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At least 865 records · Page 48Linked to original sources
PubMed1991

The significance of chondromalacic changes on the patella.

A total of 500 arthroscopies were performed in a 2-year period, with special reference made to the patellofemoral joint. In those with pain thought to be arising from this joint, 63% had chondromalacic changes on the posterior surface of the patella compared with a 45% incidence in those with meniscal pathological findings at arthroscopy. This study demonstrates that those with patellofemoral pain do not always have patellar articular changes, and patellar pathology is often asymptomatic. As a result, treatment directed at these lesions must be used with great caution.

Adult↗
PubMed1992

Human collagen gene COL5A1 maps to the q34.2----q34.3 region of chromosome 9, near the locus for nail-patella syndrome.

Type V collagen is a fibrillar collagen that is widely distributed in tissues as a minor component of extracellular matrix and is usually composed of one pro alpha 2 (V) and two pro alpha 1 (V) chains. In this report, recently isolated cDNA and genomic clones, which encode the pro alpha 1 (V) chain, are used as probes for hybridization to filter-bound DNA from a panel of human-mouse hybrid cell lines and for in situ hybridization to metaphase chromosomes. These studies establish the chromosomal location of the COL5A1 gene, which encodes the pro alpha 1 (V) chain, within segment 9q34.2----q34.3. These findings add to the previously characterized dispersion of collagen genes in the human genome, as this is the first example of a collagen locus on chromosome 9. In addition, these studies place COL5A1 near the locus for the genetic disorder, nail-patella syndrome (hereditary osteo-onychodysplasia), which also maps to 9q34.

Chromosome Mapping↗
PubMed1995

COL5A1: fine genetic mapping and exclusion as candidate gene in families with nail-patella syndrome, tuberous sclerosis 1, hereditary hemorrhagic telangiectasia, and Ehlers-Danlos Syndrome type II.

COL5A1, the gene for the alpha 1 chain of type V collagen, has been considered a candidate gene for certain diseases based on chromosomal location and/or disease phenotype. We have employed 3'-untranslated region RFLPs to exclude COL5A1 as a candidate gene in families with tuberous sclerosis 1, Ehlers-Danlos syndrome type II, and nail-patella syndrome. In addition, we describe a polymorphic simple sequence repeat (SSR) within a COL5A1 intron. This SSR is used to exclude COL5A1 as a candidate gene in hereditary hemorrhagic telangiectasia (Osler-Rendu-Weber disease) and to add COL5A1 to the existing map of "index" markers of chromosome 9 by evaluation of the COL5A1 locus on the CEPH 40-family reference pedigree set. This genetic mapping places COL5A1 between markers D9S66 and D9S67.

Base Sequence↗
PubMed2006

Clinical and biomechanical assessment of patella resurfacing in total knee arthroplasty.

BACKGROUND: Currently there is a limited understanding of the factors influencing range of motion by comparing patellar resurfacing vs non-resurfacing in total knee arthroplasty during activities of daily living. A recent meta-analysis of patellar replacement confirms better outcome with patella resurfacing; however, the result can be influenced by many other factors, such as: component design, surgeon experience, and technical aspects of the surgery. This study compares the biomechanics of the knee in patients after total knee arthroplasty with and without patellar resurfacing during stair climbing. METHODS: Forty-seven patients with total knee arthroplasty were assessed at the mean follow-up of 24 months. In all of them a posterior stabilised fixed bearing prosthesis (Optetrak PS, Exactech) was implanted. Twenty-six patients were treated without patellar resurfacing and 21 with patellar resurfacing. Clinical evaluations were performed using the International Knee Society and the Hospital for Special Surgery scores. Ten patients with patellar resurfacing and 10 patients without patellar resurfacing were also studied with motion analysis during stair climbing; 10 healthy subjects were studied for statistical comparison. FINDINGS: Clinical passive knee flexion, International Knee Society Function and Hospital for Special Surgery scores were significantly higher in the patellar resurfacing group. During stair climbing, active knee joint range of motion during the stance phase was greater in patients with patellar resurfacing. The maximum adduction moment was significantly higher in the group without patellar resurfacing. INTERPRETATION: Patients with patellar resurfacing demonstrated better clinical scores, and kinematic and kinetic data while ascending stairs.

Aged↗
PubMed2005

The basket plate in the osteosynthesis of comminuted fractures of distal pole of the patella.

The purpose of this study was to evaluate the basket plate in the treatment of comminuted fractures of the distal pole of the patella (patellar apex fracture). The basket plate was designed by Smiljanić Branimir M.D., Clinical Professor of Surgery, at the Department of Surgery, The University Hospital Sestre milosrdnice, Zagreb, Croatia. In the period from 1988 to 2003, more than 100 patients with comminuted patellar apex fractures had been treated with basket plate osteosynthesis in the Department of Surgery. Only 51 patients were subsequently available for knee examination. For evaluation of the knee, we used a modified Cincinnati knee rating system, using a manual dynamometer in the evaluation of the knee extension. The results were excellent in 30 patients, good in 16 and satisfactory in 5 patients; no poor results were observed. The stability of the osteosynthesis by basket plate allows osseous consolidation if the fracture and permits loading the leg with full body weight early in the postoperative period.

Adult↗
PubMed2006

Bilateral stress fracture of the patellae: a case report.

A case of bilateral simultaneous stress fracture of the patella is presented in a 64 year old Marathon runner sustained when he slipped off a curb whilst out walking. This was confirmed on Xray and treated by tension band wiring using the AO technique. He had an excellent result returning to normal function in both knees. This case is unusual since the fractures were not due to osteoporosis, as would be expected in this age group.

Fractures, Stress↗
PubMed2005

Tuberculosis of patella.

Osteoarticular tuberculosis is rare and affects the knee in about 8% of cases and the patella in less than 0.1%. This study reports a series of five patients who were immunologically competent but living in an endemic area for tuberculosis. Treatment with antituberculous therapy and early mobilization of the knee joint led to a successful outcome in all cases without patellectomy or arthrodesis.

Adult↗
PubMed2003

In vivo expression of putative LMX1B targets in nail-patella syndrome kidneys.

The nail-patella syndrome (NPS) is characterized by nail and bone abnormalities, associated with glomerular involvement in approximately 40% of patients. Typical glomerular changes consist of fibrillar material in the irregularly thickened glomerular basement membrane. NPS is inherited as an autosomal dominant trait and caused by heterozygous loss of function mutations in LMX1B, a member of the LIM homeodomain protein family. Mice with homozygous inactivation of the gene exhibit nail and skeletal defects, similar to those observed in patients, associated with glomerular abnormalities. Strong reduction in the glomerular expression of the alpha3 and alpha4 chains of type IV collagen, and of podocin and CD2AP, two podocyte proteins critical for glomerular function, has been observed in Lmx1b null mice. The expression of these proteins appeared to be regulated by Lmx1b. To determine whether these changes in podocyte gene expression are involved in the development of NPS nephropathy, using immunohistological techniques, we analyzed the podocyte phenotype and the renal distribution of type IV collagen chains in the kidneys of seven NPS patients with severe glomerular disease. We also examined the nature of the fibrillar material present within the glomerular extracellular matrix. The glomerular basement membrane fibrillar material was specifically labeled with anti-type III collagen antibodies, suggesting a possible regulation of type III collagen expression by LMX1B. The expression of the alpha3 and alpha4 chains of type IV collagen, and of podocin and CD2AP, was found to be normal in the seven patients. These findings indicate that heterozygous mutations of LMX1B do not appear to dramatically affect the expression of type IV collagen chains, podocin, or CD2AP in NPS patients.

Adaptor Proteins, Signal Transducing↗
PubMed1995

Technical report: radiological evaluation of patellar malalignment using a new frame for axial imaging of the patellae.

Axial radiographs were performed on 59 children and adolescent patients with patellar malalignment using the method described by Laurin. A special frame was used to keep the knees in 20 degrees flexion and to maintain standard conditions. Radiological indices were measured before realignment surgery. A statistically significant difference (P < 0.0001) in the lateral patellofemoral angle was observed comparing malaligned and control patellae. Laurin's technique using a special frame provides a method of obtaining standard radiological measurements of patellar malalignment for use in surgical planning.

Adolescent↗
PubMed1998

Lateral force-displacement behaviour of the human patella and its variation with knee flexion--a biomechanical study in vitro.

This study measured the patellar lateral force-displacement behaviour at a range of knee flexion angles in normal human cadaver specimens. The knee extensor muscles were loaded in proportion to their physiological cross-sectional areas, the tensions being applied in physiological directions along the separate quadriceps muscles. Knee extension was blocked at a range of knee flexion angles from 0 to 90 degrees, and patellar lateral displacement versus force characteristics were measured. This experiment was repeated with three total muscle forces, 20, 175 and 350 N, which were held constant at all flexion angles. It was shown that similar stability variation was obtained with the different total muscle loads, and also the forces required to produce a range of patellar displacements (1.5, 9 mm) were examined. A 5 mm lateral patellar displacement required a constant displacing force (i.e. the patella had constant lateral stability) up to 60 degrees knee flexion, and then a significant increase at 90 degrees. The results were related to surgical and anatomical observations.

Aged↗
PubMed2000

Carbon fiber implants in osteochondral defects of the rabbit patella.

Carbon fiber implants were used to fill osteochondral defects created on the articular surface of the patella of 36 rabbits, for the purpose of studying the long-term histological changes of the repair process. Six months after surgery the defect was filled by fibrous tissue, where the superficial area was organized parallel to the joint surface. Fibrocartilage developed after 9 months and, after 12 months, the defects were covered by hyaline cartilage tissue.

Animals↗
PubMed1980

Palmar-plantar hyperhidrosis occurring in a kindred with nail-patella syndrome.

Nail-patella syndrome (NPS) is an autosomal dominant genetic defect, which may be associated with, or closely linked to, the locus controlling palmar and plantar hyperhidrosis (HH). A clinical review of a family with NPS involving six generations was performed. Data were accumulated by personal examination and analysis of medical and family records for the trials characterizing NPS as well as the coincidence of HH. A family pedigree of each entity was constructed and the pedigree for HH was compared to the NPS pedigree. Thirty-three of sixty-eight members of the extended family were affected with NPS and nine members had HH. The NPS pedigree supported the previously known autosomal dominant mode of inheritance. The incidence of HH indicated a direct inheritance and occurred only in members affected with NPS. The pedigree provides evidence for concluding that HH occurred as a spontaneous mutation transmitted as an autosomal dominant trait closely linked to NPS or that HH represents a previous unrecognized associated disorder.

Adolescent↗
PubMed1984

An unusual case of intra-articular dislocation of the patella.

An unusual case of intra-articular patellar dislocation is described in which the patella rotated simultaneously in both the horizontal and vertical axes. The dislocation was sustained without apparent trauma. Reduction could not be accomplished in the emergency department. Closed reduction was accomplished successfully under general anesthesia in the operating room.

Child↗
PubMed2002

Biologic resurfacing of the patella: current status.

The techniques of biologic resurfacing of the patella, like other joint surfaces, are still evolving. Currently none of them is free from criticism. In this regard it is our hope that progress in the basic science will offer in the near future new and more optimistic therapeutic possibilities (i.e., the restoration of a reparative cartilage that is structurally and functionally comparable to the native one). The greater expectancies come perhaps from the present experimental investigations about the combined use of tissue-engineered implants embedded with staminal cells and growth factors. Many problems remain to be solved, however, before reliable applicability in humans. From a general point of view, stem cells obtained from various sources (e.g., adult bone marrow, umbilical cord) offer the same finalities as the embryonic stem cells, without the ethical obstacles related to the latter. Therefore, it may be that restoration of part or all of the articular surface of a joint will be possible by way of these mesenchymal progenitors that have the ability to differentiate into the chondrogenic and osteogenic lines, which is required for the restoration of the various layers of a normal articular cartilage and subchondral bone.

Arthroplasty, Replacement, Knee↗
PubMed1998

Sex determination by discriminant analysis of patella measurements.

The authors have analyzed 80 skeletons (40 males and 40 females) from the collection at the Institute of Legal Medicine of the University of Bari belonging to a known contemporary Southern Italian population; time of death was around 1970 and ages ranged from 25 to 80 years. Seven measurements taken on 80 intact, undeformed right patellae (max height, max width, thickness, height and width of the external facies articularis, height and width of the internal facies articularis) were used to determine sex by multivariate discriminant analysis. One function associating two parameters (max width and thickness) obtained the highest value of correct sex determination with a rate of 83.3%; other functions showed a higher percentage of misclassification (up to 17.5%). This study tests the success rate of correct sex prediction based exclusively on patellar dimensions. The discriminant factors carried out by statistical analysis may aid the forensic anthropologist when no other human skeletal remains suitable for sex determination are available.

Adult↗
PubMed1985

Diagnostic arthroscopy and longitudinal open lateral release: a safe and effective treatment for "chondromalacia patella".

Lateral release is a reliable component of any surgical treatment of patellofemoral dysfunction or "chondromalacia patella," good to excellent results in approximately 80% of cases having been reported by numerous investigators. This study confirms the efficacy of the procedure and highlights the features of the open technique as compared with the arthroscopic method. We advocate diagnostic arthroscopy for complete evaluation of the joint. Particular attention is drawn to the anatomic structures that must be divided and the care taken to secure hemostasis to optimize results. Since no correlation was found between the severity of chondromalacia and the final results, this study casts doubt on the value of shaving the rough articular surface.

Adolescent↗
PubMed1987

Arthroscopic measurement of chondromalacia of patella cartilage using a microminiature pressure transducer.

A microminiature pressure transducer was constructed to measure chondromalacia of the medial patellar facet under arthroscopic control. Normal and abnormal values were established. Among a group of 58 knees with no patellofemoral symptoms or signs, 30 knees measured "soft" using this instrument. Among a group of 107 knees with patellofemoral symptoms and signs, 98 knees measured "soft." Of these 98 knees, 55 had no observable change in the articular surface of the patella.

Adult↗