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At least 901 records · Page 50Linked to original sources
PubMed2001

Total knee arthroplasty in an adult with congenital dislocation of the patella.

This article reports the use of total knee arthroplasty with release of the lateral retinaculum, proximal extensor mechanism realignment, and patellar resurfacing as a valid treatment option for adult patients with congenital dislocation of the patella who have absence of the femoral sulcus and associated osteoarthritis. The patient presented in this case report had improvement of his Knee Society knee score and function score from preoperative levels of 8 and 45 to 77 and 80 postoperatively.

Arthroplasty, Replacement, Knee↗
PubMed2003

Orthopaedic crossfire--All patellae should be resurfaced during primary total knee arthroplasty: in the affirmative.

Patients with inflammatory arthritis, crystalline deposition disease, or severe patellofemoral arthritis have superior functional results with patellar resurfacing as compared with patellar retention. The only remaining issue is whether there is any advantage to resurfacing or retention in patients with osteoarthritic knees in the absence of severe patellofemoral arthritis. Although the answer is still unclear from available prospective randomized clinical trials, the evidence leans toward routine resurfacing of the patella during primary total knee arthroplasty in osteoarthritic knees too. Evidence exists that the results of patellar retention in osteoarthritic knees deteriorate with longer follow-up study. Long-term follow-up evaluations of available prospective clinical trials will be needed to assess this controversy more definitively.

Arthroplasty, Replacement, Knee↗
PubMed2004

[Value of various MR sequences using 1.5 and 3.0 Tesla in analyzing cartilaginous defects of the patella in an animal model].

PURPOSE: Comparison of MRI and macropathologic evaluation using various sequences and field strengths in the detection, localization and measurement of cartilage defects in an animal model. MATERIALS AND METHODS: After open creation of retropatellar cartilage defects of various widths, depths and locations in 8 cadaveric sheep knee joints, the knees were examined using a fat-suppressed (FS), proton density-weighted (PD) fast spin echo (FSE), and 2D and 3D gradient echo (GE) sequences on 1.5 T and 3.0 T MR scanners. The images were analyzed by two independent radiologists in a blinded manner, by dividing the patella into 15 virtual segments. The results were correlated with the macropathologic findings with regards to location, width, and depth of the defects. RESULTS: The highest sensitivity (67.1 %), diagnostic accuracy (85.4 %), positive (87.3 %), and negative (84.7 %) predictive values in detecting defects were obtained using the 3.0 T FS-3D-GE sequence. The highest specificity (95.6 %) yielded the 3.0 T FS-2D-GE sequence, with the other sequences inferior by no more than 2.6 %. In general, FS-3D-GE sequences were superior to FS-2D-GE (3.0 T: p < 0.05; 1.5 T: p < 0.05) and especially to FS-PD-FSE sequences (3.0 T: p < 0.01; 1.5 T: p < 0.05). In determining the defects' widths, the 3.0 T FS-3D-GE sequence was superior to all other sequences (correct measurements: 50.0 %), with only slight superiority to the 1.5 T FS-3D-GE sequence (46.9 %, p > 0.05) but clear superiority to the other sequences (28.1 - 40.6 %, vs. 1.5 T FS-PD-FSE: p < 0.05, vs. other sequences: p > 0.05). To determine the defects' depths, the 1.5 T FS-3D-GE sequence was most reliable (correct measurements: 53.1 %), followed by the 3.0 T FS-3D-GE sequence (50.0 %, significance of difference: p > 0.05). CONCLUSION: In detecting cartilage defects, the field strength of 3.0 Tesla was only superior to 1.5 T MRI using fat-saturated 3D- or 2D-GE-sequences but not in fat-saturated proton density-weighted SE-sequences. In determination of depth and length of the defects, the higher field strength was not advantageous.

Adult↗
PubMed1990

[Chondropathia patellae--study of the femoropatellar joints of healthy, athletic children].

155 children, aged 8 to 13 years, who trained regularly, were examined clinically for signs of chondropathy patellae. As control group, 200 children of the same age were included who did not take part in any sports activities except in school. 32% of the training group children showed signs suggestive of chondropathy. With increasing training age, the part of children with these signs increased from 16% in the first to 45% in the third to fourth training year. Non-training children showed in 17% positive signs of chondropathy.

Adolescent↗
PubMed1993

[MRT-specific staging of chondromalacia patellae with the aid of a special knee compressor: a comparison with the arthroscopic findings].

The present study proposes a new MRI-specific staging of chondromalacia patellae (CMP) which is based on cartilage thickness decrease and signal intensity behaviour under compression as well as cartilage morphology in the plain image. The investigation was performed in 30 patients with varying knee complaints who underwent arthroscopy after MR imaging. It was demonstrated that three CMP stages can already be differentiated by MRI under compression in arthroscopically healthy cartilage. This proves a marked improvement in the early diagnosis of CMP.

Adolescent↗
PubMedDate not supplied

[Chondromalacia of the patella and intraosseous pressure. A study of 43 patients].

There are some hints concerning a relationship between the intraosseous pressure and degenerative changes in hyaline cartilage. With a specially constructed cannula we evaluated the intraosseous pressure in 43 patients in relation to the joint position (Extension/Flexion). In two groups we compared patients with and without degenerative changes in the hyaline cartilage, diagnosed by arthroscopy. Our results show, that patients with a chondromalacia have an increase of intramedullary pressure. These changes were discussed in the possible role of the pathology of chondromalacia patellae and retropatellar arthrosis.

Adult↗
PubMedDate not supplied

[Chondropathia patellae--a sequel of a primary neurogenic lesion?].

In twenty patients with a patellar pain syndrome (Chondropathia patellae) the quadriceps muscles were examined electromyographically. The study aimed for detection of neural lesions in the respective segments. According to Weh and Eickhoff (1983) nerve root lesions are the common cause for patellar pain syndrome. In their opinion malinnervation of the quadriceps leads to a muscular disbalance of the vastus medialis and lateralis and in consequence to an unphysiological traction of their patellar insertions that induces pain. Neither clinical data nor electromyographical findings gave any indication to believe that primary nerve root disturbances are a common cause for patellar pain syndrome.

Adolescent↗
PubMedDate not supplied

[Innervation disturbances of the quadriceps muscle in chondropathia patellae. A critical appraisal of the current concept of chondropathia].

In a group of patients with typical histories of chondropathy, but in whom no other criteria of selection were applied, evidence of neurogenic damage in the quadriceps muscle was found. Innervational damage was also found regularly in the corresponding segments of the paravertebral musculature. Only in three cases, in which horn cell damage was suspected, were there no changes in the paravertebral musculature. There were abnormal structural or functional findings in the lumbar spine in all the patients. A disequilibrium between the median and lateral vastus groups, attributable to innervation, was postulated and subsequently confirmed by electromyography. The nature of chondropathia patellae as an insertion tendopathy is discussed, taking the lack of concomitance of chondropathy and chondromalacia into consideration as well as the findings in the group of patients examined. Phenomena associated with chondropathy which have hitherto incongruous may be explained on the basis of an asymmetrical innervation disturbance.

Adolescent↗
PubMed1981

[Tuebingen positioning device for defilé-X-rays of the patella (author's transl)].

A positioning device for Defilé-X-rays of the patella ist presented which, in contrast to other constructions (separately suspended above the X-ray table), is mounted at the end of the X-ray table and permits fast, exact work. The X-ray technique corresponds with the procedure of Merchant. Details of this practical X-ray technique are discussed in comparison to the other developments presented recently.

Humans↗
PubMedDate not supplied

[Osteochondrosis dissecans of the patella (author's transl)].

This is a report on seven cases of osteochondritis dissecans patellae in which the diagnosis was made and operative treatment was performed. The clinical and roentgenological follow-up after an average of fourteen months shows that generally good results have been achieved by the fixation of the osteochondral fragments by cortical match stick grafts.

Adolescent↗
PubMed1984

[Is it possible to diagnose idiopathic chondropathia patellae using radiologic methods?].

In a retrospective study of 47 cases of chondromalacia proved by operation, a correct diagnosis had been made by arthrography in three cases. In 44 patients a false negative finding had been obtained. A prospective study was carried out comparing single and double contrast arthrography as well as double contrast arthrotomography and scintigraphy in ten patients with typical chondropathia. It was confirmed by arthroscopy in nine cases. Only two patients with severe chondromalacia showed abnormal findings by arthrography or scintigraphy. Our investigation has led to the conclusion that arthrography is not a suitable method for demonstrating idiopathic chondropathia of the patella.

Adolescent↗
PubMedDate not supplied

[Surgical treatment of chronic recurrent patella dislocations. Surgical procedure and results].

This is a report about a simplified operative technique of discission of the lateral retinaculum and vastus and medial drawing tight of the capsule. After the end of growth there will be always a medial transfer of the tuberositas tibiae at the same time by an undermining technique of osteotomy and osteosynthesis with a traction screw. Evaluation of our own 135 cases (1964-1981) with 27 only soft-tissue-operations and 108 combined operations by longterm-observations or recent control (115 cases with average observation period of 5,9 years). The number of reluxations of the patients, who had only a soft-tissue-operation, was as high as other reports; the primary number of reluxations after the combined operation was much lower (6,7%). By further conservative treatment or sometimes second operation none of our patients had any longer reluxations of the patella.

Adolescent↗
PubMed1980

[Diseases of the patella caused by clothing (author's transl)].

Fashionable clothing involving tight-fitting trousers and high heels forces human to adopt an attitude leading to diseases at the point of insertion of the tendons and of the cartilage of the patella. It is emphasized that malformations of the femoropatellar joint may possibly be caused by exogenous influences and may, therefore, be successfully treated by externally applied methods during the growth period.

Clothing↗
PubMed1983

Enthesopathic erosive lesions of patella and tibial tuberosity in juvenile ankylosing spondylitis. Anatomico-radiological study of a case with tibial bursitis.

The authors report the case of a 20-year-old joiner suffering from ankylosing spondylitis, with recurrent knee effusions from the age of 11 and radiological evidence of sacro-iliac involvement. The patient presented with pain and bone erosions localized to the sites of tendinous attachments in the upper pole of the left patella and in tibial tuberosities. On both sides an inflammation of deep infrapatellar bursa was observed on anatomical examination. These destructive lesions are considered as rare forms of the erosive enthesopathy which has been described in ankylosing spondylitis, particularly on spine and calcaneum. They could be considered as highly localized forms of algodystrophy.

Adult↗
PubMed2002

Long-term clinical results and radiographic changes in the nonresurfaced patella after total knee arthroplasty: 78 knees followed for mean 12 years.

We evaluated total knee arthroplasty without patellar resurfacing retrospectively in 50 patients (78 knees; 4 men (7 knees) and 46 women (71 knees) having a mean age of 63 (34-78) years and mean weight of 52 (32-72) kg). The preoperative diagnosis was osteoarthrosis in 26 patients (43 knees) and rheumatoid arthritis in 24 (35 knees). The mean follow-up was 12 (9-14) years. Only 3 patients (4 knees) had patellar pain and they all showed patellar subluxation. The latter was found in 13 other knees, all pain-free. We detected no differences between the knees with osteoarthrosis and rheumatoid arthritis concerning the incidence of patellar pain and patellar subluxation. No patient needed revision surgery for patellar problems. We question the need to resurface the patella routinely in total knee arthroplasty if it is congruous and well-aligned.

Adult↗
PubMed1957

An electron microscope study of the cytology of the protozoan Euplotes patella.

1. Structurally the "sensory bristles" in Euplotes patella are typical cilia, but no ciliary rootlets connect their bases. 2. The "neuromotor fibrils" are composed of filaments 21 mmicro in diameter. At the point of junction of the filaments with the peripheral ciliary fibrils a granular structure 65 to 90 mmicro in diameter is seen which has dense central and peripheral zones separated by a less dense layer. Information on the interconnection of organelles is expanded. 3. A system of subpellicular fibrils is described. The external fibrillar system described by others could not be found. 4. The motorium is shown to be a mass of intertwining rootlet filaments. 5. The micronucleus is shown to have a spongy, dense material in a less dense material, all of which is surrounded by a double-layered membrane. 6. The double-layered macronuclear membrane contains annuli whose outside diameter is 70 mmicro; the macronuclear bodies are sometimes closely applied to the membrane. In the macronuclear reorganization bands, the solution plane is a fine network, while the reconstruction plane is devoid of structure at the level of resolution observed. 7. The mitochondria are composed of tubules, only occasionally oriented, usually embedded in a surrounding material of lower density. 8. Microbodies whose diameters are 250 to 350 mmicro are frequently observed in close association with mitochondrial surfaces. 9. The food vacuoles, contractile vacuoles, and ciliary vacuoles are bounded by single-layered membranes. In the food vacuoles, the bacteria are surrounded by membranes individually or in small groups. 10. Cytoplasmic rods localized in the oral region, and cytoplasmic granules dispersed at random, are described. No typical ergastoplasm, endoplasmic reticulum, or Golgi material was observed.

Animals↗