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

A kinematic study of lateral unicompartmental arthroplasty.

When the Oxford unicompartmental meniscal bearing arthroplasty (UCA) is used in the lateral compartment 10% of the bearings dislocate. A fluoroscopic study was performed to investigate if abnormal mid-sagittal plane kinematics was related to bearing dislocation. Video fluoroscopy is an accepted means of determining in-vivo knee kinematics in the sagittal plane. Video fluoroscopy was obtained of 5 Oxford lateral UCAs 10 years post-operatively and of five normal knees. Patellar tendon angle (PTA), derived from dynamic fluoroscopic images, was used to describe the joint kinematics. This in-vivo experiment demonstrated that the PTA/knee relationship for the Oxford lateral UCA is similar to the normal knee. Both the normal knee (r(2)=0.99) and the Oxford lateral UCA (r(2)=0.98) demonstrated a linear relationship between flexion angle and PTA. No significant difference in PTA was found between the normal knee and the Oxford lateral UCA. This study demonstrated normal kinematics, as indicated by PTA, ten years after implantation of the Oxford lateral UCA. It is therefore reasonable to suggest that abnormal kinematics is not a significant factor relating to meniscal bearing dislocation in the lateral compartment.

Adult↗
PubMed1999

Irreducible dislocation of the knee.

Irreducible knee dislocation is a rare injury. This case report describes a knee dislocation in a 39-year-old male U.S. Army noncommissioned officer who was injured while playing in a softball game. Arthroscopy showed the medial collateral ligament and capsule to be locked in the intercondylar notch, covering the medial femoral condyle. Arthrotomy and open reduction were required. Staged posterior cruciate ligament reconstruction using patellar tendon autograft was later performed. Review of the magnetic resonance imaging scan showed the irreducible lesion. The diagnostic clinical and radiographic features of this unusual injury are described.

Adult↗
PubMed1981

[Diagnosis and operative treatment of chondromalacia patellae by osteotomy and ventral or ventral and medial transposition of the tuberositas tibiae (Maquet/Bandi-procedure) (author's transl)].

The clinical picture of chondromalacia patellae is outlined by the patellar syndrome. The diagnostic value of double contrast arthrography by tangential X-ray (skyline-view)-technique of the femoro-patellar-joint is stressed. If conservative treatment is not satisfactory, osteotomy and ventral transposition of the tuberositas tibiae should be performed. When the patella and the extensor apparatus are dislocated laterally, it is necessary to displace the tuberositas in medial direction. From 1976 to 1980 159 patients have been treated this way. Follow-up study in 86 cases (1 to 5 years after operation) shows excellent and good results in a percentage of 77.

Adolescent↗
PubMed1994

The results of arthroscopic lateral release of the extensor mechanism for recurrent dislocation of the patella after 8 years.

We reviewed 41 knees at a mean of 4 years after arthroscopic lateral release of the extensor mechanism. The operations were performed for recurrent complete dislocation, not for subluxation, maltracking, or lateral pressure syndrome. Thirty-three of these knees were reviewed again 8 years after operation. There were 39% excellent results according to the criteria of Crosby and Insall at 4 years and 30% at 8 years. Patellar stability improved between 4 and 8 years (p < 0.01). The results in patients with subluxation of the patella on extension of the knee or generalized ligament laxity were poor; five of seven patients with these conditions were worse and had undergone another operation. With these conditions excluded, the excellent results decreased from 50% after 4 years to 37% after 8 years. The results of lateral release are better than those reported after other procedures. It is concluded that arthroscopic lateral release is the procedure of choice for patients with recurrent complete dislocation of the patella unless there is abnormal ligament laxity or subluxation on extension. The operation should not be performed in the presence of these conditions.

Adolescent↗
PubMed1983

EMG activity of the vastus medialis oblique and the vastus lateralis in their role in patellar alignment.

Using intramuscular electrodes the integrated electromyographic activity of the vastus medialis oblique and the vastus lateralis was examined in twenty normal females. The activity was recorded during the last thirty degrees of distal segment stabilized knee extension, when patellar subluxation commonly occurs. The electromyographic activity was normalized and expressed as a percentage of a maximal isometric contraction. Both muscles exhibited low levels of activity with no significant differences between the two. This study provides a quantitative method to assess whether muscular imbalance is present in patients with patellar subluxation.

Adult↗
PubMed1980

[Femoro-patellar joint. Advantages of axial projection in external rotation of the knee (author'r transl)].

The classical technic for radiological examination of femoro-patellar joint cannot visualize a lot of real chondromalacia. Their diagnosis, and, therefore, their treatment, usually surgical, rely on doubtful results of clinical examination. Axial projections combined with external rotation of the knee is not perfect, but it is a good improvement. It reveals many femoro-patellar syndroms without any radiological expression until this time.

Femur↗
PubMedDate not supplied

Magnetic resonance measurements of the deviation of the angle of force generated by contraction of the quadriceps muscle in dogs with congenital patellar luxation.

OBJECTIVE: To measure the quadriceps angle (Q-angle) in dogs with congenital patellar luxation using magnetic resonance (MR) methods. STUDY DESIGN: Prospective clinical study. ANIMALS: Thirty-eight client-owned dogs. METHODS: Thirty-eight dogs were examined and placed into the following groups based on the degree of patellar instability: normal, grade I, grade II, and grade III. MR images of 37 pelvic limbs without patellar instability, 33 pelvic limbs with patellar luxation, and 6 limbs with cranial cruciate ligament (CrCL) rupture were made. The Q-angle was calculated using trigonometric methods based on MR images. Limbs with patellar luxation were compared with normal stifles and stifle with other disorders. RESULTS: The average Q-angle of the normal group was 10.5 degrees (24.9 degrees to -2.0 degrees ). The grade I group had an average Q-angle of 12.2 degrees (28.8 degrees to 2 degrees ), the grade II group 24.3 degrees (44.6 degrees to 7.7 degrees ), and the grade III group 36.6 degrees (51.4 degrees to 15.6 degrees ). The average Q-angle of limbs with an isolated CrCL rupture was 19.3 degrees (34.7 degrees to 3.9 degrees ). CONCLUSION: MR images can be used to make exact calculations of the Q-angle. CLINICAL RELEVANCE: MR images can be used to quantify the degree of patellar luxation.

Animals↗
PubMedDate not supplied

Evaluation of patellar shape in the sagittal plane. A clinical analysis.

A prospective study of 564 patients was performed to assess the correlation between patellar shape as seen on a lateral radiograph and 1) patellar pain and 2) the radiologic determination of patellar height. A classification of patellar shape was developed based on the ratio of the patellar length to the length of the articular surface. Three classification types were established, including the "long-nosed," "Cyrano" type. Patients were placed into one of two groups based on the presence or absence of patellar pain. Lateral radiographs were evaluated for patellar height using two published indices. A significantly larger portion of Type II and Type III patellae was found in patients with patellar pain. Moreover, accepted measures of patellar height have to be used with caution in the presence of unusual patellar shapes.

Adult↗
PubMed1996

Pain reduction after anteromedial displacement of the tibial tuberosity: 5-year follow-up in 21 knees with patellofomoral arthrosis.

We performed anteromedial displacement of the tibial tuberosity in 21 knees of 16 patients having patellofemoral arthrosis with lateral subluxation. The mean age of the patients was 53 (47-65) years and they were followed for 5(2-13) years. Preoperatively, all knees were painful on descending or ascending stairs; pain was relieved after operation in 20. Retropatellar crepitations disappeared in 2 of 20 knees, but retropatellar pain when squeezing the patella against the femur disappeared in 16 of 17 knees. Patellar subluxation diminished in all knees.

Aged↗
PubMed1990

[Patellar changes following knee joint endoprosthesis-plasty].

We analysed the postoperative position of the patella and the degenerative changes in 80 implanted Guepar, Tillmann and GSB-prostheses of the knee. We did not found differences between the types of endoprostheses. We saw many dislocations of the patella, especially in patients with rheumatism, but only some patients had trouble with the operated knee. We can diminish these problems by modelling of the patella and by careful reconstruction of the muscle strength.

Adult↗
PubMed1976

Cranial cruciate ligament repair in a calf.

A 1-month-old calf was unable to use its right pelvic limb because of rupture of the cranial cruciate ligament. The ligament was replaced with a wedge of bone from the cranial one-third of the patella and the attached portion of the middle patellar tendon. Postoperative complications limited function of the joint.

Animals↗
PubMed2006

CT changes after trochleoplasty for symptomatic trochlear dysplasia.

Trochlear dysplasia is an important risk factor for patellar instability. Because of a decreased trochlear depth in combination with a low lateral femoral condyle, the patella cannot engage properly in the trochlea. Trochleoplasty is a surgical procedure, which strives to correct such bony abnormalities. The aim of this study was to describe morphological features of trochlear dysplasia and the corrective changes after trochleoplasty on CT scan. The study group consists of 17 knees with trochlear dysplasia having undergone trochleoplasty for recurrent patellofemoral dislocation at a mean age of 22.4 years. The evaluation consisted in pre- and postoperative measurements on the proximal and distal trochlea on transverse CT scans in order to determine the morphological features. We measured the transverse position and depth of the trochlear groove, the transverse position of the patella, the ratio between the posterior patellar edge and the trochlear groove, the lateral patellar inclination angle, the sulcus angle, and the lateral trochlear slope. The trochlear groove lateralised a mean of 6.1 mm in the proximal aspect and 2.5 mm in the distal aspect of the trochlea, while the patella medialised a mean of 5 mm. Preoperatively the patella was lateral in relation to the trochlear groove in 13 cases, neutral in two cases, and medial in two cases. Postoperatively it was lateral in four cases, in neutral position in seven cases, and medialised in six cases, referenced to the trochlear groove. The trochlear depth increased from 0 to 5.9 mm postoperatively in the proximal aspect of the trochlea, and from 5.5 to 8.3 mm postoperatively in the distal trochlea. The lateral patellar inclination angle decreased from a mean of 21.9 degrees to a mean of 7.8 degrees . The sulcus angle decreased from a mean of 172.1 degrees to a mean of 133 degrees in the proximal trochlea and from a mean of 141.9 degrees to a mean of 121.7 degrees in the distal trochlea. The lateral trochlear slope changed from 2.8 degrees to 22.7 degrees in the proximal and from 14.9 degrees to 26.9 degrees in the distal part of the trochlea. In the CT scan patients with trochlear dysplasia demonstrated a poor depth, or even a flat or convex trochlea with a greater sulcus and lateral trochlear slope angle, a lateralised patella to the trochlear groove with poor congruency, and a greater lateral patellar inclination angle. Trochleoplasty can correct the pathological features of trochlear dysplasia by surgically creating more normal anatomy. The goal of this surgical procedure is to steepen and lateralise the trochlear groove for a better engagement of the patella.

Adolescent↗