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At least 883 records · Page 49Linked to original sources
PubMed2006

[Preliminary study on treating patellar instability guided by arthroscopy].

OBJECTIVE: To explore the operation method in treating patellar instability guided by arthroscopy and to evaluate its therapeutic effects. METHODS: Thirty-two patients (34 knees) with patellar instability including 2 patellar tilt (2 knees), 26 (27 knees) patellar subluxation, and 4 (5 knees) patellar dislocation, diagnosed by clinical and arthroscopical standard, were treated with anterior transfer of the gracilis or medial transfer of the tibial tuberosity based on the lateral retinacular release and medial tightening. RESULTS: Twenty-eight patients were followed up for 5-87 (mean 36.6) months. The excellence rates was 92.8%. CONCLUSION: The patellofemoral alignment can be seen directly and dynamically under the arthroscopy. The combinational treatment including anterior transfer of the gracilis in repairing patellar instability can avoid the recurrence effectively and get satisfactory results.

Adolescent↗
PubMed1997

Influence of lateral release on patellar tracking and patellofemoral contact characteristics after total knee arthroplasty.

The influence of lateral release of retinaculum on patellofemoral kinematics and contact characteristics after total knee arthroplasty was investigated in vitro. Lateral release altered the patellar tracking in patellar flexion, rotation, tilting, and translation. The contact force was decreased at high flexion angles. The contact area was slightly decreased and the contact region shifted laterally on the patellar button and medially on the femoral component at most of the flexion angles. The results suggest that the lateral release in total knee arthroplasty can change some patellar tracking and patellofemoral joint contact characteristics.

Cadaver↗
PubMed1994

Reactivation of rheumatoid arthritis in knees following total knee replacement.

Between May 1985 and December 1990, 20 patients with rheumatoid arthritis had 34 total knee replacements performed. The mean follow-up period was 4.1 years and the range was 2.3 to 7.8 years. Five knees with total knee replacements (74.7%) in 4 patients were affected by activation of the rheumatoid process at an average postoperative interval of 28.6 months while the other 29 knees with total knee replacements (85.3%) remained in remission. Factors that appeared to have an influence on post total knee replacement rheumatoid activation included the activity of the disease preoperatively, and whether synovectomy was undertaken at surgery. Whether patella replacement was undertaken appeared not to have influenced postoperative reactivation of the disease. Using the Hospital for Special Surgery Knee score, total knee replacement in our cases gave excellent results. The complications included one knee with dislocation of the patella and another with infection.

Aged↗
PubMed1997

MR imaging of meniscal subluxation in the knee.

PURPOSE: The aim of this study was to establish diagnostic criteria for meniscal subluxation, and to determine whether there was any connection between meniscal subluxation and other common meniscal and knee-joint abnormalities. MATERIAL AND METHODS: The normal position of the meniscal body was assessed in 10 asymptomatic volunteers. MR signs of meniscal subluxation were evaluated retrospectively in 60 symptomatic patients with pain in the knee, impaired mobility, and/or joint swelling who had no clear diagnosis after the evaluation of case history, clinical examination, and radiography. The criterion for subluxation of the meniscus was defined as a distance of > or = 3 mm between the peripheral border of the meniscus and the edge of the tibial plateau. RESULTS: In the volunteers, the mean distance from the medial meniscus to the edge of the tibial plateau was 0.07 mm, and that from the lateral meniscus was 0 mm. In 55 symptomatic patients without meniscal subluxation, the mean distance from the meniscus to the edge of the tibial plateau was 0.27 mm. Five patients (8%) had evidence of meniscal subluxation, 4 in the medial meniscus and one in the lateral meniscus. The most commonly associated knee abnormality was joint effusion in 5 knees and osteoarthritis in 2 knees. CONCLUSION: Meniscal subluxation was not a rare finding with MR imaging in patients with painful knees. Meniscal subluxation was associated with other knee abnormalities such as joint effusion or osteoarthritis.

Adolescent↗
PubMedDate not supplied

Bilateral simultaneous rupture of the infrapatellar tendon in a recreational athlete. A case report.

Bilateral rupture of the infrapatellar tendons is a rare event in an otherwise healthy athletic individual. The event is usually quite severe and diagnosis can be readily made on a clinical examination. In the case presented here, predisposing factors consisted of an underlying patella alta and a long history of repetitive trauma to the knee. Prompt diagnosis and surgical repair will lead to a good functional result.

Adult↗
PubMedDate not supplied

A fresh appraisal of tibial osteotomy for osteoarthritis of the knee.

A retrospective study was performed on 189 arthritic knees treated by tibial osteotomy at the Nuffield Orthopaedic Centre, Oxford, England to determine the quality of the results. The objective results were deduced from a numerical system of grading of pain, function, and movement, for 132 osteoarthritic knees. No statistical difference was found between high and low tibial osteotomies. Varus and male knees fared better than valgus and female knees. The result was significant only for the male varus group. Correction of the angular deformity had a profound influence on the results for varus but not for valgus knees. A joint tilt increase usually occurred and was associated with increased subluxation and instability in valgus knees but decreased or unchanged subluxation in varus knees. This was held to be an important cause of failure to achieve good results in valgus knees, and appeared to be an irremedial fault of tibial osteotomy.

Adult↗
PubMed1990

Congenital snapping knee. Habitual anterior subluxation of the tibia in extension.

We describe a rare form of congenital snapping knee. In six knees in four children, the tibia subluxed anteriorly on the femur when the knee was extended and reduced spontaneously on flexion. The abnormal movements were seen and felt as sudden snaps or clunks at about 30 degrees of flexion. All six knees showed similar dysplastic features, although the patients had different clinical syndromes. The mechanism of the subluxation and its management are discussed.

Child↗
PubMedDate not supplied

Surgical reconstruction of severe chronic posterolateral complex injuries of the knee using allograft tissues.

We report for the first time a reconstructive procedure of the posterolateral complex using allograft tissue to restore fibular collateral ligament function. The procedure is designed for knees where insufficient soft tissues are present and suitable autogenous graft tissues are not available. Twenty consecutive patients were studied; all returned for follow-up evaluation a mean of 42 months (range, 24 to 73) after surgery. The results were evaluated with the use of a comprehensive subjective and objective system that rated 20 factors. The success rate for the operative procedure was 76% (16 of 21 operations) as judged by knee stability examination and stress radiographs. Three of the reconstructions showed partial stretching and two failed. There was significant improvement from preoperative to follow-up scores of functional limitations in sports activities (P < 0.05), symptoms (P < 0.01), and overall scores (P < 0.0001). The immediate knee motion and rehabilitation program restored 0 degrees to 135 degrees of motion in all knees and was not deleterious to the reconstructions.

Activities of Daily Living↗
PubMed1991

[A differential diagnosis of quadricipital amyotrophy syndrome: bilateral disinsertion of the quadriceps tendon].

When it occurs bilaterally, disinsertion of the quadriceps tendons may suggest quadricipital amyotrophy syndrome. Questioning and physical examination of the locomotor system usually lead to a diagnosis of mechanical lesion involving the extensor mechanism of the knee. If necessary, this diagnosis can be confirmed by ultrasonography and MRI of the knee. A search for predisposing factors may result in a specific treatment, but only surgery provides functional improvement.

Aged↗
PubMed1984

[Treatment of chondral and osteochondral fractures of the knee joint].

This paper deals with the different surgical procedures which may be performed for reconstructing destroyed structures of the cartilage or for palliating pain in delayed cases. Persisting defects of the cartilaginous surface will lead to osteoarthrotic degeneration of the joint. Therefore, the authors emphasize the immediate surgical revision of the injured knee joint. The results obtained in this way are good, especially in younger patients.

Adolescent↗
PubMed2000

Assessment of patellar maltracking using combined static and dynamic MRI.

Between January 1995 and Jul 1997, 474 patients with anterior knee pain resistant to conservative treatment were referred for MR of the knee. The MR examination consisted of routine sequences with an additional patellofemoral dynamic examination using a technique that has been developed at this institution. The dynamic study examines both knees simultaneously, with the patient supine and the quadriceps loaded. No gating or restraint apparatus is needed. Patellar subluxation or tilt was present in 188(40%) of cases, bilateral in 104 and unilateral in 84 cases (right 39, left 45). It was classified as mild in 51%, moderate in 39% and severe in 10%. Subluxation was more prevalent in females than males (42% vs. 37%) and this was most obvious in the severe group where 68% were female. In 90 knees selected at random, four measurements of patellofemoral morphology were obtained using reconstructed images from a volume gradient echo sequence. These measurements were correlated with the degree of subluxation or tilt. A tibial tubercle distance greater than 20 mm, a femoral sulcus angle greater than 150 degrees, sulcus depth less than 4 mm were specific for subluxation but no measurement proved to be sufficiently sensitive to preclude a tracking study. MRI can be used to define more precisely the anatomy of the extensor mechanism and its relationship to the femur and tibia, in both a static and dynamic setting. In this way, patients with anterior knee pain can be classified more accurately and the outcomes of treatment more reliably assessed.

Adult↗
PubMed1978

Patella alta and gonarthrosis.

The frequency of patella alta as defined by the method of Insall & Salvati in knees with femoro-patellar osteoarthrosis was determined. Patella alta was six times as frequent in knees with osteoarthrosis than in those with a normal femoro-patellar joint. Patella alta is more common in women and is often bilateral.

Female↗
PubMedDate not supplied

Endoscopic lateral retinacular release: a preliminary report.

Thirty-nine knees with lateral subluxation syndrome of the patellofemoral joint were analyzed after 18 months of follow-up examinations. Based on subjective criteria, the results of lateral release by endoscopic technique compared favorably with other methods of treatment of patellofemoral malalignment. Excellent ratings based on the complete absence of symptoms and return to full activity were obtained in 19 knees (48.7%). Thirteen knees (33.3%) were improved with a subjective rating of 6.8 on a scale of ten; seven knees (18.0%) were rated poor with no improvement in symptoms or levels of physical activity.

Adolescent↗
PubMed1993

Ultrasonographic evaluation of patellar tracking in children.

Patellar positions with the knee in extension and in 10 degrees and 20 degrees flexion were measured by ultrasonography in both knees of 20 children with patellar dislocation and in both knees of 30 healthy children for controls. Ultrasonography proved to be applicable to measuring the distance between the most anterior point of lateral femoral condyle and patellar apex, the sulcus angle and the vertical position of the patella. Compared with normal knees, the sulcus angle was wider and the patellar position more lateral and cranial in both the dislocated and asymptomatic knees of the patients. These results suggest that false tracking of the patella in early flexion is a predisposing factor to patellar dislocation.

Adolescent↗
PubMed1996

Patellar tilt and subluxation following subvastus and parapatellar approach in total knee arthroplasty. Implication for surgical technique.

Eighty-nine posterior-stabilized total knee arthroplasties (TKAs) were studied using a Merchant view to assess patellar tilt or subluxation. Forty TKAs were performed via the subvastus approach (SVA) and 49 via the standard parapatellar approach (PPA). Intraoperative tracking was assessed using a "no thumbs" test, and a lateral release was performed if necessary. Following the SVA, 40.0% of patellas tracked centrally compared to 44.9% for the PPA. With the SVA, a lateral release was necessary in 27.5% of procedures compared to 51.0% for the PPA. The data suggest that the no thumbs test may overestimate the need for lateral release following the PPA. Since there are fewer lateral releases following the SVA, reapproximation of the medial retinaculum to assess intraoperative tracking may result in fewer lateral release being performed without adversely affecting patellar position. Medial tilting of the patella is also found to be common; 29.7% of the patellas tilted this way, including 40.0% of knees operated via the SVA. Why this occurs is unclear, but the incidence of medial tilting increased after posterior-stabilized TKA.

Biomechanical Phenomena↗