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At least 991 records · Page 55Linked to original sources
PubMed2001

Dislocation of the knee with lateral dislocation of the patella. A report of four cases.

In a group of 25 patients with traumatic dislocation of the knee, four, all of whom had similar ligament and medial soft-tissue injuries, also had associated lateral patellar dislocation. In all four reconstruction was delayed because of their other serious injuries. Having encountered the combination of knee dislocation and lateral patellar dislocation in 16% of our patients, we believe that it may be less rare than is commonly believed. We think that it is important to maintain a high index of suspicion of possible patellar dislocation when medial structures have been severely damaged. Early recognition and immobilisation in extension can prevent fixed lateral dislocation of the patella.

Adolescent↗
PubMed2002

Deterioration of long-term clinical results after the Elmslie-Trillat procedure for dislocation of the patella.

We examined 39 patients (45 knees) who had undergone an Elmslie-Trillat procedure for recurrent or habitual dislocation of the patella with a follow-up of more than ten years. The mean age at the time of surgery was 18.4 years; the mean follow-up was 161 months (120 to 238). Using Fulkerson's functional knee score, 41 knees (91%) had an excellent or good result at a mean follow-up of 45 months, and this was maintained in 29 (64%) at the final review. The main cause of deterioration in the clinical results was the onset or worsening of patellofemoral joint pain, not patellar instability.

Adolescent↗
PubMed1992

[Morphological and numerical studies of the stress compatibility of patella implants].

Failure of total knee arthroplasty is relatively often caused by problems of the patellofemoral replacement. The purpose of this study was to analyze the distribution of stresses within an anatomical patella and the changes in stress distribution after patellar resurfacing with a Miller-Galante I patellar implant using two- and three dimensional finite element models (FEM). To assess validity, FEM results were compared with morphological findings from contact radiographs and densitographs. Internal orientation of bone trabeculae is in good agreement with the orientation of theoretically calculated principal stresses. Almost unchanged principal tensile stresses after implantation, together with the lack of extreme stress peaks within the cancellous bone ensure stress compatibility of the implant. In the case of a firmly seated implant with good bone ingrowth, increased von Mises stresses are found near the fixation peg/plate junction. Their relevance for improved bone ingrowth near this part of the interface is emphasized. At the same time, material failure at the peg/plate junction can be better understood. An analysis of the early postoperative period assuming nonlinear interface conditions failed to demonstrate an uniform distribution of normal and tangential interface forces.

Aged↗
PubMed1992

[Method for in vivo measurement of intraosseous pressure of the patella].

During the development of degenerative joint disease (osteoarthritis, chondropathy), a diagnostic or even pathogenetic role is attributed to the phenomenon of intraosseous pressure (IOP). Owing to technical problems and a lack of systematic experimental or clinical studies on the control mechanisms of the IOP, the actual importance of this factor is still not known with certainty. Now, a measuring method that enables correct recording of the IOP and standardized on-line processing of the measured signal minimize artefact-related problems. The technique is evaluated for reliability in an in vitro model of the human patella and in a limited clinical study of the IOP in patients undergoing knee surgery for various reasons. Factors such as intra-articular effusion, joint position or changes in intra-articular soft tissue are examined for their influence of the primary signal.

Female↗
PubMed2000

Nail-patella syndrome: identification of mutations in the LMX1B gene in Dutch families.

Nail-patella syndrome is an autosomal dominant disorder characterized by dyplasia of finger nails, skeletal anomalies, and, frequently, renal disease. It has recently been shown that this disorder is caused by putative loss-of-function mutations in a transcription factor (LMX1B) belonging to the LIM-homeodomain family, members of which are known to be important for pattern formation during development. A cohort of eight Dutch NPS families were screened for mutations in the LMX1B gene; seven different mutations, including one novel variant, were identified. Three of the mutations are very likely to result in truncated LMX1B proteins, three are predicted to influence sequence-specific DNA binding, and one is presumed to prevent the formation of a stable protein by abolishing the Zn(II) binding site of the protein. Although there was a remarkable high incidence of renal disease in one of the families, the nephropathy was not seen in all affected family members and the severity of renal impairment varied significantly among the patients. This indicates that the incidence and severity of nephropathy within this family cannot be attributed to the LMX1B genotype. In addition, evidence of a correlation between other characteristics of the NPS phenotype and specific mutations has not been found.

Base Sequence↗
PubMed1980

Anterior displacement of the tibial tuberosity in the treatment of chondromalacia patellae.

Anterior displacement of the tibial tuberosity combined with shaving of the diseased cartilage was used as treatment for chondromalacia patellae in 32 knees in 28 consecutive patients and in one patient with chondromalacia femoris. The patients were aged 17 to 57 years. One patient had earlier sustained a serious injury to the ligaments of the knee, resulting in instability. All patients except one were unfit for work before the operation. Postoperative extra-articular wound infection was noted in two knees and venous thrombosis occurred in three legs. The postoperative observation period varied from 8 months to 2 years and 10 months. In one knee the anterior displacement of the tibial tuberosity was not maintained. In lateral radiographs the anterior displacement of the tibial tuberosity in the other knees varied from 10 to 23 mm. The relief from pain obtained by the operative treatment was estimated as good in all knees except three, which were unchanged. All patients became fit for work and/or sport.

Adolescent↗
PubMed1980

Recurrent dislocation of the patella. Treatment by a modification of the method of McCarroll & Schwartzmann.

In a retrospective examination of 40 knees operated on according to a modification of the method of McCarroll & Schwartzmann, results ranging from good to excellent were seen in 68 per cent of the cases. Poor results partly attributable to synovitis and chondromalacia, were found in 20 per cent. Twelve per cent had recurrence of the dislocation. There was very little correlation between the preoperative X-ray and the final results. Open epithyseal plates were found to be a contraindication for the operation. The duration of the condition and the number of dislocations had no bearing on the end-results. The operative method is recommended for both traumatic and non-traumatic dislocations of the patella.

Adolescent↗
PubMed1980

Anterior displacement of the tibial tuberosity in chondromalacia patellae.

Sixty-eight knees in 62 patients wiht degenerative changes of the patellar joint surface, chondromalacia or arthrosis, were operated on with anterior displacement of the tibial tuberosity. Complications were encountered in no less than 22 joints and the results appeared to be somewhat related to these complications, particularly in women, even if a direct relationship between complications and remaining symptoms could not be demonstated. In a follow-up examination an average of 13 months after operation, approximately 90 per cent of the patients had improved, men as well as women. In an additional follow-up up, 30 months after operation, the men had maintained or even somewhat improved their good results whereas in women only about 70 per cent could not be classified as improved or free from symptoms. When those patients, who were not as regards all variables improved by surgery, were analysed separately, there was in this group a preponderance of women and particularly older women. Also, the patients with complications belonged to this group. Modifications of the surgical procedure did not seem to change the results nor were the results different in those patients in whom a superficial shaving of the articular cartilage of the patella had been added. The conclusion of the study is that anterior displacement of the tibial tuberosity has a lasting beneficial effect on patiens with degenerative changes of the patello-femoral joint.

Adult↗
PubMed1981

Chondromalacia patellae. The relation to abnormal patellofemoral joint mechanics.

Twenty-two patients treated non-operatively for chondromalacia patellae were followed up after an average of 5.7 years in order to evaluate the effect of abnormal patellofemoral biomechanics on the natural history of the symptoms. Clinical and radiological investigation revealed 15 patients with signs of malalignment, femoral trochlear dysplasia or excessive lateral pressure syndrome, 3 patients with marginal signs of malalignment and 4 patients with no demonstrable abnormalities. A statistically significant difference in the evolution of symptoms between the normal and the abnormal group is demonstrated, 14 out of 15 in the latter group having unchanged or worsened symptoms. The stage of chondromalacia change as judged arthrographically at the beginning of the observation period did not influence the clinical outcome.

Adolescent↗
PubMed1984

Krogius tenoplasty for recurrent dislocation of the patella. Failure associated with joint laxity.

Thirty-three patients treated with a Krogius tenoplasty for recurrent dislocation of the patella have been followed for an average of 3 years; the knees were classified according to Rünow. In 14 of 34 operated knees dislocations had recurred. Most of the recurrences were found in patients with generalized joint laxity, whereas only one of nine knees with only a high Insall index had redislocated. Patients with generalized joint laxity should not be treated with the Krogius tenoplasty as the sole procedure.

Adolescent↗
PubMed1986

Patellofemoral incongruence in chondromalacia and instability of the patella.

We measured the patellofemoral congruence in tangential radiographic projections according to Merchant in 64 patients with unilateral patellar pain. The congruence angle was usually within normal limits. However, compared with the asymptomatic side, the angle was increased in chondromalacia and instability of the patella. A comparison of congruence angles of the two knees seems more valuable than a comparison with normal values.

Adolescent↗
PubMed1987

A case of superior dislocation of the patella.

A 56-year-old woman with arthrosis of the knee sustained a fixed superior dislocation of the patella from a minor trauma. Closed reduction was performed. Only 3 other cases have been found reported in the literature.

Female↗
PubMed1989

A case of bilateral duplication of the patella.

A boy with bilateral duplication of his patellae was radiographically examined between 8 and 11 years of age. The duplication was probably caused by a disrupted fusion of two ossification centra.

Child↗
PubMed1990

Effect of glycosaminoglycan polysulfate on chondromalacia patellae. A placebo-controlled 1-year study.

The effect of glycosaminoglycan polysulfate (GAGPS) on damaged patellar cartilage and clinical symptoms of chondromalacia was studied on 31 patients in a placebo-controlled double-blind trial. The clinical diagnosis was confirmed by arthroscopy. The treatment consisted of 12 intramuscular injections of either GAGPS or placebo, and the patients were followed for 1 year. In 26 patients, rearthroscopy was performed at the 1-year follow-up. Comparison of the two arthroscopies showed improvement in 8/13 patients in the GAGPS group compared with 3/13 in the placebo group. The clinical parameters correlated well with the results of the arthroscopies. The results support the use of GAGPS for chondromalacia patellae.

Adult↗
PubMed2002

Giant-cell tumors of the patella.

This study describes the clinical, radiographic, and histopathologic features, and discusses the management options of 11 cases of benign giant-cell tumors of the patella seen over 20 years. Fine needle aspiration cytology was a useful preoperative diagnostic tool. Ptellectomy and reconstruction of the extensor apparatus is the favored treatment option with curettage and bone grafting restricted to selected localized lesions.

Adolescent↗
PubMedDate not supplied

The unstable patella after total knee arthroplasty: etiology, prevention, and management.

In total knee arthroplasty, most complications related to the extensor mechanism are caused by patellar maltracking or instability. Patellar maltracking may result from component malpositioning and limb malalignment, prosthetic design, improper patellar preparation, or soft-tissue imbalance. Patellofemoral instability likely results most frequently from internal malrotation of the femoral or tibial components. Although a patellofemoral radiograph may display the lateral subluxation of the patella, only computed tomography can quantify rotational malalignment of the femoral or tibial component. Nonsurgical treatment is generally unsuccessful; major malposition of components is best managed by implant revision. In the absence of component malposition, proximal realignments (lateral patellar retinacular release with lateral advancement of the vastus medialis obliquus muscle) or tibial tubercle transfers have been used. Surgical procedures on the patellar tendon itself may risk rupture of the extensor mechanism.

Arthroplasty, Replacement, Knee↗