, a clinical-radiographic evaluation was carried out in 50 cases. The results of the present study indicate the need of resurfacing the patella using a posterior-stabilized prosthetic design, based on the fact that more joint excursion, a low incidence of complications on the patello-femoral joint, and improved ability to perform daily activities were demonstrated.

Adult↗
PubMed1979

[Fatigue fracture of the patella in cerebral palsy (author's transl)].

Amongst approximately 1 500 spastic children under treatment, the authors have seen three cases of fatigue fracture of the patella. One patient was spastic and two others were athetotic. The fatigue fractures can be explained by a flexed knee gait aggravated by a contracture of the hamstring tendons. No fracture was seen in patients treated by Egger's operation. It is concluded that this procedure both prevents and cures fatigue fracture of the patella.

Adolescent↗
PubMed2004

Sleeve fracture of the patella in a child.

Sleeve fracture of the inferior pole of the patella is a rare and distinctive fracture in children with few published reports. These fractures are frequently misdiagnosed and neglected. We highlight a case of a neglected and misdiagnosed sleeve fracture of the patella in an eleven-year-old boy. This was initially diagnosed as an avulsion fracture of the tibial tubercle. A good outcome was achieved after open reduction and internal fixation.

Accidental Falls↗
PubMed1992

Long-term results for the McKeever patellar resurfacing prosthesis used as a salvage procedure for severe chondromalacia patellae.

From July 1972 until September 1985, 28 patients with a mean age of 36 years who had advanced arthritis of the patella were treated with a resurfacing arthroplasty using the McKeever prosthesis. The opposing articular surface of the femur appeared normal in 19 patients. The 28 patients had had a total of 50 previous operations on the patella (average, 1.8 operations per patient). These included 15 arthroscopic or open debridements, 14 lateral releases, six Maquet tibial tubercle elevations, six open patellar ligament transpositions, and seven open procedures for reduction and fixation of patellar fractures. Every case was observed postoperatively from a minimum of four years to a maximum of 16 years (mean, 8.1 years). Results were evaluated according to a patellar rating scale at five and eight years postoperatively. Seventeen of 24 were rated good or excellent at five years. Of the three poor results at five years, two were attributed to tricompartmental osteoarthrosis and were revised to total knee arthroplasties. There were no significant complications in the series. No patients had postoperative patellar instability or prosthetic loosening. Prolonged physical therapy rehabilitation (mean, 4.6 months) was necessary for patients to regain maximal ranges of motion, muscle strength, and endurance.

Adult↗
PubMedDate not supplied

[Clinical picture and molecular analysis in a familial case of Nail-Patella Syndrome--identification of a new mutation in LMX1B gene].

The Nail-Patella Syndrome (NPS) (OMIM: 161200) is an autosomal dominant disorder characterized by skeletal malformations, such as: patellar aplasia/ hypoplasia, iliac horns on X-ray as well as nail dysplasia, renal and ocular abnormalities. Mutations in the gene encoding transcription factor LMX1B, mapped on the long arm of chromosome 9 (9q34), are responsible for the clinical phenotype of NPS. A familial case (in the mother and her son) of Nail-Patella Syndrome is presented here. DNA analysis has shown a new missense mutation in exon 5 of LMX1B gene (745C-G) leading to a change of glutamine into glutamic acid (Q245E) in the coded protein. Characteristic clinical features, seen in both patients, are discussed within the context of molecular analysis results.

Adult↗
PubMed2005

Patella resurfacing in posterior stabilised total knee arthroplasty: a follow-up study in 56 patients.

Patellar resurfacing in total knee arthroplasty (TKA) remains controversial. This study evaluates the results of resurfacing and non-resurfacing of the patella. Fifty-six patients with osteoarthritis (OA) of the knee were enrolled in a prospective randomised clinical trial using a posterior-stabilised TKA. Evaluations were done preoperatively and after 1, 3, 6, 12 and 24 months. Disease specific (Knee Society Score or KSS) and functional (patella-related activities) outcomes were measured. Patient satisfaction and anterior knee pain questionnaires were completed. No patients were lost to follow-up. No significant differences were found between groups with regard to the clinical part of the Knee Society score (KSS) not even in obese patients, the ability of performing daily activities involving the patellofemoral joint, and patient satisfaction. Significant differences were found regarding the functional section of the KSS, passive flexion, anterior knee pain and patellar tilt and subluxation. In conclusion, the authors believe that, for the implant studied, patellar resurfacing can be indicated.

Aged↗