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At least 19 recordsLinked to original sources
PubMed1975

Patella alta and patella infera. Their etiological role in patellar dislocation, chondromalacia, and apophysitis of the tibial tubercle.

The Insall-Salvati method of assessing the position of the patella was applied to four groups of patients:normal patients, and those with dislocation of the patella, chondromalacia of the patella, and apophysitis of the tibial tubercle. The ratio of patellar length to tendon length was 1.0 in the normal patients, 0.8 in the patients with dislocations, 0.86 in those with chondromalacia, and 1.2 in those with apophysitis of the tibial tubercle. Patella alta may be an important cause of dislocating patella and of chondromalacia patellae. The significance of the patella infera found in the Osgood-Schlatter lesion may be one of either cause or effect.

Adult↗
PubMed1975

[Recentering the patella in the treatment of external femoropatellar arthrosis with displacement of the patella].

The authors report their experiences of the surgical treatment of external femoro-patellar arthrosis with displacement of the kneecap, by recentering the kneecap, on knees that were not deformed as seen from the front. This recentering of the kneecap, which was monitored during the operation by radiographs with axial projection, was obtained by internal transposition of anterior tibial tuberosity and section of the external " wing " of the patella. No inert or living material was placed between the patella and the trochlea. The reduction in pain and the improvement in articular function depend on how well the patella is recentered. Twenty-two cases of external femoro-patellar arthrosis with displacement of the kneecap were treated in this way; in 18 operations, 14 results that remained favourable for more than 6 months have encouraged the authors to continue their trials and to abandon, at least for the time being, patellectomies and patelloplasties.

Bone Nails↗
PubMed1979

Proximal "tube" realignment of the patella for chondromalacia patellae.

In young people complaining of patellar pain there is often an anatomic basis (an increased quadriceps angle or a high-riding patella). Forty-eight knees with one or other of these abnormalities underwent proximal quadriceps realignment. The results were excellent or good in 94%. Shaving of chondromalacic cartilage was also done in 11 knees but did not seem to improve the results, and is not now recommended except for "blister" lesions. Extensor mechanism dysplasia is an etiologically correct name for the disorder and therefore preferable to "chondromalacia patellae."

Cartilage Diseases↗
PubMed1977

Heavy metal complexation in polluted molluscs. I. Limpets (Patella vulgata and Patella intermedia).

The accumulation of cadmium, zinc and copper by the marine gastropod molluscs Patella vulgata and Patella intermedia has been studied by gel permeation chromatography of water-soluble extracts of environmentally contaminated shellfish. A major proportion of the water-soluble cadmium and copper in these molluscs is associated with a protein of molecular weight 10 800 daltons. Evidence is presented supporting the similarity of this protein with mammalian metallothionein. This protein contained only a small proportion of the zinc found in the samples.

Amino Acids↗
PubMed1978

Osteotomy of the patella in chondromalacia. Preliminary report.

There are many factors involved in the aetiology of chondromalacia of the patella. If possible, the appropriate operative procedure should be chosen for each patient, hence attempting to eliminate the cause of softening of the cartilage. Increased pressure over the lateral facet, with or without reduced pressure over the medial facet of the patella, resulting from lateral positioning or tilting of the patella, the Wiberg/Baumgartl-types III and IV, and the "Hunter's Hat" form are important causes. With reduced pressure, the cartilage is inadequately stressed and consequently receives insufficient nourishment. As the medial facet is particularly thick and has little contact with the femoral condyle, nutritional disturbance is almost a normal occurrence. Longitudinal osteotomy of the patella has been found to improve the contact of the medial surface of the patella with the femoral condylar groove. The analgesic effect of this surgical procedure may derive from the resultant reduction in subchondral interstitial pressure, presuming that the pain in chondromalacia patellae, like that of osteoarthritis, is a manifestation of raised intramedullary pressure. To ensure an improvement in patellar tracking the osteotomy is combined with a lateral capsular release.

Adult↗
PubMed1992

The Elmslie-Trillat procedure for recurrent subluxation of the patella. One to five year follow-up.

Thirty-four patients who had undergone the Elmslie-Trillat procedure from 1985 to 1989 were examined in order to evaluate the effectiveness of this operation in the treatment of recurrent subluxation of the patella. The result of an increased Q angle accompanied by patella alta, femoral sulcus dysplasia, or vastus medialus obliquus dysplasia was also studied. Only those patients with recurrent subluxation of the patella took part in this study; cases of habitual or permanent dislocation, potential instability, traumatic dislocation, and degenerative arthritis were excluded. The patients were reviewed both clinically and radiographically, and the A.R.P.E.G.E. scoring system was used to evaluate the results. The follow-up period ranged from 1 year to 5 years and 4 months, with an average of 3 years. The overall results were excellent or good in 77% of the cases, as was the subjective knee stability rating in 87% of the cases and the pain rating in 82% of the cases. Recurrence of the subluxation was observed in only one instance. The results were not significantly different when the groups of patients with patella alta and type 1 femoral sulcus dysplasia were considered separately. The results were also excellent in the patients who underwent the Elmslie-Trillat procedure with reconstruction of the vastus medialis obliquus. In conclusion, surgical realignment of the anterior tibial tubercle confirmed its reliability in the treatment of recurrent subluxation of the patella. In cases of patella alta, the authors recommend lowering the anterior tibial tubercle only when the Insall-Burstein index is greater than 1.3. Femoral sulcus-plasty should be performed in cases of type 3 sulcus dysplasia.

Adolescent↗
PubMed1977

[Operative treatment of fractures of the patella (author's transl)].

Relative incongruance and great pressure in the femoro-patella joint are, besides the primary traumatic damage of the cartilage, responsible for frequent posttraumatic arthrosis and posttraumatic chondropathy of the patella after patellafracture. An operative reconstruction with a smooth joint surface of the patella is necessary. The only reliable method to fulfil these demands is the tension wire osteosynthesis by Pauwels, which, according to the type of fracture, can be combined with Kirschner wires and small fragment screws. The best access to the patella is established by diagonal incision. Open fractures must and closed fractures should be operated immediately. In comminuted fractures with devitalised cartilagefragments there is no indication to preserve the patella. Primary patellectomy has better results as late patellectomy. According to stability the after-treatment requires 4 to 6 weeks rest in a plaster cast. Although the operation can be performed with technical skill, arthrosis and chondropathy of the patella cannot always be avoided.

Aftercare↗
PubMed1976

Structure and function of the human patella: the role of cancellous bone.

Total joint and other prosthesis often require the removal and replacement of considerable quantities of cancellous bone, and often are anchored in place by grouting into cancellous bone. Thus, a possible source of failure or loosening of many types of prostheses may be rooted in the lack of understanding of the structure, properties, and function of this material. In addition, as we have pointed out before, cancellous bone may play an important biomechanical role in the etiology of joint degeneration. With these considerations in mind, the architecture of the cancellous bone in the human patella was studied by serial sectioning and microradiography, using an improved technique developed in our laboratory. Volumes of cancellous bone with apparently different functional roles were identified. Stereological techniques were used to quantify the structural characteristics and geometrical relationships throughout the patella. These results led to a structural model for the cancellous bone of the patella, and a comprehensive picture of the internal architecture. The distribution of mechanical compliance and yield stress was also measured, as a function of location and orientation, by a specially constructed microcompression testing machine. The measurements reflected the distribution of trabecular architecture, and both the properties and architecture reflected the gross biomechanical function of the patella. Furthermore, a true structure-function relationship was derived. Patellar contact area studies were performed on fresh cadavers and mapped for various angles of flexion. The variation in contact areas and the spatial variations in stiffness are discussed relative to the biomechanics and clinical aspects of the patella.

Biomechanical Phenomena↗
PubMed1977

[The lateral splitting of the knee joint capsule for treatment of chondropathia patellae (author's transl)].

This is a report on the results of the lateral splitting of the knee-joint capsule for treatment of chondropathia patellae. The operative procedure is described. Pains relative to the patella syndrome, chondropathia patellae, forms of dysplasia of the patella and lateral dislocation of the patella are regarded as indications. 50 knee-joints were post-examined. 26% were without complaints, 54% showed improvement, 10% no change, 10% deteriorated. These results are comparable to those of other, more intensive surgery. Representing a comparatively minor operation, the lateral splitting of the capsule is therefore particularly recommended for young patients.

Adolescent↗
PubMed1978

Patella alta and chondromalacia.

The Insall-Salvati method of determining the position of the patella by radiography was employed in fifty-one patients with chondromalacia patellae that had been proved at arthrotomy. There was no definite relationship between chondromalacia patellae and patella alta. There was, however, a highly significant statistical difference between the ratio of the length of the patella to that of the patellar tendon in normal men and women.

Adolescent↗
PubMed1979

Chondromalacia and recurrent subluxation of the patella: a study of malalignment, with some indications for radiography.

The authors adopted four parameters in a study of 100 normal subjects and fifty patients affected by "chondromalacia" or by recurrent subluxation of the patella. These were: the quadriceps angle, the ratio between the length of the patellar tendon and the length of the patella, the femoral sulcus angle, and the congruence angle between the femur and patella. These parameters showed a statistically significant increase in the pathological group, thereby demonstrating that the majority of cases of "chondromalacia" of the patella and those of recurrent subluxation constitute two entities forming part of the same disease, the basis of which is malalignment and malposition of the patella.

Adolescent↗
PubMedDate not supplied

The patella index as a guide to the understanding and diagnosis of patellofemoral instability.

An analysis of 1004 X-rays has demonstrated that the medial patella facet is significantly smaller in patients with patellofemoral instability. There is no such significant difference in the width of the whole patella. Therefore the longitudinal ridge separating the smaller medial facet from the larger lateral facet must be closer to the medial patella border. As this ridge articulates with the groove between the femoral condyles, its medial position is accounted for by the patella being more laterally positioned in patients with patellofemoral instability.

Bone Diseases↗
PubMedDate not supplied

The problem of chondromalacia patellae.

Daily activity subjects the human patella to forces often several times the individual's body weight. Healthy cartilage can adjust to these forces if they are not too excessive, concentrated, or repetitive. Such abnormal stresses most frequently occur with the disturbance of normal patellar mechanical function. Chondromalacia patellae is the result common to a wide variety of unusual traumata. Treatment must be directed primarily not toward the damaged patellar cartilage but toward a correction of the mechanical abnormality causing it. Until proven otherwise, a young female complaining of knee joint pain, particularly if bilateral, should be considered as suffering from a subluxating patella, with or without chondromalacia patellae.

Adolescent↗
PubMed1975

Cartilage of the patella. Topographical variation of glycosaminoglycan content in normal and fibrillated tissue.

The variation in the glycosaminoglycan content was studied at different sites of the patella, both where the cartilage was intact and where it showed varying degrees of fibrillation. It was found that when the cartilage surface was intact the glycosaminoglycan content was the same at the different sites of the patella. Local fibrillation always gave rise to a local lowering of fixed charge density, the magnitude of the latter correlating well with the visual assessment of the severity of the lesion. Even in the presence of severe lesions, if there was a site left on the patella where the cartilage was visually normal, its fixed charge density was also at a normal level. Thus, the depletion of glycosaminoglycans is a local phenomenon, limited to the area of fibrillation. The glycosaminoglycan content of normal cartilage is lower in the knee joint than in the hip. This fact, together with the existence of high pressure during load bearing, may be responsible for the greater frequency of destructive lesions affecting the cartilage of the patella compared with that of the hip.

Adolescent↗