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PubMedDate not supplied

The lateral pivot shift: a symptom and sign of anterior cruciate ligament insufficiency.

The lateral pivot shift(LPS) is a special form of lateral compartment instability arising from anterior cruciate insufficiency. It is characterized by anterior subluxation of the tibial plateau out from beneath the lateral femoral condyle. As a consequence of this form of instability, deleterious changes of the knee joint take place, including meniscal tears, and articular cartilage erosions. The eventual result of continued symptomatic instability is late osteoarthritis of the knee. LPS is the most prominent form of instability of the knee in patients complaining of "giving way" of the knee, and recovery from severe soft-tissue injury to the knee joint.

Cartilage, Articular↗
PubMed2003

[Orthopedic treatment of a boy with Larsen's syndrome].

A case of Larsen's syndrome in a boy is presented. The syndrome is characterized by flattened facies, multiple congenital dislocations and foot deformities as a result of connective tissue maldevelopment during gestation. The importance of early intensive conservative therapy is emphasized. In the case reported, conservative therapy led, in the first stage, to the management of subluxation of both hips and improvement in left foot position and in the state of both knees. Subsequently, dislocations of the right and the left knee joint were surgically treated at 16 and 20 months, respectively, by reduction and transfixation with Kirschner's wires according to Niebauer and King. After six weeks of plaster immobilization, the wires were removed and the knee position was corrected with laminate splints. The authors point out that the syndrome is often associated with cardiovascular anomalies. Although these were not present in the case reported, due to the repeated occurrence of pericardial exudates from 2 years of the child' age, it was not possible to manage his left foot (pes equinovarus) surgically earlier than at 36 months. For that procedure, the method of posteroplantar release was used. The authors also discuss the occurrence of vertebral anomalies in Larsen's syndrome that may lead to cervical kyphosis and, potentially, to cervical spine instability. In our case, the signs of kyphosis were observed in the C1-C3 region but magnetic resonance imaging did not show any signs of either myelopathy or narrowing of the spinal canal. The intensive conservative and surgical treatment with subsequent thorough rehabilitation enabled the patient to stand up and walk without any support or orthotics. The fact that the boy was able to integrate in healthy children's playgroups can be considered a great achievement of orthopedic therapy.

Abnormalities, Multiple↗
PubMed1978

[Congenital knee luxation].

The authors discuss the frequency, etiology, symptoms and classification as well as treatment of congenital dislocation of the knee. 8 own cases are reported in the article. The authors suggest that congenital dislocation of the may be well influenced by non-operative methods. Etappe redressement by means of plaster does not interfere with the functional treatment of the hip dislocation usually treated with the Pavlik braces. Associated foot deformities may be easily corrected at the same time. The so called "earliest treatment" is most important in all the three deformities (knee-hip dislocation, club foot), the authors emphasise.

Abnormalities, Multiple↗
PubMed1988

Routine radiographs in acute knee distortions.

The value of primary knee radiographs was examined in 144 cases with acute anterior cruciate ligament rupture to determine the ability of the films to reveal or confirm the correct diagnosis. In 15% of the patients, the radiographs were found to give significant diagnostic help by revealing typical avulsion fractures associated with injury to the ligament. Primary knee radiographs are recommended in every major knee ligament injury.

Acute Disease↗
PubMed1994

[Posterior luxation of the tibia on total knee prosthesis: apropos of 6 cases].

PURPOSE OF THE STUDY: Posterior dislocation of Total knee arthroplasty is an infrequent but serious complication. Six cases of this complication were treated from 1979 to december 1993, all occurring on primary arthroplasties. MATERIAL AND METHODS: Knee arthroplasty was performed once for rheumatoid arthritis, five times for osteoarthritis. All cases occurred with a semi constrained prosthesis sacrifying posterior cruciate ligament: 2 Total condylar without posterior stabilisation, and 4 posterior stabilised prosthesis. In one case the dislocation occurred on a very severe rheumatoid arthritis: the patient, confined in a wheel chair, was not reoperated. In two patients, the dislocation was due to rotatory malposition of the tibial component. In the last three cases, we did not found any cause to the dislocation, except ligament laxity: 2 of these patients had, pre operatively, a valgus deformity. In 6 cases, we found only 2 problems on extensor system (one patellar dislocation and one patellectomy). RESULTS: 5 patients required a surgical treatment In 2 cases, we used a more constrained prosthesis, with poor results, but the knee was stable. Once, by changing the position of the tibial component, and using a thicker plate. In 2 patients we only put a thicker tibial polyethylene component. These 3 patients had a good stability: 2 have an excellent result with H.S.S. rating system, the third one has a poor result explained by patellar pseudoarthrosis occurring after traumatic patellar fracture. DISCUSSION: With our patients and cases published in North American works, we have studied the different mechanisms of such a posterior dislocation: rotatory disorder on tibial component, ligament laxity in flexion, extensor system deficiency, valgus deformity with important postero lateral release. CONCLUSION: The causes of posterior dislocation on Total knee arthroplasties must be known: we have to try to prevent such a complication. If it occurs, a precise analysis will permit a logical curative treatment, which must avoid constrained prosthesis.

Aged↗
PubMed2007

[Rotating platform spinout in LCS knee arthroplasty].

In knee arthroplasty, a lax flexion gap may cause flexion instability. Subsequently, the operated knee may subluxate or dislocate. We report on a case of recurrent subluxations with malrotation of the rotating platform (spinout) after primary LCS total knee arthroplasty. Potential causes for spinout, therapy procedures, and consequences for the primary surgical technique are discussed. In the LCS rotating platform knee arthroplasty, the flexion gap must not be laxer than the extension gap. In such an instance, we recommend a higher rotating platform and a more proximal distal transverse femoral osteotomy.

Aged↗