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At least 937 records · Page 52Linked to original sources
PubMed1985

Medial and lateral gonarthrosis treated with high tibial osteotomy. A prospective study.

A prospective series comprising 52 knees in 48 patients suffering from medial or lateral unicompartmental gonarthrosis and treated by means of high tibial osteotomy shows, by comparing mechanical axis (MA) 0 degrees corrected knees, how important is the overcorrection of the MA into valgus in medial osteoarthritis. The clinical results were significantly correlated to overcorrection, the results 2 years postoperatively being better than those obtained at a follow-up 1 year after the operation. Of the results, 82% were good within a limit of +/- 3 degrees after 2 years, while only 77% were correspondingly good 1 year postoperatively. In lateral gonarthrosis overcorrection was not as good, but there was a mean overcorrection of +2 degrees, and with respect to this overcorrection, the results were quite acceptable. The results were directly correlated to the opening up of the joint space affected (80%) and diminution or disappearance of subluxation, 1/3 being 0 degrees preoperatively, 1/2 postoperatively in medial gonarthrosis. In lateral gonarthrosis, subluxation was increased, with 2/3 being 0 degrees preoperatively, 1/3 being 0 degrees postoperatively. The extension deficit in varus knees significantly diminished after valgus osteotomy; the change in valgus knees was also evident but not significant. The mean value of extension deficit was below 5 degrees in all cases at the 2 years' follow-up examination. However, 95% of all patients showed good or fair results after a follow-up period of 2 years.

Adult↗
PubMed1978

[Etiology of dislocation of the patella (author's transl)].

Using a new method for measuring the distal femoral torsion (Janssen a. Prüssner 1977) it is possible to determine the encreased medial torsion of the distal femur in most of the patients with dislocation of the patella. A group of patients with dislocated knee-cap was studied for this purpose. The characteristic clinical and x-ray features are listed and weighted according to their value. They throw a new light on the pathogenesis and pathomechanics of patellar luxation, and point to the need to reclassify the different types of luxations according to etiological aspects.

Adolescent↗
PubMed1995

[Etiological accident types and recommendations for prevention in basketball].

The study is based on 128 basketball accidents. The following accident types were discovered: ankle sprains 54.7%, handling the ball (saving and catching) 15.6%, knee-joint-distorsions 10.2%, collisions, blows and kicks 11.7%, falls 3.9%, spontaneous damage of muscles and tendons 1.6% and getting hurt because of the equipment in the gym 2.3%. Prophylactic precautions might be physiological or synthetic taping, proprioceptor training and preventive sports medical checkups.

Ankle Injuries↗
PubMed1998

Anterior cruciate ligament injury: fast spin-echo MR imaging with arthroscopic correlation in 217 examinations.

OBJECTIVE: Our objective was to evaluate the accuracy of MR imaging strategy that uses primarily fast spin-echo sequences for the diagnosis of anterior cruciate ligament tears. MATERIALS AND METHODS: The original clinical interpretations of MR images of 217 examinations of the knee joint were correlated with subsequent arthroscopic results. Each MR examination included a double-echo fast spin-echo sequence as the only imaging sequence in the sagittal plane. Subsequent discordant MR and arthroscopic examinations were then subjected to reanalysis by two observers who were unaware of arthroscopic results to determine if misinterpretations were observer or image dependent. Two hundred sixteen patients who underwent MR imaging for suspected internal derangement of the knee subsequently underwent arthroscopic surgery. Two patients had both knees evaluated. One patient was excluded because he was referred for evaluation for osteomyelitis, not internal derangement. This yielded a total number of 217 MR examinations for suspected internal derangement of the knee. RESULTS: For 56 arthroscopically proven tears, the sensitivity of MR imaging was 96%. The specificity was 98%, yielding an overall accuracy rate of 98%. The positive and negative predictive values were 95% and 99%, respectively. These values are within the ranges of previously reported MR imaging strategies using conventional spin-echo sequences. CONCLUSION: Fast spin-echo MR imaging of the knee can be an alternative to conventional spin-echo imaging for the detection of anterior cruciate ligament tears.

Adolescent↗
PubMed2001

[Anterior knee pain associated with sports and work].

Anterior knee pain is not a disease, but a syndrome with numerous causes. This paper describes its appearance in the patellofemoral joint in sportsmen and in untrained people. Chondromalacia patellae is a condition of the cartilage, not a disease, that is, it is never diagnosed alone. Relative muscular insufficiency, especially of the knee extensors, may occur in children and adolescents, as they grow rapidly. The consequence is a unbalance of active stabilizers and the disturbance of the slippery trail of patella, particularly in the presence of dysplasia of patellofemoral joint. The impingement syndrome pain occurs in sportsmen and people overloading the patellofemoral joint. Other causes of anterior knee pain should be excluded in clinical examination and slippery trail of patella, its position, and signs of instability should be determined. This paper gives an overview of patellar chondromalacia, lateral pressure syndrome, patellar subluxation, patellar acute and recurrent luxation, and idiopathic anterior knee pain. The treatment is basically conservative. Stretching exercises and the strengthening of certain groups of femoral muscles serves to regain the balance, thus normalising the slippery trail and taking off the burden from the patellofemoral joint. If conservative treatment fails, surgery is the alternative.

Athletic Injuries↗
PubMed1978

The snapping knee of infancy.

Three infants with generalized joint laxity and a negative family history had painful episodes of snapping of one or both knees caused by involuntary, momentary lateral subluxation of the tibia. These episodes of subluxation appeared to be due to involuntary contraction of the biceps femoris muscle. Older children learned to produce the phenomenon voluntarily. Treatment should be symptomatic, since the two children who were followed gradually stopped having involuntary subluxations.

Age Factors↗
PubMedDate not supplied

Congenital subluxation of the knee--an anatomic dissection.

The knee of an infant born with congenital subluxation was dissected to delineate the pathology involved. The primary findings of importance included isolated fibrosis of the vastus intermedius muscle, absence of the gastrocnemius muscle, anterior displacement of the hamstrings and contracture of the anterior joint capsule. Comparison with previously described pathology is discussed.

Humans↗
PubMed1976

Congenital deformities about the knee.

Congenital deformities about the knee are the result of abnormalities of all the anatomical structures that make up this joint. In some cases the structural changes observed are due to primary disorders of formation and growth of one or more of the anatomical components of the knee. Disorders are known to occur in the integumentary, muscular, ligamentous supporting, and skeletal systems. Examples of these disorders are seen in the bone dysplasias and joint laxity syndromes. In other cases exaggerated intrauterine positions of the limb seem to bring about certain adaptive changes in the embryological development of this joint. Epiphyseal dysplasias can lead to precocious arthropathy. Subluxation of the patella is often an indicator of a ligamentous laxity syndrome. It can also occur as a result of anatomical abnormalities of the femoral condyles or be due to congenital or acquired quadriceps fibrosis. Hypoplasia of the patella with dislocation is seen in the nail-patella syndrome.

Abnormalities, Multiple↗
PubMed1988

Patellofemoral joint motion: evaluation by ultrafast computed tomography.

Patellofemoral maltracking is a recognized cause of peripatellar pain. Measurements of the patellofemoral relationships during active motion are not available, and clinicians currently rely on observation, palpation, and static radiographic images to evaluate the symptomatic patient. Ultrafast computed tomography (ultrafast CT) offers objective observations of the dynamic influences of muscle contraction on the patellofemoral joint as the knee is actively moved through a range of motion from 90 degrees flexion to full extension. This study reports our initial observations and establishes a range of normal values so that patients with a clinical suspicion of patellar maltracking may be evaluated.

Adult↗
PubMed1980

Hinged total knee arthroplasty.

Analysis of an on-going prospective study of seventy-seven hinged total knee arthroplasties in sixty-seven patients revealed that most patients had improvement in function, although major complications occurred in eighteen knees (23.4 per cent. These complications included sepsis, loosening, patellar tendon rupture, peroneal palsy, and patellar subluxation. Eight of nine knees with deep sepsis required removal of the prosthesis, and three of sixteen knees with patellar pain required realignment of the quadriceps. When prosthetic failure occurred, salvage of a functional extremity was difficult. Hinged total arthroplasty is not without its problems, and a cautious approach to its use is indicated. Whenever possible, a moderately constrained replacement arthroplasty should be considered.

Adult↗
PubMed1993

Acute traumatic knee hemarthrosis.

A rapidly developing hemarthrosis in an acutely injured knee is reported to be associated with "surgically significant" lesions, such as anterior cruciate ligament tears, meniscus tears, and osteochondral fractures, in < or = 90% of cases. We report two cases of adult men who showed signs of such acute hemarthroses in stable knees after significant trauma. Neither had significant intraarticular pathology, such as meniscal, articular, or ligamentous injury, at arthroscopy. Persistent postarthroscopic bleeding led to additional diagnostic testing that found mild factor VIII deficiency. Hemophilia A and other clotting disorders should be considered by arthroscopic surgeons as a possible cause of a posttraumatic hemarthrosis.

Accidental Falls↗
PubMedDate not supplied

Paradoxical phenomena of the McMurray test. An arthroscopic investigation.

We evaluated 200 patients who had a positive McMurray test and found atypical McMurray test results in 24 patients (12%). These patients revealed pain or clicking or both either in the medial compartment of the knee when the leg was internally rotated or in the lateral compartment of the knee when the leg was externally rotated. The authors analyzed these paradoxical findings at arthroscopic examination to identify the relationship between the type of meniscal tear and the direction of leg rotation that elicited the catching and displacement of the torn meniscal portion during the McMurray test. Contrary to conventional McMurray test findings, three different types of meniscal tears were found on the side of the knee where pain or a clicking sound occurred. The three types were 1) anteriorly based posterior oblique tears with anterior displacement of the meniscus, 2) bucket-handle tears in the posterior half of the menisci, and 3) peripheral detachment of discoid menisci in the posterior half of the torn portions.

Adolescent↗
PubMed1981

[Correlation between arthrography and intraoperative findings in knee meniscus lesion (author's transl)].

The diagnosis of knee meniscus lesion as a result of clinical findings has a relatively high rate of failure. The arthrography of the knee joint is a low risk method of examination which is not burdening the patient. Arthrography compared with intraoperative findings shows a correlation of 97,0% in 132 operations performed. This testifies evidently the high diagnostic value of this radiological examination. It facilitates that decision to perform an arthrotomy in cases, clinical findings are not clear enough.

Adult↗
PubMed1980

[Ways of treatment in chronic lateral instability of the knee joint (author's transl)].

Chronic insufficiency of the lateral knee ligaments is more frequent than generally known. They are more troubling than a medial one. It exists only as a rotatory -- or combined ligament instability. For treatment the joint has to be inspected thoroughly; extraarticular corrections are mandatory. The common operative technics are described; special emphasis is laid upon Hughston's procedure for antero-lateral and postero-lateral instability.

Chronic Disease↗
PubMed1991

Extrusion of the medial meniscus.

Disruption of the anchoring points of the menisci of the knee has been hypothesized to result in subluxation of the affected meniscus from the articular surface. A case report of such an extrusion of the medial meniscus is presented. Medial subluxation of the meniscus from the tibiofemoral articulation occurred as a result of avulsion of the posterior horn with concomitant medial collateral and posterior cruciate ligament injuries.

Arthroscopy↗
PubMedDate not supplied

Kinematic MRI of the knee using a specially designed positioning device.

To evaluate the benefits of a specially designed positioning device, kinematic MR studies of the patellofemoral joint and the cruciate ligaments were performed. Handling of the device and positioning of the patient's leg were easy and took only a few minutes. The positioning device was helpful for patients to guide their joint motion and to obtain sufficient image quality for kinematic MR studies of both cruciate ligaments and the patellar tracking.

Adult↗
PubMed1987

Arthroscopy of the knee in children.

Diagnostic arthroscopy was performed in 174 consecutive patients under the age of 18 years. Eight arthroscopies were bilateral. The clinical diagnosis was confirmed in only three of 17 knees in children under aged 14 years and in 44 per cent of the knees in older children. The most commonly disproved diagnoses were torn meniscus and chondromalacia patella. Arthroscopy seldom changed the diagnosis in cases of osteochondritis dissecans. In 38 per cent of the knees, arthroscopy revealed no surgical treatable abnormality, and unnecessary arthrotomy was avoided. Arthroscopy in acute hemarthrosis revealed that ligamentous tears are rather common in children; in nine of 25 knees a partial or complete tear of the anterior cruciate ligament was demonstrated at arthroscopy. The clinical diagnosis was confirmed in eight knees in cases of hemarthrosis. There was no significant difference between the hemarthrosis group and the remaining group as regards a disproved clinical diagnosis. We conclude that arthrotomy should always be preceded by diagnostic arthroscopy in children and adolescents if the clinical diagnosis leaves any doubt.

Acute Disease↗
PubMed1983

EMG activity of the vastus medialis oblique and the vastus lateralis in their role in patellar alignment.

Using intramuscular electrodes the integrated electromyographic activity of the vastus medialis oblique and the vastus lateralis was examined in twenty normal females. The activity was recorded during the last thirty degrees of distal segment stabilized knee extension, when patellar subluxation commonly occurs. The electromyographic activity was normalized and expressed as a percentage of a maximal isometric contraction. Both muscles exhibited low levels of activity with no significant differences between the two. This study provides a quantitative method to assess whether muscular imbalance is present in patients with patellar subluxation.

Adult↗