Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Knee Dislocation”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,639 records · Page 91Linked to original sources
PubMed1979

Late results of Hauser procedure for recurrent dislocation of the patella.

To determine whether the Hauser procedure for recurrent dislocation of the patella prevents repeated dislocation and provides a functional knee without late degenerative arthritis, 52 patients with 67 surgically treated knees were studied clinically and roentgenographically with an average follow-up of 17.1 years. Greater than 70% of patients had an excellent or good result up to as long as 30 years postoperatively. There appeared to be no predisposition to the development of degenerative arthritis. Recurrent dislocation persisted in 7% of cases and female patients with generalized ligamentous laxity had a high incidence of persistant, recurrent dislocation and poorer long-term results. Development of genu recurvatum is a definite risk in patients who have tibial tubercle transfer prior to epiphyseal plate closure.

Adolescent↗
PubMed2002

The arthroscopic treatment of osteochondritis dissecans of the knee with autologous bone sticks.

PURPOSE: To present a new surgical technique for the fixation of partial dislocated osteochondral fragments in athletes with osteochondritis dissecans (OCD) of the knee. TYPE OF STUDY: Retrospective case series. METHODS: Autologous bone sticks were taken from the ipsilateral tibial metaphysis and used in the arthroscopic fixation of unilateral osteochondritis dissecans of the knee in 11 patients (5 female and 6 male). Patient age ranged from 11 to 20 years (mean, 16 years). Fixation of the partially dislocated fragments of the OCD of the knee was performed following a modified arthroscopic procedure and autologous bone graft. RESULTS: Follow-up ranged from 15 to 108 months (mean, 48 months). Based on modified criteria of Hughston et al., results were satisfactory in 90.9% and unsatisfactory in 9.1% of the cases. CONCLUSIONS: Arthroscopic fixation of OCD of the knee with autologous bone sticks is technically simple and nonaggressive and provides satisfactory results in most cases.

Adolescent↗
PubMedDate not supplied

[Which knee ligaments must be reconstructed in anterior and posterior valgus and varus instability? An experimental study].

This study aims to localize the ligamentous lesions in distinct knee joint instabilities. For that reason 41 human cadaver knee joint specimens were tested in a three-dimensional determined apparatus. Ligaments were successively dissected and forces and torques were introduced. Both cruciates are the dominant structures in preventing straight anterior und posterior movement of the tibia. As a supporting element the postero-medial capsule prevents anterior dislocation in ACL-deficient knees. Therefore extraarticular procedures in cruciate instabilities will not be successful. In contrast varus- and valgus instabilities resulted after transsection of a couple of ligaments. Valgus stability decreased after cutting the medial collateral, posterior oblique and both cruciate ligaments. The most important element in preventing straight varus instability was the lateral collateral followed by the posterior cruciate ligament, while the popliteus tendon had only little influence. Therefore in medial and lateral instabilities all supporting structures should be exposed and reconstructed.

Anterior Cruciate Ligament↗
PubMed2006

A laterally positioned concave trochlear groove prevents patellar dislocation.

Patellofemoral instability is a disabling condition that occurs in adolescence. Recurrence after patellar dislocation has been reported in 2-50% of patients. We compared the distal femur in patients with patellofemoral instability with distal femura of a healthy cohort using mathematical quantification of two-dimensional shape variation at the same position in different knees. One hundred eight computed tomography scans from 54 patients with patellofemoral instability were compared with 197 computed tomography scans from 102 subjects with normal knees. We used principal components analysis to quantify variation in shape of the trochlear groove as it allows comparison of knees with patellofemoral instability to healthy knees. We found that subjects who had dislocated their patella had a flattened trochlear groove, whereas normal knees had a more concave groove. The position of the trochlear groove was more medial in patients with patellofemoral instability compared with normal knees. Groove position was more important than shape when predicting which patellae were likely to dislocate.

Adolescent↗
PubMed2002

[Tibial plateau fracture following oblique osteotomy of the tibial tubercle: a case report].

Oblique osteotomy of the tibial tubercle is a preferred technique in patellofemoral disorders, resulting in a satisfactory clinical outcome. However, postoperative fractures of the proximal metaphysis of the tibia may often develop. An incomplete fracture of the lateral tibial plateau occurred in a 23-year-old female patient following an oblique osteotomy of the tibial tubercle. There was no history of trauma. The patient had undergone two operations in the same knee due to patellar instability. She also had bilateral high congenital hip dislocation. The correct diagnosis could only be made by computed tomography. Complete union was obtained following six weeks of plaster cast fixation. Due to inherent biomechanical limitations, complications may arise following oblique osteotomy of the tibial tubercle even adequate care is given to the surgical technique.

Adult↗
PubMed1997

[Congenital dislocation of the patella in children and adolescents].

Eleven patients were treated at Orthopaedic Unit of Pediatric Surgery Department because of congenital dislocation of the patellae between 1988 and 1995. In 4 cases the condition was bilateral. Mean follow-up was 3 years and 7 months. Surgical procedures of Ali-Krogius-Roux-Goldwaith or Ali-Krogius-Hauser were performed. According to Hall and Michelli classification 6 results were rated excellent, 4 good, 3 fair and 2 poor. Flexion contracture of the knee resolved in all cases. Surgery employed proved efficient in treatment for congenital dislocation of the patella.

Adolescent↗
PubMed2006

Trochleaplasty for recurrent patellar dislocation in association with trochlear dysplasia. A 4- to 14-year follow-up study.

We investigated the clinical and radiological outcome of trochleaplasty for recurrent patellar dislocation in association with trochlear dysplasia in 38 consecutive patients (45 knees) with a mean follow-up of 8.3 years (4 to 14). None had recurrence of dislocation after trochleaplasty. Post-operatively, patellofemoral pain, present pre-operatively in only 35 knees, became worse in 15 (33.4%), remained unchanged in four (8.8%) and improved in 22 (49%). Four knees which had no pain pre-operatively (8.8%) continued to have no pain. A total of 33 knees were available for radiological assessment. Post-operatively, all but two knees (93.9%) had correction of trochlear dysplasia radiologically but degenerative changes of the patellofemoral joint developed in 30% (10) of the knees. We conclude that recurrent patellar dislocation associated with trochlear dysplasia can be treated successfully by trochleaplasty, but the impact on patellofemoral pain and the development of patellofemoral osteoarthritis is less predictable. Overall, subjective patient satisfaction with restored patellofemoral stability after trochleaplasty appeared to outweigh its possible sequelae.

Adolescent↗
PubMed2000

Orthopaedic outcome of total knee replacement in haemophilia A.

A consecutive series of 16 patients with classical Haemophilia underwent 21 total knee replacements between 1989 and 1997 for haemophilic arthropathy. The patients received Factor VIII replacement therapy via continuous infusion, and fibrin glue was used to facilitate haemostasis. Three different types of prostheses were used. A follow-up evaluation was undertaken between 2 and 10 years after the operation (mean 5.6 years) and two patients with infection were excluded. Knee scores averaged 77.5 (pre-operative 24. 1) and functional scores averaged 84.4 (preoperative 23.2). There were no cases with aseptic loosening of the prosthesis. Complications included one early deep infection controlled by conversion of the TKR into an arthrodesis, one case of late septic loosening that had to be re-operated upon, one case of patellar dislocation, two cases of stiff knee (fibro-arthrosis) that required manipulation under anaesthesia, one postoperative hepatitis, one superficial infection treated by incision and drainage and four febrile patients with no clear source of infection, who responded to antibiotics alone. In conclusion, TKR offers haemophilic patients a long-lasting improvement of their quality of life and we therefore advocate its use with the appropriate indications.

Adult↗
PubMed2002

[Recurrent dislocation of the patella--arthroscopic therapy].

PURPOSE OF THE STUDY: The authors present results of the surgical treatment of the recurring patella dislocation. They use the surgical technique of medial percutaneous raphe by absorbable PDS suture and lateral release with arthroscopis assistance. MATERIAL: The operation was performed for recurring dislocation in 19 cases in 16 patients. Three patients underwent a surgery on both knees. The average age of patients was 22 years (range, 14-29 years). The average period after the surgery was 22 months (range, 12-45 months). Minimal number of dislocations prior to operation was 3, maximal more than 20. METHOD: The surgical technique consists in medial raphe by percutaneously inserted absorbable PDS suture with arthroscopic assistance and in performing a lateral release in the "closed manner" under the check of the arthroscope. After-care consists in the application of a rigid orthesis which is starting from the first postoperative day removed for physiotherapy by CPM. After two weeks a hinged orthesis is used with a gradual increase of the range of motion. After 6 weeks the patient starts full weightbearing without any fixation. The authors evaluated the results of the operation after Bentley. They also followed the duration of turniquet of the operated on limb, the duration of hospitalization and the period necessary for the achievement of the full range of motion. Radiograph was used for the determination of the shape of patella after Baumgartl and Wiberg, the angle of the femoral sulcus, the height of patella after the Insall-Salvati index and lateral shift of patella. Arthroscopic examination focused on the evaluation of the patellar and femoral chondromalacy and its classification after Outerbridge. Clinically, Q angle was measured, the axis of the limb, anxiosity test was made and the presence of crepitation was checked. RESULTS: Ninety per cent of the patients evaluated the condition after the surgery as very good or good, twice as poor. In one patient there occurred one recurrence of dislocation after the surgery. In the second patient after the surgery pain aggravated in connection with a severe degenerative damage of the femoropatellar joint. Neither avascular necrosis of the patella nor any more extensive bleeding was encountered. There was no infectious complication in the group of patients. Chondral lesion was recorded in 80% of patients. The degree of the damage increased with the number of dislocations. A frequent complication was a recurring knee effusion with the necessity of its evacuation. The relation between the number of dislocations and the final outcome of the surgery was proved. No patient with the number of dislocations 10 and more was evaluated as excellent. DISCUSSION: AS release and medial raphe is a surgical technique which brings very good and good results in a high number of patients. Independently performed raphe or release do not have comparable good results in the therapy of recurring dislocation. The authors' results do not differ from data in specialised literature. CONCLUSION: Arthroscopically performed lateral release and medial raphe by percutaneously inserted suture and with AS assistance has a number of unquestionable benefits. The performance is associated with only minimum complications. It reduces the duration of hospitalization, immobilization of the limb, duration of physiotherapy as well as the total duration of the incapacity to work. The cosmetic result is good. It is possible to operate on also on young patients prior to the final ossification in the area of the tibial tubercle. A prerequisite of a good result is an accurate performance of the operation and subsequent physical therapy. Contraindications include marked degenerative changes in the femoropatellar joint, instability of the knee, patella dislocation in TKR. Q angle exceeding 30 degrees and valgus deformity of the limb exceeding 15 degrees. A high number of dislocations and the resulting more severe damage to the cartilage reduce the potential for achieving excellent results.

Adolescent↗
PubMed1986

[Intra-articular knee stabilization with synthetic material. A practice-oriented stabilization technic].

An intra-articular method designed to stabilise the knee joint using synthetic material after rupture of the anterior cruciate ligament is described. The results obtained in forty dogs and two cats treated by this method during the period from 1980 to 1985, are reported. The morbid-anatomical findings within fourteen months after surgery are referred to in one case. Rejection of the ligament was not observed in a single case. When habitual or stationary medial dislocation of the patella was present in addition to a lesion of the anterior cruciate ligament, the patella was no longer found to be subject to dislocation following stabilisation of the knee joint. Clinical results ranged from moderate to satisfactory, varying with the degree of arthrosis and the lesions of the meniscus which were present. This technique does not take up much time and consequently saves expenses.

Animals↗
PubMed1994

Early results of total condylar knee arthroplasty.

A total of 109 consecutive total condylar knee replacements in 73 patients were assessed at one to eight years postoperatively. The average age at surgery was 66.9 years and the range was from 52 to 84 years. The primary disease was rheumatoid arthritis in 12 and degenerative osteoarthritis in 97 knees. Out of the 109 prostheses; 101 were Miller-Galante kinematic condylar type I or II prostheses, seven were Insall-Burstern type I or II and one was a Whiteside prosthesis. The fixation technique was hybrid (only the tibial prosthesis cemented) in 63, both components uncemented in two and both components cemented in 44 knees. One hundred and five (96.3%) knees showed significant improvement in the Hospital for Special Surgery score postoperatively. The average preoperative score was 48.1 and the postoperative score was 85.4. Sixty-four patients (100 knees) were satisfied or very satisfied with the result of surgery. One hundred and four (95.4%) knees had achieved either an improvement in the range of motion and/or deformity. Complications included loosening in four (3.7%) knees, infection in three (2.8%), dislocation of the patella in four (3.7%), periprosthetic fracture in one (0.9%) and severe lateral collateral ligamentous laxity in one (0.9%).

Activities of Daily Living↗
PubMed1997

Patellar dislocation in Rubenstein-Taybi syndrome.

This report describes 11 patients with Rubinstein-Taybi syndrome (RTS) and patellar dislocation. The age at diagnosis of patellar dislocation ranged from birth to 16 years. Ten patients had chronic dislocations and 8 of 11 had bilateral patellar dislocations. Eight patients required surgical stabilization of the patella; most achieved a good outcome with surgical repair. All families reported that the patellar dislocations impaired developmental skills which improved after surgery. Seven of the 11 patients were described as having other joint abnormalities including congenital dislocations and laxity of the joints. Patients with RTS should undergo regular thorough joint examinations, including the knees, because abnormalities may result in delay of attainment of motor skills.

Adult↗
PubMed1993

The mechanical cause of congenital dislocation of the hip joint. Dynamic ultrasound study of 5 cases.

5 hip joints with untreated congenital dislocation of the hip were examined for hip movement by ultrasound. With the hip joint flexed, the direction of the dislocated femoral head was posterior to the acetabulum. The dislocated femoral head displaced more posteriorly when the knee joint was extended, with the hip joint held in flexed position. As the dislocated hip was extended, on the other hand, the direction of the dislocated femoral head was anterior to the acetabulum. The dislocated femoral head displaced more anteriorly when the baby tried to bend the hip with the joint held in extended position. These findings indicate that a fetal posture with the hip flexed and the knee extended predisposes to the development of CDH by the action of hamstrings, and that an infant posture with the hip extended is likely to provoke femoral head dislocation by the action of the iliopsoas.

Biomechanical Phenomena↗
PubMed2006

Intramedullary total femoral replacement for salvage of the compromised femur associated with hip and knee arthroplasty.

Severely compromised femora because of prosthetic loosening, osteolysis, or periprosthetic fracture around total hip and knee arthroplasties are increasing. Two approaches that create an intramedullary total femoral (IMTF) replacement are reported. Twenty-three IMTF replacements in 22 patients were performed at 2 institutions. Seven revision total knee arthroplasties with a stemmed component were linked to a well-fixed hip stem with a custom intramedullary sleeve. Sixteen IMTF replacements involved revision of both hip and knee arthroplasties which were connected via an intercalary segment with morse taper junctions. Follow-up averaged 36 months. Complications included 2 dislocations, 2 deep infections, and 2 knee revisions for tibial loosening. Advantages over conventional total femoral replacement or ORIF include less dissection, maintenance of soft tissue attachments, and immediate component stability to allow for early mobilization.

Aged↗
PubMedDate not supplied

Neglected congenital permanent dislocation of the patella: a case report.

A 50-year-old man with asymptomatic bilateral congenital permanent dislocation of the patella had never been treated until two years following a fall on his left knee, on which occasion he had torn the lateral meniscus. In this unusual case, surgical treatment was performed to restore the power of the active extension in the left knee by removal of the torn meniscus. The results at 28 months following up were satisfactory for normal occupational activities.

Humans↗