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At least 847 records · Page 47Linked to original sources
PubMed2003

[An avulsion (sleeve) fracture of the proximal patella pole in a child. Diagnosis, treatment and results in a patient after a fall onto the knee].

We report a case of an avulsion fracture (sleeve fracture) of the proximal pole of the patella in an 8 year old boy who fell onto his left knee. After the fracture was diagnosed, the patient under went surgery on the day of the accident. The articular cartilage and the upper fragment were reconstituted and fixed with transosseous sutures. A cast immobilisation in extension was used for 6 weeks and the patient regained full active mobility of the left knee joint after cast removal. A radiograph showed that the fracture had completely united. Diagnosis, pathomechanism and treatment strategies are discussed with reference to this rare case, and the literature is reviewed.

Accidental Falls↗
PubMed1999

[Arthroscopic repair of the medial retinaculum after first time dislocation of the patella].

Between March 1994 and December 1997, an arthroscopic repair of the medial retinaculum after first time dislocation of the patella was performed 38 times in 34 patients. The operative technique is being described as well as the results after an average follow-up of 25 months in 31 cases. In the group with radiologically determined predisposing factors (n = 20) as many osteochondral flakes were found as in the group without these factors, but there were significantly less chondral lesions on the lateral femoral condyle and the medial patellar facet. There were no complications during hospitalization, although in 3 (10%) cases a redislocation occurred during follow-up. According to the subjective Turba Score, 84% of the patients showed a good or very good, and 16% a fair result, including cases with redislocation. The arthroscopic repair of the medial retinaculum after first time patellar dislocation is a minimal invasive method with very low peri- and postoperative morbidity. The redislocation rate can be reduced to at least 50% compared to the published data on conservative treatment.

Adolescent↗
PubMed2003

An innovative compression-clamp for open contaminated fractures of patella: a short report of five cases.

Five patients with open contaminated fractures of the patella were managed using an indigenously designed external clamp cum compressor. All had an infected lacerated wound at the fracture site, and one had open exposed knee joint (Gustilo grade IIIB open fracture). These patients reported after 3-7 days of injury. The wounds were thoroughly washed and débrided and the clamp cum compressor was applied. They were encouraged to do active knee movements immediately post-operatively. The wounds healed within 3-4 weeks, and the fractures united within 10-16 weeks. Good functional results were achieved in four of the five.

Adult↗
PubMed2005

Operative treatment of deep chondral defects of the patella: results after abrasive arthroplasty and periosteal arthroplasty.

This prospective, non-randomized study was aimed to evaluate the effects of abrasive arthroplasty and periosteal arthroplasty in the treatment of deep chondral defects of the patella. A total of 30 patients in group A (13 male, 17 female, age: 28.7+/-6.9 years) underwent arthroscopic abrasive arthroplasty. The other patients in group B (n=17, 11 male, 8 female, age 26.8+/-7.0 years) underwent periosteal arthroplasty by an autologous periosteal flap. The maximal diameter of the defects was 31.1+/-6.7 (range 20-45 mm). The Lysholm score and the intensity of pain were evaluated preoperatively and at the time of follow-up (3.1+/-1.1, range 2-5 years). The Tegner activity score was evaluated before onset of the symptoms and at the time of follow-up. The Lysholm score increased significantly in both groups (in group a from 36.1+/-7.1 to 42.5+/-6.6 points and in group B from 42.7+/-2.4 to 67.6+/-7.8 points). The result in group B was significantly better than in group A. In group A the intensity of pain was unchanged, whereas patients from group B reported a significant reduction of pain. The level of physical activity (Tegner score) was 5.5+/-2.1 in group A and 5.5+/-2.1 in group B before onset of the complaints. In follow-up, patients from group B (4.9+/-1.2) had a reduced Tegner score in tendency. The patients in group A had a significantly reduced level of physical activity (2.7+/-0.6). A total of 12 patients from group B had a range of motion lesser than 80 degrees in flexion. These patients underwent joint mobilization and control arthroscopy. During control arthroscopy there was always found a stable periosteal flap. Short-term clinical results with periosteal arthroplasty produced a significant reduction in pain and improved Lysholm score in comparison to abrasive arthroplasty.

Adult↗
PubMed2006

Traumatic separation of an uncommon bipartite patella type: a case report.

The authors report about a case of traumatic separation of a horizontally bipartite patella in a young female soccer player. Unspecific anterior knee pain preceded the fracture, which had occurred after an inadequate trauma. Open reduction and osteosynthesis led to bony union with an excellent clinical outcome at follow-up.

Adolescent↗
PubMed1996

Intraosseous ganglion of the patella.

Osteolytic cystic lesions of the patella are rare lesions. A review of the literature revealed only one previously reported example. The pathogenesis and radiological and pathological features of intraosseous ganglion cysts are discussed. In addition, the differential diagnosis of lytic patellar lesions is discussed.

Aged↗
PubMed1996

Chondromalacia patellae: an in vitro study. Comparison of MR criteria with histologic and macroscopic findings.

OBJECTIVE: To develop MR criteria for grades of chondromalacia patellae and to assess the accuracy of these grades. DESIGN: Fat-suppressed T2-weighted double-echo, fat-suppressed T2-weighted fast spin echo, fat-suppressed T1-weighted, and gradient echo sequences were performed at 1.5 T for the evaluation of chondromalacia. A total of 1000 MR, 200 histologic, and 200 surface locations were graded for chondromalacia and statistically compared. RESULTS: Compared with gross inspection as well as with histology the most accurate sequences were fat-suppressed T2-weighted conventional spin echo and fat suppressed T2-weighted fast spin echo, although the T1-weighted and proton density images also correlated well. The most accurate MR criteria applied to the severe grades of chondromalacia, with less accurate results for lesser grades. CONCLUSIONS: This study demonstrates that fat-suppressed routine T2-weighted and fast spin echo T2-weighted sequences seem to be more accurate than proton density, T1-weighted, and gradient echo sequences in grading chondromalacia. Good histologic and macroscopic correlation was seen in more severe grades of chondromalacia, but problems remain for the early grades in all sequences studied.

Cadaver↗
PubMed2001

Primary leiomyosarcoma of the patella.

We report on a case of primary leiomyosarcoma of the patella in a 59-year-old woman. To our knowledge, this is the first report of this rare tumor in a bone where malignant lesions rarely occur.

Bone Neoplasms↗
PubMed1996

A mushroom-shaped osteochondral patella allograft.

Replacement of the damaged chondral surface of the patella is often difficult because of the high mechanical stresses and the relatively thin cancellous surfaces. A new method has been developed to resurface the whole gliding surface with a mushroom-shaped allograft which provides firm fixation and an excellent base for rapid revascularisation. Fibrin gives additional stability and bonematrix gelatin (BMG) is used to enhance creeping substitution. Immediate motion and weightbearing promote rapid rehabilitation.

Cryopreservation↗
PubMed2001

Should the patella be replaced in total knee replacement?

In 170 total knee arthroplasties for osteoarthritis 71 did not receive a patellar replacement (group A), while 99 knees had a cemented polyethylene patella (group B). The mean follow-up time was 36 months (30-50 months). In group A 10 patients underwent second-stage patellar resurfacing and in group B 2 knees underwent revision of the patellar component. Radiologically the average patellar congruency was similar. In both groups there were 21 non-congruent knees. In group A 8 were symptomatic and had low scores compared to 2 in group B (P<0.05). The mean HSS score and patellar score were higher in group B than in group A (P<0.05).

Aged↗
PubMed2001

Dorsal defect on a multi-partite patella: imaging findings.

Coincidence of dorsal defect on a multipartite patella constitutes a rare cause of anterior knee pain in the first decades of life. Imaging findings of this uncommon symptomatic skeletal variant are discussed, with emphasis on MR features.

Adolescent↗
PubMed2005

Bifocal disruption of the knee extensor apparatus ("floating patella") in a 13-year-old patient.

We present the unusual case of a traumatic "floating patella" in a 13-year-old healthy boy. No predisposing factors were diagnosed. The obvious bony avulsion was treated by immediate open reduction and screwing, whereas the quadriceps tendon rupture was missed diagnostically in the first step. During the course of the treatment, the extension lag lead to the delayed diagnosis of the concomitant rupture of the quadriceps tendon. After the surgical treatment of the latter, the patient healed with full function of the extensor apparatus and full ROM. Bifocal injury of the knee extensor apparatus is therefore possible in young adolescents without presenting the predisposing factors and should thus be considered.

Adolescent↗
PubMed1975

The long-term effect on the tibiofemoral compartment of the knee joint of comminuted fractures of the patella.

We have studied the long-term effect of comminuted fractures of the patella with particular reference to the development of degenerative changes in the tibiofemoral joint. Degenerative changes which could convincingly be ascribed to the original injury were found in only one case, but we stress that the numbers are small, and that carefull search sould be made at operation for damage to the femoral condyles.

Accidents, Home↗
PubMed1988

Herbert screw fixation of osteochondral fractures of the patella.

Two cases of osteochondral fractures of the patella are presented. These osteochondral fractures have been reduced and fixed with the Herbert scaphoid screw. This screw has several advantages over conventional methods of treatment of osteochondral fractures in that the screw is entirely buried in the bony fragment and no portion of the screw lies proud. The differential pitch of the two threads in the screw allows interfragmentary compression. The size of the screw is such that minimal articular cartilage damage is incurred in inserting the screw and this method of treatment does not require a second arthrotomy for removal of the screws.

Adolescent↗
PubMed1991

Surgical management of non-union of neglected fractures of the patella.

Three cases of non-union of the patella with large gaps between the fragments are presented. The patients' ability to cope with the problem was not entirely satisfactory. Surgical management by mobilization of the patellar fragments and fixation using the tension band principle achieved union of the fracture in all three cases. The patients also recovered an excellent, pain-free range of movement and strength in the affected knees.

Adult↗
PubMed1993

Nail-patella syndrome and pre-eclampsia.

We present here the first described case of Nail-patella syndrome (NPS) and pregnancy. Complications occurred during the pregnancy with the onset of preeclampsia at 22 weeks, leading to intrauterine fetal death at 24 weeks. The nephropathy of the NPS began clinically during the course of gestation. Postpartum, it persisted as isolated proteinuria, which became a nephrotic syndrome 18 months later.

Adult↗
PubMed1989

Mechanical and histological response of carbon fibre pads implanted in the rabbit patella.

Small carbon fibre pads (3 mm in diameter) were implanted into rabbit patellae to ascertain the relationship between their mechanical and histological responses. After 3 months a highly vascularized collagenous matrix is formed within and around the implant securely anchored to the bone and providing a continuous layer to the articular surface. Mechanically, the resulting repair is much more compliant than the original articular cartilage/bone structure since the subchondral bone plate is not present within the implant; it also provides a functioning congruent surface with no evidence of fragmentation. This may be attractive in the long term by decreasing friction and the subsequent degeneration and wear commonly seen in fibrillated, disrupted articular cartilage.

Animals↗
PubMed1995

Reflex sympathetic dystrophy of both patellae following burns.

This study describes a previously undescribed cause of reflex sympathetic dystrophy involving both patellae. This syndrome developed following burns inflicted over both knees in a male industrial worker. The report highlights physical examination findings, investigation results, socioeconomic and psychological evaluation, and rehabilitation treatments involved in patients suffering from reflex sympathetic dystrophy.

Bone and Bones↗