SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
We report 15 cases of primary tumours and pseudotumours of the patella. The radiographic features and the surgical treatment of the different histological types are described in relation to Enneking's surgical staging and data derived from the literature.
Seven hundred and five radiographs of the knee were examined and 17.6% showed a so-called Haglund imprint on the patella. The incidence was the same in patients with chondromalacia and in a control group. There was no statistical difference regarding age, sex and body weight. Haglund's imprint is a variation from the normal and is of no diagnostic value.
We present a case of a simple bone cyst in the patella in a women of 33 years. We were only able to find one similar case in the literature.
A case of bilateral habitual dislocation of the patella associated with cleft lip and palate, and short metatarsals, metacarpals and phalanges is reported. The possible cause of habitual dislocation is discussed in the light of 20 cases which have been seen by the author.
Medial dislocation of the patella is a previously unreported entity. This disorder can be disabling to the patient and may require a hospital visit for reduction. Three cases are presented in this article in which computed tomography demonstrated the dislocation. All three patients had undergone a lateral retinacular release to the involved knee for treatment of chronic knee pain or recurrent lateral patellar subluxation.
A man of 71 was seen with a solitary metastasis in the patella as the first presentation of carcinoma of the lung.
In 40 patients with patellofemoral pain, intra-osseous pressure measurements were recorded under anaesthesia with the knee first in extension and then in flexion prior to performing a longitudinal osteotomy of the patella. There was a statistically significant increase of pressure in painful knees compared with normal knees (29 mm Hg. vs 15 mm Hg.), and a marked increase when compared during sustained flexion (97 mm Hg. vs 60 mm Hg.). However wide variability of individual results made the diagnostic value of a single pressure measurement unreliable. A clinical test, based on reproduction of the characteristic pain by sustained knee flexion, proved to be reliable in predicting a good response to operation. The effect of the operation was encouraging, with significant relief of pain as measured by a visual analogue scale.
This study reports 42 cases of histologically proven and radiographically correlated primary patellar tumors. Despite diverse histologic diagnoses, the radiographic appearances of benign as opposed to malignant patellar neoplasms are essentially indistinguishable. Although the literature suggests that giant cell tumor is the most frequent benign tumor of the patella, the most common benign neoplasm in this series is chondroblastoma (16 cases). Only four primary malignant lesions were encountered, three cases of lymphoma and one case of hemangioendothelioma. Since 38 (90%) of the 42 cases were benign, a benign etiology should be strongly favored, notwithstanding the radiographic appearance, whenever a primary patellar tumor is encountered.
Forty patients who had previously been treated in a conservative way, were operated. The surgery involved the section of the external lateral patella expansion. When reviewing the patients the following criteria were taken into considerations: subjective symptomatology, clinical and radiological examinations as well as the time factor in taking up work again. The results after operation were as follows: 87% good or excellent and 13% mediocre.
In this study 17 patients with recurrent dislocation of the patella were followed up 10 years after their Goldthwait operation. The subjective and clinical findings were excellent or good in 70%. X-radiographs indicated osteoarthritis of the femoropatellar joint in 60%. Concerning the aetiopathological factors, we found an increased external torsion of the afflicted extremity (measured by computed tomography).
This is a case report of a special and undoubtedly rare complication occurring in a hinge joint with a moving instant center such as the GSB total knee joint. The preoperative situation, the history of the incident and the operative report are being described as well as a radiological follow-up. The mechanism of unhooking of the tibial shaft from its junction with the femoral stem during dislocation of the patella is being reconstructed.
We report two cases of transverse fracture of the patella in children. Contrary to the general belief that this fracture is common in children, we could not find any reported cases since 1973. Both of our cases were sports-related and each illustrates a different mechanism of injury.
Fluorescein-isothiocyanate (FITC) labeled lectins were used to study the distribution of specific binding-sites in histological sections of normal and fibrillated articular cartilage of human patellae. It has been shown that normal articular cartilage reveals lectin binding-sites for Concanavalin A (Con A) and wheat germ agglutinin (WGA), but not for soybean agglutinin (SBA), peanut agglutinin (PNA) and Ulex europaeus agglutinin (UEA). In fibrillated cartilage the distribution pattern of Con A and WGA is completely changed. SBA, PNA and UEA show a distinct staining pattern in particular in the fibrillated areas of degenerated cartilage. Lectin-staining of the extracellular matrix and the chondrocytes in both normal and fibrillated cartilage did not show any correlation with material that was either PAS- or Alcian blue-positive. In comparison with the conventional PAS- and Alcian blue reaction lectin-staining proved to be superior. Visualization of intra- and extracellular glycoconjugate-changes in normal and fibrillated cartilage in areas with no PAS and/or Alcian blue staining indicates that all layers of the cartilage are involved in the pathological process. It is evident that lectins can demonstrate minute differences between normal and arthrotic cartilage and we therefore conclude that lectins are sensitive and specific tools for the study of degenerative joint diseases.
A new method for the treatment of patella infera is presented. This technique is based on the previously described procedure for treatment of old ruptures of the patellar ligament. The main advantage of this technique is the achievement of a normal patellar position without the adverse effects on the knee extensor mechanism found with other techniques, such as patellectomy or elevation of the tibial tubercle. The main surgical steps of this technique are outlined and the preliminary results reported.
Posterior "iliac horns" are a common finding in nail-patella syndrome and when present are considered pathognomonic of the disease. We have had an opportunity to study a patient with these iliac horns and describe their appearance on computerized tomography.
A case of aneurysmal bone cyst of the patella in a 15-year-old woman was presented. An ABC occurring in a female patient is rare, and to our knowledge this is the first report in the literature. All other reports of patellar ABCs reported have occurred in young black men [2, 3]. The radiographic findings and clinical presentation were stressed since they are typical of all benign patellar tumors. Although radiographic findings are usually typical of patellar tumors, CT and MRI may be used for staging and standardization of operative treatment. MRI is also helpful for examining the integrity of the patellar tendon and quadriceps since many of these patients present with malfunction of the extensor mechanism [14].
The authors compare three surgical techniques for treatment of recurrent dislocation of patella. The best results, even in the correction of lateral patellar displacement, were achieved with proximal realignment, while the worst results occurred when lateral retinacular release was used alone. In distal realignment, the degree of correction necessary must be ascertained by thorough preoperative assessment of both patellar height and malalignment between femoral groove and tibial tubercle. If the medial retinacular structures are weakened, it may be necessary to perform proximal realignment. We believe that a single surgical option is insufficient, and that the best solution for each individual case should be chosen according to precise indications. The choices include proximal realignment, distal realignment, or a combination of both, while lateral release should always be used in combination with another technique.
Patella fractures are relatively uncommon, accounting for approximately 0.5% to 1.5% of all skeletal injuries. The most common mechanism for this injury is direct fall onto the knee, and transverse fracture is the most common type. The aims of operative treatment are accurate reduction and rigid fixation. Stable fracture types without or with minimal dislocation can be treated nonoperatively. Dislocation of more than 2 mm and comminuted fractures are indications for operative treatment. Tension band wiring, interfragmentary screw fixation, and the combination of cerclage wiring and screw fixation are used for internal fixation of these fractures. When accurate reduction and reconstruction of the retropatellar joint surface cannot be achieved in multi-fragmentary fractures, partial or total patellectomy should be considered. Since it always results in loss of quadriceps muscle power, the decision for this procedure should be made cautiously.