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At least 1,135 records · Page 63Linked to original sources
PubMedDate not supplied

The percutaneous lateral retinacular release.

This study reviews 34 of 37 original patients who were reviewed in 1981 after previously undergoing percutaneous lateral retinacular release. Short-term satisfactory results regarding reduction of pain and prevention of dislocation were maintained on this second followup (average, 48 months). With this increase in postoperative time, patients with recurrent subluxation developed an increase in patellar slipping. Patients with chondromalacia and degenerative joint disease are less suited for long-term treatment. Long-term problems occurred in 1 of 34 patients (3%).

Follow-Up Studies↗
PubMedDate not supplied

Evaluation of patellar shape in the sagittal plane. A clinical analysis.

A prospective study of 564 patients was performed to assess the correlation between patellar shape as seen on a lateral radiograph and 1) patellar pain and 2) the radiologic determination of patellar height. A classification of patellar shape was developed based on the ratio of the patellar length to the length of the articular surface. Three classification types were established, including the "long-nosed," "Cyrano" type. Patients were placed into one of two groups based on the presence or absence of patellar pain. Lateral radiographs were evaluated for patellar height using two published indices. A significantly larger portion of Type II and Type III patellae was found in patients with patellar pain. Moreover, accepted measures of patellar height have to be used with caution in the presence of unusual patellar shapes.

Adult↗
PubMedDate not supplied

The diagnosis and treatment of medial subluxation of the patella after lateral retinacular release.

Five patients with medial subluxation of the patella occurring after isolated lateral retinacular release were treated between July 1985 and July 1989. The diagnosis was made by clinical examination. The patients complained of pain, swelling, and giving way after the lateral release. All five patients had increased medial passive patellar mobility, a positive gravity subluxation test, and a positive medial apprehension test. All patients failed conservative treatment. The patients were treated by reconstruction of the lateral retinaculum using sensory epidural anesthesia. At an average followup of 3.3 years, four of the five patients had no symptoms of instability and the medial patellar mobility and gravity subluxation tests were negative. There were three excellent and two good results using the grading system of Merchant and Mercer.

Adult↗
PubMed1979

An electromyographic investigation of subluxation of the patella.

An electromyographic investigation of patients with subluxation of the patella has been carried out on the parts of the extensor apparatus which actively contribute to the alignment of the patella, both before and after the operation to correct this disorder. The electromyographic pictures have revealed a sharp fall in the activity of the vastus medialis, with full recovery to normal values after a corrective operation. Even if the aligning function of the patella is altered by a variety of factors, the present study confirms the importance of the vastus medialis in the pathogenesis of malalignment of the extensor mechanism.

Adult↗
PubMed1981

Restoration of dynamic stability of the patella by pes anserinus transposition. A new approach.

Lateral instability of the patella was found after recurrent, habitual and permanent dislocations. Contracture of soft tissues lateral to the patella only occurred with habitual and permanent dislocations, but medial laxity was present in all cases. After adequate release of the lateral contracture, the medial stability was improved by transposition of the lower three-quarters of the pes anserinus to the medial border of the patella, and the patellar ligament. This created a relatively unstretchable physiological sling which ensured dynamic stability of the patella. Six recurrent, 21 habitual and nine permanent dislocations of the patella were treated by this method. Results were excellent in 21 patients, good in 13 and fair in two. The follow-up period varied from 21 to 84 months. There have been no recurrences to date.

Adolescent↗
PubMed2001

Bicipetal tenodesis for anterior subluxation of the superior tibiofibular joint.

A technique for stabilising the superior tibiofibular joint using an autogenous biceps graft passed through a tibial tunnel is described. The common peroneal nerve should be decompressed and the lateral inferior genicular artery protected. The technique proved to be safe and effective in two patients who were followed for at least two years.

Adolescent↗
PubMed2004

Inferior subluxation of the fibular head following tibial lengthening with a unilateral external fixator.

BACKGROUND: Inferior subluxation of the proximal part of the fibula has been reported to occur with distraction osteogenesis of the tibia; however, the clinical sequelae of this subluxation are unknown. The purpose of this study was to evaluate inferior subluxation of the proximal part of the fibula and its possible clinical implications in patients who had undergone tibial lengthening by distraction osteogenesis with use of a unilateral external fixator. METHODS: Thirty tibiae in seventeen patients with a variety of conditions underwent tibial lengthening by distraction osteogenesis with use of a unilateral external fixator and were followed clinically and radiographically for a mean of two years and ten months (range, two to four years). Ten patients were female and seven were male. Their mean age at the time of the surgery was seventeen years (range, eight to twenty-five years). The mean tibial lengthening was 8.1 cm (range, 3.5 to 13 cm). RESULTS: An inferior shift of the fibular head in relation to the tibia was evident in all cases. The shift, which ranged from 0.4 to 3.3 cm, was proportionally related to the amount of tibial lengthening. This type of subluxation is probably attributable to the tension that is exerted by the intact interosseous membrane during the distraction as well as to the tension of the regenerated bone of the fibula and the fact that the fibula itself is not fixed or directly lengthened by the external fixator. CONCLUSIONS: It appears that inferior subluxation of the fibula is a common phenomenon in patients undergoing tibial lengthening by distraction osteogenesis with use of a unilateral external fixator. However, no clinical symptoms or findings related to the inferior subluxation of the fibula were found in our series.

Adolescent↗
PubMed2005

UniSpacer arthroplasty of the knee.

BACKGROUND: The operative treatment of medial compartment knee arthritis is controversial. The purpose of the present study was to report the experience of a single surgeon with the UniSpacer arthroplasty for the treatment of isolated medial compartment arthritis of the knee. METHODS: From April 2002 through November 2002, thirty-seven UniSpacer arthroplasties were performed in thirty-four patients for the treatment of arthritis that primarily involved the medial compartment of the knee. The Ahlbäck radiographic evaluation scale was used to grade the severity of arthritis; the mean preoperative score was 2.6 points for the medial compartment and 0.5 point for both the lateral and patellofemoral compartments. The study group included eighteen women (nineteen knees) and sixteen men (eighteen knees) who had a mean age of fifty-five years (range, forty-two to seventy-five years) at the time of surgery. Twelve patients had had a previous arthroscopic meniscectomy. The mean preoperative Knee Society function score was 60 points (range, 40 to 80 points), and the mean preoperative Knee Society objective score was 62 points (range, 40 to 76 points). RESULTS: After a mean duration of follow-up of twenty-six months (range, twenty-four to twenty-nine months), there were no excellent, ten good, fifteen fair, and twelve poor results. The mean postoperative total function score was 69 points (range, 40 to 82 points), and the mean Knee Society objective score was 72 points (range, 45 to 88 points). Six of the twelve poor results were in knees that had dislocation of the UniSpacer. All twelve knees were revised to a total knee arthroplasty. CONCLUSIONS: On the basis of this experience, we do not recommend UniSpacer arthroplasty for the treatment of degenerative arthritis of the medial compartment of the knee.

Aged↗
PubMed1970

Patellectomy.

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Adolescent↗