Management of patellar malalignment.
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Wedge recession is a method which utilizes the geometry of similar triangles to recess an articular wedge into the underlying bone. This concept has been applied to congenital luxating patellae in the dog. A trochlear wedge recession deepens the femoral trochlea and provides stability to the patella. Preliminary trials of the procedure in dogs produced excellent results.
Totally 165 cases of chondromalacia patellae, taken from a series of 240 patients, are presented. The cause of the chondromalacia lies in imbalances, displacements, dysplasias of patellae and in femoro-tibial axial deviations. Overload is the constant intermediary between the different starting causes and the same final result. The precocity of the clinical-radiological diagnosis is essential for the timely carrying out of a corrective surgery, directed to remove the starting causes before the reversible chondromalacia develops into irreversible arthrosis.
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A case of congenital bilateral lower limb deformities is presented. Diastasis of the distal tibia and fibula has the appearance of a severe clubfoot. Recognition of this condition and early surgical treatment are important. Tibial aplasia is best treated by disarticulation and early mobilization.
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We make a comparison of classification ability between BPN (Back Propagation Neural Network) and k-NN (k-Nearest Neighbor) classification methods. Voice data and patellar subluxation images are used. The result was that the average recognition rate of BPN was 9.2 percent higher than that of the k-NN classification method. Although k-NN classification is simple in theory, classification time was fairly long. Therefore, it seems that real time recognition is difficult. On the other hand, the BPN method is long in learning time but is very short in recognition time. Especially if the number of dimensions of the samples is large, it can be said that BPN is better than k-NN in classification ability.
This article reviews the applications of MR imaging of the patellofemoral compartment. Axial plane images are the most informative for abnormalities of this compartment. The role of MR imaging in the evaluation of the medial synovial plica and in the detection of chondromalacia is discussed. MR imaging can reliably detect and delineate the complex of injuries associated with patellar dislocations and valgus hyperextension.
This review focuses on the complications of extensor mechanism surgery for symptomatic patellar malalignment and ways to avoid those complications. We combined a review of new and referred patients who had complications resulting from extensor mechanism surgery with a review of selected literature specifically addressing similar complications. By studying the pathologic anatomy at the time of arthrotomy, it was possible in many cases to determine the causes of adverse outcomes with this type of surgery. The complications of extensor mechanism surgery can be avoided by performing a thorough preoperative evaluation, determining each component of the malalignment, tailoring the procedure to correct each patient's unique pathomechanics, and respecting the functional anatomy of the extensor mechanism.