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Sample records for chondromalacia patellae

  1. Joint hypermobility in patients with chondromalacia patellae.

    Science.gov (United States)

    al-Rawi, Z; Nessan, A H

    1997-12-01

    The relationship between joint mobility and chondromalacia patellae was reported in a prospective study. A total of 115 patients with chondromalacia patellae were compared with 110 healthy individuals without chondromalacia patellae, matched for age and sex, who served as a control group. The degree of joint mobility was scored on a scale of 0-9. The number of individuals with hypermobile joints and the total mobility scores were significantly higher in patients with chondromalacia patellae when compared to the control group (P chondromalacia patellae when compared with the knees of the control group (P Chondromalacia patellae were bilateral in 57% of our patients. It occurred more frequently in the longer leg and was associated with quadriceps muscle wasting in 50% of patients. Flat feet and backache were reported significantly more often in patients compared with the control group (P chondromalacia patellae.

  2. Collagen crosslinks in chondromalacia of the patella.

    Science.gov (United States)

    Väätäinen, U; Kiviranta, I; Jaroma, H; Arokosi, J; Tammi, M; Kovanen, V

    1998-02-01

    The aim of the study was to determine collagen concentration and collagen crosslinks in cartilage samples from chondromalacia of the patella. To study the extracellular matrix alterations associated to chondromalacia, we determined the concentration of collagen (hydroxyproline) and its hydroxylysylpyridinoline and lysylpyridinoline crosslinks from chondromalacia foci of the patellae in 12 patients and 7 controls from apparently normal cadavers. The structure of the collagen network in 8 samples of grades II-IV chondromalacia was examined under polarized light microscopy. The full-thickness cartilage samples taken with a surgical knife from chondromalacia lesions did not show changes in collagen, hydroxylysylpyridinoline and lysylpyridinoline concentration as compared with the controls. Polarized light microscopy showed decreased birefringence in the superficial cartilage of chondromalacia lesions, indicating disorganization or disappearance of collagen fibers in this zone. It is concluded that the collagen network shows gradual disorganization with the severity of chondromalacia lesion of the patella without changes in the concentration or crosslinks of collagen.

  3. Bone density in patients with chondromalacia patella.

    Science.gov (United States)

    Salehi, Iraj; Khazaeli, Shabnam; Hatami, Parta; Malekpour, Mahdi

    2010-06-01

    Chondromalacia of the patella is the most common cause of anterior knee pain in young women. The etiology of the disease is not well-understood but the initial lesion is a disorganization of collagenous structures. Since the disease is proposed to be due to generalized constitutional disturbance, we postulated that bony structures could also be involved. To investigate this hypothesis we measured the bone density of 286 patients with the diagnosis of chondromalacia of the patella during a 4-year period using dual energy X-ray absorptiometry (DXA) method. We found a significant number of patients having low bone densities. This problem was more pronounced in men and in younger age groups. We suggest base-line bone density evaluation in all patients, treatment of osteopenia or osteoporosis in select patients and regular follow-ups using DXA.

  4. Intramedullary pressure of the patella in Chondromalacia.

    Science.gov (United States)

    Björkström, S; Goldie, I F; Wetterqvist, H

    1980-01-01

    Degenerative changes in load-bearing joints are often combined with altered intramedullary circulation. This may cause an alteration in intramedullary pressures. It has been said that articular symptoms are connected with a change in intramedullary pressures being high they are suspected to cause pain. In this investigation the intramedullary pressure has been evaluated in chondromalacia and osteoarthrosis of the patella. A comparison has been made with normal patellae. A biopsy needle was drilled into the intramedullary bone of the patella and connected with a registering unit. In a control group an average value of 19 mm Hg was registered. In the condromalacia group the mean intramedullary pressure was 44 mm Hg and in osteoarthrosis 37 mm Hg.

  5. Diagnosis of chondromalacia patellae using CT arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Reiser, M.; Karpf, P.M.; Bernett, P.

    1982-08-01

    Using anatomical specimens for experimental investigations, the physical-technical prerequisites for proper demonstration of the femoro-patellar articulation were determined and the following results obtained: hyaline cartilage possesses an attenuation value of 25-35 HU; artificial lesions from 1 mm. deep and 2 mm. wide minimum can be visualized; the use of positive contrast medium is best suited for demonstration of chondral lesions. In clinical practice we found that the various stages of cartilaginous degeneration peculiar to chondromalacia (Fruend I to III) are clearly demonstrated by CT arthrography. In CT the predisposing changes in the morphology of the patella and the femoro-patellar articulation are more precisely defined than in conventional tangential roentgenograms. In 69 cases the CT arthrographic findings could be verified at operation. However, the extent and severity of the lesions was, at times, underestimated.

  6. Patellofemoral Arthralgia, Overuse Syndromes of the Knee, and Chondromalacia Patella

    OpenAIRE

    1985-01-01

    Patellofemoral arthralgia is a very common syndrome affecting athletes. Most often, examination fails to define true pathology. Conservative treatment, an active exercise program, and sports may be undertaken without harm to the knee. The patellofemoral arthralgia syndrome must be differentiated from true chondromalacia patella, where there is actual degeneration of the patella's articular cartilage, and from other sources of internal derangement such as meniscal disease or osteochondral lesi...

  7. Chondromalacia Patellae Treated by Warming Needle and Rehabilitation Training

    Institute of Scientific and Technical Information of China (English)

    QIU Ling; ZHANG Min; ZHANG Ji; GAO Le-nv; CHEN Da-wei; LIU Jun; SHE Jia-yi; WANG Ling; YU Jin-yan; HUANG Le-ping; BAI Yang

    2009-01-01

    Objective:To observe the effect of wanning needle combined with rehabilitation training on chondromalacia patellae in a randomized controlled trial. Methods: The 92 cases were randomly divided into a treatment group treated by warming needle plus rehabilitation training (47 cases) and a control group treated by medication plus rehabilitation training (45 cases), and the therapeutic effect was compared after 20 sessions.Results: The pain was relieved more obviously in the treatment group than in the control group (P<0.05),and the total effective rate was 91.8% and 71.1% respectively (P<0.01). Conclusion: Warming needle plus rehabilitation training was superior in the therapeutic effect and duration of producing relief of pain to medication plus rehabilitation training in treating chondromalacia patellae.

  8. Correlation between subcutaneous knee fat thickness and chondromalacia patellae on magnetic resonance imaging of the knee.

    LENUS (Irish Health Repository)

    Kok, Hong Kuan

    2013-08-01

    Chondromalacia patellae is a common cause of anterior knee pain in young patients and can be detected noninvasively with magnetic resonance imaging (MRI). The purpose of our study was to evaluate the correlation between subcutaneous fat thickness around the knee joint on axial MRIs as a surrogate marker of obesity, with the presence or absence of chondromalacia patellae.

  9. [Selective training of the vastus medialis muscle using electrical stimulator for chondromalacia patella].

    Science.gov (United States)

    Guo, K; Ye, Q; Lin, J; Shen, J; Yang, X

    1996-04-01

    Chondromalacia patella is closely related with subluxation and tilt of patella, as well as with muscular atrophy of quadriceps, especially in vastus medialis muscle. 364 cases of chondromalacia patella were treated with selective training of the vastus medialis muscle using electrical stimulator in our hospital. 211 cases were followed up after treatment from 6 months to 3 years. Among them excellent and good results were seen in 130 cases (62%), fair results were seen in 69 cases (33%) and no change was seen in 12 cases (5%). Significant reduction of CA (P chondromalacia patella.

  10. Chondromalacia of the patella. Natural progression.

    Science.gov (United States)

    Verni, E; Prete, G D; Beluzzi, R; Prosperi, L; Martucci, E; Fedele, L

    1997-01-01

    A total of 42 cases of patellar pain in subjects aged an average of 17.2 years submitted to arthroscopy are analyzed. Femoropatellar balance, where indicated, led to resolution of disorders with full resumption of sports activity. In the remaining cases chondromalacia showed the features of an affection with a spontaneously favorable course, confirming the common orientation towards conservative treatment. Arthroscopy is effective for a correct classification of cartilaginous lesions, and it is a good instrument to use when attempting to achieve recovery of patellofemoral joint when disorders are caused by a lack of equilibrium.

  11. The Diagnostic Value of the Clarke Sign in Assessing Chondromalacia Patella

    OpenAIRE

    2008-01-01

    Context: Various techniques have been described for assessing conditions that cause pain at the patellofemoral (PF) joint. The Clarke sign is one such test, but the diagnostic value of this test in assessing chondromalacia patella is unknown.

  12. Chondromalacia.

    Science.gov (United States)

    Connors, G. Patrick

    Chondromalacia is the degeneration of the hyaline cartilage on the under surface of the kneecap. Its causes include patella maltracking (the kneecap does not glide properly over the joint), posttraumatic condition, and chronic overuse. The treatment can be a controlled rehabilitation program, various bracing techniques, foot orthoses, or, in…

  13. Increased serum cartilage oligomeric matrix protein levels and decreased patellar bone mineral density in patients with chondromalacia patellae.

    OpenAIRE

    2002-01-01

    BACKGROUND: Chondromalacia patellae is a potentially disabling disorder characterised by features of patellar cartilage degradation. OBJECTIVE: To evaluate markers of cartilage and bone turnover in patients with chondromalacia patellae. METHODS: 18 patients with chondromalacia patellae were studied. Serum cartilage oligomeric matrix protein (s-COMP) and bone sialoprotein (s-BSP) levels were measured by enzyme linked immunosorbent assay (ELISA) and compared with those of age and sex matched he...

  14. A correlative study between prevalence of chondromalacia patellae and sports injury in 4068 students

    Institute of Scientific and Technical Information of China (English)

    张辉; 孔祥清; 程琮; 梁茂华

    2003-01-01

    Objective: To study the prevalence of chondromalacia patella among college students and the correlation with sports injury. Methods: 354 students from gymnastic department and 429 from nongymnastic department with knee joint pain were selected. 184 students from gymnastic department and 342 from nongymnastic department were checked randomly by a surgeon. 77 patients (37 males, 40 females) from gymnastic department and 119 patients (62 males, 57 females) from nongymnastic department were diagnosed as chondromalacia patellae. The amount of exercise and the occurrence of sports injury were investigated in each student. All data were analyzed with SPSS 10.0 statistical software. Results: The prevalence of chondromalacia patella was 20.1% in female students and 11.6% in male students from gymnastic department, and 5.61% in female students and 4.92% in male students from nongymnastic department. The amount of exercise and the occurrence of sports injury to the knee joint in students from gymnastic department were greater than those from nongymnastic department. Conclusions: In both female and male students, the prevalence of chondromalacia patella is higher in gymnastic department than nongymnastic department. Sports injury is an important cause of chondromalacia patella.

  15. Evaluation of chondromalacia of the patella with axial inversion recovery-fast spin-echo imaging.

    Science.gov (United States)

    Lee, S H; Suh, J S; Cho, J; Kim, S J; Kim, S J

    2001-03-01

    The purpose of our study was to assess the accuracy of inversion recovery-fast spin-echo (IR-FSE) imaging for the evaluation of chondromalacia of the patella. Eighty-six patients were included, they underwent magnetic resonance (MR) examination and subsequent knee arthroscopy. Medial and lateral facets of the patella were evaluated separately. Axial images were obtained by using IR-FSE (TR/TE/TI = 3000/25/150 msec; echo train length, 8; 4-mm thickness; 12-cm field of view; 512 x 256 matrix; two, number of excitations) with a 1.5-T MR machine. MR interpretation of chondromalacia was made on the basis of the arthroscopic grading system. Of a total of 172 facets graded, arthroscopy revealed chondromalacia in 14 facets with various grades (G0, 158; G1, 1; G2, 3; G3, 6; G4, 4). Sensitivity, specificity, and accuracy in the chondromalacia grades were 57.1%, 93.0%, and 90.1%, respectively. There was one false-negative case (G4) and 11 false-positive cases (G1, eight; G2, two; G3, one). Sensitivity and specificity corrected by one grade difference were improved to 85.7% and 98.1%, respectively. When cartilage changes were grouped into early (corresponding to grade 1 and 2) and advanced (grade 3 and 4) diseases, sensitivity and specificity of the early and advanced diseases were 75% and 94% and 80% and 99%, respectively. IR-FSE imaging of the knee revealed high specificity but low sensitivity for the evaluation of chondromalacia of the patella.

  16. MR findings of chondromalacia Patella : correlation of the grade and associated lesions with arthroscopic findings

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Yon Su; Kwon, Soon Tae; Lee, Hwan Do; Kang, Yong Soo; Byun, Ki Yong; Rhee, Kwang Jin [Chungnam National Univ., Taejon (Korea, Republic of). Coll. of Medicine

    1998-02-01

    To assess the MR findings of chondromalacia patella and correlate the grade and associated lesions with the arthroscopic findings. Twenty-five patients with pain in the anterior part of the knee underwent fat-suppressed axial and coronal T2-weighted and T2-weighted imaging, using a 10-cm field of view, and a 5-inch general purpose coil. We retrospectively assessed these findings, and the locations, grades and associated lesions, and correlated these with arthroscopic findings. We evaluated the exact location and grade of chondromalacia patella and associated lesions, as seen on MR images. These and the arthroscopic findings showed close correlation, and in cases involving this condition, MRI is thus a useful indicator of an appropriate surgical method and plan. (author). 18 refs., 5 figs.

  17. Detection of Chondromalacia Patellae by Analysis of Intrinsic Mode Functions in Knee-Joint Vibration Signals

    Institute of Scientific and Technical Information of China (English)

    WU Yun-feng; CAI Su-xian; XU Fang; SHI Lei; Sridhar Krishnan

    2014-01-01

    This paper presents the knee-joint vibration signal processing and pathological localization procedures using the empirical mode decomposition for patients with chondromalacia patellae. The artifacts of baseline wander and random noise were identified in the decomposed monotonic trend and intrinsic mode functions (IMF) using the modeling method of probability density function and the confidence limit criterion. Then, the fluctuation parts in the signal were detected by the signal method turning for count. The results demonstrated that the quality of reconstructed signal can be greatly improved, with the removal of the baseline wander (adaptive trend) and the Gaussian distributed random noise. By detecting the turn signals in the artifact-free signal, the pathological segments related to chondromalacia patellae can be effectively localized with the beginning and ending points of the span of turn signals.

  18. The association of patellofemoral joint morphology with chondromalacia patella: a quantitative MRI analysis.

    Science.gov (United States)

    Tuna, Burcu Kaya; Semiz-Oysu, Aslıhan; Pekar, Bilhan; Bukte, Yasar; Hayirlioglu, Alper

    2014-01-01

    The relationship of patellofemoral congruency with chondromalacia patellae (CP) was retrospectively evaluated. Lateral patellar tilt angle (LPTA), sulcus angle (SA), trochlear depth (TD), and patella angle (PA) were measured at 301 knee magnetic resonance images and compared between groups with and without CP. In the CP group, LPTA and TD were significantly low (P.05). The parameters were also compared between groups with mild and severe CP, and no significant difference was found (P>.05). Our results demonstrate that patellar tilt and trochlear dysplasia are related to the presence but not the degree of CP.

  19. [Preliminary investigation on the pathogeny, diagnosis and treatment of chondromalacia patella].

    Science.gov (United States)

    Ye, Q B; Wu, Z H; Wang, Y P; Lin, J; Qiu, G X

    2001-04-01

    This paper presents the preliminary investigation on chondromalacia patella at our department in recent years. A random cluster sampling survey covering 2743 normal persons was carried out. The prevalence rate is 36.2%. It was found that, applying transmission electron microscope and immunohistochemical methods on to cartilage tissues of the abnormal region, articular cartilage necrosis was in direct proportion with the abnormal pressure, while the restoration capability of local chondrocytes was in inverse proportion with pathological changes and the pressure. The chondromalacia patella was produced by repeated abnormal stress acting on the cartilage. The stress derived from the uncongruency and the decreasing in the contact area of patellofemoral joint when the subluxation or tilt of patellae was caused by the abnormal anatomical and biomechanical relationship. The initial lesion was at the matrix of cartilage, the collagen network was disrupted, then proteoglycan was lost. The microenvironment of chondrocytes was changed with degradation of matrix. So the chondrocytes became degenerative and necrosis from superficial to deep layer, then feed back the matrix again. Finally, the total cartilage layer might disappear, and the bone under cartilage might proliferate. At late stage, the cartilage was completely destroyed and had no self-restorative ability. Therefore, early diagnosis and treatment are necessary. It is highly suggested axis radiograph of the knee with the tibiae tuberositas localization are helpful to early diagnosis. Furthermore, JKY-Muscle Rehabilitation Instrument is invented for non-operative therapy. It enhances muscle power by selective training of the vastus medialis muscle using electrical stimulator to relieve pain and correct subluxation of patella with 90% efficiency (63% of excellent-effective rate). In late stage, patellofemoral replacement is recommended. The excellent-effective rate is 86.3%.

  20. Outcomes of prolotherapy in chondromalacia patella patients: improvements in pain level and function.

    Science.gov (United States)

    Hauser, Ross A; Sprague, Ingrid Schaefer

    2014-01-01

    We retrospectively evaluated the effectiveness of prolotherapy in resolving pain, stiffness, and crepitus, and improving physical activity in consecutive chondromalacia patients from February 2008 to September 2009. Sixty-nine knees that received prolotherapy in 61 patients (33 female and 36 male) who were 18-82 years old (average, 47.2 years) were enrolled. Patients received 24 prolotherapy injections (15% dextrose, 0.1% procaine, and 10% sarapin) with a total of 40 cc in the anterior knee. At least 6 weeks after their last prolotherapy session, patients provided self-evaluation of knee pain upon rest, activities of daily living (ADL) and exercise, range of motion (ROM), stiffness, and crepitus. Symptom severity, sustained improvement of symptoms, number of pain pills needed, and patient satisfaction before treatment and improvement after treatment were recorded. Following prolotherapy, patients experienced statistically significant decreases in pain at rest, during ADL, and exercise. Stiffness and crepitus decreased after prolotherapy, and ROM increased. Patients reported improved walking ability and exercise ability after prolotherapy. For daily pain level, ROM, daily stiffness, crepitus, and walking and exercise ability, sustained improvement of over 75% was reported by 85% of patients. Fewer patients required pain medication. No side effects of prolotherapy were noted. The average length of time from last prolotherapy session was 14.7 months (range, 6 months to 8 years). Only 3 of 16 knees were still recommended for surgery after prolotherapy. Prolotherapy ameliorates chondromalacia patella symptoms and improves physical ability. Patients experience long-term improvement without requiring pain medications. Prolotherapy should be considered a first-line, conservative therapy for chondromalacia patella.

  1. Questioning and thinking about chondromalacia patellae%对髌骨软骨软化症的质疑与思考

    Institute of Scientific and Technical Information of China (English)

    高尚明; 赵晓峰; 郭海; 王云龙; 李丹丹; 王自平

    2013-01-01

    To question and discuss the diagnostic terminology, chondromalacia patellae. After consulting and reviewing the related literatures, it is proposed that chondromalacia patellae is just a process of early pathological changes of knee osteoarthritis, which should not be taken as the name of a separate disease. For such patients, knee osteoarthritis was the correct diagnosis, and the same treatment principle as that for knee osteoarthritis should be followed.

  2. Correlation between chondromalacia of patella and patella maltracking%髌骨软化症与髌骨轨迹异常改变相关性调查

    Institute of Scientific and Technical Information of China (English)

    苏学涛; 赵栋; 王景贵

    2012-01-01

    Objective To investigate the correlation between patella maltracking and chondromalacia of patella.Methods Sixty patients (79 knees)with chondromalacia of patella were collected from March 2006 to December 2008,and 60 volunteers without any symptom of knee joint were enrolled in this study.All of 120 cases were taken axial and lateral X-ray radiographies with knees flexing at 30 degree.Parameters (patella height,patella index,patella thickness,adaptation angle,patellofemoral joint index,lateral patella angle,angle of patella crab,condyles intergroove angle of femur and the rate of lateral patella excursion)were measured and analyzed.Results There were significant differences between chondromalacia of patella group and control group in condyles intergroove angle of femur,patellofemoral joint index,lateral patella angle and angle of patella crab[(137° ± 6°)vs (132° ± 4°),P<0.05;(1.05 ±0.23)vs (1.49 ±0.22),P<0.01;(7.6° ±2.4°)vs (5.3° ±2.3°),P<0.05;(10.8° ± 2.7°)vs (14.6° ± 3.3 °),P < 0.01].Patellofemoral joint index,lateral patella angle,patella index,condyles intergroove angle of femur and patella height contained in first principal component,which showed the abnormal changes of patella maltracking and the severity of chondromalacia of patella.Conclusions There is a close correlation between chondromalacia of patella and patellofemoral joint apposition.Patella is much easier to dislocate to lateral when the knee is flexing at 30 degree.Patients should take axial and lateral X-ray radiographies with knees flexing at 30 degree to make correct diagnosis and treatment.%目的 调查髌骨运动轨迹的异常改变与髌骨软化症之间是否存在相关性.方法 收集2006年3月至2008年12月在我院临床诊断为髌骨软化症的患者60例,共计79侧膝关节,摄屈膝30°轴位片及侧位片,进行髌骨高度、髌骨指数、髌骨厚度、适应角、髌股关节指数、外侧髌骨角、髌骨倾斜角、股沟角、髌骨

  3. Study on Diagnostic and Grading Value of MR for Chondromalacia Patellae%探讨MR对髌骨软化症的诊断及分级价值

    Institute of Scientific and Technical Information of China (English)

    周劲松; 叶德华; 孟晓峰

    2016-01-01

    Objective To analyze and study the diagnostic and grading value of MR for chondromalacia patellae and im-prove the medical level of our hospital. Methods 60 cases of patients with chondromalacia patellae treated in our hospital from August 2012 to August 2015 were selected as the experimental and research objects, all patients adopted MR diagno-sis method, the analytic and diagnostic results and the postoperative results were compared, and the diagnostic and grading value of MR for chondromalacia patellae was determined. Results The MR diagnosis showed that chondromalacia patellae in I stage occurred to 12 cases, chondromalacia patellae in II stage occurred to 17 cases, chondromalacia patellae in III stage occurred to 13 cases and chondromalacia patellae in IV stage occurred to 18 cases, and the diagnostic results were the same as the operation or arthroscopy diagnostic results. Conclusion The hospital can completely adopt the MR diagnostic method in the diagnosis and treatment of patients with chondromalacia patellae.%目的:分析探究MR对髌骨软化症的诊断及分级价值,提高该院的医疗水平。方法随机选取该院在2012年8月—2015年8月的60例髌骨软化症患者,作为实验研究对象。所有患者均采用MR诊断的方法,并将分析诊断后的结果与手术后的结果进行对比,判断MR对髌骨软化症的诊断及分级价值。结果 MR诊断髌骨软化症I期12例,II期17例,III期13例,IV期18例,与手术或关节镜检查诊断的结果完全一样。结论医院在对髌骨软化症患者进行诊断治疗时,可以完全采用MR诊断方法。

  4. Evaluation of the Chondromalacia Patella Using a Microscopy Coil: Comparison of the Two-Dimensional Fast Spin Echo Techniques and the Three-Dimensional Fast Field Echo Techniques

    OpenAIRE

    2011-01-01

    Objective We wanted to compare the two-dimensional (2D) fast spin echo (FSE) techniques and the three-dimensional (3D) fast field echo techniques for the evaluation of the chondromalacia patella using a microscopy coil. Materials and Methods Twenty five patients who underwent total knee arthroplasty were included in this study. Preoperative MRI evaluation of the patella was performed using a microscopy coil (47 mm). The proton density-weighted fast spin echo images (PD), the fat-suppressed PD...

  5. 髌骨软化症的研究进展%Research progress of chondromalacia patellae

    Institute of Scientific and Technical Information of China (English)

    李光辉; 高宏鹰

    2015-01-01

    Chondromalacia Patellae (CMP),a common and frequently-occurring disease,is the main reason for the pain of kneel.The cause of CMP is unclear,and there is no specific clinical treatment at present.This article describes briefly the various etiologies of CMP and then proposes the multi-factor interaction is the cause of it.Meanwhile,the article summarizes the status quo of the clinical diagnosis and analyzes the pros and cons of imaging diagnosis as well.Besides, treatments for CMP such as drugs, rehabilitation,massage,acupuncture,extracorporeal shock wave,knife,occupational therapy,surgery and gene therapy are reviewed in the article,and the conclusion that the effect of all the methods above is rather limited and hence individual treatment according to the cause and early prevention are significant.%髌骨软化症(CMP)是骨科常见病、多发病,是引起膝关节疼痛的常见原因。目前病因尚未明确,临床也无特效治疗方法。本文简述CMP的各种病因学说,提出多因素相互作用是导致该疾病的原因,并归纳临床诊断的现状和影像学诊断的利弊,回顾药物、康复、推拿、电针、体外冲击波、针刀、作业疗法、手术以及基因治疗的方法,总结上述方法治疗效果的局限性,提出根据病因进行个体化治疗的观点。

  6. [Chronic chondromalacia of the patella: comparison of morphological (magnetic resonance) and functional findings (isokinetic parameters) after rehabilitation].

    Science.gov (United States)

    Felicetti, G; Avanza, F; Fiori, M; Brignoli, E; Rovescala, R

    1996-01-01

    The knee is a common site for injuries of the cartilage, capsule and ligament, which calls for the use of noninvasive techniques to assess injury severity properly and to plan adequate rehabilitation. Our study was aimed at comparing MR with isokinetic findings. To this purpose, 40 patients were examined; they were all affected with chondromalacia patellae, grades I-III, previously diagnosed at arthroscopy. Namely, 8 patients had grade I and 32 grades II and III chondromalacia. After MR and isokinetic exams, all patients were submitted to a standardized rehabilitation program. Our results indicate a marked decrease in quadriceps strength, especially in the most severe cases; in less severe cases, recovery was complete at 6 months, while the deficit remained in grades II and III injuries. MR yield was not relevant in 4 of 8 cases, while isokinetic findings were negative in one case. Both methods were positive in the most severe cases. At 6 months, both functional and MR findings were normal in grade I injuries, while some alterations remained in the others.

  7. Outcomes of Prolotherapy in Chondromalacia Patella Patients: Improvements in Pain Level and Function

    OpenAIRE

    2014-01-01

    We retrospectively evaluated the effectiveness of prolotherapy in resolving pain, stiffness, and crepitus, and improving physical activity in consecutive chondromalacia patients from February 2008 to September 2009. Sixty-nine knees that received prolotherapy in 61 patients (33 female and 36 male) who were 18–82 years old (average, 47.2 years) were enrolled. Patients received 24 prolotherapy injections (15% dextrose, 0.1% procaine, and 10% sarapin) with a total of 40 cc in the anterior knee. ...

  8. 薄氏腹针疗法治疗髌骨软化症的临床研究%Clinical research on treating chondromalacia patella by acupuncture

    Institute of Scientific and Technical Information of China (English)

    成鲁杰; 徐辉

    2015-01-01

    目的:探讨薄氏腹针在治疗髌骨软化症中的临床疗效。方法:本文选取60例髌骨软化症患者,对其进行手法治疗与薄氏腹针疗法治疗,形成对照组与治疗组。结果:治疗组所使用的薄氏腹针疗法治疗效果明显高于对照组的治疗效果,治愈率在92%以上。结论:薄氏腹针这一疗法对髌骨软化症起到了有效的治疗作用。薄氏腹针疗法是由薄智云先生所研究的针刺方法,在对髌骨软化症的治疗方面不但疗效显著,而且患者痛苦小并乐于接受,是一种非常安全有效的治疗方法。%Objective: To investigate clinical efficacy of acupuncture on chondromalacia patella. Methods: 60 cases of chondromalacia patella were divided into the control group and the treatment group. The control group was given manual therapy; and the treatment group was treated by acupuncture. Results: The efifciency in the treatment group was more than 92%, better than that in the control group. Conclusion: Acupuncture on chondromalacia patella shows a signiifcant effect, and with less pain.

  9. Chrondoblastoma of the patella

    Energy Technology Data Exchange (ETDEWEB)

    Moser, R.P. Jr.; Brockmole, D.M.; Vinh, T.N.; Kransdorf, M.J.; Aoki, J.

    1988-09-01

    This study reviews 16 cases of chondroblastoma of the patella which constitute mearly 6% of a large group of chondroblastomas scattered throughout the skeleton. Both radiologic and histologic appearances of chondroblastomas of the patella are indistinguishable from those of chondroblastomas arising in other sites. A reasonable differential diagnosis, including chondromalacia patella, is discussed together with important therapeutic considerations.

  10. Quantitative Comparison of 2D and 3D MRI Techniques for the Evaluation of Chondromalacia Patellae in 3.0T MR Imaging of the Knee

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    Ali Özgen

    2016-09-01

    Full Text Available INTRODUCTION: Chondromalacia patellae is a very common disorder of patellar cartilage. Magnetic resonance imaging (MRI is a powerful non-invasive tool to investigate patellar cartilage lesions. Although many MRI sequences have been used in MR imaging of the patellar cartilage and the optimal pulse sequence is controversial, fat-saturated proton density images have been considered very valuable to evaluate patellar cartilage. The purpose of this study is to quantitatively compare the diagnostic performance of various widely used 2D and 3D MRI techniques for the evaluation of chondromalacia patellae in 3.0T MR imaging of the knee using T2 mapping images as the reference standard. METHODS: Sevety-five knee MRI exams of 69 adult consecutive were included in the study. Fat-saturated T2-weighted (FST2, fat-saturated proton density (FSPD, water-only T2-weighted DIXON (T2mD, T2-weighted 3 dimensional steady state (3DT2FFE, merged multi-echo steady state (3DmFFE, and water selective T1-weighted fat-supressed (WATSc images were acquired. Quantitative comparison of grade 1 and grade 5 lesions were made using contrast-to-noise (CNR ratios. Grade 2-4 lesions were scored qualitatively and scorings of the lesions were compared statistically. Analysis of variance and Tukey’s tests were used to compare CNR data. Two sample z-test was used to compare the ratio of MR exams positive for grade 1 lesions noted on T2-mapping and other conventional sequences. Paired samples t-test was used to compare two different pulse sequences. RESULTS: In detecting grade 1 lesions, FSPD, FST2 and T2mD images were superior in comparison to other sequences. FSPD and FST2 images were statistically superior in detecting grade 2-4 lesions. Although all grade 5 lesions were noted in every single sequence, FST2 images have the highest mean CNR followed by 3DT2FFE images. DISCUSSION AND CONCLUSION: FST2 sequence is equal or superior in detecting every grade of patellar chondromalacia in

  11. 针刺、按摩配合拍打疗法治疗髌骨软化症的应用研究%Application study of acupuncture,massage and flapping therapy in treatment of chondromalacia patellae

    Institute of Scientific and Technical Information of China (English)

    卢铁元; 梁宇; 韩泽汉

    2013-01-01

    目的:达到髌骨软化症在早期诊断中得到及时发现并及时施以治疗。方法用实验法对60名髌骨软化症患者分组进行治疗并观察疗效。结果针刺、按摩配合拍打疗法明显优于传统疗法,且治愈率高,疗效显著。结论针刺、按摩配合拍打疗法对髌骨软化症有显著疗效,明显优于传统的针刺按摩技术。%Objective To achieve the timely detection and timely treatment of chondromalacia patellae. Methods Sixty patients with chondromalacia patellae were divided into groups according to the experimental method.The patients received treatment by group and the effects were observed. Results Acupuncture, massage and flapping therapy was significantly better than traditional therapy,with higher cure rate and more significant efficacy. Conclusion Acupuncture,massage and flapping therapy shows significant efficacy in the treatment of chondromalacia patellae and is obviously better than traditional acupuncture and massage techniques.

  12. Evaluation of the Chondromalacia Patella Using a Microscopy Coil: Comparison of the Two-Dimensional Fast Spin Echo Techniques and the Three-Dimensional Fast Field Echo Techniques

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    Kim, Hyun Joo; Lee, Sang Hoon; Kang, Chang Ho; Ryu, Jeong Ah; Shin, Myung Jin; Cho, Kyung Ja; Cho, Woo Shin [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2011-02-15

    We wanted to compare the two-dimensional (2D) fast spin echo (FSE) techniques and the three-dimensional (3D) fast field echo techniques for the evaluation of the chondromalacia patella using a microscopy coil. Twenty five patients who underwent total knee arthroplasty were included in this study. Preoperative MRI evaluation of the patella was performed using a microscopy coil (47 mm). The proton density-weighted fast spin echo images (PD), the fat-suppressed PD images (FS-PD), the intermediate weighted-fat suppressed fast spin echo images (iw-FS-FSE), the 3D balanced-fast fi eld echo images (B-FFE), the 3D water selective cartilage scan (WATS-c) and the 3D water selective fluid scan (WATS-f) were obtained on a 1.5T MRI scanner. The patellar cartilage was evaluated in nine areas: the superior, middle and the inferior portions that were subdivided into the medial, central and lateral facets in a total of 215 areas. Employing the Noyes grading system, the MRI grade 0-I, II and III lesions were compared using the gross and microscopic findings. The sensitivity, specificity and accuracy were evaluated for each sequence. The significance of the differences for the individual sequences was calculated using the McNemar test. The gross and microscopic findings demonstrated 167 grade 0-I lesions, 40 grade II lesions and eight grade III lesions. Iw-FS-FSE had the highest accuracy (sensitivity/specificity/accuracy = 88%/98%/96%), followed by FSPD (78%/98%/93%, respectively), PD (76%/98%/93%, respectively), B-FFE (71%/100%/93%, respectively), WATS-c (67%/100%/92%, respectively) and WATS-f (58%/99%/89%, respectively). There were statistically significant differences for the iw-FS-FSE and WATS-f and for the PD-FS and WATS-f (p < 0.01). The iw-FS-FSE images obtained with a microscopy coil show best diagnostic performance among the 2D and 3D GRE images for evaluating the chondromalacia patella

  13. 关节镜下微创治疗中度髌骨软化症%Arthroscopy-assisted minimally invasive treatment of chondromalacia patella

    Institute of Scientific and Technical Information of China (English)

    肖勋刚; 成明华; 李康杰; 何波勇; 周毅; 刘建伟

    2010-01-01

    Objective To study the arthroscopy-assisted minimally invasive treatment of chondromalacia patella. Methods The clinical data of 140 patients with chondromalacia patella, with a mean age of 51.9 ± 5.71 years ( range, 41 to 62 years), undergoing surgical or Non-surgical treatment in our hospital from June 2005 to December 2008 were analyzed. In non-surgical group, 72 cases (96 knees) underwent intra-articular injection of sodium hyaluronate and other non-surgical treatment. In surgical group, 68 cases (84 knees) underwent variorus Arthroscopy-Assisted minimally invasive surgery, according to the extent of the patella cartilage injury and the situation of the patellofemoral joint. Joint functional exercise were carried out after operations. Regular follow-up were done after leaving hospital. Lysholm scoring system was used to evaluate the clinical effects. Judet's evaluation criteria was used to evaluate the improvement of range of motion. Results In non-surgical group, the knee function have been improved 24. 82%. In surgical group the knee function have been improved 35.37%. At the postoperative and final follow-up, the effect in surgery group was significantly better than non-surgical group. Conclusion For the chondromalacia patella with Ⅱ, Ⅲ class cartilage injury, minimally invasive arthroscopic surgery is a good treatment method, which can reduce pain, improve function, slow down the progress of the disease, and improve the quality of life of patients.%目的 研究关节镜辅助下微创治疗中度髌骨软化症的疗效.方法 对本院2005年6月至2008年12月收治的140例患者,年龄41~62(51.9±5.71)岁;病程4~11(6.3±4.12)年.采用不完全随机分组的方法,分为非手术组72例(96膝),采用关节腔注射玻璃酸钠等非手术治疗;手术组68例(84膝),术前根据髌骨软骨损伤程度和髌股排列情况,选择合适的微创手术方式.术后均进行合理的关节功能锻炼等,出院后定期随访.依据Lysholm评

  14. Curative effect observation of traditional Chinese medical method in the treatment of chondromalacia patella in 100 cases%中医手法治疗髌骨软骨软化症100例疗效观察

    Institute of Scientific and Technical Information of China (English)

    曹礼; 肖潇

    2015-01-01

    Objective:To observe the curative effect of traditional Chinese medical sleight in the treatment of chondromalacia patella.Methods:100 cases of patients with chondromalacia patella were selected from March 2012 to March 2013.They were randomly divided into two groups.The observation group was given traditional Chinese medicine massotherapy,pushing the patella and knee joint stretching method;the control group was given oral glucosamine hydrochloride capsules,the course was 30 days,the patients were followed up for 3 months after treatment.Results:The observation group and the control group in the clinical curative effect had difference(P<0.05).The observation group was better than the control group.Conclusion:The traditional Chinese medicine massotherapy,pushing the patella and knee joint stretching method can improve the symptoms of chondromalacia patella and improve the quality of life.%目的:观察中医手法治疗髌骨软骨软化症疗效.方法:2012年3月-2013年3月收治髌骨软骨软化症患者100例,随机分为两组,观察组采用中医提拿、推拨髌骨以及膝关节牵伸手法,对照组口服盐酸氨基葡萄糖胶囊,疗程30 d,治疗后均随访 3 个月.结果:观察组与对照组临床疗效差异有统计学意义(P<0.05),观察组优于对照组.结论:中医提拿、推拨髌骨以及膝关节牵伸手法能改善髌骨软骨软化症患者的症状,提高生活质量.

  15. 髌股关节形态学与髌骨软化症之间相关性研究%Correlation between patellofemoral morphology and chondromalacia patellae

    Institute of Scientific and Technical Information of China (English)

    贾梦岩; 史占军; 肖军; 杨德盛; 黄志发

    2016-01-01

    Objective To measure the morphological parameters of patellofemoral joint on MRI and analyze the etiological correlation between patellofemoral morphology and chondromalacia patellae (CP). Methods 371 adult patients undergoing MRI examination were enrolled and those diagnosed with CP were included in the CP group(n=124)and others in the control group(n=247). Prevalence rates of CP were recalculated and grouped according to gender. The lateral patellofemoral angle, sulcus angle, trochlear depth and lateral trochlear inclination angle were measured in the MRI images on axial slices. The CP group was further divided into a mild and severe CP subgroup according to the degree of cartilage damage. The difference of patellofemoral morphology parameters among the CP group and control group, CP group (mild) and CP group (severe) were compared and the relationships among patella tilt, trochlear dysplasia and CP were further analyzed. Results The prevalence rate of CP was 33.42%, of which 49.35%was in women and 22.12%was in men. Significant differences in the lateral patellofemoral angle (P=0.00), sulcus angle (P=0.00), trochlear depth (P=0.00) and lateral trochlear inclination angle (P=0.02) could be found in the CP group and control group. However, there were no significant differences between patients in mild CP group and severe CP group in the lateral patellofemoral angle, sulcus angle, trochlear depth and lateral trochlear inclination angle(all P>0.25). Considered gender or not, patellar tilt and trochlear dysplasia were significant correlated with chondromalacia patellae(P=0.00). Conclusion Patellar tilt and trochlear dysplasia are significantly correlated with CP but not the degree of CP.%目的:通过MRI进行髌股关节形态学参数测量,分析髌股关节形态与髌骨软化症之间的关联性。方法371例接受膝关节MRI检查的成人患者,诊断为髌骨软化症(chondromalacia patellae, CP)者纳入CP组(n=124),

  16. 温针配合关节功能锻炼治疗髌骨软化症80例临床观察%Warming Acupuncture Cooperated with Joint Functional Exercise in Treatment of 80 Cases of Chondromalacia Patellae

    Institute of Scientific and Technical Information of China (English)

    熊峻; 钟爱芳; 苏月香; 黄石龙

    2013-01-01

      目的:观察温针配合关节功能锻炼治疗髌骨软化症的临床疗效.方法:选取80例符合髌骨软化症诊断的患者,随机分为治疗组与对照组.治疗组采用温针配合关节功能锻炼治疗,对照组采用传统电针治疗,治疗10次后评价疗效.结果:治疗组和对照组总有效率分别为95.0%和77.5%,两组总有效率比较有显著性差异(P<0.05).结论:温针配合关节功能锻炼治疗髌骨软化症比传统电针疗效更佳.%Objective:To observe the warming acupuncture cooperated with joint functional ex-ercise in treatment of chondromalacia patellae. Methods:80 patients with chondromalacia patellae were randomly divided into treatment group and control group. Treatment group were treated by warming acupuncture cooperated with joint functional exercise, control group were adopted tradi-tional electroacupuncture treatment. The efficacy was evaluated after 10 treatment courses. Results:The total effective rate was 95.0%in treatment group and 77.5%in control group. The comparison of two groups had significant difference (P<0.05). Conclusion:The effect of warming acupuncture cooperated with joint functional exercise in treatment of chondromalacia patellae is better than that of traditional electroacupuncture treatment.

  17. Evaluation of the curative effect of traditional Chinese medicine internal and external treatment in the treatment of chondromalacia patellae%中药内服外敷治疗髌骨软化症的疗效评价

    Institute of Scientific and Technical Information of China (English)

    张殊彦

    2015-01-01

    目的:探讨中药内服外敷治疗髌骨软化症的临床疗效。方法:收治髌骨软化症患者100例,随机分为对照组和试验组,对照组给予针刺治疗,试验组给予中药内服外敷治疗,对比分析两组患者临床治疗效果。结果:试验组临床治疗总有效率明显优于对照组(P<0.05)。结论:中药内服外敷治疗髌骨软化症患者能够明显改善患者的临床症状。%Objective:To explore the clinical curative effect of traditional Chinese medicine internal and external treatment in the treatment of chondromalacia patellae.Methods:100 patients with chondromalacia patellae were selected.They were randomly divided into the control group and the experimental group.The control group was given acupuncture treatment.The experimental group was given traditional Chinese medicine internal and external treatment.The clinical curative effects of patients in two groups were compared and analyzed.Results:The total effective rate of clinical treatment in the experimental group was significantly better than that of the control group(P<0.05).Conclusion:Traditional Chinese medicine internal and external treatment in the treatment of patients with chondromalacia patellae can significantly improve the clinical symptoms of patients.

  18. 髌骨位置与髌骨软化症之间相关性的MRI研究%The MRI study of correlation between patella location and chondromalacia

    Institute of Scientific and Technical Information of China (English)

    陆薇; 陈爽; 杨军

    2011-01-01

    Objective To discuss the relationship between patella location and chondromalacia patella,explore its mechanism and clinical significance.Methods Knee joint MRI was performed in 1052 patients (506 men and 546 female).Among them,there were 299 patients( 100 men and 199 female)with chondromalacia patella.They were divide into the group of 1-19,the group of 20-39,the group of 40-59 years old and the group of older than 60 years to compute the positive rate respectively.Insall-Salvati method was used to measure the length of chondromalacia ligaments(L) and the length of chondromalacia path(P).The relationship between patella location and chondromalacia was tested by using t test and x2 test.Results The total positive rate of chondromalacia patella was 28.4% (299/1052).In female it was 36.4% (199/546) and in men was 19.8% (100/506).The group of 1-19 years old had 16 patients ( 16.8%,16/95).The group of 20-39 years old had 71 patients( 17.9%,71/396).The group of 40-59 years old had 116 patients ( 33.2%,116/349 ).The group of older than 60 years had 96 patients (45.3%,96/212).The positive rate of chondromalacia patella increased with age.The L/P value of normal group and chondromalacia patella group were 1.15 ±0.15 and 1.24 ±0.17 respectively.The L/P value of normal group of men and women were 1.13 ± 0.15 and 1.17 ± 0.14 respectively.The L/P value of chondromalacia patella group of men and women were 1.20 ±0.17 and 1.26 ±0.16 respectively.The InsallSalvati index of age groups showed significant differences.The L/P value of pathological changes group and normal group of 1-19 years old were 1.38 ± 0.25 and 1.24 ± 0.16 respectively.The L/P value of pathological changes group and normal group of 20-39 years old were 1.24 ± 0.17 and 1.15 ± 0.16 respectively.The L/P value of pathological changes group and normal group of 40-59 years old were 1.24 ±0.16 and 1.12 ±0.12 respectively.The L/p value of pathological changes group and normal group of older

  19. Preliminary Investigation on the Pathogeny, Diagnosis and Treatment of Chondromalacia Patella%髌骨软化症的病因、诊断和治疗探索

    Institute of Scientific and Technical Information of China (English)

    叶启彬; 吴志宏; 王以朋; 林进; 邱贵兴

    2001-01-01

    This paper presents the preliminary investigation on chondromalacia patella at our department in recent years. A random cluster sampling survey covering 2743 normal persons was carried out. The prevalence rate is 36.2%. It was found that, applying transmission electron microscope and immunohistochemical methods on to cartilage tissues of the abnormal region, articular cartilage necrosis was in direct proportion with the abnormal pressure, while the restoration capability of local chondrocytes was in inverse proportion with pathological changes and the pressure. The chondromalacia patella was produced by repeated abnormal stress acting on the carilage. The stress derived from the uncongruency and the decreasing in the contact area of patellofemoral joint when the subluxation or tilt of patellae was caused by the abnormal anatomical and biomechanical relationship. The initial lesion was at the matrix of cartilage,the collagen network was disrupted, then proteoglycan was lost. The microenvironment of chondrocytes was changed with degradation of matrix. So the chon drocytes became degenerative and necrosis from superficial to deep layer, then feed back the matrix again. Finally, the total cartilage layer might disappear, and the bone under cartilage might proliferate. At late stage, the cartilage was completely destroyed and had no self-restorative ability. Therefore, early diagnosis and treatment are necessary. It is highly suggested axis radiograph of the knee with the tibiae tuberositas localization are helpful to early diagnosis. Furthermore, JKY-Muscle Rehabilitation Instrument is invented for non-operative therapy. It enhances muscle power by selective training of the vastus medialis muscle using electrical stimulator to relieve pain and correct subluxation of patella with 90% efficiency (63% of excellent-effective rate) . In late stage, patellofemoral replacement is recommended. The excellent-effective rate is 86.3%.%总结近年来我科对髌骨软化症研

  20. Curative Effect Observation on Chondromalacia Patellae Treatment with Improved Tuina Manipulation%改良推拿手法治疗髌骨软化症的疗效观察

    Institute of Scientific and Technical Information of China (English)

    周红军; 杨树安; 孟建国

    2013-01-01

    This study was aimed to observe technical improvements of the approach II ( to mainly improve the patella bone plate under pressure to stimulate) in the treatment of chondromalacia patella. A total of 100 chon-dromalacia patellae cases were randomly divided into two groups, which are group I (control group) with 50 cases treated with normal manipulation technique and group II ( treatment group ) with 50 cases treated with improved Tuina manipulation . Clinical efficacy was observed after 2 weeks of treatment . The results showed that 40 cases in the treatment group were cured , 10 cases were improved , and the cure rate was 80%. In the control group , 32 cases were cured, 18 cases were improved, and the cure rate was 64%. There were significant differences be-tween two groups (P < 0.05). It was concluded that the technical improved approach II treatment of chondromala-cia patella have a good effect. The cure rate is obviously better than the control group.%目的:观察技术改良后的手法II(改善髌骨下骨骨板压力刺激为主)治疗髌骨软化症的疗效。方法:将100例髌骨软化症患者随机分为两组:普通手法I组(对照组)50例和改良技术后的手法II组(治疗组)50例。治疗2周后分别观察临床疗效。结果:治疗组临床治愈40例,好转10例,治愈率为80%;对照组临床治愈32例,好转18例,治愈率为64%,两组有效率存在显著性差异(P<0.05)。结论:技术改良后的手法II治疗髌骨软化症有良好的疗效,治愈率明显优于对照组。

  1. Evaluation of curative effect of traditional Chinese medicine in treatment of chondromalacia of patella%中药内服外敷治疗髌骨软化症的疗效评价

    Institute of Scientific and Technical Information of China (English)

    刘劲

    2015-01-01

    Objective To investigate the therapeutic effect of traditional Chinese medicine treatment of chondromalacia patellae.Methods selected in our hospital in 2011 January-2013 year in October 60cases of chondromalacia patellae patients, digital decimation divided into study group and control group,the study group using internal and external medicine treatment,the control group was given sodium hyaluronate injection treatment,comparison and analysis of two groups of patients with clinical curative effect.Results After the treatment, the research group, the total efficiency of 96.7%, 73.3%in the control group, the total efficiency of treatment group was significantly higher than the control group;the 1-3 years of follow-up, the recurrence rate and occasional pain study group was significantly higher than that of control group.Conclusion Traditional Chinese medicine treatment of chondromalacia patella effect is good.%目的:探讨中药内服外敷治疗髌骨软化症的疗效。方法选取我院2011年1月-2013年10月60例髌骨软化症患者,数字抽取分为研究组与对照组,研究组应用中药内服外敷治疗,对照组予以玻璃酸钠膝关节腔注射治疗,分析对比两组患者临床治疗效果。结果经治疗,研究组总有效率为96.7%,对照组为73.3%,研究组治疗总有效率显著高于对照组;经1~3年随访,研究组复发率及偶有疼痛率显著低于对照组。结论中药内服外敷治疗髌骨软化症效果较好。

  2. 温针加康复训练治疗髌骨软化症的疗效观察%Warming Needle Treatment Combined with Rehabilitation Training in the Treatment of Chondromalacia Patellae

    Institute of Scientific and Technical Information of China (English)

    王源

    2012-01-01

    Objective: To observe and analyze the effect of warming needle treatment combined with rehabilitation training in the treatment of Chondromalacia Patellae. Methods;46 patients with Chondromalacia Patellae were randomly divided into acupuncture group(control group) and temperature needle with rehabilitation training (experimental group), each for 23 cases. Control group;The main points were Neixiyuan, Waixiyuan, Zusan-li, Yanglingquan, Heding; On the basis of control group, the experimental one was plused moxibustion treatment and rehabilitation training. The follow - up was six months. Results: Between two groups, there was a significantly statistical difference in therapeutic effect (P <0.05) ,and the experimental group was significantly better than the control group. There were markedly differences in the constituent ratio of cured cases between the two groups(P <0.05) ,and the experimental one was highly raised, which had a significantly statistical difference (P <0. 01). Conclusion;There is a satisfactory clinical efficacy in the treatment of Chondromalacia Patellae by warming needle treatment combined with rehabilitation training and it needs short time.%目的:观察温针配合康复训练对髌骨软化症的治疗效果.方法:选择该病患者46例,随机分为针刺组(对照组)和温针配合康复训练组(实验组),各23例.对照组选内膝眼、外膝眼、足三里、阳陵泉、鹤顶穴针刺;实验组在对照组的基础上,加用艾灸和康复训练.随访半年,观察疗效.结果:两组疗效比较有显著统计学差别(P<0.05),实验组疗效明显优于对照组.两组患者治愈例数所需疗程构成比的比较有显著统计学差异(P<0.05),治疗组较好.实验组治疗前后膝关节综合评分比较有显著统计学差别(P<0.01).结论:温针配合康复训练治疗髌骨软化症治愈疗效满意,治愈所需时间短.

  3. The Effective Observation of Chondromalacia Patellae Treated by Acupuncture and Exercise Therapy%针灸配合运动疗法治疗髌骨软化症的疗效观察

    Institute of Scientific and Technical Information of China (English)

    余晓慧

    2012-01-01

    Objective: To observe the effect of chondromalacia patellae treated by acupuncture and exercise therapy. Methods: 60 patients with chondromalacia patellae were randomly divided into two groupsi the treatment group( 30 patients) and the control groupOO patients). There was no significant difference in the age and course of disease between the two groups (P>0.05); data in the two groups were comparable. Patients in the control group were treated with Diclofenac Sodium Enteric —coated Tablets; patients in the treatment group were treated with acupuncture and exercise therapy. Results: After six months of follow—up for all 60 patients, there was significant difference in the effective rate and relapse rate between the two groups(P<0. 01), according to the effective criteria. Conclusion: The effect of chondromalacia patellae treated by acupuncture and exercise therapy was better, and it had less relapse, compared with western medicine.%目的:观察针灸配合运动疗法治疗髌骨软化症的疗效.方法:将60例髌骨软化症患者随机分为西药治疗组(对照组)30例、针灸配合运动组(治疗组)30例.对照组采用扶他林缓释片治疗,治疗组采取针灸配合运动疗法治疗.结果:60例接受完整治疗后半年随访.依据疗效标准评价治疗结果,治疗组、对照组治疗有效率比较差异有统计学意义(P<0.01),复发率比较差异有统计学意义(P<0.01).结论:针灸配合运动疗法治疗髌骨软化症疗效优于西药口服疗效,且不易复发.

  4. Clinical research on treating chondromalacia patellae by thermal moxibustion plus massage%热敏灸配合推拿手法治疗髌骨软化症的临床研究

    Institute of Scientific and Technical Information of China (English)

    林红明; 黄璐; 杨凤云

    2015-01-01

    目的:观察热敏灸配合推拿手法治疗髌骨软化症的疗效.方法:将80例髌骨软化症患者随机分为两组,观察组(40例)采用热敏灸配合推拿手法治疗,对照组(40例)口服塞来昔布200mg,2次/d,均2周为1个疗程,且都治疗2个疗程.结果:治疗组有效率为97.5%,与对照组的75%比较,差异有显著意义(P<0.05).结论:采用热敏灸配合推拿手法治疗髌骨软化症有良好的效果.%Objective: To study the efficacy of moxa stick moxibustion plus Massotherapy on chondromalacia patellae(CP). Methods: Sixty patients with patellar malacia were randomly divided into two groups, the treatment group (40 cases) was given moxa stick moxibustion combined with massotherapy,while the control group was given celecoxib capsules, are 2 weeks 1 treatment,and were all treatment 2 treatment. Results: The effective rate was 94.3% in the treatment group and 67.9% in the control group.There was a significant difference in curative effect between the two groups (P < 0.05). Conclusion: The moxa stick moxibustion plus Massotherapy is effective in treatment for chondromalacia patellae (CP).

  5. 探析大学生篮球运动导致的髌骨软化症%Analysis of the Causes of College Students Playing Basketball due to Chondromalacia Patella

    Institute of Scientific and Technical Information of China (English)

    阙祥勇; 李新志

    2016-01-01

    The Chondromalacia patella is a common Chronic injure disease in College Basketball games,In this article,through the anatomic characteristics of the knee,Basketball Action Feature and College Basketball own characteristics,the author analyzes biome-chanical situation of the patella when College students playing Basketball,In order to find effective treatment methods and preventive measures.%髌骨软化症是大学生篮球运动中常见的慢性损伤性疾病,本文通过篮球运动的动作特点和大学生篮球运动的自身特点分析大学生篮球运动时髌骨的生物力学情况,探析大学生篮球运动导致的髌骨软化症机制,从而寻找有效的治疗方法和预防措施。

  6. Determination and correlation of plasma estradiol levels in patients with chondromalacia patellae in the early stage of menopause%绝经前期女性髌骨软化症血浆雌二醇测定及相关性研究

    Institute of Scientific and Technical Information of China (English)

    苏建敏

    2016-01-01

    目的 通过对绝经前期40 ~ 45岁女性髌骨软化症(CMP)患者与同年龄志愿者血浆雌二醇(E2)水平的测定及对比,观察血浆雌二醇水平改变与髌骨软骨软化症的相关性.方法 选取2012年1月至2015年6月经门诊诊断为髌骨软骨软化症的40~ 45岁女性患者和健康女性志愿者进行观察.纳入标准的92例髌骨软化症患者为观察组,80例健康女性为对照组.髌骨软化症组患者按临床设定诊断标明确诊断,均行X线膝关节正侧位片和30°髌骨轴位片及MRI检查.上述两组均采用雌二醇电化学发光免疫分析法对血液中E2水平进行检测,观察其浓度.结果 ①髌骨软骨软化症患者血浆中雌二醇水平较同年龄段健康女性明显降低,差异有统计学意义(P<0.05);髌骨软化症分期患者组间血浆雌二醇水平比较差异未见统计学意义(P>0.05).②既往有月经异常的髌骨软化症患者血浆雌二醇水平较普通患者低(P<0.05),髌骨软化症分期后期(Ⅲ—Ⅳ期)百分比较普通患者高,差异有统计学意义(P<0.05);膝关节疲劳患者髌骨软化症分期后期(Ⅲ~Ⅳ期)百分比较普通患者高,差异有统计学意义;但二者血浆雌二醇测定比较差异未见统计学意义(P>0.05).结论 绝经前期女性雌激素下降与髌骨软骨退变具有相关性;既往月经异常的患者较正常月经者雌激素水平更低,髌骨软化症分期Ⅲ~Ⅳ期所占百分比高.%Objective Through the comparison of plasma estradiol levels between 40 to 45 years old female patients with chondromalacia patellae(CMP) in the early stage of menopause and healthy female volunteers of the same age,to observe the correlation of plasma estradiol levels change with chondromalacia patella.Methods From January 2012 to June 2015,92 chondromalacia patella patients and 80 healthy women aged 40 to 45 years were selected.Chondromalacia patella patients were diagnosed according to clinical

  7. Clinical Observation on Chondromalacia Patellae with the Fuyuan Shujin Decoction(复原舒筋汤)%复原舒筋汤治疗髌骨软化症的临床观察

    Institute of Scientific and Technical Information of China (English)

    王彦鹏; 全健

    2016-01-01

    Objective:To observe the clinical effect of Fuyuan Shujin Decoction on chondromalacia patellae.Methods:The 106 cases of patients with chondromalacia patellae were randomly divided into two groups,53 cases in each.Patients were given Fuyuan Shujin Decoction in the treatment group,and diclofenac sodium enteric coated tablets in control group.The clinical symptoms change were observed and compared between the two groups in 14 days.The visual simulation score,femoral quadriceps concentric peak torque and Lysholm knee score were observed,and the clinical efficacy was evaluated.Results:The total effective rate was 86.8% in the control group,and 79.3% in the treatment group;The difference was statistically significant (P<0.05);The VAS score was significantly reduced in the two groups after treatment,and the difference was statistically significant (P<0.05);the treatment group showed lower VAS score than the control group,with statistically significant difference (P<0.05).The Lysholm knee score as well as the femoral head of the four head of the contraction peak torque were significantly increased in two groups,at the end of the treatment,with statistically significant difference (P<0.05);The treatment group showed higher Lysholm knee score and femoral head contraction peak torque than the control group,with statistically significant difference(P<0.05).Conclusion:Fuyuan Shujin Decoction can provide good curative effect on chondromalacia patellae,relieve pain,and improve patients with knee joint function.%目的:观察复原舒筋汤治疗髌骨软化症的临床疗效.方法:将106例髌骨软化症患者随机分为两组各53例.治疗组予复原舒筋汤治疗,对照组予双氯芬酸钠肠溶片治疗,治疗14 d后观察比较两组患者临床症状变化,比较记录两组疼痛视觉模拟(VAS)评分、股四头肌向心收缩峰力矩及Lysholm膝关节评分,并评价临床疗效.结果:总有效率治疗组为86.8%,对照组为79.3

  8. 改良拔河针法治疗髌骨软化症临床观察%Clinical Observation on Chondromalacia Patellae Treated with Modified Tug of War Needling Method

    Institute of Scientific and Technical Information of China (English)

    燕军; 蒋素英; 孟江; 黄金良; 郑波; 梁宁燕

    2012-01-01

    Objective: To observe the clinical effect of tug of war needling method on chondromalacia patellae patients. Method:60 patients were divided into two groups:treatment group(group A:30 cases)and control group( group B:30 eases). The patients of group A accepted modified tug of war needling method,while the patients in group B treated with o-ral administration of diclofena capsule(75mg). Results:The total effective rate of group A was 93. 33% .while group B was 73. 33%. We found the difference was significant (X2 =4.32, P <0.05) from the statistical treatment. It indicated that the total effective rate of group A was higher than that of group B. The cure rates of the two groups were 50% , 23.33% respectively. The difference was significant(X2 = 4.59, P <0.05). It indicated that the cure rate of group A was higher than that of group B. Conclusion % The clinical effect of tug of war needling method is better than oral administration of diclofena on treating chondromalacia patellae.%目的:观察改良拔河针法治疗髌骨软化症的临床疗效.方法:将60例患者随机分为两组,A组治疗组(30例)及B组对照组(30例).治疗组采用改良拔河针法治疗;对照组采用双氯芬酸双释胶囊75mg内服.结果:治疗组总有效率为93.33%,对照组总有效率为73.33%,经统计学处理,x2=4.32,P<0.05,差异有统计学意义,说明治疗组总有效率高于对照组.两组临床治愈率分别为50%、23.33%,经统计学处理,x2=4.59,P<0.05,差异有统计学意义,说明治疗组临床治愈率高于对照组.结论:改良拔河针法治疗髌骨软化症疗效优于双氯芬酸双释胶囊内服.

  9. Sodium hyaluronate for treatment of chondromalacia patella syndrome%玻璃酸钠治疗髌骨软骨软化症

    Institute of Scientific and Technical Information of China (English)

    严浩然; 蔡俊丰; 沈彬; 温竣翔; 谭军

    2014-01-01

    BACKGROUND:According to the special physical and chemical properties, the sodium hyaluronate plays a very important physiological role, such as constructing the celular matrix, lubricating the joints, and promoting the repair of tissue damage. OBJECTIVE: To observe the therapeutic effect of sodium hyaluronate on chondromalacia patelar syndrome with different disease courses. METHODS: A total of 76 patients with chondromalacia patelar syndrome received intra-articular injection of 2 mL sodium hyaluronate once a week for 5 consecutive weeks as a course, with the entry point on the medial margin of the patela. Al the patients were divided into two groups according to the disease course: 3 months group (n=44). One-year folow-up was done to summarize the therapeutic effect. RESULTS AND CONCLUSION:After folow-up for 1 year, the excelent and good rate was 94% in the 3 months group (73%). There was no side effect and infection during the treatment. Five patients appeared to have pain worsened after treatment, which may be caused as folows: Patelar effusion was removed incompletely and early puncture was unskiled. The pain was relieved within 1-2 days after the break. Results showed that the sodium hyaluronate is an effective drug for chondromalacia patelar syndrome, while early treatment and reasonable entry point is the key to keep the therapeutic effects.%背景:玻璃酸钠本身特殊的理化性质决定了其非常重要的生理作用,如构成细胞基质、润滑关节、促进组织损伤修复等。  目的:观察玻璃酸钠注射治疗不同病程髌骨软化症的疗效。  方法:76例髌骨软化症患者关节腔内注射玻璃酸钠2 mL(以髌骨内侧缘为进针点,每周1次,5周为1个疗程),根据病程分两组,病程3个月44例,随访1年观察远期疗效。  结果与结论:随访1年发现病程3个月组(优良率73%)。治疗期间无明显毒副作用,其中有5例注射后疼痛加重,可能与髌下积

  10. The Evaluation of 3D-FS-SPGR Delayed Enhanced MR Scan in Chondromalacia Patella%髌骨软化症在MR延迟增强扫描中的表现

    Institute of Scientific and Technical Information of China (English)

    张国伟; 张光辉; 赵善娜; 盖青竹; 徐永忠

    2010-01-01

    目的 总结髌骨软化症(chondromalacia patellae,CMP)在MR三维抑脂扰相梯度回波序列(3D-FS-SPGR)延迟增强扫描(dGEMRIC)中的表现.资料与方法 分析30例经临床及关节镜确诊的不同时期的CMP患者的3D-FS-SPGR序列dGEMRIC表现.结果 30例CMP患者,共35个髌骨,其中Ⅰ期病灶6个,髌软骨厚薄均匀,内见斑点状、斑片状高信号,不超过全层50%.Ⅱ期病灶9个,髌软骨内呈斑片状与髌软骨垂直的线状高信号,范围超过全层50%.Ⅲ期病灶12个,髌软骨局限性变薄,内部见明显高信号强化灶,累及软骨全层,分层现象中断、消失,表面凹凸不平.Ⅳ期病灶8个,髌软骨明显变薄,连续性中断,分层现象中断、消失,局部软骨剥脱,软骨下骨裸露. 结论MR 3D-FS-SPGR序列dGEMRIC能清楚地显示CMP的各期表现.

  11. Mid-long term efficacy of osteo-periosteal turned over orthotopically for chondromalacia patellae%骨-骨膜原位翻转修复髌软骨软化症的中长期疗效

    Institute of Scientific and Technical Information of China (English)

    李哲海; 张霄雁; 张飞; 武宇赤; 郭永强

    2011-01-01

    Objective To investigate the method of osteo-periosteal turned over orthotopically for treating chondromalacia patellae disease and observe the mid-long term efficacy postoperatively.Methods From April 1996 to June 2000,21 patients with chondromalacia patellae were treated in our hospital.Amone them,13 cases were performed osteo-periosteal turned over orthotopically,including 3 males,10 females; with the mean age of 59 years (range,47-65 years).HSS and Lysholm knee rating scale were employed to analysis the results.Results The patients were followed up from 114 to 162 months (mean,133.2 months).One of the patients lost follow-up due to death.Before operation the HSS knee score was 20-58 (34.2±3.8),and 1 year,3 year,5 year,7 year,and 9 year after operation the HSS knee score were 55-70 (60.0±7.0),55-82 (64.1±5.9),60-90 (70.1±3.2),50-85 (63.1±4.1),and 50-75 (57.3±2.9) respectively.And Lysholm knee rating scale also showed similar results.The chondromalacia patellae patients before and after operation were significant different.Bone periosteum transplant tissue and surrounding defective tissue healed perfectly,functions recovered perfectly.Conclusion The method of osteo-periosteal turned over orthotopically has the capabilities to form cartilage.The therapeutic effect and facies articularis patellar is satisfactory.But it only can restore articular cartilage of patellar and does not help for genual malformation.%目的 探讨骨-骨膜原位翻转修复治疗髌骨软化症的软骨缺损方法,观察其中长期疗效.方法 1996年4月至2000年6月,拟在我院手术治疗的21例髌软骨软化症患者经术前和术中评估,接受骨-骨膜原位翻转术治疗13例.男3例,女10例;年龄47~65岁,平均59岁.采用HSS和Lysholm 膝关节功能评分标准进行评分.结果 术后随访114 ~162个月(平均133.2个月),13例患者中1例患者死亡,余12例获随访.按照HSS膝关节功能评分标准:术前20~58(34.2±3.8)分,术后1年为55

  12. Histological comparison of patellar cartilage degeneration between chondromalacia in youth and osteoarthritis in aging.

    Science.gov (United States)

    Mori, Y; Kubo, M; Okumo, H; Kuroki, Y

    1995-01-01

    The histological findings of the patellar cartilage were compared between cases of chondromalacia, which occurs predominantly in young persons (22 patients, average age 19.8 years) and cases of osteoarthritis, which is common among the elderly (21 patients, average age 65.4 years). The histological findings of cartilage in the chondromalacia were characterized by increased density and vigorous fibrous metaplasia of chondrocytes. These findings may be considered to represent a reactive change in the chondrocyte. Cartilage degeneration in osteoarthritis, by contrast, is regressive and presents a clearly different histological picture from that of chondromalacia patellae. We conclude that chondromalacia does not easily lead to osteoarthritis. On the other hand, the cartilage was characteristically softened, as observed by gross inspection, and showed rarefaction of the cartilage matrix. It should be noted that the change was not observed in aging, but showed a pattern of cartilage degeneration peculiar to young patients with chondromalacia patellae.

  13. Analysis on Concentric Isokinetic Test of Flexion and Extension Muscle Strength of Knee Joints in Chon-dromalacia Patellae%髌骨软骨病患者的膝屈伸肌群等速向心肌力分析

    Institute of Scientific and Technical Information of China (English)

    徐卫华; 赵彦; 王鸿; 王家祥; 孙强

    2015-01-01

    目的::运用等速肌力测试方法分析髌骨软骨病患者的膝关节屈伸肌群等速向心肌力特征,为髌骨软骨病的防治和康复提供参考。方法:对30例髌骨软骨病单膝患者和与之相应的年龄、体型相差不大的24位正常成人进行双膝等速向心肌力测试,测得其在60°/s的峰力矩,运用统计学方法分析。结果:患膝屈伸肌峰力矩均减弱,与健侧及正常人双膝相比,P<0.01,具有统计学意义;伸肌PT值下降更为明显,双侧同名伸肌差异比,显著( P<0.05)高于髌骨软骨病组的屈肌和正常对照组的屈伸肌;同时患侧 H/Q 比值也显著( P<0.05)高于健侧及对照组。结论:髌骨软骨病患者的患膝屈伸肌群力量减弱、主动肌与拮抗肌比例失衡、双膝同名伸肌力量差异明显,提示髌骨软骨病患者的诊断和康复治疗应注意峰力矩、拮抗比和双侧差异的检测以及患膝关节肌肉力量和平衡的恢复。%Objective An analysis of flexion and extension muscle strength characters of knee in Chondromalacia Pa-tellae( CP) by means of isokinetic test was performed to provide a basis for CP prevention and rehabilitation. Meth-ods 30 patients with CP and 24 matched controls who cor-responding age,size finished the concentric isokinetic test of knee flexion and extension,using statistical methods to analyze its peak torque measured at 60°/s. Results Peak torques of flexion and extension muscles of the patient knee are reduced, and are statistically significant by P<0. 01 compared with the healthy side and normal knee;PT of extension decreased more significantly, and difference ratio of bilateral homonymous extensor muscle is significantly ( P<0. 05 ) higher than flexor of chondro-malacia patellae group and flexor and extensor of normal control group;At the same time,the H/Q ratio of the pa-tient side was significantly higher than that of the control group ( P<0. 05 ) . Conclusion The flexion and

  14. The Haglund imprint on the patella.

    Science.gov (United States)

    Graf, J; Bernd, L; Simank, H G; Niethard, F U

    1993-12-01

    Seven hundred and five radiographs of the knee were examined and 17.6% showed a so-called Haglund imprint on the patella. The incidence was the same in patients with chondromalacia and in a control group. There was no statistical difference regarding age, sex and body weight. Haglund's imprint is a variation from the normal and is of no diagnostic value.

  15. On the treatment of 53 Cases with Chondromalacia Patellae by Etoricoxib combined with Glucosamine Sulphate%依托考昔片联合硫酸氨基葡萄糖胶囊治疗髌骨软化症53例

    Institute of Scientific and Technical Information of China (English)

    杨顺; 施江宏; 司文腾; 白玉

    2013-01-01

    Objective:To observe the clinical efficacy of etoricoxib combined with glucosamine sulphate in the treatment of chondromalacia patellae.Methods:94 cases with patella osteomalacia were retrospectively studied and divided into the treatment group(53 cases)treated with etoricoxib combined with glucosamine sulphate and the control group(41 cases)treated with glucosamine sulphate,observing their knee joint function and pain intensity after 1 course of treatment.Results:After treatment,the knee joint function of the two groups improved,the treatment group being better than the control group and the difference being statistically signiifcant(P<0.05);The knee pain intensity of the two groups were relieved,the treatment group being better than the control group and the difference being statistically signiifcant(P<0.05).Conclusion:It was a safe and effective method to treat chondromalacia patellae with etoricoxib combined with glucosamine sulfate.%目的:观察依托考昔片联合硫酸氨基葡萄糖治疗髌骨软化症的临床疗效。方法:回顾性研究髌骨软化症患者94例,分为治疗组53例和对照组41例。治疗组给予依托考昔联合硫酸氨基葡萄糖口服治疗,对照组仅给予硫酸氨基葡萄糖治疗。治疗1个疗程后,观察两组患者膝关节功能及疼痛强度。结果:治疗后两组患者膝关节功能均获得改善,治疗组优于对照组,差异有统计学意义(P<0.05);两组患者膝关节疼痛均获得缓解,治疗组患者疼痛缓解优于对照组,差异有统计学意义(P<0.05)。结论:依托考昔联合硫酸氨基葡萄糖是治疗髌骨软化症的一种安全、有效的方法。

  16. “扶正补土”针刺法配合股内侧肌训练治疗髌骨软化症的近期临床观察%Short-term effects of "Fuzheng-Butu (扶正补土)" acupuncture therapy combined with vastus medialis isometric training in the treatment of chondromalacia patella

    Institute of Scientific and Technical Information of China (English)

    吴福春; 陈捷; 陈麟; 张冬梅; 徐维; 邵斌

    2016-01-01

    目的 观察“扶正补土”针刺法配合股内侧肌训练治疗髌骨软化症的近期疗效.方法 选择髌骨软化症患者63例,按照随机数字表法分为A组31例,B组32例.A组选择“扶正补土”针刺法配合股内侧肌等长收缩训练,B组采用超短波理疗配合股内侧肌等长收缩训练.两组治疗均为每日1次,每周治疗6d,连续2周.于治疗前、治疗第6日及第13日时,采用视觉模拟评分法(VAS)评定疼痛及Lysholm膝关节评分量表(LKSS)评定膝关节功能.结果 治疗第6日及第13日时,两组VAS和LKSS评分较治疗前显著改善,差异均有统计学意义(P<0.05);治疗第6日时,两组VAS及LKSS评分比较差异无统计学意义(P>0.05);治疗第13日时,两组VAS评分比较差异无统计学意义(P>0.05),但两组LKSS评分比较差异具有统计学意义(P<0.05).结论 应用“扶正补土”针刺法配合股内侧肌的肌力训练,近期可有效减轻髌骨关节疼痛症状,并显著改善膝关节活动功能.%Objective To evaluate the efficacy of "Fuzheng-Butu (扶正补土)" acupuncture therapy combined with vastus medialis isometric training in the treatment of chondromalacia patella.Methods Sixty-three patients with chondromalacia patella were randomly divided into group A (31 cases) and group B (32 cases).Patients were received "Fuzheng-Butu" acupuncture therapy combined with vastus medialis isometric training in group A,while ultrashort physiotherapy combined with vastus medialis isometric training in group B,once per day,6 days per week,and 2 weeks for a course.The visual analogue scale (VAS) and Lysholm knee score scale (LKSS) were adopted to evaluate the analgesic effect and knee joint function before and at 6,13 days after the treatment.Results The VAS decreased and LKSS increased after the treatment as compared with those before the treatment in the two groups (P< 0.05).There was no statistical significance about VAS and LKSS at 6 days after the treatment

  17. Rehabilitative effectiveness of isokinetic training on chondromalacia patellae at early-middle stage%等速训练对早中期髌骨软骨病的康复疗效研究

    Institute of Scientific and Technical Information of China (English)

    徐卫华; 赵彦; 王鸿; 王家祥; 孙强

    2016-01-01

    目的::在超短波和温针治疗的基础上,观察等速训练对早中期髌骨软骨病患者进行康复的效果。方法:将58例早中期髌骨软骨病单膝自愿患者随机分成等速组30例和常规组28例。2组均采用超短波、温针进行治疗;在此基础上,等速组用等速测力仪器进行康复训练,常规组进行常规的运动疗法康复;检测比较2组患者治疗前后大腿围度和角速度为60°/s 时等速肌力测试峰力矩等指标,同时进行 Lysholm 膝关节评分和治疗后临床疗效比较。结果:治疗8周后,2组患膝屈伸肌 PT、伸肌 PT 患/健侧比值及患侧 PT 屈/伸比均较治疗前有明显改善(P <0.01),同时等速组在患膝伸肌 PT 和伸肌 PT 患/健侧比值上较常规组提高更显著(P <0.05)。2组患膝大腿腿围和 Lysholm 膝关节功能评分均较治疗前明显提高(P <0.01),等速组更高于常规组(P <0.05)。治疗后,等速组总有效率明显高于常规组(P <0.05)。结论:等速训练在早中期髌骨软骨病的康复中疗效显著。%Objective:On the basis of remedy by ultrashort wave and acupuncture with warmed needle,to observe the curative effect of isokinetic training on chondromalacia patellae (CP)at early-middle stage.Methods:Fifty-eight voluntary sole knee patients with CP at early-middle stage were randomly divided into isokinetic group (n=30)and control group (n=28).Both two groups were treated with ultrashort wave and acupuncture with warmed needle. The isokinetic group was given rehabilitation training with isokinetic dynamometer,and control group was given conventional kinesiatrics.The indexes including thigh circumference,peak torque which were measured at 60°/sec with isokinetic dynamometer before and after the treatment were detected.Simultaneously,the knee Lysholm scores and the curative effectiveness after the treatment were compared.Results:After 8-week treatment,PT of extensor and flexor,the peak torque ratios for

  18. A radiological study of the patella and the cartilage of patella by computed tomography following double-contrast arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Myung Joon; Yang, Seoung Oh [Capital Armed Forces General Hospital, Seoul (Korea, Republic of)

    1987-04-15

    Recurrent subluxation or dislocation of the patella is a painful condition that frequently leads to chondromalacia or arthrosis of the patellofemoral joint. A radiographic evaluation of the patella and patella cartilage is important in the diagnosis of chondromalacia and mal alignment. Authors performed the patellofemoral joint CT following the double contrast arthrography in 53 patients with knee joint pains who had visited to Capital Armed Forces General Hospital from July to December, 1986. Authors analysed the shape and position of patella and the shape of patella cartilage. The results were as follows; 1. shape of patella:The most common types are type II/III (14 cases) and type III (14 cases). type III {yields} IV-9 cases, type I-5 cases, type IV-5 cases, other type-4 cases, type II-2 cases, no type V. 2. position of patella:Only 2 cases showed subluxation and external rotation of patella. 3. shape of patella cartilage:a)congruous cartilage-21 cases (39.6%) b)regular cartilage-22 cases (41.5%) c)irregular cartilage-10 cases (18.9%) irregular imbibition of contrast media-7 cases localized loss of cartilage or erosion-2 cases thinning of cartilage-1 case 4. Fissure and erosions of cartilages in 3 cases were confirmed by operation and knee arthroscopy.

  19. Chondropathia patellae - preoperative and postoperative demonstration of the patellar structure in plain roentgenography

    Energy Technology Data Exchange (ETDEWEB)

    Schumacher, K.A.; Mutschler, W.; Bargon, G.

    1982-07-01

    The study is based on 86 patients surgically treated for chondromalacia patellae, who in a 2 year follow-up were controlled by defile-radiographs and clinical examination. While there was an improvement of all clinical symptoms examined, no significant change in the radiologic appearance of the patellar structure was observed as compared with the pre-operative status. This includes that neither significant changes indicating development of arthrosis nor aggravation of pre-existing arthrotic lesions could be found. However, it is commonly suggested from roentgenographic findings with type 3 lesions, that severe chondromalacia patellae may be a precursor of osteoarthrosis.

  20. [Chondropathia patellae--preoperative and postoperative demonstration of the patellar structure in plain roentgenography (author's transl)].

    Science.gov (United States)

    Schumacher, K A; Mutschler, W; Bargon, G

    1982-07-01

    The study is based on 86 patients surgically treated for chondromalacia patellae, who in a 2 year follow-up were controlled by défilé-radiographs and clinical examination. While there was an improvement of all clinical symptoms examined, no significant change in the radiologic appearance of the patellar structure was observed as compared with the pre-operative status. This includes that neither significant changes indicating development of arthrosis nor aggravation of pre-existing arthrotic lesions could be found. However, it is commonly suggested from roentgenographic findings with type 3 lesions, that severe chondromalacia patellae may be precursor of osteoarthrosis.

  1. Condromalacia patella

    OpenAIRE

    Ulku, Ozer

    2004-01-01

    Condromalacia-patella which is seen on the patellafemoral face is the degeneration of the patella articular cartilage, and generally missed since it doesnt give clinical symptom and can't be observed in rontgenogram. Here is given some information for the diagnosis and treatment of this disease releated to a patient in our clinic.

  2. Chondropathia patellae.

    Science.gov (United States)

    Soren, A; Fetto, J F

    1997-01-01

    The articular surface of the patella and the contiguous articular surfaces of the femoral condyles are sometimes affected by disintegrational changes of the articular cartilage, which remain localized there for a longer period of time. In consideration of the pronounced functional impairment arising at marked changes of these articular surfaces, resection of the patellar surface, metallic resurfacing of the patella, periosteal resurfacing of the patella, or patellectomy have been described as treatment by various authors. Most of these modalities were followed by shortcomings of the results, as indicated in pertinent follow-up examinations and reports. Thus, a more physiological modality of treatment, organic resurfacing of the patella with synovial tissue, was applied in 7 patients and led to satisfactory results as ascertained by long-term follow-up examinations.

  3. Recent developments of combined traditional Chinese and Western medicine in treatment of chondromalacia of patella%髌骨软化症的中西医结合治疗近况

    Institute of Scientific and Technical Information of China (English)

    包飞; 王凤琴

    2006-01-01

    目的:对髌骨软化症的非手术疗法现状进行系统文献回顾,以期为临床治疗提供参考资料,并探讨进一步发挥非手术疗法作用的策略.资料来源:检索Medline 2000-01/2004-12与髌骨软化症相关的文献,检索词"chondromalacia ofpatella",并限定文章语言种类为英文.检索中国医院数字图书馆1994-01/2004-12中国医学核心期刊关于髌骨软化症的相关文献,检索词"髌骨软化症",限定文章语言种类为中文.资料选择:对检索到的髌骨软化症相关文献112篇进行筛选,选择非手术疗法,并排除综述类文献,符合纳入标准的有58篇.资料提炼:对58篇文献进行分类整理,排除重复性文献,纳入27篇文献.资料综合:国内对髌骨软化症的非手术疗法是以局部治疗为主,方法主要有中药、针灸、推拿、针刀等中医疗法,在缓解临床症状方面具有较好的疗效.但目前多数资料缺乏严格的临床研究设计、统一的疗效评价标准和随访,尤其缺少临床分期诊断标准和客观监测指标,疗效机制也有待研究.结论:非手术疗法治疗髌骨软化症显示了较好的临床疗效,但仍需开展大样本随机对照研究进行科学评价,并筛选较佳治疗方案;需尽快建立临床分期诊断标准,寻求客观监测指标以助于确定非手术疗法适应症,提高临床疗效,并对疗效机制加以研究.

  4. Chondropathia patellae

    NARCIS (Netherlands)

    Rijnks, Johannes

    1976-01-01

    In dit proefschrift worden de resultaten vermeld van een onderzoek naar de chondropathia patellae. Tevens wordt een overzicht gegeven van de literatuurgegevens over dit onderwerp. Er is een analyse verricht van een aantal factoren die van invloed zijn op de belasting van het patellofemorale gewricht

  5. The relationship between patella position and length of the iliotibial band as assessed using Ober's test.

    Science.gov (United States)

    Herrington, Lee; Rivett, Natalie; Munro, Samantha

    2006-08-01

    The purpose of the study was to investigate the relationship between length of the iliotibial band (ITB) and the medio-lateral position patella. Eighty subjects (37 male, 43 female) were examined for patella position and ITB length. All subjects were physically active, asymptomatic and aged between 18 and 34 years (mean 21.5 years). ITB length was assessed using the Ober's test and modified Ober's test, with hip adduction angle being measured using a fluid goniometer. Patella position was assessed using the method first described by McConnell [The management of chondromalacia patellae: a long term solution. Australian Journal of Physiotherapy 1986;32:215-22]. Patella position had a weak correlation (r=0.28) with modified Ober's (extended knee) test and a poor correlation with Ober's (knee flexed) test (r=0.1). In the group of 47 subjects with laterally displaced patellae, patella position had a moderate statistically significant correlation to ITB length measured by modified Ober's test (r=0.34, P=0.012). Only a poor relationship existed between Ober's test and patella position in the laterally displaced group. The results of this study only partially support the hypothesis that there is a relationship between ITB length and lateral patella displacement. The relationship was not strong enough to confirm ITB length as the only cause of lateral patella displacement.

  6. [Traumatic chondropathia patellae, its significance for medical insurance in expert testimony concerning accident sequellae therapy].

    Science.gov (United States)

    Mbaruk, A

    1980-04-01

    The connection between chondropathia patellae and a trauma is discussed. Apart from direct traumas the indirect ones can also cause a chondropathia patellae as a result of the incongruence in the femoropatellar joint. In compiling the case history a preceding trauma of different forms and intensity can be found out in about 17 per cent out of all chondropathia patellae patients. When giving an expert's opinion on a case of chondromalacia sport and occupational lesions must be differentiated from genuine traumatic chondropathy. A chondropathia patellae is characterized by the above-mentioned patellar syndrome. The arthroscopy is considered the most reliable diagnostic method. The indication for operative treatment must take into consideration both the degree of the chondropathia patellae and the cause of the disorder.

  7. [The appearances of chondropathia patellae on plain films (author's transl)].

    Science.gov (United States)

    Schumacher, K A; Glöckler, W T; Mutschler, W; Rittmeyer, K

    1979-12-01

    The ability to diagnose chondropathia patellae on plain radiographs was studied in 64 patients in whom the disease had been confirmed either by operation or arthroscopy. All cases of stage III chondropathia were diagnosable by radiological examination; in stage I, 67%, and in stage II, 73% could be diagnosed. The diagnosis depends on the co-existence of marginal irregularities, irregularities of the subchondral bone lamellae, spotty diffuse demineralisation, marginal osteophytes, irregularities at the insertion of the quadriceps tendon and soft tissue changes such as joint effusions. These changes are best identified on the so-called "defilée" view. Disalignment of the axis of the patella and post-traumatic defects are of particular importance for the development of chondropathia, but in the present clinical material, the existence of dysplasia of the patella or of the femoral condyle was not associated with a demonstrable increase of chondromalacia.

  8. [Is it possible to diagnose idiopathic chondropathia patellae using radiologic methods?].

    Science.gov (United States)

    Kaufmann, J; Langlotz, M

    1984-10-01

    In a retrospective study of 47 cases of chondromalacia proved by operation, a correct diagnosis had been made by arthrography in three cases. In 44 patients a false negative finding had been obtained. A prospective study was carried out comparing single and double contrast arthrography as well as double contrast arthrotomography and scintigraphy in ten patients with typical chondropathia. It was confirmed by arthroscopy in nine cases. Only two patients with severe chondromalacia showed abnormal findings by arthrography or scintigraphy. Our investigation has led to the conclusion that arthrography is not a suitable method for demonstrating idiopathic chondropathia of the patella.

  9. Is it possible to diagnose idiopathic chondropathia of the patella by radiological methods

    Energy Technology Data Exchange (ETDEWEB)

    Kaufmann, J.; Langlotz, M.

    1984-10-01

    In a retrospective study of 47 cases of chondromalacia proved by operation, a correct diagnosis had been made by arthrography in three cases. In 44 patients a false negative finding had been obtained. A prospective study was carried out comparing single and double contrast arthrography as well as double contrast arthrotomography and scintigraphy in ten patients with typical chondropathia. It was confirmed by arthroscopy in nine cases. Only two patients with severe chondromalacia showed abnormal findings by arthrography or scintigraphy. Our investigation has led to the conclusion that arthrography is not a suitable method for demonstrating idiopathic chondropathia of the patella.

  10. [Chondropathia patellae].

    Science.gov (United States)

    Mau, H

    1980-04-01

    Chondropathia patellae on a constitutional basis, in the narrow sense of the term, is predominantly responsible for producing the painful or irritated knee in juveniles and adolescents, with an incidence peak around the 20th year of life. The traumatic form associated with signs will often produce the same disorders of the patellar gliding path and of the gliding areas, such as the hyperpression and lateralisation syndrome, as well as habitual luxation. Clinically, degenerative articular damage may temporarily exacerbate into a kind of synovitis "chondsrodetritica", especially on overstraining and after microtraumas. On reviewing the case history, the retropatellar pain after prolonged seating and on walking downhill, is particularly characteristic; this pain can also radiate in medial direction. It is also often reported that the knee tends to "give way" suddenly, and to "interlock" or "become entangled". The leading clinical symptom is, besides a feeling of roughness, the "characteristic" pain caused by the gliding pressure of the patella. Conservative treatment, consisting of physiotherapy, isometric exercises of the quadriceps femoris muscle preceded or if permissible followed by heat and massage treatment, and therapy directed at protecting the cartilage - while avoiding cortisone preparations - should be discontinued if the success of treatment does not last significantly longer than the application. Satisfactory results can be obtained with the three basic operations such as proximolateral relief operation (longitudinal splitting of the retinacula), distal relief surgery (lifting of the tuberositas) and smoothening or more vertical excision of the focus of cartilaginification, in conjunction with further surgical interventions.

  11. [Arthroscopic treatment of chondropathia patellae with lateral release and motor driven instruments].

    Science.gov (United States)

    Kündiger, R; Höpfner, V; Wuschech, H; Heller, G

    1990-01-01

    The treatment of chondromalacia of the patella is a medical problem. There are no sure concepts of therapy. We have analysed the value of the only lateral release or shaving by motorizised instruments or the combination of both methods. After lateral release have many patients no pain but the other methods also helped many patients. The comparison of these groups is impossible because of the different structure. A prospective randomised study has to bring the answer to this question.

  12. Condromalácia de patela: comparação entre os achados em aparelhos de RM de alto e baixo campo magnético Chondromalacia patellae: comparison of high-field strength versus low-field strength magnetic resonance imaging findings

    Directory of Open Access Journals (Sweden)

    Maxime Figueiredo de Oliveira Freire

    2006-06-01

    Full Text Available OBJETIVO: Comparar os aparelhos de ressonância magnética de baixo campo e de alto campo para estudo da cartilagem articular da patela. MATERIAIS E MÉTODOS: Foi realizado estudo usando as seqüências GRE 2D, GRE 3D, FSE T2 e STIR (baixo campo e TSE T2 SPIR. Cada seqüência foi analisada separadamente para o estudo da cartilagem, sem o conhecimento dos dados do paciente e do resultado das outras seqüências, sendo atribuído grau de lesão de 0 a 3 e descrita a sua localização. Os resultados de concordância e discordância foram analisados pelos testes de Kappa e McNemar. RESULTADOS: Na faceta medial houve baixas concordâncias e as discordâncias mostraram significativa superestimação. Na faceta lateral houve boas concordâncias e as discordâncias não foram significativas. No ápice houve boas concordâncias e as discordâncias mostraram significativa subestimação. CONCLUSÃO: A seqüência STIR teve a melhor concordância com a seqüência TSE T2 SPIR. Lesões de alto grau são mais bem caracterizadas pelas seqüências do aparelho de baixo campo. Áreas de aumento de sinal dificultam o estudo da cartilagem da faceta medial da patela no aparelho de baixo campo.OBJECTIVE: To compare the performance of low-field-strength and high-field-strength magnetic resonance imaging equipments for evaluation of the patella articular cartilage. MATERIALS AND METHODS: The study was developed using GRE 2D, GRE 3D, FSE T2, STIR sequences (low-field and TSE T2 SPIR sequence. Each sequence has been separately analyzed for evaluation of the cartilage without knowledge of other sequences results or any patients data; the lesion was assigned a grade from 0 to 3 and had its location defined. Agreement and disagreement results were analyzed by Kappa and McNemar tests. RESULTS: Medial facet has presented low agreement index and disagreements showed to be significantly overestimated. Lateral facet has presented a reasonable agreement index and disagreement

  13. PATELLA AND PATELLOFEMORAL RESURFACING (37 CASES REPORT)

    Institute of Scientific and Technical Information of China (English)

    沈建雄; 叶启彬; 李士英; 邱贵兴

    1994-01-01

    Chondromalacia and patellofemoral osteoarthritis are common diseases that cause pain and disablement of the knee.Conservative therapy is not always effective.Since 1983 we have used isolated polyethylene patellar prosthesis for patella resurfacing of 19 patients with patellofemoral osteoarthritis.After an average of 44.9 months follow-up ,we found the treatment was not as satisfactory as earlier trials.The main reason is the wide erosion of femoral condyle caused by the polyethylene patella.To overcome this shortness,we designed a new type of patellofemoral prosthesis which is named Y-L-Q.From January,1991 to November,1993,we used this prosthesis to treat 16 knees of 13 patients with patellofemoral osteoarthritis.Most of those patients improved both symptomatically and functionally.The good to excellent results rate was 87.5%(14/16 kness) at the time of an average 16 months follow-up.The early results of our experience with patellofemoral resurfacing are encouraging,and extended follow-ups are in progress.

  14. T2 mapping in patellar chondromalacia

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz Santiago, Fernando, E-mail: ferusan12@gmail.com [Department of Radiology, Traumatology Hospital, University Hospital Virgen de las Nieves, Granada (Spain); Pozuelo Calvo, Rocío [Department of Rehabilitation and Physical therapy, Traumatology Hospital, University Hospital Virgen de las Nieves, Granada (Spain); Almansa López, Julio [Department of Physic, University Hospital Virgen de las Nieves, Granada (Spain); Guzmán Álvarez, Luis; Castellano García, María del Mar [Department of Radiology, Traumatology Hospital, University Hospital Virgen de las Nieves, Granada (Spain)

    2014-06-15

    Objective: To study the correlation between the T2 relaxation times of the patellar cartilage and morphological MRI findings of chondromalacia. Methods: This prospective study comprises 50 patients, 27 men and 23 women suffering of anterior knee pain (mean age: 29.7, SD 8.3 years; range: 16–45 years). MRI of 97 knees were performed in these patients at 1.5 T magnet including sagittal T1, coronal intermediate, axial intermediate fat sat and T2 mapping. Chondromalacia was assessed using a modified version of Noyes classification. The relaxation time, T2, was studied segmenting the full thickness of the patellar cartilage in 12 areas: 4 proximal (external facet–proximal–lateral (EPL), external facet–proximal–central (EPC), internal facet–proximal–central (IPC), internal facet–proximal–medial (IPM), 4 in the middle section (external facet–middle–lateral (EML), external facet–middle–central (EMC), internal facet–middle–central (IMC), internal facet–middle–medial (IMM) and 4 distal (external facet–distal–lateral (EDL), external facet–distal–central (EDC), internal facet–distal–central (IDC), internal facet–distal–medial (IDM). Results: T2 values showed a significant increase in mild chondromalacia regarding normal cartilage in most of the cartilage areas (p < 0.05), except in the internal distal facet (IDC and IDM), EPC, EDL, and IMM. Severe chondromalacia was characterized by a fall of T2 relaxation times with loss of statistical significant differences in comparison with normal cartilage, except in EMC and IMC, where similar values as mild chondromalacia were maintained (p < 0.05). Conclusions: Steepest increase in T2 values of patellar cartilage occurs in early stages of patellar cartilage degeneration. Progression of morphologic changes of chondromalacia to more severe degrees is associated to a new drop of T2 relaxation times approaching basal values in most of the areas of the patellar cartilage, except in the

  15. Excessive pronation: a major biomechanical determinant in the development of chondromalacia and pelvic lists.

    Science.gov (United States)

    Rothbart, B A; Estabrook, L

    1988-10-01

    Based on statistical analysis of 97 chronic low back patients, a pelvic list model has been proposed explaining the correlation between leg length discrepancies (LLD) and sciatica. This model suggests that asymmetrical pronation patterns (one pedal arch dropping more than the contralateral pedal arch) initiates a forward downward rotation within the sacroiliac joint. Entrapment of the sciatic nerve between the piriformis muscle and sacrospinous ligament occurs. Clinically, paresis is observed: numbness, weakness and eventually paralysis of the affected limb. Based on this work, the authors have comprised a classification dividing LLD into two main categories: functional and anatomical. Functional LLD have been subdivided into two types of lists: static and dynamic. Treatment based on a combination of chiropractic and podiatric therapy is presented with a 6-month follow-up. Analysis of the success in this tandem approach is very promising. Concurrently, a chondromalacia model is proposed explaining the pathomechanical events associated with oblique tracking patellar syndrome. The authors suggest that excessive pronation is the causative factor directing asynchronous rotation between the shank and femur. This forces the patella out of its normal tracking groove, which, in turn, generates erosion between the inferior margin of the patella and femoral epicondyles.

  16. Superior results with continuous passive motion compared to active motion after periosteal transplantation. A retrospective study of human patella cartilage defect treatment.

    Science.gov (United States)

    Alfredson, H; Lorentzon, R

    1999-01-01

    Fifty-seven consecutive patients (33 men and 24 women), with a mean age of 32 years (range 16-53 years), who suffered from an isolated full-thickness cartilage defect of the patella and disabling knee pain of long duration, were treated by autologous periosteal transplantation to the cartilage defect. The first 38 consecutive patients (group A) were postoperatively treated with continuous passive motion (CPM), and the next 19 consecutive patients (group B) were treated with active motion for the first 5 days postoperatively. In both groups, the initial regimens were followed by active motion, slowly progressive strength training, and slowly progressive weight bearing. In group A, after a mean follow-up of 51 months (range 33-92 months), 29 patients (76%) were graded as excellent or good, 7 patients (19%) were graded as fair, and 2 patients (5%) were graded as poor. In group B, after a mean follow-up of 21 months (range 14-28 months), 10 patients (53%) were graded as excellent or good, 6 patients (32%) were graded as fair, and 3 patients (15%) were graded as poor. Altogether, nine of the fair or poor cases (50%) were diagnosed with chondromalacia of the patella. Our results, after performing autologous periosteal transplantation in patients with full-thickness cartilage defects of the patella and disabling knee pain, are good if CPM is used postoperatively. The clinical results using active motion postoperatively are not acceptable, especially not in patients with chondromalacia of the patella.

  17. Plating of patella fractures: techniques and outcomes.

    Science.gov (United States)

    Taylor, Benjamin C; Mehta, Sanjay; Castaneda, Joaquin; French, Bruce G; Blanchard, Chris

    2014-09-01

    Operative treatment of displaced patella fractures with tension band fixation remains the gold standard, but is associated with a significant rate of complications and symptomatic implants. Despite the evolution of tension band fixation to include cannulated screws, surprisingly little other development has been made to improve overall patient outcomes. In this article, we present the techniques and outcomes of patella plating for displaced patella fractures and patella nonunions.

  18. Computed tomography of chondropathia patellae

    Energy Technology Data Exchange (ETDEWEB)

    Lingg, H.; Hering, L.

    1983-12-01

    Experimental studies of patellae at autopsy and clinical CT-arthrographic examinations of 36 patients show that CT provides good demonstration of the retropatellar cartilage and its lesions. The value of the method compared with conventional radiographic examinations, arthroscopy and surgery is discussed.

  19. Imaging diagnosis and application of MR in the diagnosis of patella%MRI对髌骨软化症的影像诊断及应用

    Institute of Scientific and Technical Information of China (English)

    王庆

    2016-01-01

    Objective:To explore the value of MRI imaging in the diagnosis of patella.Methods:We used the fast spin echo:T2WI, T1WI,inversion recovery sequence,PDI.Results:When the chondromalacia patellae,the MRI can show abnormal cartilage signal, bone and cartilage became thin,coarse,irregular cartilage and subchondral bone exposure.Conclusion:MRI can accurately determine the extent and extent of the patella,and is the best method for the examination of the patella.%目的:探讨 MRI 对髌骨软化症的影像诊断价值。方法:采用快速自旋回波:T1WI、T2WI、反转恢复序列、PDI。结果:髌骨软骨软化时,MRI可表现为软骨信号异常、骨软骨变薄、毛糙、不规则软骨缺损及软骨下骨质暴露。结论:MRI能准确判断髌骨软化的范围及程度,是髌骨软化症的最佳检查方法。

  20. [Double-contrast arthrography in chondropathia patellae--clinical and experimental study on pathogenesis and diagnosis (author's transl)].

    Science.gov (United States)

    Reichelt, A; Hehne, H J; Rau, W S; Schlageter, M

    1979-10-01

    This study is based on the evaluation of 250 arthrographies of the patellofemoral joint ("défilé" arthrographs in Ficat's terminology) which were performed because of clinical suspicion of chondropathia patellae and which could be controlled intraoperatively in 30 cases, as well as on examinations employing an etching paste as used in metallurgy and performed on 20 knee-joints of corpses. 46% of the arthrographies showed a ridge-shaped cartilaginous thickening which was not pre-modelled in the osseous structure and which separated the medial facette into a paramedian and a marginal segment and correlated with chondromalacia to a greater degree than patellar dysplasias or secondary osseous changes. This variant, which could not be detected by plain roentgenography, must be considered as a pre-arthrotic deformity on account of the high point-shaped pressure load on the ridge. The findings were fully confirmed by macroscopic examination of the postmortem material.

  1. [Innervation disturbances of the quadriceps muscle in chondropathia patellae. A critical appraisal of the current concept of chondropathia].

    Science.gov (United States)

    Weh, L; Eickhoff, W

    1983-01-01

    In a group of patients with typical histories of chondropathy, but in whom no other criteria of selection were applied, evidence of neurogenic damage in the quadriceps muscle was found. Innervational damage was also found regularly in the corresponding segments of the paravertebral musculature. Only in three cases, in which horn cell damage was suspected, were there no changes in the paravertebral musculature. There were abnormal structural or functional findings in the lumbar spine in all the patients. A disequilibrium between the median and lateral vastus groups, attributable to innervation, was postulated and subsequently confirmed by electromyography. The nature of chondropathia patellae as an insertion tendopathy is discussed, taking the lack of concomitance of chondropathy and chondromalacia into consideration as well as the findings in the group of patients examined. Phenomena associated with chondropathy which have hitherto incongruous may be explained on the basis of an asymmetrical innervation disturbance.

  2. Cement penetration after patella venting.

    Science.gov (United States)

    Jones, Christopher W; Lam, Li-On; Butler, Adam; Wood, David J; Walsh, William R

    2009-01-01

    There is a high rate of patellofemoral complications following total knee arthroplasty. Optimization of the cement-bone interface by venting and suction of the tibial plateau has been shown to improve cement penetration. Our study was designed to investigate if venting the patella prior to cementing improved cement penetration. Ten paired cadaver patellae were allocated prior to resurfacing to be vented or non-vented. Bone mineral density (BMD) was measured by DEXA scanning. In vented specimens, a 1.6 mm Kirschner wire was used to breach the anterior cortex at the center. Specimens were resurfaced with standard Profix instrumentation and Versabond bone cement (Smith and Nephew PLC, UK). Cement penetration was assessed from Faxitron and sectioned images by a digital image software package (ImageJ V1.38, NIH, USA). Wilcoxon rank sum test was used to assess the difference in cement penetration between groups. The relationship between BMD and cement penetration was analyzed by Pearson correlation coefficient. There was a strong negative correlation between peak BMD and cement penetration when analyzed independent of experimental grouping (r(2)=-0.812, p=0.004). Wilcoxon rank sum testing demonstrated no significant difference (rank sum statistic W=27, p=0.579) in cement penetration between vented (10.53%+/-4.66; mean+/-std dev) and non-vented patellae (11.51%+/-6.23; mean+/-std dev). Venting the patella using a Kirschner wire does not have a significant effect on the amount of cement penetration achieved in vitro using Profix instrumentation and Versabond cement.

  3. Resurfacing of the patella in total knee arthroplasty. A prospective, randomized, double-blind study.

    Science.gov (United States)

    Barrack, R L; Wolfe, M W; Waldman, D A; Milicic, M; Bertot, A J; Myers, L

    1997-08-01

    of the patella in one knee and retention of the patella in the other. These patients expressed no clear preference for either knee. Eight (13 per cent) of the sixty knees that had not had resurfacing were painful anteriorly compared with four (7 per cent) of the fifty-eight that had; this was not a significant difference (p = 0.38), with the numbers available. The anterior pain that was noted postoperatively was predominantly of new onset; it had not been observed preoperatively in three of the four knees that had had resurfacing or in four of the eight that had not. No additional treatment options were offered to the patients who had anterior pain in the knee after resurfacing. However, six (10 per cent) of the sixty knees that had not had resurfacing had it subsequently, because of anterior pain in the knee, after the twelfth postoperative month (range, fifteen to thirty-nine months). The pain decreased in four of these knees. Thus, total knee arthroplasty with retention of the patella yielded clinical results that were comparable with those after total knee arthroplasty with patellar resurfacing, but it was associated with a 10 per cent prevalence of the need for subsequent resurfacing. The prevalence of anterior pain after total knee arthroplasty was not influenced by whether or not the patella had been resurfaced. The postoperative clinical scores, the postoperative development of anterior pain, and the need for subsequent resurfacing were not predicted by the presence of preoperative anterior pain, obesity, or the grade of chondromalacia observed intraoperatively. Because of the short duration of follow-up, these results should be considered preliminary. Additional follow-up is planned.

  4. Plain film appearances of chondropathia patellae

    Energy Technology Data Exchange (ETDEWEB)

    Schumacher, K.A.; Langer, R.; Langer, M.; Mutschler, W.; von Dewitz, H.

    1981-05-01

    The localised patella defects in our material of 90 patients were largely unchanged up to nine months after surgical treatment. Persistence of soft tissue swelling round the knee correlates with continuing pain. In some cases there has been remineralisation of the patella, which can be regarded as a stage in healing. Unchanged or deteriorating radiological findings may be associated with clinical improvement or deterioration.

  5. Floating patella associated with lymphoedema

    Science.gov (United States)

    Vun, Shen Hwa; Bayam, Levent; Drampalos, Efstathios; Jesry, Mohammed; Fadel, George

    2015-01-01

    Ipsilateral injury of more than one component of the knee extensor apparatus is rare. It is mostly associated with previous trauma, surgery, immunosuppression therapy and systemic disease. We present the first documented case of a spontaneous bifocal disruption of the knee extensor apparatus (i.e. floating patella) associated with lymphoedema. This case highlights the importance of considering lymphoedema as another risk factor for rupture of the knee extensor apparatus. It also highlights the importance of assessing all components of the knee extensor apparatus in patients presenting with acute knee injuries. PMID:25802253

  6. Imaging tumors of the patella

    Energy Technology Data Exchange (ETDEWEB)

    Casadei, R., E-mail: roberto.casadei@ior.it [Department of Orthopaedic Oncology, Istituto Ortopedico Rizzoli, Bologna (Italy); Kreshak, J., E-mail: j.kreshak@yahoo.com [Department of Orthopaedic Oncology, Istituto Ortopedico Rizzoli, Bologna (Italy); Department of Pathology, Istituto Ortopedico Rizzoli, Bologna (Italy); Rinaldi, R. [Department of Radiology, Istituto Ortopedico Rizzoli, Bologna (Italy); Rimondi, E., E-mail: eugenio.rimondi@ior.it [Department of Radiology, Istituto Ortopedico Rizzoli, Bologna (Italy); Bianchi, G., E-mail: giuseppe.bianchi@ior.it [Department of Orthopaedic Oncology, Istituto Ortopedico Rizzoli, Bologna (Italy); Alberghini, M., E-mail: marco.alberghini@ior.it [Department of Pathology, Istituto Ortopedico Rizzoli, Bologna (Italy); Ruggieri, P. [Department of Orthopaedic Oncology, Istituto Ortopedico Rizzoli, Bologna (Italy); Vanel, D., E-mail: daniel.vanel@ior.it [Department of Radiology, Istituto Ortopedico Rizzoli, Bologna (Italy); Department of Pathology, Istituto Ortopedico Rizzoli, Bologna (Italy)

    2013-12-01

    Background: Patellar tumors are rare; only a few series have been described in the literature and radiographic diagnosis can be challenging. We reviewed all patellar tumors at one institution and reviewed the literature. Materials and methods: In an evaluation of the database at one institution from 1916 to 2009, 23,000 bone tumors were found. Of these, 41 involved the patella. All had imaging studies and microscopic diagnostic confirmation. All medical records, imaging studies, and pathology were reviewed. Results: There were 15 females and 26 males, ranging from 8 to 68 years old (average 30). There were 30 benign tumors; eight giant cell tumors, eight chondroblastomas, seven osteoid osteomas, two aneurysmal bone cysts, two ganglions, one each of chondroma, exostosis, and hemangioma. There were 11 malignant tumors: five hemangioendotheliomas, three metastases, one lymphoma, one plasmacytoma, and one angiosarcoma. Conclusion: Patellar tumors are rare and usually benign. As the patella is an apophysis, the most frequent lesions are giant cell tumor in the adult and chondroblastoma in children. Osteoid osteomas were frequent in our series and easily diagnosed. Metastases are the most frequent malignant diagnoses in the literature; in our series malignant vascular tumors were more common. These lesions are often easily analyzed on radiographs. CT and MR define better the cortex, soft tissue extension, and fluid levels. This study presents the imaging patterns of the more common patellar tumors in order to help the radiologist when confronted with a lesion in this location.

  7. Congenital dislocation of the patella - clinical case

    Directory of Open Access Journals (Sweden)

    Pedro Miguel Sá

    2016-02-01

    Full Text Available ABSTRACT Congenital patellar dislocation is a rare condition in which the patella is permanently dislocated and cannot be reduced manually. The patella develops normally as a sesamoid bone of the femur. This congenital dislocation results from failure of the internal rotation of the myotome that forms the femur, quadriceps muscle and extensor apparatus. It usually manifests immediately after birth, although in some rare cases, the diagnosis may be delayed until adolescence or adulthood. Early diagnosis is important, thereby allowing surgical correction and avoiding late sequelae, including early degenerative changes in the knee. A case of permanent dislocation of the patella is presented here, in a female child aged seven years.

  8. Bone-scintigraphy in painful bipartite patella

    Energy Technology Data Exchange (ETDEWEB)

    Iossifidis, A. [Orthopaedic Academic Unit, St. Thomas` Hospital, London (United Kingdom); Brueton, R.N. [Orthopaedic Academic Unit, St. Thomas` Hospital, London (United Kingdom); Nunan, T.O. [Dept. of Nuclear Medicine, St. Thomas` Hospital, London (United Kingdom)

    1995-10-01

    Although, the use of technetium scintigraphy in the assessment of anterior knee pain has been described, no reference has been made to the scintigraphic appearances of painful bipartite patella. We report the scintigraphic-appearances of painful bipartite patella in 25-year-old man a 2 1/2 years history of unexplained patellar pain. Painful bipartite patella is a rare cause of chronic post-traumatic patellar pain. Bone scintigraphy, by demonstrating increased uptake by the painful accessory bipartite fragment, appears to be an imaging method of choice in the diagnosis of this condition. (orig./MG)

  9. [Conservative or operative treatment for chondropathia patellae?].

    Science.gov (United States)

    Ziegler, R; Rau, R

    1980-04-01

    Results of the conservative and operative therapy in chondropathia patellae are reported. A high percentage of freedom from symptoms was achieved by physiotherapeutic measures and intra-articular Arteparon-injections.

  10. Use of magnetic resonance imaging in the diagnosis of chondromalacia patella; Ressonancia magnetica no diagnostico da condromalacia de patela

    Energy Technology Data Exchange (ETDEWEB)

    Freire, Maxime Figueiredo de Oliveira; Fernandes, Artur da Rocha Correa; Freire Filho, Edison de Oliveira; Szejnfeld, Jacob [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail: maximefreire@ig.com.br; Juliano, Yara; Novo, Neil Ferreira [Universidade Santo Amaro (UNISA), SP (Brazil). Faculdade de Medicina; Carneiro Filho, Mario [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Ortopedia e Traumatologia; Silva, Debora da Costa [Universidade Santo Amaro (UNISA), SP (Brazil). Faculdade de Odontologia

    2006-01-15

    Patellar articular cartilage lesions are very common and due to the dissociation between signs and symptoms and the stage of the chondral lesions the diagnostic method of choice is magnetic resonance imaging. Therefore, radiologists should be familiar with chondral abnormalities in order to correctly diagnose this condition. (author)

  11. 髌骨软骨软化症的MR检查及表现%Chondromalacia patellae: evaluation with MRI

    Institute of Scientific and Technical Information of China (English)

    毛小明; 蒋廷宠; 杨建荣; 林坚

    2010-01-01

    @@ 髌骨软骨软化症广泛见于膝关节退行性变、类风湿性关节炎、创伤性关节炎等患者,是膝关节酸痛患者关节病理改变中的常见征象[1].由于常规X线、CT对软骨显示不佳,相关研究并不深入,MR进入临床后,凭借其对软组织的高分辨率,髌骨软骨软化症的研究得到了明显促进.

  12. MR on diagnosis and grading of chondromalacia patellae%MR对髌骨软化症的诊断分析

    Institute of Scientific and Technical Information of China (English)

    张振勇

    2010-01-01

    目的:探讨MR对髌骨软化症的诊断及分级价值.方法:回顾性分析452例(885膝)髌骨软化MRI表现与物理检查、临床表现或关节镜对照.结果:452例(885膝)髌骨软化症,MRI诊断髌骨软化症与物理检查及临床表现或关节镜所见符合率均为100%.结论:MRI能准确判断髌骨软化的范围及程度,是髌骨软化症的最佳检查方法.

  13. 手法治疗髌骨软骨病67例%Using Manuduction to Treat Chondromalacia Patellae

    Institute of Scientific and Technical Information of China (English)

    陈耀明

    2001-01-01

    @@ 笔者自1997年至今采用以手法治疗为主,配合医疗体育,治疗髌骨软骨病83例,其中有较完整资料的67例,现报告如下. 一般资料本组中男性28例,女性39例;年龄20~62岁,平均44岁;病程2个月~25年.双膝患病者13例,单膝患病者54例.本组绝大多数患者无外伤史,初期无明显疼痛与不适,仅在劳累后感膝关节酸软,隐痛乏力,休息后症状消失.后期疼痛逐渐增加,甚至行走或安静时也有痛感,自觉膝软无力,甚至突然跪下,任何动作都能使疼痛加重.叩诊时髌骨髌下有疼痛,髌骨软骨摩擦试验为阳性,髌骨边缘内有压痛.

  14. Case report 539: Tophaceous gout of the patella

    Energy Technology Data Exchange (ETDEWEB)

    Walot, I.; Staple, T.W.

    1989-05-01

    Anteroposterior, lateral, and skyline radiographs of a man's left knee and patella showed extensive destructive changes in the lateral half of the patella and a partially calcified adjacent soft tissue mass. The articular cartillages were moderately calcified, but the cartilage space was normal. A joint effusion was present. The diagnosis is: Tophaceous gout of the patella. (orig./GDG).

  15. Quadriceps tendon rupture through a superolateral bipartite patella.

    Science.gov (United States)

    Woods, G William; O'Connor, Daniel P; Elkousy, Hussein A

    2007-10-01

    We report a case of a quadriceps tendon rupture through a bipartite patella. Although quadriceps tendon ruptures and patella fractures are common, rupture through a bipartite patella fragment is rare. This case was managed similar to a quadriceps rupture with an excellent result.

  16. A hypoplastic patella fracture in nail patella syndrome: a case report

    LENUS (Irish Health Repository)

    Neill, Shane C O

    2012-07-16

    AbstractIntroductionNail patella syndrome is a rare autosomal dominant hereditary condition, with an incidence of 22 per million in the United Kingdom. The syndrome’s most common features include iliac horns, hypoplastic patella and nail dysplasia.Case presentationWe report the case of a 26-year-old Caucasian man with nail patella syndrome who sustained a fracture of his right hypoplastic patella after a fall. His right knee became swollen and he was unable to extend against gravity immediately post fall. Radiographs revealed a fracture of the lower pole of his right patella with associated complete disruption of the extensor mechanism of the knee. He underwent operative fixation and his post operative course was uneventful. He was further treated post operatively with a full knee cast and graded immobilization. At six months he had regained the full range of motion at the knee joint.ConclusionsTo the best of our knowledge, this is the only case report in the literature describing a patella fracture in an individual with nail patella syndrome. We hypothesize that given the extent of pre-existing knee joint impairment in these individuals, functional outcome may be inferior, suggesting the need for more frequent follow-up.

  17. Breeding implications resulting from classification of patellae luxation in dogs.

    Science.gov (United States)

    van Grevenhof, E M; Hazewinkel, H A W; Heuven, H C M

    2016-08-01

    Patellar luxation (PL) is one of the major hereditary orthopaedic abnormalities observed in a variety of dog breeds. When the patellae move sideways out of the trochlear groove, this is called PL. The PL score varies between dogs from normal to very severe. Reducing the prevalence of PL by breeding could prevent surgery, thereby improve welfare. Orthopaedic specialists differentiate between normal and loose patellae, where the patellae can be moved to the edge of the trochlear groove, considering scoring loose patellae as normal in the future. Loose patellae are considered acceptable for breeding so far by the breeding organization. The aim of this study was to analyse the genetic background of PL to decide on the importance of loose patellae when breeding for healthy dogs. Data are available from two dog breeds, that is Flat-coated Retrievers (n = 3808) and Kooiker dogs (n = 794), with a total of 4602 dogs. Results show that loose patellae indicate that dogs are genetically more susceptible to develop PL because family members of the dogs with loose patellae showed more severe PL. In addition, the estimated breeding values for dogs with loose patellae indicate that breeding values of dogs with loose patellae were worse than breeding values obtained for dogs with a normal score. Given these results, it is advised to orthopaedic specialists to continue to score loose patellae as a separate class and to dog breeders to minimize the use of dogs in breeding with a genetically higher susceptibility for PL.

  18. Diagnosis of chondropathia patellae using CT arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Reiser, M.; Rupp, N.; Zacher, H.; Paar, O.; Aigner, R.

    1985-11-01

    In suspected chondropathia patellae, CT after intraarticular contrast injection considerably facilitates the preoperative diagnosis. This technique is less costly and laborious than arthroscopy and has a high level of reliability. Before taking surgical measures, the clinical symptoms and the extent of cartilage degeneration must be known.

  19. Rubbing Therapy with Ointment for Patella Strain in 42 Cases

    Institute of Scientific and Technical Information of China (English)

    SUN De-bin; ZHANG Wan-li; XIAO Yuan-chun

    2003-01-01

    Objective: The clinical effects of rubbing therapy with ointment in treating patella strain were observed. Method: Forty-two cases of patella strain were treated by local rubbing with ointment and the changes of the clinical symptoms were observed. Results: After 3 courses of treatment, the total effective rate was 95.2%.Conclusion: It is indicated that rubbing therapy with ointment has good effects in the treatment of patella strain.

  20. Chondroblastoma patella presenting as a pathological fracture

    Directory of Open Access Journals (Sweden)

    Gudi Narayan

    2008-01-01

    Full Text Available A 24-year-old male presented with an inability to walk after a trivial fall. He had pain and mild swelling anterior to the right knee for the past one year. X-ray showed a transverse fracture of patella with a lytic lesion occupying most of the two halves of the patella. Fine needle aspiration cytology (FNAC of the lytic lesion revealed a few osteoclastic giant cells and occasional osteoblasts against a hemorrhagic background. Patellectomy was performed. Histology revealed trabecular bone admixed with proliferating chondroid tissue at places admixed with myxoid and fibrous tissue with focal areas of calcification suggestive of chondroblastoma. Focal areas showed osteoclastic giant cells with areas of hemorrhage. The purpose is to present a rare tumor occurring at an unusual site which presented as pathological fracture.

  1. Double congenital patella: case report and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Visconti, D. [Servizio di Radiologia Ospedale Cavalese Trento, Via Dossi 17, I-38 033 Cavalese (Italy); Della Sala, S.W. [U. O. di Radiologia, Sezione TAC RM, Ospedale S. Chiara, I-38100 Trento (Italy); Bianchini, G. [A. O. di Ortopedia e Traumatologia, Ospedale Cles, I-38023 Trento (Italy); Manera, V. [U. O. di Radiologia, Sezione TAC RM, Ospedale S. Chiara, I-38100 Trento (Italy)

    1996-08-01

    The authors report a case of double congenital patella, which is a rare finding. This anomaly was studied using radiography, CT and MR. Magnetic resonance imaging has enabled us to make an accurate anatomical evaluation of the double congenital patella. (orig.). With 5 figs., 2 tabs.

  2. Chondroblastoma of the patella with aneurysmal bone cyst.

    Science.gov (United States)

    Tan, Honglue; Yan, Mengning; Yue, Bing; Zeng, Yiming; Wang, You

    2014-01-01

    Chondroblastoma of the patella is rare. Aneurysmal bone cysts, which develop from a prior lesion such as a chondroblastoma, are seldom seen in the patella. The authors report a case of a 36-year-old man who presented with 2 years of right knee pain without calor, erythema, pain on palpation, or abnormal range of motion. Radiological studies suggested aneurysmal bone cyst. The lesion was excised with curettage and the residual cavity filled with autogenous bone graft. Histopathology revealed chondroblastoma associated with a secondary aneurysmal bone cyst. In the follow-up period, the patient demonstrated normal joint activities with no pain. Normal configuration of the patella and bone union were shown on plain radiographs. The authors present a review of the literature of all cases of patellar chondroblastoma with aneurysmal bone cyst. This case is the 14th report of aneurysmal bone cyst arising in a chondroblastoma of the patella. According to the literature, computed tomography and magnetic resonance imaging are useful in the study of these lesions. The pathologic diagnosis is based on the presence of chondroblastoma and aneurysmal bone cyst. Treatment of this lesion includes patellectomy, curettage alone, and curettage with bone grafting. Despite the risk of recurrence of this lesion in the patella, the authors first recommend curettage followed by filling the cavity with bone graft. To protect the anterior tension of the patella intraoperatively, the bone window should be made at the medial edge of the patella to perform the curettage and bone grafting.

  3. Magnetic resonance imaging features of asymptomatic bipartite patella

    Energy Technology Data Exchange (ETDEWEB)

    O' Brien, J., E-mail: juliemobrien@gmail.com [Department of Radiology, Adelaide and Meath Incorporating National Children' s Hospital, Tallaght, Dublin 24 (Ireland); Murphy, C.; Halpenny, D.; McNeill, G.; Torreggiani, W.C. [Department of Radiology, Adelaide and Meath Incorporating National Children' s Hospital, Tallaght, Dublin 24 (Ireland)

    2011-06-15

    Objective: The purpose of our study was to describe the magnetic resonance imaging (MRI) features of bipartite patella in asymptomatic patients. Materials and methods: The study was prospective in type and performed following institutional ethical committees approval. In total, 25 subjects were recruited into the study and informed consent obtained in each case. The local radiology database was utilised in conjunction with a clinical questionnaire to identify patients who had asymptomatic bipartite patella. Any patient with a history of trauma or symptomatic disease was excluded from the study. MRI imaging was performed in each case on a 1.5 T system using a dedicated knee coil and a standardised knee protocol. The images obtained were then analysed by two musculoskeletal radiologists in consensus. Results: Of the 25 subjects, there were 8 females and 17 males. The mean age was 34.6 years. All but one of the bipartite fragments were located on the superolateral aspect of the patella. In 23 cases, one fragment was identified. The average transverse diameter of the fragment was 12.8 mm. The average distance between the fragment and the adjacent patella in the axial plane was 1.46 mm. In addition, the cartilage overlying the patella and accessory fragment was intact in all cases. The average thickness of the patella cartilage at its border to the fragment was 2.4 mm with an average ratio of the cartilage thickness of the fragment as compared with the cartilage thickness of the patella of 0.72. There was no evidence of high signal or bone marrow oedema on fluid sensitive sequences within either the patella or the fragment in any of the patients. Fluid was identified in the cleft between the patella and the fragment in the majority of cases. Conclusions: Asymptomatic bipartite patella is characterised by intact but thinned cartilage along the border between the patella and the fragment, fluid between the cleft and a lack of any bone marrow oedema or high signal within

  4. [Operative treatment of lateral hyperpressure syndrome of the patella].

    Science.gov (United States)

    Franke, J; Riede, D; Rudolph, F

    1980-04-01

    The lateral hyperpressure syndrome of the patella according to Ficat is characterized as a main cause of chondropathia patellae. Symptoms and course as well as roentgenology of this syndrome are illustrated. The logical method of treatment of this syndrome is the lateral release-operation according to Viernstein and Weigert. With this operation we gained good and very good results in 77 per cent of the 30 operated knee-joints.

  5. Self-excision of bilateral patellae treated by replantation: a report of one case

    Institute of Scientific and Technical Information of China (English)

    YANG Mao-wei; WANG Xu-dong; CHU Li-wei

    2009-01-01

    @@ Absence of patella may be caused by congeni tal factors, trauma and surgical operations (patellectomy, etc).1 Complete absence of bi-lateral patellae is rare in clinical case. We report a case of posttraumatic bilateral patella excision. To the best of our knowledge, absence of bilateral patel-lae caused by self-mutilation has never been reported.Our patient and his family members were informed that the data concerning this case would be submit-ted for publication.

  6. Anatomic dimensions of the patella measured during total knee arthroplasty.

    Science.gov (United States)

    Baldwin, James L; House, C Ken

    2005-02-01

    The anatomic measurements of 92 patellae with normal underlying bony structure were studied during total knee arthroplasty before and after resection of the articular surface. The articular surface of the patella was found to have an oval shape with a width-to-height ratio (46 x 36 mm) of 1.30. The dome was 4.8 mm high and displaced medially 3.6 mm. The medial facet was slightly thicker than the lateral facet (18 vs 17 mm). The lateral facet is 25% wider than the medial facet. Coverage provided by oval patellar prostheses was significantly better than with round prostheses. The patellae in women were significantly smaller than in men. Size differences and deformity need to be taken into account when the patella is prepared for resurfacing. It is recommended that the bony resection should be no greater than one third of the maximum patellar thickness to avoid alteration of normal bony structure. Key words: patella, total knee arthroplasty, anatomy.

  7. Osteoid osteoma of the patella: report of two cases

    Institute of Scientific and Technical Information of China (English)

    MA Ke; ZHAO Hai-tao; NIU Xiao-hui; ZHANG Qing

    2011-01-01

    Osteoid osteoma is very rarely located in the patella,and can represent a significant diagnostic challenge,resulting in a delay of treatment.Patients with osteoid osteoma of the patella often present with knee pain that is also a typical symptom of trauma or of other diseases such as arthritis,which are much more common than osteoid osteoma.We present two young male patients diagnosed with osteoid osteoma of the patella.Each of these patients had a history of intense knee pain; however,accurate diagnosis of osteoid osteoma in the patella had been delayed for more than one year.Computed tomography (CT) scans or magnetic resonance imaging (MRI) showed a circumscribed lesion of the patella in both patients,whereas X-ray examination (posteroanterior projection) was not able to detect the tumor.Different surgical procedures were performed in these patients for resection of the tumors,and the pathology findings confirmed the diagnosis of osteoid osteoma.Both patients recovered completely from surgery.

  8. Biologic resurfacing of the patella bone versus patellectomy

    Directory of Open Access Journals (Sweden)

    Motamedi M

    1995-04-01

    Full Text Available In the past years, there was a tendency to excise the patella in pathologic conditions affecting this bone. The patella has many critical effects in the function of the knee joint. For example, after its exicision the force of quadriceps muscle decreases by forty percent (40% and the knee joint becomes prone to early osteoarthritic changes. For these reasons, in the recent years the "biologic resurfacing of patella" has been used in pathologic conditions instead of its complete removal. In this new method after resection of the diseased part of the bone, the fascia of the quadriceps muscle, with its intact base, is used to cover the resected part of the bone. In practice, after pain relief, the active motion of the joint is started. Then the limb is placed in a splint or brace and after a period of 3 weeks, passive motion is begun.

  9. A RARE FAMILIAL CASE REPORT OF NAIL-PATELLA SYNDROME

    Directory of Open Access Journals (Sweden)

    Rakesh

    2014-10-01

    Full Text Available Nail-patella syndrome is a rare genetic disorder, which is inherited as an autosomal dominant trait. This condition is also known as hereditary osteo-onychodysplasia (HOOD syndrome, Fong’s syndrome, Turner-Kieser syndrome. (1 Posterior iliac horns are commonly found in this syndrome and are considered pathognomonic. In this case report we have described almost all the radiographic features of nail-patella syndrome including the pathognomic iliac horns and other skeletal features including absent or hypoplastic patellae, elbow abnormalities, as seen on radiographs. The magnetic resonance imaging (MRI of the features of this syndrome has been mentioned in only one report, (2 however, no images were actually presented. Considering the hereditary nature (autosomal dominant of the syndrome we wanted to rule out whether any other member in the family are involved and to our surprise we found two other members(mother and elder brother in the family with similar features.

  10. 蒙古族牧民髌骨软化症及其超声诊断%Chondromalacia Patellae and Ultrasonic Diagnosis in the Mongolian Herder

    Institute of Scientific and Technical Information of China (English)

    李波; 秦林金; 刘志跃; 陈瑶; 龚岩萍

    2003-01-01

    目的:探讨蒙古族牧民髌骨软化症的发病规律及B超对该病的诊断.方法:用一般体检和B超结合,在牧区检查150人,其中苏木、嘎查干部40人,牧民110人.结果:按症状疼痛分级共检出41人,按超声分级共查出36人髌骨软骨软化症.高发年龄为40~59岁.结论:蒙古族牧民髌骨软骨软化症发病率较城镇居民高.体征、症状中的疼痛与B超膝关节软骨改变结合,可以较好地诊断髌骨软骨软化症.

  11. Therapy of Integrated Medicine in the Treatment of Chondromalacia Patellae for 50 Cases%中西医结合治疗髌骨软化症50例

    Institute of Scientific and Technical Information of China (English)

    李源培; 王战朝; 段卫峰

    2015-01-01

    目的 探讨中药熏洗、股四头肌功能锻炼配合玻璃酸钠关节腔注射治疗髌骨软化症的临床疗效.方法 100例患者随机分为两组,治疗组50例给予中药熏洗、股四头肌功能锻炼配合玻璃酸钠关节腔注射,对照组50例仅给予玻璃酸钠关节腔注射,连续治疗4周后对比两组的临床疗效.结果 治疗组有效率为95.8%,对照组有效率为86.7%,两组有效率比较,差异具有统计学意义(P<0.05).结论 中药熏洗、股四头肌功能锻炼配合玻璃酸钠关节腔注射治疗髌骨软化症具有明显的临床疗效.

  12. 髌骨软化症的中医药治疗概述%An Overview of Traditional Chinese Medicine in the Treatment of Chondromalacia Patellae

    Institute of Scientific and Technical Information of China (English)

    宋聚才; 毛书歌

    2016-01-01

    髌骨软化症的发病率逐年增高,是膝关节常见疾病之一,是由髌骨软骨面因慢性磨损发生变性,引起髌股关节病变.好发于体力劳动者、中年肥胖女性和运动员.中医认为,本症多因肝肾亏虚、筋骨萎软而发病.其治疗原则是整体与局部,治疗与锻炼并举,调动气血功能.对中医理筋手法、针灸、小针刀、中药外治、中药内服、综合治疗及预防方面进行了综述.目前,在髌骨软化症的诊治方面,还存在着诸多问题.

  13. APPLICATION OF B-MODE ULTRASONIC DIAGNOSTIC APPARATUS IN CHONDROMALACIA PATELLAE%髌骨软骨软化的B超诊断及其应用

    Institute of Scientific and Technical Information of China (English)

    李波; 秦林金; 刘志跃; 陈瑶; 龚岩萍

    2003-01-01

    目的:探讨髌骨软骨软化的B超诊断价值及与临床诊断符合率.方法:将探头置髌骨下方沿关节面向其后方关节腔内倾斜40°~60°,可获得股骨髁髁间软骨和髌骨关节软骨图像.结果:髌骨软骨软化时,软骨的厚度变化不大,但其与股骨界面和关节软骨界面回声图呈现出凸凹不平的毛糙或毛刺样改变.其改变范围与程度和临床症状中的疼痛成正相关.结论:应用B超诊断髌骨软骨软化无创、简便易行,值得推广.

  14. The Research of Low-Field MR Imaging in the Diagnosis of Chondromalacia Patellae%髌骨软化症的低场MRI诊断研究

    Institute of Scientific and Technical Information of China (English)

    王永栋; 亓建洪; 赵敏; 朱建忠; 徐荣春; 宋兴军

    2002-01-01

    目的探讨髌骨软化症的低场MRI表现特点及诊断价值.方法应用0.3 Tesla MRI装置对37例确诊为髌骨软化症的病例进行MRI检查,结合关节镜和手术结果对MRI表现进行回顾性对照分析,探讨不同程度软骨损伤的MRI表现特点.结果以关节镜和手术结果为金标准,MRI诊断CMP的准确性为79.4%,其中早期28.6%,晚期92.6%.结论低场MRI诊断晚期髌骨软化症准确性高,可作为判断髌骨软化症的首选无创性检查方法.

  15. DR诊断髌骨软骨软化的价值探讨%Value of DR in diagnosing chondromalacia patellae

    Institute of Scientific and Technical Information of China (English)

    赵其江; 高屹

    2006-01-01

    数字放射成像系统(DR)的应用,标志着放射成像技术步入了一个新的数字化时代,它较普通放射线成像具有了诸多优点。笔者主要探讨DR的图像后处理对诊断髌骨软骨软化的价值和临床意义。

  16. Observations on the Therapeutic Effect of Electroacupuncture on Chondromalacia Patellae%电针治疗髌骨软化症疗效观察

    Institute of Scientific and Technical Information of China (English)

    车涛; 陈永强; 裘敏蕾; 孙剑; 李岩峰

    2010-01-01

    目的 观察电针治疗髌骨软化症的疗效.方法 将63例患者随机分为治疗组32例和对照组31例,治疗组采用电针内外膝眼穴治疗,对照组口服双氯芬酸钠缓释剂,治疗结束后半月统计疗效.结果 治疗组治愈率与有效率均高于对照组,两组比较差异均有统计学意义(P<0.05).结论 电针膝眼穴治疗髌骨软化症疗效优于口服双氯芬酸钠缓释剂治疗.结果表明电针内外膝眼穴是治疗髌骨软化症的有效方法.

  17. 手法治疗髌骨软化症320例疗效观察%Curative Effect of Massage Manipulation on 320 Cases of Chondromalacia Patellae

    Institute of Scientific and Technical Information of China (English)

    王安有; 王静; 钟玮

    2004-01-01

    目的观察手法治疗髌骨软化症的效果.方法采用揉捻、( )、散等手法治疗髌骨软化症320例.结果临床治愈295例,好转24例,总有效率99.7%.结论手法是治疗髌骨软化症的有效方法.

  18. The Clinical Observation of Compositive Remedial Method in Chondromalacia Patellae%综合疗法治疗髌骨软骨软化症

    Institute of Scientific and Technical Information of China (English)

    扈诗兴

    2006-01-01

    髌骨软骨软化症是一种常见病、多发病.针对此病的特点,采用手法按摩、当归局部注射和功能锻炼综合运用的方法进行治疗,取得了较好疗效,二个疗程后总有效率达98%.综合运用上述三种方法,可充分发挥各自特点,达到综合治疗髌骨软骨软化症的目的,是一种较好的治疗方法.

  19. Clinical Observation on Chondromalacia Patellae Treated by Acupuncture and Massage%针灸推拿治疗髌骨软化症临床观察

    Institute of Scientific and Technical Information of China (English)

    高扬

    2002-01-01

    目的:观察针灸结合推拿治疗髌骨软化症的疗效,探讨治疗髌骨软化症的有效方法.方法:共治82例,随机分为针灸推拿治疗组52例,中药对照组30例.结果:治疗组总有效率98.1%,对照组总有效率76.7%,有非常显著性差异(P<0.01).结论:针灸结合推拿治疗髌骨软化症疗效优于中药治疗.

  20. 髌骨软化症中医治疗进展%Progress in Treatment of Chondromalacia Patellae with Traditional Chinese Medicine

    Institute of Scientific and Technical Information of China (English)

    唐传其

    2004-01-01

    髌骨软化症(chondmmalacia patellae,CP)又称髌骨软骨炎,是多种原因使髌骨软骨及相对应的股骨滑车软骨面的软骨磨损呈退行性病变,导致髌骨软化、纤维化、溃疡、剥脱、翘起等而出现膝关节痠软、疼痛、活动受限,是常见病多发病,严重影响患者的工作和生活。CP相当于中医的“痹证”、“劳损”、

  1. Superior dislocation of the patella: a case report

    Directory of Open Access Journals (Sweden)

    Garcia-Balletbo Montserrat

    2009-07-01

    Full Text Available Abstract Background Superior dislocation of the patella is an uncommon condition that mainly occurs in knees with a high patella and medial femorotibial degenerative arthritis. There are no previous reports of this condition occurring in association with tibial valgus osteotomy. Case report: We report the case of a patient in whom vertical dislocation recurred twice at 4 months after tibial valgus osteotomy. To avert additional recurrence or new dislocations, the patient was treated surgically to remove the existing osteophytes. Conclusions: An arthroscopic approach was decided because of the lower associated morbidity and good results with this technique compared to open surgery.

  2. [Chondropathy of the patella. Experiences with 100 medializations].

    Science.gov (United States)

    Villiger, K J

    1976-10-01

    After a brief reference to the biomechanics of the patellofemoral joint, the anamnesis and the clinical and the radiologic symptomatology of chondropathia and the possibilities of its therapy are described. Patellofemoral arthrography is very helpful for the diagnosis. The technique of our operation is also described. After close study of current available literature and careful control of our 100 medialization cases, the results after 6, 12, 24, and 36 months are shown in tabular form. The operation is recommended for primary chondropathia patellae with lateroposition or lateral-tipped patella.

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

    Science.gov (United States)

    Dobler, R

    1977-06-26

    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.

  4. Treatment of the chondromalacia patellae with radiofrequency (RF) and decompression of patella%关节镜下射频汽化结合髌骨周围钻孔减压治疗髌骨软骨病

    Institute of Scientific and Technical Information of China (English)

    王健; 张佐伦; 张伟; 孙水

    2005-01-01

    目的:研究射频汽化结合髌骨钻孔减压在治疗髌骨软骨病变中的临床效果.方法:利用Arthro Care 2000射频汽化仪对56例髌骨软骨病变患者行损伤的软骨面修整,髌骨周缘滑膜清理;直径2~2.5mm克氏针,自髌骨两侧缘向髌骨内钻孔减压.9例同时行外侧支持带松解.结果:随访6个月~2年10个月,平均1年7个月.术后患者疼痛症状明显缓解.Lysholm评分由术前平均56分提高到术后平均91分.结论:射频汽化仪治疗精确,最大限度地保留了未受损伤的软骨组织;联合髌骨钻孔减压治疗髌骨软骨病变效果良好,术后康复快.

  5. 部队战士髌骨软骨软化症与髌骨异常改变相关性调查%Correlation survey between chondromalacia patellae and patella exceptional change among army solider

    Institute of Scientific and Technical Information of China (English)

    赵岩; 赵奇峰

    2012-01-01

    目的 探讨部队战士髌骨软骨软化症发生与髌骨异常改变的关系.方法 选取2005-2008年正常参加部队训练且确诊为髌骨软骨软化症战士50名(观察组)和正常战士50名(对照组),均X线摄髌骨轴位片,测量6个参数并进行对照.结果 观察组患者外侧髌股角、髌骨倾斜角、髌股关节指数及适应角与对照组比较差异有统计学意义(P<0.05).结论 部队战士中髌骨异常改变易致髌骨软骨软化症,也是髌骨软骨软化症的发展结果.

  6. A case of ectopic cilia in nail-patella syndrome.

    Science.gov (United States)

    Edmunds, Matthew R; Kipioti, Athina; Colloby, Peter S; Reuser, Tristan T Q

    2012-06-01

    Both ectopic cilia and nail-patella syndrome (NPS) are rare entities. To our knowledge we report the first case of the two anomalies coexisting in one patient. We present the case of a 2-year-old girl, with no other ophthalmic complication of NPS, who had an excellent cosmetic outcome and no lesion recurrence following surgical excision of ectopic cilia.

  7. Prevalence and clinical significance of chondromalacia isolated to the anterior margin of the lateral femoral condyle as a component of patellofemoral disease: observations at MR imaging.

    LENUS (Irish Health Repository)

    Chan, V O

    2013-08-01

    To determine the prevalence of chondromalacia isolated to the anterior margin of the lateral femoral condyle as a component of patellofemoral disease in patients with anterior knee pain and to correlate it with patient demographics, patellar shape, and patellofemoral alignment.

  8. Patella fracture following anterior cruciate ligament reconstruction: A case report

    Directory of Open Access Journals (Sweden)

    Milankov Miroslav

    2003-01-01

    Full Text Available Introduction The most frequent procedure in treatment of acute or chronic anterior cruciate ligament (ACL rupture is the so called bone-tendon-bone reconstruction. A transverse dislocated patella fracture is a rare complication of this procedure with an incidence of 0.23%-2.3%. In a five year period, (1998-2002, 407 arthroscopic reconstructions of the anterior cruciate ligaments were done at our Clinic, and there was only one case of patella fracture. Case report An 18-year-old female patient, a handball player, suffered an acute rupture of anterior cruciate ligament of the left knee, so arthroscopic bone-tendon-bone reconstruction of the anterior cruciate ligament was performed. After adequate skin incision, a bone graft was taken from the patella and upper part of trapezoid tibia, which was 25 mm long, 10 mm wide and 5 mm thick, together with a part of patellar ligament. After the remains of the anterior cruciate ligament had been arthroscopically removed, tunnels were made in tibia and femur and a graft was inserted and fixed with two metal interference screws. Knee stability was tested, and drainage was put in the knee joint. The wound was closed by layers. The quadriceps exercises and passive knee movements started immediately. Full range of movements was accomplished six weeks later when the patient started to walk with full weight-bearing on her operated leg. Three weeks later, (nine weeks after the operation, the patient has accidentally lost her balance and fell. A transverse, dislocated fracture of the left patella was diagnosed and osteosynthesis of the fractured patella with two Kirschner wires and a metallic loop was performed. Postoperatively, full range of movement was allowed. Six months later, the patient felt no pain, there was no swelling, full range of knee movement was achieved, while the Lachman Test was identical in both knees and the pivot shift test was negative. Discussion Fracture of patella after ACL reconstruction is

  9. Valu of dGEMRIC in Diagnosing Early Chondromal Acia patellae%软骨延迟增强磁共振成像诊断早期髌骨软化症

    Institute of Scientific and Technical Information of China (English)

    蓝燚锋; 马云彪; 范淑玉; 吕永章; 麦莲清; 叶艺先; 熊刚; 冯经旺; 蔡宇超

    2016-01-01

    Objective Todiscuss the feasibility and the value of dGEMRIC in diagnosis of ea rly stage of chondromal acia patellae. Methods 41 patients with Chondromalacia patellae patients at early stage.3D-FS-SPGR series horizontal scan, the patients were asked to walk for 10min to make the medium disperse into the cartilage. The patients underwent dGEMRIC scan 2h later. The results compared with Arthroscopy results.Results Normal patellar articular cartilage was evident on the series band and visible high-and low-high signal three-storey structure in 3D-FS-SPGR series. Cartilage damage are relatively low signal in 3D-FS-SPGR. Are focal in dGEM RIC series high signal. 3D-FS-SPGR scan of patellar cartilage stageⅠ showed the rate 36.8% (7/19), stageⅡ of Chondromalacia disease rate 50% (11/22), delayed enhanced stageⅠof Chondromalacia disease rate 73.7% (14/19), stageⅡof Chondromalacia disease rate 86.4% (19/22). The t test, patellar cartilage delayed enhancement scan in diagnosis of stageⅠandⅡ injury rate were significantly higher than the plain( StageⅠ t=2.646, P=0.016, StageⅡ t=2.531, P=0.017).Conclusion 3D-FS-SPGR delay-enhanced judgement patellar cartilage injury more sensitive than flat whisk, is an early diagnosis of Chondromalacia patellae has advantages, non-invasive method.%目的:探讨dGEM RIC用于诊断早期髌骨软化症的可行性和价值。方法选取41例早期髌骨软化症患者,先行3D-FS-SPGR系列平扫检查,经肘静脉注射钆喷酸葡胺后步行10min 使对比剂尽量弥散至髌关节软骨内,注射后2h再行3D-FS-SPGR延迟增强对关节软骨进行评价,并将检查结果与关节镜检查结果进行对照。结果3D-FS-SPGR系列上正常髌软骨呈明显带状高信号,并可见高-低-高三层结构;软骨损伤在3D-FS-SPGR上呈相对稍低信号,在dGEM RIC系列上呈局灶高信号;3D-FS-SPGR序列平扫对Ⅰ期髌软骨损伤显示的符合率为36.8%(7/19),对Ⅱ期髌

  10. [Experiences and results of 1300 indentation operations for proximal medialization of the patella].

    Science.gov (United States)

    Villiger, K J

    1980-07-01

    Of 1039 patients, 1300 knee joints were operated on for chondropathia patellae or patellofemoral osteoarthrosis; the results are arranged in tabular form. The basic operation was proximal medialization of the patella by indent operation. Additional interventions like retropatellar should be indicated by an experienced surgeon. The excellent results found 6, 12, 40, and 60 months after the operation recommmend this procedure for the treatment of chondropathia patellae or osteoarthrosis.

  11. A Case of Patella Metastasis of Papillary Thyroid Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Han, Eun Ji; Choi, Woo Hee; Chung, Yong An; Sohn, Hyung Sun; Kang, Chang Suk [College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2009-02-15

    A 73-year-old man presented with a chief complaint of progressive left knee pain for two months. He had a history of total thyroidectomy and central lymph node dissection due to papillary thyroid carcinoma three months ago. MRI images revealed a solid mass in the left patella. A solid mass demonstrated low signal on T1 weighed image, and high signal on T2 weighed image. And whole body bone scan showed focal photon defect in same lesion of left patella. The histologic result of left knee lesion was adenocarcinoma, consistent with metastatic papillary thyroid carcinoma. Although patellar metastasis of papillary thyroid carcinoma is very rare, when knee pain and radiologic abnormality are noted, differential diagnosis of metastasis is necessary.

  12. Chondropathia patellae and knee muscle control. An electromyographic study.

    Science.gov (United States)

    Hess, T; Gleitz, M; Egert, S; Hopf, T

    1996-01-01

    The activity of knee-related muscles was registered via exercising on a bicycle ergometer by 17 patients with clinically diagnosed chondropathia patellae. M. quadriceps activity was shorter and the hamstring activity longer in the chondropathy group compared with a matched healthy control group. The changes in m. quadriceps occurred to an almost equal extent in lateral and medial sections. In five patients with unilateral complaints, the electromyographic changes were nevertheless noted on both sides. The study shows that chondropathia patellae involves a change in muscle control affecting not only the knee extensors but also the hamstrings. Through the changed innervation pattern the coactivation phase, i.e. the phase of simultaneous activation of knee flexors and extensors at the end of the extension phase, takes place at a higher angle of flexion. Physiotherapy should involve all knee-related muscles and should include not only isometric but also dynamic exercises.

  13. Traumatic separation of a type I patella bipartite in a sportsman

    DEFF Research Database (Denmark)

    Ottesen, Casper Smedegaard; Barfod, Kristoffer Weisskirchner; Holck, Kim

    2014-01-01

    fibrocartilage was found on both parts of the patella. Asymptomatic patella bi-partite was found on X-ray imaging of the patient's left knee, and he was diagnosed to have traumatic separation of a type I patella bipartite. The diagnosis was confirmed by surgical and radiological findings.......This is a case report of a 44-year-old sportsman who experi-enced acute onset of strong pain and loss of ability to extend his right knee during a game of beach volley. X-ray imaging showed a patella in two parts with rounded edges and with a diastasis of more than 2 cm. Intra-operatively atrophic...

  14. Secondary aneurysmal bone cyst following chondroblastoma of the patella.

    Science.gov (United States)

    Tomoyuki, Kato; Susa, Michiro; Nakayama, Robert; Watanabe, Itsuo; Horiuchi, Keisuke; Toyama, Yoshiaki; Morioka, Hideo

    2013-01-01

    Aneurysmal bone cyst (ABC) is a rare benign cystic lesion of the bone that composes 1-2% of the entire bone tumors. Some are idiopathic, and some occur secondary to other tumors such as giant cell tumor and chondroblastoma. In this article, we report the clinical, radiographic, and histological findings of a secondary ABC following chondroblastoma of the patella with a review of the literature.

  15. Secondary aneurysmal bone cyst following chondroblastoma of the patella

    Directory of Open Access Journals (Sweden)

    Tomoyuki Kato

    2013-09-01

    Full Text Available Aneurysmal bone cyst (ABC is a rare benign cystic lesion of the bone that composes 1-2% of the entire bone tumors. Some are idiopathic, and some occur secondary to other tumors such as giant cell tumor and chondroblastoma. In this article, we report the clinical, radiographic, and histological findings of a secondary ABC following chondroblastoma of the patella with a review of the literature.

  16. Anatomy, morphology and evolution of the patella in squamate lizards and tuatara (Sphenodon punctatus).

    Science.gov (United States)

    Regnault, Sophie; Jones, Marc E H; Pitsillides, Andrew A; Hutchinson, John R

    2016-05-01

    The patella (kneecap) is the largest and best-known of the sesamoid bones, postulated to confer biomechanical advantages including increasing joint leverage and reinforcing the tendon against compression. It has evolved several times independently in amniotes, but despite apparently widespread occurrence in lizards, the patella remains poorly characterised in this group and is, as yet, completely undescribed in their nearest extant relative Sphenodon (Rhynchocephalia). Through radiography, osteological and fossil studies we examined patellar presence in diverse lizard and lepidosauromorph taxa, and using computed tomography, dissection and histology we investigated in greater depth the anatomy and morphology of the patella in 16 lizard species and 19 Sphenodon specimens. We have found the first unambiguous evidence of a mineralised patella in Sphenodon, which appears similar to the patella of lizards and shares several gross and microscopic anatomical features. Although there may be a common mature morphology, the squamate patella exhibits a great deal of variability in development (whether from a cartilage anlage or not, and in the number of mineralised centres) and composition (bone, mineralised cartilage or fibrotendinous tissue). Unlike in mammals and birds, the patella in certain lizards and Sphenodon appears to be a polymorphic trait. We have also explored the evolution of the patella through ancestral state reconstruction, finding that the patella is ancestral for lizards and possibly Lepidosauria as a whole. Clear evidence of the patella in rhynchocephalian or stem lepidosaurian fossil taxa would clarify the evolutionary origin(s) of the patella, but due to the small size of this bone and the opportunity for degradation or loss we could not definitively conclude presence or absence in the fossils examined. The pattern of evolution in lepidosaurs is unclear but our data suggest that the emergence of this sesamoid may be related to the evolution of secondary

  17. Effect of bone block removal and patellar prosthesis on stresses in the human patella.

    Science.gov (United States)

    Friis, E A; Cooke, F W; McQueen, D A; Henning, C E

    1994-01-01

    Thermoelastic stress analysis was used to examine stresses on the anterior surface of patellae after patellar bone block excision for autogenous graft anterior cruciate ligament reconstruction. Complications of anterior cruciate ligament injury often lead to degenerative changes in the knee that can require total knee joint replacement. It was hypothesized that stresses in a bone block-compromised patella may be increased even further by insertion of a patellar prosthesis. All patellae were first tested intact and then were retested after a sequence of surgical modifications including patellar prosthesis implantation, tapered bone block excision, square bone block excision, and both shapes of excised bone blocks with a patellar prosthesis in place. Stresses in patellae with bone blocks excised were significantly greater than stresses in intact patellae. The anterior surface stress pattern in the loaded patella was significantly altered by excision of a bone block. There were no significant differences between maximum stress in patellae with tapered and square bone blocks excised. A finite element analysis showed that excision of a larger trapezoid-shaped bone block greatly increased maximum stress levels. Insertion of a patellar prosthesis did not significantly alter stress patterns or maximum stress levels in the patella.

  18. [Plain film appearances of chondropathia patellae. Morphological changes after surgical treatment (author's transl)].

    Science.gov (United States)

    Schumacher, K A; Langer, R; Langer, M; Mutschler, W; von Dewitz, H

    1981-05-01

    The localised patella defects in our material of 90 patients were largely unchanged up to nine months after surgical treatment. Persistence of soft tissue swelling round the knee correlates with continuing pain. In some cases there has been remineralisation of the patella, which can be regarded as a stage in healing. Unchanged or deteriorating radiological findings may be associated with clinical improvement or deterioration.

  19. KONDROMALASİA PATELLA (Bir vak'a Münasebetiyle)

    OpenAIRE

    Ulku, Ozer

    2004-01-01

    Condromalacia-patella which is seen on the patellafemoral face is the degeneration of the patella articular cartilage, and generally missed since it doesnt give clinical symptom and can't be observed in rontgenogram. Here is given some information for the diagnosis and treatment of this disease releated to a patient in our clinic.

  20. [Chondropathia patellae--a sequel of a primary neurogenic lesion?].

    Science.gov (United States)

    Rüther, W; Vogel, P; Tackmann, W

    1987-01-01

    In twenty patients with a patellar pain syndrome (Chondropathia patellae) the quadriceps muscles were examined electromyographically. The study aimed for detection of neural lesions in the respective segments. According to Weh and Eickhoff (1983) nerve root lesions are the common cause for patellar pain syndrome. In their opinion malinnervation of the quadriceps leads to a muscular disbalance of the vastus medialis and lateralis and in consequence to an unphysiological traction of their patellar insertions that induces pain. Neither clinical data nor electromyographical findings gave any indication to believe that primary nerve root disturbances are a common cause for patellar pain syndrome.

  1. Primary tumors of the patella. A review of 42 cases

    Energy Technology Data Exchange (ETDEWEB)

    Kransdorf, M.J. (Walter Reed Army Medical Center, Washington, DC (USA). Dept. of Radiology; University of the Health Sciences, Bethesda, MD (USA). Dept. of Radiology and Nuclear Medicine); Moser, R.P. Jr. (Armed Forces Inst. of Pathology, Washington, DC (USA). Dept. of Radiologic Pathology; University of the Health Sciences, Bethesda, MD (USA). Dept. of Radiology and Nuclear Medicine); Vinh, T.N. (Armed Forces Inst. of Pathology, Washington, DC (USA). Dept. of Orthopaedic Surgery); Aoki, J. (Armed Forces Inst. of Pathology, Washington, DC (USA). Dept. of Radiologic Pathology); Callaghan, J.J. (Duke Univ., Durham, NC (USA). Dept. of Orthopaedic Surgery)

    1989-08-01

    This study reports 42 cases of histologically proven and radiographically correlated primary patellar tumors. Despite diverse histologic diagnoses, the radiographic appearanaces of benign as opposed to malignant patellar neoplasms are essentially indistinguishable. Although the literature suggests that giant cell tumor is the most frequent benign tumor of the patella, the most common benign neoplasm in this series is chondroblastoma (16 cases). Only four primary malignant lesions were encountered, three cases of lymphoma and one case of hemangioendothelioma. Since 38 (90%) of the 42 cases were benign, a benign etiology should be strongly favored, notwithstanding the radiographic appearance, whenever a primary patellar tumor is encountered. (orig.).

  2. Knee flexion deformity and patella alta in spastic cerebral palsy.

    Science.gov (United States)

    Lotman, D B

    1976-06-01

    A study on spastic knee flexion deformity has revealed a recurrence rate of 32 per cent following attempted surgical correction on 170 knees (103 patients). This rate appeared to be unrelated to concomitant surgery for correction of hip and ankle deformity. An additional study demonstrated patella alta in 72 per cent of 100 spastic knees (50 patients) and only 2 per cent and 50 knees of a comparable group of 25 non-spastic patients. It is suggested that restoration of a normal patello-femoral relationship may reduce both the functional disability and recurrence rate of spastic knee flexion deformity when this disease is managed surgically.

  3. Determination of sex from the patella in a contemporary Spanish population.

    Science.gov (United States)

    Peckmann, Tanya R; Meek, Susan; Dilkie, Natasha; Rozendaal, Andrew

    2016-11-01

    The skull and pelvis have been used for the determination of sex for unknown human remains. However, in forensic cases where skeletal remains often exhibit postmortem damage and taphonomic changes the patella may be used for the determination of sex as it is a preservationally favoured bone. The goal of the present research was to derive discriminant function equations from the patella for estimation of sex from a contemporary Spanish population. Six parameters were measured on 106 individuals (55 males and 51 females), ranging in age from 22 to 85 years old, from the Granada Osteological Collection. The statistical analyses showed that all variables were sexually dimorphic. Discriminant function score equations were generated for use in sex determination. The overall accuracy of sex classification ranged from 75.2% to 84.8% for the direct method and 75.5%-83.8% for the stepwise method. When the South African White discriminant functions were applied to the Spanish sample they showed high accuracy rates for sexing female patellae (90%-95.9%) and low accuracy rates for sexing male patellae (52.7%-58.2%). When the South African Black discriminant functions were applied to the Spanish sample they showed high accuracy rates for sexing male patellae (90.9%) and low accuracy rates for sexing female patellae (70%-75.5%). The patella was shown to be useful for sex determination in the contemporary Spanish population.

  4. BIPARTITE PATELLA IN 35-YEAR-OLD FITNESS INSTRUCTOR: A CASE REPORT

    Science.gov (United States)

    Zabierek, Jakub; Kwapisz, Adam; Domzalski, Marcin E

    2016-01-01

    Background and Purpose The patella plays an important role in knee biomechanics and provides anterior coverage of the knee joint. One to two percent of the population has an anatomical variant of patella called a bipartite patella that usually does not case pain. However, occasionally after injury or overuse during sport it can be a source of anterior knee pain. The purpose of this case report was to present a rare variant of bipartite patella and highlight conservative treatment of this condition. Study Design Case Report Case Description A 35-year-old female patient presented with persistent bilateral non-traumatic anterior knee pain of a six-year duration that was enhanced by strenuous kinds of sport activity. Standard radiographs and MRI revealed the presence of bipartite patella with medial pole cartilage edema bilaterally. Conservative care including physical therapy, extracorporeal shock wave therapy (ESWT), and viscosupplementation was utilized. Outcome After treatment VAS decreased to 0/10 from 5/10 in the left knee and 1/10 from 5/10 in the right knee. The Kujala Scores improved after treatment to 100 and 95 for the left and right knees respectively. The subject returned to full sport activity and work as a fitness instructor without pain and limitations. Discussion This case describes a rare finding of bilateral medial bipartite patella and the successful use of physical therapy with viscosupplementation in patellar pain caused by bipartite patella. It also supports the use of Extra Corporeal Shock Wave Therapy in bipartite patella pain as a supplement for therapy. Level of Evidence 4 PMID:27757290

  5. Brown tumor of the patella caused by primary hyperparathyroidism: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Irie, Tomoko; Mawatari, Taro; Ikemura, Satoshi; Matsui, Gen; Iguchi, Takahiro; Mitsuyasu, Hiroaki [Orthopaedic Surgery, Hamanomachi Hospital, Fukuoka (Japan)

    2015-06-15

    It has been reported that the common sites of brown tumors are the jaw, pelvis, ribs, femurs and clavicles. We report our experience in a case of brown tumor of the patella caused by primary hyperparathyroidism. An initial radiograph and CT showed an osteolytic lesion and MR images showed a mixed solid and multiloculated cystic tumor in the right patella. One month after the parathyroidectomy, rapid bone formation was observed on both radiographs and CT images.1.

  6. Excision of Painful Bipartite Patella: Good Long-term Outcome in Young Adults

    Science.gov (United States)

    Parviainen, Mickael; Pihlajamäki, Harri K.

    2008-01-01

    Excision of the accessory bipartite fragment is widely used, but its long-term outcome is not known. We evaluated the outcome after surgical excision of a symptomatic accessory bipartite or multipartite patella fragment in young adult men performing their compulsory military service and determined the incidence of painful bipartite patellae in this group of skeletally mature adults. We followed 25 of 32 patients for a minimum of 10 years (mean, 15 years; range, 10–22 years). The incidence of painful, surgically treated bipartite patella was 9.2 per 100,000 recruits. Patients’ median age at surgery was 20 years. There were 19 superolateral and six lateral bipartite fragments. Other radiographic findings were rare. At followup, the Kujala score mean was 95 points (range, 75–100 points), and osteoarthrotic changes (Kellgren-Lawrence Grade 1) were seen in two knees. No reoperations related to bipartite patella occurred during the followup. Symptomatic bipartite patella is rare and does not seem primarily associated with anatomic deviations, but when incapacitating pain persists despite nonoperative treatment, surgical excision seems to yield reasonable functional outcome and quick recovery with no apparent adverse sequelae. Our data suggest there is no reason to avoid this technically undemanding procedure for treating persistent symptoms of bipartite patella in young adults. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18607662

  7. Arthropathy and proteinuria: nail-patella syndrome revisited

    Directory of Open Access Journals (Sweden)

    Albishri, Jamal

    2014-11-01

    Full Text Available [english] Nail-patella syndrome (NPS is a pleiotropic autosomal-dominant disorder due to mutations in the gene LMX1B. It has traditionally been characterized by a tetrad of dermatologic and musculoskeletal abnormalities. However, one of the most serious manifestations of NPS is kidney disease, which may be present in up to 40% of affected individuals. Although diagnosis can be made at birth, it is often missed, presumably due to the rarity of the condition. A 35-year-old female presented to our clinic with history of small joint pain of 6 months duration. In addition she complained of pedal edema off and on for the last 12 years. Prior to her current presentation she had been managed by a local doctor symptomatically. On evaluation, a nephrotic syndrome was obvious, but no secondary cause could be found. However, her physical examination was characteristic of NPS and keeping in view the autosomal dominant nature of the disorder all her three siblings were screened who too showed classical features of NPS. This rare syndrome as a cause of nephrotic range proteinuria is discussed in this report. The report underlines the importance of a good physical examination in a given clinical setting.

  8. Chondroblastoma of the patella associated with an aneurysmal bone cyst.

    Science.gov (United States)

    Trebse, R; Rotter, A; Pisot, V

    2001-06-01

    Chondroblastoma is a rare, benign tumor of bone, accounting for about 1% of all bone tumor cases. It tends to affect the epiphyseal ends of long bones, most often in males during the first and second decades of life. It has well-characterized radiographic and histologic features but despite its histologically benign appearance a few cases of metastases have been reported. Local recurrences after curettage and bone grafting occur in 11% to 25% of cases. The features of a patellar chondroblastoma are the same as for other locations. In reviewing the literature we found an unusually high male-to-female ratio. It is interesting that the usual treatment of the patellar chondroblastoma has been patellectomy, whereas curettage and bone grafting has predominated in the other locations. We present a computer tomography and magnetic resonance imaging study of a case of chondroblastoma of the patella associated with an aneurysmal bone cyst. To our knowledge, it is the seventh case reported and the second with computer tomography and magnetic resonance imaging studies. We also review and discuss in detail all the cases of patellar chondroblastoma that we found in the literature.

  9. Newly-discovered muscle in the larva of Patella coerulea (Mollusca, Gastropoda) suggests the presence of a larval extensor

    NARCIS (Netherlands)

    Damen, Peter; Dictus, Wim J.A.G.

    2002-01-01

    The development of the muscular system of the gastropod mollusc Patella has been thoroughly studied. As a result, two larval retractors, the main and accessory larval retractor, had been described in the larva of Patella. These muscles were supposed to be responsible for the retraction of the larval

  10. Runners knee (image)

    Science.gov (United States)

    ... forces on the knee, such as a misaligned patella. Chondromalacia is treated with rest or immobilization and nonsteroidal anti-inflammatory drugs for pain. Physical therapy, especially ... alignment of the patella that cannot be corrected with therapy.

  11. A STUDY ON THE MANAGEMENT OF DISPLACED FRACTURES OF PATELLA USING MODIFIED TENSION BAND WIRING

    Directory of Open Access Journals (Sweden)

    Hari Babu

    2015-10-01

    Full Text Available INTRODUCTION: Patella is an important component of the extensor mechanism of the knee. A patella fracture constitutes 1% of all skeletal fractures resulting from either direct or indirect trauma. Any improper and inadequate treatment would inevitably lead to a disability which would be most perceptibly felt in a country like India, where squatting is important activity in daily life. The goal of treatment is to regain the continuity of the extensor mechanism and congruity of patellofemoral a rticulation so that the normal function of the knee can be restored. Several techniques have been described for internal fixation of fractures of patella. The ideal fixation for the fracture patella is that it should be strong enough to allow early mobiliz ation, reduce posttraumatic stiffness and perhaps help the healing of the articular surface . AIMS: To analyze the functional outcome of displaced transverse fractures of the patella treated by Modified Tension Band Wiring principle (Muller using A. Dutta & S. K. Gupta Scoring System. To extend the application of Modified Tension Band wiring for minimally comminuted fractures of patella and assesses the results. CONCLUSION : The present study shows that modified tension band wiring (Muller is an effective p rocedure in the management of displaced transverse patellar fractures, with excellent to good results. Minimally comminuted patellar fractures also yielded excellent to good results with Modified tension band wiring as an extended application. The results in the present study are comparable to other modifications of Tension Band Wiring principle. The surgery of Modified Tension Band Wiring gives rigid fixation and helps in early mobilization. Regular and scheduled post- operative physiotherapy plays an impor tant role in the functional outcome.

  12. Scintigraphic investigations of changes in the patella following endoprosthetic replacement of the knee joint

    Energy Technology Data Exchange (ETDEWEB)

    Hagena, F.W.; Hofmann, G.O.; Jaensch, A.

    1985-04-01

    A clinical and X-ray review of 118 GSB-Knee-Protheses without resurfacing the patella - mean time follow-up 4 years - was performed in 50 knees of these an additional quantifying bone-scan with sup(99m)Tc-MDP ('ROI-method') indicated new aspects of the pathomechanics of the patella after knee replacement. Comparing 42 healthy knee joints and 82 knees with osteoarthrosis principles for early diagnosis of patellar changes could be set up. According to these findings the quantifying scans show the development of dystrophic patellar changes after knee replacement.

  13. Minimum 5-Year Results With Duracon Press-Fit Metal-Backed Patellae.

    Science.gov (United States)

    Hedley, Anthony K

    2016-02-01

    Negative outcomes of earlier metal-backed patella designs have overshadowed reports of positive outcomes achieved with careful attention paid to component design, patellar tracking, and surgical technique. Much as reported elsewhere, we found earlier component failures were caused by poor locking mechanisms, thin polyethylene, poor tracking, and minimal femur contact. Over the past decade, however, our outcomes with Duracon metal-backed patellae have been encouraging. We think these positive outcomes, seen over a minimum 5-year follow-up, are largely attributable to the thicker polyethylene and improved articular conformity of this component relative to earlier designs.

  14. Magnetic resonance imaging in the evaluation of osteochondritis dissecans of the patella

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yun Sun [Hospital for Special Surgery, Weill Medical College of Cornell University, Department of Radiology and Imaging, New York, NY (United States); Eulji Hospital, Eulji University School of Medicine, Department of Radiology, Seoul (Korea); Cohen, Noah A.; Potter, Hollis G.; Mintz, Douglas N. [Hospital for Special Surgery, Weill Medical College of Cornell University, Department of Radiology and Imaging, New York, NY (United States)

    2007-10-15

    The objective was to evaluate the magnetic resonance (MR) appearance of patellar osteochondritis dissecans (OCD). We retrospectively analyzed MR images of 16 patients (18 cases, mean age 20 years) using OCD of the patella. In 5 cases surgery was carried out, and we compared the surgical findings with the MR imaging findings in these cases. In all 18 cases, OCD was located central-inferiorly on the patella, and the average size was 11 x 11 x 7 mm. Subchondral deformities were present in 16 out of 18 cases (88.9%), subchondral cyst formation in 4 cases (22.2%), reactive bone marrow signal in 8 cases (44.4%), overlying patellar cartilage abnormality in 14 cases (77.8%), loose body in 2 cases (11.1%), patella alta in 8 cases (44.4%), hypoplastic sulcus in 7 cases (38.9%), and synovitis in 4 cases (22.2%). In all 5 cases in which surgery was carried out, the cartilage abnormality classified on the MR images was confirmed, and a loose body was removed at arthroscopy in 2 of the 5 cases. Magnetic resonance imaging of patellar OCD typically shows subchondral deformity and variable abnormalities of the overlying patellar cartilage located central-inferiorly on the patella. (orig.)

  15. Mutations in the human TBX4 gene cause small patella syndrome.

    NARCIS (Netherlands)

    Bongers, M.H.F.; Duijf, P.H.; Beersum, S.E.C. van; Schoots, J.; Kampen, A. van; Burckhardt, A.; Hamel, B.C.J.; Losan, F.; Hoefsloot, L.H.; Yntema, H.G.; Knoers, N.V.A.M.; Bokhoven, J.H.L.M. van

    2004-01-01

    Small patella syndrome (SPS) is an autosomal-dominant skeletal dysplasia characterized by patellar aplasia or hypoplasia and by anomalies of the pelvis and feet, including disrupted ossification of the ischia and inferior pubic rami. We identified an SPS critical region of 5.6 cM on chromosome 17q22

  16. PLATEAU-PATELLA ANGLE: AN OPTION FOR ASSESSING PATELLAR HEIGHT ON PROXIMAL TIBIA OSTEOTOMY

    Science.gov (United States)

    BONADIO, MARCELO BATISTA; TORRES, JÚLIO AUGUSTO DO PRADO; MAZZARO, VICENTE; HELITO, CAMILO PARTEZANI; GOBBI, RICCARDO GOMES; DEMANGE, MARCO KAWAMURA

    2016-01-01

    ABSTRACT Objective: To compare the plateau-patella angle method to the methods already established for patellar height measurement in patients undergoing high tibial osteotomy. Methods: This is a retrospective study of 13 patients undergoing medial opening tibial osteotomy. The patellar height was measured in pre and post-operative radiographs by the methods from Insall-Salvati, Caton-Deschamps, Blackburne-Peel and patella-plateau angle, as well as the tibial slope and length of the patellar tendon. Measurements were performed by two knee surgeons at two different times. Results: The mean age was 41.33 ± 01.09 years old. The average rates of Caton-Deschamps, Blackburne-Peel, Insall-Salvati and plateau-patella angle were, respectively, 1.00; 0.89; 1.10; and 23.15° preoperatively, and 0.89; 0.78; 1.11; and 20.46°, postoperatively. The correlation of Caton-Deschamps, Blackburne-Pell, and Insall-Salvati indexes and plateau-patellar angle interobserver was 0.72 (p <0.001), 0:54 (p <0.001), 0.65 (p <0.001), and 0.67 (w <0.001), respectively. Conclusion: The plateau-patella angle method undergoes changes that are correlated with changes in tibial slope after osteotomy, unlike the classical methods. This fact may lead to overestimate the reduction of patellar height after osteotomy. Level of evidence IV. Case Series. PMID:27217812

  17. Aneurysmal bone cyst secondary to a giant cell tumor of the patella: A case report

    Science.gov (United States)

    YU, XIAOLONG; GUO, RUNSHENG; FAN, CONGLIANG; LIU, HUCHENG; ZHANG, BIN; NIE, TAO; TU, YI; DAI, MIN

    2016-01-01

    The patella is an unusual location for primary and metastatic bone tumors to develop. The most frequently encountered primary osteolytic lesions at the patella include giant cell tumors of the bone (GCT), chondroblastoma and aneurysmal bone cysts (ABC). However, the presentation of an ABC originating secondary to a GCT at the patella is rare. The present study describes such a case in a 46-year-old female. The differential diagnosis of the condition was extensive. The patient underwent curettage and the addition of bone cement to fill the defect. Pathological analysis of the resected tissue demonstrated that the lesion was consistent with an ABC forming secondary to a GCT. A 3-month follow-up was completed subsequent to the surgery, with a computed tomography scan demonstrating no evidence of recurrence. However, frequent and continuous observations of the patient following diagnosis are planned in order to evaluate the long-term efficacy of the surgical treatment. To the best of our knowledge, the present study describes the third reported case in the literature of this rare, double synchronous, benign tumor located at the patella. PMID:26893764

  18. Fixation of multifragmentary patella fractures using a bilateral fixed-angle plate.

    Science.gov (United States)

    Thelen, Simon; Betsch, Marcel; Schneppendahl, Johannes; Grassmann, Jan; Hakimi, Mohssen; Eichler, Christian; Windolf, Joachim; Wild, Michael

    2013-11-01

    This biomechanical study is the first to compare 3 fixation methods-bilateral fixed-angle plate, modified anterior tension wiring, and cannulated lag screws with anterior tension wiring-in multifragmentary distal patella fractures. A T-shaped 3-part fracture simulating a multifragmentary articular distal patella fracture (AO/OTA 34-C2.2) was created in 18 human cadaver knee specimens. Three groups were created using homogenous ages and bone mineral densities based on the fixation method received. Repetitive testing over 100 cycles was performed by moving the knee against gravity from 90° flexion to full extension. Failure was defined as fracture displacement greater than 2 mm. In all patellae using fixed-angle plates, an anatomical fracture reduction could be maintained throughout cyclic testing, whereas anterior tension wiring and lag screws with tension wiring showed significant fracture displacement after 100 cycles, with mean fracture gaps of 2.0±1.3 and 1.9±1.6 mm, respectively. The differences in fracture gaps between the fixed-angle plate group and the other 2 groups were statistically significant. In both groups using tension wiring, half of the constructs (3 of 6 in each group) failed due to a fracture displacement greater than 2 mm. The bilateral fixed-angle plate was the only fixation method that sustainably stabilized a multifragmentary articular distal patella fracture during cyclic loading when compared with modified anterior tension wiring and cannulated lag screws with anterior tension wiring.

  19. 关节镜辅助下综合方法治疗髌骨软化症48例疗效分析%Therapeutic effect analysis of chondromalacia patella treated by comprehensive method with arthroscope assisted

    Institute of Scientific and Technical Information of China (English)

    肖勋刚; 成明华; 李康杰; 吴石华; 陈凌强

    2007-01-01

    目的 探讨治疗中重度髌骨软化症的最优方法.方法 髌骨软化症患者48例56膝分为2组,分别以单纯传统外科手术方法(A组:胫骨结节抬高手术组,n=26)及关节镜下外侧支持带松解、内侧支持带紧缩加关节面打孔减压综合治疗方法(B组:关节镜综合手术组,n=30)进行治疗,随访比较疗效.结果 胫骨结节抬高手术组疗效优良率61.5%,有效率69.2%;关节镜综合手术组疗效优良率86.7%,有效率93.3%.关节镜综合手术组疗效明显优于胫骨结节抬高手术组(P<0.05).结论 关节镜辅助下综合治疗是一种较为理想的治疗髌骨软化症的方法.

  20. Rehabilitation training for Wushu athletes suffering from chondromalacia patella%武术套路运动员膝关节髌骨软化症的康复训练

    Institute of Scientific and Technical Information of China (English)

    吴霞; 郑荣强

    2013-01-01

    目的:探讨武术套路运动员膝关节髌骨软化症的康复训练的方法;方法:对12名膝关节髌骨软化症的武术套路运动员进行康复功能评估,并制定6周的康复体能训练计划,分阶段进行评估;结果:通过6周的康复体能训练,患膝关节髌骨软化症的运动员的膝关节功能得到明显改善,肌肉力量和平衡能力提高.结论:通过康复训练提高了膝关节的稳定性,改善髌骨活动力线,可缓解髌骨软化症症状改善膝关节功能.

  1. 长针斜刺配合推拿治疗髌骨软化症35例%Oblique Insertion of Long Needle combined with Tuina in the Treatment of Chondromalacia Patellae for 35 Cases

    Institute of Scientific and Technical Information of China (English)

    李银武; 宋小虎

    2015-01-01

    目的 观察长针斜刺配合推拿手法治疗髌骨软化症的临床疗效.方法 取4寸(0.6×100 mm)的圆利针,沿股四头肌肌腹中结节及条索位置,自内上向外下斜刺(20°左右)穿透结节及条索;推拿方法:以揉法、滚法、一指禅推法施术于髌骨上下极及髌周软组织,以局部肌肉组织放松、膝关节发热为度,点按委中、梁丘、血海、内外膝眼等穴位.结果 在3个疗程结束时,35例患者痊愈27例(77%),显效6例(17%),有效2例(6%),总有效率100%.结论 长针斜刺结合推拿疗法治疗髌骨软化症有良好的临床疗效.

  2. 大学生髌骨软骨软化症与髌骨不稳定的相关性研究%THE STUDIES ON RELATIONSHIP BETWEEN CHONDROMALACIA PATELLA AND PATELLAR INSTABILITY IN COLLEGE STUDENTS

    Institute of Scientific and Technical Information of China (English)

    孔祥清; 纪经和; 寻长洲; 陈健; 刘明军

    2005-01-01

    目的测量大学生髌骨轴位片的参数,探讨大学生髌骨软骨软化症与髌骨不稳定的关系.方法随机抽49名男患者54个膝关节,33名女患者37个膝关节,均摄患膝髌骨轴位片,随机抽男大学生16名32个膝关节,女大学生19名38个膝关节均摄髌骨轴位片作对照,每个髌骨轴位片测量19个参数,测量结果用SPSS For Window 10.0统计软件进行处理.结果患者髌骨不稳定.结论髌骨轴位片是诊断髌骨软骨软化症的重要方法,髌骨不稳定是髌骨软骨软化症的原因,也是髌骨软骨软化症发展的结果,同时也是关节疼痛的重要原因.

  3. Warmingyang method used in the differentiation and treatment of chondromalacia patellae%温阳法在辨证治疗髌骨软化症中的运用

    Institute of Scientific and Technical Information of China (English)

    吴俊哲; 王伟群; 苏培基

    2014-01-01

    目的 观察温阳法治疗髌骨软化症的效果.方法 运用广东省名中医苏培基教授的温阳经验方“温阳汤”内服和局部熏洗,每天1剂,并于患膝选穴进行温针灸,每周2次,30 min/次,治疗髌骨软化症.4周为1个疗程,3个疗程后进行疗效判定.结果 总疗效评定:临床控制28例,显效16例,有效8例,无效4例,总有效率为92.8%;所有患者随访1年,复发5例,复发率为8.9%.结论 运用温阳法为基本治法辨证治疗髌骨软化症能够取得良好的临床效果,可推广运用.

  4. 手法治疗运动员髌骨软化症的临床观察%Observation on therapeutic effect of the clinical therapeutic manipulation of chondromalacia patellae

    Institute of Scientific and Technical Information of China (English)

    张洪木; 王锋

    2009-01-01

    目的:观察手法治疗运动员髌骨软化症的疗效.方法:应用平衡理筋手法治疗运动员髌骨软化症32例,并与玻璃酸钠关节腔注射组31例对照.结果:治疗组愈显率为84.38%,明显优于对照组61.29%.结论:本疗法对运动员髌骨软化症症状体征、起效时间的改善及疗效优于玻璃酸钠关节腔注射组.

  5. 郭艳幸教授治疗髌骨软化症经验采撷%Experience of Professor Guo Yanxing in the Treatment of Chondromalacia of Patellae

    Institute of Scientific and Technical Information of China (English)

    张锟; 陈哲; 郭艳幸

    2016-01-01

    观察郭艳幸教授运用“平乐正骨平衡思想”治疗髌骨软化症,学习并总结其治疗经验;本文从郭教授对髌骨软化症的认识、治疗原则、治疗方法和临床病例举隅四个方面进行阐释.将郭教授临床治疗髌骨软化症的经验进行推广,为广大医者治疗髌骨软化症提供更多的建议.

  6. Clinical Effect of Traditional Chinese Medicine Fumigation and Kinetotherapy in Treatment of Chondromalacia Patellae%中药熏蒸与运动疗法治疗髌骨软骨病的临床效果

    Institute of Scientific and Technical Information of China (English)

    杨亚军

    2015-01-01

    目的 探讨中药熏蒸与运动疗法治疗髌骨软骨病的效果.方法 整群选取2010年12月-2014年12月医院收治的186例髌骨软骨病患者,分成观察组93例给予中药熏蒸与运动疗法,对照组93例给予中药熏蒸,比较治疗效果和Lysholm膝关节评分.结果 观察组有效率97.8%,对照组有效率75.3%,观察组Lysholm膝关节评分治疗后(89.6±4.7)分高于治疗前(56.3±5.5)分,对照组治疗后(79.7±4.6)分高于治疗前(57.9±5.3)分,观察组评分(89.6“.7)分优于对照组(79.7±4.6)分,差异有统计学意义(P<0.05).结论 中药熏蒸与运动疗法治疗髌骨软骨病效果满意.

  7. Clinical Analysis on Chondromalacia Patellae Treated with Internal and External Medicine%中药内服外敷治疗髌骨软化症临床分析

    Institute of Scientific and Technical Information of China (English)

    闫振界; 窦群立

    2010-01-01

    目的:观察中药内服外敷治疗髌骨软化症的临床效果.方法:治疗组32例用中药内服外敷,对照组27例用玻璃酸钠膝关节腔注射.结果:治疗组总有效率96.9%,对照组总有效率70.4%,治疗组疗效明显优于对照组(P<0.05).结论:中药内服外敷治疗髌骨软化症效果较好.

  8. Application And Diagnostic Value of HighField MR Imaging in the Diagnosis of Chondromalacia Patellae%髌骨软骨软化的高场MRI诊断及应用

    Institute of Scientific and Technical Information of China (English)

    张传凤; 黄建军; 李传富

    2010-01-01

    目的 探讨髌骨软骨软化的MRI表现及诊断价值.方法 采用快速自旋回波(FSE):T1WI、T2WI和PDWI双向回波、短-TI反转恢复序列(STIR)、二维脂肪抑制扰相梯度回波序列(2D-FS-FLASH),部分患者采用三维脂肪抑制扰相梯度回波序列(3D-FS-FLASH).结果 髌骨软骨软化时,MRI可表现为软骨信号异常、骨软骨变薄、毛糙、不规则,髌软骨缺损、溃疡及软骨下骨质暴露.结论 髌软骨软化MRI表现典型、诊断敏感特异度高、无创伤、无辐射,为临床诊断及治疗提供更多信息.

  9. Clinical Effect of Treeting the Pain from Chondromalacia Patellae with Acupuncture with Warmed Needle Conbain with Rehabilitation Practise%温针配合康复训练对髌骨软化症疼痛的临床研究

    Institute of Scientific and Technical Information of China (English)

    邱玲; 张吉; 张敏; 郑旭; 谢芳; 高乐女; 陈大为

    2008-01-01

    目的:采用随机对照方法观察温针配合康复训练对缓解髌骨软化症疼痛及症状的临床研究.方法:将92例患者随机分为治疗组47例(予温针配合康复训练)、对照组45例(予药物配合康复训练).两组均治疗20次后观察疼痛症状改善情况并随访.结果:治疗组疼痛评分改善较对照组明显(P<0.01),起效时间较对照组更快(P<0.01),临床症状缓解更明显,缓解疼痛作用持续时间更长.结论:温针配合康复训练对缓解髌骨软化症疼痛及症状较药物配合康复训练疗效更佳.

  10. 推拿手法结合中药热敷治疗髌骨软化症56例%Treatment of 56 Cases of Chondromalacia Patellae by Manual Therapy and Herbal Hot Compress

    Institute of Scientific and Technical Information of China (English)

    周斌

    2008-01-01

    目的 观察推拿手法结合中药热敷治疗髌骨软化症的临床疗效.方法 108例髌骨软化症患者随机分为治疗组(56例,给予推拿手法结合中药热敷治疗)和对照组(52例,给予局部红外线照射治疗),疗程均为30 d.结果 治疗后,两组WOMAC骨关节炎指数(疼痛、僵硬、功能、总评分)均明显降低(P<0.05~0.01),且治疗组明显优于对照组(P<0.05~0.01).结论 推拿手法结合中药热敷治疗髌骨软化症临床疗效确切.

  11. Diagnosis on low field intensity MRI of chondromalacia patellae 42 Cases%低场强磁共振成像诊断髌骨软化症42例

    Institute of Scientific and Technical Information of China (English)

    何平; 王新辉; 李建文; 张剑

    2010-01-01

    目的 分析髌骨软化症低场强MRI及影像学分期表现. 方法 对60例疑似髌骨软化症病人髌股关节MRI扫描,其中42例诊断为髌骨软化症,均与关节镜作对比. 结果 Ⅰ期(4例)为软骨内点状低信号,Ⅱ期(6例)为软骨凹凸不平,有局限性变薄,Ⅲ期(14例)为软骨明显不光整,局部有软骨的缺损,Ⅳ期(18例)软骨缺损同时有骨性关节面侵蚀,与关节镜下分期基本吻合. 结论 低场强MRI诊断髌骨软化症很有价值,采用梯度回波扫描,尤其是GET1WI在诊断有独特的优势.

  12. 髌骨软化经皮内镜综合手术病人的护理%Nursing Care of the Patients with Chondromalacia Patellae Receiving Percutaneous Endoscopic Surgery

    Institute of Scientific and Technical Information of China (English)

    李艳; 杨晓琴

    2003-01-01

    对40例髌骨软化(42个膝关节)病人进行综合手术治疗和护理,术后随访10~24个月,平均 12.3个月.结果42个膝关节功能恢复良好,疼痛症状消失,均无并发感染、血肿、伤口不愈及关节粘连等并发症.提出加强术前、术后护理及早期患肢功能锻炼是经皮内镜综合手术治疗髌骨软化的主要措施,对功能恢复起重要作用.

  13. Clinical Observation On Sanbi Decoction to treat Chondromalacia Patellae(CP)through Hydronium Introduction%三痹汤离子导入治疗髌骨软化症

    Institute of Scientific and Technical Information of China (English)

    李晶; 李薇

    2010-01-01

    目的:三痹汤离子导入加功能锻炼治疗髌骨软化症的疗效.方法:将72例患者随机分为对照组和治疗组,对照组36例68膝患者采用玻璃酸钠膝关节内注射治疗,治疗组36例64膝患者采用NPD-4AE离子导入仪行中药三痹汤离子导入治疗同时进行股四头肌等长收缩及膝关节半蹲功能锻炼.结果:对照组治愈17膝,好转38膝,未愈13膝,总有效率80.9%;治疗组治愈25膝,好转36膝,无效3膝,总有效率95.3%.两组总有效率比较差异有显著性意义(P<0.05),治疗组疗效优于对照组.结论:三痹汤加减中药离子导入治疗髌骨软骨软化症疗效较玻璃酸钠膝关节内注射佳,治疗组明显优于对照组.

  14. 低场MRI在髌骨软化症的诊断及分级中的应用价值%Value of low-field MRI in diagnosis and grading of chondromalacia patella

    Institute of Scientific and Technical Information of China (English)

    何君; 俞平高; 陈鹏; 张涛

    2013-01-01

    目的 探讨髌骨软化症(CMP)的低场强MRI诊断及分级价值.方法回顾分析86例CMP的MRI资料.结果 CMP分为四期:I期 10例,II期13例,III期25例,IV期38例.结论 低场强MRI检查能对髌骨软化症做出明确诊断及分级,可作为临床判断患者有无髌骨软化症的首选无创检查方法.

  15. Clinical Observation of "Sanbi Decoction" in Treating Chondromalacia Patellae%三痹汤加减治疗髌骨软骨软化症的临床观察

    Institute of Scientific and Technical Information of China (English)

    乔根宝; 许理忠; 陈锦黎; 邬学群; 宋毅

    2005-01-01

    将277例髌骨软骨软化症患者辨证分为4型,在三痹汤的基础上根据不同证型加减用药,分别于服药2周、4周、6周后统计临床疗效.结果:6周后治愈157例,显效97例,有效15例,无效8例,总有效率达97.1%.

  16. Clinical Study of Gubin Jianxi Decoction in the Treatment of Chondromalacia Patella%固髌健膝汤治疗髌骨软化症的临床研究

    Institute of Scientific and Technical Information of China (English)

    武玉锦; 方建国

    2008-01-01

    目的:观察固髌健膝汤对于肝肾不足、筋脉瘀滞型髌骨软化症的疗效并初步探讨其作用机理.方法:自2003年9月至2005年3月将56例髌骨软化症患者随机分成治疗组和对照组进行治疗,治疗组运用固髌健膝汤治疗,对照组采用氨糖关辛治疗,4周为1疗程,通过临床疗效评定进行疗效比较.结果:临床症状评定,治疗组总有效率为89.2%,对照组为64.3%,P<0.05,两组之间差异有统计学意义.结论:固髌健膝汤治疗髌骨软化症效果确切、安全.

  17. Treatment of 72 Cases of Chondromalacia Patella With Combination of TCM and Western Medicine%中西医结合治疗髌骨软化症72例总结

    Institute of Scientific and Technical Information of China (English)

    范文

    2006-01-01

    对72例髌骨软化症给予关节内注射透明质酸钠,内服壮骨关节丸,中药熏洗的综合疗法,治愈48例,好转18例,无效6例,总有效率91.7%.文章分析了各药的作用机制.

  18. Li Haogang's Clinical Experience in Treating Chondromalacia Patella Syndrome by Heyingzhutanguben%李浩钢运用和营逐痰固本法治疗髌骨软骨软化症经验

    Institute of Scientific and Technical Information of China (English)

    郭天旻; 李浩钢

    2013-01-01

    阐述李浩钢主任治疗髌骨软骨软化症的临床经验.认为本病的发生可归结于脾肾亏虚,痰瘀交阻为患;治疗上予和营逐痰的同时兼顾脾肾同补,采用自拟方逐痰汤加减治疗,并附验案1则.

  19. 手法治疗髌骨软化症疗效观察及机理探讨%Observation of Mechanism and Therapeutic Effect on Chondromalacia Patellae Through Manipulation

    Institute of Scientific and Technical Information of China (English)

    戴七一; 韦贵康

    2002-01-01

    目的:观察手法治疗髌骨软化症的疗效及对其作用机理进行探讨.方法:选择临床诊为髌骨软化症患者66例共83只膝,观察组30例38只膝,使用手法治疗;对照组36例45只膝,使用英太青胶囊治疗.观察2组髌股关节痛、上下楼梯困难及髌骨研磨试验改善的情况.结果:2组病例在髌股关节痛改善方面疗效相近(P>0.05),但观察组在改善上下楼梯困难、髌骨研磨试验转阴率方面明显优于对照组(P<0.01).结论:手法通过解痉、调衡、减压等途径治疗髌骨软化症有较好疗效.

  20. Electromyographic investigation of unstable patella before and after its realignment operation

    Directory of Open Access Journals (Sweden)

    D D Baksi

    2011-01-01

    Full Text Available Background: Patellar dislocations are either due to superolateral contracture of the soft tissue or imbalance of the power between the vastus medialis (VM and the vastus lateralis (VL. The imbalance of muscle power as an etiology of patellar dislocation has not been studied. Hence, we studied the recurrent, habitual and permanent dislocations of the patella with an electromyogram (EMG of the vastus medialis, vastus lateralis, and pes anserinus, before and after realignment operations, to document the muscle imbalance and effectiveness of the realignment operation. Materials and Methods: An electromyographic investigation was carried out on the vastus medialis and vastus lateralis in nine recurrent, 20 habitual, and 13 permanent dislocations of the patella, before and after their realignment operations. Pes anserinus transposition, which acted as a medial stabilizer of the patella, was also investigated with an EMG study, to understand its role on patellar stability at 0΀, 30΀, 60΀, 90΀, 120΀, 150΀, and full flexion of the knee. The age of the patients varied from nine to 30 (mean 15 years. There were 24 males and 18 females. Twenty-six patellar dislocations were on the right and 16 were on the left side. Results: Electromyographic pictures reveal subnormal activity of the vastus medialis in all types of dislocations and similar activities of the vastus lateralis in permanent and habitual dislocations recorded pre operatively, which recovered to almost normal values postoperatively, at the mean one-year follow-up. Pes anserinus, which was used for medial stabilization of the patella after its realignment, maintained normal EMG activity before and after the operation. Conclusion: This study is significant for understanding the imbalance of muscle activities in patients with an unstable patella, which can be rectified without recurrence after pes anserinus transposition.

  1. Osteopetroses

    Science.gov (United States)

    ... Legg-Calvé-Perthes Disease Osgood-Schlatter Disease Infrapatellar Tendinitis Köhler Bone Disease Sever Disease Chondromalacia Patellae Osteopetroses ... Legg-Calvé-Perthes Disease Osgood-Schlatter Disease Infrapatellar Tendinitis Köhler Bone Disease Sever Disease Chondromalacia Patellae Osteopetroses ...

  2. [Problems in osteosynthesis of patella fractures with the AO tension belt and consequences for new implants. The XS nail].

    Science.gov (United States)

    Gehr, J; Friedl, W

    2001-11-01

    The eccentric ventral AO tension belt system represents the standard therapy of fractures of the patella. This often leads to unsatisfying results. Relating to Klute and Meenen [10] and the results of our own retrospective study, expressed as a percentage, 5-34% (own results 12.4%) have extremely poor treatment outcome, 23-60% (39%) end in deficiencies of bending, and there are 51-79.5% (65.7%) with subjective complaints after patella osteosynthesis. The disadvantages due to the eccentric tension belt position and the impossibility of applying the tension belt directly to the bone surface are abolished with the development of the XS nail. Due to its central position, constant compression of the entire fracture surface is provided. This is valid for all tension-stressed fractures such as those of the patella and olecranon. In synthetic patellae [5] standardized stress testing with changing tension up to 500 Newton was carried out. The XS nail was compared with the AO tension belt osteosynthesis after osteotomy and osteosynthesis in synthetic patellae. The XS nail was superior to the tension belt for all tests and therefore can be applied to all types of fractures where tension stress exists. We repaired the first 15 patella fractures with the XS nail. In 13 of 15 cases, full load of the injured leg was possible (for stairs a plaster splint was used). The experimental patella tests and first clinical results with the XS nail osteosynthesis after patella fracture confirm the new type of osteosynthesis, and functional treatment with loading seems possible.

  3. A case of chondroblastoma combined with bone cysts in the patella%髌骨软骨母细胞瘤合并骨囊肿一例

    Institute of Scientific and Technical Information of China (English)

    王武炼; 陈嵘; 肖莉莉; 陈辉; 刘献祥; 张怡元

    2012-01-01

    The patella is the largest sesamoid bone in the human body, while the tumor incidence is very low in the patella. It is difficult to diagnose patellar tumors because of the complex and changeable imaging findings, and the treatment was often delayed due to misdiagnosis. This paper reported a case of chondroblastoma combined with bone cysts in the patella, and analyzed the diagnosis of several common patellar tumors.

  4. The Association of Health Risk Behaviors and Training-Related Injury Among U.S. Army Basic Trainees

    Science.gov (United States)

    2006-04-01

    717.7 Chondromalacia Of Patella ; Degeneration of articular cartilage of patella 17-MAY-2003 1 719.46 Pain In Joint Involving Lower Leg 19-MAY-2003 I... Chondromalacia of Patella ; Degeneration of cartilage of patella 30-APR-2003 I V57.1 Other Physical Therapy 28 USACHPPM General Medical Service Study...Thera 7 I Example of diagnoses progression from pain to chondromalacia 18-APR-2003 I 0 1 719.46 Pain In Joint Involving Lower Leg 30-APR-2003· I 717.7

  5. Tumour and tumour-like lesions of the patella - a multicentre experience

    Energy Technology Data Exchange (ETDEWEB)

    Singh, J.; James, S.L.; Davies, A.M. [The Royal Orthopaedic Hospital, Department of Radiology, Birmingham (United Kingdom); Kroon, H.M. [Leiden University Medical Centre, Department of Radiology, C-2-S, P. O Box 9600, Leiden (Netherlands); Woertler, K. [Technische Universitaet Muenchen, Department of Radiology, Munich (Germany); Anderson, S.E. [Knochentumor- Referenzzentrum der Schweizerischen Gesellschaft fuer Pathologie, Basel (Switzerland)

    2009-03-15

    Fifty-nine cases of lesions presenting in the patella were identified after review of the databases of four European bone tumour registries. Of the 59 cases, 46% were non neoplastic, 39% were benign and 15% were malignant. The commonest benign neoplasm was giant cell tumour (GCT) (11 cases). Younger patients were more likely to have a benign neoplasm. Lesions in patients less than 40 years of age included giant cell tumour, chondroblastoma, aneurysmal bone cyst (ABC), osteomyelitis, osteoid osteoma and solitary bone cyst. In patients older than 40 years, the following were common lesions: intra-osseous gout, metastasis and intra-osseous ganglion. Expansion of the patella with thinning of cortex was seen more commonly in GCT and brown tumour in hyperparathyroidism. There was associated soft tissue extension in gout and malignant lesions. (orig.)

  6. ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: CLINICAL OUTCOMES OF PATELLA TENDON AND HAMSTRING TENDON GRAFTS

    Directory of Open Access Journals (Sweden)

    Dawn T. Gulick

    2002-09-01

    Full Text Available An injury to the ACL can result in significant functional impairment. It has been estimated that more than 100,000 new ACL injuries occur each year. Surgeons employ numerous techniques for reconstruction of the ACL. Of critical importance is the source of the graft to replace the damaged ACL. The graft choices include autografts (the patient's own tissue, allografts (donor tendon, and synthetic/prosthetic ligaments. Tissue harvest sites for autografting include the middle third of the patella tendon, the quadriceps tendon, semitendinosus tendon, gracilis tendon, iliotibial band, tensor fascia lata, and the Achilles tendon. Selection of the type of graft material is predicated upon the tissue's ability to tolerate high levels of stress. Likewise, the clinical presentation and functional outcome is related to the graft material selected. This manuscript specifically examined the patella tendon and hamstring tendon grafts. Numerous manuscripts that studied the outcomes of these graft materials were compiled to help the clinician appreciate the advantages and disadvantages of each of the graft materials. Outcome measures such as thigh circumference, knee range of motion, isokinetic strength, knee stability, pain, and vertical jump/1-leg hop were incorporated. The purpose of this manuscript was to compare and contrast the clinical presentation of patients who underwent an ACL reconstruction using the patella tendon versus the hamstring tendons. This information can be valuable to the clinician when considering the rehabilitation protocol after ACL reconstruction

  7. Nail-patella-syndrome in a young patient followed up over 10 years: relevance of the sagittal trochlear septum for patellofemoral pathology

    Directory of Open Access Journals (Sweden)

    Konrads Christian

    2016-01-01

    Full Text Available Introduction: Nail-patella-syndrome (NPS is a rare autosomal-dominant inherited disease with pathologies of nails, skeleton, kidneys, and eyes. Linkage to a mutated gene was found. It codes for the transcription-factor LMX1B. In most cases knees are symptomatic. Patients have hypoplastic patellae, which are laterally subluxated. In those individuals a sagittal trochlear fibrous septum was found, dividing the anterior knee-joint-space. In the literature the etiology and clinical significance of this anatomic abnormality is unclear. Based on clinical and intraoperative findings we developed a theory regarding knee pathology in nail-patella-syndrome. Successful treatment via early resection of the septum with sustained good outcome is presented. Methods: In a symptomatic six-year-old boy with nail-patella-syndrome we resected the fibrous sagittal septum adherent to the trochlea femoris and we balanced the patella via lateral release and medial plication in both knee joints. We analyzed the clinical outcome of this procedure prospectively over 10 years. Results: Postoperatively the hypoplastic patellae stayed centered and stable during further skeletal development. The patient was still pain free with normal range of motion of both operated knee joints after 10 years of follow-up. Discussion: In patients with nail-patella-syndrome and a subluxated or dislocated patella we recommend diagnostics with magnetic-resonance-imaging and early surgical treatment via resection of the trochlear septum and soft-tissue-balancing of the patella. When the septum displaces the patella and prevents physiological articulation of the patella with the trochlea femoris, early septum resection is likely to be important for a good functional outcome and proper development of the patellofemoral joint during growth.

  8. Women in the Army Policy Review

    Science.gov (United States)

    1982-11-12

    chondromalacia of the perfornmance-limiting conditions thait *eiulted from an 8-1%eek patella (21). hip or neck of femur stress fracture (20). sprains...by the Chondromalacia of patella 21 10 Hip or neck or femur stress fracture 20 9 apparent lack of heel stability inherent in ;he Army boot used Ankle...of the patella a miaieary training program on males and females Aveat Space wert also reported. Environ Afed 30: 562-566. 1979 Although the

  9. The Effect of External Loads and Cyclic Loading on Normal Patellofemoral Joint Signals.

    OpenAIRE

    1993-01-01

    Pain over the anterior portion of the knee joint is a common clinical complaint. A condition known as 'chondromalacia patella' (softening of the cartilage under the patella), which frequently causes anterior knee pain is difficult to diagnose and monitor. Vibrations detected by a contact transducer over the patellofemoral joint may be useful in the assessment of chondromalacia patella. This paper utilised this technique known as vibroarthrography (VAG), to study two potential sources o...

  10. Position of the Patella among Emirati Adult Knees. Is Insall-Salvati Ratio Applicable to Middle-Easterners?

    Directory of Open Access Journals (Sweden)

    Saeed Althani

    2016-04-01

    Full Text Available Background: Abnormal patellar height is associated with anterior knee pain and several conditions that affect the patellofemoral joint. The aim of this study was to 1 report the incidence of patella alta and patella baja and 2 investigate whether the normal limits of the Insall-Salvati ratio is applicable in adult Middle-Easterners. Methods: A radiographic review of the lateral radiographs of 736 Middle-Eastern knees were performed. Patellar tendon length (TL and the patellar length (TP was digitally measured and the ratios of these measures was used to calculate the Insall-Salvati ratio. Results: The overall mean TL/PL ratio was 1.20±0.17. The Insall-Salvati ratio was higher (p=0.0013 in males (1.22± 0.12 than in females (1.18±0.17. According to our measurement, the recommended levels for defining abnormal patellar position should be 0.86 for patella baja and 1.54 for patella alta. Conclusion: The use of TL/PL ratio demonstrated a higher incidence of patella alta and a higher mean TL/PL ratio compared to other techniques. The normal ranges for the TL/PL differs from western populations and may be attributed to lifestyle differences.

  11. Duhuo Jisheng Tang on Patella Cartilage of Chondromalacia of Patella and IL-1, MMP-1, GAG in Patellar Joint Fluid%独活寄生汤对髌骨软化症髌骨软骨及膝关节液中IL-1,MMP-1,GAG的影响

    Institute of Scientific and Technical Information of China (English)

    冯小波; 朱思刚

    2015-01-01

    目的:独活寄生汤对髌骨软化症髌骨软骨及膝关节液中白细胞介素-1(interleukin-1,IL-1),金属蛋白酶-1(metalloproteinase-1,MMP-1)及硫酸葡糖氨基聚糖(sulfate glycosaminoglycan,GAG)的影响.方法:将本院收治的86例髌骨软化症患者随机分为实验组43例和对照组43例.对照组患者行西医常规治疗,实验组患者行独活寄生汤口服及局部熏洗治疗.评价两组患者的临床治疗效果及核磁共振成像(Magnetic resonance imaging,MRI)关节软骨损害分级下各级的疗效;同时,于患者治疗前后,分别检测并对比分析患者膝关节液中IL-1,MMP-1,GAG指标水平.结果:实验组患者临床治疗的总有效率为88.37%,对照组为67.44%,两组比较,差异具有统计学意义(P<0.05).实验组和对照组内,MRI关节软骨损害Ⅰ,Ⅱ级患者临床治疗总有效率均高于Ⅲ,Ⅳ级患者(均P<0.05).治疗后,实验组患者关节液中IL-1,MMP-1指标水平均低于对照组(均P< 0.05),平均GAG指标水平高于对照组(P<0.05).结论:独活寄生汤治疗髌骨软化症的临床疗效较西医常规治疗显著,其可能通过对膝关节液中IL-1表达水平的调节,抑制MMP-1的激活及GAG的降解,从而起到对关节软骨的修复和保护作用.同时,MRI关节软骨损害分级下Ⅰ,Ⅱ级时期为患者临床治疗的最佳时期.

  12. Arthroscopic Percutaneous Release of Lateral Patella Retinaculum for the Treatment of Chondromalacia Patella%关节镜辅助下经皮髌骨外侧支持带松解术治疗髌骨软骨软化症

    Institute of Scientific and Technical Information of China (English)

    亓建洪; 孙贵新; 王信胜; 张伟; 董军; 朱宝林; 尹德振

    2001-01-01

    目的:报告关节镜辅助下经皮髌骨外侧支持带松解术治疗21例髌骨软骨软化症的治疗效果,并探讨了影响疗效的因素.临床资料:本组21例(28膝)髌软骨软化症患者均经关节镜确诊,根据Outbridge软骨退变分级标准,I级髌骨软骨退变8膝,Ⅱ级13膝,Ⅲ级4膝,Ⅳ级3膝.采用屈膝45.位Merchant髌骨轴位x线摄片结合关节镜检查诊断髌股排列错乱,发现髌骨倾斜16膝,髌骨半脱位6膝,髌骨倾斜与半脱位并存6膝.本组患者28膝均在关节镜辅助下实施经皮髌骨外侧支持带松解术.结果:随访平均17.2月,按照Crosby和Insall疗效评定标准,优12膝,良12膝,一般4膝,优良率达85.7%.结论:本术式治疗伴有髌股排列错乱的髌骨软骨软化症疗效确切,具有创伤小、并发症少、功能恢复快等优点.软骨退变的程度是影响疗效的重要因素.

  13. Results of Patello-Tibial Cerclage Wire Technique for Comminuted Patella Fractures Treated with Partial Patellectomy

    Directory of Open Access Journals (Sweden)

    Ender Alagöz

    2014-12-01

    Full Text Available Aim: Partial patellectomy and patellotibial cerclage technique used in comminuted inferior pole patellar fractures were evaluated and the results were discussed. Methods: Thirteen patients who have undergone partial distal patellar excision were evaluated in the study. In all patients, the inferior pole of the patella was resected, patellar tendon was sutured to the proximal patellar fragment and patellotibial cerclage was performed. At the last visit, the patients were evaluated using measurement of the distance between the superior pole of the patella and the tibial tubercle, the Lysholm knee scoring scale, knee range of motion and thigh circumference measurement. Results: The mean flexion value was 131.10 (±4.6 in normal knees and 117.20 (±8.0 in operated knees. The mean thigh diameter was 49.5 (±3.7 cm and 46.4 (±4.5 cm in normal knees and in operated knees, respectively. The mean Lysholm knee score in the patient group was 84.3 (±17.1 points. The mean distance between the superior pole of the patella and the tibial tubercle was 10.6 (±1.0 cm in normal knees and 10.1 (±1.2 cm in operated knees. The exstensor mechanism was intact in all patients and no revision surgery was performed. Conclusion: Patellotibial cerclage technique performed after partial patellectomy permits early motion and protects patients from harmful effects of immobilization; and good functional results are obtained if patients start early knee motion.

  14. [Differential indications for so-called "lateral release" in treatment of chondropathia patellae].

    Science.gov (United States)

    Schultz, W; Buhmann, H W; Leib, S

    1996-03-01

    The success rate of the operation of lateral release for pain caused by the patella is reported as being between 14% and 99%. The choice between arthroscopic or open procedures does not seem to affect the results. The wide ranges of results probably reflects differences in patients selection or the method and investigations of follow up. The early term outcome usually show better results than long term follow up. This study evaluates the indications for the operation of lateral releases and discusses the result of 36 out of a total of 42 patients who were follow up for 3 years later surgery. We found that an insufficiency of dysplasia of the vastus medialis, the laxity of the capsule and soft ligaments, and a strong lateral retinaculum were important factors in the indication for this procedure. The quadriceps angle was also of prime importance, but the minor forms of patellar dysplasia played only a minor role. In the so-called hyperpression syndrome, where the patella has a strong tendency to move laterally, the simple lateral release is the single most successful operation. The indication for procedures additionally to the lateral release is examined. We found that in a case with an insufficiently guided patella, a weak capsule and ligaments, an additional capsule roughing should be performed. The presence of early degenerative changes in the joint predisposes to poor results in operations such as abrasion and pride drilling. The results in our study were assessed using the Lysholm score. Our results show that the most successful technique was the combination of an arthroscopy and an extraarticular open operation controlled by arthroscopic means. This technique was not associated with major complications such as haemarthrosis and consecutive prolonged postoperative rehabilitation. Overall we achieved a rate of 83% of good or satisfactory results at more than 3 years using the indications and techniques described above.

  15. Life-history trait of the Mediterranean keystone species Patella rustica: growth and microbial bioerosion

    Directory of Open Access Journals (Sweden)

    I. PRUSINA

    2015-07-01

    Full Text Available The age and shell growth patterns in populations of Patella rustica of the Adriatic Sea were determined by analyzing the inner growth lines visible in shell sections. Marginal increment analysis showed annual periodicity with annual growth line being deposited in May. The growth analysis of 120 individual shells showed that 90.8 % of collected individuals were less than 4 years of age and only two individuals (1.6 % were older than 6 years. Population structure was described and the generalized von Bertalanffy growth parameters were calculated: asymptotic length (L∞ was 38.22 mm and the growth constant (K was 0.30 year-1. Growth performance index value of P. rustica (Ø’ was 2.64 and is among the lowest ranges reported for limpet species. Patella rustica shells were degraded to different degrees by microbial bioerosion. Microboring organisms identified were pseudofilamentous and filamentous cyanobacteria Hormathonema paulocellulare, Hyella caespitosa, Mastigocoleus testarum and Leptolyngbya sp. The overall intensity of infestation was relatively low, but increased in severity with shell length. The damage was most often restricted to the oldest parts of the shell, i.e. apex of the shell, posing difficulties in determining the exact position of the first growth line. The present study is first to introduce the use of inner growth lines in Patella rustica shell sections as a reliable method for age determination and it provides the first insight into the growth patterns of this keystone species while taking the interference of microbial shell bioerosion in consideration.

  16. Recurrent Dislocation of the Patella in Kabuki Make-Up Syndrome

    Directory of Open Access Journals (Sweden)

    Lucie Rouffiange

    2012-01-01

    Full Text Available Two patients with Kabuki make-up syndrome with bilateral recurrent dislocation of the patella are presented. They had generalized ligamentous laxity and patellofemoral dysplasia. Both developed patellar dislocation in adolescence and required surgery, with medial transfer of the tibial tuberosity associated with vastus medialis plasty (Insall technique. One postoperative complication occurred in one case: a nondisplaced tibia fracture at the sixth postoperative week that healed with conservative means. Final results were good in both cases. Good surgical results can be achieved in patellar dislocation in patients with Kabuki syndrome.

  17. [Chondropathia patellae--study of the femoropatellar joints of healthy, athletic children].

    Science.gov (United States)

    Steininger, K; Wodick, R E; Späte, W

    1990-06-01

    155 children, aged 8 to 13 years, who trained regularly, were examined clinically for signs of chondropathy patellae. As control group, 200 children of the same age were included who did not take part in any sports activities except in school. 32% of the training group children showed signs suggestive of chondropathy. With increasing training age, the part of children with these signs increased from 16% in the first to 45% in the third to fourth training year. Non-training children showed in 17% positive signs of chondropathy.

  18. Use of a TTA plate for correction of severe patella baja in a Chihuahua.

    Science.gov (United States)

    Edwards, George A; Jackson, Andrew H

    2012-01-01

    A 7 yr old spayed female Chihuahua presented for right hind limb lameness and reduced stifle range of motion. Radiographs showed a marked patella baja of the right stifle and evidence of a previous surgery to correct a medial patellar luxation. A tibial tuberosity osteotomy was performed to allow proximal translation of the tibial tuberosity, which was stabilized with a tibial tuberosity advancement plate. Four weeks postoperatively, lameness and articular range of motion were improved, and the use of anti-inflammatory and analgesic medications was discontinued. The dog was still ambulating well and had no lameness 12 mo postsurgically.

  19. Role of suture anchors in management of fractures of inferior pole of patella

    Directory of Open Access Journals (Sweden)

    Anand Ashish

    2010-01-01

    Full Text Available Background: The traditional recommendation for displaced comminuted inferior pole fractures is excision of the comminuted pole followed by reattachment of the patellar tendon with transosseous suture. To the best of our knowledge there has been no previous published study mentioning the use of suture anchors for fracture inferior pole of patella. We present a retrospective analysis of five cases of patients doing well at final follow-up of two years. Materials and Methods: Five patients treated at our institute using suture anchors for repair of comminuted inferior pole fractures of patella between January 2007 to March 2007. (range 28 years-55 years. There were three males and two females. Results: The average follow-up was 25 months (range 24 months-26 months. The patients were evaluated for range of motion, strength, patellofemoral scores and any alteration of patellar height. The outcome of the procedure was assessed with use of the patellofemoral scoring system of Noyes et al, 5 as adapted by Saltzman et al. 6 The final patellofemoral score (maximum 100 points was 94.6 (range 93-96. Conclusion: We believe it is a novel extended indication of the use of suture anchors and should be in the armament of every trauma surgeon.

  20. Basic kinematics and biomechanics of the patellofemoral joint part 2: the patella in total knee arthroplasty.

    Science.gov (United States)

    Schindler, Oliver S

    2012-02-01

    Patellar and femoral component in total knee arthroplasty are inextricably linked as a functional unit. The configuration of this unit has been a matter of ongoing debate, and the myriad of different patellar and femoral components currently available reflect the lack of consensus with respect to the ideal design. One of the major challenges is to overcome the biomechanical disadvantages of a small contact area through which high contact pressures are transferred, making this mechanical construct the weakest part of the prosthetic knee. Contact areas are highly dependent on the congruency of the patellofemoral joint articulation, and are significantly smaller for dome shaped patellar components compared to those of more anatomic designs. However, when exposed to 3-dimensional movements, the contact areas of the dome shaped patella are significantly greater, indicating enhanced forgiveness regarding patellar malpositioning. Although contact stresses, a function of implant design and surface conformity, can reach levels far beyond the yield strength of UHMWPE, catastrophic failure of resurfaced patellar components, commonly seen in metal backed patellae, fashionable in the 1980s, has rarely been observed since. Although plastic deformation and wear of UHMWPE continue to represent a problem, in the absence of suitable alternatives polyethylene remains the bearing surface of choice. The appreciation of the consequences of the mechanical environment on the behaviour of the patellofemoral joint is of particular importance in the endeavour to develop knee replacement systems which provide satisfactory function together with clinical long-term success.

  1. Inhibition of dye-coupling in Patella (mollusca) embryos by microinjection of antiserum against Nephrops (arthropoda) gap junctions

    NARCIS (Netherlands)

    Serras, F.; Buultjens, T.E.J.; Finbow, M.E.

    1988-01-01

    Antiserum raised against Nephrops gap junctions was injected into single cells of the 2-, 4-, 8-, 16-, and 32-cell stage of the Patella vulgata embryos. The pattern of junctional communication by iontophoresis of Lucifer Yellow CH was tested at the 32-cell stage. The results show that the normal pat

  2. Standardization of a Patella spp. (Mollusca, Gastropoda) embryo-larval bioassay and advantages of its use in marine ecotoxicology.

    Science.gov (United States)

    Pérez, Sara; Fernández, Nuria; Ribeiro, Pedro A

    2016-05-01

    The use of three limpet species, Patella vulgata Linnaeus, 1758, Patella depressa Pennant, 1777 and Patella ulyssiponensis Gmelin, 1791 as model organisms in marine ecotoxicology has been evaluated. Initial laboratory experiments were aimed to standardize a biological test with embryos and larvae of Patella spp, establishing the percentage of normal trochophore larvae as endpoint. Before conducting in vitro fertilization, oocytes must be maturated artificially by incubation in an alkaline solution; therefore, alkalinizing agent, pH and time of eggs alkalinization were evaluated. Moreover, time of sperm activation, optimum sperm and oocytes concentration during fertilization, gamete contact time, use of stirring during the fertilization, egg concentration and incubation temperature were examined. Minimum sample size per treatment was also estimated. Exposure of oocytes for 10min to FSW alkalinized with NH4OH at pH 9.0, the use of undiluted sperm pre-activated during 45min and a concentration of 200 oocytesmL(-1), a gamete-contact time of 180min and egg incubation at 18°C during 24h at a concentration of 80 eggsmL(-1) were the conditions allowing maximal embryo-larval development success. With an error of 0.05, a sampling size ≥320 allows a 95% confidence in the estimate. This Patella spp. acute bioassay fulfills a number of important a priori requirements to be used in ecotoxicological studies. Nevertheless, in vitro fertilization requires considerable handling, which may lead to failure in fecundation. Such difficulties are also addressed, in order to facilitate the routine use of this protocol by other laboratories.

  3. 陈旧性髌骨骨折后功能锻炼促进膝关节功能恢复%Postoperative function exercises pro-moting restoring of knee joint afterold fracture of patella

    Institute of Scientific and Technical Information of China (English)

    申永秀

    2003-01-01

    @@ RACKGROUND: The main aim for treatment of fracture of patella is to restore contnuity of knee joint extension apparatus and anatomic reduction of knee joint, avoid occurrence of traumatic arthritis. Problems in treatment of old comminuted fracture of patella are the same with fresh fracture that has been agreed on in recenl years. Except serious comminuted fracture of patella can' t be reserved, removal of patella shouldn' t be performed to others. Orthopaedics Hospital of Shenyang city thinks that the ideal method is relax of knee extension apparatus, reduction of fracture, strong internal fixation and early postoperative function exercises.

  4. Congenital Disiocation of the Patella in Children%儿童先天性髌骨脱位

    Institute of Scientific and Technical Information of China (English)

    李德达; 戴祥麒; 陶舜; 张友; 孙永胜; 周文玉

    1987-01-01

    本文作者经多年对该病的临床观察和治疗认为儿童习惯性髌骨脱位应称为先天性髌骨脱位滑脱型,以区别于其它原因造成的髌骨脱位.作者认为对该病应早治为佳,以综合性手术为主,对14岁以下总儿可施行胫骨结节内移术,以改变伸膝装置力线,同时密切注意其对胫骨上端发育的影响.%41 children were re-examined in the pathological changes in the knee operated on dislocation of the patella.The term of congenital"slipping"dislocation of the patella is more preferable to"recurrent"dislocation so as to distinguish it from the"fixed type" of the congenital dislocation of the patella.A combined procedure based on the ascertainment of the cause of the deformity is emphasized.Obviously,any delay in treatment will lead to osteomalacia of the patella or osteoarthritis of the knee.As is proved by the follow-up exoerience,a medial re-inplantalion of the tuberosity of tibia is advisable in children under the age of 14.To avoid later genu-recurva tum it should not be replaced at a' lower position.A horizontal level-shifting of the tuberosity of tibia in a "shaped bone gutier"will make the inplantation steady without any jnternal fixation.However,the possible injury of tibial epiphysis should always be kept in mind.

  5. Eccentric Exercise Protocols for Patella Tendinopathy: Should we Really be Withdrawing Athletes from Sport? A Systematic Review

    OpenAIRE

    Saithna, Adnan; Gogna, Rajiv; Baraza, Njalalle; Modi, Chetan; Spencer, Simon

    2012-01-01

    The 2007 review by Visnes and Bahr concluded that athletes with patella tendinopathy should be withdrawn from sport whilst engaging in eccentric exercise (EE) rehabilitation programs. However, deprivation of sport is associated with a number of negative psychological and physiological effects. Withdrawal from sport is therefore a decision that warrants due consideration of the risk/benefit ratio. The aim of this study was to determine whether sufficient evidence exists to warrant withdrawal o...

  6. Evaluation of cartilage repair tissue after biomaterial implantation in rat patella by using T2 mapping.

    Science.gov (United States)

    Watrin-Pinzano, A; Ruaud, J-P; Cheli, Y; Gonord, P; Grossin, L; Bettembourg-Brault, I; Gillet, P; Payan, E; Guillot, G; Netter, P; Loeuille, D

    2004-12-01

    To evaluate the ability of MR T2 mapping (8.5 T) to characterize ex vivo longitudinally, morphologically and quantitatively, alginate-based tissue engineering in a rat model of patellar cartilage chondral focal defect. Calibrated rat patellar cartilage defects (1.3 mm) were created at day 0 (D0) and alginate sponge with (Sp/C+) or without (Sp/C-) autologous chondrocytes were implanted. Animals were sacrificed sequentially at D20, D40 and D60 after surgery and dissected patellae underwent MRI exploration (8.5 T). T2 values were calculated from eight SE images by using nonlinear least-squares curve fitting on a pixel-by-pixel basis (constant repetition time of 1.5 s, eight different echo times: 5.5, 7.5, 10.5, 12.5, 15.0, 20.0, 25.0 and 30.0 ms). On the T2 map, acquired in a transversal plane through the repair zone, global T2 values and zonal variation of T2 values of repair tissue were evaluated versus control group and compared with macroscopic score and histological studies (toluidine blue, sirius red and hematoxylin-eosin). "Partial", "total" and "hypertrophic" repair patterns were identified. At D40 and D60, Sp/C+ group was characterized by a higher proportion of "total" repair in comparison to Sp/C- group. At D60, the proportion of "hypertrophic" repair was two fold in Sp/C- group versus Sp/C+ group. As confirmed morphologically and histologically, the T2 map also permitted the distinction of three types of repair tissue: "total", "partial" and "hypertrophic". "Total" repair tissue was characterized by high T2 values versus normal cartilage (p<0.05). Zonal variation, reflecting the collagen network organization, appeared only at D60 for Sp/C+ group (p<0.05). "Hypertrophic" tissue, mainly observed at D60, presented high T2 global values without zonal variation with cartilage depth. These results confirm the potency of the MR T2 map (8.5 T) to characterize macroscopically and microscopically the patterns of the scaffold guided-tissue repair of a focal chondral

  7. The basket plate in the osteosynthesis of comminuted fractures of distal pole of the patella.

    Science.gov (United States)

    Matejcić, A; Smiljanić, B; Bekavac-Beslin, M; Ledinsky, M; Puljiz, Z

    2006-06-01

    The purpose of this study was to evaluate the basket plate in the treatment of comminuted fractures of the distal pole of the patella (patellar apex fracture). The basket plate was designed by Smiljanić Branimir M.D., Clinical Professor of Surgery, at the Department of Surgery, The University Hospital Sestre milosrdnice, Zagreb, Croatia. In the period from 1988 to 2003, more than 100 patients with comminuted patellar apex fractures had been treated with basket plate osteosynthesis in the Department of Surgery. Only 51 patients were subsequently available for knee examination. For evaluation of the knee, we used a modified Cincinnati knee rating system, using a manual dynamometer in the evaluation of the knee extension. The results were excellent in 30 patients, good in 16 and satisfactory in 5 patients; no poor results were observed. The stability of the osteosynthesis by basket plate allows osseous consolidation if the fracture and permits loading the leg with full body weight early in the postoperative period.

  8. Influence of Gradual Elongation to the Patella Tendon Insertion in Rabbits

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    Hirotaka Mutsuzaki

    2014-08-01

    Full Text Available The purpose of this study was to examine the histological changes at the patella tendon (PT insertion site under gradual elongation in rabbits. Gradual elongation of the PT was performed using external fixation for 4 weeks, with a lengthening speed of 0.5 mm/day (elongation group; n = 24. Rabbits in the sham group underwent the same surgical procedure without gradual elongation (sham group; n = 24. Eight animals were sacrificed 1, 2 and 4 weeks after surgery in each group, respectively. Average thicknesses of stained glycosaminoglycan (GAGs areas by Safranin-O staining in the total cartilage layer and the uncalcified fibrocartilage layer in the elongation group were significantly higher than that in the sham group at 4 weeks (p < 0.05 and that in the intact PT group (n = 6, p < 0.05. In the elongation group, the peak in the average thicknesses of the stained GAGs areas in the total cartilage layer and the uncalcified fibrocartilage layer were observed at 4 weeks. Gradual elongation of PT insertion significantly affected the increase in the average thicknesses of the stained GAGs areas in the cartilage layer especially in the uncalcified fibrocartilage layer at 4 weeks in rabbits. Clinically, insertions of tendon and ligament can extend during gradual elongation using external fixation more than 4 weeks after the operation.

  9. Trabecular network arrangement within the human patella: how osteoarthritis remodels the 3D trabecular structure

    Science.gov (United States)

    Hoechel, Sebastian; Deyhle, Hans; Toranelli, Mireille; Müller-Gerbl, Magdalena

    2016-10-01

    Following the principles of "morphology reveals biomechanics", the anatomical structure of the cartilage-osseous interface and the supporting trabecular network show defined adaptation in their architectural properties to physiological loading. In case of a faulty relationship, the ability to support the load diminishes and the onset of osteoarthritis (OA) may arise and disturb the balanced formation and resorption processes. To describe and quantify the changes occurring, 10 human OA patellae were analysed concerning the architectural parameters of the trabecular network within the first five mms by the evaluation of 3Dmicro-CT datasets. The analysed OA-samples showed a strong irregularity for all trabecular parameters across the trabecular network, no regularity in parameter distribution was found. In general, we saw a decrease of material in the OA population as BV/TV, BS/TV, Tb.N and Tb.Th were decreased and the spacing increased. The development into depth showed a logarithmic dependency, which revealed the greatest difference for all parameters within the first mm in comparison to the physiologic samples. The differences decreased towards the 5th mm. The interpretation of the mathematic dependency leads to the conclusion that the main impact of OA is beneath the subchondral bone plate (SBP) and lessens with depth. Next to the clear difference in material, the architectural arrangement is more rod-like and isotropic just beneath the SBP in comparison to the plate-like and more anisotropic physiological arrangement.

  10. Iliotibial band autograft versus bone-patella-tendon-bone autograft, a possible alternative for ACL reconstruction

    DEFF Research Database (Denmark)

    Stensbirk, Frederik; Thorborg, Kristian; Konradsen, Lars;

    2014-01-01

    PURPOSE: The long-term results after using the iliotibial band autograft (ITB) in anterior cruciate ligament (ACL) reconstruction are not fully known. If equal in quality to conventional methods, the ITB graft could be a useful alternative as a primary graft, in revision surgery or multi-ligament......PURPOSE: The long-term results after using the iliotibial band autograft (ITB) in anterior cruciate ligament (ACL) reconstruction are not fully known. If equal in quality to conventional methods, the ITB graft could be a useful alternative as a primary graft, in revision surgery or multi......-ligament reconstruction. The purpose is to assess whether the ITB autograft is a long-term reliable alternative to the bone-patella-tendon-bone (BPTB) autograft, using a prospective randomized controlled trial design. METHODS: From 1995 to 1996, sixty patients scheduled for primary ACL reconstruction were included...... compared to the BPTB graft and is recommended as a reliable alternative autograft for ACL reconstruction. LEVEL OF EVIDENCE: Therapeutic studies, Level I....

  11. In vitro measurement of the tracking pattern of the human patella.

    Science.gov (United States)

    Ahmed, A M; Duncan, N A; Tanzer, M

    1999-04-01

    This study sought to determine whether a general pattern describing the three-dimensional tracking characteristics of the human patella could be established, and if not, then to determine the extent and nature of interspecimen variations in the characteristics in a normal population. Using 32 fresh-frozen knees subjected to extensor moment magnitudes similar to those in "static-lifting" and "leg-raising against resistance" maneuvers, patellar displacements were measured in the knee extension range 120 to 0 deg. For static-lifting, a constant foot-floor reaction of 334 N was applied. For leg-raising, a constant net quadriceps tension of 668 N was used throughout the extension range. Measurements were taken with a calibrated six-degree-of-freedom electromechanical goniometer and a displacement coordinate system referenced to the geometry of individual specimens. The three patellar displacements in the plane of knee extension/flexion (extension rotation, and anterior and proximal translations) consistently demonstrated the same pattern in the entire knee extension range with an average coefficient of variation of 13 percent. For knee angles greater than 45 deg, the three other displacements (medial-lateral translation, and rotations about the anterior--posterior and proximal--distal axes) followed a general pattern. However, for knee angles less than 45 deg, these displacements differed considerably between specimens for each loading condition, both in terms of magnitude (average coefficient of variation: 70 percent), and direction.

  12. Morphometric measurement of the patella on 3D model reconstructed from CT scan images for the southern Chinese population

    Institute of Scientific and Technical Information of China (English)

    Shang Peng; Zhang Linan; Hou Zengtao; Bai Xueling; Ye Xin; Xu Zhaobin; Huang Xu

    2014-01-01

    Background Due to racial differences in the morphology of the knee joint and due to most prostheses available in the market being designed using measurements from Caucasians,the objective of this study was to provide the morphometric data of the patella for the southern Chinese population for total knee arthroplasty (TKA),patellar resurfacing,and prostheses design.Methods The CT slices of the knee joint were obtained from both knees of 40 Chinese volunteers (20 females,20 males,and age from 20-25 years) by performing a computer tomographic scan.A 3D model was reconstructed by Mimics software based on the computed tomography images.Six metrical characteristics were measured by digital ruler.Statistical analysis was performed with the SPSS statistical program.Results The mean,standard deviation and P values of measurements and ratios were calculated using SPSS.All dimensions showed a significant gender difference with P<0.05,but the six variables of the left and right knees had no statistical significance with P>0.05.In addition,we studied the relationship between six couples (H-W,H-T,H-HAF,W-T,W-HAF,T-HAF) of the four variables (H:height,W:width,T:thickness and HAF:height of articulating facet) that were measured,which showed a significant correlation.Conclusions Examination of the southern Chinese population revealed that males have larger patellae than women.In both genders,comparing data between left and right knees shows no statistically significant difference.Compared with Westerners in previous studies,the patella in our study was thin and small.There was a good linear regression correlation between measurements of the patella.The indirect measurement method on 3D models makes it easy to obtain anatomical data,and the results can provide a region and gender specific database for morphometric measurements of the oatella,and can be helpful for designing implants suited for southern Chinese patients.

  13. Floating patella: combined quadriceps tendon, retinacula, and patellar tendon ruptures in a high-performance elite athlete.

    Science.gov (United States)

    Langer, Phillip R; Selesnick, F Harlan

    2010-09-01

    Simultaneous quadriceps and patellar tendon rupture is rare. To our knowledge, we present the first known case of simultaneous quadriceps tendon, patella tendon, and retinacula rupture in the ipsilateral knee of a high-performance elite athlete. This disabling injury in the active person results in an inability to actively obtain and maintain full knee extension. When the tendons do not heal properly, at the correct length and tension, knee range of motion and strength can become significantly altered, leading to early fatigue, patellofemoral pain, and possibly instability, preventing return to preinjury status. Immediate surgical repair is recommended for optimal return of knee function and power.

  14. Internal Fixation of Transverse Patella Fractures Using Cannulated Cancellous Screws with Anterior Tension Band Wiring

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    Khan I

    2016-07-01

    Full Text Available Aims: To evaluate the effectiveness and safety of anterior tension band wiring technique using two cannulated cancellous screws in patients with transverse (AO34-C1 or transverse with mildly comminuted (AO34-C2 patellar fractures. Materials and Methods: This is a prospective study of 25 patients with transverse fracture or transverse fracture with mildly comminuted patella fractures. All the patients were treated with open reduction and internal fixation using two parallel cannulated screws and 18G stainless steel wire as per the tension band principle. Results: There were eighteen males (72% and seven females (28%. The age group ranged from 24 to 58 years, with mean age of 38 years. The most common mode of injury was fall (72% followed by road traffic accident (20% and violent quadriceps contraction (8%. Transverse fracture was present in 60% and transverse fracture with mild comminution in 40% of patients. Mean time to achieve union was 10.7 weeks (range 8-12 weeks. Mean ROM at three months was 113.8 degree (90-130 and at final follow up this improved to 125.4 degrees (range 100-140. There was one case of knee stiffness and no case of implant failure was observed. Patients were evaluated using Bostman scoring, the mean score at three months being 26.04 which improved to 27.36 at the end of final follow up at one year. Conclusion: Cannulated cancellous screws with anterior tension band wiring is a safe, reliable and reproducible method in management of transverse patellar fractures, with less chances of implant failure and soft tissue irritation.

  15. Quantification of midkine gene expression in Patella caerulea (Mollusca, Gastropoda) exposed to cadmium

    Science.gov (United States)

    Stillitano, Francesca; Mugelli, Alessandro; Cerbai, Elisabetta; Vanucci, Silvana

    2007-10-01

    The release of cadmium into many coastal areas represents a threat to ecosystems and human health; cadmium is carcinogenic in mammals and in both marine invertebrates and vertebrates. The use of molluscs to assess the ecologic risk associated with contaminants is strongly recommended on account of their ecological role and on their highly conserved control and regulatory pathways that are often homologous to vertebrate systems. We previously identified a midkine family protein in the limpet Patella caerulea; the midkine is a recently discovered cytokines family with unequivocal informative value on repairing injury and neoplastic processes in mammals. Here we report on midkine ( mdk) and α-tubulin ( α-tub) gene expression patterns in P. caerulea exposed to cadmium. Limpets, collected on two occasions from a breakwater at a marina (Tyrrhenian Sea) were exposed to sublethal cadmium concentrations (0.5 and 1 mg l -1 Cd) over a 10-day exposure period. RNA was extracted from the viscera of unexposed and exposed specimens. Real time TaqMan RT-PCR was performed to measure the relative mdk and α-tub gene expression levels. A remarkable mdk over-expression was observed in all exposed animals with respect to unexposed ones; mdk over-expression was significantly higher in both treatments when compared with un-treatment (mean expression levels: 23- and 38-fold, for 0.5 and 1 mg l -1 Cd treatment, respectively; ANOVA, for both P < 0.01). The study also indicates that the mdk up-regulation was significantly Cd-concentration dependent ( P < 0.05). A significant up-regulation of the constitutive α-tub gene was also observed in 1 mg l -1 Cd-treated animals (mean expression level: 4-fold; ANOVA, P < 0.05). In conclusion, these data provide the first evidence paving the way for the use of the midkine as a promising new biomarker of effect in the environment risk assessment policy.

  16. Density and distribution of Patella ferruginea in a Marine Protected Area (western Sardinia, Italy: Constraint analysis for population conservation

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    S. COPPA

    2012-12-01

    Full Text Available The endemic limpet Patella ferruginea is the most endangered invertebrate of the Mediterranean Sea. Our study examined a population of P. ferruginea in the Marine Protected Area of Penisola del Sinis - Isola di Mal di Ventre (western Sardinia, Italy. During the summer 2009, we carried out a systematic census of P. ferruginea along a 8114 m georeferenced perimeter of coast in the no take-no entry zone to assess its density, spatial distribution, and morphometric characteristics. Our aim was to provide a detailed map of the distribution of P. ferruginea and to investigate the effects of accessibility, wave exposure and slope of the coast on its occurrence. Patella ferrugineashowed the lowest mean density ever reported (0.02 ind/m and a unimodal population structure characterised by fewer females and juveniles. Accessibility had a major negative effect on the occurrence of P. ferruginea. Exposure was also an important factor in influencing its density, size composition and specimen position within the mesolittoral, while the slope had little influence. Morphometric analysis showed the dominance of the Rouxi form, while the Lamarcki form was confined to exposed sites. Our results demonstrate a highly endangered population of P. ferruginea and suggest that human pressure represents the main risk factor.

  17. Eccentric Exercise Protocols for Patella Tendinopathy: Should we Really be Withdrawing Athletes from Sport? A Systematic Review

    Science.gov (United States)

    Saithna, Adnan; Gogna, Rajiv; Baraza, Njalalle; Modi, Chetan; Spencer, Simon

    2012-01-01

    The 2007 review by Visnes and Bahr concluded that athletes with patella tendinopathy should be withdrawn from sport whilst engaging in eccentric exercise (EE) rehabilitation programs. However, deprivation of sport is associated with a number of negative psychological and physiological effects. Withdrawal from sport is therefore a decision that warrants due consideration of the risk/benefit ratio. The aim of this study was to determine whether sufficient evidence exists to warrant withdrawal of athletes from sport during an eccentric exercise rehabilitation program. A systematic review of the literature was performed to identify relevant randomised trials. Data was extracted to determine whether athletes were withdrawn from sport, what evidence was presented to support the chosen strategy and whether this affected the clinical outcome. Seven studies were included. None of these reported high quality evidence to support withdrawal. In addition, three studies were identified in which athletes were not withdrawn from sport and still benefited from EE. This review has demonstrated that there is no high quality evidence to support a strategy of withdrawal from sport in the management of patella tendinopathy. PMID:23248727

  18. Quadriceps Tendon Rupture and Contralateral Patella Tendon Avulsion Post Primary Bilateral Total Knee Arthroplasty: A Case Report

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    Gaurav Sharma

    2016-07-01

    Full Text Available Background: Extensor mechanism failure secondary to knee replacement could be due to tibial tubercle avulsion, Patellar tendon rupture, patellar fracture or quadriceps tendon rupture. An incidence of Patella tendon rupture of 0.17% and Quadriceps tendon rupture of around 0.1% has been reported after Total knee arthroplasty. These are considered a devastating complication that substantially affects the clinical results and are challenging situations to treat with surgery being the mainstay of the treatment. Case Description: We report here an interesting case of a patellar tendon rupture of one knee and Quadriceps tendon rupture of the contralateral knee following simultaneous bilateral knee replacement in a case of inflammatory arthritis patient. End to end repair for Quadriceps tear and augmentation with Autologous Hamstring tendon graft was done for Patella tendon rupture. OUTCOME: Patient was followed up for a period of 1 year and there was no Extension lag with a flexion of 100 degrees in both the knees. DISCUSSION: The key learning points and important aspects of diagnosing these injuries early and the management techniques are described in this unique case of bilateral extensor mechanism disruption following knee replacements.

  19. MRI evaluation of anterior knee pain: predicting response to nonoperative treatment

    Energy Technology Data Exchange (ETDEWEB)

    Wittstein, Jocelyn R.; Garrett, William E. [Duke University Medical Center, Division of Orthopaedic Surgery, Durham, NC (United States); O' Brien, Seth D. [Brooke Army Medical Center, Department of Radiology, San Antonio, TX (United States); Vinson, Emily N. [Duke University Medical Center, Department of Radiology, Durham, NC (United States)

    2009-09-15

    Tibial tubercle lateral deviation and patellofemoral chondromalacia are associated with anterior knee pain (AKP). We hypothesized that increased tibial tubercle lateral deviation and patellofemoral chondromalacia on magnetic resonance imaging correlates with the presence of AKP and with failure of nonoperative management. In this retrospective comparative study, a blinded musculoskeletal radiologist measured tibial tubercle lateral deviation relative to the trochlear groove in 15 controls, 15 physical therapy responders with AKP, and 15 physical therapy nonresponders with AKP. Patellar and trochlear cartilage was assessed for signal abnormality, irregularity, and defects. The mean tibial tubercle lateral deviation in controls, physical therapy responders, and physical therapy nonresponders were 9.32 {+-} 0.68, 13.01 {+-} 0.82, and 16.07 {+-} 1.16 mm, respectively (data are mean {+-} standard deviation). The correlation coefficients for tubercle deviation, chondromalacia patellae, and trochlear chondromalacia were 0.51 (P < 0.01), 0.44 (P < 0.01), and 0.28 (P < 0.05), respectively. On analysis of variance, tubercle deviation and chondromalacia patellae contributed significantly to prediction of AKP and response to physical therapy. The presence of chondromalacia patellae and a tubercle deviation greater than 14.6 mm is 100% specific and 67% sensitive with a positive predictive value of 100% and negative predictive value of 75% for failure of nonoperative management. Subjects with AKP have more laterally positioned tibial tubercles and are more likely to have patellar chondromalacia. Patients with AKP, chondromalacia patellae, and a tubercle deviation greater than 14.6 mm are unlikely to respond to nonoperative treatment. Knowledge of tibial tubercle lateralization and presence of chondromalacia patellae may assist clinicians in determining patient prognosis and selecting treatment options. (orig.)

  20. Treatment of patellar instability in a case of hereditary onycho-osteodysplasia (nail-patella syndrome) with medial patellofemoral ligament reconstruction: A case report.

    Science.gov (United States)

    Gong, Yubao; Yang, Chen; Liu, Yang; Liu, Jianguo; Qi, Xin

    2016-06-01

    Hereditary onycho-osteodysplasia, also known as nail-patella syndrome (NPS), is a rare genetic disorder that is primarily characterized by poorly developed nails and patella. Patients with NPS frequently suffer from patellar instability that requires surgical management. The present case report describes a 25-year-old man with NPS. The patient presented with left knee pain and was found to have recurrent left patellar dislocation. The knee pain was first reported 1-year after a minor knee trauma incident. Following complete evaluation, a diagnosis of NPS was reached. The patient underwent surgical intervention using medial patellofemoral ligament (MPFL) reconstruction with a gracilis tendon autograft looped through two transverse 3.2-mm drill holes in the patella and fixed at the natural MPFL insertion site on the medial femoral condyle with an interference screw. The surgery resulted in stabilization of the patella in the femoral trochlea and the patient did not have any subsequent dislocations or subluxations. The patient had an excellent range of knee movement in the follow-up period. This case indicates that MPFL reconstruction in patients with patellar dislocation secondary to NPS can successfully restore normal patellar tracking and result in good range of movement and functional activity.

  1. Reconstruction of the medial patellofemoral ligament in cases of acute traumatic dislocation of the patella: current perspectives and trends in Brazil1,

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    Gustavo Gonçalves Arliani

    2014-10-01

    Full Text Available Objective:To evaluate the approaches and procedures used by knee surgeons in Brazil for treating medial patellofemoral lesions (MPFL of the knee in cases of acute traumatic dislocation of the patella.Materials and methods:A questionnaire comprising 15 closed questions on topics relating to treating MPFL of the knee following acute dislocation of the patella was used. It was applied to Brazilian knee surgeons during the three days of the 44th Brazilian Congress of Orthopedics and Traumatology, in 2012.Results:106 knee surgeons completely filled out the questionnaire and formed part of the sample analyzed. Most of them were from the southeastern region of Brazil. The majority (57% reported that they perform fewer than five MPFL reconstruction procedures per year. Indication of non-surgical treatment after a first episode of acute dislocation of the patella was preferred and done by 93.4% of the sample. Only 9.1% of the participants reported that they had never observed postoperative complications. Intraoperative radioscopy was used routinely by 48%. The professionals who did not use this tool to determine the point of ligament fixation in the femur did not have a statistically greater number of postoperative complications than those who used it (p > 0.05.Conclusions:There are clear evolutionary trends in treatments and rehabilitation for acute dislocation of the patella due to MPFL, in Brazil. However, further prospective controlled studies are needed in order to evaluate the clinical and scientific benefit of these trends.

  2. Patella Eversion Reduces Early Knee Range of Motion and Muscle Torque Recovery after Total Knee Arthroplasty: Comparison between Minimally Invasive Total Knee Arthroplasty and Conventional Total Knee Arthroplasty

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    Tokifumi Majima

    2011-01-01

    Full Text Available We hypothesized that patella eversion during total knee arthroplasty (TKA reduces early return of active knee extension and flexion, quadriceps muscle strength, and postoperative pain. In 100 conventional TKA knees and 100 minimally invasive TKA (MIS TKA knees, we compared knee range of motion (ROM, postoperative pain, and quadriceps muscle strength at 1 day, 4 days, 1 week, 2 weeks, 3 weeks, 4 weeks, 12 weeks, 1 year, and 5 years after surgery. The differences of surgical approach between MIS TKA and conventional TKA of this study are length of skin incision with subcutaneal flap and patella eversion. In MIS TKA, skin incision is shorter than conventional TKA. Furthermore, patella is not everted in MIS TKA procedure. There were no significant differences in preoperative factors. Postoperative improvement of ROM, postoperative muscle strength recovery, and postoperative improvement of visual analog scale were faster in patients with MIS TKA when compared to that in patients with conventional TKA. On the other hand, no significant difference was observed in complication, 5-year clinical results of subjective knee function score, and the postoperative component angle and lower leg alignment. These results indicate that patella eversion may affect muscle strength recovery and postoperative pain.

  3. Closed patella fracture combined with cruciate ligament injury:a case control study

    Institute of Scientific and Technical Information of China (English)

    LI Han; WANG Wei; LIU Yue-ju; CHEN Wei; ZHANG Qi; LI Xu; ZHU Lian

    2013-01-01

    Background Patellar fracture and cruciate ligament injury are a common consequence of traumatic knee injury.Patellar fracture combined with cruciate ligament injury is rarely reported,although the mechanisms of two things are similar.This study aimed to evaluate the incidence of closed patella fracture combined with cruciate ligament injury.Methods From 2012 March 1 to June 30,magnetic resonance images of 60 patients with unilateral closed patellar fracture were studied in our institution.The mean age of the patients at presentation was 40.2 years (range,13-64 years) and 48 patients were men.First,patients were divided according to the cause of injury.Twenty-eight patients had highenergy trauma from a falling injury or motor vehicle accident,and 32 patients had low-energy trauma resulting from a tumbling injury.Second,according to the fracture pattern,31 patients had a transverse fracture and 29 patients had a comminuted fracture.Results We found seven cases of closed patellar fracture combined with cruciate ligament injury among 60 patients,including two cases of a completely ruptured posterior cruciate ligament,two with a partially torn posterior cruciate ligament,and three with a partially torn anterior cruciate ligament.The percentage of this combined injury was 11.6% (7/60).The incidence of a combined injury of the cruciate ligament with a comminuted fracture (6/29,20.7%) was significantly higher than that with a transverse fracture (1/31,3.2%,P <0.05).The most common mechanism of injury in patellar fracture combined with cruciate ligament injury was high-energy trauma from road traffic accidents (94%),whereas in the patellar fracture alone,it was tumbling (62%).The incidence of combined injury with high-energy trauma (6/28,21.4%) was significantly higher than that with low-energy trauma (1/32,3.1%,P <0.05).Conclusions These data suggest that high-energy trauma often results in a comminuted patellar fracture,which is often combined with

  4. Patella spp. as na alternative to Mytilus spp in marine pollution studies

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    Begoña Pérez-Fernández

    2014-06-01

    Full Text Available The most widely used species for marine pollution studies is mussel, Mytilus spp., as it is a filter feeder, sessile, easy to get and present in most worldwide coasts. However, sometimes it is necessary to have an alternative for areas where mussels are scarce or even absent. Patella spp. could be a useful substitute to Mytilus as these organisms have already been used in some pollution studies (Bartolomé, 2011 and both groups have similar characteristics except for the feeding strategy that in limpets is based on grazing on the small algae that grow on the rocks where they live. For this study, four sampling sites where selected: two in Galicia (Ría de Arousa and Ría de Ferrol and two in the Bay of Biscay (Suances and Fuenterrabía. In the four sampling sites both mussels and limpets were collected and 12 parent PAHs were analysed by means of HPLC and fluorescence detector with programmable wavelength (Viñas 2002. The method is subject to a strict quality control that guarantees the quality of the data. Mussels always present a higher PAH content than limpets sampled in the same area. When comparing the value for the sum of PAHs, it is shown that the maximum value measured in limpets (26.0 µg/kg d.w. in Arousa is less than the minimum value measured in mussels (63.7 µg/kg d.w. in Fuenterrabía. However, the sites pointed as more polluted using limpets coincide with the ones that are pointed out using mussels and the other way around. The individual PAH distribution pattern also presents some differences in both species mainly due to the phenathrene proportion that is higher in limpets than in mussels and this is clearer in the Bay of Biscay area. The main conclusion of the study is that there is no direct conversion factor between the PAH burden in both species but it could be possible to estimate the pollution status of an area using limpets. To compare levels between species it would be necessary to do some more work including more

  5. Postoperative evaluation of the position of interference screws, boneblocks and ligamentum patellae autografts in anterlor cruciate ligament replacement; Evaluierung von Knochenblockposition, Interferenzschraubenlage und Ersatzplastik des vorderen Kreuzbandes nach Ligamentum patellae-Transplantat mittels CT

    Energy Technology Data Exchange (ETDEWEB)

    Bauer, R, [Leipzig Univ. (Germany). FUSt 8/Radiologie; Kolbus, F.; Brueckner, B. [Leipzig Univ. (Germany). Abt. 2/Chirurgie des Bundeswehrkrankenhauses Leipzig

    2000-06-01

    Purpose: Evaluation of arthroscopically assisted reconstruction of the anterior cruciate ligament using ligamentum patellae autografts in the bone-tendon-bone technique with special regard to the position of blocks and interference screws. Material and methods: In a prospective study 28 patients were included after undergoing arthroscopic anterior cruciate ligament replacement surgery. Data thus obtained were correlated with the postoperatively determined functional parameters of the affected joint. Results: Interference screws, bone-blocks and ligamentous transplants could be well imaged using CT. In a comparison of our data with clinical results there was a statistically highly significant correlation between clinical outcome and the position of bone-blocks and interference screws in the tibia. Angles between screw and bone-block exceeding a standard deviation led to significantly worse results, while a divergence in femoral angles did not lead to significantly worse results. (orig./AJ) [German] Ziel: Evaluation der arthroskopischen Ersatzplastik des vorderen Kreuzbandes unter besonderer Beruecksichtigung der Lage der Knochenbloecke, Interferenzschrauben und Bohrkanaele mittels CT und Vergleich der radiologischen Daten mit klinischen und funktionellen Parametern. Material und Methodik: In einer prospektiven Studie wurden 28 Patienten nach arthroskopischer Ersatzplastik des vorderen Kreuzbandes mittels Lig. patellae-Transplantat im CT untersucht. Anschliessend erfolgte die Pruefung der Korrelation mit postoperativ erhobenen klinisch-funktionellen Parametern des Kniegelenks. Ergebnisse: Die Interferenzschrauben, Bohrkanaele und Knochenbloecke sowie das Transplantat konnten in allen Faellen gut dargestellt werden. Bei einem Vergleich unserer Daten mit den klinischen Untersuchungsergebnissen der Chirurgen zeigte sich ein statistisch hochsignifikanter Zusammenhang mit den Winkeldivergenzen zwischen Interferenzschraube und Bohrkanal im Bereich der Tibia. Divergenzen

  6. 髌骨骨折关节镜下闭合复位内固定术后的康复训练%Rehabilitation exercises after closed reduction internal fixation of fracture of patella under arthroscope

    Institute of Scientific and Technical Information of China (English)

    朴成哲; 李培; 阿良; 王敏

    2003-01-01

    @@ INTRODUCTION Closed reduction internal fixation under arthroscope is performed from August, 2000 to April, 2001 and advanced domestic and foreign rehabilitation programs are combined to treat fracture of patella comprehensively, satisfying effects are achieved.

  7. Effect of femoral component design on patellofemoral crepitance and patella clunk syndrome after posterior-stabilized total knee arthroplasty.

    Science.gov (United States)

    Frye, Benjamin M; Floyd, Mark W; Pham, Dahn C; Feldman, John J; Hamlin, Brian R

    2012-06-01

    The purpose of this study was to determine if recent changes to the femoral component of a particular posterior-stabilized total knee prosthesis would affect the incidence of postoperative patellofemoral crepitance and patella clunk syndrome. One hundred eight total knee arthroplasties were performed with the conventional design; 136 were performed after the femoral component was changed. Complications were compared between the groups with an average follow-up of 17.7 months and 12.4 months, respectively. Thirteen knees with the conventional design (12%) were found to have patellofemoral complications; no complications were noted with the new design (P < .0001). Femoral components with a deep trochlear groove and smooth transition of the intercondylar box appear to better accommodate any peripatellar fibrous nodule that may form after total knee arthroplasty.

  8. Presence of Gamma-Aminobutyric Acid (Gaba) in the Pedal Mucus of the Critically Endangered Species Patella ferruginea.

    Science.gov (United States)

    Rivera-Ingraham, G A; Espinosa, F; Krock, B

    2015-05-01

    Patella ferruginea is a giant patellid limpet endemic to the Mediterranean Sea. It presently is in danger of extinction, and many have called for developing conservation measures including the mass production of spats for re-introduction projects. However, so far all attempts have been relatively unsuccessful. Previous work analyzing the effects of gamma-aminobutyric acid (GABA) on the recruitment of patellid limpets has shown that larvae respond to the presence of this signaling molecule. This response could explain the gregarious distribution typical of this species. In the present study, we demonstrated that GABA is naturally secreted by P. ferruginea in the pedal mucus. GABA is preferentially secreted during the summer, coinciding with the reproductive resting period of the species. Further research should aim to analyze the effects of GABA on larval development and metamorphosis in order to assess its potential use to improve conservation efforts.

  9. Microenvironmental Ecology of the Chlorophyll b-containing Symbiotic Cyanobacterium Prochloron in the Didemnid Ascidian Lissoclinum patella

    Directory of Open Access Journals (Sweden)

    Michael eKühl

    2012-11-01

    Full Text Available The discovery of the cyanobacterium Prochloron was the first finding of a bacterial oxyphototroph with chlorophyll (Chl b, in addition to Chl a. It was first described as Prochloron didemni but a number of clades have since been described. Prochloron is a conspicuously large (7-25 µm unicellular cyanobacterium living in a symbiotic relationship, primarily with (sub- tropical didemnid ascidians; it has resisted numerous cultivation attempts and appears truly obligatory symbiotic. Recently, a Prochloron draft genome was published, revealing no lack of metabolic genes that could explain the apparent inability to reproduce and sustain photosynthesis in a free-living stage. Possibly, the unsuccessful cultivation is partly due to a lack of knowledge about the microenvironmental conditions and ecophysiology of Prochloron in its natural habitat. We used microsensors, variable chlorophyll fluorescence imaging and imaging of O2 and pH to obtain a detailed insight to the microenvironmental ecology and photobiology of Prochloron in hospite in the didemnid ascidian Lissoclinum patella. The microenvironment within ascidians is characterized by steep gradients of light and chemical parameters that change rapidly with varying irradiances. The interior zone of the ascidians harboring Prochloron thus became anoxic and acidic within a few min of darkness, while the same zone exhibited O2 super-saturation and strongly alkaline pH after a few min of illumination. Photosynthesis showed lack of photoinhibition even at high irradiances equivalent to full sunlight, and photosynthesis recovered rapidly after periods of anoxia. We discuss these new insights on the ecological niche of Prochloron and possible interactions with its host and other microbes in light of its recently published genome and a recent study of the overall microbial diversity and metagenome of L. patella.

  10. Inibição muscular dos extensores do joelho em sujeitos acometidos por condromalácia patelar e osteoartrite do joelho - um estudo de revisão sistemática Knee extensor muscle inhibition in subjects with chondromalacia patellae and knee osteoarthritis - a systematic review

    OpenAIRE

    Klauber Dalcero Pompeo; Mônica de Oliveira Mello; Marco Aurélio Vaz

    2012-01-01

    A inibição muscular (IM) tem sido reportada como um dos fatores associados à fraqueza muscular presente na osteoartrite (OA) e condromalácia patelar (CP), sendo inclusive associada com a etiologia e a progressão. Entretanto, parece existir uma lacuna na literatura em relação a estudos de revisão que avaliaram o grau de IM de sujeitos acometidos por CP e OA. O objetivo do estudo foi reunir os resultados de estudos que investigaram o grau de IM na OA e CP e identificar possíveis diferenças na I...

  11. 玻璃酸钠注射结合股内侧肌电刺激治疗髌骨软化症的效果观察%Effect observation of sodium hyaluronate injection combined with medial vastus muscle electrical stimulation treating chondromalacia patellae

    Institute of Scientific and Technical Information of China (English)

    李光辉; 高宏鹰

    2016-01-01

    目的 探讨玻璃酸钠注射结合股内侧肌电刺激治疗髌骨软化症的效果.方法 回顾性分析201 1年10月~2014年6月在我科治疗的102例髌骨软化症患者,随机分成A、B、C组,A组采用膝关节注射玻璃酸钠注射液治疗,B组采用股内侧肌电刺激治疗,C组采用膝关节注射玻璃酸钠注射液联合股内侧肌电刺激治疗,随访12个月,评价3种方法的治疗效果.结果 C组的优良率高于A、B组(P<0.05),B组的优良率高于A组(P<0.05).结论 玻璃酸钠膝关节注射结合股内侧肌电刺激治疗治疗髌骨软化症的效果优于单独采用玻璃酸钠或股内侧肌电刺激.

  12. 玻璃酸钠注射液配合膝痛宁熏蒸治疗髌骨软化症55例%Sodium Hyaluronate Intra-articular Injection combined with Xitongning Fumigation in the Treatment of Chondromalacia Patellae for 55 Cases

    Institute of Scientific and Technical Information of China (English)

    邱小魁

    2016-01-01

    目的 观察玻璃酸钠关节腔注射配合中药组方膝痛宁熏蒸治疗髌骨软化症的临床疗效.方法 对55例髌骨软化症患者,给予玻璃酸钠关节腔注射及中药组方膝痛宁熏蒸治疗,观察治疗后患者的恢复情况.结果 55例患者治疗结束后,按照《中医病证诊断疗效标准》中髌骨软化症的疗效标准评定,治愈20例、好转31例、未愈4例.结论 玻璃酸钠关节腔注射配合中药组方膝痛宁熏蒸治疗能够有效缓解髌骨软化症的临床症状,安全性较高,疗效确切,值得临床应用.

  13. Therapeutic effect of traditional Chinese herb and selective medial vastus muscle electric stimulation in treatment of chondromalacia of patella%中药联合选择性股内侧肌电刺激治疗髌骨软化症的疗效观察

    Institute of Scientific and Technical Information of China (English)

    张文庆; 周湘桂; 易化平; 胡小玲; 万春英

    2010-01-01

    [目的]观察中药联合选择性股内侧肌电刺激治疗髌骨软化症(CMP)的疗效.[方法]选择90例CMP患者,随机分成三个治疗组进行治疗,每组各30例,分别为单纯中药治疗组(A组)、单纯选择性股内侧肌电刺激治疗组(B组)、中药联合选择性股内侧肌电刺激治疗组(C组).随访9~12个月,测量膝关节轴位片适应角(CA)、外侧髌股角(LPA),对治疗后的疗效进行评价,并进行统计分析.[结果]三个治疗组治疗前后CA、LPA均有明显差异性(P0.05).[结论]中药联合选择性股内侧肌电刺激治疗CMP的疗效优于单纯中药治疗及单纯选择性股内侧肌电刺激治疗CMP的疗效,它是一种更好的治疗CMP的方法.

  14. 关节镜下髌外侧支持带松解及内侧支持带紧缩治疗髌骨软化症%Lateral retinaculum releasing and medial retinaculum reefing for the treatment of chondromalacia patellae

    Institute of Scientific and Technical Information of China (English)

    梁杰; 杜远立; 金涛; 李玉鹏; 陈波

    2005-01-01

    目的探讨膝关节镜下外侧支持带松解及内侧支持带紧缩治疗髌骨软化症的疗效.方法对31例(36膝)髌骨软化症患者在关节镜下用等离子刀松解外侧支持带及外侧髌-股韧带,同时紧缩缝合内侧支持带及内侧髌-股韧带.结果随访10~48个月,患者症状和体征均得到明显改善.与术前相比,Lysholm评分由70.2分提高至平均92.1分,差异有显著性(P<0.01).结论该术式治疗髌骨软化症不仅能松解外侧支持带,同时还可有效地紧缩内侧支持带,疗效确切,具有创伤小、并发症少、功能恢复快等优点.

  15. 中药薰蒸辅运动疗法治疗运动员髌骨软骨病疗效观察%Clinical observation on curative effect of fumigate with TCM and movement therapy to cure chondromalacia of patella in athletes

    Institute of Scientific and Technical Information of China (English)

    张振虎; 李天荣

    2009-01-01

    目的:探讨中药薰蒸与运动疗法治疗运动员髌骨软骨病的疗效.方法:选择明确诊断髌骨软骨病的运动员60例,随机分成A组与B组,A组采用中药薰蒸方法治疗,B组除采用A组方法外加用运动疗法治疗.结果:疗程结束后分别用视觉模拟疼痛评分和Lysholm膝关节量表评分,经t检验,两组患者症状均明显减轻,B组患膝功能改善明显,能系统参加运动训练,疗效优于A组(P<0.01).结论:中药薰蒸具有较好的消炎、消肿、镇痛作用,运动疗法能增强肌力,增加患膝的稳定性,改善关节的活动范围,两者合用能增强疗效,更好地促进膝关节功能的康复,防止髌骨软骨病复发.

  16. 中药熏洗加针刺治疗髌骨软骨软化症97例%A Study of Fumigation and Washing Treatment with Traditional Chinese Medicine and Acupuncture Treatment for 97 Patients with Chondromalacia of Patella

    Institute of Scientific and Technical Information of China (English)

    赵晓; 姚乃捷; 陈扬声; 黄飞麒

    2010-01-01

    目的 观察中药熏洗及针刺治疗髌骨软骨软化症的临床疗效.方法 采用中药熏洗及针刺治疗两周.结果 97例中,治愈63例,占64.9%;好转28例,占28.9%,未愈6例,占6.2%,有效率93.8%.结论 中药熏洗及针刺治疗髌骨软骨软化症临床疗效满意.

  17. 黏弹性材料关节腔填充配合肌力训练治疗髌骨软化症120例%Visco-elastic materials for joint cavity filling combined with exercise for power in the treatment of chondromalacia patellae in 120 patients

    Institute of Scientific and Technical Information of China (English)

    姜贵云; 鞠智卿; 杨晓莲; 徐振奇

    2007-01-01

    为探讨黏弹性材料玻璃酸钠关节腔填充配合肌力训练治疗髌骨软化症的效果.于2003-04/2006-05选择承德医学院附属医院康复医学科收治膝关节骨关节炎患者120例(179膝).患膝屈曲90°,髌骨下内侧注射玻璃酸钠溶液2 mL,1次/周,5次为1个疗程.同时,配合增强股内侧肌肌力为主的等长训练.结果表明,治疗5周后优良率达91.1%,总有效率为98.9%.优:膝关节疼痛及僵硬感消失,活动自如,膝关节屈>130°,伸0°102膝;良:膝关节疼痛及僵硬感基本消失,活动轻度受限,膝关节屈>110°,伸0°61膝;可:膝关节偶有疼痛和僵硬感,休息后即可恢复,关节活动轻度受限,膝关节屈90°,伸0°14膝;差:膝关节疼痛及僵硬感和注射前相比无改善,关节活动受限,膝关节屈<90°,伸0°2膝.

  18. 电针配合外侧支持带松解治疗髌骨软骨软化症的临床观察%Clinical Observation of Electric Acupuncture Combined with Lateral Retinacular Release in the Treatment of Chondromalacia Patellae

    Institute of Scientific and Technical Information of China (English)

    吴文虎; 郭纪涛

    2009-01-01

    目的:探讨电针配合外侧支持带松解治疗髌骨软骨软化症的临床疗效.方法:将60例患者随机分为治疗组和对照组.每组各30例,治疗组采用电针膝眼穴配合外侧支持带松解治疗;对照组采用电针膝眼穴治疗.根据HSS膝关节功能评分标准进行治疗前后及两组疗效的评价.结果:经治疗4周后,两组HSS评分均与治疗前相比差异有统计学意义(P<0.05),治疗组HSS评分与对照组比较差异有统计学意义(P<0.05).治疗组总有效率为96.7%,对照组总有效率为86.7%,两组疗效比较差异具有统计学意义(P<0.05).结论:电针配合外侧支持带松解治疗髌骨软骨软化症疗效确切,是一种安全有效的治疗方法.

  19. Experimental study on rabbit articular cartilage damage caused by patella tilt%髌骨倾斜对兔髌骨关节软骨损害的实验研究

    Institute of Scientific and Technical Information of China (English)

    王国良; 孙艳; 唐兆春; 于其龙; 王宗江

    2014-01-01

    目的:建立兔髌骨倾斜的模型并观察髌股关节软骨损害的变化,为临床治疗髌股关节疾病提供实验依据。方法新西兰大白兔24只,随机分3组,每组8只,行右膝髌骨内侧支持带松解和外侧支持带紧缩术,术后不固定右膝关节。左膝髌骨为对照组。分别于术后第2周、4周、8周处死取材,分别进行髌骨倾斜角CT测量、髌骨关节面软骨大体观察、软骨组织Mankin评分。结果(1)实验侧髌骨倾斜角明显大于对照侧;(2)术后4周可见关节软骨软化,色泽晦暗,裂隙形成;术后8周关节软骨粗糙,有大的裂隙且色泽晦暗;对照组无软骨退变;(3) HE染色光镜下观察关节软骨,术后4周时,关节软骨轻度变性,可见软骨细胞变扁,表面不规则,术后8周时,软骨明显变性,可见软骨细胞增殖,排列紊乱,基质减少,潮线不完整。根据软骨Mankin评分,术后4、8周时右膝实验组得分明显高于左膝空白对照组,相比较有显著的统计学意义( P<0.05)。结论兔髌骨倾斜后4周,髌骨外侧关节面软骨出现软骨软化,随着时间的延长软骨退变进一步加重,为治疗髌股关节软骨疾病提供实验依据。%Objective To establish a rabbit model of patellar tilt and observe the change of the patellofemoral cartilage damage , which can provide experimental basis for the clinical treatment of patellofemoral joint diseases .Methods Twenty-four New Zealand rabbits were randomly divided into three groups.The right knee was the experimental side which was operated to make the patella tilted .The left knee was used as the normal control .The animals were sacrificed in the 2nd week, 4th week, and 8th week after the operation .The patellar tilt angle on the CT scanning was measured , gross observation and Mankin scores were also performed . Results ( 1 ) The results revealed that the patellar tilt angle of the

  20. Migration of a Kirschner wire to the dorsolateral side of the foot following osteosynthesis of a patella fracture with tension band wiring: a case report

    OpenAIRE

    Aydın, Ekrem; Dülgeroğlu, Turan Cihan; Metineren, Hasan

    2016-01-01

    Background Patella fractures represent 1 % of all musculoskeletal system fractures. Fixation of patellar fractures using open reduction and tension band wiring is a commonly used and successful surgical fixation method. Case presentation A 28-year-old male patient from Turkey presented to our clinic with complaints of palpable foreign bodies under the skin on the dorsolateral side of his right foot. Except for the palpable and moving body of about 6 cm length under the skin in his foot, he ha...

  1. Evaluation of the relationship between T1ρ and T2 values and patella cartilage degeneration in patients of the same age group

    Energy Technology Data Exchange (ETDEWEB)

    Nishioka, Hiroaki, E-mail: kinuhnishiok@fc.kuh.kumamoto-u.ac.jp [Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556 (Japan); Hirose, Jun; Okamoto, Nobukazu; Okada, Tatsuya; Oka, Kiyoshi; Taniwaki, Takuya; Nakamura, Eiichi [Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556 (Japan); Yamashita, Yasuyuki [Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556 (Japan); Mizuta, Hiroshi [Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556 (Japan)

    2015-03-15

    Highlights: •This prospective cohort study investigated the association between the T1ρ and T2 values and the progression of cartilage degeneration in patients of the same age group. In this study, to the best of our knowledge, this is the first report to compare the T1ρ and T2 values between normal and OA knees within the same age group and to further investigate the relationship between the degree of cartilage degeneration and the T1ρ and T2 values in OA-grading groups of the same age. Our study confirmed that T1ρ and T2 mapping can be used to quantitatively evaluate the degree of patella cartilage degeneration in patients within the same age group.. -- Abstract: Objective: The aim of this study was to investigate the association between the T1ρ and T2 values and the progression of cartilage degeneration in patients of the same age group. Materials and methods: Sagittal T1ρ and T2 mapping and three-dimensional (3D) gradient-echo images were obtained from 78 subjects with medial knee osteoarthritis (OA). The degree of patella cartilage degeneration was classified into four groups using MRI-based grading: apparently normal cartilage, mild OA, moderate OA, and severe OA group. We measured the T1ρ and T2 values (ms) in the regions of interest set on the full-thickness patella cartilage. Then, we analyzed the relationship between the T1ρ and T2 values and the degree of patella cartilage degeneration. Results: There were no significant differences in age among the four groups. Both the T1ρ and T2 values showed a positive correlation with the degree of OA progression (ρ = 0.737 and ρ = 0.632, respectively). By comparison between the apparently normal cartilage and the mild OA groups, there were significant differences in the T1ρ mapping, but not in the T2 mapping. Conclusions: Our study confirmed that T1ρ and T2 mapping can quantitatively evaluate the degree of patella cartilage degeneration in patients within the same age group.

  2. Patterns of spatial genetic structuring in the endangered limpet Patella ferruginea: implications for the conservation of a Mediterranean endemic.

    Science.gov (United States)

    Casu, Marco; Rivera-Ingraham, Georgina A; Cossu, Piero; Lai, Tiziana; Sanna, Daria; Dedola, Gian Luca; Sussarellu, Rossana; Sella, Gabriella; Cristo, Benedetto; Curini-Galletti, Marco; García-Gómez, José Carlos; Espinosa, Free

    2011-10-01

    Patella ferruginea Gmelin, 1791 is an endangered marine gastropod endemic to the Western Mediterranean. Its range is restricted to the Sardinian-Corsican region (SCR), North Africa, a few scattered sites in Southern Spain, and Sicily. Inter-simple sequence repeat (ISSR) markers and three different mitochondrial DNA (mtDNA) regions, Cytochrome c Oxidase subunit I, 12S (small-subunit ribosomal RNA gene) and 16S (large-subunit ribosomal RNA gene), were used to investigate the presence of genetic population structuring. The mtDNA sequences showed very low levels of genetic differentiation. Conversely, ISSRs showed the presence of two main genetic groups, corresponding to Spain, North Africa and Sicily and the SCR. The SCR was further split into two subgroups. The ISSR results suggest that, on a regional scale, the genetic structure of P. ferruginea is mainly determined by the restriction of gene flow by dispersal barriers. On a more local scale human harvesting may play a crucial role in population structuring by increasing the effect of genetic drift.

  3. Niveles de plomo y cadmio en agua marina y lapas (Patella vulgata L. de la Ría de Vigo

    Directory of Open Access Journals (Sweden)

    M. Pérez López

    2003-01-01

    Full Text Available El empleo de seres vivos para monitorizar la contaminación por metales pesados en los ecosistemas acuáticos es de extremo interés en el campo de la ecotoxicología. En el presente estudio se han recogido muestras de agua marina y de lapas (Patella vulgata L. de distintos puntos de la Ría de Vigo, con la intención de determinar en ellos los niveles de plomo y cadmio, por medio de una técnica de voltamperometría. Los resultados obtenidos mostraron una relación estrecha entre los niveles hallados en las muestras de agua, y los encontrados en los moluscos, sobre todo los correspondientes a los tejidos blandos de lapas, relacionándose directamente a un incremento en la contaminación medioambiental. La concentración fue más elevada en los tejidos blandos que en la valva, especialmente en el caso del Cd (incremento aproximado de 93.6 veces. Los niveles de contaminación metálica fueron mayores en los animales recogidos en la zona interior de la Ría, salvo en el caso del cadmio presente en los tejidos blandos, donde la concentración máxima (5.62 ppm correspondió con muestras próximas al mar abierto

  4. Circumferential electrocautery of the patella in primary total knee replacement without patellar replacement: a meta-analysis and systematic review

    Science.gov (United States)

    Fan, Lihong; Ge, Zhaogang; Zhang, Chen; Li, Jia; Yu, Zefeng; Dang, Xiaoqian; Wang, Kunzheng

    2015-03-01

    The purpose of this meta-analysis and systematic review was to identify and assess whether circumferential electrocautery is useful for improving outcomes after primary total knee replacement(TKR). We searched MEDLINE, EMBASE, PubMed, SpringerLink, Web of Knowledge, OVID CINAHL, OVID EBM and Google Scholar and included articles published through January 2014. A total of 6 articles met the inclusion criteria. Of the 776 cases included in the analysis, 388 cases involved patellar denervation, and 388 cases were designated as the control group. The meta-analysis revealed no significant difference in the incidence of anterior knee pain (AKP, p = 0.18) or in the visual analogue scale score (VAS, p = 0.23) between the two groups. In addition, AKSS Function Score indicated no significant difference between the two groups (p = 0.28). However, the OKS (p = 0.02), patellar score (p = 0.01), AKSS-Knee Score (p = 0.004), range of motion (ROM, p < 0.0001) and WOMAC Score (p = 0.0003) indicated that circumpatellarelectrocautery improved clinical outcomes compared with non-electrocautery. The results indicate that circumferential electrocautery of the patella does not significantly improve AKP compared with non-electrocautery techniques but that circumferential electrocautery significantly improves patients' knee function after surgery. Therefore, we believe that circumferential electrocautery is beneficial to the outcome of primary TKR surgery without patellar replacement.

  5. Secondary aneurysmal bone cystic change of the chondroblastoma, mistaken for a primary aneurysmal bone cyst in the patella.

    Science.gov (United States)

    Chung, Jin Wha; Lee, Hwa Sung

    2014-03-01

    A 29-year-old woman complained of a 3-month history of left knee pain without trauma history. X-ray showed a well-defined osteolytic lesion with a sclerotic margin in the patella and magnetic resonance imaging showed T1-low and T2-high signal intensity with different fluid level. Our impression was an aneurysmal bone cyst. At surgery, the lesion was a blood-filled cystic cavity, surrounded by a gray or brownish tissue. Hemorrhagic soft tissues with recognizable bone fragments were observed. Curettage and autogenous bone graft was done. Microscopically, sheets of tumor cells were intermingled with some areas of eosinophilic chondroid matrix. The tumor cells showed oval-shaped nuclei with moderate eosinophilic cytoplasm. Several multinucleated giant cells and blood filled cystic cavities were observed. The final diagnosis was a chondroblastoma with a secondary aneurysmal bone cyst. At the post-operative 1.5-year follow-up, grafted bones were well incorporated radiographically and there were no recurrent evidence or any other abnormal symptoms.

  6. Spatial diversity of rocky midlittoral macro-invertebrates associated with the endangered species Patella ferruginea (Mollusca: Gastropoda) of Tunisian coastline

    Science.gov (United States)

    Tlig-Zouari, Sabiha; Rabaoui, Lotfi; Fguiri, Hosni; Diawara, Moctar; Ben Hassine, Oum Kalthoum

    2010-04-01

    The present study focuses on horizontal spatial variability of benthic macrofauna associated with Patella ferruginea. Thirty-six samples collected at 12 transects belonging to 4 midlittoral sites along the rocky Tunisian coastline, were examined. A total of 44 species belonging to 5 taxa were found. Multivariate analysis applied on gathered data did not show a horizontal spatial variability at small scale (between transects), but at large scale, between sites as well as sectors. Thus, three groups of communities were identified (GI: Korbous and El Haouaria; GIIa: Zembra Island and GIIb: Kelibia). The distribution of species abundance within these groups revealed that crustaceans were the most abundant taxon, due to the overwhelming dominance of Chthamalus stellatus. This substratum appeared to create favourable micro-habitats for the installation of molluscs including gastropods. Regarding the low diversity index ( H') and evenness ( J), they seemed to reflect a disturbance and a demographic unbalance within these communities. The heterogeneity of substrate surface, created by C. stellatus specimens appeared to be caused by various complex interactions established between the key components of these communities in particular suspension feeders, predators, herbivorous molluscs and macroalgae. Thus, the dynamic status of each of these communities is the result of these complex interactions.

  7. Novel treatment of a failed quadriceps tendon repair in a diabetic patient using a patella-quadriceps tendon allograft.

    Science.gov (United States)

    Druskin, Sasha C; Rodeo, Scott A

    2013-07-01

    Recurrent quadriceps tendon rupture is a debilitating condition that may be challenging to treat, especially in the presence of systemic disease such as diabetes mellitus (Bedi et al., J Shoulder Elbow Surg 19:978-988, 2010; Chbnou and Frenette, Am J Physiol Regul Integr Comp Physiol 5:R952-R957, 2004; Chen et al., J Shoulder Elbow Surg 5:416-421, 2003). Many surgical treatment protocols have been proposed (Azar, in Canale and Beatty, eds., Campbell's Operative Orthopedics, Mosby/Elsevier, Philadelphia, PA, 2008; Ilan et al., J Am Acad Orthop Surg 3:192-200, 2003; Rodeo and Izawa, in Garrett et al., eds., Principles and Practice of Orthopedic Sports Medicine, Lippincott Williams & Wilkins, Philadelphia, PA, 2000). We report the case of a diabetic male with multiple treatment failures. He ultimately sustained a good outcome following treatment with a novel surgical technique that utilized a patella quadriceps tendon allograft. Tendon allograft-to-native bone healing had previously failed in this patient, so we used a bone-tendon construct allograft to provide an allograft bone-to-native bone healing site. Now, 13 months postoperative, the patient has increased strength, minimal pain, 20 ° of extensor lag and 130 ° of flexion.

  8. Putative midkine family protein up-regulation in Patella caerulea (Mollusca, Gastropoda) exposed to sublethal concentrations of cadmium

    Energy Technology Data Exchange (ETDEWEB)

    Vanucci, Silvana [Department of Animal Biology and Marine Ecology, University of Messina, Salita Sperone 31, 98166 S Agata, Messina (Italy)]. E-mail: silvana.vanucci@unime.it; Minerdi, Daniela [Department of Animal Biology and Genetics, University of Florence, via Romana 19, 50125 Florence (Italy); Kadomatsu, Kenji [Department of Biochemistry, University of Nagoya Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550 (Japan); Mengoni, Alessio [Department of Animal Biology and Genetics, University of Florence, via Romana 19, 50125 Florence (Italy); Bazzicalupo, Marco [Department of Animal Biology and Genetics, University of Florence, via Romana 19, 50125 Florence (Italy)

    2005-11-30

    A cDNA sequence of a putative midkine (MK) family protein was identified and characterised in the mollusc Patella caerulea. The midkine family consists of two members, midkine and pleiotrophin (PTN), and it is one of the recently discovered cytokines. Our results show that this putative midkine protein is up-regulated in specimens of P. caerulea exposed to sublethal cadmium concentrations (i.e. 0.5 and 1 mg l{sup -1} Cd) over a 10-day exposure period. Semiquantitative RT-PCR and quantitative Real time RT-PCR estimations indicate elevated expression of midkine mRNA in exposed specimens compared to controls. Moreover, RT-PCR Real time values were higher in the viscera (here defined as the part of the soft tissue including digestive gland plus gills) than in the foot (i.e. foot plus head plus heart) of the limpets. At present, information on the functional signalling significance of the midkine family proteins suggests that the up-regulation of P. caerulea putative midkine family protein is a distress signal likely with informative value on health status of the organism and with potential prognostic capability.

  9. Radioisotope diagnosis of the insufficient femoropatellar joint

    Energy Technology Data Exchange (ETDEWEB)

    Popko, J.; Mnich, Z.; Wasilewski, A. (Akademia Medyczna, Bialystok (Poland))

    1984-01-01

    In 14 patients suffering from chondromalacia patellae as well as in 6 patients with a femoropatellar arthrosis the perfusion of the kneecap was measured scintigraphically by means of /sup 125/I-iodoantipirin. A retarded elimination of the isotopes could be found both with the chondromalacia and with the arthrosis. The course of the curve of secretion of /sup 125/I-iodoantipirin as well as the calculated half-life-period of the decline of activity give valuable diagnostic and therapeutic hints.

  10. Recessive multiple epiphyseal dysplasia (rMED with homozygosity for C653S mutation in the DTDST gene - Phenotype, molecular diagnosis and surgical treatment of habitual dislocation of multilayered patella: Case report

    Directory of Open Access Journals (Sweden)

    Bonafé Luisa

    2010-06-01

    Full Text Available Abstract Background Multiple epiphyseal dysplasia (MED is one of the more common generalised skeletal dysplasias. Due to its clinical heterogeneity diagnosis may be difficult. Mutations of at least six separate genes can cause MED. Joint deformities, joint pain and gait disorders are common symptoms. Case Presentation We report on a 27-year-old male patient suffering from clinical symptoms of autosomal recessive MED with habitual dislocation of a multilayered patella on both sides, on the surgical treatment and on short-term clinical outcome. Clinical findings were: bilateral hip and knee pain, instability of femorotibial and patellofemoral joints with habitual patella dislocation on both sides, contractures of hip, elbow and second metacarpophalangeal joints. Main radiographic findings were: bilateral dislocated multilayered patella, dysplastic medial tibial plateaus, deformity of both femoral heads and osteoarthritis of the hip joints, and deformity of both radial heads. In the molecular genetic analysis, the DTDST mutation g.1984T > A (p.C653S was found at the homozygote state. Carrier status was confirmed in the DNA of the patient's parents. The mutation could be considered to be the reason for the patient's disease. Surgical treatment of habitual patella dislocation with medialisation of the tibial tuberosity led to an excellent clinical outcome. Conclusions The knowledge of different phenotypes of skeletal dysplasias helps to select genes for genetic analysis. Compared to other DTDST mutations, this is a rather mild phenotype. Molecular diagnosis is important for genetic counselling and for an accurate prognosis. Even in case of a multilayered patella in MED, habitual patella dislocation could be managed successfully by medialisation of the tibial tuberosity.

  11. Knee Injuries and Disability Among Enlisted Males in the U.S. Navy.

    Science.gov (United States)

    1985-05-01

    Loose body in knee 1 0.5 6 729.6 Chondromalacia 96 49.5 1 729.7 Other knee diseases 28 14.4 3 729.9 Fractured patella 5 2.6 5 822.0. 822.1 Dislocated...derangements (30.8%), and Chondromalacia (19.9%) were the most common knee diagnoses among the 1974 cohort. Estimated annual age- (length-of-service- and pay...ICDA-8 Code Description 724.5 Other knee derangement 729.6 Loose body in knee 729.7 Chondromalacia of knee 729.9 other diseases of knee 822.0, 822.1

  12. 粉碎性髌骨骨折术后康复治疗机制探讨%Study on mechanism involved in postoperative rehabilitation of comminuted fracture of patella

    Institute of Scientific and Technical Information of China (English)

    韩裕; 李大志; 何先晓; 张连明; 陈建华; 张玉宏

    2002-01-01

    Objective To investigate mechanism involved in knee joint rehabilition by comprehensive rehabilitation therapy following comminuted fracture of patella surgery.Method 25 patients suffered from comminuted fracture of patella received rehabilitation training,drugs administration and physical therapy.Results Knee joint function was evaluated,excellent 22 cases,good 2 cases,favorable 1 case,good rate was 96% .Conclusion Rehabilitation of knee joint is satisfying in patients underwent comprehensive rehabilitation treatment.So,comprehensive rehabilitation treatment is valuable in clinic.

  13. 记忆合金髌骨爪治疗髌骨骨折的护理%Nursing of memory alloy patelia treatment patella fracture.

    Institute of Scientific and Technical Information of China (English)

    廖红英

    2011-01-01

    Objective:To discuss the effect of memory alloy patella treatment patella fracture and its nursing care. Methods: 53 patellar fractures patients treated by shape memory alloy patella,do well preoperative and postoperative nursing, including psychological nursing,preoperation preparation, and joint functional exercise. Results: All patients healed without bone non - union or delayed union, non - patella extrusion, displacement or the wrong format, no knee joint stiffness. The fractures level: excellent 37 cases, good 13 cases, moderate 3 cases,the good rate was 95. 3%. The knee range: excellent 50 cases, good 3 cases,the good rate was 100.0%. The knee function assessment: excellent 48 cases,the good 5 cases,the good rate was 100.0%. Conclusion: The scientific nursing, comprehensive nursing,effective prevention of complications were the key to ensure successful operation.%目的:探讨应用记忆合金髌骨爪治疗髌骨骨折的疗效与护理.方法:回顾性分析53例髌骨骨折患者采用形状记忆合金髌骨爪治疗的效果.护理要点:做好术前心理护理、术前准备及术后关节功能锻炼等.结果:所有病例均一期愈合,无骨不愈合或延迟愈合,无髌骨爪脱出、移位或髌骨关节面错格现象,无膝关节强直.骨折复位程度:优37例,良13例,中3例,优良率为94.3%;膝关节活动范围:优50例,良3例,优良率为100%;膝关节功能评价:优48例,良5例,优良率为100%.结论:科学的护理方法,全方位的护理措施,有效的预防并发症是确保手术成功的关键.

  14. 镍钛-聚髌器配合功能锻炼促进髌骨骨折功能恢复%Functional recovery of patellar fracture following applying of nickel titanium convergencing patella plus functional training

    Institute of Scientific and Technical Information of China (English)

    徐泽孔; 王树德; 李明

    2002-01-01

    @@ Background: Patellar fracture is a common kind of fracture in clinic.Preservation of patella,early functional exercise, effectively fixation and anatomical reduction were necessary for rehabilitation of knee movement.Nickel titanium patellar convergence (NT PC) make early functional exercise and favorable prognosis become available . Objective:To discuss impact of NT PC on rehabilitation following patellar fracture.

  15. THE ANALYSIS OF PATELLA FEMORAL (Q ANGLE’S CORRELATION BETWEEN LEG STRENGTH AND BALANCE IN ATHLETES

    Directory of Open Access Journals (Sweden)

    Kürşat HAZAR

    2016-08-01

    Full Text Available The aim of this study is the analyze of patella femoral (q angle’s correlation between leg strength and balance in athletes with different genders.50 female and 75 male athletes, average of age 20,120±,961, who are receiving education in departments related to Muğla Sıtkı Koçman University Faculty of Sports Science in total 125 regularly practicing and participating in sports competitions athletes voluntarily took part in. Stature, weight, Q angle, medial condyle and medial malleolus space, dynamic balance, leg strength and flexibility values of the participants in the study research study group have been carried out respectively. Comparison of Q angles, balance, strength and flexibility values according to gender has been conducted with t test in SPSS program, Q angle values of the athletes’ relationship with age, stature, weight and fitness age, with Pearson Correlation Test, it is analyzed that if there’s a relationship between position right-left feet Q angle values in standing& supine position and medial condyle, medial malleolus, balance values, leg strength, flexibility and relative strength values. It is determined that there is a significant difference between left foot Q angles in standing& supine position and right foot Q angles in standing& supine position, and relative strength and medial condyle angles when considered Q angle values of the participants according to gender (p<0,01. It is determined that there is a significant negative correlation between female athletes’ supine position right and left feet Q angle value and fitness age. There is a significant negative correlation between age, medial malleolus, weight and medial condyle, as well (p<0,05. It is determined that while there is a positive correlation between female athletes’ both standing & supine positions and both legs Q angles; there is a negative correlation between balance and relative strength values. It is seen that there is a significant negative

  16. Analysis of the relative factors affecting the functional restoration of knee joint after the fracture of patella%髌骨骨折后影响屈膝功能恢复的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    王国新; 江钟立; 李涛; 陈文红

    2002-01-01

    Objective To explore the relative factors affecting the functional restoration of knee joint after the fracture of patella, and to anticipate the effect of middle term and short time rehabilitation therapy. Method 23 patients with limited flexion function of knee joint after the fracture of patella, accepted the routine rehabilitation treatment in out  patient service, and some of the patients adopted local heat therapy at the same time. The 13 factors have been selected for regression analysis step by step under the help of SPSS statistical software. Result The flexible degree of the knee joint before rehabilitation (X1), the non smooth posterior edge of patella (X2), and the immobilization time of the joint (X3) are relative factors for the flexible degree of knee joint 1 month after ehabilitation (Y1) and the flexible degree of knee joint 3 onths after rehabilitation (Y2), and Y1 can also be affected by whether surgery therapy or not (X4), (partial regression coefficient P< 0.05). The differences between theoretical mean and practical mean of Y1 and Y2 are 5.6% and 4.2% respectively in the 23 cases. Conclusion The flexible degree of the knee joint before rehabilitation, whether the posterior edge of patella is smooth or not, and the immobilization time of the joint are relative factors affecting the middle term and short term flexible function of knee joint after the fracture of patella, and short term restoration can also be affected by whether surgery therapy or not. The effects of middle term and short term rehabilitation can be predicted by regression equation primarily.

  17. 髌骨软骨母细胞瘤临床病理观察%Clinicopathologic features of chondroblastoma in patella

    Institute of Scientific and Technical Information of China (English)

    杨艳丽; 刘斌; 邢传平; 哈英娣; 苏勤军; 高自芳

    2009-01-01

    Objective To investigate the clinicopathological and immunohistochemical features and imaging changes as well as its prognosis of chondroblastoma in the patella. Methods The literatures related to chondroblastoma in patella during recent three decades were reviewed and a case was reported. Meanwhile, the diagnosis and differential diagnosis, clinicopathological and immunohistochemical features as well as image changes were analyzed. Results This case is a 21-year-old man with left knee pain associated with acratia of left lower extremity in half a year. Radiologic features showed the lesion was lytic in the inner of the patella. Histologic feature of chondroblastoma included sheets of closely packed roundish or polygonal chondroblastic cells with interspersed multinucleated giant cells and islands of hypocellular eosinophilic cartilage matrix, focal areas of dystrophic calcification, S-100 ( + ). Conclusion The chondroblastoma occurred in the ptella is rare and its estimated incidence is about 2% in chondroblastoma. The tumor shows pleomorphic and its diagnosis must incorporate the clinical, pathologic features as well as its image changes.%目的 探讨髌骨软骨母细胞瘤(CB)的临床特点、病理形态、免疫表型、影像学及预后.方法 报告1例髌骨软骨母细胞瘤,复习近38年国内外有关文献报道,分析髌CB瘤的临床、病理和影像的诊断与鉴别诊断及预后资料.结果 患者男性,21岁.左膝部疼痛伴左下肢无力半年.X线片可见髌骨内溶骨性破坏.镜下肿瘤由圆形或多角形软骨母细胞、多核巨细胞、局灶样类软骨组织及小的钙化灶等成分组成,瘤组织S-100(+).结论 软骨母细胞瘤发生在髌骨甚为罕见,其发生率约占软骨母细胞瘤的2%,因其在组织学上表现的多样性应临床、病理学、影像学检查三结合进行诊断.

  18. A Microdeletion of Chromosome 9q33.3 Encompasses the Entire LMX1B Gene in a Chinese Family with Nail Patella Syndrome

    Directory of Open Access Journals (Sweden)

    Shujuan Jiang

    2014-11-01

    Full Text Available Nail patella syndrome (NPS is an autosomal dominant disorder characterized by nail malformations, patellar apoplasia, or patellar hypoplasia. Mutations within the LMX1B gene are found in 85% of families with NPS; thus, this gene has been characterized as the causative gene of NPS. In this study, we identified a heterozygous microdeletion of the entire LMX1B gene using multiplex ligation-dependent probe amplification (MLPA in a Chinese family with NPS. The determination of the deletion breakpoints by Illumina genome-wide DNA analysis beadchip showed that the deletion was located in chromosome 9q33.3 and spanned about 0.66 Mb in size. This heterozygous deletion provides strong evidence for haploinsufficiency as the pathogenic mechanism of NPS.

  19. Robust patella motion tracking using intensity-based 2D-3D registration on dynamic bi-plane fluoroscopy: towards quantitative assessment in MPFL reconstruction surgery

    Science.gov (United States)

    Otake, Yoshito; Esnault, Matthieu; Grupp, Robert; Kosugi, Shinichi; Sato, Yoshinobu

    2016-03-01

    The determination of in vivo motion of multiple-bones using dynamic fluoroscopic images and computed tomography (CT) is useful for post-operative assessment of orthopaedic surgeries such as medial patellofemoral ligament reconstruction. We propose a robust method to measure the 3D motion of multiple rigid objects with high accuracy using a series of bi-plane fluoroscopic images and a multi-resolution, intensity-based, 2D-3D registration. A Covariance Matrix Adaptation Evolution Strategy (CMA-ES) optimizer was used with a gradient correlation similarity metric. Four approaches to register three rigid objects (femur, tibia-fibula and patella) were implemented: 1) an individual bone approach registering one bone at a time, each with optimization of a six degrees of freedom (6DOF) parameter, 2) a sequential approach registering one bone at a time but using the previous bone results as the background in DRR generation, 3) a simultaneous approach registering all the bones together (18DOF) and 4) a combination of the sequential and the simultaneous approaches. These approaches were compared in experiments using simulated images generated from the CT of a healthy volunteer and measured fluoroscopic images. Over the 120 simulated frames of motion, the simultaneous approach showed improved registration accuracy compared to the individual approach: with less than 0.68mm root-mean-square error (RMSE) for translation and less than 1.12° RMSE for rotation. A robustness evaluation was conducted with 45 trials of a randomly perturbed initialization showed that the sequential approach improved robustness significantly (74% success rate) compared to the individual bone approach (34% success) for patella registration (femur and tibia-fibula registration had a 100% success rate with each approach).

  20. 全膝关节置换术中髌骨处理方法的研究%Management methods of patella in total knee arthroplasty

    Institute of Scientific and Technical Information of China (English)

    孙业青; 朱裕昌; 蔡新宇; 蔡郑东

    2012-01-01

    Objective To compare the clinical effects of patellar resurfacing with patella reservation and patellaplasty in the total knee arthroplasty(TKA)for osteoarthritis so as to discuss appropriate management of patellas in TKA.Methods A retrospective study was conducted on 198 patients with osteoarthritis treated by TKA from January 2002 to December 2008.There were 62 patients managed by patellaplasty(patellaplasty group)and 136 patients by patellar resurfacing with patella reservation(patellar resurfacing group).The osteophytes of the patella were removed to make the articular surface of patellas similar to the primary one.Knee Society Score(KSS),Bristol patellar score,satisfaction survey and evaluation of joint range of motion(ROM)were performed during the regular follow-up.Incidence of postoperative anterior knee pain were analyzed and X-ray films were reviewed to understand the condition of the implants.Results A total of 125 patients were followed up,including 43 patients from the patellaplasty group and 82 from the patellar resurfacing group.The mean follow-up period was 51 months(range,36-80 months).Both groups showed significant improvement of each score postoperatively.No significant differences were found between the two groups regarding KSS score,patellar score and patient satisfaction in the follow-up one year later;but KSS function score in the patellar resurfacing group was superior to that in the patellaplasty group,with statistical difference.The incidence of anterior knee pain of the two groups had no statistical significance.Postoperative radiographs revealed no significant differences between the two groups concerning patellofemoral congruence,incidence of postoperative anterior knee pain or incidence of patellar related complications.Conclusion Patellar resurfacing with patella reservation for osteoarthritis in TKA can achieve satisfactory patellofemoral congruence and low incidence of intraoperative anterior knee pain,with comparable mid

  1. Histological and morphological observations on the distribution of circum-patella nerve fibers%人髌周组织神经末梢分布的组织形态学观察

    Institute of Scientific and Technical Information of China (English)

    程锐; 高兴华; 侯之启

    2013-01-01

    目的 对髌骨周围软组织的神经末梢分布情况进行组织形态学观察,为人工全膝关节置换手术中行髌骨周围烧灼提供理论依据.方法 取自4具新鲜截肢的髌骨标本(2例糖尿病足截肢、1例下肢动脉闭塞截肢和1例车祸伤截肢),采集髌骨周围0.5 cm以内软组织,长0.5 cm×宽0.5 cm×纵向全层的三维立体标本,通过HE染色、甘氨酸银染色,在同一视野下对髌周软组织标本紧贴髌骨内侧截面的神经末梢分布进行组织形态学观察.结果 大体解剖发现来源于皮肤的血管网直接进入髌骨滋养孔区域参与构成髌骨滋养孔区域的血管网络并在2、4、7和10点位发现有血管进入髌骨;组织学观察发现髌骨周围软组织内存在大量的神经纤维,但4个髌骨标本周围软组织内神经纤维的区域分布没有明显区别.髌骨周围软组织内侧滑膜层有神经入髌的通道,主要存在于7、11和13点位,髌骨外侧没有发现神经进入髌骨的通道.神经纤维呈“区域性集中分布”现象,以5、6、7点位及10、11、12、1、2点位分布数目最多,其中又以股四头肌肌腱和髌腱两极居多,在髌骨滋养孔区域的筋膜及骨膜中也发现了大量的神经纤维.神经纤维分层分布,主要集中在滑膜层、脂肪垫、肌腱结缔组织间层的近髌骨端.结论 髌骨周围软组织内神经纤维分布多,神经进入髌骨的通道主要存在于髌骨内侧和滋养孔区域,神经纤维分布呈分层且区域性集中现象,“中央较多,下多于上,内多于外,两极多于其他”.髌周烧灼去神经化操作,通过减少外周伤害感受器的数目实现“减敏”在临床上具有可行性.%Objective To observe the distribution of circum-patella nerve fibers in the soft tissue to provide experimental evidence,which is significant in denervation for Total Knee Arthroplasty (TKA).Methods Patella specimens were collected from 4 cadavers (2 cases of

  2. Can Unshod Running Reduce Running Injuries?

    Science.gov (United States)

    2012-06-08

    caused by high impact forces include stress fractures, shin splints, chondromalacia patellae, plantar fasciitis, and Achilles tendinitis . Is running......strike that utilizes the mid 33 percent of the foot between the ball of the foot and the heel. Patellar tendinitis - Also known as jumper’s knee, is a

  3. Draft genome assemblies and predicted microRNA complements of the intertidal lophotrochozoans Patella vulgata (Mollusca, Patellogastropoda) and Spirobranchus (Pomatoceros) lamarcki (Annelida, Serpulida).

    Science.gov (United States)

    Kenny, Nathan J; Namigai, Erica K O; Marlétaz, Ferdinand; Hui, Jerome H L; Shimeld, Sebastian M

    2015-12-01

    MicroRNAs (miRNA) are small non-coding RNAs that act post-transcriptionally to regulate gene expression levels. Some studies have indicated that microRNAs may have low homoplasy, and as a consequence the phylogenetic distribution of microRNA families has been used to study animal evolutionary relationships. Limited levels of lineage sampling, however, may distort such analyses. Lophotrochozoa is an under-sampled taxon that includes molluscs, annelids and nemerteans, among other phyla. Here, we present two novel draft genomes, those of the limpet Patella vulgata and polychaete Spirobranchus (Pomatoceros) lamarcki. Surveying these genomes for known microRNAs identifies numerous potential orthologues, including a number that have been considered to be confined to other lineages. RT-PCR demonstrates that some of these (miR-1285, miR-1287, miR-1957, miR-1983 and miR-3533), previously thought to be found only in vertebrates, are expressed. This study provides genomic resources for two lophotrochozoans and reveals patterns of microRNA evolution that could be hidden by more restricted sampling.

  4. Conservation status and updated census of Patella ferruginea (Gastropoda, Patellidae in Ceuta: distribution patterns and new evidence of the effects of environmental parameters on population structure

    Directory of Open Access Journals (Sweden)

    Rivera–Ingraham, G. A.

    2011-06-01

    Full Text Available The Strait of Gibraltar has important populations of the highly endangered patellid limpet Patella ferruginea. Between 2006 and 2010, an exhaustive census was carried out in Ceuta. The total coastline was divided into 17 sectors. The coast of each sector was examined by using 10 m transects. For the case of those sectors composed of breakwaters, jetties or islets, no transects were used, and instead, the total number of individuals was recorded. Each individual was measured to the nearest millimetre using a calliper. Moreover, the complete rocky shore length where the species could potentially be present was calculated, and an estimation of the total number of individuals that each sector could host was made. Results indicate that Ceuta could be home to around 44,000 individuals. The species found in Point Benzú, its westernmost limit of distribution on the North African coasts. The largest populations were recorded on the South Bay, with higher Mediterranean influence. Our results indicate that substrate roughness (topographic heterogeneity and the area’s accessibility highly influence the abundance and population structure. Those populations located on high topographic heterogeneity substrates show higher recruitment rates and lower percentages of larger individuals, while medium to low rugosity surfaces presented the opposite pattern. Additionally, easily accessible areas (and frequented by humans presented smaller average shell sizes. Implications of the results for conservation purposes are discussed.

  5. 髌骨骨折AO张力带内固定有限元模型的建立和分析%Construction and analysis of a finite-element model of patella fracture fixed with AO tensile force girdle

    Institute of Scientific and Technical Information of China (English)

    徐洪璋; 余斌

    2011-01-01

    BACKGROUND: Currently, most of biomechanical research about internal fixation of patellar fracture has been carried out by corpse. Few researchers carried out it using modern finite element method.OBJECTIVE: To establish the finite element model of patella fracture fixed with AO tensile force girdle and to perfore finite element mechano-analysis.METHODS: An adult female volunteer was selected, underwent a lamellar computed tomography (CT) scan on the lower extremity, extract right patella's polylines by Mimics10.01 software and construct geometrical models. Then the geometrical model was imported into PRO/E 2.0 software, to simulate bone fractu re by intersected function of PRO/E 2.0 software and generate two bent Kirschner wires and annular steel-wire, rebuild 3D model of patella fracture fixed with AO tensile force girdle.After that, the model was imported into the ANSYS software to constructe 3D finite-element models that analyzing displacement and deformation features simulating patellofemoral joint under 600 N loading at 90° knee bending.RESULTS AND CONCLUSION: The AO tensile force girdle could force patella fracture in many ways, and opposed to tensile force of musculus quadriceps fexoris. The finite element analytic result coincides with biomechanical result. The 3D finite-element model of patella fracture fixed with AO tensile force girdle was scientific, which is beneficial to better understanding of the biomechanical principle about patella f racture fixed with AO tensile force girdle and provides clinical instruction.%背景:目前有关髌骨骨折内固定的生物力学研究大多集中在尸体标本上,应用现代有限元法进行分析的报道较少.目的:建立髌骨骨折AO张力带内固定的三维有限元模型,并对所建模型进行有限元力学分析.方法:选择1名成年女性志愿者,行下肢薄层CT扫描,将图像数据导入Mimics 10.01 软件通过Region growing提取右侧髌骨polylines,导入Geomagic studio 10.0建

  6. Chondromalacia of sesamoids in first metatarsophalangeal joint

    Institute of Scientific and Technical Information of China (English)

    杜宏; 聂林; 王洪申; 张传军

    2004-01-01

    @@ The incidence of sesamoids in the firstmetatarsophalangeal joint is 100% and they areattached on the flexor hallucis brevis in thearticular capsule. 1 On the compulsory effect of externalfactors, the feet receive unusual long-term loads andthe sesamoids will exhibit the clinical symptoms suchas injury, denaturalization and pain. We have treated4 patients, who are verified to suffer fromchondromalacia of sesamoids by pathologicalexamination, in our hospital.

  7. 锚钉结合张力带钢丝治疗髌骨下极骨折%Suture anchors combined with tension band wiring for inferior polar fracture of the patella

    Institute of Scientific and Technical Information of China (English)

    江潮胤; 徐铮宇; 王韬

    2012-01-01

    Objective To observe the result of treatment of inferior polar fracture of the patella with suture anchors and tension band wiring. Methods Thirty-four patients with inferior polar fracture of the patella were treated with suture anchors and tension band wiring in our hospital between March 2008 and September 2009, The fracture and patellar tendon were fixed and repaired with suture anchors. A stainless steel wire was passed through a transverse hole drilled in the proximal part of the patella and tibial tubercle and tightened as a tension band wiring. Results All the patients were followed up for 12-25 months (average, 17 months) and all the fractures were healed Two patients had shown superficial incisional infection and healed through intravenous antibiotic therapy and dressing change. According to the LU Yu-pu's score of knee function, 27 patients were excellent, 6 patients-were good, 1 patient was fair. The excellent and good rate was 97. 1%. Conclusion Suture anchors combined with tension band wiring for inferior polar fracture of the patella can obtain excellent clinical result with few complications.%目的 研究锚钉结合张力带钢丝治疗髌骨下极骨折的疗效.方法 我院于2008年3月至2009年9月采用锚钉结合张力带钢丝方法治疗髌骨下极骨折34例.术中以锚钉固定修补髌骨下极骨折块及髌韧带,并辅以胫骨结节至髌骨中上部的张力带钢丝.结果 34例患者均获12~25个月,平均17个月随访,所有骨折均愈合,2例术后出现局部浅表感染,经换药及相应抗炎治疗后愈合.陆裕朴膝关节功能评定标准评价显示,优27例,良6例,可1例,优良率为97.1%.结论 锚钉结合张力带钢丝治疗髌骨下极骨折固定牢靠,并发症少,效果确切.

  8. Investigation of heavy metal pollution in eastern Aegean Sea coastal waters by using Cystoseira barbata, Patella caerulea, and Liza aurata as biological indicators.

    Science.gov (United States)

    Aydın-Önen, S; Öztürk, M

    2017-01-19

    In order to have an extensive contamination profile of heavy metal levels (Cd, Cu, Fe, Mn, Ni, Pb, and Zn), seawater, sediment, Patella caerulea, Cystoseira barbata, and Liza aurata were investigated by using inductively coupled plasma-atomic emission spectrometry (ICP-AES). Samples were collected from five coastal stations along the eastern Aegean Sea coast (Turkey) on a monthly basis from July 2002 through May 2003. According to the results of this study, heavy metal levels were arranged in the following sequence: Fe > Pb > Zn > Mn > Ni > Cu > Cd for water, Fe > Cu > Mn > Ni > Zn > Pb > Cd for sediment, Fe > Zn > Mn > Pb > Ni > Cd > Cu for C. barbata, Fe > Zn > Mn > Ni > Pb > Cu > Cd for P. caerulea, and Fe > Zn > Mn > Cu > Ni > Pb > Cd for L. aurata. Moreover, positive relationships between Fe in water and Mn in water, Fe in sediment and Mn in sediment, Fe in C. barbata and Mn in C. barbata, Fe in P. caerulea and Mn in P. caerulea, and Fe in L. aurata and Mn in L. aurata may suggest that these metals could be originated from the same anthropogenic source. C. barbata represented with higher bioconcentration factor (BCF) values, especially for Fe, Mn, and Zn values. This observation may support that C. barbata can be used as an indicator species for the determinations of Fe, Mn, and Zn levels. Regarding Turkish Food Codex Regulation's residue limits, metal values in L. aurata were found to be lower than the maximum permissible levels issued by Turkish legislation and also the recommended limits set by FAO/WHO guidelines. The results of the investigation indicated that P. caerulea, L. aurata, and especially C. barbata are quantitative water-quality bioindicators and biomonitoring subjects for biologically available metal accumulation for Aegean Sea coastal waters.

  9. Moisture permeability of the total surface bearing prosthetic socket with a silicone liner: is it superior to the patella-tendon bearing prosthetic socket?

    Science.gov (United States)

    Hachisuka, K; Matsushima, Y; Ohmine, S; Shitama, H; Shinkoda, K

    2001-09-01

    The purpose of this study was to examine the moisture permeability properties of materials used for total surface bearing (TSB) socket with a silicone liner, a combination of Silicone Suction Socket or Icelandic Roll-On Silicone Socket (ICEROSS) and an acrylic plastic sheet (Degaplast), patella-tendon bearing (PTB) socket, a combination of Pe-Lite and Degaplast, and wooden socket made of poplar. Moisture permeability of the socket materials was measured as the diminution of water in a container after 12 hours in a climatic chamber. Eight containers with their open, top side were uncovered (no material) or sealed with one of the socket materials; the experiment was repeated four times. One-way analysis of variance followed by Bonferroni's test was applied to examine the differences in moisture permeability. Moisture permeability levels were as follows: no material, 85.9 +/- 1.3 g; poplar, 4.3 +/- 0.4 g; Silicone Suction Socket, 1.1 +/- 0.2 g; ICEROSS, 1.0 +/- 0.2 g; Pe-Lite, 0.8 +/- 0.1 g; 3S + Degaplast, 0.8 +/- 0.1 g; ICEROSS + Degaplast, 0.8 +/- 0.2 g; and Pe-Lite + Degaplast, 0.8 +/- 0.1 g. There were significant differences between the uncovered container and the others, and between poplar and the others (P socket with a silicone liner is not superior to the PTB socket with regard to moisture permeability, and that it is necessary to develop a new prosthetic socket that allows heat release and drainage of sweat.

  10. Field testing the Unified Classification System for periprosthetic fractures of the femur, tibia and patella in association with knee replacement: an international collaboration.

    Science.gov (United States)

    Van der Merwe, J M; Haddad, F S; Duncan, C P

    2014-12-01

    The Unified Classification System (UCS) was introduced because of a growing need to have a standardised universal classification system of periprosthetic fractures. It combines and simplifies many existing classification systems, and can be applied to any fracture around any partial or total joint replacement occurring during or after operation. Our goal was to assess the inter- and intra-observer reliability of the UCS in association with knee replacement when classifying fractures affecting one or more of the femur, tibia or patella. We used an international panel of ten orthopaedic surgeons with subspecialty fellowship training and expertise in adult hip and knee reconstruction ('experts') and ten residents of orthopaedic surgery in the last two years of training ('pre-experts'). They each received 15 radiographs for evaluation. After six weeks they evaluated the same radiographs again but in a different order. The reliability was assessed using the Kappa and weighted Kappa values. The Kappa values for inter-observer reliability for the experts and the pre-experts were 0.741 (95% confidence interval (CI) 0.707 to 0.774) and 0.765 (95% CI 0.733 to 0.797), respectively. The weighted Kappa values for intra-observer reliability for the experts and pre-experts were 0.898 (95% CI 0.846 to 0.950) and 0.878 (95% CI 0.815 to 0.942) respectively. The UCS has substantial inter-observer reliability and 'near perfect' intra-observer reliability when used for periprosthetic fractures in association with knee replacement in the hands of experienced and inexperienced users.

  11. 人工全膝关节表面置换中髌骨的处理%Patella treatment in total knee arthroplasty

    Institute of Scientific and Technical Information of China (English)

    张欣; 王志伟

    2011-01-01

    背景:随着临床工作与实验研究的深入开展,膝关节置换的技术与假体设计均得到了不断地改进,然而髌骨的处理方法一直是争论的焦点.目的:分析髌骨常规置换、髌骨常规保留、髌骨选择性置换3种方法的各自特点及优缺点,寻求膝关节置换过程中髌骨处理的最佳方案.方法:由第一作者于2010-01应用计算机检索PubMed数据库、万方数据库和维普数据库相关文献.英文资料的检索时间为1990/2010;中文资料的检索时间为1990/2010.英文检索词为"total knee arthroplasty;patellar;replacement";中文检索词为"人工全膝关节表面置换;髌骨;处理;常规置换;常规保留;选择性置换".纳入标准:①人工全膝关节表面置换假体设计相关研究.②人工膝关节假体的生物相容性.③人工全膝关节表面置换时髌骨的处理方法.阅读标题和摘要进行筛选,共纳入32篇用于综述.结果及结论:长期以来,国内外学者围绕是否应进行髌骨置换在随访研究中各持己见,观点不一,逐渐演化为髌骨常规置换、髌骨常规保留、髌骨选择性置换3种观点.目前人工全膝关节表面置换关于髌骨处理的问题仍需进一步长期的随访和随机对照研究,在对文献进行回顾分析、随机化对照研究时,应慎重把握文献的可信度、时间范围、评价标准,以更准确、合理地指导医生们的临床工作.%BACKGROUND: Total knee arthroplasty technique and prosthetic design have been improved with the development of clinical practice and experimental research, however, the treatment of patella is a bone of contention in total knee arthroplasty.OBJECTIVE: To analyze the features of routine patellar resurfacing, routine patellar reservation and selective patellar resurfacing in order to provide preferred plan for patellar treatment in total knee arthroplasty.METHODS: PubMed, Wanfang and VIP databases were searched by the first author with key

  12. c.194 A>C (Q65P) mutation in the LMX1B gene in patients with nail-patella syndrome associated with glaucoma

    Science.gov (United States)

    Romero, Pablo; Sanhueza, Felipe; Lopez, Pamela; Reyes, Loreto

    2011-01-01

    Purpose To report the clinical, ophthalmic, extraophthalmic, and genetic characteristics of nail-patella syndrome (NPS) in a Chilean family and to investigate the expressivity of open angle glaucoma (OAG) and ocular hypertension (OHT) in the family members. Methods Five family members affected with NPS and two unaffected members underwent a complete ophthalmologic examination, including computerized visual field, optical coherence tomography (OCT) of the optic disc and ultrasound pachymetry. Renal function was assessed by urinalysis and blood tests. Orthopedic evaluations were also performed, including radiological studies of the wrist, elbow and hip joints. Genomic DNA was extracted from peripheral leukocytes of the five affected and two unaffected family members. Exons 2–6 of the LIM homeobox transcription factor 1-beta (LMX1B) gene were screened for mutations by DNA sequencing of the proband. We also screened for mutations in exon 2 by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) of the other participants and 91 blood donors. Results Five living family members from three generations were positively diagnosed with NPS, three of them with varying degrees of OAG and one with OHT. Retinal nerve fiber layer (RNFL) thickness measured by spectral domain OCT was below normal values in three individuals. All subjects evaluated had normal nephrologic function. Orthopedic, clinical, and radiological alterations were compatible with NPS. Screening for mutations in exons 2- 6 of LMX1B showed a heterozygous missense mutation c.194 A>C changing glutamine to proline within exon 2 in codon 65 (Q65P) of the coding sequence. This mutation was present in all NPS subjects and absent in the unaffected family members and in 91 Chilean blood donors. Conclusions This is the first report of c.194 A>C mutation in LMX1B in a Chilean family with NPS and the second worldwide. The phenotype associated with this mutation is variable within the family

  13. Transplante osteocondral autólogo no tratamento de lesões condrais na patela Osteochondral autologous transplantation for treating chondral lesions in the patella

    Directory of Open Access Journals (Sweden)

    Moises Cohen

    2012-01-01

    autologous osteochondral transplantation is a good treatment method for total-thickness symptomatic chondral lesions of the joint surface of the patella.

  14. Síndrome unha-patela: Evolução da instabilidade da patela Nail-patella syndrome: evolution of pattelar instability

    Directory of Open Access Journals (Sweden)

    Lucas Busnardo Ramadan

    2007-01-01

    Full Text Available A síndrome da unha-patela é uma doença de caráter autossômico dominante, com algumas características clássicas dermatológicas, músculoesqueléticas e, eventualmente, renais, oculares e gastrointestinais. Tem como principal sintoma ortopédico dor patelofemoral associada com instabilidade da patela desde a primeira infância. A melhor maneira de obter bons resultados nestes casos é um tratamento precoce da instabilidade do joelho. Tratada tardiamente, pode levar a uma artrose precoce, com limitação funcional da articulação do joelho. O presente caso mostra uma paciente que, tem se apresentado com essa síndrome, foi submetida a tratamento cirúrgico tardio e evoluiu com degeneração articular e limitação funcional do joelho. O objetivo deste trabalho é atentar para as características fenotípicas sindrômicas da doença e relacioná-las com as queixas ortopédicas comuns no consultório (tais como dor e instabilidade do joelho e, possivelmente, do cotovelo e, finalmente, poder tratar esses sintomas precocemente, garantindo uma evolução favorável para a paciente.The nail-patella syndrome is an autosomal dominant disease with some dermatological, musculoskeletal and, occasionally, renal, ocular and gastrointestinal classical characteristics. Its main clinical orthopaedic symptom is patellofemoral pain associated with patellar instability since early childhood. The best way to achieve good results in such cases is to establish an early treatment for knee instability, otherwise it may lead to early arthrosis and functional limitation of the knee joint. The present case describes a patient with such syndrome who underwent late surgical treatment and evolved with joint degeneration and functional limitation of the knee. The objective of this study is to consider the syndromic phenotypic features of the disease, correlate them with orthopaedic complaints commonly reported to the physician, such as pain and instability of the knee

  15. Prevalence and influence of tibial tunnel widening after isolated anterior cruciate ligament reconstruction using patella-bone-tendon-bone-graft: long-term follow-up

    Directory of Open Access Journals (Sweden)

    Johannes Struewer

    2012-06-01

    Full Text Available The aim of the present study was to evaluate incidence, degree and impact of tibial tunnel widening (TW on patient-reported long-term clinical outcome, knee joint stability and prevalence of osteoarthritis (OA after isolated anterior cruciate ligament (ACL reconstruction. On average, 13.5 years after ACL reconstruction via patella-bone-tendon-bone autograft, 73 patients have been re-evaluated. Inclusion criteria consisted of an isolated anterior cruciate ligament rupture and reconstruction, a minimum of 10-year follow-up and no previous anterior cruciate ligament repair or associated intra-articular lesions. Clinical evaluation was performed via the International Knee Documentation Committee (IKDC score and the Tegner and Lysholm scores. Instrumental anterior laxity testing was carried out with the KT-1000™ arthrometer. The degree of degenerative changes and the prevalence of osteoarthritis were assessed with the Kellgren-Lawrence score. Tibial tunnel enlargement was radiographically evaluated on both antero-posterior and lateral views under establishment of 4 degrees of tibial tunnel widening by measuring the actual tunnel diameters in mm on the sclerotic margins of the inserted tunnels on 3 different points (T1-T3. Afterwards, a conversion of the absolute values in mm into a 4 staged ratio, based on the comparison to the results of the initial drill-width, should provide a better quantification and statistical analysis. Evaluation was performed postoperatively as well as on 2 year follow-up and 13 years after ACL reconstruction. Minimum follow-up was 10 years. 75% of patients were graded A or B according to IKDC score. The mean Lysholm score was 90.2 ± 4.8 (25-100. Radiological assessment on long-term follow-up showed in 45% a grade I, in 24% a grade II, in 17% a grade III and in additional 12% a grade IV enlargement of the tibial tunnel. No evident progression of TW was found in comparison to the 2 year results. Radiological evaluation

  16. [Nail-patella-elbow syndrome].

    Science.gov (United States)

    Uruñuela, J; Ybarra, J; Escudero, R

    1976-01-01

    The authors describe a typical, non familiar case of nail-patela-elbow syndrome, in which was found malformation of the nails and bones involving mainly the Knees and elbows, together with spondylolisthesis of the spine at the level L5-S1. There were no renal, ocular or psychic alterations.

  17. Imaging of patellofemoral disorders

    Energy Technology Data Exchange (ETDEWEB)

    Elias, D.A. E-mail: david.elias@kingsch.nhs.uk; White, L.M

    2004-07-01

    Anterior knee pain is a common symptom, which may have a large variety of causes including patellofemoral pathologies. Patellofemoral maltracking refers to dynamic abnormality of patellofemoral alignment and has been measured using plain film, computed tomography (CT) and magnetic resonance imaging (MRI) using static and kinematic techniques. Patellar dislocation is usually transient, but specific conventional radiographic and MRI features may provide evidence of prior acute or chronic dislocation. In addition, chondromalacia patellae, osteochondritis dissecans, patellofemoral osteoarthritis, excessive lateral pressure syndrome, and bipartite patella have all been implicated in causing patellofemoral pain. The imaging and clinical features of these processes are reviewed, highlighting the specific diagnostic features of each condition.

  18. Lesions of cartilage in the femoropateliar joint, diagnosis by computerized tomography

    Energy Technology Data Exchange (ETDEWEB)

    Reiser, M.; Anacker, H.; Karpf, P.M.; Hoerterer, H.; Paar, O.; Riel, K.A.

    1982-01-21

    The conventional arthrographic methods for demonstration of the femoro-patellar joint are not sufficiently reliable. Through the use of CT-arthrography a cross-sectional image free of superimposition and possessing a high density resolution is available thus facilitating a direct demonstration of the joint cartilage. Traumatic and degenerative lesions of the cartilage can be clearly shown by CT-arthrography. Damage of cartilage in patients with chondromalacia patellae can be differentiated in its different stages. The shape of the patella and its relation to femoral condyles can be evaluated more accurate than by conventional axial X-rays.

  19. Pathology of the region of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Aufdermaur, M.

    1981-09-01

    Radiological, clinical and pathologic-anatomical findings seen in four types of disorders of the region of the knee jointare described. An attempt is made to explain the clinical symptomatology on the basis of pathologic-anatomical findings. It is demonstrated that the histology of a giant cell neoplasm does not permit conclusions as to prognosis. Etiology and pathogenesis of villonodular synovitis and of chondrocalcinosis are unexplained. Pathologic-anatomical findings of chondromalacia patellae are those of early osteoarthrosis.

  20. Arthralgia in Children

    OpenAIRE

    1983-01-01

    Arthralgia is joint pain unaccompanied by obvious clinical signs of arthritis or trauma. In most children and adolescents, the affected joint is the knee, hip, ankle, or less commonly an arm joint. Causes of arthralgia include arthritis; systemic disease; tumor; infection; growing pains; transient synovitis of the hip; osteochondroses; ostochondritis dissecans; traction syndrome; chondromalacia of the patella and post-traumatic synovitis. Some pains can be diagnosed with confidence with histo...

  1. Anatomic Perspective of the Female Athlete: An Approach to Musculoskeletal Profiling of Women in Sports,

    Science.gov (United States)

    1982-01-11

    which involved time loss from training were chondromalacia of the patella, achilles tendinitis , and sprains. In an attempt to decrease the incidence of...frequent disorder, accounting for 26 percent of all injuries. This study found that men sustained more achilles tendinitis and patellar tendinitis ...height and weight are recorded. Skinfold measurements are taken from the subscapular, tricep, bicep , and suprailiac areas. Percent body fat is estimated

  2. Causation,Treatment and Precaution on the Speed Skaters' Patella Strain%速滑运动员髌骨劳损的原因和防治措施

    Institute of Scientific and Technical Information of China (English)

    高文岳; 臧克成; 尹炳南; 宋克宁

    2011-01-01

    The speed skaters' patella strain is one of the most common athletic injuries,which is related with the knee joint's adductive or abductive exerting force with half squat in skating.Wrong or delayed treatment and precaution will badly influence their athletic life and even their future daily living.After discussing the causation of speed skaters' patella strain,the paper elaborates the means of treating the knee joint's acute injury.In order to help them have more scientific training and actively cooperate with the medical workers,effectively avoid and reduce the injury and its adverse effects,it indicates how to prevent the injury from following aspects: improve the athletic talents' identification;pay attention to the strength training of quadriceps femoris;enhance the training of flexibility,coordination and proprioceptive sensibility;reinforce the stability and balance force of knee joint muscles.%膝关节髌骨劳损在速滑专业运动员群体中是最常见的运动损伤之一,这与该项目在运动过程中,膝关节多在半蹲位内收或外展发力有关,如预防和治疗不正确、不及时,不仅会严重速滑影响运动员的运动寿命,甚至还会影响今后的日常生活。从多方面分析和总结了速滑运动员髌骨劳损的原因,阐述了膝关节急性损伤的处理等治疗措施,指出从运动员选材,注重股四头肌肌肉力量的训练,加强柔韧性、协调性和本体感受性的训练,保持肌肉平衡及关节稳定性等方面对速滑运动员的髌骨劳损进行预防,以期帮助运动员科学训练并积极配合医务人员,有效地避免和减少髌骨劳损的发生及其带来的不良影响。

  3. X线及MRI诊断早期髌骨软化症的对比研究

    Institute of Scientific and Technical Information of China (English)

    张太娟; 张丽

    2014-01-01

    Objective To compare the value of X-ray and MRI for the early diagnosis of chondromalacia patellae.Methods In 35 patients with clinical conifrmed early patella softening,analysis of the X-ray and MRI findings to look for evidence of chondromalacia patella.ResultsMRI had no positive findings in 4 cases,31 cases of cartilage and subchondral bone changes change slightly, the accuracy rate of diagnosis in 88.57%;X-ray manifestations of 12 cases of normal,23 cases of patella bone trailing edge change slightly,the accuracy rate of diagnosis in 65.71%;The comparison between the two had statistical signiifcance.ConclusionMRI is superior to X-ray in diagnosis of early chondromalacia patella.%目的:比较X线及MRI对诊断早期髌骨软化症的价值。方法对35例经临床证实的早期髌骨软化症患者回顾分析其X线和MRI表现,寻找早期髌骨软化症的证据。结果 MRI无阳性表现4例,有软骨改变及轻微软骨下骨质改变的31例,诊断准确率88.57%; X线表现正常的12例,髌骨后缘轻微骨质改变的23例,诊断准确率65.71%;两者比较有统计学意义。结论 MRI对于早期髌骨软化症的诊断价值优于X线。

  4. Subluxación primaria recidivante medial de rótulas: Revisión a largo plazo de un caso asociado a síndrome de desalineación torsional severa Primary recurrent medial subdislocation of both patellae: Long-term review of an exceptional case of miserably malalignment syndrome

    Directory of Open Access Journals (Sweden)

    S. García-Mata

    2007-12-01

    Full Text Available Presentamos una revisión a largo plazo de una chica de 11 años de edad con subluxación medial recidivante de ambas rótulas de varios meses de evolución asociado a síndrome de desalineación torsional severa. No ha sido descrito ningún caso de luxación o subluxación medial de rótulas hasta el momento. Había sufrido luxación medial de la rótula derecha tres años antes tras un salto, reducida por ella misma y no inmovilizada, seguida de 10 episodios de subluxación y tres de luxaciones mediales. Acudió a consulta por imposibilidad a la deambulación por subluxación persistente o habitual y al dolor fémoro-rotuliano, principalmente en la rodilla derecha. Presentaba subluxación medial habitual de rótulas, con desplazamiento rotuliano medial, amiotrofia cuadricipital, inestabilidad medial evidente de ambas rótulas. El test de supresión medial era positivo. Mostraba anteversión femoral excesiva de caderas (RI: 90º, RE: 30º, genu varum, torsión tibial neutra, patella alta, surcos trocleares displásicos con hipoplasia del cóndilo medial y rótulas displásicas (Wiberg tipo III. Se realizó osteotomía femoral subtrocantérea desrotatoria y realineación proximal rotuliana bilateral. Tras la cirugía recuperó la estabilidad rotuliana bilateral, marcha y carrera normales, con tests de Smillie y aprehensión (-, y movilidad de cadera de RE: 65º, RI: 50º. Quince años tras la cirugía la paciente aquejaba dolor antero-lateral de la rodilla derecha en la deambulación prolongada, al subir y bajar escaleras y la sedestación prolongada, que se diagnosticó de síndrome de hiperpresión rotuliana externa.We present a long-term review of a girl aged 11 years and 4 months with medial primary recurrent subluxation of both patellae of several months evolution associated with miserably malalignment syndrome. Not one case of medial recurrent dislocation of the patellae has been described previously. Three years previously following a

  5. 髌骨脱位行内侧髌骨股骨韧带重建术后的康复治疗%Research of rehabilitation therapy on patients with dislocation of patella after medial patellofemoral ligament reconstruction

    Institute of Scientific and Technical Information of China (English)

    李旭; 郭险峰; 钟珊

    2013-01-01

    目的:探讨内侧髌骨股骨韧带(MPFL)重建术后髌骨脱位患者康复治疗方法,最大程度恢复膝关节功能.方法:50例MPFL重建术后的髌骨脱位患者随机分成治疗组和对照组,每组各25例.治疗组给予等速肌力训练等综合康复,对照组进行指导回家自行训练,术后第12、24周对两组患者进行等速测试(慢速60°/s、快速180°/s),并将股四头肌及股内侧肌患侧/健侧峰力矩百分比、膝关节活动度(ROM)及Lysholm膝关节评分进行比较.结果:治疗组术后第12、24周,股四头肌患侧/健侧峰力矩百分比慢速分别为61.19±4.80、83.08±2.52,快速分别为68.62±5.04、90.85±1.82,股内侧肌百分比慢速分别为73.19±6.27、91.73±8.11,快速分别为68.49±2.64、82.42±4.12,Lysholm评分分别为82.36±2.57、95.79±1.03,均优于对照组(P<0.05),ROM分别为138.31±4.79、141.72±5.16,与对照组差异无显著性(P>0.05).结论:该方案能成功应用于MPFL重建的髌骨脱位患者术后的康复,并取得良好的效果.%Objective: To explore the rehabilitation therapy for dislocation of patella after medial patellofemoral ligament (MP- FL) reconstruction to regain the knee function maximally. Method: Fifty patients after MPFL reconstruction, were randomly divided into treatment group and control group, each group 25 cases. The treatment group received comprehensive rehabilitation, and the control group received medical instruction, then self-exercise. After 12 and 24 weeks postoperation, subjects were assessed with isokinet- ic measurement, and the involved / uninvolved peak torque ratio of quadriceps femoris and medial vastus muscle, range of motion (ROM) of knee joint and Lysholm score. Result: After 12 and 24 weeks postoperation, the peak torque ratio of treatment group's quadriceps femoris on low-speed were 61.19 ±4.80, 83.08 ± 2.52, on high-speed were 68.62 ± 5.04, 90.85 ± 1.82; and which of medial vastus muscle on low-speed were 73.19

  6. Influence of Patella resection thickness on patellofemoral contact pressure and patellat bone strain in total knee arthroplasty%人工膝关节置换术中髌骨截骨厚度对髌股关节压力及髌骨应变影响的研究进展

    Institute of Scientific and Technical Information of China (English)

    强硕; 郑稼

    2016-01-01

    Objective To evaluate the characteristics of patellofemal and research progress of the effect of patellar resection thickness changes on contact stress and patella strain in total knee arthroplasty (TKA). Methods The related literatures with “patella thickness, patellofemoral stress, patellar strain”about the realationship between patellar thickness and the biomechanics characteristic of patellofemoral were searched, analyzed, and summarized in the database of PubMed, Springer Link, FMJS and Wanfang data from January 1985 to January 2015. Results The change of patellar thickness can affect the biomechanics characteristic of patellofemoral regardless of whether resurfaceing the patella in TKA. It might aggravate the wear between the components and increase patella strain, which resulted in potential delamination wear debris and possible loosening or antetior knee pain. Increasing the patellar composite 2 - 4 mm might increase patellofemoral contact stress, which possiblely increased the risks of operation failure. After patellar resection, patella would suffer higher strain in thinner patellar than thicker patellar, which had higher risks of patellar fracture, or resulted in patellofemoral pain. Conclusions We should try to keep the patellar thickness as same as the thickness before the operation, which can keep stable of patellofemoral, release the contact pressure of patellofemoral and the wear of component. The reduction of resection thickness can depress patellar strain after the operation, and reduce the incidence of fracture of patellar and the knee anterior pain.%目的:总结髌股关节力学特点及人工膝关节置换术(TKA)中髌骨截骨厚度变化对髌股关节压力及髌骨应变影响的研究进展。方法在 PubMed、Springer Link、FMJS、万方等数据库以“髌骨厚度、髌股关节应力、髌骨应变”为关键词,检索1985年1月—2015年1月国内外有关髌骨厚度变化与髌股关节力学关系的相关文献

  7. Chondromalacia induced by patellar subluxation in the rabbit

    DEFF Research Database (Denmark)

    Møller, B.N.; Møller-Larsen, F.; Frich, Lars Henrik

    1989-01-01

    A unilateral patellar malalignment was induced in 20 young and 20 mature rabbits by lateral displacement of the tibial tuberosity, the other knee serving as osteotomized in situ control. At 6 weeks, all the knees appeared macroscopically normal, but histologically definite cartilage degeneration...... was found on the experimental side. At 3 months, macroscopic changes occurred in 5 of 10 mature rabbits, and histologic cartilage degeneration was found in all the experimental knees, most pronounced in mature animals, and particularly in joint facets submitted to high pressure. This experimental model...

  8. USE OF SPECIAL DESMOTOMER IN SURGICAL TREATMENT OF UPWARD FIXATION OF PATELLA IN BOVINES EMPREGO DE DESMÓTOMO ESPECIAL NO TRATAMENTO CIRÚRGICO DA FIXAÇÃO DORSAL DE PATELA EM BOVINOS

    Directory of Open Access Journals (Sweden)

    Olízio Claudino da Silva

    2008-04-01

    Full Text Available Upward fixation of patella is a disease observed in large animals and it occurs in bovines in unilateral or bilateral form, affecting male and female, different breeds and usually adults. The aim of this study was to evaluate the efficiency of an special surgical instrument designed for surgical treatment of upward fixation of patella in bovines, compare the results to those obtained applying the usual incision technique for this disease and to evaluate the post-operative period. It was submitted to medial patellar desmotomy, 32 UFP carrier female bovines with unilateral form, divided in four groups with eight animals each (GI, GII, GIII and GIV. After 12 hours of fasting, sedation with 2% xylazine, restraining in lateral recumbency and local anesthesia with 2% lidocaine on medial patellar ligament, the bovines from GI and GII were submitted to desmotomy after 4 cm length skin incision. In animals from groups III and IV, it was proceeded skin incision of 0.5 cm, followed by section gracile and sartorium muscles fasciae and desmotomy with stainless steel instrument developed for this purpose. To visualize the desmotomy with this surgical instrument, it was used, experimentally, the video-surgery. For skin closure it was used 2-0 cotton thread in animals from groups I and II. In postoperative period, bovines from groups I and III received antimicrobial drugs and it was evaluated during 28 days the occurrence of edema, wound dehiscence, abscess formation, granuloma and cicatricial evolution of the surgical wound in the animals from all groups. It was not detected any difference concerned to the use of antimicrobiane drug. Edema, wound dehiscence and abscesses occurred on the bovines from GI and GII and the clinical healing was earlier on the animals from GIII and GIV. All animals healed, but the designed instrument allowed more quick and less invasive interventions

  9. 计算机辅助髌骨三维形态学及虚拟截骨手术的测量%Morphometric assessment and virtual resection of the patellae on three dimensional CT-based models using computer assisted technology

    Institute of Scientific and Technical Information of China (English)

    黄爱兵; 罗骁; 宋长辉; 齐岩松; 王少杰; 张正政; 张继英; 杨永强; 余家阔

    2016-01-01

    目的 利用计算机辅助技术重建髌骨三维模型,评价髌骨三维形态及验证髌骨截骨时参照“外侧关节面”法(以外侧关节面软骨下骨水平为截骨参照)的可靠性.方法 募集髌骨结构正常的接受前十字韧带重建手术的志愿者200例,男100例,女100例.行CT扫描获取膝关节解剖学信息,图像导入医学工程软件Mimics中进行三维重建,构建髌骨三维数字化模型.测量髌骨宽度、厚度、高度、关节面长度及髌骨嵴位置等形态学参数.模拟全膝关节置换术参照“外侧关节面”对髌骨实行虚拟截骨,并对截骨后髌骨相关解剖学参数进行测量.结果 测量方法的组间及组内一致性高(组内相关系数> 0.75).不同性别组髌骨宽度、厚度、高度及关节面长度的差异均有统计学意义(P<0.05),各参数值女性均较男性小.男性、女性髌骨宽度/厚度比均为1.95±0.11.髌骨宽度及厚度具有正相关性(男性r=0.67,P=0.00;女性r=0.63,P=0.00).髌骨截骨的总体截骨厚度(9.59±1.53) mm,其中男性(10.21±1.53) mm、女性(8.98±1.27) mm.89%的女性截骨厚度为8~11 mm,82%的男性截骨厚度为9~12 mm.结论 通过CT扫描和医学工程软件构建髌骨三维数字化模型对髌骨进行三维形态学评价具有较高的精确性,髌骨相关形态学参数为全膝关节置换术中髌骨置换提供了参考依据.%Objective To assess patellar morphology and determine the reliability of the subchondral method (resecting the patella at the level of the subchondral bone of the lateral facet) for patellar resection in total knee arthroplasty (TKA) using computer assisted technology.Methods Computer tomography examinations were performed in 200 volunteers (100 males,100 females).The CT scan images were imported into the Mimics software for generating 3D patellar models.Furthermore,comprehensive assessment of patellar morphology and virtually resurfacing the patella were conducted

  10. The Effect of External Loads and Cyclic Loading on Normal Patellofemoral Joint Signals.

    Directory of Open Access Journals (Sweden)

    K. O. Ladly

    1993-07-01

    Full Text Available Pain over the anterior portion of the knee joint is a common clinical complaint. A condition known as 'chondromalacia patella' (softening of the cartilage under the patella, which frequently causes anterior knee pain is difficult to diagnose and monitor. Vibrations detected by a contact transducer over the patellofemoral joint may be useful in the assessment of chondromalacia patella. This paper utilised this technique known as vibroarthrography (VAG, to study two potential sources of variability of the normal patellofemoral joint signal. The effect of increased muscular force on the VAG signal was measured by externally loading the joint. The effect of load history (cyclic loading on the VAG signal was determined by comparing signals before, during, and after application of weights under similar cyclic loading conditions. Results indicated that external loading of the patellofemoral joint caused only minor signal variation. Cyclical loading of the joint, on the other hand, was determined to be a major source of variability of the normal patellofemoral joint signal, which must be controlled in future VAG tests.

  11. Knee joint examinations by magnetic resonance imaging: The correlation of pathology, age, and sex

    Directory of Open Access Journals (Sweden)

    Serhat Avcu

    2010-01-01

    Full Text Available Aims: The aim of our study was to investigate the incidence and coexistence of multiple knee joint pathologies and the distribution of knee joint pathologies according to age and sex. Patients and Methods: A retrospective analysis was performed using the clinical data of patients evaluated with magnetic resonance imaging (MRI of the knee joint. Data from 308 patients examined between August 2002 and July 2003 were included into this study. A Pearson correlation analysis was performed to examine the relationship between the pathological findings and the age and sex of the patients. Results: The ages of the patients ranged between 1 and 74 years (mean: 43.3 years. Age was significantly correlated with meniscal degeneration and tears, medial collateral ligament degeneration, parameniscal cyst, and chondromalacia patellae. There was a significant correlation between male gender and anterior cruciate ligament injury. Meniscal injury was significantly correlated with bursitis, as well as medial collateral ligament injury. Bone bruise was significantly correlated with medial collateral ligament injury, lateral collateral ligament injury, Baker′s cyst, and anterior cruciate ligament injury. Chondromalacia patellae was significantly correlated with anterior cruciate ligament injury, patellae alta, and osteochondral lesion. Bursitis (in 53.2% of the patients followed by grade-II meniscal degeneration (in 43% of the patients were the most common knee pathologies observed by MRI. Conclusions: MRI findings of select knee pathologies are significantly correlated with each other and the age and sex of the patient.

  12. Knee joint examinations by magnetic resonance imaging: The correlation of pathology, age, and sex

    Directory of Open Access Journals (Sweden)

    Serhat Avcu

    2010-04-01

    Full Text Available Aims: The aim of our study was to investigate the incidence and coexistence of multiple knee joint pathologies and the distribution of knee joint pathologies according to age and sex. Patients and Methods: A retrospective analysis was performed using the clinical data of patients evaluated with magnetic resonance imaging (MRI of the knee joint. Data from 308 patients examined between August 2002 and July 2003 were included into this study. A Pearson correlation analysis was performed to examine the relationship between the pathological findings and the age and sex of the patients. Results: The ages of the patients ranged between 1 and 74 years (mean: 43.3 years. Age was significantly correlated with meniscal degeneration and tears, medial collateral ligament degeneration, parameniscal cyst, and chondromalacia patellae. There was a significant correlation between male gender and anterior cruciate ligament injury. Meniscal injury was significantly correlated with bursitis, as well as medial collateral ligament injury. Bone bruise was significantly correlated with medial collateral ligament injury, lateral collateral ligament injury, Baker’s cyst, and anterior cruciate ligament injury. Chondromalacia patellae was significantly correlated with anterior cruciate ligament injury, patellae alta, and osteochondral lesion. Bursitis (in 53.2% of the patients followed by grade-II meniscal degeneration (in 43% of the patients were the most common knee pathologies observed by MRI. Conclusions: MRI findings of select knee pathologies are significantly correlated with each other and the age and sex of the patient.

  13. [Diagnosis and therapy of chondropathia patellae].

    Science.gov (United States)

    Jungmichel, D

    1980-04-01

    As a role the comprehensive compiling of the case history as well as the clinical and roentgenological examination give the correct diagnosis. But the variable conservative and/or operative treatment must be carried out without polypragmasy. Thus good up to very good results can be achieved in 80 per cent. The therapy must aim at making the patients free from symptoms, but it is not the aim to enable them to accomplish great physical performances.

  14. Closed reduction of an everted patella.

    Science.gov (United States)

    Ganong, R B

    1996-02-01

    A 29-year-old woman was struck from behind while skiing, sustaining a blow to her back that threw her into the air, at which time she heard a "pop" in her left knee before hitting the ground. She arrived at the base facility clinic in acute distress with the ski patrol report of a kneecap dislocation.

  15. ROLE OF MRI IN EVALUATION OF TRAUMATIC KNEE INJURIE S

    Directory of Open Access Journals (Sweden)

    Saurabh

    2013-02-01

    Full Text Available ABSTRACT : MRI is an accurate, noninvasive imaging modality for evaluation of knee injuries, and determines the patient management, saving them f rom unnecessary arthroscopy. Our study focuses on the fundamental biomechanical forces und erlying the most common injuries and correlate MRI findings with specific traumatic mecha nisms. We conducted a retrospective study on 138 patients having prior history of knee trauma. The studies evaluated cruciate ligament tears, collateral ligament injuries, chondromalacia patella, bone marrow contusions, joint effusions, tendon tear, meniscal tear and osteoarth ritis.

  16. 微络放血治疗髌骨软化症31例

    Institute of Scientific and Technical Information of China (English)

    王舰; 张素玲; 吴明霞

    2010-01-01

    @@ 髌骨软化症(chondromalacia patellae,CP),又称髌骨软骨软化症或髌骨软骨病,多因局部外伤和劳损所致.对髌骨软化症的普查结果发现,其发病率高达36.2%,且女性发病率高于男性[1].目前临床上尚无良好的治疗方法,手术治疗患者难以接受.

  17. 髌骨软骨软化症病因的生物力学分析

    Institute of Scientific and Technical Information of China (English)

    张允; 涂豫建; 张林辉

    2004-01-01

    @@ 髌骨软骨软化症(Chondromalacia of the Patella ,以下简称CP)是膝前部疼痛中常见的疾病之一,是运动创伤中的多发病和常见病,在正常人群中也有较高发病率.周元铭认为CP好发于女性,多见于极不活动的近10岁女孩和极好动的近20岁男孩[32].

  18. Patellar subluxation syndrome. Observation of the patellofemoral joint using CT-scan

    Energy Technology Data Exchange (ETDEWEB)

    Yagi, Tomonori; Sasaki, Tetsuto; Susuda, Koichi; Moji, Junichi (Hokkaido Univ., Sapporo (Japan). School of Medicine)

    1983-10-01

    Clinical symptoms of patellar subluxation syndrome associated with pain were investigated for 24 knees of 20 patients, and the state of patella dislocation was observed by CT-scan. The patients had high incidence of an apprehension sign, showing their fear of patellar luxation. Many of them complained of patello-femoral joint pain due to chondromalacia patellae. In order to derive patellar subluxation, the method of CT-Q-contraction was carried out at the extended position of the patellar joint. In patients with patellar subluxation syndrome, the rate of shift in the diseased side was significantly higher than that of the other side, suggesting decreased muscular strength of the musculus vastus of the diseased side. Improvement of the symptoms was seen in all except one of 12 knees operated by the combined method of Green's method with Blauth's more than 6 months before. Availability of this operation was verified by the CT-Q-contraction.

  19. The Application Value of T1-vibe MRI Imaging Combined with Argus Software in Measuring the Knee Osteoarthritis Patella Cartilage Volume%T1-vibe MRI成像结合Argus软件测量膝骨关节炎髌骨软骨体积的应用价值

    Institute of Scientific and Technical Information of China (English)

    董玉茹; 王宏; 刘腾; 尹媛媛

    2015-01-01

    目的:研究T1-vibe MRI成像结合Argus软件测量膝骨关节炎髌骨软骨体积的应用价值。方法选择2013年6月至2014年6月,于我院治疗膝骨关节炎的患者88例作为研究对象。以数字法随机将其分为观察组44例以及对照组44例。观察组患者使用T1-vibe MRI成像结合Argus软件对髌骨软骨的体积进行测量,对照组患者使用T1-vibe MRI成像技术结合常规手工测量,对比观察两组测量结果,研究其应用价值。结果两组在操作过程中,观察组所需时间明显少于对照组,差异有统计学意义(P<0.05)。两组进行测量的可重复性误差之间进行比较,观察组的误差分别为6.2%,1.6%,(0.7-2.0)%以及22%,除个体间差异外,其它均明显低于对照组误差,差异均有统计学意义(P<0.05)。两组髌骨体积测量结果显示,观察组测量体积和对照组并无较大差异(P>0.05),系统配对误差为-3.8%,两组随机配对误差为(4.7±2.6)%。结论使用T1-vibe MRI成像结合Argus软件测量膝骨关节炎髌骨软骨体积,大大减少了检测所耗时长,并且可重复性较高,安全性较好,值得临床测量使用推荐。%Objective Research the application value of T1-vibe MRI imaging combined with Argus software in measuring the knee osteoarthritis patella cartilage volume. Methods Choose 88 knee osteoarthritis patients who were admitted in our hospital from June 2013 to June 2014, which were devided into two groups with random number table method, every group had 44 patients. We used T1-vibe MRI imaging combined with Argus software to measure the patella cartilage volume of observation group while the control group use T1-vibe MRI imaging combined with manual measurement. Compare the measurement results of two groups and study its application value. Results The examination time of observation group was obviously less than the control group. There's significant difference in the

  20. 髌骨缝合线双荷包缝合法结合张力带缝合法治疗髌骨骨折%The methods of patellar suture with double ring suture band combining with tension band to heal patella fracture

    Institute of Scientific and Technical Information of China (English)

    李志君; 郑玉鹏; 王坤; 宋秀峰

    2012-01-01

    Objective To discuss the technique and effect of the methods of patellar suture with double ring suture band combining with tension band to heal patella fracture by straight incision in the front of knee. Methods 206 patients patella fracture, by early slit for recovery site, the methods of double ring suture band combining with tension band for stated healing and assistant early functional practice after operation. Results All patients were followed up from 12 months to 24 months, average 19 months. All fracture were healable. As the level of LU Yu-pu,the excellent results is 168,the good results is 16,th middle results is 3.The rate of excellent and good is 98.4%. Conclusions The methods of patellar suture with double ring suture band combining with tension band to heal patella fracture by straight incision in the front of knee, has enough surgical field in small incision and not injury saphenous nerve and artery of patellar descending branch. The principle of the method consists with biomechanics and tension band principle. Patellar suture has histocompatibility. By early activity after operation and little postoperative complications, the patients recover fastly by low-cost, the effect is specific and the internal fixation need not hand out by operation.%目的探讨膝前正中直切口髌骨缝合线双荷包法结合张力带缝合法治疗髌骨骨折的疗效.方法对206例髌骨骨折,采用膝前正中直切口髌骨缝合线荷包缝合结合张力带缝合法治疗,并辅以术后早期功能锻炼.结果187例随访12~24个月,平均19个月.骨折愈合时间8~12周,无内固定松动及再骨折.按陆裕朴等功能评定标准:优168例,良16例,可3例,优良率达到98.4%.结论膝前正中直切口髌骨缝合线双荷包结合张力带缝合法治疗髌骨骨折显露充分,切口小,不损伤隐神经和膝降动脉髌下支,操作简单,缝合方法符合生物学固定方法及张力带原则,丝线组织相容

  1. Clinical Efficacy of Herbal Compress for the Complications after the Surgery of Medial Patella Instability through Reconstruction of the Medial Patellofemoral Ligament with Iliotibial Band%中药热敷治疗膝关节内侧髌股韧带重建术后并发症疗效观察

    Institute of Scientific and Technical Information of China (English)

    孔令俊; 赵军; 刘朝辉; 王承祥

    2013-01-01

    Ob jective: To study clinical efficacy of herbal com press for the com plications after the surgery of medial patella instability through reconstruction of the medialpatellofem oralligam entwith iliotibialband. Method: All86 patients were allocated into 46 cases in the treatm ent group and 40 cases in the observation group. The treatm ent group received herbal com press com bined with functional exercise, the observation group functional exercise only. The im provem ents of pain were assessed with visual analogue scale (VAS) after surgery in 12 to 24 months, meanwhile the range of motion (ROM ) was observed. Result: The treatm ent group was less than the observation group in VAS (P<0.05); the excellentrate of ROM in the treatm entgroup and the control group were 95.6% and 80% , com parisonsbetw een both groups showed statisticalm eaning. Conclusion:Herbalcom press for the knee after the surgery of medial patella instability through reconstruction of the medial patellofem oral ligam entw ith iliotibialband is effective in the rem ission of jointpain and the increase of ROM .%目的:观察髂胫束重建内侧髌股韧带术及术后患膝中药热敷治疗髌骨内侧不稳的临床疗效.方法:将86例髂胫束重建内侧髌股韧带治疗髌骨内侧不稳术的患者随机分为治疗组和观察组,治疗组46例,观察组40例.治疗组采用中药热敷结合功能锻炼,观察组仅采用功能锻炼,于术后12~24月采用视觉模拟评分法(VAS)评价疼痛程度改善情况,同时观察关节活动度.结果:治疗组较观察组VAS评分降低(P<0.05);关节活动度治疗组优良率为95.6%,对照组为80%,2组相比差异有统计学意义.结论:髌股韧带重建治疗髌骨内侧不稳术后采用患膝中药热敷对关节疼痛程度的缓解以及关节活动度的增加方面疗效显著.

  2. 髌骨治疗髌骨骨折%Treatment of Patella Fracture with Patella Ring

    Institute of Scientific and Technical Information of China (English)

    袁翔; 柯雯昙

    2015-01-01

    对46例髌骨骨折患者选择髌骨环作为内固定物治疗的疗效进行回顾分析,认为髌骨环治疗髌骨骨折具有固定牢靠、操作简易、利于术后功能训练等优点,是治疗髌骨骨折特别是粉碎性髌骨骨折的一个不错选择。%46 cases of patel ar fracture patients choose patel ar ring as the therapeutic ef ect of internal fixation for retrospective analysis, think with fixation treatment of patel a fracture of patel a ring, and the advantages of simple operation, good for postoperative function training, is the treatment of patel a fractures especial y comminuted patel ar fractures are a good choice.

  3. Effect of different body position care combined with early rehabilitation training on the functional recovery of knee joint after surgery for fracture of patella%髌骨骨折术后不同体位护理联合早期康复训练对膝关节功能恢复的影响

    Institute of Scientific and Technical Information of China (English)

    余敏; 刘长英

    2014-01-01

    目的:探讨髌骨骨折术后不同体位护理联合早期康复训练对膝关节功能恢复的影响。方法:将47例髌骨骨折患者随机分为实验组24例和对照组23例,实验组内固定术后局部弹力绷带包扎,膝后垫软枕,予屈曲膝关节90°~120°体位放置;常规组内固定术后常规抬高患肢15°~20°,膝后垫软枕,膝关节屈曲5°~10°体位。两组患者术后均实施冷敷,第2天由主管医生、护士和康复师对其进行康复指导,分别于术后第3天、第14天、第30天比较两组患者不同体位护理效果。结果:实验组患肢肿胀、疼痛程度明显轻于对照组,功能锻炼主动配合、膝关节功能恢复情况明显优于对照组,患者平均住院天数明显短于对照组(P﹤0.05);实验组早期体位舒适度较对照组差( P﹤0.05)。结论:髌骨骨折患者术后正确的体位、早期及时正确的功能锻炼是膝关节功能康复的关键。%Objective:To investigate the effect of different body position care combined with early rehabilitation training on the function-al recovery of knee joint after fracture of patella. Methods:47 patients with patellar fracture were randomly divided into the experimental group(n=24)and the control group(n=23). The local bandage was adopted with elastic bandages and soft pillow was used to cushion the knee flexion(90 °~120 °)after internal fixation in the experimental group;the affected limb was lifted about 15 °~ 20 °and soft pil-low was put under the knee in the position of knee flexion(5 ° ~ 10 °)after internal fixation in the control group. The patients in both groups were treated with cold compress after operation and they were given rehabilitation guidance by the doctor and nurse in charge and physical therapist on the second day,the effect of different body position care was compared respectively on the 3rd,14th and 30th day after operation. Results:The severity of swelling and

  4. 克氏针张力带与髌骨爪内固定治疗髌骨下极骨折的疗效比较%Effect of Kirschner tension-band wire and memory alloy patellar holder in treating inferior polar fracture of patella

    Institute of Scientific and Technical Information of China (English)

    陈文学; 齐越峰; 谢克波; 郑移兵

    2013-01-01

    Objective To compare the therapeutic effects of Kirschner tension-band wire and memory alloy patellar holder in the treatment of inferior polar fracture of patella.Methods All 92 patients with inferior polar fracture of patella treated with Kirschner tension-band wire or memory alloy patellar holder were selected.Of 92 patients,53 cases suffered Kirschner tension-band wire including 45 cases with comminuted fractures,39 cases underwent memory alloy patellar holder including 35 cases with comminuted fractures.All cases were performed surgical reduction and internal fixation under spinal anesthesia.The results were analyzed based on their surgical duration,fracture healing time,postoperative effects,complication rate and cost of hospitalization.Results Patients were followed up for 6 to 18 months,with an average of (11.5 ± 1.0) months.①) For patients with non-comminuted fracture,there was no significant difference between two groups in terms of surgical duration,fracture healing time,the hospital costs (excluding cost for surgical materials),the incidence rate of complication and postoperative effects (P > 0.05).Patients with patellar holder had a lower rate of complication (P < 0.05).There was significant difference in average total hospital costs between patients with patellar holder and patients with Kirschner tension-band wire [(7148 ± 155)yuan vs (5490 ± 129)yuan,P < 0.01].(②) For patients with comminuted fracture,there was no significant difference in fracture healing time between two groups (P > 0.05),but there was significant difference in terms of the curative effect [100.0% (35/35) vs 91.1% (41/45),P < 0.05].For patients with Kirschner tensionband wire,the surgical duration and rate of complications were significantly higher than those in the other group [(63.6 ± 2.5) min vs(48.3 ± 2.2) min,8.9% (4/45) vs 0.0%,P < 0.05 or P < 0.01].There was a significant difference in average total hospital costs between patients with

  5. 大收肌腱移位重建内侧髌股韧带治疗儿童复发性髌骨脱位初期效果分析%A short-term follow-up study after reconstruction of medial patellofemoral ligament(MPFL) combined with adductor magnus tendon autograft for the treatment of recurrent dislocation of patella(RDP)

    Institute of Scientific and Technical Information of China (English)

    冯超; 王玉琨; 张建立; 朱振华; 郭源; 宋猛

    2012-01-01

    Objective To explore the technique and efficacy of the arthroscopic reconstruction of medial patellofemoral ligament (MPFL) combined with adductor magnus tendon autograft in treatment of recurrent dislocation of patella(RDP) in children.Methods Six cases of RDP were treated using arthroscopic reconstruction of MPFL combined with adductor magnus tendon autogmft beween Jan 2007to Jul 2010.The condition of patellofemoral joint and MPFL were detected with X-ray,CT and MRI preoperatively.The arthroscopic exanination was conducted before reconstruction to observe pateltofemoral congruence and patellar track,as well as articular cartilage.The MPFL was reconstructed followed by adductor magnus tendon autograft.Then arthroscopic examination was taken again for measurement of patellofemoral congruence and patellar track after surgery.Function training of knee joint was applied and subjective symptoms were further scored postoperatively.Results No infection,graft rejection and rupture were seen in all cases.Patients were followed up for 12-36 months (Average 18 months).Lysholm scores showed an improvement from 76.7 ± 8.7 in pre-surgery to 95.6 ± 5.7 ( P =0.000) in post-surgery.X-ray detection indicated excellent patella reduction without recurrence of dislocation or subluxaion.Conclusions The reconstruction of medial patellofemoral ligament (MPFL) combined with adductor magnus tendon autograft,is effective approach to treat RDP.%目的 探讨关节镜辅助下大收肌腱移位重建内侧髌股韧带(medial patellofemoral ligament,MPFL)治疗儿童复发性髌骨脱位(recurrent dislocation of patella,RDP)的手术技术和临床效果.方法 2008年1月至2010年7月收治了6例RDP(1例为双膝)的患儿,术前进行临床检查、X 线片、CT、MRI了解髌股关节及MPFL情况,并进行Lysholm评分,术中先用关节镜观察髌股关节的对合关系、运动轨迹及关节软骨情况,通过髌骨内侧缘切口确定MPFL髌骨止点,并在髌骨

  6. Percutaneous AO Kirschner wire plus tension band wire fixation for patella closed transverse fracture%经皮穿刺克氏针加张力带钢丝固定治疗闭合性髌骨横断骨折

    Institute of Scientific and Technical Information of China (English)

    赵斌修; 王坤正

    2007-01-01

    手术方法具有创伤小、恢复快及术区美观等特点,并能允许膝关节早期活动,临床疗效满意.%BACKGROUND: Tension band suture fixation is always used in treating patellar fracture, and its modified method of Kirschner wire plus tension band steel-wire is also widely applied. But because the traditional surgery always causes massive incision and scar formation, it affects the appearance and function of knee joint.OBJECTIVE: To investigate the clinical curative effect of percutaneous puncture plus tension zone steel-wire fixation for the treatment of patella closed transverse fracture.DESIGN: Retrospective analysis:SETTING: Second Hospital of Medical College, Xi'an Jiaotong University.PARTICIPANTS: Twenty-nine patients with closed patellar transverse fracture admitted by Department of Orthopedics,Medical College of Xi'an Jiaotong University were selected from an average age of 36 years old. Only people that were diagnosed by X-ray as closed patellar transverse fracture were enrolled, and the informed consent was obtained from them.jostled until resetting, and then the fractured pieces were clamped by a clavical clamp to fix. Two incisions were made at the upper and lower ends of patella, and two were penetrated from the incision until its tip out of the lower hole of the same Kirschner wire under skin. The soft steel wire was drawn tightly and bended along the tip of Kirschner wire. The three-grading method, and the recovery of patients in 4 years after operation was evaluated according to the composite evaluation means about the knee joint established by Xu et al (pain, movement range of knee joint and reset of the fracture in patellar face. Meanwhile, the postoperative complications were observed.MAIN OUTCOME MEASURES: Wound healing, postoperative functional recovery and complications of patients.cases scored in grade 1, accounted for 93%, 2 cases in grade 2, accounted for 7%, who were recovered after change of means about the knee joint

  7. 自体骨-髌腱(中1/3)-骨重建后交叉韧带的中长期临床观察研究%Arthroscopic reconstruction of the posterior cruciate ligament using single-bundle bone-patella tendon-bone graft with moderate to long term follow-up

    Institute of Scientific and Technical Information of China (English)

    刘平; 敖英芳; 王健全; 崔国庆; 安华; 刘晓鹏

    2009-01-01

    Objectives To evaluate the 4- to 10- year results of arthroscopic reconstruction of the posterior cruciate ligament (PCL) using single-bundle bone-patella tendon-bone graft, and to find out the principle and influential factor of the isolated PCL reconstruction. Methods From May 1998 to July 2004 the data of 29 patients with isolated PCL reconstruction retrospectively investigated,using single-bundle bone-patella tendon-bone graft. Twenty-two cases were followed up with average 7.1 years (5-10 years). Follow-up included the subjective knee function evaluation, KT2000, Biodex and the radiographic assessment. Results The mean final follow-up IKDC score, Lysholm score, and Tegner score of the 22 cases were 89.4±8.1, 94.5±9.2, and 6.9±2.6 respectively. There were statistically significant improvements in them when compared with preoperative data respectively (P<0.01). The average posterior displacement measured with KT2000 was (4.9±1.1)mm (90°flexion) and (4.3±1.2)mm (30°flexion) respectively. At the final follow-up, KT2000 examination revealed ≥6 mm of posterior laxity in 6 patients (group A), and ≤5 mm posterior laxity in 16 patients (group A). A statistically significant improvement was noted in comparing the mean final follow-up IKDC score, Lysholm score, and Tegner score between the group A and B (P<0.01). The average time from injury to surgery of group A and B was (17.6±3.9) months and (2.9±2.1) months respectively, the difference was statistically significant (P<0.01). The data was received from the Biodex dynamometer for the 22 patients who were followed up in clinic service. Patients achieved(90±22)% (60°/s) and (87±19)% (120°/s) recovery of the extensor peak torque respectively, for the flexor peak torque patients achieved (93±16)% (60°/s) and (92±20)%(120°/s) respectively, the difference between the peak torque of extensor and flexor in the same condition was statistically significant (P<0.01). X-ray findings: 8 of the 22 patients (36

  8. Utilização de contrairritante no tratamento da fixação dorsal de patela intermitente em equinos: relato de casos The use of counterirritant in the treatment of upward fixation of intermittent patella in horses: case report

    Directory of Open Access Journals (Sweden)

    M.J. Watanabe

    2013-04-01

    Full Text Available Em nove equinos atendidos por apresentarem fixação dorsal de patela intermitente, optou-se pela aplicação de 2mL de contrairritante na região subcutânea, ao longo dos ligamentos patelares medial e intermédio. No período de 12 a 48h após a aplicação, os animais apresentaram aumento de volume e de temperatura local, sensibilidade dolorosa à palpação e relutância à locomoção. Após esse período, os sinais clínicos de inflamação e fixação dorsal de patela foram gradativamente diminuindo até o sétimo dia, em sete dos nove animais avaliados. Após a remissão dos sinais de inflamação, dois animais não responderam ao tratamento, sendo necessária a repetição em um dos casos e realização de desmotomia patelar medial no outro. A aplicação de contrairritante foi eficaz na remissão do sinal clínico de fixação dorsal da patela intermitente. Comparativamente às técnicas cirúrgicas para a correção da enfermidade descritas na literatura, o tratamento promoveu melhora precoce dos sinais, curto período de convalescência e praticidade na realização.Nine horses were admitted showing intermittent lameness due to upward fixation of the patella (UFP and were injected with 2mL of counter-irritant subcutaneously, through the middle and medial patellar ligaments. From 12 to 48 hours after application, these animals showed increased volume and local temperature, painful response to palpation and reluctance to bear weight. Subsequently, the inflammatory signs were gradually decreasing until the seventh day, along with signs of UFP in seven of the nine animals. After remission of inflammatory signs, two of the nine horses did not respond to the treatment. In these two animals, one horse needed a repeated counter-irritant injection and the other received the medial patellar desmotomy. The use of counter-irritant was effective in the remission of clinical signs of UFP. In comparison with the surgical techniques described in

  9. Avaliação quantitativa das forças laterais da patela: ressonância magnética estática e cinemática Quantitative evaluation of lateral forces on the patella: static and kinematic magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Je Hoon Yang

    2007-08-01

    evaluated in both groups. Among the patients the differences between static and kinematic measurements were greater than those found in the volunteers, at 30° and 20° flexion, with bisect offset and lateral patellar displacement. CONCLUSION: Static and kinematic magnetic resonance imaging, when performed in association, demonstrated that the lateral forces being exerted on the patella are higher at a knee flexion at the range between 20° and 30°, particularly in individuals symptomatic for femoropatellar instability.

  10. Use of castor oil polyurethane in an alternative technique for medial patella surgical correction in dogs Utilização do poliuretano de mamona em técnica alternativa de correção cirúrgica da luxação medial de patela em cães

    Directory of Open Access Journals (Sweden)

    Fabrício de Oliveira Frazilio

    2006-01-01

    Full Text Available PURPOSE: Comparative morphologic study of utilization of castor oil polymer in dogs joints, as an alternative technique to autogenous graft, in surgical correction of medial patella luxation. METHODS:Twelve adult dogs, of both sexes, were randomly allocated to two different groups of six animals each. Group I (biopolymer consisted of the deepening of the right femoral troclea, with the implantation of the biopolymer prothesis, and compared to group II (control which consisted of the conventional trocleoplastia technique with wedged cut of the left femoral troclea. The dogs were sacrified after 30 or 90 days and the anathomic peaces were analyzed macro and microscopically. Qui square and Wilcoxon tests were used for the statistic analyses of the results, considering probability of 5%. RESULTS: It was not observed bony integration on the castor oil polymer group. There was resorption of the graft along experimental period and absence of inflammatory cells in the studied periods. CONCLUSION: Castor oil polymer assisted cicatrisation process, was biocompatible without inflammation, and it can be used in joints as an alternative for bony filling.OBJETIVO: Estudo morfológico do implante da prótese de polímero de mamona em articulações de cães, como técnica alternativa ao enxerto ósseo autógeno na correção cirúrgica da luxação medial de patela. MÉTODOS: Doze cães adultos, de ambos os sexos, foram distribuídos aleatoriamente em dois grupos de 6 animais. No grupo I (poliuretano foi feito o aprofundamento da tróclea femoral direita com prótese de polímero de mamona, que foi comparado com o grupo II (controle sendo feita a trocleoplastia por ressecção em cunha da tróclea femoral esquerda. Os animais foram sacrificados após 30 e 90 dias e as peças anatômicas foram avaliadas macro e microscopicamente. O teste do quiquadrado e o teste não-paramétrico de Wilcoxon foram utilizados para a análise estatística dos resultados. Fixou

  11. Region specific patella tendon hypertrophy in humans following resistance training

    DEFF Research Database (Denmark)

    Kongsgaard, M.; Reitelseder, S; Pedersen, T.G.

    2007-01-01

    (MVC) was determined unilaterally in both legs. PT CSA was measured at the proximal-, mid- and distal PT level and quadriceps muscle CSA was measured at mid-thigh level using magnetic resonance imaging. Mechanical properties of the patellar tendons were determined using ultrasonography. Subsequently......, subjects performed 12 weeks of heavy resistance knee extension training with one leg (Heavy-leg), and light resistance knee extension training with the other leg (Light-leg). RESULTS: The MVC increased for heavy-leg (15 +/- 4%, P

  12. Patellofemoral arthrodesis as pain relief in extreme patella alta

    NARCIS (Netherlands)

    Venkatesan, S.; Kampen, A. van

    2014-01-01

    PURPOSE: There is no golden standard management for neglected, chronic patellar tendon rupture as they are fairly rare. Nevertheless, accompanying pain can be highly debilitating. By presenting a case of patellar tendon repair, the exceptional results of a patellofemoral arthrodesis are described. M

  13. Region-specific mechanical properties of the human patella tendon

    DEFF Research Database (Denmark)

    Haraldsson, B T; Aagaard, P; Krogsgaard, M

    2004-01-01

    . A stereoscopic microscope equipped with a digital camera recorded elongation. The fascicles were preconditioned five cycles before the failure test based on pilot data on rat tendon fascicle. Human fascicle length increased with repeated cycles (P

  14. Bone injuries in the post-traumatic knee: evaluation by magnetic resonance imaging; Comprometimento osseo do joelho pos-trauma: avaliacao pela ressonancia magnetica

    Energy Technology Data Exchange (ETDEWEB)

    De Grossi, Carla Martins [Universidade Federal, Rio de Janeiro, RJ (Brazil). Curso de Pos-graduacao em Radiologia; Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Servico de Radiologia; Santos, Alair Augusto S.M.D. dos [Hospital Santa Cruz, Niteroi, RJ (Brazil). Servico de Radiologia]. E-mail: edmarchiori@zipmail.com.br

    2001-06-01

    This paper presents the results of 50 patients with trauma of the knee submitted to magnetic resonance imaging in the period of January 1996 to December 1997. The appearance and incidence of the main bone lesions were evaluated and correlated with the mechanisms of aggression and with clinical data. Associated lesions were also evaluated. Bone contusions were the most commonly findings encountered and were observed in 38 patients (76%). Osteochondral fractures occurred in five patients (10%) and bone fractures were detected in five patients (10%), of which two were associated with contusions in other adjoining bone compartments. Chondromalacia of the patella was observed only in two patients (4%). We concluded that magnetic resonance imaging is the imaging method of choice for the diagnosis of bone lesions in patients with trauma of the knee. (author)

  15. 透刺加温针治疗髌骨软化症32例

    Institute of Scientific and Technical Information of China (English)

    王舰; 洪昆达; 吴明霞

    2011-01-01

    @@ 髌骨软化症(chondromalacia patellae,CP)又称髌骨软骨软化症或髌骨软骨病,多因局部外伤和劳损所致.对髌骨软化症的普查结果发现:其患病率高达36.2%,且女性发病率高于男性[1].目前临床上尚无良好的治疗方法,手术治疗患者难以接受.我们自2002年以来运用透刺加温针治疗髌骨软化症32例,取得满意疗效,现报道如下.

  16. 髌骨软骨软化症的首诊治疗

    Institute of Scientific and Technical Information of China (English)

    王文格

    2004-01-01

    髌骨软骨软化症(Chondromalacia of the Patella)于1908年由Buedinger首先描述髌骨软骨软化症的病变,1924年Koenig首先使用“髌骨软骨软化症”这一术语,实际上髌骨软骨软化是描述髌骨软骨水肿、皲裂、糜烂、剥脱等一系列病损的病理诊断。髌骨软骨软化是髌股痛的常见原因,对其发病机理和治疗争议颇多。一般认为髌骨发育障碍、畸形、Q角增大,

  17. Patellar calcar: MRI appearance of a previously undescribed anatomical entity

    Energy Technology Data Exchange (ETDEWEB)

    Collins, Mark S.; Tiegs-Heiden, Christin A. [Department of Radiology, Mayo Clinic, Rochester, Minnesota (United States); Stuart, Michael J. [Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota (United States)

    2014-02-15

    The femoral calcar is a constant anatomical structure within the proximal femur representing a condensation of bone trabeculae. It is our impression that a similar structure is present within the patella. The purpose of this retrospective study was to define the prevalence, appearance, location, and configuration of the patellar calcar on MRI examinations. One hundred consecutive unenhanced knee MRIs were retrospectively reviewed by two readers who were blinded to the clinical indication. The patellar calcar was defined as a dark signaling, linear or curvilinear structure subjacent to the patellar articular surface. If present, the patellar calcar was assigned to a ''well seen,'' ''moderately well seen,'' or ''faintly seen'' category. Location of the calcar within the patella, orientation, configuration, and thickness were recorded. Confounding variables, such as marrow edema, patellar chondromalacia, bipartite patella, or postoperative changes were also recorded. The patellar calcar was visualized in 81 out of 100 (81 %) MRIs. When detected, the calcar was well seen in 20 out of 81 (25 %), moderately well seen in 35 out of 81 (43 %), and faintly seen in 26 out of 81 (32 %). The anteroposterior width of the calcar measured at its thickest segment was: < 1 mm in 43 out of 81 (53 %), 1 mm in 28 out of 81 (35 %), and >1 mm in 10 out of 81 (12 %). The patellar calcar was seen in the majority of knee MRIs and had a consistent imaging appearance. The calcar may be obscured by degenerative arthrosis of the patella and rarely may mimic patellar stress fracture or osteochondritis dissecans. Radiologists and clinicians should be familiar with this normal anatomical structure. (orig.)

  18. Patellar Articular Overlap on MRI Is a Simple Alternative to Conventional Measurements of Patellar Height

    Science.gov (United States)

    Munch, Jacqueline L.; Sullivan, Jaron P.; Nguyen, Joseph T.; Mintz, Douglas; Green, Daniel W.; Shubin Stein, Beth E.; Strickland, Sabrina

    2016-01-01

    Background: Patella alta describes an abnormally high-riding patella in relationship to the femur and has been shown to correlate with patellofemoral pain, instability, chondromalacia, and arthrosis. Conventional measurements of patella alta involve multiple measurements and are often not defined on cross-sectional imaging as related to radiographs. Hypothesis: Patellar articular overlap on sagittal magnetic resonance imaging (MRI) will correlate well with conventional measurements of patella alta as measured by a standardized technique defined by our group. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: MRIs of 239 knees were reviewed by 3 attending surgeons with practices focusing on patellofemoral disease, as well as 2 sports medicine fellows and 1 musculoskeletal radiologist. Measurements included articular overlap, percentage of articular coverage, Caton-Deschamps index, Blackburne-Peel index, and modified Insall-Salvati index. Results: Interrater reliability was high for Caton-Deschamps, Blackburne-Peel, and modified Insall-Salvati indices (intraclass correlation coefficient [ICC], 0.877, 0.828, and 0.787, respectively). Articular overlap and percentage articular coverage correlated well with each other (ICC, 0.961; P < .001) and with the Caton-Deschamps (overlap r = –0.271, P < .001; coverage r = –0.131, P = .037) and Blackburne-Peel (overlap r = 0.343, P < .001; coverage r = –0.238, P < .001) indices. Articular overlap and percentage coverage failed to correlate with the modified Insall-Salvati index (overlap r = –0.117, P = .091; coverage r = 0.007, P = .918). Conclusion: Patellar articular overlap and percentage of patellar articular coverage show promise as a simpler alternative to conventional, ratio-based measurements of patellar height. Future studies are needed to evaluate the range of normal and the relationship to our traditionally used measurements. PMID:27482530

  19. ENVIRONMENTAL AND MANAGEMENT EFFECTS ON PREVALENCE OF UPWARD FIXATION OF PATELLA IN CATTLE IN GOIÁS STATE, BRAZIL: EPIDEMIOLOGICAL STUDY EFEITOS AMBIENTAIS E DE MANEJO NA PREVALÊNCIA DE FIXAÇÃO DORSAL DE PATELA EM BOVINOS NO ESTADO DE GOIÁS, BRASIL: ESTUDO EPIDEMIOLÓGICO

    Directory of Open Access Journals (Sweden)

    Maria Auxiliadora Leão

    2007-12-01

    Full Text Available

    Upward fixation of patella is a chronic disease observed in bovines managed in several kinds of handling systems and presents in unilateral or bilateral clinical form, affecting male and females, different breeds and age. The aim of this study was to determine the distribution of the disease in Goias State using a questionnaire that allows to characterize the farms in aspects as time of cattle breeding, soil topography, bred herd and adopted management, the main age of the animals at the beginning of the disease, destiny of ill bovines, among others parameters. It was analyzed in this study 128 farms in 59 cities from the Goias State involving a total of 118,657 animals from 15 different breeds, in dry weather, between August and October, 2003. From 128 studied properties, in 32 (25.0% the UFP never had been diagnosed; in 46 (36,0% farms it was observed 110 (29.1% bovines with UFP along the years of cattle breeding. In the 50 (39.0% lasting farms, the total of the past occurrence and the occurrence of UFP at the moment of the application of the questionnaire was present in 268 (69.6% bovines. Among the animals diag-nosed with UFP, 61 (0.5% belonged to Girolando breed and 22 (0.04% were Nelore bovines. The results obtained in this research allowed to conclude that UFP in bovines is a multifactorial disease and the factors, breed, age, soil topography of the farms and time of cattle breeding are the main factors associated to unleashing of this disease.

    Key-words: Epidemiology, locomotion system, ruminants.

    A fixação dorsal de patela é uma enfermidade de caráter crônico observada em bovinos criados sob variados sistemas de manejo, apresentando-se de forma uni ou bilateral, em ambos os sexos, diferentes raças e idades. O objetivo deste estudo foi identificar a distribuição da enfermidade no Estado de Goiás, utilizando-se um questionário que permitisse caracterizar as

  20. Ativação muscular estabilizadora da patela e do quadril durante exercícios de agachamento em indivíduos saudáveis Muscular activity of patella and hip stabilizers of healthy subjects during squat exercises

    Directory of Open Access Journals (Sweden)

    Lilian R. Felício

    2011-06-01

    muscles is relevant for physical therapy treatments. OBJECTIVE: To compare the electromyographic activity of patella and pelvic stabilizers during traditional squat and squat associated with isometric hip adduction or abduction in subjects without AKP. METHODS: Electromyography signals were captured using double-differential electrodes at the vastus medialis obliquus (VMO, vastus lateralis obliquus (VLO, vastus lateralis longus (VLL and gluteus medium (GMed in 15 healthy and sedentary women during squats exercises: traditional and associated with hip adduction and hip abduction with load of 25% of body weight. Linear mixed models with significance level of 5% were used for data analysis. RESULTS: Squat associated with hip adduction and abduction produced electromyographic activity of GMed of 0.47 (0.2 and 0.59 (0.22 respectively, while conventional squat produced an electromyiographic activity of 0.33 (0.27. The higher VMO activity was 0.59 (0.27 during the isometric contraction in the squat associated with hip adduction. The higher VLO activity was 0.60 (0.32 during isometric contraction in the squat associated with hip abduction. CONCLUSION: Squat exercise associated with hip adduction increased VMO muscle activity as well as the activity of GMed activity.

  1. 髌骨周围去神经化对保留髌骨的全膝关节置换术后影响的meta分析%Circumferential electrocautery of the patellar in primary total knee replacement without patella replacement: a meta-analysis and systematic review

    Institute of Scientific and Technical Information of China (English)

    葛兆刚; 樊立宏; 刘琪; 时志斌; 党晓谦; 王坤正

    2015-01-01

    no significant difference in the incidence of anterior knee pain (P =0.18) and visual analogue scale (VAS) (P =0.23) between two groups.However,patellar score (P =0.01),Western Ontario and McMaster Universities osteoarthritis index (WOMAC) score (P < 0.01),and range of motion (ROM) (P < 0.01) indicated that circumpatellar electrocautery improved clinical outcomes compared to non-electrocautery groups.Conclusions The results indicated that circumferential electrocautery of the patellar did not significantly improve anterior knee pain relative to non-electrocautery techniques.However,circumferential electrocautery significantly improved patients' knee function after surgery.Therefore,circumferential electrocautery might be beneficial to the outcome of primary total knee replacement surgery without patella replacement.

  2. Evaluation of knee extensor mechanism disorders: clinical presentation of 1 12 patients*.

    Science.gov (United States)

    Antich, T J; Randall, C C; Westbrook, R A; Morrissey, M C; Brewster, C E

    1986-01-01

    Results of physical therapy evaluation of 112 patients with extensor mechanism disorders (chondromalacia patella, infrapatellar tendinitis, and peripatellar pain) are presented. An equal number of male and female patients were evaluated and of the 73 patients with unilateral involvement (65%) there were equal numbers of right and left involved knees. Running was the activity most commonly associated with pain, followed by basketball and tennis. Stairclimbing was painful in 79% of the patients, with ascending being more painful than descending in patients reporting a clear-cut difference. Hamstring and quadriceps tightness was statistically significant relative to the uninvolved limb although clinically, negligible differences were measured. The inferior pole of the patella was the most tender site to palpation, followed by medial peripatellar structures, then lateral sites. Biomechanical malalignment was not detected by the attending therapist in the majority of patients. The authors emphasize careful assessment of flexibility, quadriceps (VMOIVL) imbalance, and biomechanical alignment in performing a thorough evaluation of patients with extensor mechanism disorders. J Orthop Sports Phys Ther 1986;8(5):248-254.

  3. Measurement of patella height and advance of patella alta%髌骨高度的测量及高位髌骨的研究进展

    Institute of Scientific and Technical Information of China (English)

    郭瑞鹏; 徐斌

    2014-01-01

    BACKGROUND:With the development of sports medicine and research of patel ofemoral disorder, patel a alta has been paid increasing attention as the exact pathogenesis of patel ofemoral disorder. There are many radiographic measurement indexes of patel a alta. A large number of clinicians and radiography physicians are trying to diagnose and treat this disease as early as possible. OBJECTIVE:To review the radiographic measurement and research progress of patel a alta, find out the advantages and disadvantages of different indexes, and look into the future development prospects. METHODS:A computer-based online search of Pubmed and CNKI databases between 1989 and 2013 was performed for articles addressing radiographic diagnose and measurement patel a alta. The key words were“patel a alta, patel a height, measurement, diagnosis”in English and“patel a alta, patel a height, patel a position, diagnosis, measurement”in Chinese. RESULTS AND CONCLUSION:Now there are many measurement indexes of patel a alta and they are divided into two groups:indirect index and direct index. The indirect index measures the relative location of patel a and tibia, such as Insal-Salvat index, Blackburne-Peel index, and Caton-Deschamps index. The direct index measures the relative location of patel a and femur, such as patel otrochlear index, and patel ophyseal index. The latest study indicates that the biomechanics of patel ofemoral joint is the key to understand the pathogenesis of patel ofemoral disorder. As the MRI technique develops, direct index for the location of articular cartilage of patel ofemoral joint, such as patel otrochlear index, seems to be the best measurement to patel a alta. However we stil have many problems in the study of patel otrochlear index.%背景:随着运动医学的不断发展以及对髌股关节疾病的深入研究,高位髌骨作为髌股关节病的重要发病因素被越来越多的研究,其影像学测量指标众多,广大临床医生和影像学工作者尝试早期诊断和治疗这一重要疾病。  目的:对高位髌骨的影像学诊断及最新进展进行综述,指出各个指标的优点和局限性,为下一步研究拓宽思路。  方法:应用计算机检索1989至2013年中国知网及Pubmed数据库,关于髌骨高度测量、高位髌骨的影像学诊断方面的文献报道,并对不同的诊断指标进行归纳综述。中文检索词为“高位髌骨、髌骨高度、髌骨位置、诊断、测量”,英文检索词为“patel a alta, patel a height,measurement,diagnosis”。  结果与结论:目前临床上常用的评估髌骨高度的指标很多,主要被分为两类:一类是间接指标,评估髌骨与胫骨之间的位置关系,比如经典的Insal-Salvat(IS)指数,Blackburne-Peel(BP)指数,和Caton-Deschamps(CD)指数。另一类是直接指标,评估髌骨与股骨之间的关系。包括等“The patel otrochlear index”,“The patel ophyseal index”等。现在认为,髌股关节的生物力学是阐明髌骨关节紊乱疾病基础的关键。随着MRI技术的推广,直接评估髌股关节关节软骨面位置关系的指标如髌骨滑车指数被认为反映髌股关节的实际匹配状况的最佳指标。但对于髌骨滑车指数的研究同样有不少问题等待解决。

  4. Is there a role of pulsed electromagnetic fields in management of patellofemoral pain syndrome? Randomized controlled study at one year follow-up.

    Science.gov (United States)

    Servodio Iammarrone, Clemente; Cadossi, Matteo; Sambri, Andrea; Grosso, Eugenio; Corrado, Bruno; Servodio Iammarrone, Fernanda

    2016-02-01

    Patellofemoral pain syndrome (PFPS) is a common cause of recurrent or chronic knee pain in young adults, generally located in the retropatellar region. Etiology is controversial and includes several factors, such as anatomical defects, muscular imbalance, or joint overuse. Good results have been reported with exercise therapy, including home exercise program (HEP). Joint inflammation with increase of pro-inflammatory cytokines levels in the synovial fluid might be seen especially when chondromalacia becomes evident. Biophysical stimulation with pulsed electromagnetic fields (PEMFs) has shown anti-inflammatory effects and anabolic chondrocyte activity. The purpose of this randomized controlled study was to evaluate if the combination of HEP with PEMFs was more effective than HEP alone in PFPS treatment. Thirty-one PFPS patients were enrolled in this study. All patients were instructed to train with HEP. Patients in the PEMFs group associated HEP with PEMFs. Function and pain were assessed with Victorian Institute of Sport Assessment score (VISA), Visual Analog Scale (VAS), and Feller's Patella Score at baseline at 2, 6, and 12 months of follow-up. Drug assumption was also recorded. Increase in VISA score was significantly higher in PEMFs group compared to controls at 6 and 12 months, as well as the increase in the Feller's Patella Score at 12 months. VAS score became significantly lower in the PEMFs group with respect to control group since 6 month follow-up. Pain reduction obtained with PEMFs enhanced practicing therapeutic exercises leading to a better recovery process; this is extremely important in addressing the expectations of young patients, who wish to return to sporting activities.

  5. Lateral dislocation of the patella: MR imaging findings; Stellenwert der MR-Tomographie bei traumatischen Patellaluxationen

    Energy Technology Data Exchange (ETDEWEB)

    Kreitner, K.F. [Klinik und Poliklinik fuer Radiologie, Johannes Gutenberg-Universitaet, Mainz (Germany); Grebe, P. [Klinik und Poliklinik fuer Radiologie, Johannes Gutenberg-Universitaet, Mainz (Germany); Runkel, M. [Klinik und Poliklinik fuer Unfallchirurgie, Johannes Gutenberg-Universitaet, Mainz (Germany); Schadmand-Fischer, S. [Klinik und Poliklinik fuer Radiologie, Johannes Gutenberg-Universitaet, Mainz (Germany); Meurer, A. [Klinik und Poliklinik fuer Orthopaedie, Johannes Gutenberg-Universitaet, Mainz (Germany)

    1995-07-01

    The MRIs of 31 patients with patellar dislocation were evaluated retrospectively. Hemarthrosis was found in 30/31, contusions of the lateral femoral condyle in 30/31 and of the medial patellar facet in 26/31 cases. Injury of the medial patellar retinaculum was seen in 28/31 cases. Osteochondral fractures were found in 18 patients; compared to arthroscopy there were one false-positive and 5 false-negative findings concerning loose cartilage bodies. In 7 cases, patellar dislocation was not suspected before MR imaging. (orig./MG) [Deutsch] Retrospektiv wurden die MR-Tomogramme des Kniegelenkes von 31 Patienten mit einer Patellaluxation ausgewertet. Ein Haemarthros lag in 30/31, eine Kontusion des lateralen Femurkondylus in 30/31 und der medialen Patellafacette in 26/31 Faellen vor. Eine Verletzung des medialen Retinakulums fand sich bei 28/31 Patienten. Osteochondrale Frakturen fanden sich bei 18 Patienten, im Vergleich zur Arthroskopie wurden bezueglich freier Gelenkkoerper ein falsch-positiver und 5 falsch-negative Befunde erhoben. In 7 Faellen war eine Patellaluxation klinisch nicht vermutet worden. (orig./MG)

  6. Radiological changes in the region of the patella in chronic alcoholics

    Energy Technology Data Exchange (ETDEWEB)

    Szanto, D.

    1982-07-01

    The author has reviewed the changes in the patello-femoral joint seen on plain films in 41 male alcoholics. These are due to the effect of hyperlipoproteinaemia type IV on the patello-femoral joint. These joints show bilateral secondary arthrosis. At the same time as these erosions and defects of the articular surface develop, there are also changes in the femoro-tibial joint.

  7. Effects of immobilization on thickness of superficial zone of articular cartilage of patella in rats

    Directory of Open Access Journals (Sweden)

    Khadija Iqbal

    2012-01-01

    Conclusion: Each segment of superficial zone behaves differentially on immobilization and remobilization. Perhaps a much longer duration of remobilization is required to reverse changes of immobilization in articular cartilage and plays a significant role in knee joint movements.

  8. A BIOMECHANICAL STUDY OF LATERAL RELEASE AND ELMSLIE-TRILLAT PROCEDURES TO RESTABILISETHE MALTRACKTNG PATELLA

    Directory of Open Access Journals (Sweden)

    MM. Tahmasbi

    1999-09-01

    Full Text Available  The resistant* of pateSa against lateral displacement (Le. the stability, was studied tinder a range of conditions in vitro, at a range of knee flexion angles. Muscle forces were applied in physiological directions along the separate quadriceps muscles. Normal muscle actions with constant tension showed constant patellar stability up to sixty degrees knee flexion, and then a significant increase at ninety degrees. A pathological knee was simulated by relaxing vastus medians, and ■ lateral stability then dropped by 47%. Isolated rttlnaeular release in the pathological knee did not improve stability significantly towards normal, while 6mm tibial tubercle medlaEsatum restored stabtBty by 52% towards normal, except neat JuM extension. Combined release phis tubercle medtafisathm. restored stability 59% towards normal In knee flexion, and 23% up to ten degrees flexion.

  9. Coordinated collagen and muscle protein synthesis in human patella tendon and quadriceps muscle after exercise

    DEFF Research Database (Denmark)

    Miller, Benjamin F; Olesen, Jens L; Hansen, Mette

    2005-01-01

    We hypothesized that an acute bout of strenuous, non-damaging exercise would increase rates of protein synthesis of collagen in tendon and skeletal muscle but these would be less than those of muscle myofibrillar and sarcoplasmic proteins. Two groups (n = 8 and 6) of healthy young men were studied...... collagen (0.077% h(-1)), muscle collagen (0.054% h(-1)), myofibrillar protein (0.121% h(-1)), and sarcoplasmic protein (0.134% h(-1))). The rates decreased toward basal values by 72 h although rates of tendon collagen and myofibrillar protein synthesis remained elevated. There was no tissue damage...... of muscle visible on histological evaluation. Neither tissue microdialysate nor serum concentrations of IGF-I and IGF binding proteins (IGFBP-3 and IGFBP-4) or procollagen type I N-terminal propeptide changed from resting values. Thus, there is a rapid increase in collagen synthesis after strenuous exercise...

  10. Medial release and lateral imbrication for intractable anterior knee pain: diagnostic process, technique, and results

    Directory of Open Access Journals (Sweden)

    Meldrum AR

    2015-01-01

    Full Text Available Alexander R Meldrum,1 Jeremy R Reed,2 Megan D Dash3 1Department of Surgery, Section of Orthopedic Surgery, University of Calgary, Calgary, AB, Canada; 2Department of Surgery, University of Saskatchewan College of Medicine, Regina, SK, Canada; 3Department of Family Medicine, College of Medicine, University of Saskatchewan, Regina, SK, Canada Purpose: To present two cases of intractable patellofemoral pain syndrome treated with a novel procedure, arthroscopic medial release, and lateral imbrication of the patellar retinaculum. Patients and methods: This case series presents the treatment of three knees in two patients (one bilateral in whom an all-inside arthroscopic medial release and lateral imbrication of the patellar retinaculum was performed. Subjective measurement of pain was the primary outcome measurement, and subjective patellofemoral instability was the secondary outcome measurement. Results: Subjectively the two patients had full resolution of their pain, without any patellofemoral instability. Conclusion: Medial release and lateral imbrication of the patellar retinaculum is a new surgical procedure that has been used in the treatment of intractable patellofemoral pain syndrome. This is the first report of its kind in the literature. While outcome measurements were less than ideal, the patients had positive outcomes, both functionally and in terms of pain. Keywords: anterior knee pain syndrome, chondromalacia patellae, runners knee, patellar chondropathy, patellofemoral dysfunction, patellofemoral tracking disorder

  11. Kinematic CT and MR imaging of the patellofemoral joint

    Energy Technology Data Exchange (ETDEWEB)

    Muhle, C.; Brossmann, J.; Heller, M. [Klinik fuer Radiologische Diagnostik, Christian-Albrechts-Universitaet, Kiel (Germany)

    1999-04-01

    Anterior knee pain is a frequently encountered orthopedic symptom and is often associated with patellofemoral malalignment, which may cause chondromalacia of the patella. The difficulty in determining the patellar position between 0 and 30 of knee flexion with a conventional axial radiographic examination is well known. The introduction of computed tomography (CT) and magnetic resonance (MR) imaging for the diagnosis of knee joint abnormalities has enabled assessment of the patellar position in this critical range. More recently, emphasis has been placed on dynamic visualization of patellar motion to detect an abnormal tracking pattern. The important influence of the quadriceps muscle on the patellar tracking pattern is well known and has been examined during active knee extension by the use of ultrafast CT, and motion-triggered and ultrafast MR imaging. This article provides an overview of the current status of kinematic CT and MR imaging in the diagnosis of patellofemoral alignment, its clinical implications, and future directions. (orig.) With 13 figs., 5 tabs., 47 refs.

  12. 中医治疗髌骨软化症的现状

    Institute of Scientific and Technical Information of China (English)

    范春兰

    2012-01-01

    @@ 髌骨软化症(Chondromalacia Patellae,CP)又叫髌骨软骨炎,髌骨软骨软化症.髌骨软化症是膝前痛的常见原因之一,对城乡2745例进行了髌骨软化症普查发现其患病率为36.2%[1],在各年龄阶段均可发病,其病理特点为髌骨软骨软化、水肿、破碎进而出现软骨下骨裸露、骨硬化、滑膜水肿,出现无菌性炎症、关节渗液等病理变化.临床表现为前膝痛,尤其以髌骨后疼痛为著,打软腿,股四头肌萎缩,反复膝关节积液,上下楼梯及下蹲困难或症状加重而进一步发展成为膝骨关节病.

  13. 髌骨软化症非手术治疗进展

    Institute of Scientific and Technical Information of China (English)

    王正

    2003-01-01

    @@髌骨软化症实际上是髌骨软骨软化症(chondromalacia of patella,简称CP),也有称为髌骨软骨病或髌股痛,是髌股关节软骨的一种退行性病变。其特点是髌骨关节面的软骨水肿,软化,进而破裂;软骨下骨质裸露,增生,硬化而出现膝关节疼痛,肿胀,活动受限。中医认为系风、寒、湿、瘀等邪侵袭关节,阻遏局部,气血营卫失调所致。对CP的普查结果发现,其患病率高达36.2%,且女性发病率高于男性[1]。CP是临床常见病、多发病,也是骨科面临的一个难题。现就近十年来国内对CP的非手术治疗的进展情况综述如下。

  14. 中医治疗髌骨软化症的现状

    Institute of Scientific and Technical Information of China (English)

    范春兰

    2012-01-01

    髌骨软化症(Chondromalacia Patellae,CP)又叫髌骨软骨炎,髌骨软骨软化症.髌骨软化症是膝前痛的常见原因之一,对城乡2745例进行了髌骨软化症普查发现其患病率为36.2%[1],在各年龄阶段均可发病,其病理特点为髌骨软骨软化、水肿、破碎进而出现软骨下骨裸露、骨硬化、滑膜水肿,出现无菌性炎症、关节渗液等病理变化.临床表现为前膝痛,尤其以髌骨后疼痛为著,打软腿,股四头肌萎缩,反复膝关节积液,上下楼梯及下蹲困难或症状加重而进一步发展成为膝骨关节病.

  15. 中药外洗配合手法按摩治疗髌骨软化症%Treating CP in TCM plus manual massage

    Institute of Scientific and Technical Information of China (English)

    陈桂林; 钱南平; 杜兵强; 李广

    2012-01-01

      目的:观察中药外洗配合手法按摩治疗髌骨软化症的疗效.方法:采用中药外洗髌骨部,手法点揉膝关节周围痛点、穴位,配合股四头肌锻炼治疗髌骨软化症.结果:总有效率97.9%.提示:本方法对髌骨软化症具有改善血液循环,缓解疼痛症状的功效.%  Objective: To observe the curative effect of external washout in TCM plus manual massage in treating chondromalacia patellae (CP). Methods: Washed the whirbone in TCM, kneaded the pain spots and acupoints around knee joint, plus musculus quadriceps fexoris training to treat CP. Results: The total effective rate was 97.9%. Conclusion: The method had obvious effect in improving blood circulation and relieving pains of CP.

  16. 中医手法加中药内服治疗髌骨软化症64例

    Institute of Scientific and Technical Information of China (English)

    朱磊

    2009-01-01

    @@ 髌骨软化症(chondromalacia patellae,CP),又称髌骨软骨软化症、髌骨软骨炎.髌骨软骨软化是一种中老年多发的退行性膝关节病变,是常见的膝关节慢性劳损性疾病,是一种由各种原因导致髌骨关节软骨发生退变而引起膝部疼痛无力的疾病.主要病理变化是软骨的退行性改变,包括软骨的肿胀、碎裂、脱落,最后可引起股骨踝的对应部位也发生同样的病变.从而导致髌股关节骨性关节炎.据调查发现,髌骨软化症患病率达36.2%,且女性发病率高于男性.作者自2000~2006

  17. Luxación intra-articular de rótula Intra-articular dislocation of patella

    OpenAIRE

    2006-01-01

    Presentamos el caso de una paciente de 73 años de edad que, tras una caída accidental en las escaleras, sufrió una luxación intra-articular aguda de rótula de la rodilla izquierda. Esta luxación excepcional presentaba incarceración del polo proximal rotuliano en el surco intercondíleo femoral. Se realizó reducción bajo anestesia general debido al dolor y contractura muscular en los intentos de reducción sin anestesia. Realizamos revision quirúrgica que descartó lesiones asociadas del aparato ...

  18. Functional and structural changes in m. vastus lateralis and m. vastus medialis in cases of meniscopathy and chondropathia patellae.

    Science.gov (United States)

    Pieper, K S; Bähr, B; Biskop, M; Paul, B; Gärtner, C; Förster, E

    1986-01-01

    The skeletal muscle undergoes selective cellular changes in the sense of the myopathic and neurogeneous tissue syndrome, in the case of degenerative joint diseases. The occurring FT-fibre atrophy is coupled with a decrease of the glycolytic activity and of the LDH isoenzyme pattern. A neurogeneous component is under discussion.

  19. Bifocal osseous avulsion of the patellar tendon from the distal patella and tibial tuberosity in a child.

    Science.gov (United States)

    Hermansen, Lars L; Freund, Knud G

    2016-03-01

    This case report describes a 12-year-old boy, who suffered an injury to the right knee in a skateboard accident. Radiographs and surgery confirmed the extremely rare bifocal avulsion fracture including the distal patellar pole and tibial tuberosity. Open reduction and internal fixation was accomplished, and 4-month follow-up demonstrated a good outcome.

  20. Influence of the pneumatic tourniquet on patella tracking in total knee arthroplasty: a prospective randomized study in 100 patients

    DEFF Research Database (Denmark)

    Husted, Henrik; Toftgaard Jensen, T

    2005-01-01

    One hundred consecutive patients with osteoarthritis of the knee joint and scheduled for primary total knee arthroplasty performed in a bloodless field were prospectively randomized to have the tourniquet inflated on either straight leg or maximally flexed knee. There was no difference in the num...

  1. Luxación intra-articular de rótula Intra-articular dislocation of patella

    Directory of Open Access Journals (Sweden)

    S. García-Mata

    2006-08-01

    Full Text Available Presentamos el caso de una paciente de 73 años de edad que, tras una caída accidental en las escaleras, sufrió una luxación intra-articular aguda de rótula de la rodilla izquierda. Esta luxación excepcional presentaba incarceración del polo proximal rotuliano en el surco intercondíleo femoral. Se realizó reducción bajo anestesia general debido al dolor y contractura muscular en los intentos de reducción sin anestesia. Realizamos revision quirúrgica que descartó lesiones asociadas del aparato extensor, partes blandas, estructuras articulares y osteofitos. Presentaba artrosis avanzada, sobre todo fémoro-patelar. Tras dos semanas de inmovilización reinició movilidad. No ha presentado recidiva u otro tipo de complicaciones.The case of a patient aged 73 years who, following an accidental fall on a staircase, suffered an acute intraarticular dislocation in the left knee-cap is presented. This exceptional dislocation presented incarceration of the proximal kneecap pole in the femoral intercondylar groove. A reduction was carried out under general anaesthetic due to pain and muscular contraction in the attempts at reduction without anaesthetic. We made a surgical check that ruled out associated lesions to the extensor apparatus, soft parts, joint structures and osteophytes. The patient presented advanced arthrosis, above all femoral-patellar. Following two weeks of immobilisation, the patient restarted mobility. There has been no relapse or other type of complication.

  2. Effect of anti-inflammatory medication on the running-induced rise in patella tendon collagen synthesis in humans

    DEFF Research Database (Denmark)

    Christensen, Britt; Dandanell, Sune; Kjaer, Michael;

    2011-01-01

    NSAIDs are widely used in the treatment of inflammatory diseases as well as of tendon diseases associated with pain in sports and labor. However, the effect of NSAID intake, and thus blockade of PGE(2) production, on the tendon tissue adaptation is unknown. The purpose of the present study...

  3. Comparison of Indirect MR Arthrography With Conventional MRI in the Diagnosis of Knee Pathologies in Patients With Knee Pain

    Directory of Open Access Journals (Sweden)

    Babaei Jandaghi

    2016-03-01

    Full Text Available Background Knee pain is a common problem in the general population. In order to determine the extent of the injury and the appropriate treatment, MRI provides the most accurate imaging method. This may be done through conventional MRI techniques or by injecting a contrast material (MR arthrography. Objectives The purpose of this study was to compare the diagnostic value of these two methods. Patients and Methods The study involved the diagnostic evaluation on 60 patients with knee pain who received treatment over the course of a one-year period. Referred patients were randomly divided into two groups: indirect MR arthrography was performed on one group, and conventional MRI was performed on the other group. Both groups then underwent arthroscopy. The results from both groups were compared with the arthroscopic findings. Results In all of the pathologies studied, the sensitivity, specificity, and the positive and negative predictive values were evaluated. A high rate of accuracy was found between MR arthrography and arthroscopy (P < 0.05 for all knee injuries, however a similar rate of accuracy between conventional MRI and arthroscopy was only seen in patients with damage to the posterior cruciate ligament (PCL, the tibio-femoral articular cartilage, and patella chondromalacia (P < 0.05. The highest rate of accuracy was seen in cases where indirect MR arthrography was used for the diagnosis of anterior cruciate ligament (ACL damage (K = 1. Conclusions Our results have shown that indirect MR arthrography had greater diagnostic accuracy in regards to the sensitivity, specificity, and positive and negative predictive values than conventional MRI in knee pathologies.

  4. 针灸治疗疑难杂症两则

    Institute of Scientific and Technical Information of China (English)

    吴建军; 戚玲娟

    2008-01-01

    @@ 针灸治疗疑难病症是中医学的特色之一,在中医理论的指导下对临床不常见以及症情复杂的疾病如能准确辨证,取穴精当,灵活运用适宜手法,常能获得满意的疗效.兹录治验两则,以为佐证. 1 髌骨软化症(chondromalacia patellae,CP) 王某,女,57岁,2006年7月14日来就诊.患者右侧膝关节疼痛2年,受寒则疼痛加重,尤以屈膝或上下楼梯时疼痛加剧.查体:右髌骨内侧明显压痛,伸膝时可听及摩擦音,推髌骨抗阻试验阳性及单腿半蹲试验阳性.辅助检查:血沉12mm/1小时,抗"O"<500U;MRI示右侧髌骨软骨轮廓不规则,软骨下骨可见两个囊状长T1、T2低密度影.其余骨及关节软骨形态、内外侧半月板、内外侧副韧带及前后交叉韧带显示良好,关节腔未见积液,周围软组织无明显肿胀.诊断为髌骨软化症.

  5. Routine patellar resurfacing using an inset patellar technique.

    LENUS (Irish Health Repository)

    Hurson, Conor

    2012-02-01

    The management of the patella in total knee arthroplasty still causes controversy. Whether or not to resurface the patella in primary total knee arthroplasty remains unclear. In this study we examined 220 consecutive total knee replacements, by a single surgeon, where the patella was routinely resurfaced using the inset technique. All patellae were suitable for resurfacing. Patellar thickness was not altered in 54.5% of patellae. In 97.2% the patella was within 2 mm of the original thickness. There were no significant complications. In this study we have found that the inset technique of patella resurfacing in total knee replacement is a simple and safe resurfacing procedure.

  6. Resultados de artroplastia total de joelho com e sem implante de recapeamento (resurfacing patelar Results of total knee replacement with/without resurfacing of the patella

    Directory of Open Access Journals (Sweden)

    Abdul Khan

    2012-01-01

    Full Text Available OBJETIVO: Estudar a diferença de dor, estalido e crepitação patelofemoral no pós-operatório em pacientes com ou sem recapeamento patelar após 5 anos, os quais tinham dor patelofemoral antes da cirurgia. Estudar a incidência de dor, estalido e crepitação patelofemoral depois de pateloplastia em ambos os grupos. MÉTODOS: Revisão retrospectiva de 765 pacientes submetidos a artroplastia total do joelho (ATJ com ou sem recapeamento patelar. Os pacientes foram perguntados sobre dor pré e pós-operatória, 5 anos depois da cirurgia. Foram examinados por enfermeiro especializado 5 anos, após a cirurgia para verificar estalidos ou crepitação patelofemoral (PF. RESULTADOS: 688 pacientes (89,9% tinham dor PF pré-operatória. De 688 pacientes, 449 tinham recapeamento patelar (R e 239 não tinham (NR. Trinta e seis pacientes do grupo NR tinham pateloplastia. A incidência de dor PF pós-operatória foi 13,3% no grupo R e 13,6% no grupo NR. A incidência de estalido PF pós-operatório no grupo R foi 10,4% e apenas 1,3% no grupo NR (estatisticamente significante, p OBJECTIVE: To study the difference of post-op patellofemoral pain, clunk and crepitus in patients with/without resurfacing at 5 years who had pre-op patellofemoral pain. To study the incidence of post-operative patellofemoral pain, clunk and crepitus following patelloplasty in both the groups. METHODS: Retrospective review of 765 patients who had total knee replacement with/without resurfacing.Patients were asked about both pre-operative pain and also post-operative pain 5 years after the operation. Patients were examined by a specialist nurse at 5 years post-operatively to check for any patellofemoral clunk/crepitus. RESULTS: 688 patients (89.9% had preoperative PF pain. Of 688 patients, 449 had patellar resurfacing and 239 had not (NR. Thirty-six patients from the NR group had patelloplasty. The incidence of postoperative PF pain was 13.3% in the R group and 13.6% in the NR group. The incidence of postoperative PF clunk in was 10.4% in the R group and only 1.3% in the NR group (statistically significant, p < 0.005 compared to the R group. CONCLUSION: In patients with pre-op PF pain, there is significant (p<0.005 higher incidence of post-op clunk in the R group. In patients without pre-op PF pain, there is significantly (p<0.005 higher incidence of post-op crepitus in the R group. In patients with/without pre-op PF pain, the incidence of post-op PF pain, clunk and crepitus is lower than in patients who underwent patelloplasty when compared to the other members of the NR group (statistically significant p<0.005. Level of Evidence Type 4, Case Series.

  7. 髌骨骨折不同治疗方法的临床疗效分析%Clinical Effect of Different Treatment Methods for Patella Fracture

    Institute of Scientific and Technical Information of China (English)

    鲁春民

    2016-01-01

    目的:研究不同方法治疗髌骨骨折的临床效果。方法选择2014年6月~2015年6月诊治的230例髌骨骨折患者,根据治疗方法不同分为3组,分别应用改良克氏针张力带方式治疗、空心螺丝钉张力带治疗以及髌骨爪内固定方法治疗,比较3组患者的临床治疗效果以及并发症的发生率。结果髌骨爪内固定治疗的效果比其他两种方法好,而且并发症发生率比其他两种方法低,差异有统计学意义(P<0.05)。结论髌骨骨折患者应用髌骨爪内固定治疗的临床效果显著,尤其是针对粉碎性髌骨骨折的患者,如为单纯的横行骨折,可应用克氏针张力带方法进行治疗,临床医生应根据情况选择治疗方法。%Objective To study the clinical effect of different methods in the treatment of patelar fracture.Methods 230 cases of patelar fracture patients from June 2014 to June 2015 who were diagnosed and treated in our hospital were divided into three groups according to different treatment methods,they were respectively treated with modified kirschner wire tension band,holow screws and concentratorinternal fixation of tension band,clinical curative effect and complications among three groups were compared.Results By comparison,the effect of concentratorinternal fixation was obviously better than the other two approaches,and the probability of complications was significantly lower than the other two methods,the difference was statisticaly significant(P<0.05).ConclusionThe clinical effect of patela concentratorinternal fixation in the treatment of patients with fracture is significant, especialy for comminuted patelar fracture patients,such as simple fracture, kirschner wire and tension band method can be used,clinicians should chose difference methods according to different conditions.

  8. 髌腱及股四头肌腱断裂的诊断与治疗%Patella ligament and femoral quadriceps tendon rupture

    Institute of Scientific and Technical Information of China (English)

    贺良; 王陶; 王满宜; 荣国威

    2002-01-01

    目的探讨髌腱及股四头肌腱断裂的诊断与治疗问题. 方法 23例髌腱及股四头肌腱断裂的患者.股四头肌或股四头肌腱断裂12例(急性股四头肌或股四头肌腱损伤7例,陈旧性股四头肌或股四头肌腱损伤5例).髌腱断裂11例(急性髌腱损伤共8例,陈旧性髌腱损伤共3例).回顾性统计患者的年龄、致伤原因、损伤性质、症状、体征、辅助检查、受伤至手术时间间隔、手术治疗方式、制动情况、膝关节活动度、功能恢复情况(采用Lysholm评分.积分达95分以上者为优秀,94~85分为良好,84~65分为尚可,小于65分为差)、髌骨位置高低(Insall方法)及满意程度. 结果 23例髌腱及股四头肌腱断裂患者平均随访期为6年(4个月~11年6个月).3例因联系方式失效而失访.急性股四头肌或肌腱断裂急诊修复者5例优秀,2例良可.急性髌腱断裂急诊修复8例均为优秀.陈旧性股四头肌及股四头肌腱损伤5例,2例为优秀(3例失访).陈旧性髌腱断裂重建结果为优秀1例,优良2例. 结论手术治疗髌腱及股四头肌腱断裂,急性髌腱及股四头肌腱断裂早期修复有很好的预后.陈旧性损伤的预后劣于急性髌腱及股四头肌腱断裂早期修复,但经过治疗亦可取得较为满意的结果.

  9. 关节腔内注射透明质酸钠治疗髌骨软化症疗效观察

    Institute of Scientific and Technical Information of China (English)

    才久波

    2007-01-01

    髌骨软化症(chondromalacia patellae,CP),又称髌骨软骨炎,是引起膝前痛的常见原因之一。其患病率高达36.2%,且女性高于男性[1]。临床以髌股关节疼痛,膝前痛为主要表现,其机制目前尚未明了。我们从2003-05~2005-11用透明质酸钠治疗髌骨软化症36例,随访3mo~6mo,取得比较满意疗效。现将结果报道如下。1资料与方法1.1一般资料本组53例58膝,其中男17例,女36例;年龄18.40岁36例,41.55岁14例,60岁以上3例,临床主要以膝关节疼痛,下楼下蹲疼痛加重,行走受限。临床体征:髌骨、髌周、髌骨缘以及髌骨后方压痂明显,并伴有关节积液。恐惧试验阳性,下蹲试验阳性。其中6例出现类似半月板损伤的绞索及打软腿表现。X线表现髌骨排列紊乱,股骨外髁发育不良。1.2方法常规消毒,髌骨内侧缘进针,如果关节有积液先抽净积液,然后注入透明质酸钠,被动活动数次后,包扎针孔,一周一次,连续四周,治疗期间减少患肢负重,避免上下楼梯及下蹲动作,同时练习股四头肌肌力,不使用解热镇痛药、抗菌素及激素类药物。1.3观察指标及分级观察指标包括症状、体症、功能症状指标有疼痛1项,按4级记录。1分:疼痛...

  10. 髌骨抓与张力带克氏针固定横行髌骨骨折术后早期锻炼临床效果分析%Clinical Effect Analysis of Early Postoperative Exercise After Patella Grasping and Tension Band Fixation With Patella Fracture

    Institute of Scientific and Technical Information of China (English)

    田志国; 于鉴筠

    2016-01-01

    Objective Analysis of patela catching and tension band gram fixed needle transverse patelar fracture early postoperative exercise of effect.Methods Transverse patelar fracture patients 30 cases were randomly divided into experimental group and control group. Both groups accepted patelar grasp and tension with gram fixed needle treatment and conventional nursing,the experimental group with early exercise measures at the same time.Results Experimental group nursing satisfaction and was higher than the control group,P<0.05.Conclusion Transverse patelar fracture early postoperative patients with positive guidance to do the right amount of exercise,can improve the curative effect and nursing quality.%目的:分析髌骨抓与张力带克氏针固定横行髌骨骨折术后早期锻炼的效果。方法将横行髌骨骨折患者30例随机等分成实验组与对照组。两组都接受髌骨抓与张力带克氏针固定治疗及常规护理,实验组同时加用早期锻炼措施。结果实验组护理满意度与优良率高于对照组, P<0.05。结论横行髌骨骨折术后积极指导患者做适量的早期锻炼,可提高疗效及护理质量。

  11. 髌骨骨折聚髌器内固定术后早期功能锻炼疗效观察%Effect of the early function exercise after the operation of internal fixation with patella gatherer on fracture of patella

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@ Backgrand: After incision,correction and internal fixation with Kirschner pins and steel pins, many patients has been observed to have joints dysfunction even rigidity after the elimination of more than 4 weeks knee's extention movement under outer fixation protection which is necessary. Unit: Red Cross Hospital of Jingjiang City.

  12. Disease: H00464 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available ndrome; Ear-patella-short statute syndrome Patella dysplasias are a group of disorders that include aplasia/hypoplasia...oplasia: a rare constituent of congenital syndromes. Acta Orthop Belg 69:29-34 (200... the nail-patella syndrome. Pediatr Radiol. 27:432-5 (1997) PMID:12666288 (description) Sferopoulos NK, Tsitouridis I Ischiopubic hyp

  13. Comparative evaluation of patellar height methods in the Brazilian population

    Directory of Open Access Journals (Sweden)

    Christian Behrendt

    2016-02-01

    Full Text Available ABSTRACT OBJECTIVE: The methods most used for patellar height measurement were compared with the plateau-patella angle method. METHODS: A cross-sectional study was conducted, in which lateral-view radiographs of the knee were evaluated using the three methods already established in the literature: Insall-Salvati (IS, Blackburne-Peel (BP and Caton-Deschamps (CD. These were compared with the plateau-patella angle method. One hundred and ninety-six randomly selected patients were included in the sample. RESULTS: The data were initially evaluated using the chi-square test. This analysis was deemed to be positive with p < 0.0001. We compared the traditional methods with the plateau-patella angle measurement, using Fisher's exact test. In comparing the IS index with the plateau-patella angle, we did not find any statistically significant differences in relation to the proportion of altered cases between the two groups. The traditional methods were compared with the plateau-patella angle with regard to the proportions of cases of high and low patella, by means of Fisher's exact test. This analysis showed that the plateau-patella angle identified fewer cases of high patella than did the IS, BP and CD methods, but more cases of low patella. In comparing pairs, we found that the IS and CD indices were capable of identifying more cases of high patella than was the plateau-patella angle. In relation to the cases of low patella, the plateau-patella angle was capable of identifying more cases than were the other three methods. CONCLUSIONS: The plateau-patella angle found more patients with low patella than did the classical methods and showed results that diverged from those of the other indices studied.

  14. Comparative evaluation of patellar height methods in the Brazilian population☆

    Science.gov (United States)

    Behrendt, Christian; Zaluski, Alexandre; e Albuquerque, Rodrigo Pires; de Sousa, Eduardo Branco; Cavanellas, Naasson

    2015-01-01

    Objective The methods most used for patellar height measurement were compared with the plateau–patella angle method. Methods A cross-sectional study was conducted, in which lateral-view radiographs of the knee were evaluated using the three methods already established in the literature: Insall–Salvati (IS), Blackburne–Peel (BP) and Caton–Deschamps (CD). These were compared with the plateau–patella angle method. One hundred and ninety-six randomly selected patients were included in the sample. Results The data were initially evaluated using the chi-square test. This analysis was deemed to be positive with p < 0.0001. We compared the traditional methods with the plateau–patella angle measurement, using Fisher's exact test. In comparing the IS index with the plateau–patella angle, we did not find any statistically significant differences in relation to the proportion of altered cases between the two groups. The traditional methods were compared with the plateau–patella angle with regard to the proportions of cases of high and low patella, by means of Fisher's exact test. This analysis showed that the plateau–patella angle identified fewer cases of high patella than did the IS, BP and CD methods, but more cases of low patella. In comparing pairs, we found that the IS and CD indices were capable of identifying more cases of high patella than was the plateau–patella angle. In relation to the cases of low patella, the plateau–patella angle was capable of identifying more cases than were the other three methods. Conclusions The plateau–patella angle found more patients with low patella than did the classical methods and showed results that diverged from those of the other indices studied. PMID:26962492

  15. 濒危帽贝铁锈笠螺的活动节律和采食行为的初步观察%Preliminary observations on activity rhythms and foraging behaviour in the endangered limpet Patella ferruginea

    Institute of Scientific and Technical Information of China (English)

    Free ESPINOSA; Alexandre R. GONZ(A)LEZ; Manuel J. MAESTRE; Darren FA; José M. GUERRA-GARC(I)A; José C. GARC(I)A-G(O)MEZ

    2007-01-01

    铁锈笠螺是地中海最濒危的海洋无脊椎动物,对其生物学知之甚少,缺少对其活动节律和采食行为的了解.使用环氧树脂Eporai 1127 原位标记了20个不同外壳长度的个体,并在每个外壳上标有不同的数字,作者在白昼或黑夜的高潮和低潮期收集了有关数据.可能由于云斑厚纹蟹(Pachygrapsus marmoratus)的捕食影响,铁锈笠螺白天的活动和运动多于夜间,但铁锈笠螺采食行为似乎仅限于高潮期.此外,汹涌的海面条件诱导了铁锈笠螺的活动和运动.

  16. Arthroscopic medial patellofemoral ligament reefing plus lateral patella retinaculum lysis in treatment of patellofemoral pain syndrome%关节镜下治疗髌股关节疼痛综合征的临床观察

    Institute of Scientific and Technical Information of China (English)

    唐刚健; 靳嘉昌; 柴晟

    2008-01-01

    目的 探讨治疗髌股关节疼痛综合征的手术疗效.方法 将100例髌股关节疼痛综合征患者随机分为治疗组和对照组各50例.所有手术均在关节镜下进行,治疗组采用内侧髌股韧带紧缩、髌骨外侧支持带松解术式治疗.对照组采用临床广泛使用单一外侧髌韧带松解手术治疗.结果 平均随访13个月,采用kujala评分系统评价疗效,治疗组平均积分(76.66±5.255 16),对照组(69.36±3.421 18)(P<0.05).结论 与外侧支持带松解术式相比,本术式更能纠正髌股关节的病理运动轨迹,使髌股关节内外侧问隙平衡更为容易,对髌前疼痛的缓解更有效,术后无关节内血肿、髌骨坏死和髌骨脱位等并发症发生.

  17. 不同内固定方法治疗髌骨骨折的效果探析%Comparative Study on Different Internal Fixation Methods Effects in Treatment of Patella Fracture

    Institute of Scientific and Technical Information of China (English)

    林琳

    2015-01-01

    Objective Clinical effects of different internal fixation Methods in treatment of patela fracture are to be comparatively studied.Methods Choose 35 patients with patela fracture who are treated in hospital from January 2012 to May 2015 and separate them into control group (26 patients) and study group (27 patients) at random and then make an observation and comparative study on treatment effects of ring wire internal fixation treatment and memory aloy patela concentrator internal fixation treatment between two groups.Results Treatment efficacy in study group is 92.6%, which is much higher than 73.1% in control group; and patients' post-surgical recovery are much better than that of patients in control group; there is a differential between two groups and such a differential has statistic value (P<0.05).Conclusion sMemory aloy patela concentrator internal fixation treatment is of efficacy in treatment of patients with patela fracture; it is conducive to improving patients' joint recovery and reducing fracture healing time; thus, such a treatment is quite worthwhile to be promoted and applied widespread.%目的 对不同内固定方法治疗髌骨骨折的临床效果进行分析比较.方法 选取于2012年1月~2015年5月期间在我院接受治疗的53例髌骨骨折患者,根据不同的内固定方法将患者随机分为对照组(26例)和治疗组(27例)进行对照研究,观察并比较环形钢丝内固定法与记忆合金抓髌器内固定术的效果.结果 治疗组患者的优良率为92.6%,显著高于对照组患者的73.1%;同时治疗组患者的术后恢复情况显著优于对照组,差异显著,有统计学意义(P<0.05).结论 记忆合金抓髌器内固定术治疗髌骨骨折的效果显著,关节功能恢复更理想,并且骨折愈合时间短,值得大力推广.

  18. Lateral retinacular release and patella ligament reconstruction under arthroscopy for recurrent patellar dislocations%外侧支持带松解联合髌骨韧带重建修复复发性髌骨脱位

    Institute of Scientific and Technical Information of China (English)

    陈辉; 王群; 燕双喜; 董天云; 邹海兵

    2015-01-01

    背景:关节镜检查能够直接动态观察髌股关节的对合关系,准确了解髌股关节异常是否可以完全纠正。目的:分析关节镜下外侧支持带松解联合髌骨韧带重建对复发性髌骨脱位的临床疗效。方法:复发性髌骨脱位患者共58例,随机将其分为对照组和观察组各29例,对照组患者给予常规手术行外侧支持带松解联合髌骨韧带重建,观察组患者给予关节镜下外侧支持带松解联合髌骨韧带重建。结果与结论:治疗前两组患者的Lysholm评分和Kujala评分的比较,差异均无显著性意义(P >0.05);治疗12个月后两组患者的Lysholm评分和Kujala评分均升高,且观察组升高的更明显(P 0.05);治疗12个月后两组患者的适合角和外侧髌股角CT测量值均降低,且观察组降低的更明显(P 0.05), but at 12 months after treatment, the Lysholm and Kujala scores were both increased in the two groups, especialy in the treatment group (P 0.05), and CT measurement values of the congruence angle and lateral patelofemoral angle were both decreased in the two groups, especialy in the experimental group, at 12 months after treatment. In addition, the operation time, healing time, and total effective rate were better in the experimental group than the control group (P < 0.05). These results indicate that the lateral retinacular release and ligament reconstruction under arthroscopy has a better effect on recurrent patelar dislocation.

  19. Clinical Analysis of the Treatment of Patella Transverse Fracture With the Compression Screw%可埋头加压螺钉治疗髌骨横行骨折的临床分析

    Institute of Scientific and Technical Information of China (English)

    李光千

    2015-01-01

    Objective To analyze the clinical efficacy of patela transverse fracture with the compression screw.Methods In our hospital, 54 cases of patela fracture patients were randomly divided into two groups (countersunk screws plus) and control group (tension band wire fixation).ResultsThe mean operation time, fracture healing time compared with the control group was statisticaly significant (P 0.05) and he postoperative complication rate of the observation group was lower than that of the control group (P0.05);且观察组术后并发症发生率低于对照组(P<0.01)。结论可埋头加压螺钉治疗髌骨横行骨折具有临床疗效。

  20. Gd-DTPA enhanced MR-follow-up of autologous patellar ligament transplants for anterior cruciate ligament repair. Gadolinium-DTPA gestuetzte MRT zur Beurteilung des Einheilens von autologen Ligamentum-patellae-Transplantaten als vorderer Kreuzbandersatzplastik

    Energy Technology Data Exchange (ETDEWEB)

    Tosch, U.; Felix, R. (Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik); Hertel, P.; Bernard, M. (Freie Univ. Berlin (Germany). Unfallchirurgische Abt. Martin-Luther Krankenhaus); Lais, E. (Freie Univ. Berlin (Germany). Unfallchirurgische Abt. Klinikum Rudolf Virchow)

    1993-01-01

    Eighteen patients with autologous patellar tendon transplant for reconstruction the anterior cruciate ligament were examined postoperatively. The time between operation and MR study was up to 3 weeks in ten patients, between 3 and 35 weeks in three patients and more than 35 weeks in five patients. In all patients, Gd-DTPA enhancement on the surface of the ligamentous transplant was visualized. This enhancement was between 1 and 10 mm thick. In all patients, complete stability of the knee joint was postoperatively. In 15 patients achieved flexion and extension were normal at the postoperative investigation. Three patients had a limitation of knee movement. In these MR studies, significant hyperplasia of the synovial membrane of the entire joint was diagnosed, explaining the persisting problems. Gd-DTPA-enhanced MR of the knee joint allows non-invasive documentation of remodelling following a patellar ligament transplant and possible complications. (orig.).

  1. 髌骨骨软骨冠状面骨折伴股四头肌腱断裂1例%A case of coronal fracture of patella with rupture of the quadriceps tendon

    Institute of Scientific and Technical Information of China (English)

    明立功; 明新杰; 明新广

    2001-01-01

    @@患者,女,25岁,于1999年8月30日因电锯伤致右膝部致疼痛、流血伴活动受限,在当地行清创缝合术,术后1天来院诊治。查体:右下肢伸膝位,关节肿胀,髌骨上缘约1.0 cm处有10 cm长横弧形伤口(已缝合),局部压痛明显,触及有骨擦感,浮髌试验阳性。右膝关节拒动,抬腿不能,足趾无麻木,末梢血运良好。侧位X线片示右髌骨较健侧变薄,且可见一骨块上移(图1)。诊断:右髌骨骨软骨冠状面开放性骨折。于1999年9月20日在连续硬膜外麻醉下行切开复位内固定术。取右膝关节内侧改良纵弧形切口。

  2. 分体式髌骨爪内固定治疗髌骨骨折效果探讨%Effect Analysis of the Treatment of Patellar Fracture by Internal Fixation with Split Type of Patella

    Institute of Scientific and Technical Information of China (English)

    孙勇

    2015-01-01

    Objective To explore patel a claws separate the ef ect of internal fixation treatment of patel a fracture.Methods From January 2013~June 2015 for the treatment of 50 cases of patel ar fracture patients,the implementation of internal fixation for treatment of patel a claw of separate patients with retrospective analysis of clinical therapeutic ef ect.Results 50 cases of patel ar fracture patients with patel ar claw internal fixation for treatment of separate treatment of fine rate was 98%.Conclusion Internal fixation treatment of patel a fracture of patel a claw separate,not only the simple operation,good rigidity,and shorter operation time,do not need special auxiliary equipment,reduce the occur ence of complications.%目的:探析分体式髌骨爪内固定治疗髌骨骨折的效果。方法选取我院2013年1月~2015年6月治疗的50例髌骨骨折患者,实施分体式髌骨爪内固定进行治疗,回顾分析患者的临床治疗效果。结果50例髌骨骨折患者使用分体式髌骨爪内固定进行治疗,治疗优良率是98%。结论分体式髌骨爪内固定治疗髌骨骨折,不仅操作简单,固定性好,而且手术时间较短,不需要特殊器械的辅助,减少并发症的发生。

  3. [Displacement of the tibial tuberosity in retropatellar cartilage damage and recurrent patellar dislocation].

    Science.gov (United States)

    Krause, R; Paar, O; Bernett, P; Mayr, B

    1989-02-01

    In our hospital in the years 1980 till 1986 37 displacements of the tuberositas tibiae were performed in chondropathia patellae and recurrent luxation of the patella. The follow-up examination took into consideration the radiological and clinical findings, the subjective complaints and the ability of going in for sports. These clinical experiences and pressure measurements in the femoro-patellar joint show the best results after the displacement of the tuberositas tibiae according to Blauth. Additionally we recommend an accurate indication for chondropathia patellae and recurrent luxation of the patella and accompanying surgical measures.

  4. Simultaneous MPFL and LPFL reconstruction for recurrent lateral patellar dislocation with medial patellofemoral instability

    Directory of Open Access Journals (Sweden)

    Masashi Kusano

    2014-01-01

    Full Text Available We report an extremely rare case of both recurrent lateral patella dislocation and medial patellofemoral instability, following prior operations to correct patella maltracking. Manual translation of the patella revealed medial and lateral instability with a positive apprehension sign. 3-D computer modelling of kinematics based on MRI data demonstrated that the patella deviated laterally at full extension and translated medially with knee flexion. The medial and lateral patellofemoral ligaments were reconstructed simultaneously with hamstring tendons, alleviating peripatellar pain and patellar instability in both directions.

  5. Nail patela elbow syndrome

    Directory of Open Access Journals (Sweden)

    Jain V

    1990-01-01

    Full Text Available A 15 year old male having nail-patella elbow syndrome presented with deficient nail with pterygium formation rudimentry patellae, iliac horn, increased carrying angle of elbow joints and thickened ribs. Family history was suggestive of autosomal dominant inheritance.

  6. Patellafrakturen im Kindesalter

    DEFF Research Database (Denmark)

    Schmal, H.; Seif El Nasr, M.; Schlickewei, W.

    2000-01-01

    With a retrospective study all patella fractures of infants (to 16 years) treated between 1992 and 1996 at the Department of Traumatology of the University of Freiburg were evaluated. Because of the rare occasion of a fracture event in this group caused by flexible anchoring of the patella not su...

  7. Mutations in the pre-replication complex cause Meier-Gorlin syndrome

    NARCIS (Netherlands)

    Bicknell, L.S.; Bongers, M.H.F.; Leitch, A.; Brown, S.; Schoots, J.; Harley, M.E.; Aftimos, S.; Al-Aama, J.Y.; Bober, M.; Brown, P.A.; Bokhoven, J.H.L.M. van; Dean, J.; Edrees, A.Y.; Feingold, M.; Fryer, A.; Hoefsloot, L.H.; Kau, N.; Knoers, N.V.A.M.; Mackenzie, J.; Opitz, J.M.; Sarda, P.; Ross, A.; Temple, I.K.; Toutain, A.; Wise, C.A.; Wright, M.; Jackson, A.P.

    2011-01-01

    Meier-Gorlin syndrome (ear, patella and short-stature syndrome) is an autosomal recessive primordial dwarfism syndrome characterized by absent or hypoplastic patellae and markedly small ears(1)(3). Both pre- and post-natal growth are impaired in this disorder, and although microcephaly is often evid

  8. Clinical and molecular characterisation of human syndromes with congenital patellar malformations

    NARCIS (Netherlands)

    Bongers, M.H.F.

    2006-01-01

    In this thesis the results are described of clinical and molecular investigation of human syndromes with congenital patellar malformations as a hallmark feature, with emphasis on nail patella syndrome, small patella syndrome, isolated patellar aplasia or hypoplasia, and Meier-Gorlin syndrome. The el

  9. Meier-Gorlin syndrome: report of eight additional cases and review.

    NARCIS (Netherlands)

    Bongers, M.H.F.; Opitz, J.M.; Fryer, A.; Sarda, P.; Hennekam, R.C.M.; Hall, B.D.; Superneau, D.W.; Harbison, M.; Poss, A.; Bokhoven, J.H.L.M. van; Hamel, B.C.J.; Knoers, N.V.A.M.

    2001-01-01

    The Meier-Gorlin syndrome or ear, patella, short stature syndrome (MIM 224690) is a rare autosomal recessive disorder, characterized by the association of bilateral microtia, aplasia/hypoplasia of the patellae, and severe pre- and postnatal growth retardation. Twenty-one cases have been reported in

  10. Imaging patellar complications after knee arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Melloni, Pietro [Unitat de Imatge d' Alta Tecnologia, Centre Diagnostic, Corporacio Parc Tauli, Universitat Autonoma de Barcelona, Sabadell (Barcelona) (Spain)], E-mail: pmelloni@cspt.es; Valls, Rafael; Veintemillas, Maite [Unitat de Imatge d' Alta Tecnologia, Centre Diagnostic, Corporacio Parc Tauli, Universitat Autonoma de Barcelona, Sabadell (Barcelona) (Spain)

    2008-03-15

    The purpose of this study is to describe complications affecting the patella in patients with total or partial knee arthroplasty. We respectively analysed plain-film radiographs, as well as ultrasound images when acquired, in a consecutive series of 1272 patients. The mean interval from knee replacement to patellar complications was 5 years and 7 months (range, 5 months to 14 years). The complications described include fracture, instability, dislocation or luxation, necrosis of the patella, infection of the patella, erosion of the patella, patellar impingement on the prosthesis and patellar or quadricipital tendon tear. We discuss the pathological imaging findings in the patella and their differential diagnosis after knee arthroplasty. Patellar complications after knee arthroplasty are uncommon but often potentially serious.

  11. Tibial tubercle osteotomy in patello-femoral instability and in patellar height abnormality.

    Science.gov (United States)

    Caton, Jacques H; Dejour, David

    2010-02-01

    The aim of this study was to present the different surgical procedures of tibial tubercle osteotomies for patellar instability or patellar mispositioning such as patella alta or patella infera. This study analysed the Caton-Deschamps index used for assessment of vertical patella height in order to make a precise plan for tibial tuberosity osteotomies. This study included 61 knees (50 patients) treated for patellar instability with patella alta and 24 patients treated for patella infera of mechanical origin. The results of medial transfer of the tibial tuberosity, with or without distal transfer in cases of patellar instability with patella alta, gives excellent results for stability in 76.8% of the cases. The results of the proximal transfer of the tibial tuberosity in cases of patella infera were excellent or good in 80% of the cases in our series of 24 patients. A precise preoperative plan is needed with determination of the vertical patellar height using the Caton-Deschamps index and the situation of the tibial tuberosity and the Tibial Tubercle to Trochlear Groove distance (TT-TG) of the knee on CT scan in order to obtain satisfactory results.

  12. Patellar Dislocations and Reduction Procedure.

    Science.gov (United States)

    Ramponi, Denise

    2016-01-01

    Acute patellar dislocations are a common injury occurring in adolescents involved in sports and dancing activities. This injury usually occurs when the knee is in full extension and sustains a valgus stress on the knee. The medial patellofemoral ligament is the medial restraint that assists in stabilizing the patella from lateral dislocations. The patella usually dislocates laterally and is usually not difficult to reduce after patient evaluation and prereduction radiographs. After postreduction radiographs confirm proper position of the patella postreduction and the absence of fractures, the patient is usually treated conservatively with initial immobilization, orthopedic referral, and physical therapy.

  13. Muscular Strength Gains and Sensory Perception Changes: A Comparison of Electrical and Combined Electrical/Magnetic Stimulation.

    Science.gov (United States)

    1992-04-10

    Trentin and Visentin applied low-amplitude (200 to 600 gauss) magnetic stimulation to patients suffering from rheumatoid and osteoarthritis with mixed...results. The osteoarthritis group had pain and range of motion changes they classified as "good", but were limited to only four months. 64 Binder and co...muscle. Physiotherapy Canada. 1979;31:265-267. 5. Johnson DH, ThurstonP, Ashcroft PJ. The Russian techique of faradism in the treatment of chondromalacia

  14. Bilateral recurrent auricular pseudocyst: Importance of fine-needle aspiration cytology and lactate dehydrogenase estimation

    Directory of Open Access Journals (Sweden)

    Kalyan Khan

    2013-01-01

    Full Text Available Auricular pseudocyst or Idiopathic cystic chondromalacia is a rare, benign condition characterized by a focal noninflammatory cystic swelling on the pinna, occurring usually in young male patients. Bilaterality and recurrence have been reported rarely. We report a case of bilateral, recurrent auricular pseudocyst in a young male patient, where fine needle aspiration cytology coupled with fluid lactate dehydrogenase level estimation was diagnostic. Repeated surgery was avoided and conservative treatment was proved to be effective.

  15. Upper Extremity Injuries in Gymnasts.

    Science.gov (United States)

    Wolf, Megan R; Avery, Daniel; Wolf, Jennifer Moriatis

    2017-02-01

    Gymnastics is a unique sport, which loads the wrist and arms as weight-bearing extremities. Because of the load demands on the wrist in particular, stress fractures, physeal injury, and overuse syndromes may be observed. This spectrum of injury has been termed "gymnast's wrist," and incorporates such disorders as wrist capsulitis, ligamentous tears, triangular fibrocartilage complex tears, chondromalacia of the carpus, stress fractures, distal radius physeal arrest, and grip lock injury.

  16. Three-dimensional anatomy of the ostrich (Struthio camelus knee joint

    Directory of Open Access Journals (Sweden)

    Kyle P. Chadwick

    2014-12-01

    Full Text Available The three-dimensional anatomy of the ostrich (Struthio camelus knee (femorotibial, femorofibular, and femoropatellar joint has scarcely been studied, and could elucidate certain mechanobiological properties of sesamoid bones. The adult ostrich is unique in that it has double patellae, while another similar ratite bird, the emu, has none. Understanding why these patellae form and what purpose they may serve is dually important for future studies on ratites as well as for understanding the mechanobiological characteristics of sesamoid bone development. For this purpose, we present a three-dimensional anatomical study of the ostrich knee joint, detailing osteology, ligaments and menisci, and myology. We have identified seven muscles which connect to the two patellae and compare our findings to past descriptions. These descriptions can be used to further study the biomechanical loading and implications of the double patella in the ostrich.

  17. USASOC Injury Prevention/Performance Optimization Musculoskeletal Screening Initiative

    Science.gov (United States)

    2012-11-01

    Anatomic Location Specific Injuries Probable Causes Knee Patellar Tendinitis Overuse places chronic stress on patella tendon Lack of lower...climbing activities too quickly Rotator cuff becomes fatigued during long climbs Biceps tendinitis Scapulohumeral rhythm becomes compromised

  18. Opto-numerical procedures supporting dynamic lower limbs monitoring and their medical diagnosis

    Science.gov (United States)

    Witkowski, Marcin; Kujawińska, Malgorzata; Rapp, Walter; Sitnik, Robert

    2006-01-01

    New optical full-field shape measurement systems allow transient shape capture at rates between 15 and 30 Hz. These frequency rates are enough to monitor controlled movements used e.g. for medical examination purposes. In this paper we present a set of algorithms which may be applied for processing of data gathered by fringe projection method implemented for lower limbs shape measurement. The purpose of presented algorithms is to locate anatomical structures based on the limb shape and its deformation in time. The algorithms are based on local surface curvature calculation and analysis of curvature maps changes during the measurement sequence. One of anatomical structure of high medical interest that is possible to scan and analyze, is patella. Tracking of patella position and orientation under dynamic conditions may lead to detect pathological patella movements and help in knee joint disease diagnosis. Therefore the usefulness of the algorithms developed was proven at examples of patella localization and monitoring.

  19. La influencia de la superficie articular y la membrana sinovial en la evolución de pacientes afectos por bloqueo crónico de la articulación temporomandibular tratados mediante artroscopia Influence of the joint surface and the synovial membrane on the evolution of patients affected by chronic temporomandibular joint block who were treated with arthroscopic surgery

    Directory of Open Access Journals (Sweden)

    R. González-García

    2010-03-01

    joints met the criteria for chronic block of the TMJ. One hundred and seventy-two patients with unilateral affectation were selected for this study. Synovitis and chondromalacia are the parameters chosen to evaluate the synovitis membrane and joint surface, respectively. Two groups of patients were formed: a patients with light affectation: level I/II synovitis and level I/II chondromalacia, and b patients with severe affectation: level III/IV synovitis and level III/ IV chondromalacia. The dependent variables were pain and interincisal maximum oral opening (MOO. All of the patients had post operative follow-up at 1, 3, 6, 12, and 24 months. The "t" Student test was used before and after surgery to match evidence to compare the average values of visual analogical scale (VAS and function (MOO. The "t" Student test was used for independent samples to compare the different groups that were established. A value of p < 0.05 was considered statistically significant. Results: Level I/II synovitis was seen using arthroscopy in 87 (50.58% patients, and level III/ IV synovitis was seen in 54 (31.39% of patients, while level I/II chondromalacia was observed in 66 (38.37% patients and level III/IV chondromalacia was observed in 54 (31.39%. During the follow-up period a significant decrease in pain and a parallel increase in oral opening were observed after arthroscopy in patients affected by level I/II and III/IV synovitis and level I/II and III/IV chondromalacia. There was a significant statistical difference in relation to observed pain in patients with level I/II synovitis and in patients with level III/IV synovitis in the sixth month after surgery. However this difference did not continue in the rest of the follow-up period. Nor were there any statistical differences related to the MOO related to synovitis during follow-up. There were no differences in pain or oral opening between patients with level I/II chondromalacia and patients with level III/IV chondromalacia at any time

  20. 对中国女曲队员崔秋霞髌骨骨折后激进型康复体能训练疗效的观察%Curative Effect Observation of the Radical Rehabilitation Training after the Patella Fracture of Cui Qiuxia, Athlete of Chinese Women's Field Hockey Team

    Institute of Scientific and Technical Information of China (English)

    陈德康; 高志; 黄俊; 华英汇; 周栋; 封旭华

    2014-01-01

    目的:崔秋霞,中国女曲队员,2011年11月左侧髌骨发生下三分之一处横行骨折,采用了激进型康复体能训练,力争参加2012年伦敦奥运会.方法:对髌骨骨折后传统保守康复方法做了一些创新,主要包括固定时间大为缩短;早期引入水疗;早期引入离心训练;有效应用护具、支持带和肌效贴;结果:与传统的髌骨骨折后康复疗程相比,康复进程大为缩短,固定期缩短了近2周时间,功能康复期缩短了5周时间,总体提前了近2个月回到运动场上,正常跟上了国家队的训练节奏,在奥运会前竞技能力恢复了90%左右,而且患肢未见明显肿胀和疼痛,本体感觉功能和肌肉力量保持良好状态.结论:本次针对崔秋霞髌骨骨折的激进型康复体能训练方法较为科学有效.

  1. Clinical observation of arthroscopic lateral retinacular release in the treatment of patella lateral pressure syndrome%关节镜下外侧支持带松解治疗髌骨外侧高压综合征临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    廖军; 孟庆才

    2014-01-01

    目的:探讨关节镜下外侧支持带松解术治疗髌骨外侧高压综合征(EL PS )的临床疗效。方法选择2009年6月-2013年8月新疆医科大学附属中医医院关节外科收治的100例髌骨外侧高压综合征患者,将其分为两组:关节镜下行外侧支持带松解术58例(ALRR组),保守治疗42例(对照组),参考Lysholm膝关节功能评分评价临床疗效。结果两组患者随访3~15个月,平均8.6个月,对照组和 ALRR组有效率分别为85.71%和982.8%;两组患者治疗后Lysholm评分均较治疗前提高,差异有统计学意义(P <00.5);两组患者治疗后Lysholm评分差异有统计学意义(P <00.5),ALRR组高于对照组。结论关节镜下外侧支持带松解术可有效地减轻髌骨外侧高压导致的髌股关节疼痛,且具备术后康复快、并发症少、膝关节功能恢复好等优势,其远期疗效有待进一步观察。%Objective To discuss the effective and clinical value of arthroscopic lateral retinaculum release treatment in excessive lateral pressure syndrome .Methods From June 2009 to August 2013 ,110 patients with patellar lateral pressure syndrome were randomly divided into lateral retinaculum under arthroscopy release (ALRR) treatment group (58 cases ,conservative treatment group (42 cases ,two groups of pa-tients with preoperative general data no statistically significant difference (P >0 0.5) ,there was no statis-tically significant difference Lysholm score before treatment (P >0 0.5) .Results Two groups of patients were followed up for 3-15 months ,an average of 8 6. months ,conservative treatment group and ALRR group effectiveness 85 7.1% ,98 2.8% respectively ;Lysholm score after treatment in both groups was im-proved ,the difference was statistically significant (P < 0 .05);Lysholm score after treatment in both groups ,the difference was statistically significant (P <0 0.5);Conclusion The lateral retinaculum release technique can effectively relieve patellar lateral patellofemoral joint pain and other symptoms caused by high pressure syndrome ,and less complications .

  2. Cable-Pin系统微创与切开复位克氏针张力带修复髌骨横行骨折:随机对照%Cable-Pin System minimally invasive treatmentversus open reduction and Kirschner wire tension band technology for the repair of transverse patella fractures:a randomized controlled trial

    Institute of Scientific and Technical Information of China (English)

    江永良; 卢春闻; 吴云刚; 吴锦辉; 丁慕晨; 吕润潇; 康凯; 毛宁方

    2015-01-01

    BACKGROUND:Open reduction and Kirschner wire tension band technique has been a traditional surgical method for the treatment of patela fracture. However, there stil exist some complications such as Kirschner wire slippage and breakage. Cable-Pin system is a new fixation device. A series of good clinical results has been achieved in patients with patela fracture using this fixation device through a minimaly invasive way. OBJECTIVE:To compare and investigate the clinical results of minimaly invasive fixation with Cable-Pin system and Kirschner wire tension band technique for patela fracture and the complications. METHODS:Eighty patients with radiology-confirmed transverse displacement of patela participated in this trial, and were randomly divided into two groups. Forty patients underwent a minimaly invasive technique and the others had conventional open surgery using Kirschner wire. At postoperative intervals of 1, 3, 6, 12, and 24 months, pain was measured by Visual Analogue Scale scores, range of motion was measured by goniometry, and knee function was evaluated using the Bostman clinical grading scale. RESULTS AND CONCLUSION: Easement of pain was better in the minimaly invasive surgery group than in the control group at 1 and 3 months after treatment (P < 0.05). Above dominance disappeared at 6 months after treatment. At 3-24 months, the knee flexion training was faster and flexion angle was greater in the minimaly invasive surgery group, and results were significantly better than in the control group (P < 0.05). The incidence of discomfort fixation-induced complications was lower in the minimaly invasive surgery group than in the conventional open surgery group (P < 0.05). These data confirm that after minimaly invasive fixation with Cable-Pin system, pain was noticeably lessened, range of motion of affected knee was great, the recovery of knee function was better, the incidence of complications was reduced, and the repair effect was better than the conventional Kirschner wire fixation.%背景:切开复位克氏针张力带内固定是修复髌骨横行骨折的传统方法,但存在克氏针滑脱、钢丝断裂等并发症。Cable-Pin系统是一种新型内固定装置,作者利用微创方式将其应用于髌骨横行骨折,取得了良好的修复效果。目的:对比观察 Cable-Pin 系统微创技术与切开复位克氏针张力带内固定修复髌骨横行骨折的效果及并发症发生情况。方法:纳入80例影像学确诊为髌骨横行移位的患者,随机分为两组,微创组40例接受Cable-Pin系统微创内固定治疗,40例接受切开复位克氏针内固定治疗。随访时间点分别为治疗后1,3,6,12和24个月,随访内容包括疼痛目测类比疼痛评分、膝关节活动度以及Bostman膝关节功能评分。结果与结论:微创组疼痛缓解情况在治疗后1,3个月要优于对照组(P<0.05),此种优势在治疗后6个月即消失。治疗后3-24个月,微创组膝关节屈曲训练更快,屈曲角度更大,显著优于对照组(P<0.05)。此外微创组患者内固定不适引起并发症发生率要低于传统组(P<0.05)。提示患者接受Cable-Pin系统微创内固定后疼痛缓解更明显,患膝活动度更大,膝关节功能恢复更好,并发症发生率降低,其修复效果优于传统克氏针内固定治疗。

  3. 小针刀结合手法对髌骨骨折内固定术后膝关节创伤性关节炎的治疗价值分析%The Analysis of Needle knife Combined With Manipulation on Patella Fracture After Internal Fixation Treatment of Traumatic Arthritis of Knee Joint

    Institute of Scientific and Technical Information of China (English)

    毛灵

    2015-01-01

    目的:分析小针刀结合手法对髌骨骨折内固定术后膝关节创伤性关节炎的治疗价值。方法选取2014年1月~12月我院收治的髌骨骨折内固定术后膝关节创伤性关节炎患者32例,均给予小针刀结合手法治疗。结果2周治疗结束后,患者膝关节功能恢复率为93.75%。结论小针刀结合手法可以有效治疗髌骨骨折内固定术后膝关节创伤性关节炎。%Objective Analysis of therapeutic value about smal needle knife combined with manipulation of patelar fracture by internal fixation of traumatic arthritis of knee joint.MethodsSelected 32 cases in our hospital of patela fracture by internal fixation after knee traumatic arthritis from January to December 2014 and treated with smal needle knife combined treatment approach.ResultsThe recovery of the knee joint function was 93.75% after 2 weeks.Conclusion Acupotomy combined with manipulation in the treatment of patelar fracture in fixation after traumatic arthritis of knee joint is significant.

  4. 可调式髌骨爪结合可吸收线与克氏针钢丝张力带修复粉碎性髌骨骨折的比较%Adjustable patella claws and absorbable sutureversus Kirschner wire tension band in the repair of comminuted patellar fractures

    Institute of Scientific and Technical Information of China (English)

    崔海峰

    2015-01-01

    BACKGROUND:High-energy patelar comminuted fracture significantly increased. Single fixation cannot meet the requirement of anatomical repositioning of the patela, multiple-point strong fixation, and early functional exercise. OBJECTIVE:To compare the clinical effect of adjustable patela claws + absorbable suture and Kirschner wire tension band in the repair of comminuted patelar fractures. METHODS: A total of 57 patients with comminuted patela fracture were randomly selected and randomly assigned to two groups. 29 cases received open reduction and adjustable patela claws + absorbable suture fixation. 28 cases received open reduction and Kirschner wire tension band fixation. Operative time, incision length, fracture healing time, postoperative complications and Hospital for Special Surgery knee function scores were compared between the two groups, and then statistical analysis was conducted. RESULTS AND CONCLUSION:No significant difference in incision length and operative time was detected between the adjustable patela claws + absorbable suture group and Kirschner wire tension band group. Significant differences in healing time, incidence of complications and knee function after treatment were observed between the two groups, and above indications were better in the adjustable patela claws + absorbable suture group than in the Kirschner wire tension band group (P < 0.05). These results confirm that compared with the Kirschner wire tension band, adjustable patela claws + absorbable suture in repair of patelar comminuted fracture has some advantages such as short healing time, less postoperative complications, as wel as good functional recovery of knee joint. The fixation is accorded with biomechanical principle of internal fixation, simple to operate, firmly fixed, and has good prospects.%背景:高能量下髌骨粉碎性骨折明显增多,单一的内固定已无法满足髌骨解剖复位、多点坚强固定及早期功能锻炼的要求。目的:比较切开复位可调式髌骨爪+可吸收线与克氏针钢丝张力带修复粉碎性髌骨骨折的临床效果。方法:纳入粉碎性髌骨骨折患者57例,随机分为2组,29例采用切开复位可调式髌骨爪+可吸收线固定,28例切开复位克氏针钢丝张力带固定。对比观察两组手术时间、切口长度、骨折愈合时间、治疗后并发症及膝关节功能美国特种外科医院评分,并进行统计学分析。结果与结论:可调式髌骨爪+可吸收线固定组与克氏针钢丝张力带固定组切口长度、手术时间方面的差异无显著性意义;两组在骨折愈合时间、并发症发生率及治疗后膝关节功能方面的差异有显著性意义,可调式髌骨爪+可吸收线固定组优于克氏针钢丝张力带固定组(P <0.05)。提示与克氏针钢丝张力带相比,可调式髌骨爪+可吸收线固定修复髌骨粉碎性骨折具有骨折愈合时间短、治疗后并发症少、膝关节功能恢复好等优点,固定符合生物力学内固定的原则,且操作简便,固定牢靠,具有良好的应用前景。

  5. 关节镜内侧髌骨支持带缝合与石膏固定治疗急性髌骨脱位比较%Comparison of Arthroscopy Medial Patella Ligament Strengthening and Plaster Immobilization in Treating Acute Patellar Luxation

    Institute of Scientific and Technical Information of China (English)

    张虎; 叶明钧; 叶挺

    2016-01-01

    Objective To investigate the clinical effect of arthroscopy medial patela ligament strengthening and plaster immobilization in treating acute patelar luxation.Methods82 cases with acute patelar luxation in our hospital from August 2013 to August 2014 were selected as study objects.They were divided into two groups,41 cases in each group. Control group was given plaster immobilization treatment and observation group was given arthroscopy medial patela ligament strengthening. Compared the clinical effect of the two groups.Results Patela slant angle of observation group was obviously better than control group after 1 year treatment,the difference was statisticaly significant(P<0.05). Lysholm score of observation group was obviously higher than control group, the difference was statisticaly significant(P<0.05).Conclusion Compared with plaster immobilization, arthroscopy medial patela ligament strengthening in treating acute patelar luxation has better significant effect.%目的:研究分析关节镜内侧髌骨支持带缝合和石膏固定治疗急性髌骨脱位的临床效果。方法选取2013年8月~2014年8月我院收治的急性髌骨脱位患者82例,随机分为两组,各41例。对照组采用石膏外固定治疗,观察组采用关节镜内侧髌骨支持带缝合术治疗,对比两组临床治疗效果。结果观察组在治疗后1年髌骨倾斜角优于对照组,差异有统计学意义(P<0.05);观察组各项Lysholm评分均高于对照组,差异有统计学意义(P<0.05)。结论相比于石膏外固定治疗,关节镜内侧髌骨支持带缝合术治疗急性髌骨脱位效果良好,可提高治疗效果。

  6. Clinical Analysis of Tension Band Internal Fixation Screw Combined with Cannulated Titanium Wire Treatment of Patella Fracture%空心加压螺纹钉结合钛丝张力带法内固定治疗髌骨骨折临床探讨

    Institute of Scientific and Technical Information of China (English)

    陈哲

    2015-01-01

    Objective To hol ow compression screw nail combining with titanium wire internal fixation treatment of patel a fracture with tension band method shal be discussed in this paper.Methods Selected from October 2011to October 2014 were 31 cases of patel ar fracture patients,using hol ow compression screw nails with internal fixation with titanium wire tension band method to treatment, the treatment ef ect analysis.Results Al patients were successful y completed surgery,no looseness or breakage implants,knee function and basic returned to normal.Conclusion The treatment in patients with patel ar fracture,hol ow compression screw nails in combination with the use of internal fixation with titanium wire tension band method,fixed ef ect is good,can be as early as possible for knee joint function in patients with postoperative exercise,is a bet er treatment method.%目的对空心加压螺纹钉结合钛丝张力带法内固定治疗髌骨骨折予以探讨。方法选取我院2011年10月~2014年10月收治的31例髌骨骨折患者,采用空心加压螺纹钉结合钛丝张力带法内固定予以治疗,对治疗效果予以分析。结果所有患者均顺利完成手术,植入物无松动或断裂,膝关节功能也基本恢复正常。结论对髌骨骨折患者予以治疗时,空心加压螺纹钉结合钛丝张力带法内固定的运用,固定效果较好,术后患者可以尽早进行膝关节功能锻炼,是一种较好的治疗方法。

  7. 小针刀结合手法对髌骨骨折内固定术后膝关节创伤性关节炎的治疗效果观察%Curative Effect Observation on Needle Knife Combined With Manipulation on Patella Fracture After Internal Fixation of Knee Joint Traumatic Arthritis

    Institute of Scientific and Technical Information of China (English)

    乔正华

    2015-01-01

    ObjectiveTo observe the summary with needle knife combined with surgery for patelar fracture by internal fixation after traumatic arthritis of knee joint treatment effect.Methods Study from 32 cases of patelar fracture by internal fixation after knee joint traumatic arthritis patients with smal needle knife combined with surgical treatment.Results32 cases of patelar fracture internal fixation after the treatment of traumatic arthritis of the knee joint was 93.8%.Conclusion Patelar fracture after internal fixation of knee joint traumatic arthritis patients with needle knife combined with operation therapy significantly.%目的:观察总结小针刀结合手法对髌骨骨折内固定术后膝关节创伤性关节炎的治疗效果。方法研究收治的32例髌骨骨折内固定术后膝关节创伤性关节炎患者用小针刀联合手法治疗效果。结果32例髌骨骨折内固定术后膝关节创伤性关节炎治疗后优良率为93.8%。结论髌骨骨折内固定术后膝关节创伤性关节炎患者实施小针刀结合手法治疗疗效显著。

  8. Preliminary clinical research of arthroscopic anterior cruciate ligament reconstruction using a patella tendon allograft%关节镜下同种异体髌腱组织重建膝前交叉韧带的初步临床研究

    Institute of Scientific and Technical Information of China (English)

    徐志宏; 蒋青; 陈东阳; 李文; 孙旭

    2004-01-01

    目的探讨关节镜下应用异体髌腱(骨-腱-骨组织,BPTB)重建膝关节前交叉韧带(anterior cruciate ligament,ACL)的方法及初步临床疗效.方法关节镜下应用深低温冷冻异体BPTB移植重建ACL 8例.对手术时间、手术切口及术后体温恢复、ACL体征、X-ray检查分析手术疗效;术后关节屈曲度及Lysholm-Ⅱ评分评定膝关节功能.结果关节镜下应用异体BPTB重建ACL切口小,手术时间短,术后5 d内体温恢复正常,无一例感染及免疫排斥现象.平均随访时间4个月(2~6个月),所有患者症状均有缓解,前抽屉试验(-)(anterior drawer test,ADT),Lachman(-),X-ray检查界面螺钉在位,未见骨道异常;术后2周平均屈曲度可至105°(80°~130°),术后2个月膝关节平均屈曲度可达120°(100°~130°),术前Lysholm-Ⅱ评分平均38.5分(24~50分),术后2个月Lysholm-Ⅱ评分平均88分(76~97分).结论应用深低温冷冻异体髌腱重建ACL可减少手术创伤,早期即可有效改善膝关节功能,是一种可行的重建ACL的方法,远期疗效尚需进一步的观察.

  9. Novel Therapy for Bone Regeneration in Large Segmental Defects

    Science.gov (United States)

    2015-10-01

    blood samples and will begin blood chemistry analysis this reporting period. That said, the most significant findings during this period is that TPO is...muscles was divided using blunt dissection to localize the femur. The lateral structures stabilizing the patella were divided and the patella manually ...down-regulating the muscle marker Pax336. These studies provide evidence that, in the appropriate environmental conditions, muscle can supply

  10. Interesting clinical presentation of anterior knee pain causing diagnostic dilemma.

    Science.gov (United States)

    Morgan, Samer S; Balasubramanian, S; Teanby, D

    2009-09-01

    A diverse variety of lesions may occasionally occur in the patella. In this case report, we are presenting an interesting case of anterior knee pain in middle aged gentleman. Initial investigations including Magnetic Resonance Imaging not showed any abnormality. Due to prolonged continued pain he had bone scan and MRI, which confirmed the diagnosis of Brodie's abscess. We are presenting this case of Brodie's abscess of the patella causing diagnostic dilemma because of its rarity.

  11. Evolution of the patellar sesamoid bone in mammals

    Science.gov (United States)

    Samuels, Mark E.; Regnault, Sophie

    2017-01-01

    The patella is a sesamoid bone located in the major extensor tendon of the knee joint, in the hindlimb of many tetrapods. Although numerous aspects of knee morphology are ancient and conserved among most tetrapods, the evolutionary occurrence of an ossified patella is highly variable. Among extant (crown clade) groups it is found in most birds, most lizards, the monotreme mammals and almost all placental mammals, but it is absent in most marsupial mammals as well as many reptiles. Here, we integrate data from the literature and first-hand studies of fossil and recent skeletal remains to reconstruct the evolution of the mammalian patella. We infer that bony patellae most likely evolved between four and six times in crown group Mammalia: in monotremes, in the extinct multituberculates, in one or more stem-mammal genera outside of therian or eutherian mammals and up to three times in therian mammals. Furthermore, an ossified patella was lost several times in mammals, not including those with absent hindlimbs: once or more in marsupials (with some re-acquisition) and at least once in bats. Our inferences about patellar evolution in mammals are reciprocally informed by the existence of several human genetic conditions in which the patella is either absent or severely reduced. Clearly, development of the patella is under close genomic control, although its responsiveness to its mechanical environment is also important (and perhaps variable among taxa). Where a bony patella is present it plays an important role in hindlimb function, especially in resisting gravity by providing an enhanced lever system for the knee joint. Yet the evolutionary origins, persistence and modifications of a patella in diverse groups with widely varying habits and habitats—from digging to running to aquatic, small or large body sizes, bipeds or quadrupeds—remain complex and perplexing, impeding a conclusive synthesis of form, function, development and genetics across mammalian evolution

  12. Automatic anatomical structures location based on dynamic shape measurement

    Science.gov (United States)

    Witkowski, Marcin; Rapp, Walter; Sitnik, Robert; Kujawinska, Malgorzata; Vander Sloten, Jos; Haex, Bart; Bogaert, Nico; Heitmann, Kjell

    2005-09-01

    New image processing methods and active photonics apparatus have made possible the development of relatively inexpensive optical systems for complex shape and object measurements. We present dynamic 360° scanning method for analysis of human lower body biomechanics, with an emphasis on the analysis of the knee joint. The anatomical structure (of high medical interest) that is possible to scan and analyze, is patella. Tracking of patella position and orientation under dynamic conditions may lead to detect pathological patella movements and help in knee joint disease diagnosis. The processed data is obtained from a dynamic laser triangulation surface measurement system, able to capture slow to normal movements with a scan frequency between 15 and 30 Hz. These frequency rates are enough to capture controlled movements used e.g. for medical examination purposes. The purpose of the work presented is to develop surface analysis methods that may be used as support of diagnosis of motoric abilities of lower limbs. The paper presents algorithms used to process acquired lower limbs surface data in order to find the position and orientation of patella. The algorithms implemented include input data preparation, curvature description methods, knee region discrimination and patella assumed position/orientation calculation. Additionally, a method of 4D (3D + time) medical data visualization is proposed. Also some exemplary results are presented.

  13. Imaging assessment of patellar instability and its treatment in children and adolescents

    Energy Technology Data Exchange (ETDEWEB)

    Meyers, Arthur B.; Sharafinski, Mark [Children' s Hospital of Wisconsin, Medical College of Wisconsin, Department of Radiology, P.O. Box 1997, Milwaukee, WI (United States); Laor, Tal; Zbojniewicz, Andrew M. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)

    2016-05-15

    Transient patellar dislocation is a common entity in children and adolescents, characterized by lateral dislocation of the patella, usually with spontaneous reduction. Many predisposing conditions have been described, including trochlear dysplasia, excessive lateral patellar tilt, patella alta and lateralization of the tibial tuberosity. Associated injuries are bone bruises of the patella and lateral femoral condyle, tears of the medial retinaculum that include the medial patellofemoral ligament (MPFL), tears of the vastus medialis obliquus muscle, injuries of articular cartilage, and intra-articular bodies. Children who are refractory to conservative management, have a large cartilage defect, or are at substantial risk for recurrent dislocations are candidates for surgical procedures to prevent future dislocations. Procedures can include MPFL repair or reconstruction, tibial tubercle repositioning and lateral retinacular release. The purpose of this review is to illustrate the imaging findings of transient patellar dislocation in the acute setting, the normal imaging appearance after surgical intervention, and post-surgical complications. (orig.)

  14. Secondary Patellar Resurfacing after Primary Bicondylar Knee Arthroplasty did Not Meet Patients’ Expectations

    Science.gov (United States)

    Correia, João; Sieder, Marc; Kendoff, Daniel; Citak, Mustafa; Gehrke, Thorsten; Klauser, Wolfgang; Haasper, Carl

    2012-01-01

    Secondary patella resurfacing is a controversial procedure which is applied in patients with anterior knee pain after a bicondylar knee arthroplasty (with unresurfaced patella). A group of 46 patients were submitted to this procedure and their satisfaction, range of motion and pain improvement was evaluated. 52.2% of the patients were satisfied with the procedure, with an improvement in pain (Visual Analogue Scale) of 65% and an improvement in range of motion in 56,5%, with roundabout half of the patients having no resolution to their complaints. Whilst an improvement was not achieved in all patients, as it was initially hypothesised, this procedure should be considered when a revision knee arthroplasty is performed with an unresurfaced patella. PMID:23002412

  15. Secondary Patellar Resurfacing after Primary Bicondylar Knee Arthroplasty did Not Meet Patients' Expectations.

    Science.gov (United States)

    Correia, João; Sieder, Marc; Kendoff, Daniel; Citak, Mustafa; Gehrke, Thorsten; Klauser, Wolfgang; Haasper, Carl

    2012-01-01

    Secondary patella resurfacing is a controversial procedure which is applied in patients with anterior knee pain after a bicondylar knee arthroplasty (with unresurfaced patella). A group of 46 patients were submitted to this procedure and their satisfaction, range of motion and pain improvement was evaluated. 52.2% of the patients were satisfied with the procedure, with an improvement in pain (Visual Analogue Scale) of 65% and an improvement in range of motion in 56,5%, with roundabout half of the patients having no resolution to their complaints. Whilst an improvement was not achieved in all patients, as it was initially hypothesised, this procedure should be considered when a revision knee arthroplasty is performed with an unresurfaced patella.

  16. Meier-Gorlin syndrome with ventriculomegaly and hypoplastic corpus callosum: a rarely reported congenital malformation

    Directory of Open Access Journals (Sweden)

    Nabanita Kora

    2016-02-01

    Full Text Available Meier-Gorlin syndrome (MGS or ear-patella-short stature syndrome (MIM 224690 is a rarely reported autosomal recessive disorder having characteristic triad of microtia, short stature and aplastic or hypoplastic patella. Only 67 cases are reported. We are reporting a newborn female baby with typical features of MGS along with some other features never described before, ventriculomegaly and hypoplastic corpus callosum. We did x-rays of whole body (infantogram and MRI of brain for microcephaly. Ultrasonography of both knees showed absence of patellae and brain MRI showed ventriculomegaly and hypoplastic corpus callosum. To our best knowledge this is the second case report of MGS in India; the first reported a MGS associated with papilledema. In previously reported cases, there was no statement regarding agenesis of corpus callosum.

  17. Surgical Correction of Patellar Luxation in a Rabbit

    Directory of Open Access Journals (Sweden)

    J. Riggs

    2013-01-01

    Full Text Available A two-and-a-half-year-old giant lop-eared rabbit, weighing 5.1 kg, presented with a one-month history of intermittent right hind limb lameness. The limb locked in extension during hopping. On examination, a grade-2 medial patellar luxation of the right hind was diagnosed, with associated stifle joint swelling. Radiographic findings of the right stifle comprised periarticular osteophyte formation consistent with mild degenerative joint disease and joint effusion. Surgical correction involving right trochlear wedge recession sulcoplasty and lateral imbrication was carried out to stabilise the patella in the trochlear groove. The right hind limb lameness resolved, and the patella was stable at a 6-month postoperative examination. One year postoperatively, the right patella was luxating again concurrent with bilateral stifle effusions. Euthanasia was performed twenty months after surgery due to recurrent lameness in the right hind limb.

  18. 髌骨软化症的研究进展

    Institute of Scientific and Technical Information of China (English)

    武玉锦; 方建国

    2006-01-01

    髌骨软化症(chondromalacia patellae,CP),又称髌骨软骨软化症、髌骨软骨炎,是引起膝前痛的常见原因之一。对髌骨软化症的普查结果发现,其患病率高达36.2%,且女性发病率高于男性。目前其病因尚不清楚,是骨科面临的一个难题。现就其研究近况作一综述。

  19. Autologous chondrocyte implantation in children and adolescents

    DEFF Research Database (Denmark)

    Schmal, H; Pestka, J M; Salzmann, G

    2013-01-01

    PURPOSE: Autologous chondrocyte implantation (ACI) is a well-established treatment method for cartilage defects in knees. Age-related grouping was based on expression data of cartilage-specific markers. Specificities of ACI in the different populations were analysed. METHODS: Two hundred and sixt...... months after the operation. CONCLUSIONS: Age-related expression of cartilage-specific markers allows definition of adolescents in cartilage regenerating surgery. Chondromalacia in these patients is mainly caused by OCD or trauma. LEVEL OF EVIDENCE: Case series, Level IV....

  20. Differential blockade to assess surgical repair by intraoperative active mobilization in knee injuries-Beyond labour analgesia

    Directory of Open Access Journals (Sweden)

    G Vijay Anand

    2011-01-01

    Full Text Available Motor-sparing selective epidural analgesia has long been practised in the field of labour analgesia. However, the utility of such techniques in other fields remain limited. We present the successful use of a similar technique of differential blockade in a case of quadriceps plasty with realignment of patella for recurrent dislocation of patella. A very low concentration of bupivacaine and fentanyl was used through continous epidural. The adequacy of repair was assessed intraoperatively by active movement of operated limb by patient himself.

  1. Imaging of postoperative knee extensor mechanism

    Energy Technology Data Exchange (ETDEWEB)

    Motamedi, Kambiz [David Geffen School of Medicine at UCLA, Musculoskeletal Imaging-Department of Radiology, 200 Medical Plaza, Suite 165-59, Los Angeles, CA 90095 (United States); Seeger, Leanne L. [David Geffen School of Medicine at UCLA, Musculoskeletal Imaging-Department of Radiology, 200 Medical Plaza, Suite 165-57, Los Angeles, CA 90095 (United States); Hame, Sharon L. [David Geffen School of Medicine at UCLA, Department of Orthopedic Surgery, Box 956902, 76-143 CHS, Los Angeles, CA 90095 (United States)

    2005-05-01

    Disorders of the anterior knee are common and include patellofemoral syndrome, patella instability, patella fracture, and patellar and quadriceps tendon ruptures. Depending on the operative procedure performed, the post-operative imaging appearance of these knees may be confusing. It is crucial for the radiologist to be familiar with the procedures performed in order to recognize the postoperative findings. Radiologists must be able to interpret hardware (anchors, screw and wires) and disruptions in soft tissue planes that may persist with these types of procedures.

  2. Suture anchor versus suture through tunnel fixation for quadriceps tendon rupture: a biomechanical study.

    Science.gov (United States)

    Lighthart, William A; Cohen, David A; Levine, Richard G; Parks, Brent G; Boucher, Henry R

    2008-05-01

    This biomechanical study compared suture anchors versus transosseous sutures for repair of quadriceps tendon ruptures using a force of 150 N at a frequency of 0.5 Hz. No significant difference in displacement was found between the 2 techniques with initial loading or with load or no load after 1000 cycles. Displacement after 1000 cycles for suture anchors and bone tunnels was 4.65 and 4.50 mm, respectively. These findings suggest a possible role for suture anchors in repairing quadriceps tendon ruptures. Suture anchors are relatively expensive but require less dissection over the patella and do not involve suture placement about the patella tendon.

  3. Tunnel widening in anterior cruciate ligament reconstruction

    DEFF Research Database (Denmark)

    Clatworthy, M G; Annear, P; Bulow, J U

    1999-01-01

    .1% in the patella tendon group (P = film measurements. Tunnel widening did not correlate with the clinical findings, knee scores, KT-1000 or isokinetic muscle strength. Tunnel widening is marked in the hamstring group. Tunnel widening does not correlate with instability......We report a prospective series evaluating the incidence and degree of tunnel widening in a well-matched series of patients receiving a hamstring or patella tendon graft for anterior cruciate ligament (ACL) deficiency. We correlated tunnel widening with clinical factors, knee scores, KT-1000...

  4. Clinical, roentgenographic, and scintigraphic results after interruption of the superior lateral genicular artery during total knee arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Ritter, M.A.; Keating, E.M.; Faris, P.M. (Center for Hip and Knee Surgery, Mooresville, IN (USA))

    1989-11-01

    Forty-eight patients treated by primary bilateral simultaneous total knee arthroplasty, in which one knee had a lateral release and the other did not, were evaluated clinically and roentgenographically from one to 12 years postoperatively. Thirty of these patients also had a technetium-99 bone scan. Mean clinical scores at the last follow-up examination were 90 for both groups. Roentgenographically, there were no subluxations, dislocations, or fractures in either group. There were two metal-backed patellae (one in each group) with signs of polyethylene wear and developed debris. Bone scans showed no difference between the two groups and no signs of osteonecrosis of the patella.

  5. [Modelling of the knee joint loading conditions in the view of mechanics].

    Science.gov (United States)

    Pustovoĭt, K B; Karpins'kyĭ, M Iu

    2013-02-01

    The results of mathematic modelling of work of femoropatellar joint in normal conditions and in the presence of dysplastic deformity were adduced. There was established, that a knee joint (KJ) by its external appearance and function constitutes a classic cam mechanism. Biomechanical scheme of interaction between the femoral bone processus and patella was elaborated. In accordance to scheme of cam mechanism its experimental roentgenometric investigations were performed. According to statistical analysis performed, in conditions of dysplasia in femoropatellar joint the changes in the KJ occur, which may cause its blockade; the patella position in the KJ depends on peculiarities of anatomical structure of the femoral bone processuses.

  6. MRI findings in renal transplant recipients with hip and knee pain

    Energy Technology Data Exchange (ETDEWEB)

    Donmez, Fuldem Yildirim [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Caddesi 10. sokak no: 45, Bahcelievler 06490, Ankara (Turkey)], E-mail: fuldemyildirim@yahoo.com; Basaran, Ceyla [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Caddesi 10. sokak no: 45, Bahcelievler 06490, Ankara (Turkey)], E-mail: ceylab@baskent-ank.edu.tr; Ulu, Esra Meltem Kayahan [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Caddesi 10. sokak no: 45, Bahcelievler 06490, Ankara (Turkey)], E-mail: emkayahanulu@yahoo.com; Uyusur, Arzu [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Caddesi 10. sokak no: 45, Bahcelievler 06490, Ankara (Turkey)], E-mail: arzuuyusur@yahoo.com; Tarhan, Nefise Cagla [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Caddesi 10. sokak no: 45, Bahcelievler 06490, Ankara (Turkey)], E-mail: caglat@baskent-ank.edu.tr; Muhtesem Agildere, A. [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Caddesi 10. sokak no: 45, Bahcelievler 06490, Ankara (Turkey)], E-mail: amuhtesem@superonline.com

    2009-09-15

    Purpose: To evaluate and demonstrate the MRI findings of renal transplant recipients with hip and knee pain and to investigate the most common etiology of pain. Materials and methods: 69 hip MRIs of 57 patients with hip pain and 30 knee MRIs of 24 patients with knee pain with no history of trauma were retrospectively evaluated by two radiologists. Results: In the evaluation of hip MRIs, 24 patients had avascular necrosis and effusion, 2 patients had bone marrow edema consistent with early stage of avascular necrosis. 18 patients had only intraarticular effusion, 6 patients had tendinitis, 6 patients had bursitis and 1 patient had soft tissue abscess. Five patients had muscle edema and five patients had muscle atrophy as additional findings to the primary pathologies. Among patients with knee pain, nine patients had degenerative joint disease. Seven patients had chondromalacia, five had bone marrow edema, six had meniscal tear, six had ligament rupture and two had bone infarct. Three of the patients had muscle edema accompanying to other pathologies. Conclusion: The most common etiology of hip pain in renal transplant recipients is avascular necrosis as expected, intraarticular effusion is found to be Second reason for pain. However, knee pain is explained by ligament pathology, meniscal tear, chondromalacia or degenerative joint disease rather than osteonecrosis.

  7. Diagnostic of patellar instability after total knee arthroplasty

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    T. V. Zhizhenkova

    2015-01-01

    Full Text Available Objectives - to identify main reasons of patella instability after primary total knee arthroplasty, and to determine further treatment strategy of this complication. Material and methods. Since 2011 till 2014 1098 total knee arthroplasties have been performed in Yaroslavl Regional Hospital for Veterans of Wars. We observed 14 (1.3% patients with postoperative patella instability The evaluation included clinical and radiographic methods. Rotational alignment of the femoral and tibial components was studied by computed tomography (CT scanner. Conclusion. Position of the femoral components ranged from 2° excessive external to 8° excessive internal rotation. Position of the tibial components ranged from 0° to 6° excessive internal rotation. The summary endoprosthetic position ranged from 1 ° to 10° excessive internal rotation. We found direct correlation between summary implant internal rotation and the severity of postoperative complications in patellafemoral joint. Results. The main reason of the patella instability is implant summary internal malrotation. Extensive lateral release with patella resurfacing was sufficient for pain relief and tracking correction if the combined internal rotation did not exceed 6°. Large value of internal malrotation was the indication for revision surgery with selective approach.

  8. Reducing the Risk of ACL Injury in Female Athletes

    Science.gov (United States)

    McDaniel, Larry W.; Rasche, Adrienna; Gaudet, Laura; Jackson, Allen

    2010-01-01

    The Anterior Cruciate Ligament (ACL) is located behind the kneecap (patella) and connects the thigh bone (femur) to the shin bone (tibia). Stabilizing the knee joint is the primary responsibility of the ACL. Injuries that affect the ACL are three to five times more common in females than males. This is a result of anatomical, biomechanical,…

  9. Patellofemoral ligament reconstruction in a patient with Rubinstein-Taybi syndrome.

    Directory of Open Access Journals (Sweden)

    Fardin Mirzatolooei

    2014-03-01

    Full Text Available Recurrent dislocation of patella may occur in patients with ligament laxity. Method of treatment in this condition is controversial but patellofemoral ligament reconstruction is the most accepted method. We present a patient with Rubinstein-Taybi syndrome and recurrent patellar dislocation who managed successfully by patellofemoral ligament reconstruction.

  10. Eenvoudige diagnostiek leidt tot behandeling op maat van patellofemorale instabiliteit

    NARCIS (Netherlands)

    Kampen, A. van; Koeter, S.

    2006-01-01

    Three patients presented with patellar instability. On physical examination, the first patient, a 20-year-old male soccer player, reported pain at the medial insertion ofthe medial patellofemoral ligament (MPFL) after a traumatic patella luxation. He was successfully treated by MPFL reconstruction.

  11. THE EFFECT IN-VITRO OF IRRIGATING SOLUTIONS ON INTACT RAT ARTICULAR-CARTILAGE

    NARCIS (Netherlands)

    Bulstra, Sjoerd K; KUIJER, R; EERDMANS, P; VANDERLINDEN, AJ

    1994-01-01

    Rat patellae were preincubated with culture medium M199 for one hour and then with either fresh culture medium or Ringer's solution, Ringer lactate, Ringer glucose, normal saline or Betadine for another hour. The rate of proteoglycan synthesis in the articular cartilage was then measured by uptake o

  12. [X-ray diagnosis of retropatellar diseases (author's transl)].

    Science.gov (United States)

    Wahlers, B

    1979-08-01

    The article reports on a comprehensive, stepwise diagnosis in diseases of the knee joints. This includes a description of the indication, the technique of taking x-ray films, and x-ray findings, as well as arthrography of the femoropatellar joint in retropatellar diseases such as chondropathia patellae, osteochondrosis dissecans, traumas of the knee joints and arthrosis deformans.

  13. Patellofemoral Pressure Changes After Static and Dynamic Medial Patellofemoral Ligament Reconstructions

    NARCIS (Netherlands)

    Rood, A.; Hannink, G.; Lenting, A.; Groenen, K.; Koeter, S.; Verdonschot, N.J.; Kampen, A. van

    2015-01-01

    BACKGROUND: Reconstructing the medial patellofemoral ligament (MPFL) has become a key procedure for stabilizing the patella. Different techniques to reconstruct the MPFL have been described: static techniques in which the graft is fixed rigidly to the bone or dynamic techniques with soft tissue fixa

  14. Patellofemoral pressure changes after static and dynamic medial patellofemoral ligament reconstructions

    NARCIS (Netherlands)

    Rood, A.; Hannink, G.; Lenting, A.; Groenen, K.; Koëter, S.; Verdonschot, N.J.J.; Kampen, van A.

    2015-01-01

    Background: Reconstructing the medial patellofemoral ligament (MPFL) has become a key procedure for stabilizing the patella. Different techniques to reconstruct the MPFL have been described: static techniques in which the graft is fixed rigidly to the bone or dynamic techniques with soft tissue fixa

  15. 应用缝匠肌治疗伸膝功能障碍%The application of sartorius muscle for treatment of extension disorders of knee

    Institute of Scientific and Technical Information of China (English)

    陈秋生; 李松建; 余斌; 陈霞; 朱立新; 杨建成

    2002-01-01

    Objective Sartorius muscle was applied to treat dislocation or subluxation of patella and extension disorder of knee resulted from poliomyelitis,patellectomy and quadriceps femoris injury.Method The distal one third part or two thirds part of sartorius muscle excluded its insertion was freed,then transposed and threaded to the front surface of patella.Result 30 cases(37 knees)with dislocation or subluxation of patella were treated and 25 cases(28 knees)were followed up(mean followed up time 4 years).pain in the patello femeral joint disappeared without any recurrence of dislocation.75 with weak extensor of knee were treated and 50 were followed up for mean 2 years and 1 month.The extensor strength in the patients with poliomyelitis increased from 0.89 preoperatively to 2.76 postoperatively.The joint movement in the patients with extension stiffness of knee increased from 15° preoperatively to 102° postoperatively.The extensor strength in the patients with patellectomy increased by 2 grades postoperatively,which enable the patients to complete the last 10° to 15° extension movement of knee.Conclusion The authors modified the usual surgery methods,by which the results were far from perfect,in treatment of the lateral displacement of patella and advanced a new treatment for the patients with extension stiffness of knee and the patients with weak extensor strength after patellectomy.

  16. Iliotibial band release as an adjunct to the surgical management of patellar stress fracture in the athlete: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Keeley Anthony

    2009-07-01

    Full Text Available Abstract Stress fracture of the patella is rare. In this report, a case of patellar stress fracture occurring in an amateur athlete is presented, and an operative adjunct to the surgical management of this condition is proposed. A review of the English literature identified 21 previous cases of stress fracture of the patella, the majority in young athletes. None of these reports discussed treatment addressing the pathological process contributing to patellar stress fracture. The subject of this case report is a young male netballer who presented with a transverse stress fracture in the inferior third of his patella, on a background of patellofemoral overload. The patient underwent open reduction and internal fixation of his patella, combined with release of the iliotibial band. He returned to training after 6 weeks. The previous literature suggests that operative fixation is indicated for the treatment of displaced patellar stress fractures. Iliotibial band release, as a surgical adjunct to this treatment, may address the pathology of these fractures, and facilitate a return to sport at the highest level.

  17. Iliotibial band release as an adjunct to the surgical management of patellar stress fracture in the athlete: a case report and review of the literature.

    Science.gov (United States)

    Keeley, Anthony; Bloomfield, Paul; Cairns, Peter; Molnar, Robert

    2009-07-30

    Stress fracture of the patella is rare. In this report, a case of patellar stress fracture occurring in an amateur athlete is presented, and an operative adjunct to the surgical management of this condition is proposed.A review of the English literature identified 21 previous cases of stress fracture of the patella, the majority in young athletes. None of these reports discussed treatment addressing the pathological process contributing to patellar stress fracture.The subject of this case report is a young male netballer who presented with a transverse stress fracture in the inferior third of his patella, on a background of patellofemoral overload. The patient underwent open reduction and internal fixation of his patella, combined with release of the iliotibial band. He returned to training after 6 weeks.The previous literature suggests that operative fixation is indicated for the treatment of displaced patellar stress fractures. Iliotibial band release, as a surgical adjunct to this treatment, may address the pathology of these fractures, and facilitate a return to sport at the highest level.

  18. No effect of Osteoset, a bone graft substitute, on bone healing in humans: a prospective randomized double-blind study

    DEFF Research Database (Denmark)

    Petruskevicius, Juozas; Nielsen, Mette Strange; Kaalund, Søren;

    2002-01-01

    We studied the effects of a newly marketed bone substitute, Osteoset, on bone healing in a tibial defect in humans. 20 patients undergoing an ACL (anterior cruciate ligament) reconstruction with bone-patella tendon-bone graft were block-randomized into 2 groups of 10 each. In the treatment group...

  19. MEDIAL PATELLAR DESMOTOMY BY BLIND METHOD IN LARGE RUMINANTS DURING UPWARD PATELLAR FIXATION

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    S.Mondal

    2013-12-01

    Full Text Available A total number of 21 cases were reported with the clinical history of locked stifle joint. All cases were operated by medial patellar desmotomy using blind (closed method. Cases were recovered 100% with immediate relief. This blind method may be followed for operation of upward fixation of patella.

  20. Chronic quadriceps rupture: treatment with lengthening and early mobilization without cerclage augmentation and a report of three cases.

    Science.gov (United States)

    Rizio, Louis; Jarmon, Nicholas

    2008-01-01

    In this study, 3 patients with chronic quadriceps tears and gaps tendon, repair of the tendon through drill holes in the patella without cerclage augmentation, and early mobilization. The gap was quadriceps tendon. Results of this technique are presented with a minimum of 1-year follow-up.

  1. Total ruptures of the extensor apparatus of the knee

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    Diogo Moura

    Full Text Available ABSTRACT OBJECTIVE: This was a retrospective case-control study on total ruptures of the extensor apparatus of the knee, aimed to compare patella fractures with tendinous ruptures. METHODS: The sample included 190 patients and 198 total ruptures of the knee extensor apparatus. All patients were evaluated by the same examiner after a minimum one-year follow-up. RESULTS: Tendinous ruptures occurred most frequently in men, in younger patients, and had better clinical and functional outcomes when compared with patella fractures; however, the former presented higher levels of thigh atrophy. Patella fractures occurred most frequently in women and in older patients and caused most frequently caused residual pain, muscle weakness, and limitations in daily activities. Comminuted fractures were related to high-energy trauma, lower clinical and functional outcomes, and higher levels of residual pain and osteosynthesis failure. Early removal of osteosynthesis material was related to better outcomes. Regarding the tendinous ruptures, over half of the patients presented risk conditions for tendinous degeneration; a longer delay until surgery was related to lower Kujala scores. CONCLUSION: The surgical repair of bilateral ruptures of the knee extensor apparatus resulted in satisfactory clinical and functional outcomes, which were better for tendinous ruptures when compared with patella fractures. However, these lesions are associated with non-negligible levels of residual pain, muscle weakness, atrophy, and other complications.

  2. Avaliação eletromiográfica dos músculos estabilizadores da patela durante exercício isométrico de agachamento em indivíduos com síndrome da dor femoropatelar Evaluacion eletromiográfica de los músculos estabilizadores patelares durante el ejercício isométrico de agachamiento en indivíduos con síndrome de dolor femoropatelar Electromyographic activity evaluation of the patella muscles during squat isometric exercise in individuals with patellofemoral pain syndrome

    OpenAIRE

    Débora Bevilaqua-Grossi; Lílian Ramiro Felicio; Rebeca Simões; Kelly Rafael Ribeiro Coqueiro; Vanessa Monteiro-Pedro

    2005-01-01

    O objetivo deste trabalho foi comparar a atividade elétrica dos músculos vasto medial oblíquo (VMO), vasto lateral longo (VLL) e vasto lateral oblíquo (VLO) durante os exercícios isométricos de agachamento wall slide a 45º (WS 45º) e 60º (WS 60º) de flexão do joelho. Foram avaliadas 15 mulheres clinicamente saudáveis e 15 mulheres com síndrome da dor femoropatelar (SDFP). Os registros eletromiográficos foram obtidos por eletrodos ativos simples conectados a um eletromiógrafo durante a contraç...

  3. Avaliação eletromiográfica dos músculos estabilizadores da patela durante exercício isométrico de agachamento em indivíduos com síndrome da dor femoropatelar Evaluacion eletromiográfica de los músculos estabilizadores patelares durante el ejercício isométrico de agachamiento en indivíduos con síndrome de dolor femoropatelar Electromyographic activity evaluation of the patella muscles during squat isometric exercise in individuals with patellofemoral pain syndrome

    Directory of Open Access Journals (Sweden)

    Débora Bevilaqua-Grossi

    2005-06-01

    Full Text Available O objetivo deste trabalho foi comparar a atividade elétrica dos músculos vasto medial oblíquo (VMO, vasto lateral longo (VLL e vasto lateral oblíquo (VLO durante os exercícios isométricos de agachamento wall slide a 45º (WS 45º e 60º (WS 60º de flexão do joelho. Foram avaliadas 15 mulheres clinicamente saudáveis e 15 mulheres com síndrome da dor femoropatelar (SDFP. Os registros eletromiográficos foram obtidos por eletrodos ativos simples conectados a um eletromiógrafo durante a contração isométrica voluntária máxima (CIVM do WS 45º e WS 60º. Os dados foram analisados pela média dos valores do root mean square (RMS do sinal eletromiográfico, normalizado pela média do RMS obtido no agachamento a 75º de flexão do joelho. A análise estatística empregada foi o teste ANOVA two way (p El objetivo de este trabajo fué el de comparar la actvividad eléctrica de los músculos vasto medial oblíqüo (VMO, vasto lateral longo (VLL y vasto lateral oblicuo (VLO durante los ejercicios isometricos de agachamiento wall slide a 45º (WS 45º e 60º (WS 60º de flexión de rodilla. Fueron evaluadas 15 mujeres clinicamente saludables con sindrome de dolor femoropatelar (SDFP. Los registros fueron obtenidos por electrodos activos simples conectados a un electromiografo durante la contraccion isometrica voluntaria máxima (CIVM de WS 45º y de WS 60º. Los datos fueron analizados por la media de los valores de Root Mean Square - RMS de señal eletromiográfica, normalizada por la media del RMS obtenido en el agachamiento a 75º de flexión de la rodilla. El análisis estatístico empleado fue el test ANOVA two way (p The objective of this study was to compare the electromyographic (EMG activity of vastus medialis obliquus (VMO, vastus lateralis longus (VLL and vastus lateralis oblíquus (VLO during wall slide squat isometric exercises at 45º (WS 45º and at 60º (WS 60º of knee flexion. Fifteen healthy control women and fifteen women with patellofemoral pain syndrome (PPS participated in this study. The EMG activity was registered during WS 45º and WS 60º performed at maximal isometric voluntary contraction (MIVC using surface differential electrodes connected to an EMG system. The EMG signals were analyzed using the root mean square (RMS values and were normalized by MIVC obtained at 75º of knee flexion. To compare data between groups and exercises, the ANOVA-two-way and Duncan post hoc tests were applied (p < 0.05. The results demonstrated higher EMG activity for all muscles studied at WS 60º when compared to WS 45º in both control and PPS groups. There were not significant differences between muscles during WS 60º in the control group, although a higher activity of VLL in relation to VMO and VLO was observed during WS 45º in control group. For the PPS group, no statistical difference was observed between muscles during both exercises. Thus, strengthening programs using WS 60º could be more effective for healthy women; however, both exercises could be indicated for rehabilitation programs aimed at women with PPS. In addition, the absence of significant differences between muscles in PPS group verified in this study suggests that muscle unbalance could not be a predisposing factor for PPS in women.

  4. Modification of the method of Figgie for determination of joint line shifting in total knee arthroplasty; Modifizierung der Messmethode nach Figgie zur Bestimmung der Gelenklinienverschiebung in der Knieendoprothetik

    Energy Technology Data Exchange (ETDEWEB)

    Classen, T.; Wegner, A.; Knoch, M. von [Universitaet Duisburg-Essen, Klinik fuer Orthopaedie, Essen (Germany)

    2009-06-15

    An important factor for a good result after total knee arthroplasty is the position of the patella in relation to the tibiofemoral joint line. The position of the patella itself is not influenced by arthroplasty, therefore any changes in the position of the tibiofemoral joint line are of special interest. The Figgie method to describe patella height delivers only absolute measurements, which makes it difficult to compare different radiographs. For this reason we developed a new JL/P quotient (JL: distance from the tibial plateau to the tibial tubercle, P: distance from the inferior pole of the patella to the tibial plateau) to enable better comparison. Furthermore, we modified the JL/P quotient and instead of taking the tibial plateau as the reference line, we constructed a tangent on the femoral condyle. With this modification, problems such as tibial inlays of different heights which have to be taken into account in the measurements, the slope of the tibial component or difficult assessment of the tibial joint surface in osteoarthritic knees do not arise. The JL/P quotient shows massive shift to cranialisation of the tibiofemoral joint line which does not correspond to reality. The modified method also shows cranialisation of the tibiofemoral joint line, but in a realistic way. Both methods show a minimal interobserver variability. The modified JL/P quotient seems to be a good method for determining the shift in the tibiofemoral joint line after total knee arthroplasty. (orig.) [German] Ein bedeutender Faktor fuer ein gutes postoperatives Ergebnis nach einer Knieendoprothesenimplantation ist die Stellung der Patella in Relation zur tibiofemoralen Gelenklinie. Da die Stellung der Patella durch den operativen Eingriff primaer nicht beeinflusst wird, liegt besonderes Augenmerk auf den Veraenderungen der Gelenklinie des Tibiofemoralgelenks. Die Messmethode zur Bestimmung der Patellahoehe nach Figgie liefert dafuer nur absolute Werte, was eine Vergleichbarkeit von

  5. The post-arthro-CT of the wrist clinical evaluation

    CERN Document Server

    Scheurecker, G

    2001-01-01

    To compare the diagnostic effectiveness of post-arthro-CT (PACT) and 3-compartment wrist arthrography (AG) both separate and combined versus wrist arthroscopy for scapho-lunate ligament (SLL), luno-triquetral ligament (LTL) and triangular fibrocartilage (TFC) defects and chondromalacia of the carpal bones. Material and methods: in 58 patients (16-69 years) the affected wrist was examined initially by conventional 3-compartment wrist arthrography with digital subtraction technique during injection followed by digital stress images. Afterwards spiral arthro-CT was performed in the semi-coronal and axial plane with 1 mm slice thickness and secondary true-coronal and sagittal reconstructions. Within 1 month arthroscopy was performed in general anesthesia utilizing standard joint entry points combined with routine digital picture archiving. All examinations were evaluated for SLL, LTL and TFC defects, PACT and AS for ChM too. Results: AG versus AS: the following detection rates were observed (AG and AS positive/AG...

  6. Total knee arthroplasty with subvastus approach in patient with chronic post-traumatic patellar dislocation

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    Jader Joel Machado Junqueira

    Full Text Available ABSTRACT Chronic lateral dislocation of the patella is a rare condition and acquired causes are usually secondary to knee trauma. The neglected chronic dislocation leads to progressive genu valgum and external tibial torsion deformities with subsequent gonarthrosis, which becomes painful and debilitating. There is no consensus regarding treatment of these patients, but total knee arthroplasty (TKA is a useful therapy in cases of painful symptomatic gonarthrosis. Few reports have shown that subvastus approach and lateral release may be a valid option for TKA, since it allows the correction of valgus deformity and patellar tracking without interrupting vascular blood supply of patella. This article reports a case of TKA and extensor mechanism realignment without patellar resurfacing in a patient with genu valgum and chronic post-traumatic patellar dislocation with satisfactory results after two years of follow-up.

  7. Extensor-mechanism-reconstruction of the knee joint after traumatic loss of the entire extensor apparatus.

    Science.gov (United States)

    Raschke, D; Schüttrumpf, J P; Tezval, M; Stürmer, K M; Balcarek, P

    2014-06-01

    Injuries to the extensor apparatus of the knee joint have an incidence of 0.5% to 6%. Although previous studies have described the advantages and disadvantages of operative treatment in cases of patellar tendon rupture, patella fracture or quadriceps tendon lesions, a report on the reconstruction of the extensor apparatus after traumatic loss of the patella, the patellar tendon, the tibial tuberosity and parts of the lateral quadriceps muscle is absent from the literature. We present the case of a young motorcyclist who underwent a reconstruction of the extensor apparatus using autologous tendon grafts. At a 24-month follow-up, the patient has a nearly physiological range of motion of the knee joint and is able to cope well with everyday life.

  8. Comparative validation of the radiographic and tomographic measurement of patellar height

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    Marco Antonio Schueda

    2013-09-01

    Full Text Available OBJECTIVE: To evaluate and validate the radiographic measurement of patellar height with computerized tomography scans. METHODS: Measured the patellar height through the lateral radiographic image supported by one foot and sagittal tomographic view of the knee in extension, flexion of 20°, and quadriceps contraction of 40 patients (80 knees, asymptomatic and no history of knee injuries using Insall-Salvati index. There were 20 adult females and 20 adult males. RESULTS: The height patellar index was higher in women of all images taken, in proportion. There was no statistical difference of patellar height index between the radiographics and tomographics images. CONCLUSION: The Insall-Salvati index in females was higher in all cases evaluated. Furthermore, it is possible to measure the patellar height index during tomographic study without distorting the results obtained, using to define the presence of patella alta or patella baja.

  9. Tibial tubercle osteotomy for patello-femoral joint disorders.

    Science.gov (United States)

    Hall, Matthew J; Mandalia, Vipul I

    2016-03-01

    Tibial tubercle osteotomy has a long history in the management of patella instability and patello-femoral arthritis. This review aims to provide a comprehensive review of the literature describing the biomechanics of the patello-femoral joint and the rationale behind the use of the tibial tubercle osteotomy in modern day practice. Several different tibial tubercle osteotomies are available and we aim to detail the concepts behind their use and the subsequent clinical results. With continued developments of chondrocyte implantation techniques, the potential to fill defects on the chondral surface of either the patella or trochlea in conjunction with a tibial tubercle osteotomy may well become more commonplace in a group that is commonly young and difficult to manage. Level of evidence III.

  10. Reconstruction and restoration of neglected ruptured patellar tendon using semitendinosus and gracilis tendons with preserved distal insertions: two case reports.

    Science.gov (United States)

    Chen, Bin; Li, Runguang; Zhang, Sheng

    2012-08-01

    Neglected rupture of the patellar tendon is rare but becomes more difficult to repair the longer it is left untreated. The most common rupture sites are the inferior pole of the patella and distal insertion. Proximal retraction of the patella and extensor mechanism adhesions makes the treatment more difficult than acute tendon rupture. We report two patients with neglected patellar tendon rupture treated by reconstruction and restoration using semitendinosus-gracilis (STG) tendons with preserved distal insertions. Preserved distal insertion provided sufficient blood supply to accelerate healing, while combined fixation with tension-reducing wire, offered the initial stability of the closed-loop sutured tendon. Both patients reacquired near normal strength and stability of the patellar tendon and restoration of function after operation and rehabilitation.

  11. Total knee arthroplasty with subvastus approach in patient with chronic post-traumatic patellar dislocation.

    Science.gov (United States)

    Junqueira, Jader Joel Machado; Helito, Camilo Partezani; Bonadio, Marcelo Batista; Pécora, Jose Ricardo; Demange, Marco Kawamura

    2016-01-01

    Chronic lateral dislocation of the patella is a rare condition and acquired causes are usually secondary to knee trauma. The neglected chronic dislocation leads to progressive genu valgum and external tibial torsion deformities with subsequent gonarthrosis, which becomes painful and debilitating. There is no consensus regarding treatment of these patients, but total knee arthroplasty (TKA) is a useful therapy in cases of painful symptomatic gonarthrosis. Few reports have shown that subvastus approach and lateral release may be a valid option for TKA, since it allows the correction of valgus deformity and patellar tracking without interrupting vascular blood supply of patella. This article reports a case of TKA and extensor mechanism realignment without patellar resurfacing in a patient with genu valgum and chronic post-traumatic patellar dislocation with satisfactory results after two years of follow-up.

  12. Hybrid total knee arthroplasty: a retrospective analysis of clinical and radiographic outcomes at average 10 years follow-up.

    Science.gov (United States)

    Illgen, Richard; Tueting, Jonathan; Enright, Timothy; Schreibman, Ken; McBeath, Andrew; Heiner, John

    2004-10-01

    Cemented total knee arthroplasty has demonstrated high success rates at 10-12 years. Although many cementless designs have demonstrated inferior outcomes, hybrid fixation has not been studied in detail. We retrospectively reviewed 112 hybrid total knee arthroplasties (PCA-67 and Duracon-45) after clinical and radiographic review using the SF-12 and Knee Society Scores at an average 10-year follow-up. The revision rate was 4.5%: 4 occurred in patients with metal-backed patellae and 1 in a patient with infection. No revisions were performed for aseptic loosening of the femoral component. Hybrid total knee arthroplasty with these designs provided excellent clinical and radiographic performance at 10 years comparable to cemented series. Aseptic loosening and radiographic failure rates were 0% if patients with metal-backed patellae were excluded. The durability of hybrid fixation beyond 10 years deserves further study.

  13. Simultaneous bilateral patellar tendon rupture without

    Directory of Open Access Journals (Sweden)

    LU Hua-ding

    2012-04-01

    Full Text Available 【Abstract】There is a dearth of case reports de-scribing simultaneous bilateral patellar tendon ruptures in the medical literature. These ruptures are often associated with systemic disorders such as lupus erythematosus or chronic steroid use. The author describes a case of a 24-year-old man who sustained traumatic bilateral patellar ten-don ruptures without any history of systemic disease or steroidal medication. We repaired and reattached the rup-tured tendons to the patella and augmented our procedure with allogeneic tendon followed by wire loop reinforcement. One year after operation, the patient regained a satisfactory range of motion of both knees with good quadriceps strength and no extensor lag. The recurrent microtrauma from a history of intense sports activity and a high body mass index may have played an important role in this trauma event. Key words: Patella; Patellar ligament; Rupture; Ten-don injuries; Knee

  14. Segmentation of multiple knee bones from CT for orthopedic knee surgery planning.

    Science.gov (United States)

    Wu, Dijia; Sofka, Michal; Birkbeck, Neil; Zhou, S Kevin

    2014-01-01

    Patient-specific orthopedic knee surgery planning requires precisely segmenting from 3D CT images multiple knee bones, namely femur, tibia, fibula, and patella, around the knee joint with severe pathologies. In this work, we propose a fully automated, highly precise, and computationally efficient segmentation approach for multiple bones. First, each bone is initially segmented using a model-based marginal space learning framework for pose estimation followed by non-rigid boundary deformation. To recover shape details, we then refine the bone segmentation using graph cut that incorporates the shape priors derived from the initial segmentation. Finally we remove overlap between neighboring bones using multi-layer graph partition. In experiments, we achieve simultaneous segmentation of femur, tibia, patella, and fibula with an overall accuracy of less than 1mm surface-to-surface error in less than 90s on hundreds of 3D CT scans with pathological knee joints.

  15. Bilateral traumatic patellar fracture: a case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    Gupta Vinay; Kundu Zile; Garg Rakesh; Sanjay Gaurav

    2012-01-01

    Simultaneous isolated bilateral patellar fractures are very rare injuries and most often associated with systemic disorders such as hyperparathyroidism,osteoporosis,stress fracture and kidney failure.Isolated bilateral traumatic fracture of patella following an unusual mode of injury is seldomly reported in the literature.We reported such a case following a road traffic accident without any associated injuries or co-morbid condition.The patella on the right side had transverse open fracture which was fixed with two Kirschner wires following tension band principle,and that on the left side sustained upper pole comminution which was treated by partial patellectomy.The patient achieved good outcome:at 6 months he was able to squat and sit cross legged; at one year he obtained nearly normal muscle strength and full range of motion.We discussed the injury mechanism,management and rehabilitation in such a case and reviewed the available literature regarding such a presentation.

  16. A Brief History of Anterior Cruciate Ligament Reconstruction

    Directory of Open Access Journals (Sweden)

    Nikolaos Davarinos

    2014-01-01

    Full Text Available Reconstructions of the anterior cruciate ligament (ACL are among the most frequently performed procedures in knee surgery nowadays. The history of ACL surgery can be traced as far back as the Egyptian times. The early years reflect the efforts to establish a viable, consistently successful reconstruction technique while, during the early 20th century, we witness an increasing awareness of, and interest in, the ligament and its lesions. Finally, we highlight the most important steps in the evolution of the ACL reconstruction surgery by discussing the various techniques spanning the years using not only autologous grafts (fascia lata, meniscal, hamstring, patella tendon, bone-patella tendon-bone, and double bundle grafts but also synthetic ones and allografts.

  17. Una especie nueva de Diplocentrus (Scorpiones: Diplocentridae del estado de Michoacán, México A new species of Diplocentrus (Scorpiones: Diplocentridae from the state of Michoacán, Mexico

    Directory of Open Access Journals (Sweden)

    Oscar F. Francke

    2009-12-01

    Full Text Available Se describe Diplocentrus poncei sp. nov. del estado de Michoacán, México. Es la primera especie del género y de la familia con neobotriotaxia incremental en la patela y quela de los pedipalpos. Se da a conocer por primera vez que Diplocentrus magnus también tiene neobotriotaxia incremental en la patela, pero no en la quela de los pedipalpos.Diplocentrus poncei, sp. nov. from the state of Michoacán, Mexico is described. This is the first species in the genus and family with increasing neobothriotaxy on the patella and chela of the pedipalps. Diplocentrus magnus has been found to have increasing neobothriotaxy on the patella but not on the chela of the pedipalps.

  18. Journal of Special Operations Medicine. Volume 9, Edition 2, Spring 2009

    Science.gov (United States)

    2009-01-01

    than expected for patella-femoral syndrome. During examination of the lower extremities, bilateral non-erythematous tender knee effusions with warmth to...deterioration of interpersonal relation- ships between FEST and the rest of MRT triggered open dissension within these elements.92 Beginning with the period...can spell failure for a Q-Course can- didate as resoundingly so as do any social interpersonal shortcomings. Through each phase of the Q-Course, the

  19. Efectividad del taping en el tratamiento conservador del síndrome de dolor patelofemoral. Una revisión sistemática

    OpenAIRE

    Meneses, José Francisco; Araque, Ronald Eduardo

    2013-01-01

    Objective. To evaluate patellar taping, in treatment of SDFMmethodology. A systematic review was performed to CENTRAL, MEDLINE, EMBASE, CINAHL, PEDro, SPORTDiscus and AMED data bases, with the following search terms: “patellofemoral pain syndrome”, “patella-femoral pain syndrome treatment”, “tape”, “anterior knee pain”, “patellar taping”, “kinesiotaping”,“knee taping”, y “McConell taping. At random controlled studies were included, published since January through February  2012, in English la...

  20. Fixation of an osteochondral fragment after acute patellar dislocation in an immature skeleton,

    Directory of Open Access Journals (Sweden)

    Rodrigo Pires e Albuquerque

    2014-04-01

    Full Text Available Fixation of an osteochondral fracture after acute patellar dislocation is an infrequent form of treatment. Likewise, the location of this fragment in the lateral region of the lateral femoral condyle, functioning as a free body, is uncommon. The aim of this study was to present a case of osteochondral fracture of the patella at an unusual site, along with the therapy used and the clinical follow-up.

  1. [Operative therapy in patellar chondropathy].

    Science.gov (United States)

    Jäger, M; Plitz, W

    1983-01-01

    A critical appraisal of the results of conservative and surgical treatment of chondropathia patellae revealed that it has not yet proved possible to achieve a good surgical result in excess of 75%. Findings with a new direct method of measuring retropatellar pressure distribution on human specimens, and the knowledge thus obtained, are discussed in connection with clinical results. They show that more detailed knowledge of the cause of the chondropathy is required if surgical treatment is to be successful.

  2. Osteology and Functional Morphology of the Hind Limb of the Marine Sloth Thalassocnus (Mammalia, Tardigrada)

    OpenAIRE

    Amson, Eli; Argot, Christine; McDonald, H. Gregory; de Muizon, Christian

    2014-01-01

    International audience; The anatomy of the skeletal elements of the hind limb of Thalassocnus is described. This genus of “ground sloth” comprises five species represented by Neogene specimens from the coast of Peru and Chile, mostly found in the Pisco Formation. The hind limb of the genus Thalassocnus as a whole is characterized by a small iliac wing, a gracile femur with well-formed femoral neck, teardrop shaped patella, long and slender tibia, triangular tuber calcis, and proximal developm...

  3. POST TRAUMATIC KNEE FRACTURE ( X-RAY

    Directory of Open Access Journals (Sweden)

    Dr. Jalaja Prakash.

    2013-06-01

    Full Text Available A 51 year old male patient met with a road traffic accident on August 2010. On examination thepatient was unable to stand and walk. His right knee was swollen and complained of pain withinstability. The X-Ray of patient showed transverse fracture of patella along with comminutedfracture of lower end of femur. He was treated with “K” wire and internal fixation. The patient wasadvised early physiotherapy which include range of motion exercises, knee strengthening and gaittraining.

  4. Effect of mechanical convection on the partitioning of an anionic iodinated contrast agent in intact patellar cartilage.

    Science.gov (United States)

    Entezari, Vahid; Bansal, Prashant N; Stewart, Rachel C; Lakin, Benjamin A; Grinstaff, Mark W; Snyder, Brian D

    2014-10-01

    To determine if mechanical convection accelerates partitioning of an anionic contrast agent into cartilage while maintaining its ability to reflect the glycosaminoglycan (GAG) content in contrast-enhanced computed tomography (CECT) of cartilage. Bovine patellae (N = 4) were immersed in iothalamate and serially imaged over 24 h of passive diffusion at 34°C. Following saline washing for 14 h, each patella was serially imaged over 2.5 h of mechanical convection by cyclic compressive loading (120N, 1 Hz) while immersed in iothalamate at 34°C. After similar saline washing, each patella was sectioned into 15 blocks (n = 60) and contrast concentration per time point as well as GAG content were determined for each cartilage block. Mechanical convection produced 70.6%, 34.4%, and 16.4% higher contrast concentration at 30, 60, and 90 min, respectively, compared to passive diffusion (p correlation between contrast concentration and GAG content was significant at all time points and correlation coefficients improved with time, reaching R(2)  = 0.60 after 180 min of passive diffusion and 22.5 min of mechanical convection. Mechanical convection significantly accelerated partitioning of a contrast agent into healthy cartilage while maintaining strong correlations with GAG content, providing an evidence-based rationale for adopting walking regimens in CECT imaging protocols.

  5. Muscle Damage following Maximal Eccentric Knee Extensions in Males and Females

    Science.gov (United States)

    2016-01-01

    Aim To investigate whether there is a sex difference in exercise induced muscle damage. Materials and Method Vastus Lateralis and patella tendon properties were measured in males and females using ultrasonography. During maximal voluntary eccentric knee extensions (12 reps x 6 sets), Vastus Lateralis fascicle lengthening and maximal voluntary eccentric knee extensions torque were recorded every 10° of knee joint angle (20–90°). Isometric torque, Creatine Kinase and muscle soreness were measured pre, post, 48, 96 and 168 hours post damage as markers of exercise induced muscle damage. Results Patella tendon stiffness and Vastus Lateralis fascicle lengthening were significantly higher in males compared to females (ptorque loss and muscle soreness post exercise induced muscle damage (p>0.05). Creatine Kinase levels post exercise induced muscle damage were higher in males compared to females (pknee extension torque, relative to estimated quadriceps anatomical cross sectional area, was taken as a covariate (ptorque loss, there is no sex difference in exercise induced muscle damage. The higher Creatine Kinase in males could not be explained by differences in maximal voluntary eccentric knee extension torque, Vastus Lateralis fascicle lengthening and patella tendon stiffness. Further research is required to understand the significant sex differences in Creatine Kinase levels following exercise induced muscle damage. PMID:26986066

  6. Patellar hypomobility and the flexibility of the iliotibial band and the femoral quadriceps.

    Science.gov (United States)

    Getka, Aleksandra

    2005-12-30

    Background. The aim of our study was to determine whether or not the flexibility of the iliotibial band and femoral quadriceps have an impact on patellar hypomobility, due to their connections with the patellar stabilizers. Material and methods. We examined 62 patients (44 females, 18 males) with a median age of 15 years (range 9-19). All these patients had patellofemoral dysfunction in the tested knees (101). The medial and distal glide of the patella were tested with a manual test according to Kaltenborn's scale. Ober's test was performed to test the tightness of the iliotibial band. The flexibility of the quadriceps femoris was tested while the patient was lying prone with the tested leg on the couch and the other beside it. Results. Statistical analysis based on the c2 test (P=0.05) found no dependence between the flexibility parameters of the iliotibial band or the femoral quadriceps and the parameters of patellar hypomobility. Of the tested joints, 37.6% showed hypomobile patella and positive Ober's test, while 34.7% had hypomobile patella and a positive test for femoral quadriceps flexibility. Conclusions. The flexibility of the iliotibial band and femoral quadriceps has no direct influence on passive patellar hypomobility, but can affect the biomechanics of the patellofemoral joint and the location of the point of contact on articular surfaces during dynamic knee work. The flexibility of these muscles should be a diagnostic factor in patients with patellofemoral dysfunction.

  7. Above-knee vein harvest for coronary revascularization increases ASEPSIS score.

    Science.gov (United States)

    Akowuah, Enoch; Shrivastava, Vivek; Ponniah, Alan; Jamnadas, Binal; Chilton, Gary; Cooper, Graham

    2006-02-01

    The long saphenous vein may be harvested from the thigh or the lower leg, depending on the operating surgeon's preference. This prospective study compared the incidence of altered wound healing between these two sites in 175 patients undergoing routine coronary artery bypass grafting over a 3-month period. The patients were divided into 3 groups. In group A, the vein harvest site was restricted to above the upper border of the patella. Group B included harvest sites that started at the ankle but extended above the level of the upper border of the patella. In group C, the vein harvest site was restricted to below the upper border of the patella. The wounds were assessed daily using the ASEPSIS scoring system. In group A, significantly more patients (24%) had an ASEPSIS score > 10, compared to group B (3%) and group C (2%). The mean ASEPSIS score was significantly lower in group C than groups A or B, 1.5 +/- 2.4 vs. 6.5 +/- 3.2 or 3.7 +/- 1.7, respectively. The ASEPSIS score is reduced when vein harvest is restricted to below the level of the knee.

  8. The distribution of superficial zone protein (SZP)/lubricin/PRG4 and boundary mode frictional properties of the bovine diarthrodial joint.

    Science.gov (United States)

    Peng, Gordon; McNary, Sean M; Athanasiou, Kyriacos A; Reddi, A Hari

    2015-09-18

    The diarthrodial, knee joint is a remarkably efficient bearing system; articulating cartilage surfaces provide nearly frictionless performance with minimal wear. The low friction properties of the cartilage surfaces are due in part to the boundary lubricant, superficial zone protein (SZP); also known as lubricin or proteoglycan 4 (PRG4). In previous work, SZP localization and cartilage friction were examined across the femoral condyles. Studies in the literature have also individually investigated the other tissues that comprise the human knee and four-legged animal stifle joint, such as the meniscus or patella. However, comparisons between individual studies are limited due to the variable testing conditions employed. Friction is a system property that is dependent on the opposing articulating surface, entraining speed, and loading. A cross-comparison of the frictional properties and SZP localization across the knee/stifle joint tissues utilizing a common testing configuration is therefore needed. The objective of this investigation was to determine the friction coefficient and SZP localization of the tissues comprising the three compartments of the bovine stifle joint: patella, patellofemoral groove, femoral condyles, meniscus, tibial plateau, and anterior cruciate ligament. The boundary mode coefficient of friction was greater in tissues of the patellofemoral compartment than the lateral and medial tibiofemoral compartments. SZP immunolocalization followed this trend with reduced depth of staining and intensity in the patella and patellofemoral groove compared to the femoral condyles and tibial plateau. These results illustrate the important role of SZP in reducing friction in the tissues and compartments of the knee/stifle joint.

  9. Computer-assisted patellar resection system: development and insights.

    Science.gov (United States)

    Fu, Chun Kit; Wai, Jeff; Lee, Estee; Hutchison, Carol; Myden, Curtis; Batuyong, Eldridge; Anglin, Carolyn

    2012-04-01

    Incorrect resection of the patella during total knee arthroplasty (TKA) can lead to anterior knee pain (AKP), patellar maltracking, patellofemoral impingement, patellar fracture, component loosening, and reduced range of motion. Computer-assisted surgery (CAS) systems for the tibia and femur improve cut accuracy, but no CAS system is available for patellar resection. We developed a system that included an optoelectronic localizer, marker arrays on the patella and instruments, and navigation software. Three users performed resections on artificial patellae mounted in a simulated surgical setup using five techniques (two CAS, three conventional), each repeated at least three times in randomized order. Computer-assisted patellar resection produced better or equal cut symmetry compared to conventional techniques, particularly superoinferiorly. Using CAS with a sawguide produced better results than using CAS freehand with an oscillating saw. This study showed the feasibility of computer-assisted patellar resection, which could lead to reduced pain and complications after TKA. The feedback provided could also make patellar CAS a valuable training tool.

  10. Iliotibial band tightness and patellofemoral pain syndrome: a case-control study.

    Science.gov (United States)

    Hudson, Zoe; Darthuy, Emma

    2009-04-01

    Tight lateral structures have been implicated in subjects presenting with patellofemoral pain syndrome (PFPS). It has been proposed that a tight iliotibial band (ITB) through its attachment of the lateral retinaculum into the patella could cause lateral patella tracking, patella tilt and compression. Twelve subjects presenting with PFPS were compared with 12 matched control subjects. Hip adduction was measured using the Ober test in each subject as an indirect measure of ITB length. The mean values for hip adduction in the control group were 21.4 (+/-4.9) and 20.3 (+/-3.8) degrees in the left and right legs, respectively, and in the PFPS group, 17.3 (+/-6.1) and 14.9 (+/-4.2) degrees in the non-painful leg and painful leg, respectively. One way analysis of variance (ANOVA) revealed a highly significant difference between groups (F=4.485, p=0.008) and post-hoc analysis showed a significant difference between the painful leg in the PFPS group and the left and right legs in the control group, p=0.002 and 0.009, respectively. The results from this study show that subjects presenting with PFPS do have a tighter ITB. Future work should investigate this observation prospectively in order to determine whether a tight ITB is the cause or effect of PFPS.

  11. Muscle Damage following Maximal Eccentric Knee Extensions in Males and Females.

    Directory of Open Access Journals (Sweden)

    K M Hicks

    Full Text Available To investigate whether there is a sex difference in exercise induced muscle damage.Vastus Lateralis and patella tendon properties were measured in males and females using ultrasonography. During maximal voluntary eccentric knee extensions (12 reps x 6 sets, Vastus Lateralis fascicle lengthening and maximal voluntary eccentric knee extensions torque were recorded every 10° of knee joint angle (20-90°. Isometric torque, Creatine Kinase and muscle soreness were measured pre, post, 48, 96 and 168 hours post damage as markers of exercise induced muscle damage.Patella tendon stiffness and Vastus Lateralis fascicle lengthening were significantly higher in males compared to females (p0.05. Creatine Kinase levels post exercise induced muscle damage were higher in males compared to females (p<0.05, and remained higher when maximal voluntary eccentric knee extension torque, relative to estimated quadriceps anatomical cross sectional area, was taken as a covariate (p<0.05.Based on isometric torque loss, there is no sex difference in exercise induced muscle damage. The higher Creatine Kinase in males could not be explained by differences in maximal voluntary eccentric knee extension torque, Vastus Lateralis fascicle lengthening and patella tendon stiffness. Further research is required to understand the significant sex differences in Creatine Kinase levels following exercise induced muscle damage.

  12. Seasonality Records From Stable Isotopes and Trace Elements in Mussel and Limpet Shells From Archaeological Sites on Gibraltar

    Science.gov (United States)

    Fa, D.; Ferguson, J. E.; Atkinson, T. C.; Barton, R. N.; Ditchfield, P.; Finlayson, G.; Finlayson, J. C.; Henderson, G. M.

    2007-12-01

    Seasonal resolution climate records from mid and high latitudes would allow investigation of the role of seasonality in controlling mean climate on diverse timescales, and of the evolution of climate systems such as the North Atlantic Oscillation (NAO). But achieving such seasonal resolution is difficult for regions outside the growth range of surface corals. Marine mollusc shells provide a possible archive and contain growth increments varying in scale from tidal to annual. However, finding and dating sequences of marine mollusc shells spanning long periods of time is difficult due to sea-level change and the destructional nature of most coastal environments. In this study, we have made use of the habit of hominins on Gibraltar to collect molluscs for food over at least the last 120 kyr. In archaeological excavations of two caves (Gorham's and Vanguard Caves), mollusc shells were found, in habitation levels and in sediment blown into the caves. Existing 14C, OSL, and U-series chronologies provide a chronological framework for this suite of samples. The species found are predominantly Mytilus (mussels) or Patella (limpets). Gibraltar is an interesting location for paleoclimate reconstruction due to its proximity to the boundary of modern day climate belts but also due to its anthropological and archaeological importance. To gain a quantitative understanding of the local controls on stable isotopes and trace elements within Gibraltarian shells, we have initiated a water-sampling programme; emplaced a temperature and salinity logger near the sampling site; and marked live Patella and Mytilus with fluorescent dye to firmly establish growth rates and controls on chemical composition. We have also conducted stable-isotope and trace-element analysis of modern and fossil Patella and Mytilus shells by micromilling. Recent Patella and Mytilus shells show that the oxygen isotope composition of modern shells allow the accurate reconstruction of the full seasonal range in sea

  13. Genesis Ⅱ与PFC两种假体全膝关节置换术后膝前痛的比较研究%Comparison of anterior knee pain after total knee arthroplasty using Genesis Ⅱ and PFC knee prostheses

    Institute of Scientific and Technical Information of China (English)

    吴伟东; 严世贵; 吴立东; 吴浩波; 何荣新

    2012-01-01

    Objective To explore relationship between anterior knee pain after total knee arthroplasty and patella resurfacing and prosthesis design,and to evaluate which femoral prosthesis is more friendly with patella:Genesis Ⅱ or PFC knee prostheses.Methods Data of 145 patients (145 knees) who had undergone primary total knee arthroplasty for treating osteoarthritis were retrospectively analyzed.Posterior-cruciate-substituting total knee prostheses were used in all patients.Among 74 patients who had undergone patella resurfacing,Genesis Ⅱ knee prosthesis was used in 32 patients and PFC knee prosthesis in 42 patients.Among 71 patients who had not undergone patella resurfacing,Genesis Ⅱ knee prosthesis was used in 38 patients and PFC knee prosthesis in 33 patients.The Hospital for Special Surgery(HSS) score,patella score,patellar function score,range of motion of knee,anterior knee pain scale,and patient satisfaction were used to evaluate clinical outcomes.At the same time,the imaging results were evaluated by X-rays.Results 144 patients were successfully followed up for 21 to 43 months (average,33 months).There was no significant difference in incidence of anterior knee pain between the group with patella resurfacing and the group without patella resurfacing,while a significant difference was found between patients receiving Genesis Ⅱ knee prosthesis and those receiving PFC knee prosthesis.Four patients who had undergone total knee arthroplasty using PFC prosthesis underwent reoperation.There were no significant differences in postoperative HSS score,range of motion of knee and patient satisfaction between the Genesis Ⅱ group and the PFC group,while there were significant differences in patella score and patellar function score between them.Conclusion Postoperative anterior knee pain was related to the prosthesis design,rather than to the patella resurfacing.Genesis Ⅱ knee prosthesis was more friendly with patella than PFC knee prosthesis.%目的 探讨全膝关

  14. [Jumper's knee--a review].

    Science.gov (United States)

    Tibesku, C O; Pässler, H H

    2005-06-01

    Jumper's knee has been defined as painful chronic overuse injury of the extensor mechanism of the knee joint. The disease has a high incidence in jumping sports and depends on training frequency and level of performance. Its natural course is protracted, repetitive, and often bilaterally occurring. Its etiology is a chronic overload of the knee extensor mechanism which is triggered by jumping sports (volleyball, basketball etc.) as well as different intrinsic (ligamentous laxity, Q-angle, patella height, tenderness, pattern of force development) and extrinsic dispositions (frequency of training, level of performance, hardness of underground). The place of pathology most often is the osteo-tendinous transition zone of the proximal patellar tendon. Histologic evaluation of the tendon showed that the disease is rather degenerative than inflammatory. The diagnosis is primarily based on the typical sports history, physical examination, and ultrasound. MRI is helpful in operation planning. Plain radiography, CT, and bone scans are used to rule out differential diagnoses. Therapy should be chosen according to the stage of the disease and usually starts with a non-surgical approach. This includes rest from sports activities, immobilisation, non-steroid antiphlogistics, para-tendinous cortisone injections, massage, electric therapy, ultrasound and extracorporal shock waves. Afterwards an increase of activities is begun (moderate training, adequate warm-up, ice cooling after activity, muscle stretching, eccentric strengthening of the quadriceps). Patella straps and soft insoles are used as prevention. Up to 42 % of patients need surgical therapy after failure of long-lasting non-surgical measures, carried out either open or arthroscopically. Surgical principles include excision of the para-tendon, excision of the degenerative tissue, resection of the lower patella pole, and longitudinal incisions into the tendon. Most patients are pain-free after surgery but return to sports

  15. Quality control and statistical modeling for environmental epigenetics: a study on in utero lead exposure and DNA methylation at birth.

    Science.gov (United States)

    Goodrich, Jaclyn M; Sánchez, Brisa N; Dolinoy, Dana C; Zhang, Zhenzhen; Hernández-Ávila, Mauricio; Hu, Howard; Peterson, Karen E; Téllez-Rojo, Martha M

    2015-01-01

    DNA methylation data assayed using pyrosequencing techniques are increasingly being used in human cohort studies to investigate associations between epigenetic modifications at candidate genes and exposures to environmental toxicants and to examine environmentally-induced epigenetic alterations as a mechanism underlying observed toxicant-health outcome associations. For instance, in utero lead (Pb) exposure is a neurodevelopmental toxicant of global concern that has also been linked to altered growth in human epidemiological cohorts; a potential mechanism of this association is through alteration of DNA methylation (e.g., at growth-related genes). However, because the associations between toxicants and DNA methylation might be weak, using appropriate quality control and statistical methods is important to increase reliability and power of such studies. Using a simulation study, we compared potential approaches to estimate toxicant-DNA methylation associations that varied by how methylation data were analyzed (repeated measures vs. averaging all CpG sites) and by method to adjust for batch effects (batch controls vs. random effects). We demonstrate that correcting for batch effects using plate controls yields unbiased associations, and that explicitly modeling the CpG site-specific variances and correlations among CpG sites increases statistical power. Using the recommended approaches, we examined the association between DNA methylation (in LINE-1 and growth related genes IGF2, H19 and HSD11B2) and 3 biomarkers of Pb exposure (Pb concentrations in umbilical cord blood, maternal tibia, and maternal patella), among mother-infant pairs of the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) cohort (n = 247). Those with 10 μg/g higher patella Pb had, on average, 0.61% higher IGF2 methylation (P = 0.05). Sex-specific trends between Pb and DNA methylation (P < 0.1) were observed among girls including a 0.23% increase in HSD11B2 methylation with 10

  16. Inferior patellar pole fragmentation in children: just a normal variant?

    Energy Technology Data Exchange (ETDEWEB)

    Kan, J.H.; Vogelius, Esben S.; Orth, Robert C.; Guillerman, R.P.; Jadhav, Siddharth P. [Texas Children' s Hospital, E.B. Singleton Pediatric Radiology, Houston, TX (United States)

    2015-06-15

    Fragmentary ossification of the inferior patella is often dismissed as a normal variant in children younger than 10 years of age. The purpose of this study was to determine whether fragmentary inferior patellar pole ossification is a normal variant or is associated with symptoms or signs of pathology using MRI and clinical exam findings as reference. A retrospective review was performed on 150 patients ages 5-10 years who underwent 164 knee radiography and MRI exams (45.1% male, mean age: 7.8 years). The presence or absence of inferior patellar pole fragmentation on radiography was correlated with the presence or absence of edema-like signal on MR images. Clinical notes were reviewed for the presence of symptoms or signs referable to the inferior patellar pole. These data were compared with a 1:1 age- and sex-matched control group without inferior pole fragmentation. Statistical analysis was performed using two-tailed t-tests. Forty of 164 (24.4%) knee radiographs showed fragmentary ossification of the inferior patella. Of these 40 knees, 62.5% (25/40) had edema-like signal of the inferior patellar bone marrow compared with 7.5% (3/40) of controls (P = 0.035). Patients with fragmentary ossification at the inferior patella had a significantly higher incidence of documented focal inferior patellar pain compared with controls (20% vs. 2.5%, P = 0.015). Inferior patellar pole fragmentation in children 5 to 10 years of age may be associated with localized symptoms and bone marrow edema-like signal and should not be routinely dismissed as a normal variant of ossification. (orig.)

  17. The efficacy of combined cryotherapy and compression compared with cryotherapy alone following anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Waterman, Brian; Walker, John J; Swaims, Chad; Shortt, Michael; Todd, Michael S; Machen, Shaun M; Owens, Brett D

    2012-05-01

    While cryotherapy has been shown to decrease postoperative pain after anterior cruciate ligament (ACL) reconstruction, less is known of the effects of combined cryotherapy and compression. The goal of this study was to compare subjective and objective patient outcomes following ACL reconstruction with combined compression and cryotherapy compared with traditional ice therapy alone. Patients undergoing ACL reconstruction were randomized to cryotherapy/compression device (group 1) or a standardized ice pack (group 2). Both groups were instructed to use the ice or cryotherapy/compression device three times per day and return to the clinic at 1, 2, and 6 weeks postoperatively. Patient-derived outcome measurements used in this study consisted of the visual analog scale (VAS), the Lysholm knee score, Short Form-36 (SF-36), and single assessment numerical evaluation (SANE). Circumferential measurements of the knee at three locations (1 cm proximal to patella, mid-patella, and 1 cm distal to patella) were also obtained as a measure of postoperative edema. Narcotic medication use was recorded by questionnaire. The primary outcome measure (VAS) was significantly different among groups in the preoperative measurement, despite similarities in group demographics. Baseline VAS for group 1 was 54.9 compared with group 2 at 35.6 (p = 0.01). By 6 weeks, this had lowered to 28.1 and 40.3, respectively, resulting in a significant 27-point decrease in mean VAS for group 1 (p cryotherapy and compression in the postoperative period after ACL reconstruction results in improved, short-term pain relief and a greater likelihood of independence from narcotic use compared with cryotherapy alone.

  18. sEMG during Whole-Body Vibration Contains Motion Artifacts and Reflex Activity

    Directory of Open Access Journals (Sweden)

    Karin Lienhard

    2015-01-01

    Full Text Available The purpose of this study was to determine whether the excessive spikes observed in the surface electromyography (sEMG spectrum recorded during whole-body vibration (WBV exercises contain motion artifacts and/or reflex activity. The occurrence of motion artifacts was tested by electrical recordings of the patella. The involvement of reflex activity was investigated by analyzing the magnitude of the isolated spikes during changes in voluntary background muscle activity. Eighteen physically active volunteers performed static squats while the sEMG was measured of five lower limb muscles during vertical WBV using no load and an additional load of 33 kg. In order to record motion artifacts during WBV, a pair of electrodes was positioned on the patella with several layers of tape between skin and electrodes. Spectral analysis of the patella signal revealed recordings of motion artifacts as high peaks at the vibration frequency (fundamental and marginal peaks at the multiple harmonics were observed. For the sEMG recordings, the root mean square of the spikes increased with increasing additional loads (p < 0.05, and was significantly correlated to the sEMG signal without the spikes of the respective muscle (r range: 0.54 - 0.92, p < 0.05. This finding indicates that reflex activity might be contained in the isolated spikes, as identical behavior has been found for stretch reflex responses evoked during direct vibration. In conclusion, the spikes visible in the sEMG spectrum during WBV exercises contain motion artifacts and possibly reflex activity.

  19. Influencia de la altura rotuliana sobre la biomecánica de la rodilla

    OpenAIRE

    Aparicio Campillo, Gustavo

    2016-01-01

    La alteración de la altura rotuliana tiene importantes repercusiones clínicas.La patella baja se ha asociado con rigidez ,dolor y pérdida de fuerza extensora. La patela alta se relaciona con inestabilidad femoropatelar, entesopatías del aparato extensor, enfermedades de Osgood-Schlatter y Sinding-Larsen Johansson en adolescentes, dolor en cara anterior de rodilla y artrosis femoropatelar. La alteración de la línea articular en prótesis de rodilla afecta la fuerza extensora de los pacientes y ...

  20. Bilateral pertrochanteric fractures with bilateral patellar fractures with missed medial process fracture of talus in a young adult: a case report and review of literature.

    Science.gov (United States)

    Bali, Kamal; Krishnan, Vibhu; Sen, Ramesh

    2011-12-01

    Management of polytrauma patients is one the most difficult and challenging tasks for an orthopaedic surgeon, and it includes different aspects of intervention: emergent resuscitative care, early surgical care, post-operative care and delayed rehabilitative care. We report an interesting case of multiple skeletal injuries with a coexisting pattern of fractures of bilateral patellae with bilateral pertrochanteric fractures of femur with a missed talar fracture following a dashboard type of injury in a road traffic accident. We are not aware of a similar case reported in literature in the past. We highlight the management protocol in such a case and review the available literature regarding such a presentation.

  1. "A 40-year-old female with painless, slow growing prepatellar mass".

    Science.gov (United States)

    Arora, Sumit; Batra, Sahil; Rao, Seema; Maini, Lalit; Gautam, V K

    2014-12-01

    A 40-year-old woman from India presented with a mass in the front of her left knee which had been present for 8 months. Local examination revealed a globular mass of approximate size 5 cm × 4 cm × 4 cm in front of the lower pole of left patella. The patient was investigated with imaging studies and laboratory tests. Plain radiograph of the chest was normal. In addition, contrast enhanced Magnetic Resonance Imaging (MRI) of the left knee was performed. Based on the history, physical examination, laboratory and imaging studies, what is the differential diagnosis?

  2. Meier–Gorlin syndrome: An additional Egyptian patient with gastroesophageal reflux, hydronephrosis, renal stones and hypoplastic labia majora and minora with clitromegaly

    Directory of Open Access Journals (Sweden)

    Rabah M. Shawky

    2016-10-01

    Full Text Available We report a 4.5 year old female child with the classical triad of Meier–Gorlin syndrome (microtia, absent patella and short stature with normal mentality. She had small triangular face, long peaked nose, high nasal bridge, bilateral low set very small ears (microtia, retromicrognathia, high arched palate, maxillary hypoplasia, decayed teeth, and bilateral partial syndactyly between 2nd and 3rd toes. Our patient had a gastroesophageal reflux, renal stones, hydronephrosis and hypoplastic labia majora and minora with clitromegaly.

  3. The relationship between patellofemoral and tibiofemoral morphology and gait biomechanics following arthroscopic partial medial meniscectomy

    DEFF Research Database (Denmark)

    Dempsey, Alasdair R.; Wang, Yuanyuan; Thorlund, Jonas Bloch

    2013-01-01

    Purpose To examine the relationship between tibiofemoral and patellofemoral joint articular cartilage and subchondral bone in the medial and gait biomechanics following partial medial meniscectomy. Methods For this cross-sectional study, 122 patients aged 30–55 years, without evidence of knee...... with decreased patella cartilage volume (B = −17.9 (95 % CI −35.4, −0.4) p = 0.045) while knee adduction moment impulse was associated with increased medial tibial plateau area (B = 7.7 (95 % CI 0.9, 13.3) p = 0.025). A number of other variables approached significance. Conclusions Knee joint biomechanics...

  4. Quadriceps and patellar tendon pie-crusting as a treatment for limited flexion in total knee arthroplasty.

    Science.gov (United States)

    Burge, J Ross; Sanchez, Hugo B; Wagner, Russell A

    2014-04-01

    The pie-crusting method of ligament and tendon lengthening has been used successfully in various tissues but is not reported in the literature as an option for patellar or quadriceps tendons to address flexion limitation. Our case report discusses a patient with longstanding flexion limitation who underwent primary total knee arthroplasty. The report reviews the literature on intraoperative treatments, which primarily pertains to the condition of patella baja, and demonstrates that the pie-crusting technique should be included as a treatment option for a tight extensor mechanism while having some advantages over tibial tubercle osteotomy or Z-plasty.

  5. Normal osseous variants presenting as cystic or lucent areas on radiography and CT imaging: a pictorial overview

    Energy Technology Data Exchange (ETDEWEB)

    Wilde, Vally de; Maeseneer, Michel de E-mail: midema@village.uunet.be; Lenchik, Leon; Roy, Peter van; Beeckman, Paul; Osteaux, Michel

    2004-07-01

    We present a number of commonly encountered pseudolesions. These represent areas of the skeleton that are relatively radiolucent simulating an osteolytic or cystic lesion. Such areas discussed in this article include the superolateral humeral head, rhomboid fossa of the clavicle, scapular defect, supratrochlear foramen, biceps tendon insertion, vascular channel of the ulna, distal condylar area of the knee, 'bone in bone' disturbance, dorsal defect of the patella, metadiaphyseal area, 'Wards' triangle', inframalleolar fossa of the fibula, and anterior lytic defect of the calcaneus. We provide an overview of commonly encountered pseudolesions, that may lead to false positive diagnosis of an osteolytic or cystic lesion.

  6. BIOMECHANICS AND PATHOMECHANICS OF THE PATELLOFEMORAL JOINT.

    Science.gov (United States)

    Loudon, Janice K

    2016-12-01

    The patellofemoral joint is a joint that can be an area of concern for athletes of various sports and ages. The joint is somewhat complex with multiple contact points and numerous tissues that attach to the patella. Joint forces are variable and depend on the degree of knee flexion and whether the foot is in contact with the ground. The sports medicine specialist must have a good working knowledge of the anatomy and biomechanics of the patellofemoral joint in order to treat it effectively.

  7. Minor element partitioning and mineralogy in limpets from the Ischia CO2 vent site

    Science.gov (United States)

    Langer, Gerald; Sadekov, Aleksey; Nehrke, Gernot; Baggini, Cecilia; Rodolfo-Metalpa, Riccardo; Hall-Spencer, Jason; Bijma, Jelle; Elderfield, Henry

    2015-04-01

    Specimens of the patellogastropod limpet Patella caerulea were collected within and outside a CO2 vent site at Ischia, Italy. The shells were sectioned transversally and scanned for polymorph distribution by means of confocal Raman microscopy. Minor element to calcium ratios were measured using laser-ablation-inductively-coupled-plasma-mass-spectroscopy (LA-ICPMS). Mg/Ca, Sr/Ca, and Li/Ca ratios were determined in calcitic as well as aragonitic parts of the shells. This approach allows for investigating the effects of the polymorph and the seawater carbonate chemistry on minor element partitioning separately.

  8. APPLICATION OF A BIODEGRADABLE MATERIAL FOR BONE REPLACEMENT IN TRAUMATOLOGY

    Directory of Open Access Journals (Sweden)

    T. V. Druzhinina

    2014-01-01

    Full Text Available 20 men (medium age (31.5 ± 13.5 years were studied. All patients underwent arthroscopic auditing plastic anterior cruciate ligament of the knee. Osteoregeneration dynamics were determined by biochemical testing of blood serum and X-ray computed tomography (CT of the fracture in 1–4 months after surgery. As a result, an estimation of the bone tissue reparative regeneration according to CT data in 10 patients with a defect of the patella, treated with the material is provided. The obtained results of the clinical study indicate the reparative effect of the biodegradable material for bone replacing on bone regeneration

  9. Meier-Gorlin syndrome: Report of an additional patient with congenital heart disease

    Directory of Open Access Journals (Sweden)

    Rabah M. Shawky

    2014-10-01

    Full Text Available We report a 7 year old female child with the classical triad of Meier-Gorlin syndrome (MGS, (microtia, absent patella and short stature. She had the characteristic facial features, with normal mentality and defective speech, skeletal abnormalities, conductive hearing loss, cystitis and normal growth hormone level. She suffered from recurrent chest infection during the first year of life which improved gradually with age. Although congenital heart is rarely observed in MGS, our patient had in addition fenestrated interatrial septal defect.

  10. A new high-elevation scorpion species of the genus Scorpiops Peters, 1861 (Scorpiones: Euscorpiidae: Scorpiopinae) from the Himalayas, India.

    Science.gov (United States)

    Zambre, Amod; Sanap, Rajesh V; Mirza, Zeeshan A

    2014-06-01

    A new high-elevation scorpion species of the genus Scorpiops is described from the Indian state of Himachal Pradesh. Scorpiops spitiensis sp. nov. is the second highest-elevation scorpion species in Asia and the first one from India occurring at elevations above 4200 m. The new species closely resembles Scorpiops petersii, but it can be distinguished from it based on a suit of characters, one of which is the presence of 16 trichobothria on the external aspect of the patella, which is unique to the new species.

  11. Horizontal intra-articular patellar dislocation resulting in quadriceps avulsion and medial patellofemoral ligament tear: a case report.

    Science.gov (United States)

    Kramer, Dennis E; Simoni, Michael K

    2013-07-01

    Intra-articular patellar dislocations are rare. We present a 13-year-old boy who sustained a complete horizontal intra-articular patellar dislocation following blunt trauma to the flexed knee. Closed reduction was unsuccessful and open reduction indicated a repairable quadriceps avulsion and medial patellofemoral ligament tear. He is the youngest patient to sustain a quadriceps rupture and the only patient to sustain a medial patellofemoral ligament tear to date. His flexed knee and the horizontally positioned patella (seen on lateral radiograph) were indicative of a complete rotational injury with extensor mechanism involvement. Open reduction allowed for the repair of both injuries and a favorable outcome.

  12. Intracellular coagulation inhibits the extraction of proteins from Prochloron

    Science.gov (United States)

    Fall, R.; Lewin, R. A.; Fall, L. R.

    1983-01-01

    Protein extraction from the prokaryotic alga Prochloron LP (isolated from the ascidian host Lissoclinum patella) was complicated by an irreversible loss of cell fragility in the isolated algae. Accompanying this phenomenon, which is termed intracellular coagulation, was a redistribution of thylakoids around the cell periphery, a loss of photosynthetic O2 production, and a drastic decrease in the extractability of cell proteins. Procedures are described for the successful preparation and transport of cell extracts yielding the enzymes glucose-6-phosphate dehydrogenase and 6-phosphogluconate dehydrogenase as well as other soluble proteins.

  13. MORPHOMETRIC ANALYSIS OF VERTICAL GROOVE ON ANTERIOR SURFACE OF TIBIAL LATERAL CONDYLE AND ITS RELATION WITH SQUATTING

    Directory of Open Access Journals (Sweden)

    Narinder

    2015-05-01

    Full Text Available Seventy dry tibiae of adult and unknown sex were collected from the department of Anatomy Government Medical College Jammu. The region under the course of the ligamentum patellae of every tibia was carefully examined and studied for the presence or absence of a vertical groove and its characteristics like shape, length and depth were noted. In India, one of the commonest mode of sitting is squatting. Squatters are known to show certain adap tational features in the lower extremities like vertical groove on the anterior surface of lateral condyle of tibia. This groove is produced on the tibia by pressure of the tendon of quadriceps femoris (ligamentum patellae. The pressure of the tendon of q uadriceps femoris occurs due to great deal of flexion of knee joint, occuring during squatting. Squatting is one of the frequently used exercise in the field of strength and conditioning. It is also an integral component in the sport of competitive weight lifting and power lifting and regarded as a supreme test of lower body strength. (1,2 INTRODUCTION: A vertical groove is present is present on the anterior surface of tibial lateral condyle in squatters. In India most of the people have a habit of sitting down by squatting. During squatting there is excessive flexion of the knee joint which exerts a great deal of pressure on the strong tendon of quadriceps femoris (ligamentum patellae which is inserted on the tibial tuberosity. The pressure so exerted lead s to the formation of a groove on the unattached part of the ligamentum patella. This vertical groove so formed is also called as quadracipital groove. (3 It is shallow but distinct with a prominent lateral lip and extends proximally in a vertical directio n. It is inverted “J” shaped as described by Hughes and Sunderland 1946. (4 The lateral lip is prominent due to lateral angulation between femur and tibia. If the groove is absent then either the person is a non - squatter (eg Europeans or is weak

  14. The role of osteonecrosis in canine coronoid dysplasia: arthroscopic and histopathological findings.

    Science.gov (United States)

    Mariee, I C; Gröne, A; Theyse, L F H

    2014-06-01

    Coronoid dysplasia (CD) or medial coronoid disease is part of canine elbow dysplasia and eventually results in osteoarthrosis. Although CD was originally attributed to disturbed endochondral ossification, more recent data point to the subchondral bone. The objective of this study was to assess dysplastic bone and cartilage of dogs that underwent unilateral or bilateral arthroscopic subtotal coronoidectomy for the treatment of CD. Arthroscopic findings and histopathology of bone and cartilage removed from elbow joints with CD were compared. The most common arthroscopic finding was fragmentation with softening of the subchondral bone of the central part of the medial coronoid process. In dogs without obvious fragmentation, CD was characterised by bone softening and chondromalacia. During arthroscopic intervention dysplastic bone and cartilage were collected for histopathological assessment. Forty-five slices of formalin-fixed, paraffin-embedded bone and cartilage samples were stained using haematoxylin and eosin and evaluated. Histopathological findings primarily consisted of osteonecrosis of subchondral bone with necrosis within the marrow spaces. Histopathological changes in the articular cartilage were characterised by fibrillation, chondrocyte clone formation, and focal cartilage necrosis. The pathology was found primarily in the subchondral bone and not in the articular cartilage. Vascular compromise may play a role in the pathogenesis of osteonecrosis in CD.

  15. Approach to the active patient with chronic anterior knee pain.

    Science.gov (United States)

    Atanda, Alfred; Ruiz, Devin; Dodson, Christopher C; Frederick, Robert W

    2012-02-01

    The diagnosis and management of chronic anterior knee pain in the active individual can be frustrating for both the patient and physician. Pain may be a result of a single traumatic event or, more commonly, repetitive overuse. "Anterior knee pain," "patellofemoral pain syndrome," and "chondromalacia" are terms that are often used interchangeably to describe multiple conditions that occur in the same anatomic region but that can have significantly different etiologies. Potential pain sources include connective or soft tissue irritation, intra-articular cartilage damage, mechanical irritation, nerve-mediated abnormalities, systemic conditions, or psychosocial issues. Patients with anterior knee pain often report pain during weightbearing activities that involve significant knee flexion, such as squatting, running, jumping, and walking up stairs. A detailed history and thorough physical examination can improve the differential diagnosis. Plain radiographs (anteroposterior, anteroposterior flexion, lateral, and axial views) can be ordered in severe or recalcitrant cases. Treatment is typically nonoperative and includes activity modification, nonsteroidal anti-inflammatory drugs, supervised physical therapy, orthotics, and footwear adjustment. Patients should be informed that it may take several months for symptoms to resolve. It is important for patients to be aware of and avoid aggravating activities that can cause symptom recurrence. Patients who are unresponsive to conservative treatment, or those who have an underlying systemic condition, should be referred to an orthopedic surgeon or an appropriate medical specialist.

  16. The acute effect of bipolar radiofrequency energy thermal chondroplasty on intrinsic biomechanical properties and thickness of chondromalacic human articular cartilage.

    Science.gov (United States)

    Dutcheshen, Nicholas; Maerz, Tristan; Rabban, Patrick; Haut, Roger C; Button, Keith D; Baker, Kevin C; Guettler, Joseph

    2012-08-01

    Radio frequency energy (RFE) thermal chondroplasty has been a widely-utilized method of cartilage debridement in the past. Little is known regarding its effect on tissue mechanics. This study investigated the acute biomechanical effects of bipolar RFE treatment on human chondromalacic cartilage. Articular cartilage specimens were extracted (n = 50) from femoral condyle samples of patients undergoing total knee arthroplasty. Chondromalacia was graded with the Outerbridge classification system. Tissue thicknesses were measured using a needle punch test. Specimens underwent pretreatment load-relaxation testing using a spherical indenter. Bipolar RFE treatment was applied for 45 s and the indentation protocol was repeated. Structural properties were derived from the force-time data. Mechanical properties were derived using a fibril-reinforced biphasic cartilage model. Statistics were performed using repeated measures ANOVA. Cartilage thickness decreased after RFE treatment from a mean of 2.61 mm to 2.20 mm in Grade II, II-III, and III specimens (P resistance to shear and tension could be compromised due to removal of the superficial layer and decreased fibril modulus, RFE treatment increases matrix modulus and decreases tissue permeability which may restore the load- bearing capacity of the cartilage.

  17. Arthroscopic treatment of symptomatic type D medial plica.

    Science.gov (United States)

    Uysal, Mustafa; Asik, Mehmet; Akpinar, Sercan; Ciftci, Feyyaz; Cesur, Necip; Tandogan, Reha N

    2008-12-01

    We aimed to review the results of subtotal arthroscopic resection of symptomatic type D medial plica. We retrospectively evaluated 23 knees with symptomatic type D medial plica in 22 patients without other intra-articular pathology. All patients complained of chronic knee pain that had not been alleviated by medical treatment or physical therapy. In only three (13%) of the patients studied was the plica diagnosed pre-operatively with magnetic resonance imaging. The type D medial plicae in our series were classified as fenestrated (14 knees), torn (5 knees), or reduplicated (4 knees). Fibrotic changes in the plicae and degenerative changes on the medial femoral condyle were found in 16 knees Patellofemoral chondromalacia was present in three knees Arthroscopic partial resection was performed in all patients. Comparative Lysholm Knee Scale scores before and after surgery revealed a significant clinical improvement (pre-operative status, 67.19 +/- 8.05 vs. post-operative status, 90.57 +/- 9.80; P knee pain. Arthroscopic partial resection of the plicae in symptomatic patients gives satisfactory results.

  18. Mechanical and morphological evaluation of osteochondral implants in dogs.

    Science.gov (United States)

    Bavaresco, Vanessa P; Garrido, Luiz; Batista, Nilza A; Malmonge, Sônia M; Belangero, William D

    2008-04-01

    The mechanical behavior of osteochondral defects was evaluated in this study with the intention of developing alternative procedures. Cylindrical pins (5.00 mm in diameter and in height) made of pHEMA hydrogel covered ultra-high molecular weight polyethylene (UHMWPE) or beta-tricalcium phosphate (beta-TCP) matrix were used. Ostoechondral defects were caused in the knees of adult dogs and the evaluation was carried out after a 9-month follow-up period. The mechanical behavior of the implants was evaluated by means of an indentation creep test that showed that the UHMWPE matrix maintained its viscoelastic behavior even after follow-up time, while the beta-TCP matrix osteochondral implants presented significant alterations. It is believed that the beta-TCP osteochondral implants were unable to withstand the load applied, causing an increase of complacency when compared to the UHMWPE osteochondral implants. Based on micro and macroscopic analysis, no significant wear was observed in either of the osteochondral implants when compared to the controls. However, morphological alterations, with fragmentation indices in the patella, were observed either due to friction with the hydrogel in the first postoperative months or due to forming of a dense conjunctive tissue. This wear mechanism caused on the counterface of the implant (patella) was observed, notwithstanding the osteochondral implant studied.

  19. Progression of Gene Expression Changes following a Mechanical Injury to Articular Cartilage as a Model of Early Stage Osteoarthritis.

    Science.gov (United States)

    McCulloch, R S; Ashwell, M S; Maltecca, C; O'Nan, A T; Mente, P L

    2014-01-01

    An impact injury model of early stage osteoarthritis (OA) progression was developed using a mechanical insult to an articular cartilage surface to evaluate differential gene expression changes over time and treatment. Porcine patellae with intact cartilage surfaces were randomized to one of three treatments: nonimpacted control, axial impaction (2000 N), or a shear impaction (500 N axial, with tangential displacement to induce shear forces). After impact, the patellae were returned to culture for 0, 3, 7, or 14 days. At the appropriate time point, RNA was extracted from full-thickness cartilage slices at the impact site. Quantitative real-time PCR was used to evaluate differential gene expression for 18 OA related genes from four categories: cartilage matrix, degradative enzymes and inhibitors, inflammatory response and signaling, and cell apoptosis. The shear impacted specimens were compared to the axial impacted specimens and showed that shear specimens more highly expressed type I collagen (Col1a1) at the early time points. In addition, there was generally elevated expression of degradative enzymes, inflammatory response genes, and apoptosis markers at the early time points. These changes suggest that the more physiologically relevant shear loading may initially be more damaging to the cartilage and induces more repair efforts after loading.

  20. Neurophysiological basis for neurogenic-mediated articular cartilage anabolism alteration.

    Science.gov (United States)

    Gouze-Decaris, E; Philippe, L; Minn, A; Haouzi, P; Gillet, P; Netter, P; Terlain, B

    2001-01-01

    This study was designed to investigate the pathways involved in neurogenic-mediated articular cartilage damage triggered by a nonsystemic distant subcutaneous or intra-articular inflammation. The cartilage damage was assessed 24 h after subcutaneous or intra-articular complete Freund's adjuvant (CFA) injection measuring patellar proteoglycan (PG) synthesis (ex vivo [Na(2)(35)SO(4)] incorporation) in 96 Wistar rats. Unilateral subcutaneous or intra-articular injection of CFA induced significant decrease (25-29%) in PG synthesis in both patellae. Chronic administration of capsaicin (50 mg. kg(-1). day(-1) during 4 days), which blunted the normal response of C fiber stimulation, prevented the bilateral significant decrease in cartilage synthesis. Similarly, intrathecal injection of MK-801 (10 nmol/day during 5 days), which blocked the glutamatergic synaptic transmission at the dorsal horn of signal originating in primary afferent C fibers, eliminated the CFA-induced PG synthesis decrease in both patellae. Chemical sympathectomy, induced by guanethidine (12.5 mg. kg(-1). day(-1) during 6 wk), also prevented PG synthesis alteration. Finally, compression of the spinal cord at the T3-T5 level had a similar protective effect on the reduction of [Na(2)(35)SO(4)] incorporation. It is concluded that the signal that triggers articular cartilage synthesis damage induced by a distant local inflammation 1) is transmitted through the afferent C fibers, 2) makes glutamatergic synaptic connections with the preganglionic neurons of the sympathetic system, and 3) involves spinal and supraspinal pathways.

  1. Barriers to gene flow in the marine environment: insights from two common intertidal limpet species of the Atlantic and Mediterranean.

    Directory of Open Access Journals (Sweden)

    Alexandra Sá-Pinto

    Full Text Available Knowledge of the scale of dispersal and the mechanisms governing gene flow in marine environments remains fragmentary despite being essential for understanding evolution of marine biota and to design management plans. We use the limpets Patella ulyssiponensis and Patella rustica as models for identifying factors affecting gene flow in marine organisms across the North-East Atlantic and the Mediterranean Sea. A set of allozyme loci and a fragment of the mitochondrial gene cytochrome C oxidase subunit I were screened for genetic variation through starch gel electrophoresis and DNA sequencing, respectively. An approach combining clustering algorithms with clinal analyses was used to test for the existence of barriers to gene flow and estimate their geographic location and abruptness. Sharp breaks in the genetic composition of individuals were observed in the transitions between the Atlantic and the Mediterranean and across southern Italian shores. An additional break within the Atlantic cluster separates samples from the Alboran Sea and Atlantic African shores from those of the Iberian Atlantic shores. The geographic congruence of the genetic breaks detected in these two limpet species strongly supports the existence of transpecific barriers to gene flow in the Mediterranean Sea and Northeastern Atlantic. This leads to testable hypotheses regarding factors restricting gene flow across the study area.

  2. The biomechanical evaluation of polyester as a tension band for the internal fixation of patellar fractures.

    LENUS (Irish Health Repository)

    McGreal, G

    2012-02-03

    We use a braided polyester suture in place of cerclage wire in tension band fixations. The objective of this study was to test the biomechanical properties of this technique. Sixteen cadaveric patellae were fractured and repaired by modified tension band fixation. Eight were fixed using eighteen gauge stainless steel wire as a tension band and eight using braided polyester. All specimens were subjected to tensile testing. Polyester was 75.0% as strong as wire. For dynamic testing, the patellae of seven cadaveric knees were fractured and then fixed with polyester tension bands. These were mounted in a device capable of extending the knees from 90 degrees to neutral against an applied force. None of the fixations failed. Three of the specimens fixed using 18 gauge stainless steel wire were compared with three fixed using polyester over 2000 cycles of knee flexion and extension. Polyester performed as well as wire. We conclude that polyester is an acceptable alternative to wire in tension band fixation.

  3. A mini-invasive adductor magnus tendon transfer technique for medial patellofemoral ligament reconstruction: a technical note.

    Science.gov (United States)

    Sillanpää, Petri J; Mäenpää, Heikki M; Mattila, Ville M; Visuri, Tuomo; Pihlajamäki, Harri

    2009-05-01

    Patellar dislocations are associated with injuries to the medial patellofemoral ligament (MPFL). Several techniques for MPFL reconstruction have been recently published with some disadvantages involved, including large skin incisions and donor site morbidity. Arthroscopic stabilizing techniques carry the potential of inadequate restoration of MPFL function. We present a minimally invasive technique for MPFL reconstruction using adductor magnus tendon autograft. This technique is easily performed, safe, and provides a stabilizing effect equal to current MPFL reconstructions. Skin incision of only 3-4 cm is located at the level of the proximal half of the patella. After identifying the distal insertion of the adductor magnus tendon, a tendon harvester is introduced to harvest the medial two-thirds of the tendon, while the distal insertion is left intact. The adductor magnus tendon is cut at 12-14 cm from its distal insertion and transferred into the patellar medial margin. Two suture anchors are inserted through the same incision at the superomedial aspect of the patella in the anatomic MPFL origin. The graft is tightened at 30 degrees knee flexion. Aftercare includes 4 weeks of brace treatment with restricted range of motion.

  4. The influence of varied gravito-inertial fields on the cardiac response of orb-weaving spiders

    Science.gov (United States)

    Finck, A.

    1982-01-01

    The Gz transfer function was described for the orb weaving spider A. sericatus. The functional relationship between the heartrate and the intensity of G is linear in the form of: Y = a Log Gz-1 +k. The heartrate in unrestrained animals was recorded by a laser plethysmograph developed specifically for this purpose. Following a control, sample heartrate were taken postrotation between 1.001 and 1.5 Gz in 6 steps. The underlying distribution of heartrates does not appear significantly different from a Gaussian distribution. A method of varnishing the legs of the spider was developed. This was done in order to compromise the lyriform organs, especially those located on the patellae. The lyriform organ is hypothesized to serve the receptor role in the transduction of gravity related stimuli. In preliminary animals the Gz function, post varnishing of the patellae, appears to be changed in the direction of poorer discrimination. We also observed that the resting heartrate following the varnish procedure is substantially increased.

  5. Amino acid geochronology of raised beaches in south west Britain

    Science.gov (United States)

    Bowen, D. Q.; Sykes, G. A.; Reeves (nee Henry), Alayne; Miller, G. H.; Andrews, J. T.; Brew, J. S.; Hare, P. E.

    Based on (1) the epimerization of L:isoleucine to D:alloisoleucine ( {D}/{L} ratios) in Patella vulgata, Littorina littorea, L. littoralis, L. saxatilis, Littorina species and Nucella lapillus from raised beaches in south west Britain, (2) statistical analysis of the {D}/{L} ratios, and (3) lithostratigraphic and geomorphic evaluation, three ( {D}/{L}) Stages are proposed. The {D}/{L} ratios for all the species measured are converted to a Patella vulgata standard. The three ( {D}/{L}) Stages are: (1) The Minchin Hole ( {D}/{L}) Stage, {D}/{L} ratios 0.175 ± 0.014, defined at a stratotype in Minchin Hole Cave, Gower, Wales. (2) A provisionally defined, but as yet, unamed ( {D}/{L}) Stage, because of the current unavailability of a suitable stratotype, with {D}/{L} ratios of 0.135 ± 0.014 (3) The Pennard ( {D}/{L}) Stage, {D}/{L} ratios 0.105 ± 0.016, defined at a stratotype in Minchin Hole Cave, Gower, Wales. Two geochronological models of the three high sea-level events representing the {D}/{L} Stages are constrained by uranium-series age determinations on stalagmite interbedded with marine beds in Minchin Hole and Bacon Hole Caves, Gower, Wales. A potential 'fixed point' in model evaluation is an age determination which is equivalent to Oxygen Isotope Sub-stage 5e (122 ka). The two models are:

  6. Description of patellar movement by 3D parameters obtained from dynamic CT acquisition

    Science.gov (United States)

    de Sá Rebelo, Marina; Moreno, Ramon Alfredo; Gobbi, Riccardo Gomes; Camanho, Gilberto Luis; de Ávila, Luiz Francisco Rodrigues; Demange, Marco Kawamura; Pecora, Jose Ricardo; Gutierrez, Marco Antonio

    2014-03-01

    The patellofemoral joint is critical in the biomechanics of the knee. The patellofemoral instability is one condition that generates pain, functional impairment and often requires surgery as part of orthopedic treatment. The analysis of the patellofemoral dynamics has been performed by several medical image modalities. The clinical parameters assessed are mainly based on 2D measurements, such as the patellar tilt angle and the lateral shift among others. Besides, the acquisition protocols are mostly performed with the leg laid static at fixed angles. The use of helical multi slice CT scanner can allow the capture and display of the joint's movement performed actively by the patient. However, the orthopedic applications of this scanner have not yet been standardized or widespread. In this work we present a method to evaluate the biomechanics of the patellofemoral joint during active contraction using multi slice CT images. This approach can greatly improve the analysis of patellar instability by displaying the physiology during muscle contraction. The movement was evaluated by computing its 3D displacements and rotations from different knee angles. The first processing step registered the images in both angles based on the femuŕs position. The transformation matrix of the patella from the images was then calculated, which provided the rotations and translations performed by the patella from its position in the first image to its position in the second image. Analysis of these parameters for all frames provided real 3D information about the patellar displacement.

  7. A 10 year follow-up study after Roux-Elmslie-Trillat treatment for cases of patellar instability

    Directory of Open Access Journals (Sweden)

    Wilke Axel

    2011-02-01

    Full Text Available Abstract Background A retrospective study concerning patients presenting with patella instability, treated using a Roux-Elmslie-Trillat reconstruction operation and followed up for 10 years following surgery, is presented. Methods Pre-operative and follow-up radiographic evaluation included the weight-bearing anteroposterior and merchant views. Evaluation was carried out using the Insall-Salvati index, sulcus and congruence angle. The Roux-Elmslie-Trillat reconstruction operation was performed on 18 patients. The clinical evaluation at follow-up was performed using the Knee-Society-Score (KSS and Tegner-Score. Results Subjective results of the operation were classed as excellent or good in 16 of the 18 patients ten years after surgery; persistent instability of the patella was recorded in only one of the 18 patients. The majority of patients returned to the same level of sporting activity after surgery as they had participated in before injury. Conclusions The Roux-Elmslie-Trillat procedure could be recommended in cases presenting with an increased q-angle, trochlea dysplasia or failed soft tissue surgery. In the present study the majority of patients report a return to previous sporting activity ten years after surgery.

  8. Long-term Results of Primary Total Knee Arthroplasty with and without Patellar Resurfacing

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    Park,Se-Jin

    2010-10-01

    Full Text Available Among patients that underwent total knee arthroplasty from June, 1990 to January, 1999, 61 cases (44 patients that could be followed for more than 10 years were included in this study. The patients were divided into a patellar retention group and a patellar resurfacing group, and were compared with regard to their clinical and radiological outcomes. In patients undergoing primary TKA, a selective patellar resurfacing protocol was used. The indications for patellar retention were a small patella, nearly normal articular cartilage, minimal preoperative patellofemoral pain, poor patellar bone quality, and young patient age. When patellar retention was performed, osteophytes of the patella were removed and marginal electrocauterization was carried out. There were 25 cases (20 patients in the patellar retention group and 36 cases (29 patients in the patellar resurfacing group. The mean follow-up period was 140.7 months in the patellar retention group and 149.0 months in the patellar resurfacing group. The selective patellar resurfacing with total knee arthroplasty had a favorable outcome;there were a significant difference noted between the 2 groups in the functional scores, which showed better outcomes in the patellar resurfacing group than in the patellar retention group.

  9. Evaluation Of Patellar Tracking During Knee Range Of Motion In Patients With Patellar Lateralization And Normal Subjects

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    Goharpei S

    2004-08-01

    Full Text Available Background: Patellofemoral joint disorders are the most common cause of anterior knee pain in patients who referred to orthopedic clinics. Patellar lateralization cause anterior knee pain due to weakness of vastus medialis oblique muscle or tightness of lateral structures like lateral retinaculum or iliotibial band muscle. Materials and Methods: For evaluation of this abnormality, plane radiography, CT scan and MRI are useful. In plane radiography only one view in a single joint position can be obtained, because of that it is not a good method to detect abnormal tracking during knee range of motion. The purpose of this study was to evaluate patellar tracking by kinematics MRI during five serial degrees of knee range of motion (40, 30, 20, 10, 0 degrees in 30 patients with patellar lateralization and 10 normal subjects, aged 18-30 years. Results and Conclusion: tistical analysis showed that in patients group, patella had the most stability in 40 degree of knee flexion and this stability reduced when knee reached to full extension. At this point, patella moved laterally and the most instability was seen during 20 to 0 degree of knee extension.

  10. 18S ribosomal DNA sequences provide insight into the phylogeny of patellogastropod limpets (Mollusca: Gastropoda).

    Science.gov (United States)

    Yoon, Sook Hee; Kim, Won

    2007-02-28

    To investigate the phylogeny of Patellogastropoda, the complete 18S rDNA sequences of nine patellogastropod limpets Cymbula canescens (Gmelin, 1791), Helcion dunkeri (Krauss, 1848), Patella rustica Linnaeus, 1758, Cellana toreuma (Reeve, 1855), Cellana nigrolineata (Reeve, 1854), Nacella magellanica Gmelin, 1791, Nipponacmea concinna (Lischke, 1870), Niveotectura pallida (Gould, 1859), and Lottia dorsuosa Gould, 1859 were determined. These sequences were then analyzed along with the published 18S rDNA sequences of 35 gastropods, one bivalve, and one chiton species. Phylogenetic trees were constructed by maximum parsimony, maximum likelihood, and Bayesian inference. The results of our 18S rDNA sequence analysis strongly support the monophyly of Patellogastropoda and the existence of three subgroups. Of these, two subgroups, the Patelloidea and Acmaeoidea, are closely related, with branching patterns that can be summarized as [(Cymbula + Helcion) + Patella] and [(Nipponacmea + Lottia) + Niveotectura]. The remaining subgroup, Nacelloidea, emerges as basal and paraphyletic, while its genus Cellana is monophyletic. Our analysis also indicates that the Patellogastropoda have a sister relationship with the order Cocculiniformia within the Gastropoda.

  11. Barriers to gene flow in the marine environment: insights from two common intertidal limpet species of the Atlantic and Mediterranean.

    Science.gov (United States)

    Sá-Pinto, Alexandra; Branco, Madalena S; Alexandrino, Paulo B; Fontaine, Michaël C; Baird, Stuart J E

    2012-01-01

    Knowledge of the scale of dispersal and the mechanisms governing gene flow in marine environments remains fragmentary despite being essential for understanding evolution of marine biota and to design management plans. We use the limpets Patella ulyssiponensis and Patella rustica as models for identifying factors affecting gene flow in marine organisms across the North-East Atlantic and the Mediterranean Sea. A set of allozyme loci and a fragment of the mitochondrial gene cytochrome C oxidase subunit I were screened for genetic variation through starch gel electrophoresis and DNA sequencing, respectively. An approach combining clustering algorithms with clinal analyses was used to test for the existence of barriers to gene flow and estimate their geographic location and abruptness. Sharp breaks in the genetic composition of individuals were observed in the transitions between the Atlantic and the Mediterranean and across southern Italian shores. An additional break within the Atlantic cluster separates samples from the Alboran Sea and Atlantic African shores from those of the Iberian Atlantic shores. The geographic congruence of the genetic breaks detected in these two limpet species strongly supports the existence of transpecific barriers to gene flow in the Mediterranean Sea and Northeastern Atlantic. This leads to testable hypotheses regarding factors restricting gene flow across the study area.

  12. Clinical signs and anatomical correlation of patellar tendinitis

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    Rath Ehud

    2010-01-01

    Full Text Available Background: Patellar tendinitis is one of the several differential diagnosis of anterior knee pain. The clinical diagnosis of patellar tendinitis is based on tenderness to palpation at the inferior pole of the patella. The tenderness has been noted to be maximal when the knee is extended and the quadriceps relaxed, but a definite clinical sign for diagnosis is lacking. The accuracy of two clinical signs was assesed by a two-stage study which included physical examination, MRI and a cadaveric study. Materials and Methods: Two clinical signs, the "passive flexion-extension sign" and the "standing active quadriceps sign" were assessed in 10 consecutive patients with presumed patellar tendinitis. Five patients had an MRI, showed focal abnormality in the tendon. The location of the MRI finding corresponded, to the region of maximal tenderness. A cadaveric dissection was undertaken to describe the anatomy of the patella and the patellar tendon during these tests. Results: Both tests showed a significant decrease in tenderness at the area of inflammation when the patellar tendon was under tension. The cadaveric dissection showed that when the knee is flexed to 90΀ or when the quadriceps is tensioned the deep fibers of the tendon do not deform to anteriorly applied pressure. Conclusion: We suggest using these studies routinely in the evaluation of patients with anterior knee pain.

  13. Patellar Subluxation With Early-Phase Synovial Chondromatosis of the Knee.

    Science.gov (United States)

    Bashaireh, Khaldoon M

    2016-01-01

    Primary synovial chondromatosis is a rare, benign, monoarticular disease process that affects the synovial membrane of the joint, the synovial sheath, or the bursa around the joint. The etiology is unknown, but it has been associated with trauma in some cases. Although it is a benign lesion, if left untreated, it may lead to early secondary osteoarthritis of the joint. The knee joint is affected in 50% to 65% of cases, followed by the elbow and the hip. This article reports a 30-year-old active woman who presented to the author's clinic with a large infrapatellar mass that caused lateral subluxation of the patella, swelling, and episodic pain with crepitations 14 months after direct trauma to the knee. Clinical examination, magnetic resonance imaging, and arthroscopy revealed a large infrapatellar mass causing lateral subluxation of the patella with no loose bodies. Hoffa's disease, para-articular osteochondroma, and early-phase synovial chondromatosis were considered in the differential diagnosis. The histopathologic and clinical features were consistent with early synovial chondromatosis. The patient underwent local excision of the mass through a medial parapatellar arthrotomy. At 5 years of follow-up, she had no recurrence of the lesion or progression of the disease. Early diagnosis of synovial chondromatosis with local excision offers a reliable cure. However, long-term follow-up is advised because of the high recurrence rates as well as the risk of metaplastic transformation.

  14. The wrinkled patellar tendon: An indication of abnormality in the extensor mechanism of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Berlin, R.C.; Levinsohn, E.M. (State Univ. of New York, Syracuse, NY (USA). Dept. of Radiology); Chrisman, H. (State Univ. of New York, Syracuse, NY (USA). Coll. of Medicine)

    1991-04-01

    Rupture of the quadriceps tendon is an uncommon condition which requires early diagnosis and treatment to avert prolonged disability. In four patients who had surgically confirmed quadriceps tendon rupture, lateral radiographs of the knee and/or sagittal magnetic resonance (MR) images demonstrated a corrugated appearance to the patellar tendon. Sagittal MR images of the knee following patellectomy in one patient and radiographs of a transverse fracture of the patella in another also demonstrated this appearance. MRI has superb contrast resolution which provides optimal visualization of the contour of the patellar tendon on sagittal images. A retrospective review of 50 consecutive knee MRI examinations was carried out to evaluate the appearance of the normal patellar tendon. In 49 of 50 patients, the sagittal images demonstrated a straight or nearly straight patellar tendon. A corrugated appearance of the patellar tendon on sagittal images indicates a reduction in the normal tensile force applied to it and indicates the need for careful evaluation of the patella and quadriceps tendon mechanism. (orig.).

  15. Arthroscopic Quadriceps Tendon Repair: Two Case Reports

    Directory of Open Access Journals (Sweden)

    Hidetomo Saito

    2015-01-01

    Full Text Available Recently, although some studies of open repair of the tendon of the quadriceps femoris have been published, there have been no reports in the literature on primary arthroscopic repair. In our present study, we present two cases of quadriceps tendon injury arthroscopically repaired with excellent results. Case 1 involved a 68-year-old man who was injured while shifting his weight to prevent a fall. MRI showed complete rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using both suture anchor and pull-out suture fixation methods via bone tunnels (hereafter, pull-out fixation. Two years after surgery, retearing was not observed on MRI and both Japan Orthopedic Association (JOA Knee and Lysholm scores had recovered to 100. Case 2 involved a 50-year-old man who was also injured when shifting his weight to prevent a fall. MRI showed incomplete superficial rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using pull-out fixation of six strand sutures. One year after surgery, MRI revealed a healed tendon and his JOA and Lysholm scores were 95 and 100, respectively. Thus, arthroscopic repair may be a useful surgical method for repairing quadriceps tendon injury.

  16. Arthroscopic quadriceps tendon repair: two case reports.

    Science.gov (United States)

    Saito, Hidetomo; Shimada, Yoichi; Yamamura, Toshiaki; Yamada, Shin; Sato, Takahiro; Nozaka, Koji; Kijima, Hiroaki; Saito, Kimio

    2015-01-01

    Recently, although some studies of open repair of the tendon of the quadriceps femoris have been published, there have been no reports in the literature on primary arthroscopic repair. In our present study, we present two cases of quadriceps tendon injury arthroscopically repaired with excellent results. Case 1 involved a 68-year-old man who was injured while shifting his weight to prevent a fall. MRI showed complete rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using both suture anchor and pull-out suture fixation methods via bone tunnels (hereafter, pull-out fixation). Two years after surgery, retearing was not observed on MRI and both Japan Orthopedic Association (JOA) Knee and Lysholm scores had recovered to 100. Case 2 involved a 50-year-old man who was also injured when shifting his weight to prevent a fall. MRI showed incomplete superficial rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using pull-out fixation of six strand sutures. One year after surgery, MRI revealed a healed tendon and his JOA and Lysholm scores were 95 and 100, respectively. Thus, arthroscopic repair may be a useful surgical method for repairing quadriceps tendon injury.

  17. [A simplified technique for repair of quadriceps tendon rupture by transpatellar PDS-cord].

    Science.gov (United States)

    Hosseini, H; Agneskirchner, J D; Lobenhoffer, P

    2005-06-01

    Quadriceps tendon ruptures are relatively unusual injuries caused by direct or more frequently indirect trauma. Since complete ruptures lead to loss of active extension of the knee joint, operative treatment is usually indicated. Several techniques are described in the literature. However, relatively little is known about the functional outcome after operative treatment of acute quadriceps tendon ruptures. We present a new operative technique using a 1.3-mm PDS cord passed through a transverse drill hole in the proximal pole of the patella. We operated ten consecutive cases of complete quadriceps tendon ruptures with the technique described between January 2000 and June 2003. Eight of ten patients were evaluated after a mean follow-up time of 38 months by physical examination, IKDC Subjective score, Lysholm and Tegner score as well as an isokinetic test of the quadriceps strength. No complications were noted in this period. The average postoperative scores were 87 (IKDC), 98 (Lysholm), and 4.5 (Tegner). Isokinetic testing showed an average of 25% quadriceps strength deficit. The operative treatment of complete quadriceps tendon ruptures using a PDS cord through a drill hole in the patella is a safe and effective technique permitting functional postoperative treatment.

  18. LMX1B Mutations Cause Hereditary FSGS without Extrarenal Involvement

    Science.gov (United States)

    Boyer, Olivia; Woerner, Stéphanie; Yang, Fan; Oakeley, Edward J.; Linghu, Bolan; Gribouval, Olivier; Tête, Marie-Josèphe; Duca, José S.; Klickstein, Lloyd; Damask, Amy J.; Szustakowski, Joseph D.; Heibel, Françoise; Matignon, Marie; Baudouin, Véronique; Chantrel, François; Champigneulle, Jacqueline; Martin, Laurent; Nitschké, Patrick; Gubler, Marie-Claire; Johnson, Keith J.; Chibout, Salah-Dine

    2013-01-01

    LMX1B encodes a homeodomain-containing transcription factor that is essential during development. Mutations in LMX1B cause nail-patella syndrome, characterized by dysplasia of the patellae, nails, and elbows and FSGS with specific ultrastructural lesions of the glomerular basement membrane (GBM). By linkage analysis and exome sequencing, we unexpectedly identified an LMX1B mutation segregating with disease in a pedigree of five patients with autosomal dominant FSGS but without either extrarenal features or ultrastructural abnormalities of the GBM suggestive of nail-patella–like renal disease. Subsequently, we screened 73 additional unrelated families with FSGS and found mutations involving the same amino acid (R246) in 2 families. An LMX1B in silico homology model suggested that the mutated residue plays an important role in strengthening the interaction between the LMX1B homeodomain and DNA; both identified mutations would be expected to diminish such interactions. In summary, these results suggest that isolated FSGS could result from mutations in genes that are also involved in syndromic forms of FSGS. This highlights the need to include these genes in all diagnostic approaches to FSGS that involve next-generation sequencing. PMID:23687361

  19. Patellofemoral pain: Challenging current practice - A case report.

    Science.gov (United States)

    Smith, Benjamin E; Hendrick, Paul; Logan, Pip

    2016-04-01

    Patellofemoral pain (PFP) is a common problem in young people, with 1 in 6 suffering at any one time. It is unclear which management approach is the optimal method for treating PFP in the long term, with traditional physiotherapy examination focusing on assessing for specific structural dysfunction. A rationale for a different assessment and treatment approach, one that moves the focus away from a biomedical/tissue pathology model towards one directed at the neurophysiology of pain, has been suggested. The patient was a 21 year old male with a 6 year history of PFP with previous failed physiotherapeutic treatment. He reported previous multiple healthcare practitioners' advice to avoid activities that were painful as reasons for being unable to participate in sporting activities. No specific structural testing was performed, such as specific muscle strength, length, foot position, patella movement and position, or movement patterns. Descriptions of tissue based pathology models of pain, e.g. patella mal-tracking, were actively discouraged and challenged. The patient was taught to perform one uncomfortable/painful exercise as part of his rehabilitation programme twice a day. The patient achieved 80% improvement in his symptoms over 7 appointments and a return to physical activity following a 5 month rehabilitation programme purposively designed to elicit pain by means of gradually exercising and loading the tissues. This case report highlights the need for further research into exercise protocols for patients suffering with PFP based upon neurophysiology models of pain.

  20. Biomechanical Role of Bone Anisotropy Estimated on Clinical CT Scans by Image Registration.

    Science.gov (United States)

    Taghizadeh, Elham; Reyes, Mauricio; Zysset, Philippe; Latypova, Adeliya; Terrier, Alexandre; Büchler, Philippe

    2016-08-01

    Image-based modeling is a popular approach to perform patient-specific biomechanical simulations. Accurate modeling is critical for orthopedic application to evaluate implant design and surgical planning. It has been shown that bone strength can be estimated from the bone mineral density (BMD) and trabecular bone architecture. However, these findings cannot be directly and fully transferred to patient-specific modeling since only BMD can be derived from clinical CT. Therefore, the objective of this study was to propose a method to predict the trabecular bone structure using a µCT atlas and an image registration technique. The approach has been evaluated on femurs and patellae under physiological loading. The displacement and ultimate force for femurs loaded in stance position were predicted with an error of 2.5% and 3.7%, respectively, while predictions obtained with an isotropic material resulted in errors of 7.3% and 6.9%. Similar results were obtained for the patella, where the strain predicted using the registration approach resulted in an improved mean squared error compared to the isotropic model. We conclude that the registration of anisotropic information from of a single template bone enables more accurate patient-specific simulations from clinical image datasets than isotropic model.