WorldWideScience

Sample records for chondromalacia patellae

  1. Chondromalacia of patella. Haglund-Loewen Frund disease

    International Nuclear Information System (INIS)

    A study of 15 cases of chondromalacia of patella is presented. The investigation and diagnosis through conventional radiology pneumoartography, arthroscopy, urgical and patological anatomy studies are done. The clinical aspects, the incidence in relation to the age and sex, the x-ray characteristics and the gross features viewed at the surgery are emphasized. (Author)

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. 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),

  8. 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.

  9. 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

  10. 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。

  11. Patella Alta

    OpenAIRE

    Cakmak, Mehmet; Taser, Omer; Karamehmetoglu, Mahmut; Domanic, Unsal

    2004-01-01

    Patella alta is investigated with Insall-Salvati method in lateral X-rays obtained with the knee in 30 flexion in 26 cases with recurrent dislocation of the patella and in 16 cases diagnosed to have chondromalasia. Patella alta is identified in 12 cases with recurrent dislocation of patella and in 9 cases with chondromalasia. Patella alta, which is one of the significaint consative agents of patella femoral instrability, is reviewed under the literature data.

  12. 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.

  13. [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.

  14. 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.

  15. 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

  16. [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.

  17. 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

  18. [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.

  19. [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.

  20. [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.

  1. [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.

  2. 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.

  3. CONGENITAL PATELLA LUXATION

    OpenAIRE

    Cakmak, Mehmet; Taser, Omer; Domanic, Unsal; Temelli, Yener; Karamehmetoglu, Mahmut

    2004-01-01

    Five cases of congenital patella luxation which is rarely seen, have been presented. The diagnosis and treatment problems of this disease have been discussed in our cases with literature on the subject. It was concluded the method of the plastic of Williams-Picat quadriceps performed in the unification with the method of Krogius is the most appropriate form of treatment.

  4. MRI findings in bipartite patella

    Energy Technology Data Exchange (ETDEWEB)

    Kavanagh, Eoin C. [University of Pittsburgh Medical Centre, Department of Radiology, Pittsburgh, PA (United States); Zoga, Adam; Omar, Imran [Thomas Jefferson University Hospital, Department of Radiology, Philadelphia, PA (United States); Ford, Stephanie; Eustace, Stephen [Cappagh National Orthopaedic Hospital, Department of Radiology, Dublin (Ireland); Schweitzer, Mark [Hospital for Joint Disease, Orthopedic Institute, Department of Radiology, New York, NY (United States)

    2007-03-15

    Bipartite patella is a known cause of anterior knee pain. Our purpose was to detail the magnetic resonance imaging (MRI) features of bipartite patella in a retrospective cohort of patients imaged at our institution. MRI exams from 53 patients with findings of bipartite patella were evaluated to assess for the presence of bone marrow edema within the bipartite fragment and for the presence of abnormal signal across the synchondrosis or pseudarthrosis. Any other significant knee pathology seen at MRI was also recorded. We also reviewed 400 consecutive knee MRI studies to determine the MRI prevalence of bipartite patella. Of the 53 patients with bipartite patella 40 (75%) were male; 35 (66%) had edema within the bipartite fragment. Of the 18 with no edema an alternative explanation for knee pain was found in 13 (72%). Edema within the bipartite fragment was the sole finding in 26 of 53 (49%) patients. Bipartite patella was seen in 3 (0.7%) of 400 patients. In patients with bipartite patella at knee MRI, bone marrow edema within the bipartite fragment was the sole finding on knee MRI in almost half of the patients in our series. (orig.)

  5. 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)

  6. Primary tumors of the patella.

    Science.gov (United States)

    Song, Mingzhi; Zhang, Zhen; Wu, Yuxuan; Ma, Kai; Lu, Ming

    2015-01-01

    The patella is an uncommon location for cancerous occurrence and development. The majority of tumors of the patella are benign, with a significant incidence of giant cell tumors and chondroblastoma. With the development of modern diagnostic technologies, there appear however many other histological types which raise challenges of diagnosis and treatment. In this article, we review the reported histological types of primary patellar tumors. Specifically, epidemiology, symptomatology, imageology, histopathology, and treatment options for these histological lesions will be discussed, respectively. As there is an increasing focus on the diagnosis and the treatment of these lesions, the availability of the integrated information about primary patellar tumors becomes more significant. PMID:25906772

  7. [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.

  8. [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.

  9. 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.

  10. Recurrent Dislocation of the Patella

    Science.gov (United States)

    Benítez, Gustavo

    2015-01-01

    Purpose: To evaluate results of medial patellofemoral ligament (MPFL) reconstruction associated with lateral release and advancement of vastus medialis in recurrent dislocation of the patella. Methods: We retrospectively evaluated 11 patients with a mean follow-up of 19 months. Mean age was 23, mainly women. We did MPFL reconstruction with semitendinosus or gracilis tendon depending on BMI, associated with advancement of vastus medialis and lateral release. Results: Mean Kujala score improved from 46,54 pts. preoperative to 88,36 postoperative. Our main complication was 1 patient with rigid knee, who required movilization under anesthesia and arthroscopic arthrolisis to improve her outcome. Conclusion: The combination of this techniques are a good alternative to treat patients with recurrent patella disclocation, with good short and mid-term results. Biomechanic intra and postop complications of MPFL reconstruction are related to patellar fixation, anatomic positioning of femoral tunnel and knee position of the graft fixation.

  11. Transverse Stress Fracture of the Proximal Patella

    OpenAIRE

    ATSUMI, SATORU; Arai, Yuji; Kato, Ko; Nishimura, Akinobu; Nakazora, Shigeto; Nakagawa, Shuji; Ikoma, Kazuya; Fujiwara, Hiroyoshi; Sudo, Akihiro; Kubo, Toshikazu

    2016-01-01

    Abstract Among stress fractures associated with sports activities, patellar stress fracture is rare. Regarding patella stress fractures, so far only distal transverse or lateral longitudinal fractures have been reported, but there are no reports of transverse fractures occurring in the proximal patella. We describe an extremely rare case of transverse stress fracture of proximal patella in a 9-year-old athlete. A 9-year old boy, who participated in sports (sprints and Kendo) presented with le...

  12. 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. PMID:19010682

  13. 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.

  14. 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.

  15. [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.

  16. 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.

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

    Directory of Open Access Journals (Sweden)

    Neill Shane C O

    2012-07-01

    Full Text Available Abstract Introduction Nail 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 presentation We 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. Conclusions To 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.

  18. 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.

  19. 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.

  20. Recurrent dislocation of the patella accompanying hypotrochlea of the femur and malalignment of the patella

    OpenAIRE

    Horikawa, Akira; Kodama, Hiroyuki; Miyakoshi, Naohisa; Yamada, Shin; Miyamoto, Seiya

    2011-01-01

    This case report describes a rare case of recurrent dislocation of the patella which was accompanied with trochlear dysplasia and malalignment of the patella in a 15-year-old girl. She complained of hemoarthrosis and recurrent patellar dislocation in the early knee flexion phase. Plain radiography and computed tomography (CT) showed patellar malalignment (quadriceps angle 20°) and severe dysplasia of the trochlea of the femur (sulcus angle 170°). Surgery was performed, consisting of trochleop...

  1. Evaluation of grades 3 and 4 chondromalacia of the knee using T2*-weighted 3D gradient-echo articular cartilage imaging

    Energy Technology Data Exchange (ETDEWEB)

    Murphy, B.J. [Dept. of Radiology, Univ. of Miami School of Medicine, FL (United States)

    2001-06-01

    Objective. To determine the accuracy of T2*-weighted three-dimensional (3D) gradient-echo articular cartilage imaging in the identification of grades 3 and 4 chondromalacia of the knee.Design and patients. A retrospective evaluation of 80 patients who underwent both arthroscopic and MRI evaluation was performed. The 3D images were interpreted by one observer without knowledge of the surgical results. The medial and lateral femoral condyles, the medial and lateral tibial plateau, the patellar cartilage and trochlear groove were evaluated. MR cartilage images were considered positive if focal reduction of cartilage thickness was present (grade 3 chondromalacia) or if complete loss of cartilage was present (grade 4 chondromalacia). Comparison of the 3D MR results with the arthroscopic findings was performed.Results. Eighty patients were included in the study group. A total of 480 articular cartilage sites were evaluated with MRI and arthroscopy. Results of MR identification of grades 3 and 4 chondromalacia, all sites combined, were: sensitivity 83%, specificity 97%, false negative rate 17%, false positive rate 3%, positive predictive value 87%, negative predictive value 95%, overall accuracy 93%.Conclusion. The results demonstrate that T2*-weighted 3D gradient-echo articular cartilage imaging can identify grades 3 and 4 chondromalacia of the knee. (orig.)

  2. Patella Dislocation with Vertical Axis Rotation: The “Dorsal Fin” Patella

    Science.gov (United States)

    Gamble, David; Carrothers, Andrew D.; Khanduja, Vikas

    2015-01-01

    A 44-year-old woman presented following minor trauma to her right knee. While dancing she externally rotated around a planted foot and felt sudden pain in her right knee. She presented with her knee locked in extension with a “dorsal fin” appearance of the soft tissues tented over the patella. This was diagnosed as a rare case of an intraarticular patella dislocation, which was rotated 90 degrees about the vertical axis. Closed reduction in the emergency room was unsuccessful but was achieved in theatre under general anaesthetic with muscle relaxation. Postreduction arthroscopy demonstrated that no osteochondral or soft tissue damage to the knee had been sustained. In patients presenting with a knee locked in extension with tenting of skin over the patella (the “dorsal fin” appearance), intra-articular patella dislocation should be suspected. Attempts to reduce vertical patella dislocations under sedation with excessive force or repeatedly without success should be avoided to prevent unnecessary damage to the patellofemoral joint. In this clinical situation we recommend closed reduction under general anaesthetic followed by immediate knee arthroscopy under the same anaesthetic to ensure that there is no chondral damage to the patella or femoral trochlea and to rule out an osteochondral fracture. PMID:25883819

  3. Patella Dislocation with Vertical Axis Rotation: The “Dorsal Fin” Patella

    Directory of Open Access Journals (Sweden)

    David Gamble

    2015-01-01

    Full Text Available A 44-year-old woman presented following minor trauma to her right knee. While dancing she externally rotated around a planted foot and felt sudden pain in her right knee. She presented with her knee locked in extension with a “dorsal fin” appearance of the soft tissues tented over the patella. This was diagnosed as a rare case of an intraarticular patella dislocation, which was rotated 90 degrees about the vertical axis. Closed reduction in the emergency room was unsuccessful but was achieved in theatre under general anaesthetic with muscle relaxation. Postreduction arthroscopy demonstrated that no osteochondral or soft tissue damage to the knee had been sustained. In patients presenting with a knee locked in extension with tenting of skin over the patella (the “dorsal fin” appearance, intra-articular patella dislocation should be suspected. Attempts to reduce vertical patella dislocations under sedation with excessive force or repeatedly without success should be avoided to prevent unnecessary damage to the patellofemoral joint. In this clinical situation we recommend closed reduction under general anaesthetic followed by immediate knee arthroscopy under the same anaesthetic to ensure that there is no chondral damage to the patella or femoral trochlea and to rule out an osteochondral fracture.

  4. 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.

  5. 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.

  6. Radiographic findings in the nail-patella syndrome

    OpenAIRE

    West, James A.; Louis, Thomas H.

    2015-01-01

    Nail-patella syndrome is a rare disorder characterized classically by the tetrad of nail hypoplasia or aplasia, aplastic or hypoplastic patellae, elbow dysplasia, and the presence of iliac horns. Iliac horns are considered pathognomonic, and the presence of hypoplastic or aplastic patellae in conjunction with nail abnormalities is a cardinal feature of diagnosis. Elbow dysplasia is present in most cases and can exhibit features typical of the syndrome. Herein we present the radiographic findi...

  7. 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. PMID:26403830

  8. 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.

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

    International Nuclear Information System (INIS)

    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

  10. 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.

  11. 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. PMID:24683664

  12. Congenital dislocation of the patella – clinical case☆

    Science.gov (United States)

    Miguel Sá, Pedro; Raposo, Filipa; Santos Carvalho, Manuel; Alegrete, Nuno; Coutinho, Jorge; Costa, Gilberto

    2015-01-01

    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. PMID:26962496

  13. Injury of a bipartite patella in a young upcoming sportsman.

    Science.gov (United States)

    Stocker, Roland L; van Laer, Lutz

    2011-01-01

    The aim of this study was to report the clinical features of a young athletic patient with bipartite patella, and review the literature to discuss the entity of this rare anomaly. In the course of an athletics competition, a 12-year-old top sportsman felt an intense pain around his left knee-cap while taking off from a jumping-board and broke down the competition. X-rays and magnetic resonance imaging showed an isolated distal pole of the patella with just minor diastasis; however, the X-rays did not suggest a recent fracture but rather hint at an atypically injured bipartite patella. A conservative therapy of 5 weeks with brace followed including a ban on sport activities for 12 weeks. Ten weeks later, the radiographs revealed a complete consolidation. Six months after the injury, MRI only presented a generally inconspicuous horizontal sclerosed structure. A fracture or separation of the bipartite patella was retrospectively diagnosed. PMID:20490524

  14. Çocukta akut patella osteomiyeliti (olgu sunumu)

    OpenAIRE

    Talu, Ufuk; Altinel, Levent; Boynuk, Burak

    2004-01-01

    Acute osteomyelitis of the patella is rarely seen in pediatric population compared to adults. False or delayed diagnosis is possible because of the mild onset of symptoms at presentation. Here we present a six year old boy with acute osteomyelitis of the patella. The pathologic process was very well documented by plain radiographs, CT and MRI and recovery was very quick and uneventful after medical and surgical treatment which should adhere to the general principles of treatment for bone and ...

  15. [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.

  16. Osteomyelitis of the Patella Caused by Legionella anisa

    OpenAIRE

    Sanchez, Martha Cristina; Sebti, Rani; Hassoun, Patrice; Mannion, Ciaran; Goy, Andre H.; Feldman, Tatyana; Mato, Anthony; Hong, Tao

    2013-01-01

    A 51-year-old man with a history of stage IV angioimmunoblastic T-cell lymphoma was diagnosed with osteomyelitis of the patella. Legionella anisa was identified by 16S rRNA gene sequencing and culture. The patient had pneumonia 2 months prior to this osteomyelitis episode. L. anisa was retrospectively detected in his lung tissue by 16S rRNA gene sequencing and was considered the source of the L. anisa that caused his patella osteomyelitis.

  17. Transverse Stress Fracture of the Proximal Patella: A Case Report.

    Science.gov (United States)

    Atsumi, Satoru; Arai, Yuji; Kato, Ko; Nishimura, Akinobu; Nakazora, Shigeto; Nakagawa, Shuji; Ikoma, Kazuya; Fujiwara, Hiroyoshi; Sudo, Akihiro; Kubo, Toshikazu

    2016-02-01

    Among stress fractures associated with sports activities, patellar stress fracture is rare. Regarding patella stress fractures, so far only distal transverse or lateral longitudinal fractures have been reported, but there are no reports of transverse fractures occurring in the proximal patella. We describe an extremely rare case of transverse stress fracture of proximal patella in a 9-year-old athlete.A 9-year old boy, who participated in sports (sprints and Kendo) presented with left knee pain without any external injury. In plain radiographs, a fracture line was observed in the proximal 1/3 of the left patella, and a patella stress fracture was diagnosed. For treatment, because 7 months of conservative therapy showed no improvement, internal fixation was carried out using Acutrak screws, and bone union was thus achieved. Three months after the operation, he was able to return to his previous level of athletic sports activity.Regarding the mechanism of onset, it is believed that the causes are longitudinal traction force and patellofemoral contact pressure. On the other hand, the contact region of the patella with the femur changes with the flexion angle of the knee. In the current case, the fracture occurred at a site where the patella was in contact with the femur at a flexion angle of >90°, so it is believed that it occurred as a clinical condition from being subjected to repeated longitudinal traction force and patellofemoral contact pressure at a flexion angle of >90°, during the sports activities of sprints and Kendo. The nonunion of the transverse stress fracture of his proximal patella was successfully treated with internal fixation using Acutrak screws. PMID:26871789

  18. Fracture of the patella after the anterior cruciate ligament reconstruction

    OpenAIRE

    Milović Milan; Bojat Veselin; Kovačev Nemanja; Rašović Predrag; Milankov Miroslav

    2012-01-01

    Introduction. Fracture of the patella, after harvesting the central third of the patellar tendon for a bone-tendon-bone autograft, is a rare complication. Material and Methods. We made 1714 reconstructions of the anterior cruciate ligament of the knee using bone-patellar tendon-bone technique, and 7 patients had fracture of the patella (0.42%). The fracture was immediately recognized in the patients with vertical non-displaced patellar fracture and the broken screw osteosynthesis was ca...

  19. 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.

  20. 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.

  1. Magnetic Resonance Imaging Findings in Small Patella Syndrome.

    Science.gov (United States)

    Kim, Hyoung-Soo; Yoo, Jeong-Hyun; Park, Noh-Hyuck; Chang, Jun-Hee; Ban, Yun-Seong; Song, Sang-Heon

    2016-03-01

    Small patella syndrome (SPS) is characterized by aplasia or hypoplasia of the patella and pelvic girdle abnormalities, including bilateral absence or delayed ossification of the ischiopubic junction and infra-acetabular axe-cut notches. Here, we report a case of SPS in a 26-year-old female. Magnetic resonance image (MRI) showed a small patella with thick eccentric non-ossified patellar cartilage and femoral trochlear dysplasia with hypoplastic patellar undersurface. To our knowledge, this is the first report of MRI findings in SPS. MRI findings could be clinically relevant because elongation of the medial patellofemoral ligament and trochlear dysplasia with eccentric non-ossified patellar cartilage might lead to patellofemoral maltracking with an osteochondral lesion or acute dislocation or an extensor mechanism injury. Though the patient presented in this case report only had a gastrocnemius injury at the origin site, physicians should carefully examine abnormalities with MRI when an SPS patient has a trauma to the knee. PMID:26955616

  2. 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.

  3. Current concepts review: Fractures of the patella

    Directory of Open Access Journals (Sweden)

    Gwinner, Clemens

    2016-01-01

    Full Text Available Fractures of the patella account for about 1% of all skeletal injuries and can lead to profound impairment due to its crucial function in the extensor mechanism of the knee. Diagnosis is based on the injury mechanism, physical examination and radiological findings. While the clinical diagnosis is often distinct, there are numerous treatment options available. The type of treatment as well as the optimum timing of surgical intervention depends on the underlying fracture type, the associated soft tissue damage, patient factors (i.e. age, bone quality, activity level and compliance and the stability of the extensor mechanism. Regardless of the treatment method an early rehabilitation is recommended in order to avoid contractures of the knee joint capsule and cartilage degeneration. For non-displaced and dislocated non-comminuted transverse patellar fractures (2-part modified anterior tension band wiring is the treatment of choice and can be combined – due to its biomechanical superiority – with cannulated screw fixation. In severe comminuted fractures, open reduction and fixation with small fragment screws or new angular stable plates for anatomic restoration of the retropatellar surface and extension mechanism results in best outcome. Additional circular cerclage wiring using either typical metal cerclage wires or resorbable PDS/non-resorbable FiberWires increases fixation stability and decreases risk for re-dislocation. Distal avulsion fractures should be fixed with small fragment screws and should be protected by a transtibial McLaughlin cerclage. Partial or complete patellectomy should be regarded only as a very rare salvage operation due to its severe functional impairment.

  4. Current concepts review: Fractures of the patella.

    Science.gov (United States)

    Gwinner, Clemens; Märdian, Sven; Schwabe, Philipp; Schaser, Klaus-D; Krapohl, Björn Dirk; Jung, Tobias M

    2016-01-01

    Fractures of the patella account for about 1% of all skeletal injuries and can lead to profound impairment due to its crucial function in the extensor mechanism of the knee. Diagnosis is based on the injury mechanism, physical examination and radiological findings. While the clinical diagnosis is often distinct, there are numerous treatment options available. The type of treatment as well as the optimum timing of surgical intervention depends on the underlying fracture type, the associated soft tissue damage, patient factors (i.e. age, bone quality, activity level and compliance) and the stability of the extensor mechanism. Regardless of the treatment method an early rehabilitation is recommended in order to avoid contractures of the knee joint capsule and cartilage degeneration. For non-displaced and dislocated non-comminuted transverse patellar fractures (2-part) modified anterior tension band wiring is the treatment of choice and can be combined - due to its biomechanical superiority - with cannulated screw fixation. In severe comminuted fractures, open reduction and fixation with small fragment screws or new angular stable plates for anatomic restoration of the retropatellar surface and extension mechanism results in best outcome. Additional circular cerclage wiring using either typical metal cerclage wires or resorbable PDS/non-resorbable FiberWires increases fixation stability and decreases risk for re-dislocation. Distal avulsion fractures should be fixed with small fragment screws and should be protected by a transtibial McLaughlin cerclage. Partial or complete patellectomy should be regarded only as a very rare salvage operation due to its severe functional impairment. PMID:26816667

  5. [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.

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

    OpenAIRE

    Milankov Miroslav; Kecojević Vaso; Ninković Srđan; Gajdobranski Đorđe R.

    2003-01-01

    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 patie...

  7. [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.

  8. Tuberculosis of the patella masquerading as prepatellar bursitis

    OpenAIRE

    MacLean, S.; Kulkarni, S

    2013-01-01

    Tuberculosis of bone is an uncommon entity in the Western world. We present a case of tuberculosis of the patella mimicking prepatellar bursitis in an otherwise fit and well woman of Bangladeshi origin. We believe tuberculosis of bone should form a differential diagnosis of the swollen knee in high risk patients.

  9. Operative treatment in patella fractures and its late results

    OpenAIRE

    Domanic, U.; Durmaz, H.; Cakmak, M.; Taser, O.; Akalin, Y.

    2004-01-01

    78 cases with patella fractures which have been treated operatively between 1970-1983 are assesed for the type of treatment and late results. The results and the affecting factors are discussed under the light of literature knowledge and our experiences.

  10. 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

  11. Fracture of the patella after the anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Milović Milan

    2012-01-01

    Full Text Available Introduction. Fracture of the patella, after harvesting the central third of the patellar tendon for a bone-tendon-bone autograft, is a rare complication. Material and Methods. We made 1714 reconstructions of the anterior cruciate ligament of the knee using bone-patellar tendon-bone technique, and 7 patients had fracture of the patella (0.42%. The fracture was immediately recognized in the patients with vertical non-displaced patellar fracture and the broken screw osteosynthesis was carried out without changes in the rehabilitation period. One patient was treated non-operatively and patellar fracture in four patients was treated with operative reduction and osteosynthesis. Results. The patients were invited for the check-up 5 years (2-8 years after surgery on average. The mean Lysholm score was 92 (85-100. All of them continued to engage in sporting activities at the same or greater level after 9 months on average (6-12 months. In all patients the Lachman test was with the firm stop compared to the other leg. X-ray changes in the patella were found in 2 patients who had multifragmentary fractures. Discussion and Conclusion. The fracture of patella can be prevented by avoiding to take too much bone graft, by using the most precise tools for cutting, while rehabilitation must be carefully planned. The optimal treatment of the fracture of the patella after the reconstruction of the anterior cruciate ligament is a firm osteosynthesis, which allows healing of the bone and continuation of the rehabilitation program.

  12. 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.

  13. 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.

  14. [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.

  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. Secondary aneurysmal bone cyst following chondroblastoma of the patella

    OpenAIRE

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

    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.

  17. 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.

  18. [Traumatic separation of a type I patella bipartite in a sportsman.

    Science.gov (United States)

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

    2014-05-12

    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 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. PMID:25351835

  19. [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.

  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. Unknown syndrome: mental retardation with dysmorphic features, early balding, patella luxations, acromicria, and hypogonadism

    OpenAIRE

    Scholte, F A; Begeer, J H; van Essen, A J

    1991-01-01

    A patient is described with severe mental retardation, a peculiar face with small palpebral fissures and premature balding, habitual patella luxations, small hands and feet, and hypogonadism, a combination which appears to represent a new syndrome.

  3. Clinical evaluation of the modified tension band wiring technique for the fractured patella

    OpenAIRE

    Gudapati, Dr Dinesh; V.R, Dr Chandrakanth; Reddy.P, Dr Praveen Kumar; T. M.; K.N, Dr Arun; Mugadlimath, Anand Basayya

    2014-01-01

    The patella is of importance for the extension of the knee joint. It increases the force of the quadriceps apparatus by improving the leverage. In addition, it protects the anterior articular surface of the distal femur against external violence, but may easily be injured due to its unprotected position.Several methods of internal fixation of fractured patella have been advocated. This dissertation is directed towards the clinical evaluation of the modified tension band wiring technique for t...

  4. 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.

  5. 可分离式髌骨爪治疗髌骨下极骨折%Treatment of splintered anus perineum patella fractures with the separability patella claw

    Institute of Scientific and Technical Information of China (English)

    许安平

    2011-01-01

    目的 探讨可分离式髌骨爪治疗髌骨下极粉碎性骨折的临床应用和效果.方法 采用可分离式髌骨爪固定治疗髌骨粉碎性骨折45例,前正中切口、复位用可分离式髌骨爪固定及膝关节加压包扎3 d后行膝关节被动屈伸锻练.结果 随访10~37月平均20月,骨折愈合时间8~12周临床疗效优40例,良4例,中1例,功能恢复优良率97.8%疗效满意.结论 可分离式髌骨爪是治疗髌骨下极粉碎性骨折一种良好的固定方法.%Aim To observe the clinical curative effec:t of separability patella claw in treatment of splintered anus perineum patella fractures. Methods 45 cases of splintered anus perineuru patella fracture patients werer treated with median incision , reset, separability patella claw ,pressure dressing and passive flexion and extension ac:tivity after 3 days. Results 45 cases were followed up, of which 40 patients were excellent, better in 4 cases,medium in lcase , with the total effective rate of 97% . Conclusion It is a good way in treatment of splintered anus perineum patella fractures with separability patella claw.

  6. Superior Dislocation of the Patella in a Young Woman without Osteophytes: A Case Report.

    Science.gov (United States)

    Kataoka, Tatsunori; Iizawa, Norishige; Takai, Shinro

    2016-01-01

    Superior dislocation of the patella without patellar ligament injury is an extremely rare condition. A review of the English-language literature found only 23 reported cases. In addition, the primary factor for dislocation in most of these cases was considered to be osteophytes in the inferior pole of the patella and the anterior surface of the femoral condyle; only 1 case had no osteophytes. We treated a 19-year-old woman who sustained a painful locking of the left knee after colliding with a friend. Plain radiography and computed tomography showed superior-lateral dislocation of the patella and an interlocking between notches in the inferior pole of the patella and the anterior surface of the femoral condyle. Closed reduction without sedation was performed without difficulty, and the patient was able to walk home without pain. After 1 week, the knee was without problems. The patient had no osteophytes in the knee and had no other common risk factors, such as patella alta, ligamentous laxity, genu recurvatum, and paralytic disorders. After a comparison with previously reported cases of superior patella dislocation, we concluded that the primary factor in the present case might have been a different condition. PMID:26960585

  7. 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

  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. Surgical treatment of a chronically fixed lateral patella dislocation in an adolescent patient

    Directory of Open Access Journals (Sweden)

    Xinning Li

    2013-06-01

    Full Text Available Acute patellar dislocation or subluxation is a common cause for knee injuries in the United States and accounts for 2% to 3% of all injuries. Up to 49% of patients will have recurrent subluxations or dislocations. Importance of both soft tissue\t(predominantly,\tthe medial patellofemoral ligament, MPFL, which is responsible for 60% of the resistance to lateral dislocation and bony constraint of femoral trochlea in preventing subluxation and dislocation is well documented. Acute patella dislocation will require closed reduction and management typically consist of conservative or surgical treatment depending on the symptoms and recurrence of instability. Most patients are diagnosed and treated in a timely manner. We present a 15 years old male with a missed traumatic lateral patella dislocation during childhood. The patient presented as an adolescent with a chronically fixed lateral patella dislocation and was management with surgery. The key steps in the surgical reconstruction of this patient required first mobilizing the patella with a lateral retinacular release and V-Y lengthening of the shortened or contracted quadriceps tendon. Then a combination of MPFL reconstruction using the semi-tendinosis autograft, tibial tubercle osteotomy with anterio-medialization, and lateral facetectomy was performed. At the one-year follow-up, our patient had improved knee range of motion and decrease in pain. Chronically fixed lateral dislocated patella is a rare and complex problem to manage in older patients that will require a thorough work-up and appropriate surgical planning along with reconstruction.

  10. Diagnosis and treatment of stress fracture of the patella in athletes.

    Science.gov (United States)

    Orava, S; Taimela, S; Kvist, M; Karpakka, J; Hulkko, A; Kujala, U

    1996-01-01

    Five cases of stress fracture of the patella in athletes are presented. Four of these occurred transversally in the lower part and one longitudinally in the lateral part of the patella. Three of the patients were females (endurance runner, high jumper, and orienteerer) and two males (volleyball and soccer player). The diagnosis was made 2-8 months from the onset of the symptoms. Conservative treatment was successful in only one patient; all others were treated surgically, with good end result. Drilling of the fracture line was performed twice with metal wire cerclage fixation, excision of the lateral fragment was carried out once, and a bone graft with K wires and cerclage compression (tension band) was performed once. In all cases the patellar retinaculum was intact, indicating a stress injury. Stress fracture of the patella is a rare overuse injury, and therefore difficulties and delays in the diagnosis and treatment may occur. In cases with delayed diagnosis we recommend operative treatment. PMID:9046504

  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. Medial patellofemoral ligament injury patterns and associated pathology in lateral patella dislocation: an MRI study

    Directory of Open Access Journals (Sweden)

    Guerrero Patrick

    2009-07-01

    Full Text Available Abstract Background Lateral Patella dislocations are common injuries seen in the active and young adult populations. Our study focus was to evaluate medial patellofemoral ligament (MPFL injury patterns and associated knee pathology using Magnetic Resonance Imaging studies. Methods MRI studies taken at one imaging site between January, 2007 to January, 2008 with the final diagnosis of patella dislocation were screened for this study. Of the 324 cases that were found, 195 patients with lateral patellar dislocation traumatic enough to cause bone bruises on the lateral femoral trochlea and the medial facet of the patella were selected for this study. The MRI images were reviewed by three independent observers for location and type of MPFL injury, osteochondral defects, loose bodies, MCL and meniscus tears. The data was analyzed as a single cohort and by gender. Results This study consisted of 127 males and 68 females; mean age of 23 yrs. Tear of the MPFL at the patellar attachment occurred in 93/195 knees (47%, at the femoral attachment in 50/195 knees (26%, and at both the femoral and patella attachment sites in 26/195 knees (13%. Attenuation of the MPFL without rupture occurred in 26/195 knees (13%. Associated findings included loose bodies in 23/195 (13%, meniscus tears 41/195 (21%, patella avulsion/fracture in 14/195 (7%, medial collateral ligament sprains/tears in 37/195 (19% and osteochondral lesions in 96/195 knees (49%. Statistical analysis showed females had significantly more associated meniscus tears than the males (27% vs. 17%, p = 0.04. Although not statistically significant, osteochondral lesions were seen more in male patients with acute patella dislocation (52% vs. 42%, p = 0.08. Conclusion Patients who present with lateral patella dislocation with the classic bone bruise pattern seen on MRI will likely rupture the MPFL at the patellar side. Females are more likely to have an associated meniscal tear than males; however, more males

  13. 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.)

  14. 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

  15. 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

  16. 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

    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...

  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. Vertical open patella fracture, treatment, rehabilitation and the moment to fixation.

    Science.gov (United States)

    Larangeira, Joao Alberto; Bellenzier, Liliane; Rigo, Vanessa da Silva; Ramos Neto, Elias Josue; Krum, Francisco Fritsch Machry; Ribeiro, Tiango Aguiar

    2015-02-01

    Patella fracture is relatively uncommon and the vertical trace fracture represents almost 12-17%. The open patella fracture expresses 6-30%. The association of these two uncommon conditions was the aim of this case report even as the treatment and the moment of fixation (definitive surgical treatment). A 27-year-old man after a motorcycle accident showed an open patella fracture classified as a Gustilo and Anderson type IIIA lesion. The patient was immediately treated with precocious surgery fixation with a modified tension band which consists of two parallel K-wires positioned orthogonal to the fracture line and a cerclage wire shaped anteriorly at patella as an eight. The premature fixation benefited the infection prevention and provided earlier joint motion, which increased the nutrition of articular cartilage. Six months postoperatively, the patient had a satisfactory joint motion with full extension and 116° of joint flexion and returned to his daily life activities without restriction. Twelve months postoperatively, the patient had full extension and 120° of knee flexion without pain, joint effusion and instability. Muscle strength force was considered normal at grade V. In conclusion, early chirurgic treatment and precocious articular mobilization improve prognosis, suggesting that the employment of these practices should be adopted whenever possible in most of the open fractures. PMID:25436033

  19. 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...... number of lateral releases between the groups, and position of the knee in maximal flexion during inflation of the tourniquet did not decrease the number of lateral releases. There was no difference in clinical or radiological patella tracking between groups. If the patella was maltracking, tourniquet...... deflation led to better patella tracking and saved 5 (31%) of 16 releases with no difference between groups. We recommend tourniquet deflation and reevaluation of patella tracking before performing lateral release in patellar maltracking....

  20. Mental retardation, premature balding, small genitalia, small acra and small patellae in brothers: Confirmation of an entity

    NARCIS (Netherlands)

    A.M. Vandersteen; R.C. Hennekam

    2010-01-01

    We describe two brothers with moderate to severe mental retardation, short stature, an unusual skull shape, early anterior balding, unusual facial morphology, hypogonadotrophic hypogonadism, small genitalia, and small patellae. The older sib had generalized hypotonia without focal neurological abnor

  1. Case report 548: Nail-patella syndrome (hereditary onycho-osteodysplasia) with congenital absence of the fibulae

    International Nuclear Information System (INIS)

    Nail-patella syndrome is a rare disease inherited in an autosomal dominant fashion with multiple skeletal anomalies, including absent or hypoplastic patellae, absent or hypoplastic nails, dislocation of the radial heads and the pathognomonic sign of posterior iliac horns. The most clinically significant anomaly associated with this syndrome is a disorder of the renal basement membrane causing proteinuria and sometimes chronic renal failure. Congenital absence of the fibulae is believed to be a spontaneous mutation. (orig./GDG)

  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. Prevalence of pain on palpation of the inferior pole of the patella among patients with complaints of knee pain

    Directory of Open Access Journals (Sweden)

    Leonardo Addêo Ramos

    2009-03-01

    Full Text Available CONTEXT AND OBJECTIVE: Patellar tendinopathy is a common condition in sports. It may occur at any location of the patellar tendon, but the most commonly affected area is the inferior pole of the patella. Among various diagnostic tests, the one most used is palpation of the inferior pole of the patella. The aim of this study was to investigate the prevalence of pain complaints among individuals with pathological knee conditions and to evaluate palpation of the inferior pole of the patella as a diagnostic test for patellar tendinopathy. METHODS: Palpation of the patellar tendon was performed on 318 individuals who presented with knee-related complaints. Palpation was performed with the individual in the supine position and the knee extended. The age, gender, physical activity and labor activity of each individual were recorded at the time the symptoms appeared; the diagnosis was also recorded. RESULTS: Of the total number of individuals evaluated, 124 (39% felt pain on palpation of the inferior pole of the patella. Of these, only 40 (32.3% received a diagnosis of patellar tendinopathy. We did not observe any difference with respect to gender and age distribution. When evaluating daily physical activity levels, however, we observed that individuals with pain on palpation of the inferior pole of the patella experienced more intense physical activity. CONCLUSIONS: Palpation of the inferior pole of the patella is a diagnostic procedure with high sensitivity and moderate specificity for diagnosing patellar tendinopathy, especially among individuals who perform activities with high functional demands.

  4. 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.)

  5. 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.

  6. A Combined Procedure For Irreducible Dislocation Of Patella In Children With Ligamentous Laxity: A Preliminary Report

    OpenAIRE

    Inan, Muharrem; Sarikaya, Ilker; Seker, Ali; Beng, Kubilay

    2015-01-01

    Objectives: Irreducible patellar dislocation accompanying ligamentous laxity is rarely seen in pediatric patients. Most common complaints due to this condition are inability to walk, delayed walking and difficulties with orthotics. The purpose of this retrospective study is to describe a novel surgical technique to treat dislocated patella in patients with symptomatic ligamentous laxity. Patients and Methods: Fourteen knees of nine patients operated by a single surgeon between 2009-2012 were ...

  7. 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

  8. 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.

  9. 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.

  10. [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.

  11. Osteochondral fragmentation of the distal aspect of the patella in horses

    International Nuclear Information System (INIS)

    A condition characterised by osteochondral fragmentation of the distal aspect of the patella in 15 horses is described. The problem was unilateral in six horses and bilateral in nine. There were eight Quarterhorses, three Thoroughbreds, two American Saddlebreds, one American Paint and one Warmblood-Thoroughbred cross. A previous medial patellar desmotomy had been performed on 12 of the 15 horses. The condition manifested as hindlimb lameness and stiffness ranging from mild to severe. There was fibrous thickening in the stifle area in the 12 cases with a previous medial patellar desmotomy, and synovial effusion in seven of 12 cases. Synovial effusion was present in two of the three cases in which a previous medial patellar desmotomy was not performed. The radiographic changes included bony fragmentation, spurring (with or without an associated subchondral defect), subchondral roughening and subchondral lysis of the distal aspect of the patella. All horses were treated with arthroscopic surgery. The lesions at arthroscopy varied from flaking, fissuring, undermining or fragmentation of the articular cartilage to fragmentation or lysis of the bone at the distal aspect of the patella. The subchondral bone was involved in all cases that had a previous medial patellar desmotomy. Of the 12 horses that had a previous medial patellar desmotomy, eight became sound at their intended use, one was sold in training without problems, one is in early training without problems, one never improved and one is in convalescence. Of the three that did not have a patellar desmotomy, two performed their intended use well but one was unsatisfactory

  12. 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.

  13. Comparison of the Insall-Salvati ratio of the patella in patients with and without an ACL tear.

    Science.gov (United States)

    Lin, Chien-Fu Jeff; Wu, Jiunn-Jer; Chen, Teng-Shung; Huang, Tung-Fu

    2005-01-01

    The object of this prospective study is to compare the Insall-Salvati ratio between the patients who have an anterior cruciate ligament (ACL) tear and receive arthroscopic-assistant ACL reconstruction and the patients who have no ACL tear but do have an internal disorder of the knee and receive arthroscopic surgery. We prospectively and consecutively collected into two groups a total of 217 patients who had sport injuries and received arthroscopic surgery. The study group included 115 patients who had an ACL tear and received arthroscopic-assistant ACL reconstruction with middle-third bone-patella tendon-bone graft. The control group included 102 patients with internal disorders of the knee joint, including meniscus tear, plicae, or other chondral lesion, but without an ACL tear. We measured the patellar Insall-Salvati ratio [12] on the pre-operative X-ray films for all patients. The Insall-Salvati ratio in the ACL-tear study group is significantly smaller than the control group of internal disorders of the knee (0.99+/-0.11 vs 1.05+/-0.12, p=0.001). There is no significant difference in age, gender, the side of the involved knee, duration of symptoms, patella length and patella tendon length between the two groups. In conclusion, our study shows that patella infra has an association with ACL tears, and patella infra may be a risk factor for ACL tears. In patients with an ACL tear who had patella baja, the middle-third patellar tendon may not be an ideal graft for reconstruction. PMID:15654645

  14. 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.

  15. Extreme femoral valgus and patella dislocation following lateral plate fixation of a pediatric femur fracture.

    Science.gov (United States)

    Ezzat, Ahmed; Iobst, Christopher

    2016-07-01

    A 15-year-old boy presented with a 35° femoral valgus deformity, leg-length discrepancy, painful retained hardware, and a lateral dislocation of the patella 4 years after undergoing lateral plate fixation of a distal femur fracture. Femoral valgus is a possible complication of lateral plate fixation in up to 30% of pediatric distal femur fractures. With this patient's unusual combination of deformities as an example, we suggest early hardware removal after fracture union to prevent the development of deformity. If plate removal is not chosen, then continued close monitoring of the patient is necessary until skeletal maturity. PMID:27243610

  16. [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.

  17. Nail-patella syndrome—a novel mutation in the LMX1B gene

    OpenAIRE

    Nair, Rajesh R.; Unni, Vavullipathy N.; Indu, Kadevalappil N.; Nampoothiri, Sheela; Mathew, Anil; Kurian, George; Vimala, Avadaiammal

    2013-01-01

    Nail-patella syndrome (NPS) is an autosomal-dominant pleiotropic disorder characterized by dyplasia of finger nails, skeletal anomalies and frequently renal disease. In the reported case, genetic analysis revealed a new missense mutation in the homeodomain of LMX1B, presumed to abolish DNA binding (c.725T>C, p.Val242Ala). A missense mutation at codon 725 was identified, where thymine was replaced by cytosine which led to the replacement of valine by alanine at position 242. It was not detecte...

  18. Joint pain

    Science.gov (United States)

    ... or conditions. It may be linked to arthritis , bursitis , and muscle pain . No matter what causes it, ... Autoimmune diseases such as rheumatoid arthritis and lupus Bursitis Chondromalacia patellae Crystals in the joint: gout (especially ...

  19. Anterior knee pain

    Science.gov (United States)

    Patellofemoral syndrome; Chondromalacia patella; Runner's knee; Patellar tendinitis; Jumper's knee ... Collado H, Fredericson M. Patellofemoral pain syndrome. Clin Sports ... www.ncbi.nlm.nih.gov/pubmed/20610028 . De Carlo M, Armstrong ...

  20. Coccidiomycosis infection of the patella mimicking a neoplasm – two case reports

    International Nuclear Information System (INIS)

    Coccidioidomycosis is an endemic fungal infection in the southwestern of United States. Most infections are asymptomatic or manifest with mild respiratory complaints. Rare cases may cause extrapulmonary or disseminated disease. We report two cases of knee involvement that presented as isolated lytic lesions of the patella mimicking neoplasms. The first case, a 27 year-old immunocompetent male had progressive left anterior knee pain for four months. The second case was a 78 year-old male had left anterior knee pain for three months. Both of them had visited general physicians without conclusive diagnosis. A low attenuation lytic lesion in the patella was demonstrated on their image studies, and the initial radiologist’s interpretation was suggestive of a primary bony neoplasm. The patients were referred for orthopaedic oncology consultation. The first case had a past episode of pulmonary coccioidomycosis 2 years prior, while the second case had no previous coccioidal infection history but lived in an endemic area, the central valley of California. Surgical biopsy was performed in both cases due to diagnostic uncertainty. Final pathologic examination revealed large thick walled spherules filled with endospores establishing the final diagnosis of extrapulmonary coccidioidomycosis. Though history and laboratory findings are supportive, definitive diagnosis still depends on growth in culture or endospores identified on histology. We suggest that orthopaedic surgeons and radiologists keep in mind that chronic fungal infections can mimic osseous neoplasm by imaging

  1. 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.

  2. Patellar Shape-Memory Fixator for the Treatment of Comminuted Fractures of the Inferior Pole of the Patella

    Science.gov (United States)

    Liu, Xin-Wei; Shang, Hui-Juan; Xu, Shuo-Gui; Wang, Zhi-Wei; Zhang, Chun-Cai; Fu, Qing-Ge

    2011-07-01

    Comminuted and displaced fractures of the inferior pole of the patella are not easy to reduce and it is difficult to fix the fragments soundly enough to allow early movement of the knee. The purpose of this study is to evaluate the clinical effectiveness of the internal fixation technique with Patellar Shape-Memory Fixator (PSMF) in acute comminuted fractures of the inferior pole of the patella. We retrospectively studied 25 patients with comminuted fractures of the inferior pole of the patella who were treated with PSMF and followed up for a mean period of 26 months (14 to 60). All the fractures healed at a mean of 6 weeks (5 to 7). The mean grading at the final follow-up was 29.5 points (27 to 30) using the Bostman score, with no observable restriction of movement. No breakage of the PSMF or infection occurred. No delayed union, nonunion, and infection were seen. This technique preserved the length of the patella, reduced the comminuted fragments of the inferior pole and avoided long-term immobilization of the knee.

  3. 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.

  4. 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.)

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

    International Nuclear Information System (INIS)

    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.)

  6. Retrospective 5-Year Analysis of Revision Rate and Functional Outcome of TKA With and Without Patella Implant.

    Science.gov (United States)

    Albrecht, Dominique C; Ottersbach, Andreas

    2016-05-01

    The aim of this study was to compare a patient cohort after total knee arthroplasty (TKA) in terms of the revision rate and the functional outcome, with and without patella resurfacing. Sixty-six patients (71 TKAs) were implanted with the mobile-bearing knee prosthesis system e.motion UC (Aesculap AG, Tuttlingen, Germany). These patients were divided into 2 groups, 1 of which received primary patella resurfacing (PPR; 51 TKAs) and 1 of which did not (non-PPR; 20 TKAs), with an average follow-up of 65.6 months (±6.9). The cohort was recorded consecutively. The evaluation was performed using the Knee Society Score and selected questions relating to the Knee Injury and Osteoarthritis Outcome Score, as well as with radiographs. Results showed that PPR was no better than non-PPR in terms of functional outcome. Two knees (10%) were revised in the non-PPR group, and 1 knee (1.96%) in the PPR group (not significant). In this cohort, 100% of implants, including the 5 TKAs of patients who did not attend the follow-up examination, had neither explanted nor loosened at the time of follow-up examination. The authors concluded that the revision rate for PPR is slightly lower, and this avoids the need for secondary patella resurfacing. The risk for complications is low, and the functional outcome is comparable. [Orthopedics. 2016; 39(3):S31-S35.]. PMID:27219724

  7. 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.

  8. 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.

  9. Palmar-plantar hyperhidrosis occurring in a kindred with nail-patella syndrome.

    Science.gov (United States)

    Pechman, K J; Bergfeld, W F

    1980-12-01

    Nail-patella syndrome (NPS) is an autosomal dominant genetic defect, which may be associated with, or closely linked to, the locus controlling palmar and plantar hyperhidrosis (HH). A clinical review of a family with NPS involving six generations was performed. Data were accumulated by personal examination and analysis of medical and family records for the trials characterizing NPS as well as the coincidence of HH. A family pedigree of each entity was constructed and the pedigree for HH was compared to the NPS pedigree. Thirty-three of sixty-eight members of the extended family were affected with NPS and nine members had HH. The NPS pedigree supported the previously known autosomal dominant mode of inheritance. The incidence of HH indicated a direct inheritance and occurred only in members affected with NPS. The pedigree provides evidence for concluding that HH occurred as a spontaneous mutation transmitted as an autosomal dominant trait closely linked to NPS or that HH represents a previous unrecognized associated disorder. PMID:7204680

  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. The influence of simulated exploitation on Patella vulgata populations: protandric sex change is size-dependent.

    Science.gov (United States)

    Borges, Carla D G; Hawkins, Stephen J; Crowe, Tasman P; Doncaster, C Patrick

    2016-01-01

    Grazing mollusks are used as a food resource worldwide, and limpets are harvested commercially for both local consumption and export in several countries. This study describes a field experiment to assess the effects of simulated human exploitation of limpets Patella vulgata on their population ecology in terms of protandry (age-related sex change from male to female), growth, recruitment, migration, and density regulation. Limpet populations at two locations in southwest England were artificially exploited by systematic removal of the largest individuals for 18 months in plots assigned to three treatments at each site: no (control), low, and high exploitation. The shell size at sex change (L 50: the size at which there is a 50:50 sex ratio) decreased in response to the exploitation treatments, as did the mean shell size of sexual stages. Size-dependent sex change was indicated by L 50 occurring at smaller sizes in treatments than controls, suggesting an earlier switch to females. Mean shell size of P. vulgata neuters changed little under different levels of exploitation, while males and females both decreased markedly in size with exploitation. No differences were detected in the relative abundances of sexual stages, indicating some compensation for the removal of the bigger individuals via recruitment and sex change as no migratory patterns were detected between treatments. At the end of the experiment, 0-15 mm recruits were more abundant at one of the locations but no differences were detected between treatments. We conclude that sex change in P. vulgata can be induced at smaller sizes by reductions in density of the largest individuals reducing interage class competition. Knowledge of sex-change adaptation in exploited limpet populations should underpin strategies to counteract population decline and improve rocky shore conservation and resource management. PMID:26843935

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

    OpenAIRE

    Pérez López, M.; M.C Nóvoa; J. Alonso; M. A. García Fernández; M.J. Melgar

    2003-01-01

    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 entr...

  13. 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.

  14. TUMORS OF THE PATELLA: THE EXPERIENCE OF INSTITUTE OF ORTHOPEDICS AND TRAUMATOLOGY AT UNIVERSITY OF SÃO PAULO, BRAZIL

    Science.gov (United States)

    BAPTISTA, ANDRÉ MATHIAS; SARGENTINI, SYLVIO CESAR; ZUMÁRRAGA, JUAN PABLO; CAMARGO, ANDRÉ FERRARI DE FRANÇA; CAMARGO, OLAVO PIRES DE

    2016-01-01

    ABSTRACT Objective: To obtain epidemiological data from the tumors of the patella diagnosed and treated at the Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Universidade de São Paulo (IOT-HC-FMUSP) between 1998 and 2015. Methods: Series of cases with retrospective evaluation of patients diagnosed with tumors located in the patella. The data was obtained from the records and patients' charts at the Department of Pathology of IOT-HC-FMUSP. Results: A total of 2220 medical records from patients with anatomopathological reports were included in the study. Only eight (0.3%) patients had patellar tumors. We found that six (75%) of these were benign, one (12.5%) was a pseudotumoral lesions and one (12.5%) was reported as malignant. Among benign tumors, the giant cell tumor (GCT) was the most frequently reported corresponding to 50% of the cases. Hemagioendothelioma was the only case of malignant tumor in this series. As for the pseudotumoral lesions, we found a brown tumor. Conclusion: From the data obtained retrospectively in a 17 year time frame, in a service that treats benign, malignant and pseudotumoral bone lesions, we conclude that our casuistry in patellar tumors is similar to that reported in scientific literature, where benign tumors are predominant in a 7:1 ratio over malignant tumors, being a rare location of appearance, with the GCT as the most common diagnosis . Level of Evidence IV, Case Series. PMID:27217817

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Bioabsorbable Pins for Treatment of Osteochondral Fractures of the Knee after Acute Patella Dislocation in Children and Young Adolescents

    Directory of Open Access Journals (Sweden)

    A. Gkiokas

    2012-01-01

    Full Text Available A retrospective study was performed on the use of bioabsorbable pins in the fixation of osteochondral fractures (OCFs after traumatic patellar dislocation in children. Eighteen children (13 females, 5 males aged 11 to 15 years (mean age 13.1 years with osteochondral fracture (OCF of the knee joint were treated at the authors’ institution. Followup ranged from 22 months to 5 years. Diagnosis was verified by X-ray and magnetic resonance imaging (MRI of the knee and patella. In seven patients the osteochondral fragment was detached from the patella and in 11 it was detached from the lateral femoral condyle. All patients were subjected to open reduction and fixation of the lesion with bioabsorbable pins. Postoperatively, the knee was immobilized in a cast and all patients were mobilized applying a standardized protocol. Bone consolidation was successful in 17 of the 18 patients. Bioabsorbable pins reliably fix OCF in children and adolescents, demonstrating a high incidence of consolidation of the detached osteochondral fragment in short- and middle-term followup without requiring further operative procedures.

  17. 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

  18. Profound mental retardation, characteristic facies with midfacial hypoplasia and premature frontotemporal balding, muscular hypotrophy, and small patellae in two unrelated male patients.

    OpenAIRE

    Fryns, J P; Thiry, P.; Geutjens, J; Smeets, E.; Vinken, L; Van den Berghe, H

    1993-01-01

    Two profoundly mentally retarded, unrelated males are reported with an unidentified multiple congenital anomaly/mental retardation syndrome, including early balding, patella luxations, small hands and feet, and hypogonadism, similar to a previous publication in this journal of a severely mentally retarded male patient with dysmorphic features.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Genotype-phenotype studies in nail-patella syndrome show that LMX1B mutation location is involved in the risk of developing nephropathy

    NARCIS (Netherlands)

    Bongers, Ernie M H F; Huysmans, Frans T; Levtchenko, Elena; de Rooy, Jacky W; Blickman, Johan G; Admiraal, Ronald J C; Huygen, Patrick L M; Cruysberg, Johannes R M; Toolens, Pauline A M P; Prins, Judith B; Krabbe, Paul F M; Borm, George F; Schoots, Jeroen; van Bokhoven, Hans; van Remortele, Angela M F; Hoefsloot, Lies H; van Kampen, Albert; Knoers, Nine V A M

    2005-01-01

    Nail-patella syndrome (NPS) is characterized by developmental defects of dorsal limb structures, nephropathy, and glaucoma and is caused by heterozygous mutations in the LIM homeodomain transcription factor LMX1B. In order to identify possible genotype-phenotype correlations, we performed LMX1B muta

  1. A retrospective comparison of the modified tension band technique and the parallel titanium cannulated lag screw technique in transverse patella fracture

    Directory of Open Access Journals (Sweden)

    Wang Chengxue

    2014-07-01

    Full Text Available 【Abstract】Objective: To compare efficacy between the modified tension band technique and the parallel titanium cannulated lag screw technique for the transverse patella fracture. Methods:Seventy-two patients were retrospectively analyzed aged 22 to 79 years (mean, 55.6 years with transverse patella fractures, among whom 37 patients underwent the modified tension band and 35 patients received the titanium cannulated lag screw. Patients were followed up for 1-3 years. We analyzed the difference of operation time, complications, fracture reduction, fracture healing time, and the Iowa score for knee function between both groups. Results:In modified tension band group, five patients had skin irritation and seven suffered wire migration, two of whom required a second operation. In comparison, there were no complications in the titanium cannulated lag screw group, which also had a higher fracture reduction rate and less operation time. Conclusion:The parallel titanium cannulated lag screw technique has superior results and should be considered as an alternative method to treat transverse patella fracture. Key words: Fractures, bone; Patella; Titanium; Bone screws

  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

    Directory of Open Access Journals (Sweden)

    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. 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

  4. 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.

  5. Changes in junctional communication associated with cell cycle arrest and differentiation of trochoblasts in embryos of Patella vulgata.

    Science.gov (United States)

    Serras, F; Dictus, W J; Van den Biggelaar, J A

    1990-01-01

    In early embryos of molluscs, different clones of successively determined trochoblasts differentiate into prototroch cells and together contribute to the formation of a ciliated ring of cells known as the prototroch. Trochoblasts differentiate after cell cycle arrest, which occurs two cell cycles after the commitment of their stem cell. To study the changes of junctional communication in embryos of Patella vulgata in relation to commitment, cell cycle arrest, and differentiation of the trochoblasts, we have monitored electrical coupling as well as transfer of fluorescent dyes. The appearance of dye coupling in embryos of Patella occurs after the fifth cleavage (at the 32-cell stage), when the cell cycles of all embryonic cells become asynchronous and longer. At the 32- and 64-cell stages all cells are well coupled. However, after the 72-cell stage dye transfer to or from any cell of the four interradial clones of four primary trochoblasts becomes abruptly reduced, whereas electrical coupling between these cells and the rest of the embryo can still be detected. From scanning electron microscopical analysis of the cell pattern we conclude that this change in gap junctional communication coincides with cell cycle arrest and with the development of cilia in all four clones of primary trochoblasts. Similarly, after the 88-cell stage the four radial clones of accessory trochoblasts stop dividing, reduce cell coupling, and become ciliated. By the formation of the prototroch, the embryo becomes subdivided into an anterior (pretrochal) and a posterior (posttrochal) domain which will develop different structures of the adult. At the 88-cell stage, the cells within each of these two domains remain well coupled and form two different communication compartments that are separated from each other by the interposed ring of uncoupled trochoblasts. The relations among control of cell cycle, changes in junctional communication, and differentiation are discussed. PMID:2295366

  6. 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.

  7. 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.

  8. Anisometry of Medial Patellofemoral Ligament Reconstruction in the Setting of Patella Alta and Increased Tibial Tubercle-Trochlear Groove (TT-TG) Distance

    Science.gov (United States)

    Redler, Lauren H.; Meyers, Kathleen N.; Munch, Jacqueline; Dennis, Elizabeth R.; Nguyen, Joseph; Stein, Beth E. Shubin

    2016-01-01

    Objectives: Medial patellofemoral ligament (MPFL) reconstruction is a common procedure to treat recurrent patellofemoral instability. However, the effects of an elevated tibial tubercle-trochlear groove (TT-TG) distance and patella alta, as measured by the Caton-Deschamps (C/D) ratio, on MPFL isometry remain unclear. We hypothesized that increased lateralization and proximalization of the tibial tubercle (TT) will have increasingly adverse effects on the isometry of the MPFL. Methods: Ten fresh-frozen cadaveric knees were placed on a custom testing fixture, with a fixed femur and tibia mobile through 120 degrees of flexion. The quadriceps tendon was loaded with 10.8 N in an anatomic direction using a weighted pulley system. A 0.2 N patellar lateral displacement load was used to simulate an intact lateral retinaculum to avoid over-medializing the patella. A tunnel was drilled under fluoroscopic guidance from Schottle’s point on the medial distal femur through the lateral cortex. A suture anchor was placed at the upper 66% of the medial border of the patella and the sutures were shuttled through to the lateral side and attached to a pulley with a 1 N weight. Retroreflective markers were attached to the femur, tibia, patella, and suture. MPFL length change, as measured by suture marker motion, was assessed using a 3D motion capture system through a range of motion between 0 deg and 110 deg with the native TT anatomy. Recordings were repeated after a flat TT osteotomy and transfer to a TT-TG of 20 mm and 25 mm and a C/D ratio of 1.2 and 1.4, including all combinations. Generalized estimating equation (GEE) modeling technique was used to analyze and control for the clustered nature of the data. SAS version 9.3 (SAS Inc., Cary, NC) was used for all data analyses. Results: Analysis was performed on 9 specimens secondary to significant deviations in the baseline normative data. Intact knees showed MPFL isometry through 20-70 degrees range of motion. Tibial tubercle

  9. Evidence for wastewater influence in a low impacted area throughout stable isotope analyses of the limpet Patella caerulea and epilithic biofilms

    OpenAIRE

    Vermeulen, Simon; Lepoint, Gilles; Gobert, Sylvie

    2009-01-01

    Eutrophication is considered to be one of the main threats to marine environments leading to changes in trophic status of ecosystems and alteration of biological diversity. Carbon and Nitrogen stable isotopes analyses were performed on the limpet Patella caerulea and one of its food sources (epilithic biofilms) to assess their potential as early indicators of eutrophication. Samples were seasonally collected in 2005-2006 on five locations gradually exposed to urban sewage in the Calvi Bay and...

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

    International Nuclear Information System (INIS)

    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

  11. 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. PMID:24639947

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. Orthopaedic measurements with computed radiography: Methodological development, accuracy, and radiation dose with special reference to the weight-bearing lower extremity and the dislocating patella

    International Nuclear Information System (INIS)

    The overall aim of this study was to develop and evaluate a measurement system for computed radiography and Picture Archiving and Communication Systems, permitting measurements of long distances and angles in and between related images. The developed measurement system, which was based on the QUESTOR Precision Radiography system, was applied to the weight-bearing knee with special reference to the dislocating patella. The QPR system modified for CR fulfilled the criteria for measuring the weight-bearing knee. The special measuring assistance tools that were developed were important for the implementation of CR and PACS, particularly in workstations programmed for musculoskeletal radiology. The energy imparted to the patient was reduced by 98% at the lowest exposure of the CR-system, compared with our conventional analogue method, without loss of diagnostic accuracy. The CR technique creates a possibility, to an extent not previously feasible, to differentiate the exposure parameters (and thus minimise the radiation dose to the patient) by carefully considering the purpose of the examination. A radiographic method for measuring the rotation of the femur and the tibia, and the patellar translation was developed and applied to healthy volunteers. The introduced patellar variables have yielded new insights into the complex sequence of motions between the femur, tibia, and patella. The patients with a dislocating patella were subdivided into one 'clean' group of spontaneous dislocations and one group with various traumas in the history, which thus resulted in two groups with distinct radiographic differences. The Q-angle was decreased in knees that had suffered dislocations, and the traditional surgical treatment with a further reduction of the Q-angle must be challenged. The use of clinical measurements of the Q-angle was not an optimal way to evaluate the mechanical alignment in the patellofemoral joint under physiological conditions. In this study, we have proved

  17. 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.

  18. 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.

  19. Patellofemoral pain.

    Science.gov (United States)

    Crossley, Kay M; Callaghan, Michael J; van Linschoten, Robbart

    2016-02-01

    Patellofemoral pain refers to pain behind or around the patella (also known as patellofemoral pain syndrome, anterior knee pain, runner's knee, and, formerly, chondromalacia patellae). Patellofemoral pain is common, accounting for 11-17% of all knee pain presentations to general practice.(1 2) While it typically occurs in physically active people aged Patellofemoral pain can be diagnosed in the clinic, and evidence based treatments can reduce pain and improve function, allowing patients to maintain a physically active lifestyle. PMID:26834209

  20. Arthroscopic Assessment and Treatment of Dancers' Knee Injuries.

    Science.gov (United States)

    Silver, Daniel M.; Campbell, Pat

    1985-01-01

    Arthroscopic examination of 16 dancers with dance-related knee injuries which defied conservative treatment showed 15 meniscal tears and 4 cases of chondromalacia patellae. Partial arthroscopic meniscectomy was used to treat the tears. The results were excellent, with 13 of the 16 returning to preoperative levels of dance activity. (MT)

  1. 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.

  2. 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.

  3. 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.

  4. Orthopaedic measurements with computed radiography: Methodological development, accuracy, and radiation dose with special reference to the weight-bearing lower extremity and the dislocating patella

    Energy Technology Data Exchange (ETDEWEB)

    Sanfridsson, J. [Univ. Hospital, Lund (Sweden). Dept. of Diagnostic Radiology

    2001-03-01

    The overall aim of this study was to develop and evaluate a measurement system for computed radiography and Picture Archiving and Communication Systems, permitting measurements of long distances and angles in and between related images. The developed measurement system, which was based on the QUESTOR Precision Radiography system, was applied to the weight-bearing knee with special reference to the dislocating patella. The QPR system modified for CR fulfilled the criteria for measuring the weight-bearing knee. The special measuring assistance tools that were developed were important for the implementation of CR and PACS, particularly in workstations programmed for musculoskeletal radiology. The energy imparted to the patient was reduced by 98% at the lowest exposure of the CR-system, compared with our conventional analogue method, without loss of diagnostic accuracy. The CR technique creates a possibility, to an extent not previously feasible, to differentiate the exposure parameters (and thus minimise the radiation dose to the patient) by carefully considering the purpose of the examination. A radiographic method for measuring the rotation of the femur and the tibia, and the patellar translation was developed and applied to healthy volunteers. The introduced patellar variables have yielded new insights into the complex sequence of motions between the femur, tibia, and patella. The patients with a dislocating patella were subdivided into one 'clean' group of spontaneous dislocations and one group with various traumas in the history, which thus resulted in two groups with distinct radiographic differences. The Q-angle was decreased in knees that had suffered dislocations, and the traditional surgical treatment with a further reduction of the Q-angle must be challenged. The use of clinical measurements of the Q-angle was not an optimal way to evaluate the mechanical alignment in the patellofemoral joint under physiological conditions. In this study, we have

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

    Science.gov (United States)

    Jiang, Shujuan; Zhang, Jiubin; Huang, Dan; Zhang, Yuanyuan; Liu, Xiaoliang; Wang, Yinzhao; He, Rong; Zhao, Yanyan

    2014-01-01

    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. PMID:25380522

  6. 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.

  7. Quantitative T2 mapping of the patella at 3.0 T is sensitive to early cartilage degeneration, but also to loading of the knee

    International Nuclear Information System (INIS)

    Objective: The aim of the study was to explore the sensitivity and robustness of T2 mapping in the detection and quantification of early degenerative cartilage changes at the patella. Materials and methods: Forty-two patients (22 women, 20 men) with a mean age of 30.3 years and a symptomatic cartilage defect of ICRS grade ≤2 were examined using a 3 T MRI with an 8-channel knee coil. The cartilage lesion was graded based on high-resolution PD TSE and 3D isotropic TrueFISP images. T2 maps were calculated from a standard MESE-sequence, performed at the beginning and at the end of the scan (40 min in-between). Depending on the defect size, a region-of-interest (ROI) analysis was performed on 1–3 consecutive slices. Mean T2 values for the deep, superficial, and global layer as well as the zonal variation were compared among defect grades (ANOVA, post hoc Duncan-test) and over time (Student's t-test). Results: T2-measurements directly correlated with the extent of cartilage defect (ICRS grade) at all layers and at both time-points. However, correlations were closer for the second measurement at the end of the scan. In this unloaded state, differences in T2-values became more pronounced and were significant even between cartilage of normal appearance adjacent to the defect and healthy cartilage of control patients (both ICRS grade 0). In contrast, there were no such differences among grades in the zonal variation at any time. Conclusion: T2 mapping might be a sensitive method for the detection of early cartilage degeneration at the patella in the unloaded joint.

  8. 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...

  9. 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.

  10. 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.

  11. 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.

  12. Limp Affecting the Hip and Knee in Children

    OpenAIRE

    Bobechko, Walter P.

    1985-01-01

    Limp and pain are common findings about the hip and knee in growing children. Epiphyseal growth peculiarities in children account for many of the specific disease entities. Simple but specific physical examination and mandatory simple X-rays will virtually always give or exclude a diagnosis. problems about the hip are usually serious, for example Legg-Perthes, slipped epiphysis and septic arthritis. Most childhood knee problems are annoying but not serious. Chondromalacia patellae and Osgood-...

  13. 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

  14. 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

  15. 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.

  16. 髂胫束重建内侧髌股韧带治疗习惯性髌骨脱位%Reconstruction of the Medial Patellofemoral Ligament with Iliotibial Tract for the Treatment of Habitual Dislocation of Patella

    Institute of Scientific and Technical Information of China (English)

    肖健; 林共周

    2011-01-01

    目的:探讨采用髂胫束重建内侧髌股韧带治疗习惯性髌骨脱位的手术方法和临床效果.方法:2006年9月至2009年2月,对12例习惯性髌骨脱位患者的13个膝关节进行了手术治疗,男4例,女8例,平均年龄27岁.全部病例行髌骨外侧软组织松解,内侧关节囊紧缩,取带Gerdy's结节骨块的髂胫束组织重建内侧髌股韧带.结果:全部患者均得到随访,随访时间1~3年,平均23个月.1例双膝手术者脱位复发,余11例无髌骨再脱位.2例患者膝关节屈曲略受限.5例感膝关节无力.结论:髌骨外侧软组织松解,内侧关节囊紧缩,髂胫束重建内侧髌股韧带治疗习惯性髌骨脱位,操作简单,效果可靠,手术损伤小,恢复快.%Objective To study the clinical outcome of surgical technique intervention on the treatment of habitual dislocation of patella. Methods From September 2006 to February 2009, 12 patients including 4 males and 8 females with habitual dislocation of patella (5 left and 8 right) received surgical treatment. All patients had been reviewed at least one year after the operation with an average of 23 months ( 12 ~ 46) . The average age was 27 years ( 13 ~ 57) . Standard AP, lateral and axial view of the X-rays were obtained before surgery. All patients underwent lateral release, tightening of medial capsule and reconstruction of the medial patellofemoral ligament with iliotibial tract. Results Except one patient in both knees, no recurrence was found in 11 patients. The flexion angle decreased lightly in two patients. Five patients felt weakness of the knee. Conclusion Lateral release, tightening of medial capsule and reconstruction of the medial patellofemoral ligament with iliotibial tract was proved to be a satisfactory treatment of habitual dislocation of patella, with advantages of mini-invasion and rapid recovery.

  17. The Relevance between Morphological of the Abnormal Patella and Osteoarthritis of the Knee%髌骨形态异常与膝关节骨关节炎之间相关性

    Institute of Scientific and Technical Information of China (English)

    胡彬; 谢兴文; 黄晋; 秦林原; 白玉茹; 延净德

    2014-01-01

    目的:利用计算机辅助测量技术,对一定样本量的甘肃省中医院影像科膝关节X线片进行骨形态测量和相关比值分析研究,得出膝关节相关参数的正常范围,确立膝关节发育缺陷与膝关节骨关节炎之间相关性,找出导致髌股关节骨关节炎的骨性致病因素。方法测量指标:股骨髁宽度、胫骨髁宽度、髌骨宽度、髌骨纵径、髌骨关节面高度、髌骨厚度、髌骨下缘与关节间隙距离、股骨内髁前后径、胫骨平台前后径、髌骨关节面距胫骨平台距离、髌骨中点距股骨纵轴距离,采用SPSS 17.0软件对各有关比值进行处理和分析,采用90%(p5~p95)医学参考范围为正常参考范围描述;计数资料采用χ2检验,设检验水平为0.05,P<0.05为差异有显著性意义。结果通过测量136例正常膝关节X线片各骨形态数据及相关比值,以90%医学参考范围为正常范围,得出髌骨厚度/股骨内髁前后径:0.162362~0.335135,髌骨纵径/髌骨关节面高度:1.217105~1.643902为正常范围。以此标准在481例膝关节骨关节炎病例中,髌骨厚度/股骨内髁前后径异常率6.4%,髌骨纵径/髌骨关节面高度异常率23.5%。结论髌骨偏厚、髌骨偏薄等形态异常在膝骨关节炎中占有一定的比例且女性发病率高于男性。%Objective To got the normal range of knee relevant parameters,established the correlation between defect of knee joint development with knee osteoarthritis and find the causes of bony pathogenic factors of patellofemoral osteoarthritis. Methods The following datat was collected:femoral condyle wide,( WFC),tibia condyle patella wide( WTP),patellar width ( WP),patella longitudinal diameter( HP),the articular surface of the patella length( LPAS),patellar thickness( DP),the pa-tella and the lower edge of the joint gap distance( PIAGD),before and after the medial condyle of the femur diameter( SLM

  18. 关节镜诊治髌内侧滑膜皱襞综合征80例%Diagnosis and treatment of medial patella synovial plica syndrome by arthroscopy

    Institute of Scientific and Technical Information of China (English)

    唐向盛; 岳德波; 王佰亮; 王卫国; 郭万首

    2011-01-01

    目的:探讨髌内侧滑膜皱襞综合征的临床特点、诊断及疗效.方法:回顾分析2003年1月~2011年1月收治的80例关节镜诊治的髌内侧滑膜皱襞综合征患者,按Sakakibara法分析其关节镜下形态,按Outerbridge 法分析股骨内侧髁及股骨滑车的关节软骨损伤程度.关节镜下行皱襞切除术,术后随访,按Lysholm法进行疗效评定.结果:80例髌内侧滑膜皱襞综合征患者中,术前正确诊断62例,14例术前诊断为半月板损伤,4例为膝关节痛待查.镜下形态A型5例,B型21例,C型38例,D型16例.术后随访60例,随访时间8个月~8年,平均43个月,优良率86.7%.结论:术前根据临床症状诊断髌内侧滑膜皱襞综合征比较困难,关节镜是诊断和治疗髌内侧滑膜皱襞综合征的有效方法.%Objective:To explore the clinical characteristic,diagnosis and outcome of medial patella synovial plica syndrome by arthroscopy.Methods: A retrospective survey was performed in 80 patients treated by arthroscopy from January 2003 to January 2011.The arthroscopic type (using the Sakakibara classification)of medial plica,chondral injury(using the Outerbridge classification)of medial femoral condyle and the trochlea of the femur were recorded.Arthroscopic plicaectomy were performed for all the cases.Results: Among 80 cases of medial patella synovial plica syndrome, 14 cases were diagnosed with meniscus injury preoperatively,there were 5 cases graded into type A,21 cases into type B,38 cases into type C and 16 cases into type D.Sixty cases were followed up with mean time 43 months (range from 8 months to 8 years).The rate of excellent and good were 86.7% according to Lysholm scores.Conclusion: Accurate preoperative diagnosis of medial patella synovial plica syndrome is difficult, diagnose and treat it by arthroscopy is still an effective method.

  19. 带血管蒂腓肠肌内侧头肌瓣转移重建髌腱的长期随访%Medial gastrocnemius muscle transferring reconstruction the patella tendon with long following-up

    Institute of Scientific and Technical Information of China (English)

    王晋; 谢显彪; 尹军强; 黄纲; 邹昌业; 李浩淼; 尤涛; 沈靖南

    2010-01-01

    目的 总结胫骨近端侵袭性骨肿瘤广泛切除假体置换手术,应用带血管蒂腓肠肌内侧头肌瓣转移重建髌腱的长期随访结果.方法 胫骨近端肉瘤广泛切除后,应用带血管蒂腓肠肌瓣转移重建髌腱附着,长期随访及评估伸膝动力和并发症.结果 临床治疗69例,对45例生存患者平均随访68.6(24~128)个月,局部复发率8.7%(6/69),伸膝肌力平均4.2级(3.6~5.0),膝关节屈曲平均95°(75°~135°),伸膝平均-2°(0°~12°),5例膝关节不能完全伸直;患肢MSTS功能评分为77%(23.1/30),外观正常.结论 在胫骨近端侵袭性骨肿瘤保肢术中,应用带血管蒂腓肠肌瓣转移重建髌腱,能够恢复伸膝力量,改善软组织覆盖和患肢功能.%Objective To evaluate the long following-up outcome of the medial gastrocnemius muscle transferring reconstruction the patella tendon after the wide resection of aggressive bone tumors in the proximal tibia. Methods With the 69 patients of the osteogenetic sarcoma in the proximal tibia were treated with the wide resection and reconstruction the patella tendon. After the long following up the knee extensor,function and complications were evaluated. Results With the 69 patients, the 45 survival patients were followed up for the average 68.6 (24-128) months. The local recurrence rate was 8.7%(6/69). The strength of knee extending was in the average of grade 4.2(3.6-5.0), the degree of knee flexion was in the average of 95°(75°-135°), the degree of knee extension was in the average of-2°(0°-12°), the knees of five patients cannot fully extension. The MSTS functional score was in the average of 77% (23.1/30). Conclusion During the limb salvage of the proximal tibial aggressive bone tumors, the medial gastrocnemius muscle transferring reconstruction the patella tendon could offer the knee extension strength; improve the soft tissue coverage and functional results.

  20. COL5A1: Genetic mapping and exclusion as candidate gene in families with nail-patella syndrome, tuberous sclerosis 1, hereditary hemorrhagic telangiectasia, and Ehlers-Danlos syndrome type II

    Energy Technology Data Exchange (ETDEWEB)

    Greenspan, D.S. [Univ. of Wisconsin Medical School, Madison, WI (United States); Northrup, H.; Au, K.S. [Univ. of Texas Medical School, Houston, TX (United States)] [and others

    1995-02-10

    COL5A1, the gene for the {alpha}1 chain of type V collagen, has been considered a candidate gene for certain diseases based on chromosomal location and/or disease phenotype. We have employed 3{prime}-untranslated region RFLPs to exclude COL5A1 as a candidate gene in families with tuberous sclerosis 1, Ehlers-Danlos syndrome type H, and nail-patella syndrome. In addition, we describe a polymorphic simple sequence repeat (SSR) within a COL5A1 intron. This SSR is used to exclude COL5A1 as a candidate gene in hereditary hemorrhagic telangiectasia (Osler-Rendu-Weber disease) and to add COL5A1 to the existing map of {open_quotes}index{close_quotes} markers of chromosome 9 by evaluation of the COL5A1 locus on the CEPH 40-family reference pedigree set. This genetic mapping places COL5A1 between markers D9S66 and D9S67. 14 refs., 1 fig., 2 tabs.

  1. 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

  2. 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

  3. A Meta-analysis of patella prosthesis maintenance versus non-maintenance in revision of total knee arthroplasty%全膝关节置换翻修术中保留与非保留髌骨假体的Meta分析

    Institute of Scientific and Technical Information of China (English)

    郝永壮; 卫小春; 段王平; 魏垒

    2012-01-01

    Objective To compare the treatment effect of patella prosthesis maintenance versus non-maintenance in revision of total knee arthroplasty by Meta-analysis. Methods The lileratures were searched with whether retaining patella prosthesis in revision of total knee arthroplasty under special inclusion and exclusion criteria including clinical score, function score, SF physical score, SF-mental score and patienls satisfaction score. The software RevMan4. 2. 10 was used for Meta-ananlysis. Results 231 cases from three randomized controlled trials were included ( 154 cases of patella prosthesis maintenance versus 77 cases of prosthesis non-maintenance). The result of Meta-analysis showed no statistica statistical significance (clinical score; P = 0. 91; function score; P = 0. 35; SF physical score: P = 0. 39; SF mental score: P = 0. 13) . Conclusions There is no significant difference of function and clinical outcomes between patella prosthesis maintenance and non-maintenance after revision of total knee arthroplasty.%目的 通过Meta分析,比较全膝关节置换翻修术(RTKA)中髌骨假体保留与否的疗效差异.方法 全面检索国内外关于RTKA中与是否保留髌骨假体疗效相关的文献,经特定的纳入、排除标准筛选文献,提取临床评分、功能评分、SF躯体及心理评分、患者满意度等相关数据后,采用Review Manager (RevMan) 4.2.10软件进行Meta分析.结果 纳入随机对照研究3篇,共计231例RTKA患者,其中保留髌骨假体组共154例,非保留髌骨假体组共77例.Meta分析结果显示,保留髌骨假体组的临床评分(P=0.91)、功能评分(P=0.35)、SF躯体(P=0.39)及心理评分(P=0.13)与非保留组差异均无统计学意义.结论 RTKA术中髌骨假体的保留与否对术后症状改善、功能恢复等无明显的影响.

  4. 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.

  5. 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.

  6. [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.

  7. 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.

  8. 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.

  9. The influence of knee function to patella replacement and patellar plasty in totle knee arthroplasty%全膝关节置换术中髌骨置换与髌骨成形对膝关节功能的影响

    Institute of Scientific and Technical Information of China (English)

    杨小春; 郝邵文; 马晓军; 金群华

    2013-01-01

    Objective To investigate the effects on knee function between patella plasty and patellar replacement in total knee arthroplasty.Methods From August 2010 to November 2010,48 patients (69 knees) of osteoarthritis performed TKA were covered in this study.All the patients were randomly assigned to the following two groups:one group contained 24 patients (34 knees) performed patella plasty,and the other group contained other 24 patients (35 knees) performed patellar replacement.There was no significant difference between the two groups in age,weight,height,BMI,patellar score and the American Knee Society Score (KSS).Every patient was followed up for 6 weeks,3 months,6 months,one year,and two years.All the results,which were used to compare the difference between the two groups,in KSS knee score,knee function score,patellar score,the incidence of anterior knee pain,and imaging findings.Results In this clinical study,20 patients (30 knees) in patellar replacement group and 20 patients (29 knees) in patella plasty group were followed up.No significant difference was found in the postoperative KSS knee score between 2 groups at each time point.The KSS knee function score in replacement group was significantly higher than that in arthroplasty group at 6,12 and 24 months after operation.The incidence of anterior knee pain after the surgery in replacement group was significant different from the plasty group at every time point after operation.There was no significant difference in tibiofemoral angle,patellar ligament ratio,patellar tilt angle,congruence angle and lateral patellar displacement between two groups at last follow-up.Conclusion Total knee arthroplasty with patella replacement can improve both knee function and patella function,and reduce the incidence of postoperative anterior knee pain.%目的 探讨髌骨置换与髌骨成形对全膝关节置换术后膝关节功能的影响.方法 对2010年8月至11月拟行全膝关节置换术的48例(69膝)膝关节骨

  10. 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.

  11. 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.

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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

  17. Clinical, epidemiological and endoscopic characteristics of the synovial plica in patients with arthroscopy

    International Nuclear Information System (INIS)

    A prospective study of patients with surgical treatment of the knee through arthroscopy was carried out at the Rheumatology Service, belonging to 'Saturnino Lora' Teaching Clinical Surgical Provincial Hospital from Santiago de Cuba during the years 2000-2009; a decade in which 663 knees were surgically treated and, 208 due to a synovial plica. This last one turned out to be the most frequent disease, with predominance in the female sex and the ages from 16 to 25 years. There was a marked clinicoarthroscopic correspondence. Preoperative diagnosis consisted of lesion of the internal meniscus, chondromalacia patellae and synovitis, reason why they should be kept in mind as differential diagnosis in this syndrome. The way of healing the surgical section of the synovial plica is the cause of symptomatic relapse and surgical reintervention, as it happened in the patients of the case material 54,0 %, mainly attributable to fibrosis in the wound area.(author)

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

    DEFF Research Database (Denmark)

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

    2007-01-01

    AIM: To examine if cross-sectional area (CSA) differs along the length of the human patellar tendon (PT), and if there is PT hypertrophy in response to resistance training. METHODS: Twelve healthy young men underwent baseline and post-training assessments. Maximal isometric knee extension strength...... (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....... CONCLUSIONS: To our knowledge, this study is the first to report tendon hypertrophy following resistance training. Further, the data show that the human PT CSA varies along the length of the tendon....

  19. 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.

  20. 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

  1. 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.)

  2. 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.

  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. PMID:26756278

  5. 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

  6. 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...

  7. Preferential feeding by the crab Necora puber on differing sizes of the intertidal limpet Patella vulgata

    OpenAIRE

    A.C. Silva; Hawkins, S. J.; Clarke, K.R.; Boaventura, D.M.; Thompson, R C

    2010-01-01

    The crab Necora puber L. is a common predator of limpets, the major grazer on rocky shores in Northern Europe. Information on interactions between crabs and their limpet prey is limited, extending mainly to limpet defensive and predator offensive tactics, while the importance of prey size on the outcome of such interactions remains largely unknown. Here, a laboratory approach was used to test for preference in feeding habits. Predation by N. puber with cheliped height 3 to 27 mm (carapace wid...

  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. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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...

  14. 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.

  15. Disease: H00464 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available H00464 Patella dysplasias, including: Small patella syndrome (SPS); Nail-patella syndrome; Ear-patel...la-short statute syndrome Patella dysplasias are a group of disorders that include aplasia/hypoplasia of patel...lar. Small patella syndrome is a skeletal dysplasia with anomalies of the pelvis. Ossific...ation of the ischia and inferior pubic rami is also disrupted in patients with small patel...la syndrome. Nail-patella syndrome is a condition caused by mutation in LMX1B that regulates COL4A4

  16. 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.

  17. 外伤性闭合性髌骨完全翻转1例报告%Traumatic closed patella overturn entirely:A case report

    Institute of Scientific and Technical Information of China (English)

    张世强; 刘玲; 张英; 吴希瑞

    2004-01-01

    @@ A 34-year-old man was involved in a high-speed motor vehiclecollision. Survey revealed the right lower extremity was very swell-ing, the skin undermining deglove injury in the limb lateral be-tween the level of great trochanter and 10cm upper ankle, skintemperature low, touching the skin having the feeling of floating.

  18. The Patella Pro study — effect of a knee brace on patellofemoral pain syndrome: design of a randomized clinical trial (DRKS-ID:DRKS00003291)

    OpenAIRE

    Petersen, Wolf; Ellermann, Andree; Rembitzki, Ingo Volker; Scheffler, Sven; Herbort, Mirco; Sprenker, Frederike Sophie; Achtnich, Andrea; Brüggemann, Gert Peter; Best, Raymond; Hoffmann, Frank [Hrsg.; Koppenburg, Andreas Gösele; Liebau, Christian

    2014-01-01

    Background Patellofemoral pain syndrome (PFPS) is a frequent cause of anterior knee pain predominantly affecting young female patients who do not have significant chondral damage. Development of PFPS is probably multifactorial, involving various knee, hip, and foot kinematic factors. Biomechanical studies have described patellar maltracking and dynamic valgus (functional malalignment) in patients with patellofemoral pain syndrome. The literature provides evidence for short-term use of nonster...

  19. 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.

  20. 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.

  1. Total Knee Replacement for Women

    Medline Plus

    Full Text Available ... the surgery, and the patient has patella femoral arthritis too, and our plan is to resurface the ... or just with patients that have patellar/femoral arthritis?” I personally resurface the patella and in all ...

  2. 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

  3. Diagnosis and treatment of medial plica syndrome of the knee by arthroscopy:Analysis of 46 cases%46例经关节镜诊治膝关节髌内侧滑膜皱襞综合征分析

    Institute of Scientific and Technical Information of China (English)

    丛宇; 周利武; 赵建宁; 郭亭; 包倪荣

    2015-01-01

    Objective With the emerging omnipresence of arthroscopy, the plica syndrome has achieved a clinical recogni-tion as a pathological entity .This study is to investigate the clinical diagnosis and treatment of the medial plica syndrome of the knee . Methods We retrospectively analyzed 198 cases of medial plica syndrome, internal semilunar cartilage and chondromalacia patellae in the knee joints treated in our department from January 2008 to December 2011 .All the patients received physical and MRI examina-tions before admission and underwent plicaectomy, their knee function evaluated according to their Lysholm scores pre-and post-opera-tively. Results The diseased plica synovialis was completely excised in 46 cases diagnosed as simple medial plica syndrome by ar-throscopy.Forty-four of the patients were followed up for 6 to 32 (mean 26) months, and the excellence rate of treatment result was 95.5%. Conclusion Medial plica syndrome of the knee constitutes a larger proportion of knee disorders, for which arthroscopy re-mains the best diagnostic option and total excision of the diseased plica synovialis is an effective treatment .%目的:随着关节镜的广泛应用,滑膜皱襞综合征在临床上已经得到越来越多的重视。文中探讨膝关节髌内侧滑膜皱襞综合征的诊断、治疗及治疗效果。方法回顾性分析南京军区南京总医院骨科2008年1月至2011年12月间收治的诊断为膝关节髌内侧滑膜皱襞综合征、膝关节内侧半月板损伤、髌软骨软化症的膝关节紊乱患者198例。入院前均给予常规体检和MRI检查,住院期间均行膝关节镜手术,术前及术后的膝关节功能根据Lysholm评分系统进行评定,并随访疗效。结果46例经关节镜诊断为单纯髌内侧滑膜皱襞综合征,病理性滑膜皱襞均彻底清除。术后44例获得随访,平均随访时间为26个月(6~32个月),治疗结果优良率为95.5%。结论膝关节紊乱患者中

  4. Application of arthroscopy in the treatment of knee joint injury among the island garrison force%驻岛官兵膝关节损伤的膝关节镜治疗疗效观察

    Institute of Scientific and Technical Information of China (English)

    张志凌; 黄绍盛; 童良勇; 陈立喜; 黄垂邦; 卢福萧

    2015-01-01

    Objective To investigate types of knee joint injury among island garrison force and the effect of arthroscopy,and also to recommend related preventive measures.Methods Forty-two cases of knee joint injury were collected from the medical data registered from March,2012 to April,2013,and diagnosis and treatment were performed by arthroscopy.Results Of the 42 cases of knee joint injury,there were 31 cases of anterior cruciate ligament injury,14 cases of internal meniscus injury combined with external meniscus injury,2 cases of simple meniscus injury,1 case of external discoid cartilage injury,2 cases of chondromalacia patellae,3 cases of traumatic synovitis,1 case of posterior cruciate ligament injury,and 1 case of traumatic knee joint arthritis.Following treatment by arthroscopy,all the patients returned to duty.Conclusion In the knee joint injury that occurred among island garrison military per-sonnel,the highest incidence was anterior cruciate ligament injury,with complete rupture of ligament in most cases.There was a rela-tively high rate of misdiagnosis and treatment delay.For this reason,attention should be paid to knee joint injury occurred among mili-tary personnel,and early arthroscopy should be performed as early as possible,so as to improve cure rate.%目的:研究驻岛官兵膝关‘损伤的类型及关‘镜治疗效果,提出相应的预防措施。方法收集2012年3月到2013年4月共42例膝关‘损伤病例,应用膝关‘镜技术进行镜下诊断及治疗。结果42例膝关‘损伤中,前交叉韧带损伤31例,部分损伤1例,合并内侧或外侧半月板损伤14例,单纯半月板损伤2例,外侧盘状软骨损伤1例,髌骨软化症2例,创伤性滑膜炎3例,后交叉韧带损伤1例,股骨滑车软骨损伤1例,创伤性关‘炎1例。所有患者经关‘镜治疗,均重返工作岗位。结论驻岛官兵膝关‘损伤中前交叉韧带损伤发生率最高,绝大多数为完全断裂,早期误诊率较

  5. 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.

  6. CLASSIFICATION AND SIGNIFICANCE UNDER THE ARTHROSCOPE OF PATELLA MEDIAL SYNOVIAL PLICA OF KNEE%膝关节髌内侧滑膜皱襞的关节镜下分型及意义

    Institute of Scientific and Technical Information of China (English)

    易智; 凌鸣; 罗振群; 徐洪海

    2002-01-01

    目的:探讨膝关节髌内侧滑膜皱襞的关节镜下分型及其与滑膜皱襞综合征的关系.方法:对75例(75膝)关节镜下发现有髌内侧滑膜皱襞的病人,详细记录皱襞的特点,并加以分型.结果:髌内侧滑膜皱襞的位置、形态、质地的变化呈现多样性,因此其致病特点亦不相同.结论:将髌内侧滑膜皱襞的镜下表现分为七型,Ⅳ、Ⅴ、Ⅵ、Ⅶ型因其肥厚、纤维化,并与关节产生不相适应的摩擦、挤压而导致滑膜皱襞综合征.

  7. 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。

  8. 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.

  9. 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.).

  10. 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.

  11. 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。

  12. Radiologic study of patellofemoral congruence in normal adults

    International Nuclear Information System (INIS)

    In order to establish the normal position of the patella, in relation to the intercondilar sulcus, we have evaluated 72 adults patients, making use of the FICAT view in axial radiographys at 300: a simple and accurate technique adopted to measure the congrunce angle in the detection of sub-luxation of the patella. The value of +90 was used as the normal pattern for the maximal lateral position of the patella in the intercondilar sulcus. (Author)

  13. Split Fracture: A Complication of Cerclage Wiring of Acute Patellar Fracture

    OpenAIRE

    Lo, Cho Yau; Lui, Tun Hing; Sit, Yan Kit

    2014-01-01

    Introduction: Iatrogenic patellar fracture is reported as a complication of patella procedures, such as medial patellofemoral ligament reconstruction, reconstruction of the anterior cruciate ligament of the knee using bone-patellar tendon-bone technique, and resurfacing the patella in total knee arthroplasty. Case Presentation: A 65-year-old lady with right patella fracture was treated with open reduction and cerclage wiring. An iatrogenic split fracture was noted during tension of the cercla...

  14. 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.

  15. [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.

  16. Patellar nomenclature: the Tower of Babel revisited.

    Science.gov (United States)

    Grelsamer, Ronald P

    2005-07-01

    Because we communicate mainly through words, it is important that terms be understood in the same manner by all readers. Unfortunately, the study of the patellofemoral joint is complicated by the use of expressions that hold different meanings for different readers. Ideally, the community of musculoskeletal physicians should agree on a single definition of terms, but until then, authors and speakers should define their terms clearly. Some terms, such as chondromalacia and patellofemoral syndrome, should be abandoned altogether. I propose a glossary of confusing terms pertaining to the patellofemoral joint, the various interpretations of these terms, and possible resolutions of these conflicts. Words and terms included in this review include chondromalacia, patellofemoral syndrome, anterior knee pain, subluxation, malalignment, proximal realignment, Roux procedure, and "normal." PMID:15995421

  17. 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.

  18. Minimally Invasive Total Knee Arthroplasty

    Medline Plus

    Full Text Available ... female. The knee is a little -- I would grade it a one plus lax knee but it’s ... I do not see problems with loss of blood supply in my patella and I don't ... I don't have problems with losing my blood supply of this patella. So this lady measured ...

  19. Development and validation of a weight-bearing finite element model for total knee replacement.

    Science.gov (United States)

    Woiczinski, M; Steinbrück, A; Weber, P; Müller, P E; Jansson, V; Schröder, Ch

    2016-08-01

    Total knee arthroplasty (TKA) is a successful procedure for osteoarthritis. However, some patients (19%) do have pain after surgery. A finite element model was developed based on boundary conditions of a knee rig. A 3D-model of an anatomical full leg was generated from magnetic resonance image data and a total knee prosthesis was implanted without patella resurfacing. In the finite element model, a restarting procedure was programmed in order to hold the ground reaction force constant with an adapted quadriceps muscle force during a squat from 20° to 105° of flexion. Knee rig experimental data were used to validate the numerical model in the patellofemoral and femorotibial joint. Furthermore, sensitivity analyses of Young's modulus of the patella cartilage, posterior cruciate ligament (PCL) stiffness, and patella tendon origin were performed. Pearson's correlations for retropatellar contact area, pressure, patella flexion, and femorotibial ap-movement were near to 1. Lowest root mean square error for retropatellar pressure, patella flexion, and femorotibial ap-movement were found for the baseline model setup with Young's modulus of 5 MPa for patella cartilage, a downscaled PCL stiffness of 25% compared to the literature given value and an anatomical origin of the patella tendon. The results of the conducted finite element model are comparable with the experimental results. Therefore, the finite element model developed in this study can be used for further clinical investigations and will help to better understand the clinical aspects after TKA with an unresurfaced patella. PMID:26618541

  20. Radiologic findings of nail-pateIIa syndrome: case report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sung Bin [Seoul Regional Military Manpower Office, Seoul (Korea, Republic of); Yoo, Jeong Su [Military Manpower Administration, Daejeon (Korea, Republic of)

    2004-09-01

    Nail-patella syndrome is a rare autosomal dominant pleiotropic disorder characterized by dysplasia of the nails, pateller aplasia or hypoplasia, iliac horns, and dysplasia or dislocation of the elbow. We experienced a case of nail-patella syndrome. NPS is a relatively uncommon disease; however, an understanding of the typical radiologic findings is useful in establishing the diagnosis and guiding the treatment.

  1. 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.

  2. 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. PMID:27139130

  3. Evidence of accumulated stress in Achilles and anterior knee tendons in elite badminton players

    DEFF Research Database (Denmark)

    Boesen, Anders Ploug; Boesen, Morten Ilum; Koenig, Merete Juhl;

    2011-01-01

    vascular response as indicated by colour Doppler (CD) activity in both the Achilles and patella tendon after loading during high-level badminton matches. The Achilles tendon was subdivided into a mid-tendon, pre-insertional, and insertional region and the anterior knee tendons into a quadriceps-, patella......, there was a trend towards a stepwise increase in intra-tendinous flow. The preliminary results indicate that high amount of intra-tendinous flow was found in elite badminton players at baseline and was increased after repetitive loading, especially in the patella tendon (dominant leg). The colour...

  4. Treatment of the knee stiffness caused by partial patellectomy; Case report - Technical tricks

    Directory of Open Access Journals (Sweden)

    Milankov M

    2005-12-01

    Full Text Available Partial patellectomy is advised in treating comminuted fractures of patella when accurate reduction and stable fixation cannot be achieved. Usually, after partial patellectomy, the tendon-to-bone junction requires prolonged protection. One of the effects of the prolonged immobilization is lack of knee flexion. Stiffness of the knee was treated with manipulation under anaesthesia. In order to protect patellar ligament insertion to the patella remnant, a Steinmann pin was put through tibial tuberosity, a metal wire was pulled through the patella remnant and tied firmly to the pin. Gentle manipulation was performed and full flexion of the knee was achieved without damaging bone ligament complex.

  5. 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 .

  6. 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.

  7. 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.

  8. 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。

  9. 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.

  10. Knee pain (image)

    Science.gov (United States)

    ... front of the knee can be due to bursitis, arthritis, or softening of the patella cartilage as ... knee. Overall knee pain can be due to bursitis, arthritis, tears in the ligaments, osteoarthritis of the ...

  11. Knee Pain and the Weekend Warriors

    Medline Plus

    Full Text Available ... show this to you. This is the kneecap right here, and then I’ve marked that out. ... structures would be. This is the kneecap tendon right here, or the patella tendon, and this is ...

  12. 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.

  13. 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.

  14. The late results of Hauser's operation

    OpenAIRE

    Cakmak, Mehmet; Domanic, Unsal; Akalin, Yilmaz; Taser, Omer

    2004-01-01

    Attempts have been made to examine the late results obtained from 9 knees in 7 cases, as well as to discuss the place of Hauser's operation today under the light of literature. It has also been stressed that Hausers operation should not be performed before the age of 14 and in cases of habitual patella dislocations and that Blauth-Mann modification should be applied in recurrent patella dislocations ana subluxations.

  15. 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.

  16. Sesamoid disorders of the first metatarsophalangeal joint.

    Science.gov (United States)

    Boike, Allan; Schnirring-Judge, Molly; McMillin, Sean

    2011-04-01

    The sesamoid complex is located centrally and plantar to the first metatarsal head, where they are imbedded within the plantar plate, which transmits 50% of body weight and more than 300% during push-off, is susceptible to numerous pathologies. These pathologies include sesamoiditis, stress fracture, avascular necrosis, osteochondral fractures, and chondromalacia, and are secondary to these large weight-bearing loads. This article discusses sesamoid conditions and their relationship with hallux limitus, and reviews the conditions that predispose the first metatarsophalangeal joint to osteoarthritic changes. PMID:21669339

  17. Structure, ontogeny and evolution of the patellar tendon in emus (Dromaius novaehollandiae and other palaeognath birds

    Directory of Open Access Journals (Sweden)

    Sophie Regnault

    2014-12-01

    Full Text Available The patella (kneecap exhibits multiple evolutionary origins in birds, mammals, and lizards, and is thought to increase the mechanical advantage of the knee extensor muscles. Despite appreciable interest in the specialized anatomy and locomotion of palaeognathous birds (ratites and relatives, the structure, ontogeny and evolution of the patella in these species remains poorly characterized. Within Palaeognathae, the patella has been reported to be either present, absent, or fused with other bones, but it is unclear how much of this variation is real, erroneous or ontogenetic. Clarification of the patella’s form in palaeognaths would provide insight into the early evolution of the patella in birds, in addition to the specialized locomotion of these species. Findings would also provide new character data of use in resolving the controversial evolutionary relationships of palaeognaths. In this study, we examined the gross and histological anatomy of the emu patellar tendon across several age groups from five weeks to 18 months. We combined these results with our observations and those of others regarding the patella in palaeognaths and their outgroups (both extant and extinct, to reconstruct the evolution of the patella in birds. We found no evidence of an ossified patella in emus, but noted its tendon to have a highly unusual morphology comprising large volumes of adipose tissue contained within a collagenous meshwork. The emu patellar tendon also included increasing amounts of a cartilage-like tissue throughout ontogeny. We speculate that the unusual morphology of the patellar tendon in emus results from assimilation of a peri-articular fat pad, and metaplastic formation of cartilage, both potentially as adaptations to increasing tendon load. We corroborate previous observations of a ‘double patella’ in ostriches, but in contrast to some assertions, we find independent (i.e., unfused ossified patellae in kiwis and tinamous. Our

  18. 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.

  19. A New Promising Technique of 3D Isovoxel Imaging Using 3T MRI in the Wrist: Comparison with 3T MR Arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Guen Young; Kim, Baek Hyun; Park, Jong Woong [Korea University Ansan Hospital, Korea University College of Medicine, Ansan (Korea, Republic of)

    2011-02-15

    We wanted to evaluate the usefulness of 3D isovoxel MR imaging using 3T MRI in the wrist joint, as compared with 3T MR arthrography. A total of 33 patients underwent both MR arthrography and 3D isovoxel imaging of the wrist joints using 3T MR, including 11 patients with arthroscopic confirmation. 3D isovoxel MR imaging was performed using an intermediateweighted fast spin echo coronal scan with a 0.4-mm slice thickness and the axial images were reconstructed with a 1-mm slice thickness. One radiologist evaluated for the presence of scapholunate or lunotriquetral ligament tear and she determined the grade of the triangular fibrocartilage complex tear and chondromalacia with its location. We compared the two examinations using kappa values. The rates of detecting wrist injury were similar for both exams with substantial to almost perfect inter-examination agreement (kappa value = 0.864 for scapholunate ligament tear, 0.835 for lunotriquetral ligament tear, 0.799 for TFCC tear and 0.940 for chondromalacia). For the eleven cases that underwent arthroscopy, their results of 3D isovoxel MRI were also similar to that of MR arthrography. 3D isovoxel MR imaging is useful for the evaluation of the wrist joint

  20. Soft-Tissue Loop for Medial Patellofemoral Ligament Reconstruction.

    Science.gov (United States)

    Miswan, Mohd Fairudz Bin Mohd; Al-Fayyadh, Mohamed Zubair Mohamed; Seow Hui, Teo; Mohamed Ali, Mohamed Razif Bin; Ng, Wuey Min

    2016-04-01

    A patient with patellar instability frequently presents with anterior knee pain, patellar subluxation, or dislocation. Medial patellofemoral ligament (MPFL) has a key role for normal patella tracking and stability. Reconstruction of the MPFL using a hamstring graft is a commonly used procedure for the treatment of chronic lateral subluxation of patella. Anchor sutures and bony tunnels are used for the patellar attachment of the graft. This can be associated with complications such as patella fracture; besides, it does not produce an anatomical reconstruction for the native MPFL that can alter the direction of tension applied on the patella. To overcome these problems, a soft-tissue loop technique is used for MPFL reconstruction. During this procedure, a semitendinosus graft was passed through the prepatellar extensor retinaculum and secured with sutures. The free ends of the graft were then passed between the second and third layers of the medial patellofemoral retinaculum and fixed to a femoral tunnel on the medial femoral condyle with an interference screw. The desired amount of tension on the graft is achieved under direct vision of patella tracking arthroscopically. We found this method to be relatively safe and fast. It is more anatomical and can avoid the complications during the conventional bony procedures. PMID:27354953

  1. 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.

  2. 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.

  3. 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.)

  4. Imaging assessment of patellar instability and its treatment in children and adolescents

    International Nuclear Information System (INIS)

    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.)

  5. 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.

  6. 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

  7. 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.

  8. 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.

  9. Hamstring transfer for quadriceps paralysis in post polio residual paralysis

    Directory of Open Access Journals (Sweden)

    Jagadish J Patwa

    2012-01-01

    Conclusions: H to Q transfer in the presence of quadriceps paralysis with good power in hamstring is a better alternative than supracondylar osteotomy because it is a dynamic correction and it produces some degree of recurvatum with increasing stability of knee in extension while walking. While inserting hamstring over patella the periosteum is not cut in an I-shaped fashion to create a flap which gives additional strength to new insertion and also patella act as a fulcrum during the extension of knee by producing the bowstring effect.

  10. 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.

  11. Fibromyalgia syndrome. New associations.

    Science.gov (United States)

    Waylonis, G W; Heck, W

    1992-12-01

    Previous research has demonstrated a number of conditions, such as sleep disturbance, fatigue, depression, spastic colon and mitral valve prolapse, associated with fibromyalgia. The present report describes additional symptoms and medical conditions that appear to be associated with the syndrome based on a survey of 554 individuals with fibromyalgia compared with a group of 169 controls. Individuals with fibromyalgia self report a greater incidence of bursitis, chondromalacia, constipation, diarrhea, temporomandibular joint dysfunction, vertigo, sinus and thyroid problems. Symptomatic complaints found statistically more prevalent in fibromyalgia patients included concentration problems, sensory symptoms, swollen glands and tinnitus. Other associations occurring with significant increased frequency were chronic cough, coccygeal and pelvic pain, tachycardia and weakness. Our previous report on inheritance patterns in fibromyalgia was reaffirmed with 12% reporting symptomatic children and 25% reporting symptomatic parents. Of the respondents, 70% noted that their symptoms were aggravated by noise, lights, stress, posture and weather. PMID:1466872

  12. 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...

  13. 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.

  14. 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.

  15. 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.

  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.

    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.

  17. MEDIAL PATELLAR DESMOTOMY BY BLIND METHOD IN LARGE RUMINANTS DURING UPWARD PATELLAR FIXATION

    Directory of Open Access Journals (Sweden)

    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.

  18. 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.

  19. Hereditary onycho-osteo dysplasia syndrome

    OpenAIRE

    Yadav T; Gupta V; Mishra S; Gautam R; Sharma P

    1995-01-01

    We report a two and a half year old male child with dystrophy of all the nails, absent patellae and iliac horns. In addition he had dysmorphic facial features, sparing of lunula and bilateral hallux valgus deformity, hitherto not reported earlier.

  20. Periprosthetic fractures of the femur after total knee arthroplasty

    OpenAIRE

    McGraw, Phil; Kumar, Arun

    2010-01-01

    Periprosthetic fracture following total knee arthroplasty is a potentially serious complication. This injury can involve the distal femur, proximal tibia or the patella. This review article analyzes the prevalence, risk factors, classification and treatment options for periprosthetic fractures of the femur.

  1. [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.

  2. 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.

  3. Cell communication compartments in molluscan embryos.

    Science.gov (United States)

    Serras, F; Kühtreiber, W M; Krul, M R; van den Biggelaar, J A

    1985-08-01

    Early embryos of Patella vulgata have been injected with Lucifer Yellow. No restriction of dye spread was found. We show that later in the development, the larval trochophore stage present evidence of compartments of cell communication. These dye compartments coincide with different presumptive regions. PMID:4028198

  4. Recurrent Patellar Instabilty Culminating in a Vertically Rotated and a Locked Patellar Dislocation – A Rare Entity

    Science.gov (United States)

    A, Devgan; R, Rohilla; A, Jain; H, Mehta; S, Singh

    2016-01-01

    Introduction: Locked vertical patellar dislocations are rare and pose a therapeutic challenge. This case is more unusual, as the patient was a known case of recurrent patellar dislocation and presented with an atraumatic locked and vertically rotated patellar dislocation. This type of presentation has never been reported in literature to the best of our knowledge. Case presentation: A 14-year-old healthy male child with previous history of recurrent lateral dislocation of patella presented to accident & emergency department with complaints of inability to walk or bear weight on his left lower limb after he spontaneously dislocated his patella while running on uneven ground. Radiographs revealed a laterally displaced and vertically rotated patella along its long axis with the medial patellar edge locked and dipping into the lateral gutter. Open reduction was performed along with lateral patellar retinacular release with medial patellar retinaculum plication, to achieve satisfactory patellar stability and patellofemoral tracking. Conclusion: We would recommend that in the settings of patella being vertically dislocated and locked, open reduction would be the management of choice, as these types of dislocations are difficult to relocate by closed reduction. Repeated attempts of closed reduction may cause osteochondral damage. Open reduction not only yields better outcomes but also allows the surgeon to perform patellar realignment procedures in order to prevent further patellar dislocations in cases of prior patellar instability.

  5. 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...

  6. 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,…

  7. Tunnel widening in anterior cruciate ligament reconstruction

    DEFF Research Database (Denmark)

    Clatworthy, M G; Annear, P; Bulow, J U;

    1999-01-01

    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...

  8. 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.

  9. 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

  10. 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.

  11. Comparative validation of the radiographic and tomographic measurement of patellar height

    Directory of Open Access Journals (Sweden)

    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.

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. Temporal trending of lead and cadmium contamination in the Vigo estuary intertidal area Evolución temporal de la contaminación por plomo y cadmio en la zona intermareal de la ría de Vigo

    OpenAIRE

    J. Alonso Díaz; M. J. Melgar Riol; M. Méndez García; Pérez López, M.

    2004-01-01

    At the present work, limpet (Patella vulgata L.) and seaweed (Ulva lactuca) specimens have been monthly sampled at the same point from the Vigo estuary, during a year. Heavy metal (cadmium and lead) content has been determined by means of differential pulse anodic stripping voltammetry in both limpet and seaweed tissues, as well as in seawater. The obtained results have shown the main heavy metal content in limpet soft tissues with respect to shell, with maximum concentrations of 3 ppm (limpe...

  17. Testosterone Reduces Knee Passive Range of Motion and Expression of Relaxin Receptor Isoforms via 5α-Dihydrotestosterone and Androgen Receptor Binding

    OpenAIRE

    Firouzeh Dehghan; Sekaran Muniandy; Ashril Yusof; Naguib Salleh

    2014-01-01

    Ovarian steroids such as estrogen and progesterone have been reported to influence knee laxity. The effect of testosterone, however, remains unknown. This study investigated the effect of testosterone on the knee range of motion (ROM) and the molecular mechanisms that might involve changes in the expression of relaxin receptor isoforms, Rxfp1 and Rxfp2 in the patella tendon and lateral collateral ligament of the female rat knee. Ovariectomized adult female Wistar rats received three days trea...

  18. PROTECTION DEVICE ON THE REPAIR OF RUPTURES OF KNEE EXTENSOR MECHANISM

    OpenAIRE

    Arguello Frutos, Carlos Francisco; Arbix Camargo, Osmar Pedro; Severino, Nilson Roberto; Leite Cury, Ricardo de Paula; de Oliveira, Victor Marques; Aihara, Tatsuo; Avakian, Roger

    2015-01-01

    To evaluate results obtained using the protection device technique for osteosintesis or suture of extensor mechanism lesions. Material and Methods: The authors reviewed 18 charts of patients submitted to protection device technique due to traumatic lesion of extensor mechanism that had occurred between the anterior tibial tuberosity and the apical portion of patella. Age ranged from 22 to 69 years, with a mean of 44 years. Male patients prevailed, with 67% of the cases. The most affected spot...

  19. Nevrodynamiske tester ved patellofemorale smerter

    OpenAIRE

    Vegstein, Kristine

    2010-01-01

    Background: Patellofemoral pain syndrom (PFPS) is a common musculoskeletal disorder which can develop to a chronic problem. There is no consensus in medical literature concerning the etiology of PFPS. Recent studies indicate an involvement of the peripheral nervous system around the patella. Neurodynamic tests are used to explore the mechanosensitivity of peripheral nerves. Several studies have shown relationship between increased mechanosensitivity and musculoskeletal problems in the upper e...

  20. 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.

  1. In-game Management of Common Joint Dislocations

    OpenAIRE

    Skelley, Nathan W.; McCormick, Jeremy J; Smith, Matthew V.

    2014-01-01

    Context: Sideline management of sports-related joint dislocations often places the treating medical professional in a challenging position. These injuries frequently require prompt evaluation, diagnosis, reduction, and postreduction management before they can be evaluated at a medical facility. Our objective is to review the mechanism, evaluation, reduction, and postreduction management of sports-related dislocations to the shoulder, elbow, finger, knee, patella, and ankle joints. Evidence Ac...

  2. Concurrent cases of bilateral anterior shoulder dislocation: our observations in three cases

    OpenAIRE

    Orhan Akinci; Yavuz Akalin; Ali Otuzbir; Alpaslan Oztürk

    2016-01-01

    Bilateral anterior shoulder dislocations are  rarely seen and usually occur due to the same mechanism arising from traumatic injuries. In here, we discussed three cases of traumatic bilateral anterior shoulder dislocation , one had an additional patella fracture, and the other one had bilateral tuberculum majus fracture. All of the patients were female and our first case that presented here was 65-year-old and given a closed reduction for isolated bilateral anterior shoulder dislocation that ...

  3. Bursae around the knee joints

    Directory of Open Access Journals (Sweden)

    Priyank S Chatra

    2012-01-01

    Full Text Available A bursa is a fluid-filled structure that is present between the skin and tendon or tendon and bone. The main function of a bursa is to reduce friction between adjacent moving structures. Bursae around the knee can be classified as those around the patella and those that occur elsewhere. In this pictorial essay we describe the most commonly encountered lesions and their MRI appearance.

  4. Biology and augmentation of tendon-bone insertion repair

    OpenAIRE

    Lui PPY; Zhang P; KM, Chan; Qin L

    2010-01-01

    Abstract Surgical reattachment of tendon and bone such as in rotator cuff repair, patellar-patella tendon repair and anterior cruciate ligament (ACL) reconstruction often fails due to the failure of regeneration of the specialized tissue ("enthesis") which connects tendon to bone. Tendon-to-bone healing taking place between inhomogenous tissues is a slow process compared to healing within homogenous tissue, such as tendon to tendon or bone to bone healing. Therefore special attention must be ...

  5. Atraumatic patellar prosthesis dislocation with patellar tendon injury following a total knee arthroplasty: a case report

    OpenAIRE

    Singh Alka; Singh Yashwant; Singh Pankaj; Singh Vinay; Javed Sadaf; Abdunabi Murad

    2010-01-01

    Abstract Introduction Total knee arthroplasty is a well-established procedure with gratifying results. There is no consensus in the literature whether to routinely resurface the patella while performing total knee arthroplasty or not. Although an extremely rare occurrence in clinical practice, patellar prosthesis dislocation is a possible complication resulting from total knee arthroplasty. Case presentation We report a rare case of atraumatic spontaneous dislocation of patellar prosthesis in...

  6. Minimally Invasive Reconstruction of the Medial Patellofemoral Ligament Using Quadriceps Tendon

    OpenAIRE

    Fink, Christian; Veselko, Matjaz; Herbort, Mirco; Hoser, Christian

    2014-01-01

    Reconstruction of the medial patellofemoral ligament (MPFL) for the treatment of patellar instability has received increased attention over the past few years. Most operative techniques use hamstring grafts fixed with bone tunnels and/or anchors on the patella. Despite good clinical results using these techniques, complications such as implant breakage, patellar fractures through bone tunnels, and loss of knee motion have occurred. We present a minimally invasive technique for MPFL reconstruc...

  7. Bioavailable metals and cellular effects in the digestive gland of marine limpets living close to shallow water hydrothermal vents.

    OpenAIRE

    Cunha, Luís; Amaral, André; Medeiros, Vera; Martins, Gustavo M.; Wallenstein, Francisco; Couto, Ruben P.; Neto, Ana I.; Rodrigues, Armindo

    2008-01-01

    Copyright © 2007 Elsevier Ltd All rights reserved. The pressure exerted by shallow water hydrothermal vents on edible gastropods and their cellular responses triggered by these stresses are almost unknown. The aims of this study were to evaluate the bioavailability of metals in the Macaronesian endemic limpet Patella candei gomesii living close to shallow water hydrothermal vents, and the structural differences in their digestive gland as well as the levels of apoptosis in that organ. L...

  8. [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.

  9. Effects of Open and Closed Kinetic Chains of Sling Exercise Therapy on the Muscle Activity of the Vastus Medialis Oblique and Vastus Lateralis

    OpenAIRE

    Chang, Wen-Dien; Huang, Wei-Syuan; Lee, Chia-Lun; Lin, Hung-Yu; Lai, Ping-Tung

    2014-01-01

    [Purpose] The muscle strength of the quadriceps muscle is critical in patellofemoral pain syndrome. The quadriceps muscle supplies the power for dynamic patellar movement, and the vastus medialis oblique (VMO) and vastus lateralis (VL) enable the patella to stabilize during tracking. We followed the theories about open and closed kinetic chain exercises to design two exercises, sling open chain knee extension (SOCKE) exercise and sling closed chain knee extension (SCCKE) exercise. The purpose...

  10. CT patellar cortex tilt angle: A radiological method to measure patellar tilt

    International Nuclear Information System (INIS)

    Background/Objectives: the role of patellar tilt in the anterior knee pain is indisputable. Traditionally. the lateral patello-femoral angle of Laurin has been defined in both the axial view and CT images for measuring the tilt of patella. We present a new angle. which is independent of the morphology of patella and directly relates to clinical assessment of the tilt. which is appreciated from palpation of the edges of the patella. Patients and Methods: 38 patients with anterior knee pain and forty normal control subjects were examined using CT scan of patello-femoral joint in 15 degrees of knee flexion. The amount of lateral patellar tilt was quantitatively assessed using the lateral patello-femoral angle, as described by Laurin et al, and the newly defined patellar cortex tilt angle. This angle is subtended by the line drawn along the posterior femoral condyles and the one parallel to the subchondral bone of patellar cortex. The fifteen-degree tilt was taken as normal cut-off point for patellar cortex tilt angle in the control group. Results: in patients, the average tilt of patella. using the patellar cortex tilt angle was 15.26 versus 7.05 in the control group. Using Student's t test, the difference between the two means was significant (P<0.001). The sensitivity and specificity of patellar cortex tilt angle were 40 and 90 percent, respectively There was a moderate agreement between our presented test and the lateral tilt angle test (kappa=0.40. P<0.001). Conclusion: our results indicate that patellar tilt can also be detected using patellar cortex tilt angle. We need more specific studies ta determine the validity of the test

  11. In Vivo Patellar Tracking: Clinical Motions and Patellofemoral Indices

    OpenAIRE

    Nha, Kyung W.; Papannagari, Ramprasad; Gill, Thomas J.; Van de Velde, Samuel K.; Freiberg, Andrew A.; Rubash, Harry E.; Li, Guoan

    2008-01-01

    Patellar tracking during in vivo weightbearing knee function is not well understood. This study investigated patellar tracking of eight subjects during a full range of weightbearing flexion using magnetic resonance imaging and dual orthogonal fluoroscopy. The data were reported using a clinical description based on patellar and femoral joint coordinate systems and using patellar indices based on geometrical features of the femur and patella. The mean patellar shift was within 3 mm over the en...

  12. IMPACT DE LA POLLUTION BACTERIENNE SUR L’OURSIN P. LIVIDUS (LCK, 1816) ET LA PATELLE P. CAERULEA (L.,1758) DE LA COTE OUEST ALGERIENNE.

    OpenAIRE

    A. MATALLAH-BOUTIBA; Y. SEDDIK; H. SOUIDI; Z. Boutiba

    2011-01-01

    This work refers to the evaluation of the bacterial contamination in sea water of the Oranian coast using two marine species largely distributed on the littoral and used as bioindicators of pollution: the edible sea urchin Paracentrotus lividus and the common patella Patellacoerulea. Sampling was conducted from (december-may 2008), monthly, in two coastal areas of Oran, (west Algeria), first the impacted area near the discharge channels: Genêts; second non- impacted Ain Defla considered as he...

  13. 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.

  14. 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

  15. 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.

  16. A cladistic phylogeny of the family Patellidae (Mollusca: Gastropoda)

    Science.gov (United States)

    Ridgway, S. A.

    1998-01-01

    A phylogenetic hypothesis for the patellid limpets is reconstructed by cladistic analysis of morphological characters from 37 species, representing all but one of the living members of the family. Characters included in the analysis are derived from shell shape and microstructure, headfoot and pallial complex, radula and sperm. The species fall into four clades, providing the basis for a new phylogenetic classification into four monophyletic genera: Helcion (four species; southern Africa), Cymbula (eight species; southern Africa, eastern Atlantic, southern Indian Ocean), Scutellastra (17 species; southern and southwestern Africa, Australia, Indo-West Pacific, Eastern Pacific) and Patella (nine species; northeastern Atlantic and Mediterranean). The analysis suggests sister-group relationships between Helcion and Cymbula, and between Scutellastra and Patella. In combination with present-day patterns of geographical distribution, this phylogenetic hypothesis is used to discuss the historical biogeography of the Patellidae. Scutellastra may have originated in southern Africa and dispersed across the Pacific, or alternatively may be a primitively Tethyan group. Both Helcion and Cymbula appear to have originated in southern Africa, but three Cymbula species have dispersed respectively to northwest Africa, St Helena and the southern Indian Ocean. The patellids of the northeastern Atlantic form a single clade, Patella (including P. pellucida), which may have arrived by northward dispersal of an ancestor from southern Africa, or possibly by vicariance of a widespread ancestral Tethyan distribution. The known fossil record of patellids is too fragmentary to permit choice between these alternatives.

  17. Accuracy of biplane x-ray imaging combined with model-based tracking for measuring in-vivo patellofemoral joint motion

    Directory of Open Access Journals (Sweden)

    Zauel Roger

    2008-09-01

    Full Text Available Abstract Background Accurately measuring in-vivo motion of the knee's patellofemoral (PF joint is challenging. Conventional measurement techniques have largely been unable to accurately measure three-dimensional, in-vivo motion of the patella during dynamic activities. The purpose of this study was to assess the accuracy of a new model-based technique for measuring PF joint motion. Methods To assess the accuracy of this technique, we implanted tantalum beads into the femur and patella of three cadaveric knee specimens and then recorded dynamic biplane radiographic images while manually flexing and extending the specimen. The position of the femur and patella were measured from the biplane images using both the model-based tracking system and a validated dynamic radiostereometric analysis (RSA technique. Model-based tracking was compared to dynamic RSA by computing measures of bias, precision, and overall dynamic accuracy of four clinically-relevant kinematic parameters (patellar shift, flexion, tilt, and rotation. Results The model-based tracking technique results were in excellent agreement with the RSA technique. Overall dynamic accuracy indicated errors of less than 0.395 mm for patellar shift, 0.875° for flexion, 0.863° for tilt, and 0.877° for rotation. Conclusion This model-based tracking technique is a non-invasive method for accurately measuring dynamic PF joint motion under in-vivo conditions. The technique is sufficiently accurate in measuring clinically relevant changes in PF joint motion following conservative or surgical treatment.

  18. 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.

  19. 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. PMID:18313972

  20. Minimally invasive reconstruction of the medial patellofemoral ligament using quadriceps tendon.

    Science.gov (United States)

    Fink, Christian; Veselko, Matjaz; Herbort, Mirco; Hoser, Christian

    2014-06-01

    Reconstruction of the medial patellofemoral ligament (MPFL) for the treatment of patellar instability has received increased attention over the past few years. Most operative techniques use hamstring grafts fixed with bone tunnels and/or anchors on the patella. Despite good clinical results using these techniques, complications such as implant breakage, patellar fractures through bone tunnels, and loss of knee motion have occurred. We present a minimally invasive technique for MPFL reconstruction using a strip of quadriceps tendon. With the use of specially designed instruments, the graft is harvested through a 3-cm transverse incision at the proximal pole of the patella. The tendon strip is then dissected distally on the patella, left attached, and diverged 90° medially underneath the medial prepatellar tissue. The graft is fixed on the femur in 20° of knee flexion in a bone tunnel with a bioabsorbable interference screw (adults) or a bone anchor (children). We think that this technique presents a valuable alternative to common hamstring techniques for primary MPFL reconstruction in children and adults, as well as for MPFL revision surgery. PMID:25126496

  1. 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.

  2. Posttraumatic chronic patellar dislocation treated by distal femoral osteotomy and medial patellofemoral ligament reconstruction.

    Science.gov (United States)

    Purushothaman, Balaji; Agarwal, Amit; Dawson, Matt

    2012-11-01

    Chronic patellar dislocation is a rare condition where the patella remains dislocated throughout knee range of motion during flexion and extension. In adults, the delayed presentation of this condition is often due to symptoms caused by the onset of severe secondary osteoarthritis. To the authors' knowledge, all of the cases reported in the literature have been treated by patellofemoral or total knee replacements depending on patient age and the extent of the arthritis. This article describes a rare case of a 22-year-old woman who sustained a traumatic chronic patellar dislocation for 5 months. Clinical examination revealed a valgus deformity of the left leg secondary to childhood injury and that the patella lay lateral to the lateral femoral condyle throughout flexion and extension. Radiographs of the knee revealed patellar dislocation. Long-leg radiographs of the left leg showed an anatomic tibiofemoral angle of 17° valgus. The anatomical (74°) and mechanical (80°) lateral distal femoral angles were abnormal, whereas the medial proximal tibial angle (87°) was normal, confirming that the valgus deformity was due to the abnormal distal femur. The authors performed a distal femoral osteotomy to correct the valgus deformity. Medial patellofemoral ligament reconstruction using a hamstring autograft was performed to stabilize the patella. PMID:23127463

  3. Patellar dislocation with genu valgum treated by DFO.

    Science.gov (United States)

    Kwon, Jae Ho; Kim, Jong In; Seo, Dong-Hyun; Kang, Kyung-Woon; Nam, Ji Ho; Nha, Kyung-Wook

    2013-06-01

    Congenital habitual patellar dislocation is a rare condition of the knee where the patella dislocates during flexion and relocates during extension. The congenital form is permanent, irreducible, and presents at birth. It is characterized by a short quadriceps and a major patellofemoral dysplasia and short height. This article presents a rare case of a 27-year-old woman with recurring bilateral habitual dislocation of the patella after a failed previous proximal and distal realignment procedure. Clinical examinations of both knees revealed genu valgus knees and lateral joint pain that recurred after several previous operations. Radiographs of both knees showed patellar dislocation and genu valgum associated with patellofemoral dysplasia and osteoarthritis of the lateral compartment. Long-leg standing radiographs showed an anatomic tibiofemoral angle of right 13° and left 6° valgus and a mechanical tibiofemoral angle of right 8° and left 2° valgus and weight-bearing line of 65% on the right and 48% on the left. The authors performed a distal femoral closing wedging osteotomy to correct the valgus deformity, and then percutaneous lateral release and medial reefing were performed to stabilize the patellas of both knees simultaneously. PMID:23746026

  4. Reconstruction of medial patello-femoral ligament: Comparison of two surgical techniques.

    Science.gov (United States)

    Criscenti, G; De Maria, C; Sebastiani, E; Tei, M; Placella, G; Speziali, A; Vozzi, G; Cerulli, G

    2016-06-01

    The medial patello-femoral ligament is considered the most important passive patellar stabilizer and its proper functionality is essential for the patello-femoral joint stability. In this work, 18 human knees were randomly divided into two groups and reconstructed through two different surgical techniques: the "Through tunnel tendon" and the "Double converging tunnel" reconstructions. Subsequently, the samples were mechanically tested to evaluate the structural properties of reconstructed femur-MPFL-Patella complex (rFMPC). Particular attention was given to maintain the anatomical orientation between the patella and the graft. Both procedures showed lower stiffness and higher ultimate strain and absorbed energy compared to the native MPFL, but the advantages of the double converging tunnel technique are related to the restoration of the native MPFL sail-shape, to a better stress distribution on the patella, to the use of a single interference screw as fixation device and to the simplicity, rapidity and cost-effectivity of the surgical procedure. The evaluation of the structural properties of rMPFL is fundamental to evaluate the adequacy of the different techniques to restore the physiological structural properties of the native MPFL. PMID:26894660

  5. Diagnostic Algorithm for Residual Pain After Total Knee Arthroplasty.

    Science.gov (United States)

    Park, Caroline N; White, Peter B; Meftah, Morteza; Ranawat, Amar S; Ranawat, Chitranjan S

    2016-01-01

    Although total knee arthroplasty is a successful and cost-effective procedure, patient dissatisfaction remains as high as 50%. Postoperative residual knee pain after total knee arthroplasty, with or without crepitation, is a major factor that contributes to patient dissatisfaction. The most common location for residual pain after total knee arthroplasty is anteriorly. Because residual pain has been associated with an un-resurfaced patella, this review includes only registry data and total knee arthroplasty with patella replacement. Some suggest that the pathogenesis of residual knee pain may be related to mechanical stimuli that activate free nerve endings around the patellofemoral joint. Various etiologies have been implicated in residual pain, including (1) low-grade infection, (2) midflexion instability, and (3) component malalignment with patellar maltracking. Less common causes include (4) crepitation and patellar clunk syndrome; (5) patellofemoral symptoms, including overstuffing and avascular necrosis of the patella; (6) early aseptic loosening; (7) hypersensitivity to metal or cement; (8) complex regional pain syndrome; and (9) pseudoaneurysm. Because all of these conditions can lead to residual pain, identifying the etiology can be a difficult diagnostic challenge. Often, patients with persistent pain and normal findings on radiographs and laboratory workup may benefit from a diagnostic injection or further imaging. However, up to 10% to 15% of patients with residual pain may have unexplained pain. This literature review summarizes the findings on the causes of residual pain and presents a diagnostic algorithm to facilitate an accurate diagnosis for residual pain after total knee arthroplasty. PMID:26811953

  6. 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.

  7. A case of patellar fractures in monozygotic twin gymnasts

    Directory of Open Access Journals (Sweden)

    Beamish Andrew J

    2012-06-01

    Full Text Available Abstract We present a case of near identical patellar fractures in adolescent monozygotic twins who are both high-level competitive gymnasts. These patients presented 14 months apart with almost identical history and clinical findings. Both had an intense training regime involving over 30 hours per week of load-bearing exercise. Clinical and radiological examinations suggested avulsion or sleeve fracture of the inferior pole of the patella with minimal displacement. Diagnoses of patellar stress fracture with avulsion of the distal pole and symptomatic bipartite patella could not be reliably excluded. Both fractures were treated conservatively with immobilisation of the knee in extension. An excellent functional result was observed in both patients with return to full activity at 8 weeks. This is the first published case of identical injury to the patella in monozygotic twins. A significant genetic influence on bone mineral density (BMD has been reported and low BMD is associated with increased susceptibility to fracture. These injuries corroborate a genetic influence on susceptibility to fracture. There is a requirement for further work to investigate genetic factors influencing susceptibility to fracture.

  8. 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.

  9. 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.

  10. 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

  11. Bone bruise in acute traumatic patellar dislocation: volumetric magnetic resonance imaging analysis with follow-up mean of 12 months

    Energy Technology Data Exchange (ETDEWEB)

    Paakkala, Antti; Paakkala, Timo [Tampere University Hospital, Department of Radiology, Tampere (Finland); Sillanpaeae, Petri; Maeenpaeae, Heikki [Tampere University Hospital, Department of Orthopaedics and Traumatology, Tampere (Finland); Huhtala, Heini [University of Tampere, School of Public Health, Tampere (Finland)

    2010-07-15

    The aim of the study was to assess volumetric analysis of bone bruises in acute primary traumatic patellar dislocation by magnetic resonance imaging (MRI) and resolving resolution of bruises in follow-up MRI. MRI was performed in 23 cases. A follow-up examination was done at a mean of 12 months after dislocation. Volumes of patellar and femur bruises for every patient were evaluated separately by two musculoskeletal radiologists, and mean values of the bruises were assessed. Other MRI findings were evaluated, together with agreement by consensus. Bone bruise volumes were compared with other MR findings. In the acute study 100% of patients showed bruising of the lateral femoral condyle and 96% bruising of the patella. The bruise was located at the medial femoral condyle in 30% and at the patellar median ridge in 74% of patients. The median volume of the femoral bruise was 25,831 mm{sup 3} and of the patellar bruise 2,832 mm{sup 3}. At the follow-up study 22% of patients showed bruising of the lateral femoral condyle and 39% bruising of the patella, the median volumes of the bruises being 5,062 mm{sup 3} and 1,380 mm{sup 3}, respectively. Larger patellar bruise volume correlated with larger femur bruise volume in the acute (r=0.389, P=0.074) and the follow-up (r=1.000, P<0.01) studies. Other MRI findings did not correlate significantly with bone bruise volumes. Bone bruising is the commonest finding in cases of acute patellar dislocation, being seen even 1 year after trauma and indicating significant bone trabecular injury in the patellofemoral joint. A large bruise volume may be associated with subsequent chondral lesion progression at the patella. We concluded that the measurement of bone bruise volume in patients with acute patellar dislocation is a reproducible method but requires further studies to evaluate its clinical use. (orig.)

  12. Inferior patellar pole fragmentation in children: just a normal variant?

    International Nuclear Information System (INIS)

    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.)

  13. 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.)

  14. Characterization of calcium and zinc spatial distributions at the fibrocartilage zone of bone-tendon junction by synchrotron radiation-based micro X-ray fluorescence analysis combined with backscattered electron imaging

    Science.gov (United States)

    Lu, Hongbin; Chen, Can; Wang, Zhanwen; Qu, Jin; Xu, Daqi; Wu, Tianding; Cao, Yong; Zhou, Jingyong; Zheng, Cheng; Hu, Jianzhong

    2015-09-01

    Tendon attaches to bone through a functionally graded fibrocartilage zone, including uncalcified fibrocartilage (UF), tidemark (TM) and calcified fibrocartilage (CF). This transition zone plays a pivotal role in relaxing load transfer between tendon and bone, and serves as a boundary between otherwise structurally and functionally distinct tissue types. Calcium and zinc are believed to play important roles in the normal growth, mineralization, and repair of the fibrocartilage zone of bone-tendon junction (BTJ). However, spatial distributions of calcium and zinc at the fibrocartilage zone of BTJ and their distribution-function relationship are not totally understood. Thus, synchrotron radiation-based micro X-ray fluorescence analysis (SR-μXRF) in combination with backscattered electron imaging (BEI) was employed to characterize the distributions of calcium and zinc at the fibrocartilage zone of rabbit patella-patellar tendon complex (PPTC). For the first time, the unique distributions of calcium and zinc at the fibrocartilage zone of the PPTC were clearly mapped by this method. The distributions of calcium and zinc at the fibrocartilage zone of the PPTC were inhomogeneous. A significant accumulation of zinc was exhibited in the transition region between UF and CF. The highest zinc content (3.17 times of that of patellar tendon) was found in the TM of fibrocartilage zone. The calcium content began to increase near the TM and increased exponentially across the calcified fibrocartilage region towards the patella. The highest calcium content (43.14 times of that of patellar tendon) was in the transitional zone of calcified fibrocartilage region and the patella, approximately 69 μm from the location with the highest zinc content. This study indicated, for the first time, that there is a differential distribution of calcium and zinc at the fibrocartilage zone of PPTC. These observations reveal new insights into region-dependent changes across the fibrocartilage zone of

  15. Iliotibial band tension affects patellofemoral and tibiofemoral kinematics.

    Science.gov (United States)

    Merican, Azhar M; Amis, Andrew A

    2009-07-22

    The iliotibial band (ITB) has an important role in knee mechanics and tightness can cause patellofemoral maltracking. This study investigated the effects of increasing ITB tension on knee kinematics. Nine fresh-frozen cadaveric knees had the components of the quadriceps loaded with 175 N. A Polaris optical tracking system was used to acquire joint kinematics during extension from 100 degrees to 0 degrees flexion. This was repeated after the following ITB loads: 30, 60 and 90 N. There was no change with 30 N load for patellar translation. On average, at 60 and 90 N, the patella translated laterally by 0.8 and 1.4mm in the mid flexion range compared to the ITB unloaded condition. The patella became more laterally tilted with increasing ITB loads by 0.7 degrees, 1.2 degrees and 1.5 degrees for 30, 60 and 90 N, respectively. There were comparable increases in patellar lateral rotation (distal patella moves laterally) towards the end of the flexion cycle. Increased external rotation of the tibia occurred from early flexion onwards and was maximal between 60 degrees and 75 degrees flexion. The increase was 5.2 degrees, 9.5 degrees and 13 degrees in this range for 30, 60 and 90 N, respectively. Increased tibial abduction with ITB loads was not observed. The combination of increased patellar lateral translation and tilt suggests increased lateral cartilage pressure. Additionally, the increased tibial external rotation would increase the Q angle. The clinical consequences and their relationship to lateral retinacular releases may be examined, now that the effects of a tight ITB are known. PMID:19481211

  16. Organophosphorous biocides reduce tenacity and cellular viability but not esterase activities in a non-target prosobranch (limpet)

    International Nuclear Information System (INIS)

    Detecting impacts of organophosphorus biocides (OP) is facilitated by analysing “biomarkers” – biological responses to environmental insults. Understanding is hampered by studying biomarkers in isolation at different levels of biological response and limited work on ecologically-important species. We tested the relevance of esterases as biomarkers of OP-exposure in limpets (Patella vulgata), abundant prosobranchs that structure the assemblages on rocky shores through their grazing. We characterized esterases in haemolymph and tissue, and quantified their dose-dependent inhibition by chlorfenvinphos (0.1–3.0 mM) in vitro. To determine whether esterases are useful biomarkers we exposed limpets to chlorfenvinphos (0–10 μg L−1). Despite reduced tenacity (ability to stick to a surface) and haemocyte-viability, esterases remained unaffected. Tenacity was reduced by >50% at 5 μg L−1 and by 95% at 10 μg L−1, whilst haemocyte-viability was more sensitive with >40% reductions at concentrations of 0.5 μg L−1 and above. We discuss results in relation to linking sub-lethal and ecological impacts at contaminated sites. - Highlights: • We investigated if esterases are useful biomarkers of chlorfenvinphos-exposure. • Esterases in tissues of limpets (Patella vulgata) were characterized. • The dose-dependent inhibition of esterases by chlorfenvinphos was shown in vitro. • In vivo, tenacity and haemocyte-viability were reduced, but not esterase activities. - Organophosphorous biocides reduce tenacity and cellular viability but not esterase activities in the limpet, Patella vulgata

  17. 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.

  18. 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.

  19. Synovial folds in the knee joint. The plica parapatellaris medialis

    Energy Technology Data Exchange (ETDEWEB)

    Schaefer, H.

    1987-12-01

    Stimulated by arthroscopic insight into central abnormalities of the knee joint and by the large number of unexplained case of 'anterior knee pain', we have studied the synovia in more than 2000 contrast examinations of the joint. Surprisingly, and contrary to the views expressed in the literature, the clinically significant plica parapatellaris medialis was seen as frequently during pneumo-arthrography as during more complex procedures. Abnormalities in the synovial fold emerged as a discreet disease identified as the 'medial shelf syndrome' and should be included in the differential diagnosis of causes of pain round the lower end of the femur and patella.

  20. 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.

  1. Neural Anatomy of the Anterolateral Thigh Flap

    OpenAIRE

    Luenam, Suriya; Prugsawan, Krit; Kosiyatrakul, Arkaphat; Chotanaphuti, Thanainit; Sriya, Piyanee

    2015-01-01

    The anterolateral thigh (ALT) flap is one of the commonly used sensate flaps for intra-oral, hand, and foot reconstruction. The objective of this study was to describe the anatomic location of the sensory nerves supplying the ALT flap in relation to the surface landmarks and with the vascular pedicles. The dissections were carried out in 28 embalmed specimens. An axial line from the anterior superior iliac spine to the superolateral border of the patella and two circles with radii of 5 and 10...

  2. Medial patellofemoral ligament reconstruction using the gracilis tendon in single tunnel for patellar dislocation%单隧道自体股薄肌腱移植重建内侧髌股韧带治疗髌骨不稳定

    Institute of Scientific and Technical Information of China (English)

    姜侃; 钟广军; 孙荣鑫

    2011-01-01

    目的 探讨单隧道自体股薄肌腱移植内侧髌股韧带(MPFL )重建术治疗复发性髌骨外脱位及半脱位的手术方法及临床疗效.方法 选择选择经临床检查确诊的髌骨外脱位及半脱位患者23例((31膝),在膝关节镜监视下行单隧道自体股薄肌腱移植重建内侧髌股韧带(MPFL)的基础上,配合髌外侧支持带切开松解、小切口胫骨结节内移等手术治疗.手术前后均对患者的膝关节功能进行Lysholm评分.结果 随访7-17个月,平均10个月,术后膝关节稳定性增加,无髌骨再脱位发生,恐惧试验为阴性.Lysholm评分术前平均72.6±4.5,术后平均92.7±14.1.结论 单隧道自体股薄肌腱移植重建内侧髌股韧带(MPFL)治疗髌骨不稳定能有效防止其复发,对维持髌骨的稳定有重要作用.%Objective To investigate the outcome of medial patellofemoral ligament reconstruction using the gra-cilis tendon in single tunnel for dislocation of the patella. Methods Twenty three patients (31 knees) with dislocation or subluxation of patella, diagnosed by clinical final diagnosis, were treated with medial patellofemoral ligament reconstruction or matching the brisement of lateral patellar retinaculum or medial transfer of the tibial tuberosity by small incision and monitored by arthroscopes. Knee function was evaluated by Lysholm's score preoperatively and postoperatively. Results Twenty three patients were followed up for 7-17 (mean 10) months. No patellar dislocation reccurred postoperatively. Apprehensive test and patella tilt test were negative. The average Lysholm's score was (72.6±4.5) points preoperatively and (92.7±4.1) points postoperatively. Conclusion Medial patellofemoral ligament reconstruction using the gracilis tendon in single tunnel can effectively treat recurrent dislocation of the patella. This procedure may have an important impact on knee joint function.

  3. APPLICATION OF A BIODEGRADABLE MATERIAL FOR BONE REPLACEMENT IN TRAUMATOLOGY

    OpenAIRE

    T. V. Druzhinina; K. V. Trofimov; V. F. Naydanov; A. V. Rostovzev; D. V. Burkov; A. V. Zhulyabin; A. A. Isupov; A. V. Verevin

    2014-01-01

    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 r...

  4. 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

  5. [The digital reprocessing of underexposed x-rays. Studies with a fluorescent light scanner].

    Science.gov (United States)

    Hidajat, N; Schröder, R J; Bergh, B; Cordes, M; Felix, R

    1994-09-01

    Incorrect exposure of conventional radiographs frequently leads to repetition of the examination and thereby to increased radiation exposure for the patient. Underexposed films of an Alderson-Rando phantom, an ankle joint and a patella were digitised by means of an inexpensive fluorescent light scanner, and subsequent image manipulation improved quality so as to make the image diagnostically adequate. For the demonstration of markedly underexposed structures digitalisation with subsequent contrast enhancement was used. Well exposed structures are best evaluated in contrast enhanced transmitted light. Our results suggest it should be possible to reduce the number of repeat exposures and thereby to limit radiation exposure. PMID:7919250

  6. Mechanisms of improved knee flexion after rectus femoris transfer surgery

    OpenAIRE

    Fox, Melanie D.; Reinbolt, Jeffrey A.; Õunpuu, Sylvia; Delp, Scott L.

    2009-01-01

    Rectus femoris transfer is frequently performed to treat stiff-knee gait in subjects with cerebral palsy. In this surgery, the distal tendon is released from the patella and re-attached to one of several sites, such as the sartorius or the iliotibial band. Surgical outcomes vary, and the mechanisms by which the surgery improves knee motion are unclear. The purpose of this study was to clarify the mechanism by which the transferred muscle improves knee flexion by examining three types of trans...

  7. New species of Eupalaestrus from Argentina (Araneae, Theraphosidae, Theraphosinae

    Directory of Open Access Journals (Sweden)

    Nelson Ferretti

    2012-09-01

    Full Text Available A new species of Eupalaestrus Pocock, 1901 from northern Argentina is described and illustrated. Males and females of Eupalaestrus larae sp. nov. differ from those all other species of the genus by the color with distinct two parallel longitudinal stripes on the femora, patellae, tibiae and one longitudinal stripe reaching half of metatarsi; the presence of a thickened femur and tibia IV; a straight embolus of the male palpal bulb and retrolateral keel pronounced. Specimens were captured in Chaco province, inhabiting unflooded flat grasslands open areas inside forest in transitional Chaco eco-region.

  8. 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.

  9. Plutonium and americium in arctic waters, the North Sea and Scottish and Irish coastal zones

    DEFF Research Database (Denmark)

    Hallstadius, L.; Aarkrog, Asker; Dahlgaard, Henning;

    1986-01-01

    Plutonium and americium have been measured in surface waters of the Greenland and Barents Seas and in the northern North Sea from 1980 through 1984. Measurements in water and biota, Fucus, Mytilus and Patella, were carried out in North-English and Scottish waters in 1982 and Fucus samples were...... plutonium from the latter to Spitsbergen waters. Fallout plutonium in Arctic waters has a residence time of the order of several years, while for Pu from Sellafield we estimate mean residence times of 11–15 months in Scottish waters and, tentatively, 1·5-3 y during transport from the North Channel (north...

  10. 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

  11. Two cases of surgically treated feline patellar fractures.

    Science.gov (United States)

    Guillaumot, P; Scotti, S; Carozzo, C; Bouvy, B; Genevois, J-P

    2008-01-01

    A transverse patellar fracture in a six-month-old cat was successfully treated by figure-of-eight dorsal wiring of the patella. A longitudinal patellar fracture with luxation of a large medial fragment in a 2.5-year-old cat was treated by lateral marginal patellectomy with a positive outcome. While adding material to the few veterinary reports in that species, in this brief communication, the authors discuss the aetiology, diagnosis, and the treatment of the presented cases with regards to findings in previously published feline cases. PMID:18545720

  12. Questionário específico para sintomas do joelho "Lysholm Knee Scoring Scale": tradução e validação para a língua portuguesa Specific questionnaire for knee symptoms - the "Lysholm Knee Scoring Scale": translation and validation into Portuguese

    Directory of Open Access Journals (Sweden)

    Maria Stella Peccin

    2006-01-01

    Full Text Available As doenças do joelho apresentam conseqüências variadas para a função e a qualidade de vida do indivíduo. Para traduzir, validar e verificar as propriedades de medida do questionário específico para sintomas do joelho "Lysholm Knee Scoring Scale" para a língua portuguesa, selecionamos, por conveniência, 50 pacientes (29 homens e 21 mulheres, média de idade 38,7 anos com lesão de joelho (lesão meniscal, lesão do ligamento cruzado anterior, condromalácia ou artrose. A reprodutibilidade e a concordância ordinal inter e intra-entrevistador foram excelentes (alfa = 0,9. A concordância nominal inter-entrevistadores foi boa (Kappa = 0,7 e intra-entrevistador, excelente (Kappa = 0,8. No processo de validação, correlacionamos o questionário Lysholm com a escala numérica da dor (r=-0,6; p=0,001 e com o índice de Lequesne (r= -0,8; p=0,001. As correlações entre o Lysholm e a avaliação global da saúde pelo paciente e pelo terapeuta apresentaram-se fracas e não significantes. As correlações entre o questionário Lysholm e o SF-36 foram significantes nos aspectos físicos (r = 0,4; p = 0,04, de dor (r = 0,5; p = 0,001 e de capacidade funcional (r = 0,7; p = 0,0001. Concluímos que a tradução e adaptação cultural do "Lysholm knee scoring scale" para o nosso idioma apresentou reprodutibilidade e validade em pacientes com lesão meniscal, lesão do ligamento cruzado anterior, condromalácia ou artrose do joelho.Knee diseases present variable consequences for an individual’s function and quality of life. For the purposes of translating, validating and checking the measurement properties of the specific questionnaire for knee symptoms - the "Lysholm Knee Scoring Scale" - into Portuguese, we selected, for convenience, 50 patients (29 males and 21 females, mean age = 38.7 years with knee injuries (meniscal injury, anterior cruciate ligament injury, chondromalacia or arthrosis. Reproducibility and ordinal consistency inter- and

  13. Are radiographs needed when MR imaging is performed for non-acute knee symptoms in patients younger than 45 years of age?

    Energy Technology Data Exchange (ETDEWEB)

    Braak, Bert P.M. ter; Vincken, Patrice W.J.; Erkel, Arian R. van; Bloem, Johan L. [Leiden University Medical Center, Department of Radiology, P.O. Box 9600, Leiden (Netherlands); Bloem, Rolf M. [Leiden University Medical Center, Department of Orthopaedic Surgery, Leiden (Netherlands); Napoleon, L.J.; Coene, M.N. [HAGA Hospital, Department of Orthopaedic Surgery, The Hague (Netherlands); Luijt, Peter A. van [Leiden University Medical Center, Department of Traumatology, Leiden (Netherlands); Lange, Sam de [Medical Center Haaglanden, Department of Orthopaedic Surgery, The Hague (Netherlands); Department of Orthopaedic Surgery, Delft (Netherlands)

    2007-12-15

    The objective was to determine the value of radiographs in young adults with non-acute knee symptoms who are scheduled for magnetic resonance imaging (MRI). Nine hundred and sixty-one consecutive patients aged between 16 and 45 years with knee symptoms of at least 4 weeks' duration were prospectively included in three participating hospitals. After applying exclusion criteria, 798 patients remained. Exclusion criteria were previous knee surgery (including arthroscopy) or MRI, history of rheumatoid arthritis, clinical diagnosis of retropatellar chondromalacia, contra-indication for MRI and recent trauma. We identified two groups: group A with no history of trauma (n = 332), and group B with an old (>4 weeks) history of trauma (n = 466). Patients had a standardized history taken, and underwent a physical exam, antero-posterior (AP) and lateral radiographs and MRI. We evaluated the radiographs and MRI for osseous lesions, articular surface lesions, fractures, osteoarthritis, loose bodies, bone marrow edema and incidental findings. Subsequently, patients with osseous abnormalities (Kellgren grade 1 and 2 excluded) on radiographs and a matched control group was evaluated again using MRI without radiographs. Median duration of symptoms was 20 weeks. In group A, radiographs showed 36 osseous abnormalities in 332 patients (10.8%). Only 13 of these, all Kellgren grade 1 osteoarthritis, were not confirmed on MRI. MRI showed 72 (21.7%) additional abnormalities not confirmed on radiographs. In group B, radiographs showed 40 osseous abnormalities (8.6%) in 466 patients. Only 15 of these, all Kellgren grade 1 osteoarthritis, were not confirmed on MRI. MRI showed 194 (41.6%) additional abnormalities not confirmed on radiographs. The second evaluation of MRI without radiographs in 34 patients was identical to the first MRI evaluation. Common lesions were significantly more often diagnosed with MRI than with radiographs. Radiographs should not be obtained routinely when MRI is

  14. Clear regression of harvested intertidal mollusks. A 20-year (1994-2014) comparative study.

    Science.gov (United States)

    Riera, Rodrigo; Pérez, Óscar; Álvarez, Omar; Simón, David; Díaz, Dácil; Monterroso, Óscar; Núñez, Jorge

    2016-02-01

    Intertidal mollusks are subjected to an intense environmental pressure, from human-induced stressors, mainly harvesting, to competition for food and space with other species. Here we used mollusk shell size as a measure of size distribution and reproductive potential of intertidal limpets. Two species of exploited limpets (Patella candei crenata and Patella aspera) were monitored throughout the littoral of Tenerife (Canary Islands, NE Atlantic Ocean), an overpopulated island with a high coastal pressure. The exploitation of these two limpet species is controlled by regional legislation, with seasonal closures and limits of harvest for professional (10 kg) and recreational harvesters (3-5 kg). A long-term comparison (1994-2014) of limpet size has been conducted as a surrogate of the state of conservation of these two limpets. Both species showed populations dominated largely by small-sized individuals (60 mm). The proximity to coastal settlements was not a factor to explain limpet assemblage structure. The temporal (1994-2014) comparative study showed a sharp decrease in the mean size of both limpet species (7 mm in P. aspera and 5 mm in P. candei crenata). These results might be indicative of overharvesting of both species in Tenerife. The conservation of the two studied species needs to be accomplished by the strict fulfillment of current protective strategies, as well as the creation of marine protected areas where intertidal harvesting is totally banned all over the year.

  15. 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.

  16. Imaging of traumatic injury and impingement of anterior knee fat.

    Science.gov (United States)

    Lapègue, F; Sans, N; Brun, C; Bakouche, S; Brucher, N; Cambon, Z; Chiavassa, H; Larbi, A; Faruch, M

    2016-01-01

    Fat is not just used by the body as bulk tissue. In addition to its role in storing energy and regulating hormone action, fat is used in some parts of the body for its mechanical properties. The anatomy of anterior knee fat is more complex than it appears at first sight and is capable of withstanding considerable compressive and shear stress. Specific lesions occur when such mechanical stress exceeds the physiological limits and are yet little known. Superficial fat can be the site of either acute injury by closed degloving called the Morel-Lavallée lesion or chronic injury, when subject to repeat excessive shear forces, due to more complex and less well-defined disruptions that result in pseudo-bursitis. There are three main anterior, intracapsular and extrasynovial fat pads in the knee joint, which are the infrapatellar fat pad (IFP) or Hoffa's fat pad, the quadriceps fat pad and the prefemoral fat pad. The IFP plays an important role as a mechanical shock absorber and guides the patella tendon and even the patella itself during flexion-extension movements. In response to repeated excessive stress, an inflammatory reaction and swelling of the IFP is first observed, followed by a fibrotic reaction with metaplastic transformation into fibrous, cartilaginous or bone tissue. More rarely, the two other deep fat pads (quadriceps and prefemoral) can, if subject to repeated stress, undergo similar restructuring inflammatory reactions with metaplasia resulting in tissue hardening, anterior pain and partial loss of function. PMID:27118690

  17. Evaluation Of Patellar Tracking During Knee Range Of Motion In Patients With Patellar Lateralization And Normal Subjects

    Directory of Open Access Journals (Sweden)

    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.

  18. 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.

  19. 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.

  20. Successful management of bilateral patellar tendon rupture in a dog.

    Science.gov (United States)

    Shipov, A; Shahar, R; Joseph, R; Milgram, J

    2008-01-01

    A seven-year-old, 41 kg, intact, cross breed dog, was presented with a history of bilateral hind limb lameness after falling from a height of 1 m. Clinical and radiographic findings were consistent with bilateral patellar tendon rupture. Surgical repair was performed bilaterally. The tendons were sutured primarily, and an internal splint of nylon leader was added. Good apposition of the severed tendon ends had been achieved intraoperatively; however, post operative radiographs showed supra-trochlear displacement of both patellae. The casts used to immobilize the stifle joints slipped distally and three days post operatively the tendon repair had broken down, bilaterally. Revision surgery was undertaken and the tendons were re-sutured. Nylon leader was placed through holes that had been drilled in the patellae and tibiae. The stifle joints were immobilized with type I external skeletal fixators (ESFs). Both freeform polymethylmethacrylate (PMMA) connecting bars were found to be broken at the level of the stifle joints two days later, without any disruption of the primary tendon repair. Each connecting bar was replaced with two connecting bars of PMMA reinforced with 3 mm steel wire. The dog was fully weight-bearing with a reduced range of motion in flexion immediately after removal of the ESFs at six weeks and was still sound 18 months post-operatively. Primary tendon repair in combination with adequate immobilization allowed for an excellent outcome in a complicated bilateral pathology. PMID:18545725

  1. 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

  2. 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.

  3. [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.

  4. 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.

  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. 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.).

  7. 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.

  8. Engineered allogeneic chondrocyte pellet for reconstruction of fibrocartilage zone at bone-tendon junction--a preliminary histological observation.

    Science.gov (United States)

    Wong, Margaret W N; Qin, Lin; Tai, Jenny K O; Lee, Simon K M; Leung, K S; Chan, K M

    2004-08-15

    This study examined histologically the potential of using allogeneic cultured chondrocyte pellet (CCP) in enhancing bone-tendon junction (BTJ) healing using a rabbit partial patellectomy model. Chondrocytes isolated from the cartilaginous ribs of 6-week-old New Zealand white rabbits were cultured for 14 days to form CCP. Partial patellectomy was performed on 30 18-week-old rabbits. After removal of the distal third patella, the BTJ gap was repaired surgically with or without CCP interposition. Four samples of patella-patellar tendon complexes (PPTC) for each group were harvested each at 8, 12, and 16 weeks; and two additional PPTC for each group were harvested at 2, 4, and 6 weeks for early observation of fibrocartilage zone regeneration, histologically. Results showed that CCP interposition demonstrated earlier structural integration at the BTJ after 8, 12, and 16 weeks of healing, and formation of a fibrocartilage zone like structure, compared with control specimens. In addition, no immune rejection was observed in CCP experimental group. The results suggested that CCP had a stimulatory effect on BTJ healing. This bioengineering approach might have potential clinical application in treatment of difficult BTJ healing. However, systemic histomorphometric, immunological tests, and biomechanical evaluations are needed before any clinical trials. PMID:15264320

  9. 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.

  10. Differential concentration of Technetium-99 (99Tc) in common intertidal molluscs with different food habits

    International Nuclear Information System (INIS)

    Highlights: → 99Tc-concentrations were measured in fucoids and four mollusc species. → Study was done in an intertidal locality on the southwestern coast of Norway. → The results showed that the 99Tc-concentrations differed between the mollusc species. → Fucoids at the locality showed very high 99Tc-concentrations. → Highest 99Tc-concentrations in the herbivorous gastropods Patella vulgata and Littorina obtusata. - Abstract: Concentration of 99Tc has been measured in fucoids and molluscs, sampled in a sheltered intertidal at the southwest coast of Norway from February to November 2006. The concentrations of 99Tc in molluscs differed significantly between species. The filtering bivalve Mytilus edulis had the lowest concentrations with averages of 2.3-5.9 Bq kg-1 d.w., while the herbivorous gastropods Littorinalittorina, Littorina obtusata and Patella vulgata had higher concentrations. P. vulgata and L. obtusata had the highest concentrations, 40-47 and 26-30 Bq kg-1 d.w., respectively. L. obtusata has a specialized habit of living, and prefers to feed on fucoids. P. vulgata can graze extensively on the fucoid Ascophyllum nodosum when available. Fucoids are known to have very high uptake of 99Tc, and this was also found in the present study. The high 99Tc-concentrations of L. obtusata and P. vulgata are most likely due to their habit of feeding on fucoids.

  11. Recurrent locked knee caused by an impaction fracture following inferior patellar dislocation: a case report

    Directory of Open Access Journals (Sweden)

    Sutcliffe William

    2011-08-01

    Full Text Available Abstract Introduction Locked knee caused by inferior patellar dislocation is considered rare in elderly patients. It was originally thought that, in the osteoarthritic knee, osteophytes on the pole of the patella become entrapped in the inter-condylar notch, which is managed by performing closed reduction and immobilization in a knee splint for three to four weeks. We present an unusual case of a locked knee with an impaction fracture. To the best of our knowledge, there have been no previous reports of such impaction fractures managed with arthroscopy. Case presentation We present an unusual case of an 88-year-old Caucasian woman with moderate arthritis who had a locked knee caused by an impaction fracture of the patella into the lateral femoral condyle. In this case report, we describe the need for arthroscopic surgery to prevent relocking of the knee in these patients. Conclusions This case report emphasizes the need for careful assessment of locked knees in elderly patients. Impaction fractures should be considered in all rare cases of patellar dislocation, and we advocate arthroscopic assessment of the articular cartilage in these patients. This is an important consideration, as the population demographics change and such impaction fractures may become more common in patients with degeneration in the knees.

  12. Chemical fingerprinting applied to the evaluation of marine oil pollution in the coasts of Canary Islands (Spain)

    International Nuclear Information System (INIS)

    Chemical fingerprinting approach to environmental assessment is illustrated in the evaluation of marine oil pollution in the coasts using two limpet species as bioindicator organisms, and based on profiles and concentrations of n-alkanes and aromatic hydrocarbons in their tissues. Accidental and chronic releases of hydrocarbons can contaminate the marine environment of the Canary Islands not only because of their geographical situation but also because of the very dense tank traffic around. This situation affects coastal areas, fishing activities, tourism resort, etc. Concentrations of n-alkanes and aromatic hydrocarbons (polycyclic aromatic hydrocarbons and methyl-polycyclic aromatic hydrocarbons) in the soft tissues of the marine intertidal and subtidal limpets, Patella crenata and Patella ullysiponensis aspera, were evaluated. Limpet samples were collected at monthly intervals, at three locations on the southeast coast of Tenerife over a 3-year period (1991-93). Levels of hydrocarbons found in limpets are similar to concentrations found in unpolluted areas around the world. From application of principal component analysis, the interpretation of variable loading plots gives information on variable correlation and can be used to distinguish among potential sources of pollution and the ability of studied molluscs to be used as bioindicator organisms. (Author)

  13. The effects of thermal capsulorrhaphy of medial parapatellar capsule on patellar lateral displacement

    Directory of Open Access Journals (Sweden)

    Davis Brent R

    2008-09-01

    Full Text Available Abstract Background The effectiveness of thermal shrinkage on the medial parapatellar capsule for treating recurrent patellar dislocation is controversial. One of reasons why it is still controversial is that the effectiveness is still qualitatively measured. The purpose of this study was to quantitatively determine the immediate effectiveness of the medial parapatellar capsule shrinkage as in clinical setting. Methods Nine cadaveric knees were used to collect lateral displacement data before and after medial shrinkage or open surgery. The force and displacement were recorded while a physician pressed the patella from the medial side to mimic the physical exam used in clinic. Ten healthy subjects were used to test the feasibility of the technique on patients and establish normal range of lateral displacement of the patella under a medial force. The force applied, the resulting displacement and the ratio of force over displacement were compared among four data groups (normal knees, cadaveric knees before medial shrinkage, after shrinkage and after open surgery. Results Displacements of the cadaveric knees both before and after thermal modification were similar to normal subjects, and the applied forces were significantly higher. No significant differences were found between before and after thermal modification groups. After open surgery, displacements were reduced significantly while applied forces were significantly higher. Conclusion No immediate difference was found after thermal shrinkage of the medial parapatellar capsule. Open surgery immediately improved of the lateral stiffness of the knee capsule.

  14. Principal component analysis in construction of 3D human knee joint models using a statistical shape model method.

    Science.gov (United States)

    Tsai, Tsung-Yuan; Li, Jing-Sheng; Wang, Shaobai; Li, Pingyue; Kwon, Young-Min; Li, Guoan

    2015-01-01

    The statistical shape model (SSM) method that uses 2D images of the knee joint to predict the three-dimensional (3D) joint surface model has been reported in the literature. In this study, we constructed a SSM database using 152 human computed tomography (CT) knee joint models, including the femur, tibia and patella and analysed the characteristics of each principal component of the SSM. The surface models of two in vivo knees were predicted using the SSM and their 2D bi-plane fluoroscopic images. The predicted models were compared to their CT joint models. The differences between the predicted 3D knee joint surfaces and the CT image-based surfaces were 0.30 ± 0.81 mm, 0.34 ± 0.79 mm and 0.36 ± 0.59 mm for the femur, tibia and patella, respectively (average ± standard deviation). The computational time for each bone of the knee joint was within 30 s using a personal computer. The analysis of this study indicated that the SSM method could be a useful tool to construct 3D surface models of the knee with sub-millimeter accuracy in real time. Thus, it may have a broad application in computer-assisted knee surgeries that require 3D surface models of the knee.

  15. Biology and augmentation of tendon-bone insertion repair

    Directory of Open Access Journals (Sweden)

    Lui PPY

    2010-08-01

    Full Text Available Abstract Surgical reattachment of tendon and bone such as in rotator cuff repair, patellar-patella tendon repair and anterior cruciate ligament (ACL reconstruction often fails due to the failure of regeneration of the specialized tissue ("enthesis" which connects tendon to bone. Tendon-to-bone healing taking place between inhomogenous tissues is a slow process compared to healing within homogenous tissue, such as tendon to tendon or bone to bone healing. Therefore special attention must be paid to augment tendon to bone insertion (TBI healing. Apart from surgical fixation, biological and biophysical interventions have been studied aiming at regeneration of TBI healing complex, especially the regeneration of interpositioned fibrocartilage and new bone at the healing junction. This paper described the biology and the factors influencing TBI healing using patella-patellar tendon (PPT healing and tendon graft to bone tunnel healing in ACL reconstruction as examples. Recent development in the improvement of TBI healing and directions for future studies were also reviewed and discussed.

  16. Can 3D ultrasound identify trochlea dysplasia in newborns? Evaluation and applicability of a technique

    International Nuclear Information System (INIS)

    Highlights: • We evaluated a possible screening method for trochlea dysplasia. • 3D ultrasound was used to perform the measurements on standardized axial planes. • The evaluation of the technique showed comparable results to other studies. • This technique may be used as a screening technique as it is quick and easy to perform. - Abstract: Femoro-patellar dysplasia is considered as a significant risk factor of patellar instability. Different studies suggest that the shape of the trochlea is already developed in early childhood. Therefore early identification of a dysplastic configuration might be relevant information for the treating physician. An easy applicable routine screening of the trochlea is yet not available. The purpose of this study was to establish and evaluate a screening method for femoro-patellar dysplasia using 3D ultrasound. From 2012 to 2013 we prospectively imaged 160 consecutive femoro-patellar joints in 80 newborns from the 36th to 61st gestational week that underwent a routine hip sonography (Graf). All ultrasounds were performed by a pediatric radiologist with only minimal additional time to the routine hip ultrasound. In 30° flexion of the knee, axial, coronal, and sagittal reformats were used to standardize a reconstructed axial plane through the femoral condyle and the mid-patella. The sulcus angle, the lateral-to-medial facet ratio of the trochlea and the shape of the patella (Wiberg Classification) were evaluated. In all examinations reconstruction of the standardized axial plane was achieved, the mean trochlea angle was 149.1° (SD 4.9°), the lateral-to-medial facet ratio of the trochlea ratio was 1.3 (SD 0.22), and a Wiberg type I patella was found in 95% of the newborn. No statistical difference was detected between boys and girls. Using standardized reconstructions of the axial plane allows measurements to be made with lower operator dependency and higher accuracy in a short time. Therefore 3D ultrasound is an easy

  17. PHYSICAL THERAPY INTERVENTION FOR MEDIAL PATELLOFEMORAL LIGAMENT RECONSTRUCTION AFTER REPEATED LATERAL PATELLAR SUBLUXATION/DISLOCATION

    Science.gov (United States)

    Mooney, Brianne; Vitale, Ashley; Apergis, Demitra; Wirth, Stephen; Grossman, Mark G.

    2016-01-01

    ABSTRACT Background The incidence of patellar subluxation or dislocation has been documented up to 43/100,000 with females more prevalent then males. There are many contributing factors involving the hip, knee, and ankle that lead to patellar subluxation. A patellar position of lateral tilt with lateral glide may indicate weakness of the vastus medialis oblique (VMO) and adductors, increased tightness in the iliotibial band, and overpowering of the vastus lateralis. Patella alta can predispose an individual to lateral dislocation due to the patella placement outside of the femoral trochlear groove with a disadvantage of boney stability. Other factors that may cause the patella to laterally sublux or dislocate during a functional activity or sporting activity include a position of femoral external rotation, tibial internal rotation, and excessive contraction of the vastus lateralis. The medial patellofemoral ligament (MPFL) aids in the prevention of a lateral patellar subluxation or dislocation. In cases where there is recurrent subluxation/dislocation and Magnetic Resonance Imaging confirms a MPFL tear, a reconstruction may be the treatment of choice. Purpose The purpose of this case series is to describe the post-surgical physical therapy management of MPFL reconstructions, outcomes using the Modified Cincinnati Knee Outcome Measure (MCKOM) and to propose staged physical therapy interventions for this pathology in the form of a treatment progression. Methods Post-operative management data and outcomes were retrospectively collected using a detailed chart review methodology from seven subjects who underwent MPFL reconstruction. Findings The Modified Cincinnati Knee Outcome Measure (MCKOM) was analyzed for each participant in four sections that were most important to the return and maintenance of participation in sport. At follow-up the mean scores for the seven subjects in Section 3 (instability) was 19.3/20, Section 4 (overall activity level) was 17.3/20, Section

  18. Role of pathophysiology of patellofemoral instability in the treatment of spontaneous medial patellofemoral subluxation: a case report

    Directory of Open Access Journals (Sweden)

    Doğruyol Dağhan

    2010-05-01

    Full Text Available Abstract Introduction Medial patellar subluxation is usually seen after lateral retinacular release. Spontaneous medial subluxation of the patella is a very rare condition. There are few reports in the literature on the pathophysiology of iatrogenic medial patellar subluxation. To our knowledge, there are no reports of the pathophysiology of non-iatrogenic medial patellar subluxation in the English literature. In this study we present a case of spontaneous medial patellar instability that is more prominent in extension during weight bearing. We also try to define the treatment protocol based on pathophsiology. Case presentation We report the case of a 21-year-old Turkish man with spontaneous medial patellar instability. He had suffered right knee pain, clicking and popping sensation in the affected knee for three months prior to presentation. Clinical examination demonstrated medial patellar subluxation that is more prominent in extension during the weight bearing phase of gait and while standing. Increased medial tilt was observed when the patella was stressed medially. Conventional anterior to posterior, lateral and Merchant radiographs did not reveal any abnormalities. After three months of physical therapy, our patient was still suffering from right knee pain which disturbed his gait pattern. Throughout the surgery, medial patellar translation was tested following the imbrication of lateral structures. He still had a medial patellar translation that was more than 50% of his patellar width. Patellotibial ligament augmentation using an iliotibial band flap was added. When examined after surgery, the alignment of the patella was effectively corrected. Conclusions Chronic imbalance between the strengths of vastus lateralis and vastus medialis results in secondary changes in passive ligamentous structures and causes additional instability. Physical therapy modalities that aim to strengthen the vastus lateralis might be sufficient for the

  19. A Comparative Study On The Action Potential Simulation (APS Therapy And The Routine Physiotherapy Protocol In Knee Osteoarthritisin Elderly People

    Directory of Open Access Journals (Sweden)

    Abbas Rahimi

    2012-04-01

    Full Text Available Background and Aim: Knee osteoarthritis is the most common cause for which the elderly people refere to physiotherapy outpatient clinics. This study aimed to investigate the effects of the Action Potential Stimulation (APS Therapy and the routine physiotherapy (PT protocol on relieving pain and swelling as well as the duration of the relief period in patients with knee osteoarthritis. Materials and Methods: 69 patients (62 females & 7 males with knee osteoarthritis were recruited in this study. The subjects were divided into two groups including APS Therapy (n=37, mean age: 55±13 years old and the routine PT protocol (n=32, mean age: 61±14 years old groups. A 10-session treatment period was carried out for each group; and their pain and swelling were measured at the first, fifth and tenth sessions and also one-month after the last session (follow up. The swelling was measured using measuring the circumference of the knee on the patella, 5 Cm above and 5 Cm below the patella. The routine PT protocol consisted of hot pack, ultrasound, TENS and exercise; and the APS therapy protocol included hot pack, APS Therapy and the same exercise. During the follow up, 50 out of 61 subjects were called on the phone and any pain changes were recorded.Results: In terms of swelling, the results showed significant reduction just on the patella only in the APS Therapy group (P<0.05. Visual Analogue Pain Scale (VAPS indicated a significant pain reduction in both groups. However, the APS Therapy group showed significantly pain reduction at the end of sessions five, ten and the follow up session (P<0.05. It was also revealed that while routine PT subjects showed no significant pain changes between the tenth and the follow up session, a gradual pain reduction was seen in the APS therapy group during this period (P<0.05. A gradual dosage reduction was recorded only in the APS therapy group, indicating a slight correlation with pain reduction (r=0.4.Conclusion: The

  20. Can 3D ultrasound identify trochlea dysplasia in newborns? Evaluation and applicability of a technique

    Energy Technology Data Exchange (ETDEWEB)

    Kohlhof, Hendrik, E-mail: Hendrik.Kohlhof@ukb.uni-bonn.de [Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn (Germany); Heidt, Christoph, E-mail: Christoph.heidt@kispi.uzh.ch [Department of Orthopedic Surgery, University Children' s Hospital Zurich, Steinwiesstrasse 74, 8032 Switzerland (Switzerland); Bähler, Alexandrine, E-mail: Alexandrine.baehler@insel.ch [Department of Pediatric Radiology, University Children' s Hospital Berne, Freiburgstrasse 18, 3010 Berne (Switzerland); Kohl, Sandro, E-mail: sandro.kohl@insel.ch [Department of Orthopedic Surgery, University Hospital Berne, Freiburgstrasse 18, 3010 Berne (Switzerland); Gravius, Sascha, E-mail: sascha.gravius@ukb.uni-bonn.de [Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn (Germany); Friedrich, Max J., E-mail: Max.Friedrich@ukb.uni-bonn.de [Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn (Germany); Ziebarth, Kai, E-mail: kai.ziebarth@insel.ch [Department of Orthopedic Surgery, University Hospital Berne, Freiburgstrasse 18, 3010 Berne (Switzerland); Stranzinger, Enno, E-mail: Enno.Stranzinger@insel.ch [Department of Pediatric Radiology, University Children' s Hospital Berne, Freiburgstrasse 18, 3010 Berne (Switzerland)

    2015-06-15

    Highlights: • We evaluated a possible screening method for trochlea dysplasia. • 3D ultrasound was used to perform the measurements on standardized axial planes. • The evaluation of the technique showed comparable results to other studies. • This technique may be used as a screening technique as it is quick and easy to perform. - Abstract: Femoro-patellar dysplasia is considered as a significant risk factor of patellar instability. Different studies suggest that the shape of the trochlea is already developed in early childhood. Therefore early identification of a dysplastic configuration might be relevant information for the treating physician. An easy applicable routine screening of the trochlea is yet not available. The purpose of this study was to establish and evaluate a screening method for femoro-patellar dysplasia using 3D ultrasound. From 2012 to 2013 we prospectively imaged 160 consecutive femoro-patellar joints in 80 newborns from the 36th to 61st gestational week that underwent a routine hip sonography (Graf). All ultrasounds were performed by a pediatric radiologist with only minimal additional time to the routine hip ultrasound. In 30° flexion of the knee, axial, coronal, and sagittal reformats were used to standardize a reconstructed axial plane through the femoral condyle and the mid-patella. The sulcus angle, the lateral-to-medial facet ratio of the trochlea and the shape of the patella (Wiberg Classification) were evaluated. In all examinations reconstruction of the standardized axial plane was achieved, the mean trochlea angle was 149.1° (SD 4.9°), the lateral-to-medial facet ratio of the trochlea ratio was 1.3 (SD 0.22), and a Wiberg type I patella was found in 95% of the newborn. No statistical difference was detected between boys and girls. Using standardized reconstructions of the axial plane allows measurements to be made with lower operator dependency and higher accuracy in a short time. Therefore 3D ultrasound is an easy

  1. MRI findings of juvenile acute pure cartilage fracture of the knee joint

    International Nuclear Information System (INIS)

    Objective: To study the MRI manifestation of juvenile acute pule cartilage fracture of the knee joint. Methods: The MRI changes of cartilage, subcartilage low signal line and subcartilage bone were analysed retrospectively in 26 juvenile patients with acute pure cartilage fracture confirmed by arthroscopy. Sagittal and coronal MRI scanning were performed in 26 patients. Using fast low angle shot fat saturation T1-weighted image (FLASH-FS-T1WI) sequences, spin echo T1-weighted image (SE-TWI) and fast imaging with steady-state precession three dimensional fat saturation T2-weighted image(FISP-3D -FS- T2WI) sequences in sagittal plane, SE-T1WI and multi echo data image combination T2-weighted imaging (MEDIC or ME-T2WI) in coronal plane. Using ME-T2WI sequence, axial plane MRI scanning in 5 patients. Results: Twenty-seven sites of 26 patients include 8 patella, 7 femoral medial condyle, 11 femoral lateral condyle and l tibial plateau. Three types pure cartilage fracture were observed, totally defect of the cartilage in 7 sites (include 3 patella, 2 femoral medial condyle, 1 femoral lateral condyle and 1 tibial plateau), fissuring fracture in 3 sites (include 2 femoral medial and 1 femoral lateral condyles), superficial defect of the cartilage in 17 sites (include 5 patella, 3 femoral medial and 9 femoral lateral condyle). Corpus liberum was found in 21 patients' knee joints by arthroscopy, but only 3 cases by MRI. Bone bruise was detected, and subcartilage low signal lines were normal. Conclusion: Using FLASH-FS- T1WI, SE-T1WI, FISP-3D-FS-T2WI and ME-T2WI sequences, sagittal and coronal MRI scanning in femoral and tibial plateau pure cartilage fractures, and using ME-T2WI sequence axial scanning in patellar cartilage fractures may show the position, extension and types of the acute pure cartilage fracture of the knee joint. MRI is the best non-invasive method for studying cartilage fracture. (authors)

  2. Lung hypoplasia and patellar agenesis in Ehlers-Danlos syndrome.

    Science.gov (United States)

    Pradhan, P; Deb, J; Deb, R; Chakrabarti, S

    2009-12-01

    A 22-year-old male patient was admitted with severe cough associated with purulent expectoration, left-sided chest pain and breathlessness. There was a history of recurrent respiratory ailments since childhood. The patient appeared younger than his chronological age. His face and ears were both dysmorphic. Clinically, the patient was diagnosed with Ehlers-Danlos syndrome (EDS). Computed tomography of the thoracic region revealed hypoplasia of the left lung and hyperplasia of the right lung. Both the patellae were absent. However, ultrasonography of his abdomen, echocardiography and other routine blood and urine examination showed no gross abnormalities. Although other respiratory tract abnormalities with EDS are not uncommon, unilateral lung hypoplasia and patellar agenesis in EDS make this case unique. PMID:20087544

  3. Synchronous quadriceps tendon rupture and unilateral ACL tear in a weightlifter, associated with anabolic steroid use.

    Science.gov (United States)

    Fenelon, Christopher; Dalton, David M; Galbraith, John G; Masterson, Eric L

    2016-01-01

    Synchronous quadriceps tendon rupture is rare. A 29-year-old man, an amateur weight lifter, taking androgenic-anabolic steroids (AAS), developed sudden onset bilateral pain and swelling of his anterior thighs when attempting to squat 280 kg (620 lb). Examination revealed gross swelling superior to the patella and palpable gaps in both quadriceps tendons. He underwent successful operative repair. MRI revealed a partial tear of the anterior cruciate ligament (ACL) of the right knee. This was not reconstructed. Only a few case reports of the association between AAS and quadriceps rupture exist in the literature, with none to the best of our knowledge in the past 10 years. ACL rupture coexisting is very rare, with only two reported cases. PMID:27154985

  4. Saphenous neuropathy in a patient with low back pain

    Directory of Open Access Journals (Sweden)

    Togha Mansoureh

    2010-01-01

    Full Text Available Abstract Saphenous nerve, a pure sensory nerve, may compromise as a result or complication of a surgical procedure or secondary to trauma or insidiously. We present a male patient with low back pain concomitant with pain in medial portion of left thigh in addition to pain and numbness in medial part of leg and inferior part of patella after a strenuous activity. Preliminary diagnosis suggested that the patient had radiculopathy but electrodiagnostic tests revealed the absence of left saphenous response both in medial leg and infrapatellar region, while normal findings were recorded from right side. Needle electromyography in L4 innervated muscles were normal. The patient had saphenous nerve entrapment in left thigh. Two months later symptoms relieved with conservative therapy.

  5. Assessment of patellofemoral pain syndrome in women

    Directory of Open Access Journals (Sweden)

    Altair Argentino Pereira Júnior

    2011-03-01

    Full Text Available Objective: To assess women diagnosed with patellofemoral pain syndrome (PFPS. Methods: A descriptive study held with 40 women aged between 18 to 40 years, with defined medical diagnosis of PFPS. We conducted the verification of knee function using the Lysholm scale;kinetic- functional and radiologic assessment; determination of body mass index (BMI and investigation of physical activity level by the International Physical Activity Questionnaire. Results: There was a predominance of genu valgum, internal femoral rotation and highlateral patella. The level of physical activity was less than 150 minutes in 21 (52.5%of the sample. Overweight was found in 16 (40%and knee function classified as unsatisfactory in 31 (77.5%of the participants. Conclusion: The study participants had similar kineticfunction alterations and presence of overweight. The PFPS commits the knee function, hindering the activities of daily living and sports.

  6. Patellofemoral morphometry in patients with idiopathic patellofemoral pain syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Mar Carrion Martin, Maria del [Department of Rehabilitation, Hospital of Traumatology (Ciudad Sanitaria Virgen de las Nieves), Carretera de Jaen SN, 18014 Granada (Spain); Ruiz Santiago, Fernando, E-mail: ferruizsan@terra.e [Department of Radiology, Hospital of Traumatology (Ciudad Sanitaria Virgen de las Nieves), Carretera de Jaen SN, 18014 Granada (Spain); Pozuelo Calvo, Rocio [Department of Rehabilitation, Hospital of Traumatology (Ciudad Sanitaria Virgen de las Nieves), Carretera de Jaen SN, 18014 Granada (Spain); Guzman Alvarez, Luis [Department of Radiology, Hospital of Traumatology (Ciudad Sanitaria Virgen de las Nieves), Carretera de Jaen SN, 18014 Granada (Spain)

    2010-07-15

    Purpose: To compare clinical and computed tomography (CT) measures in extension, 20{sup o} and 30{sup o} of flexion of symptomatic knees of patient with idiopathic patellofemoral pain syndrome with the contra lateral asymptomatic knee. Materials and methods: Knees of 52 consecutive patients with idiopathic patellofemoral pain were studied with CT. In 28 patients this condition was unilateral and asymptomatic knee was used as control; 76 knees were symptomatic. Results: In patients with idiopathic patellofemoral pain we found a greater Q angle and internal condylar facet width in symptomatic knees with regard to asymptomatic knees. Conclusion: Greater Q angle and medial condylar facet can lead to overpressure on the medial knee compartment during maneuvers that increase contact between patella and medial condylar facet, such as knee flexion and squatting, contributing to development of idiopathic patellofemoral pain.

  7. Successful conservative management of symptomatic bilateral dorsal patellar defects presenting with cartilage involvement and bone marrow edema: MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Kwee, Thomas C. [University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Utrecht (Netherlands); Meander Medical Center, Department of Radiology, Amersfoort (Netherlands); Sonneveld, Heleen [Meander Medical Center, Department of Orthopaedics, Amersfoort (Netherlands); Nix, Maarten [Meander Medical Center, Department of Radiology, Amersfoort (Netherlands)

    2016-05-15

    The dorsal patellar defect is a relatively rare entity that involves the superolateral quadrant of the patella. It is usually considered to represent a delayed ossification process, although its exact origin remains unclear. Because of its usually innocuous nature and clinical course, invasive interventions are generally deemed unnecessary, although curretage has been successfully performed on symptomatic cases. This case report presents a rather unusual case of symptomatic bilateral dorsal patellar defects with cartilage involvement and widespread surrounding bone marrow edema as demonstrated by magnetic resonance imaging (MRI). Both cartilage involvement and bone marrow edema should be considered part of the spectrum of associated MRI findings that can be encountered in this entity. Furthermore, the presented case shows that symptomatic dorsal patellar defects can be treated conservatively with success and that (decrease of) pain symptoms are likely related to (decrease of) bone marrow edema. (orig.)

  8. Arthrography and the medical compartment of the patello-femoral joint

    Energy Technology Data Exchange (ETDEWEB)

    Thijn, C.J.P.; Hillen, B.

    1984-03-01

    In four groups of patients with normal patellar cartilage, synovitis, patellar chondropathy, and degenerative changes of the patellar surface of the femur, the anatomical relationships within the medial compartment of the patello-femoral joint were examined. Clear differences were observed between these groups in the incidence of visualization of the medial alar plica and the mediopatellar synovial plica. As a consequence, an explanation has been sought for the occurrence of patellar chondropathy and degenerative changes of the patellar surface of the femur. It seems probable that a long-standing traumatic synovitis with effusion, attenuation of the synovial membrane, and the composition of the synovial fluid can lead to patellar chondropathy. The degenerative changes of the patellar surface of the femur are usually secondary to those of the load-bearing patellar facet. Insufficient covering of the cartilage by soft tissue may play a role in chondropathy of the nonload-bearing portion of the patella and the femoral condyle.

  9. Computed tomography in sport injuries

    International Nuclear Information System (INIS)

    Computed tomography (CT) provides axial slices plane and shows excellent details of bones and different soft tissues, favoring its use in traumatic lesions caused by sporting activities. Complex anatomical structures such as the shoulder, the vertebral column, the pelvis, the knee, the tarsal and carpal bones are often better recognized in detail than by conventional radiography. Fracture lines, localization of bone fragments and involvement of soft tissues are clearly demonstrated. Luxations and bone changes leading to luxations can be shown. CT arthrography provides for the first time a direct visualization of joint cartilage and of cruciate ligaments in the knee joint, so traumatic lesions such as chondropathia patellae or rupture of the cruciate ligaments are shown with a high degree of reliability. (orig.)

  10. Sport injuries of the extensor mechanism of the knee

    International Nuclear Information System (INIS)

    Injuries of the extensor mechanism of the knee occur frequently during sport activity. For a successful treatment they must be diagnosed early. Besides osseous structures the patellar tendon, the patella, the quadriceps muscle and tendon, retinacula and bursae can be affected. After initial clinical examination there are different noninvasive imaging modalities available for assessment of bone, cartilage, ligaments, tendons and soft tissue. Conventional radiographs are still the basic imaging tool for the clinician. Additional information about the osseous status is provided by computed tomography, whereas sonography plays an important role concerning diagnosis of soft tissue injuries. For the detection of cartilagenous, ligamentous or tendon lesions MRI is the superior non-invasive imaging modality. (orig.)

  11. Concomitant changes in cross-sectional area and water content in skeletal muscle after resistance exercise

    DEFF Research Database (Denmark)

    Kristiansen, M S; Uhrbrand, Anders; Hansen, M;

    2014-01-01

    This study investigated how one bout (1EX) and three bouts (3EX) of strenuous resistance exercise affected the cross-sectional area (CSA) and water content (WC) of the quadriceps muscle and patella tendon (PT), 4 h and 52 h after the last exercise bout. Ten healthy untrained male subjects performed...... was significantly reduced at 52 h (3EX: 14 ± 2%) compared with baseline and (3EX: 13 ± 1%) compared with 4 h. Present data demonstrate that strenuous resistance exercise results in an acute increase in muscle WC and underlines the importance of ensuring sufficient time between the last exercise bout...

  12. Transosseous-Equivalent Repair for Distal Patellar Tendon Avulsion.

    Science.gov (United States)

    Galos, David K; Konda, Sanjit R; Kaplan, Daniel J; Ryan, William E; Alaia, Michael J

    2016-04-01

    Extensor mechanism disruptions are relatively uncommon injuries involving injury to the quadriceps tendon, patella, or patellar tendon. Patellar tendon avulsions from the tibial tubercle in adults are rare; as such, little technical information has been written regarding surgical management of this injury in the adult. Transosseous-equivalent repairs have been described in the management of several types of tendon ruptures, including rotator cuff and distal triceps tendon ruptures, but not previously in patellar injuries. We present a technique for repairing an avulsion injury of the patellar tendon from the tibial tubercle using suture anchors in a transosseous-equivalent manner. This technique for treating distal patellar tendon avulsion injuries likely increases contact area at the repair site while potentially improving fixation strength. PMID:27462538

  13. Anchor proximal migration in the medial patellofemoral ligament reconstruction in skeletally immature patients

    Directory of Open Access Journals (Sweden)

    Fabiano Kupczik

    2013-09-01

    Full Text Available The medial patellofemoral ligament (MPFL injury has been considered instrumental in lateral patellar instability after patellar dislocation. Consequently, the focus on the study of this ligament reconstruction has increased in recent years. The MPFL femoral anatomical origin point has great importance at the moment of reconstruction surgery, because a graft fixation in a non anatomical position may result in medial overload, medial subluxation of the patella or excessive tensioning of the graft with subsequent failure. In the pediatric population, the location of this point is highlighted by the presence of femoral physis. The literature is still controversial regarding the best placement of the graft. We describe two cases of skeletally immature patients in whom LPFM reconstruction was performed. The femoral fixation was through anchors that were placed above the physis. With the growth and development of the patients, the femoral origin point of the graft moved proximally, resulting in failure in these two cases.

  14. 股骨髁部骨折术后康复治疗%Rehabilitation after the operation of fracture of femoral condyle

    Institute of Scientific and Technical Information of China (English)

    郑义; 苏佳灿

    2001-01-01

    @@ Background: Fracture of femoral condyle is caused mainly by direct violents, and is a kind of intra- articular fracture difficult to be cured. A simple fracture of medial or external maleolus has no obvious displacement, and its traditional therapy method is: outer fixation by gypsum or splint for 6~ 8 weeks.Long- term immobilization caused the adhesion between the patella and the thigh,or between the condyle of femur and the tibial plateau , or of quadriceps muscle of thigh , or of tissues surrounding the knee joint , which makes dysfunction of the knee joint; at the same time,immobilization may cause disuse changs of the bone and its surrounding tissues, joint's contraction and dysfunction.

  15. The difficult primary total knee arthroplasty: a review.

    Science.gov (United States)

    Baldini, A; Castellani, L; Traverso, F; Balatri, A; Balato, G; Franceschini, V

    2015-10-01

    Primary total knee arthroplasty (TKA) is a reliable procedure with reproducible long-term results. Nevertheless, there are conditions related to the type of patient or local conditions of the knee that can make it a difficult procedure. The most common scenarios that make it difficult are discussed in this review. These include patients with many previous operations and incisions, and those with severe coronal deformities, genu recurvatum, a stiff knee, extra-articular deformities and those who have previously undergone osteotomy around the knee and those with chronic dislocation of the patella. Each condition is analysed according to the characteristics of the patient, the pre-operative planning and the reported outcomes. When approaching the difficult primary TKA surgeons should use a systematic approach, which begins with the review of the existing literature for each specific clinical situation.

  16. Successful conservative management of symptomatic bilateral dorsal patellar defects presenting with cartilage involvement and bone marrow edema: MRI findings

    International Nuclear Information System (INIS)

    The dorsal patellar defect is a relatively rare entity that involves the superolateral quadrant of the patella. It is usually considered to represent a delayed ossification process, although its exact origin remains unclear. Because of its usually innocuous nature and clinical course, invasive interventions are generally deemed unnecessary, although curretage has been successfully performed on symptomatic cases. This case report presents a rather unusual case of symptomatic bilateral dorsal patellar defects with cartilage involvement and widespread surrounding bone marrow edema as demonstrated by magnetic resonance imaging (MRI). Both cartilage involvement and bone marrow edema should be considered part of the spectrum of associated MRI findings that can be encountered in this entity. Furthermore, the presented case shows that symptomatic dorsal patellar defects can be treated conservatively with success and that (decrease of) pain symptoms are likely related to (decrease of) bone marrow edema. (orig.)

  17. Influence of autograft removal on rabbit patellar tendon length.

    Science.gov (United States)

    Monllau, J C; Hinarejos, P; Alvarez, P; Alameda, F; Ballester, J

    2004-02-01

    Twelve adult New Zealand white rabbits were randomly divided into two groups. In group 1, 30% of the central mass of the right patellar tendon was removed. In group 2, 60% was removed. The left knees served as controls. The animals were killed 1 year later. The patella-patellar tendon-tibial tuberosity units of all knees were studied using histological and morphometric analysis. In both groups, the tendons had lengthened. Lengthening average was 2.50 mm in group 1 and 8.17 mm in group 2. In both groups, histology revealed poor alignment of the collagen fibres and high cellularity, although the findings in group 1 were nearer the normal histological pattern. The results suggest that removal of significant portions of the patellar tendon leads to lengthening of the resulting tendon. In clinical practice, it seems prudent to pay attention to the dimensions of the patellar tendon when harvesting a graft.

  18. Atraumatic patellar prosthesis dislocation with patellar tendon injury following a total knee arthroplasty: a case report

    Directory of Open Access Journals (Sweden)

    Singh Alka

    2010-01-01

    Full Text Available Abstract Introduction Total knee arthroplasty is a well-established procedure with gratifying results. There is no consensus in the literature whether to routinely resurface the patella while performing total knee arthroplasty or not. Although an extremely rare occurrence in clinical practice, patellar prosthesis dislocation is a possible complication resulting from total knee arthroplasty. Case presentation We report a rare case of atraumatic spontaneous dislocation of patellar prosthesis in a 63-year-old Caucasian man of British origin with patellar tendon injury. The patient was treated successfully through a revision of the patellar component and tendon repair. In two years follow-up the patient is asymptomatic with no sign of loosening of his patellar prosthesis. Conclusions A thorough understanding of knee biomechanics is imperative in performing total knee arthroplasty in order to achieve a better functional outcome and to prevent early prosthetic failure.

  19. Cam Femoroacetabular Impingement as a Possible Explanation of Recalcitrant Anterior Knee Pain

    Directory of Open Access Journals (Sweden)

    Vicente Sanchis-Alfonso

    2016-01-01

    Full Text Available We present a case of a patient with chronic anterior knee pain (AKP recalcitrant to conservative treatment who returned to our office for severe hip pain secondary to Cam femoroacetabular impingement (Cam FAI at 10 months after the onset of knee pain. This case highlights the fact that the main problem is not in the patella but in the hip in some patients with AKP. We hypothesize that there is an external femoral rotation in order to avoid the impingement and therefore the hip pain in patients with Cam FAI. This functional femoral rotation could provoke a patellofemoral imbalance that may be, in theory, responsible for patellofemoral pain in this particular patient. In our case, Cam FAI resolution was related to the resolution of AKP.

  20. Influence of aging on the in vivo properties of human patellar tendon

    DEFF Research Database (Denmark)

    Carroll, CC; Dickinson, J M; Haus, J M;

    2008-01-01

    Tendons are important for optimal muscle force transfer to bone and play a key role in functional ability. Changes in tendon properties with aging could contribute to declines in physical function commonly associated with aging. We investigated the in vivo mechanical properties of the patellar...... tendon in 37 men and women [11 young (27 +/- 1 yr) and 26 old (65 +/- 1 yr)] using ultrasonography and magnetic resonance imaging (MRI). Patella displacement relative to the tibia was monitored with ultrasonography during ramped isometric contractions of the knee extensors, and MRI was used to determine...... tendon cross-sectional area (CSA) and signal intensity. At peak force, patellar tendon deformation, stress, and strain were 13 (P = 0.05), 19, and 12% less in old compared with young (P

  1. Imaging methods for knee-joint diagnostics. Bildgebende Verfahren zur Diagnostik von Kniegelenksverletzungen und -erkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Haller, W. (Klinikum rechts der Isar, Muenchen (Germany, F.R.). Orthopaedische Klinik und Poliklinik); Lehner, K. (Klinikum rechts der Isar, Muenchen (Germany, F.R.). Inst. fuer Roentgendiagnostik)

    1989-06-01

    Imaging methods are essential tools for orthopedic diagnostics. For examination of knee-joint disorder, X-ray radiography in four planes is a standard task. Special diagnostic methods are available and can be selected according to the case, and sonography is a method very likely to gain significance. In case of suspected fracture, conventional tomography is the method of choice, although arthroscopy is discussed in this context as a primary examination. CT or NMR imaging are indicated for evaluation of tumors near the knee joint, and latest results show that magnetic resonance tomography is useful for examination of the cruciate ligaments or the cartilage, and CT for imaging of the menisci. CT assisted arthrography for sliding path and cartilage analysis already is an established method for diagnostic evaluation of the chondropathia patellae. (orig./MG).

  2. [Computer tomography of sports injuries].

    Science.gov (United States)

    Reiser, M; Rupp, N

    1984-01-01

    Computed tomography (CT) provides axial slices plane and shows excellent details of bones and different soft tissues, favoring its use in traumatic lesions caused by sporting activities. Complex anatomical structures such as the shoulder, the vertebral column, the pelvis, the knee, the tarsal and carpal bones are often better recognized in detail than by conventional radiography. Fracture lines, localization of bone fragments and involvement of soft tissues are clearly demonstrated. Luxations and bone changes leading to luxations can be shown. CT arthrography provides for the first time a direct visualization of joint cartilage and of cruciate ligaments in the knee joint, so traumatic lesions such as chondropathia patellae or rupture of the cruciate ligaments are shown with a high degree of reliability.

  3. Computed tomography in sport injuries

    Energy Technology Data Exchange (ETDEWEB)

    Reiser, M.; Rupp, N.

    1984-01-01

    Computed tomography (CT) provides axial slices plane and shows excellent details of bones and different soft tissues, favoring its use in traumatic lesions caused by sporting activities. Complex anatomical structures such as the shoulder, the vertebral column, the pelvis, the knee, the tarsal and carpal bones are often better recognized in detail than by conventional radiography. Fracture lines, localization of bone fragments and involvement of soft tissues are clearly demonstrated. Luxations and bone changes leading to luxations can be shown. CT arthrography provides for the first time a direct visualization of joint cartilage and of cruciate ligaments in the knee joint, so traumatic lesions such as chondropathia patellae or rupture of the cruciate ligaments are shown with a high degree of reliability.

  4. Synchronous quadriceps tendon rupture and unilateral ACL tear in a weightlifter, associated with anabolic steroid use.

    Science.gov (United States)

    Fenelon, Christopher; Dalton, David M; Galbraith, John G; Masterson, Eric L

    2016-05-06

    Synchronous quadriceps tendon rupture is rare. A 29-year-old man, an amateur weight lifter, taking androgenic-anabolic steroids (AAS), developed sudden onset bilateral pain and swelling of his anterior thighs when attempting to squat 280 kg (620 lb). Examination revealed gross swelling superior to the patella and palpable gaps in both quadriceps tendons. He underwent successful operative repair. MRI revealed a partial tear of the anterior cruciate ligament (ACL) of the right knee. This was not reconstructed. Only a few case reports of the association between AAS and quadriceps rupture exist in the literature, with none to the best of our knowledge in the past 10 years. ACL rupture coexisting is very rare, with only two reported cases.

  5. IMPACT DE LA POLLUTION BACTERIENNE SUR L’OURSIN P. LIVIDUS (LCK, 1816 ET LA PATELLE P. CAERULEA (L.,1758 DE LA COTE OUEST ALGERIENNE.

    Directory of Open Access Journals (Sweden)

    A. MATALLAH-BOUTIBA

    2011-01-01

    Full Text Available This work refers to the evaluation of the bacterial contamination in sea water of the Oranian coast using two marine species largely distributed on the littoral and used as bioindicators of pollution: the edible sea urchin Paracentrotus lividus and the common patella Patellacoerulea. Sampling was conducted from (december-may 2008, monthly, in two coastal areas of Oran, (west Algeria, first the impacted area near the discharge channels: Genêts; second non- impacted Ain Defla considered as healthy site. The bacteriological analyzes bring out the presence of bacteria which testifies the existence of an important bacterial pollution, of fecal origin, on the level of the flesh of the two marine organism of the impacted area. On the other hand, the fecal concentrations weakest are recorded during the months of sampling on the level of the non-impacted area.

  6. Analysis of knee-joint forces during flexed-knee stance.

    Science.gov (United States)

    Perry, J; Antonelli, D; Ford, W

    1975-10-01

    Using an instrumented cadaver lower extremity, the forces in the quadriceps, patella, and tibia during flexed-knee stance were measured and the calculated and experimental data were found to correlate with an average discrepancy of 6 per cent. The quadriceps force required to stabilize the knee was 75 per cent of the load on the femoral head at 15 degrees of knee flexion, 210 per cent at 30 degrees, and 410 per cent at 60 degrees. Stresses at the tibiofemoral and patellofemoral joint surfaces increased in similar fashion. The quadriceps force was equivalent to 20 per cent of average maximum quadriceps strength at 15 degrees and to 50 per cent at 30 degrees, as determined from torque tests on five normal subjects.

  7. Simultaneous bilateral patellar tendon rupture without predisposing systemic disease or steroid use: a case report

    Institute of Scientific and Technical Information of China (English)

    LU Hua-ding; CAI Dao-zhang; WANG Kun; ZENG Chun

    2012-01-01

    There is a dearth of case reports describing 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 tendon ruptures without any history of systemic disease or steroidal medication.We repaired and reattached the ruptured 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.

  8. Surgical management of acute quadriceps tendon rupture (a case report with literature review).

    Science.gov (United States)

    Ennaciri, Badr; Montbarbon, Eric; Beaudouin, Emmanuel

    2015-01-01

    Quadriceps tendon rupture is uncommon and often overlooked in emergency. Tearing affects weakening tendon by systemic diseases or some medications. The mechanism is generally indirect. Inability to actively extend the knee associated to a supra-patellar defect evoke easily the diagnosis without other investigations. Surgical repair is realized in emergency to completely restore the extension. We report a case of a patient who has sustained of complete quadriceps tendon tear after a long period of tendon weakening by statin therapy, hypertension and diabetes. The repair has consisted on end-to-end Krackow sutures associated with bone suture to the proximal pole of the patella. Surgeons and emergency physicians must think to this form of extensor apparatus rupture, because early diagnosis leads to early treatment and to best outcomes.

  9. Rubinsten Taybi Syndrome

    Directory of Open Access Journals (Sweden)

    J. Jannati

    2008-01-01

    Full Text Available Rubinstein Taybi syndrome or Broad Thumb and Hallux syndrome is a genetic multisystem disorder with unknown mode of inheritance. "nThis syndrome characterized by Broad terminal phalange of the thumbs and /or hallucess broad terminal phalanges of other fingers, characteristic facies (small head, beaked nose, hypertelorism, antimongoloid slant of the palpebral fissures, strabismus, high arch palate, abnormalities of ears, mental and motor retardation."nRadiologic manifestations are short and wide terminal phalanx of thumbs and great toes, flaring of iliac (small iliac index, and skeletal maturation retardation."nLarge foramen magnum, congenital heart disease, urinary tract anomalies, prominent forehead, vertebral anomalies, sternal anomalies, dislocation of patella, syndactyly, polydactyly, absence of corpus callosum are other reported anomalies."nThe radiologic manifestations of this syndrome are discussed in this case report.

  10. Bone mineral density in female athletes representing sports with different loading characteristics of the skeleton.

    Science.gov (United States)

    Heinonen, A; Oja, P; Kannus, P; Sievänen, H; Haapasalo, H; Mänttäri, A; Vuori, I

    1995-09-01

    To address the hypothesis that osteogenic effect of physical loading increases with increasing strain rates and peak forces, we examined 59 competitive Finnish female athletes (representing three sports with different skeletal loading characteristics), physically active referents (they reported an average of five various types of exercise sessions per week), and sedentary referents (two sessions per week) using dual energy X-ray absorptiometry. The measured anatomic sites were at the lumbar spine, femoral neck, distal femur, patella, proximal tibia, calcaneus, and distal radius. The athlete group consisted of aerobic dancers (N = 27), squash players (N = 18), and speed skaters (N = 14). The squash players had the highest values for weight-adjusted bone mineral density (BMD) at the lumbar spine (13.8% p forces, is more effective in bone formation than training with a large number of low-force repetitions. PMID:8541131

  11. CHONDROBLASTOMA IN DISTAL TIBIA - A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Chinmaya

    2013-04-01

    Full Text Available INTRODUCTION: Chondroblastoma was first described as calcified gi ant cell tumour by Ewing. Codman described it as epiphyseal chondromatous giant cell tumour. Jaffe and Lichtenstein named it as chondroblastoma, a rare benign cartilag inous tumour. It represents less than 1% of all primary bone tumours and most commonly originate from the epiphyses of long bones, particularly from the epiphyses of the proximal and dis tal parts of the femur, the proximal part of the humerus, and the proximal part of the tibia. O ther reported sites are talus, scapula , patella, pelvis, distal radius, distal tibia , ribs, proximal fibula, calcaneum. Its occurrence in distal tibia is very rare with 2 documented cases in UK from 1974 to 2000, 3 documented cases in FRANCE from 1950 to 200 5 , no documented case from 1977 to 2000 in Harvard, USA. The purpose is to present a rare tumour occurring at an unusual site.

  12. Patellotibial contusions in anterior cruciate ligament tears.

    Science.gov (United States)

    Wissman, Robert D; England, Eric; Mehta, Kaushal; Nepute, Joshua; Von Fischer, Nathaniel; Apgar, Josh; Javadi, Ariyan

    2014-02-01

    Bone contusions are an important ancillary finding of many knee injuries. Not only are they a source of pain, they may suggest a mechanism of injury or a specific derangement of the knee joint. We have encountered a small number of patients being evaluated for anterior cruciate ligament (ACL) tears with unexplained patellar and tibial edema at magnetic resonance (MR) imaging. We present three individuals with contusions of the inferior patella with a corresponding contusion of the anteromedial tibial plateau. Internal derangements in these patients were similar to other individuals with acute ACL tears, however osseous contusions were more widespread. In conclusion, patellotibial contusions are rare and may indicate an injury with forces greater than usually encountered in most ACL tears. A careful search for uncommon associated injuries is prudent in these high-energy knee injuries. PMID:24037484

  13. Delayed migration of K-wire into popliteal fossa used for tension band wiring of patellar fracture

    Institute of Scientific and Technical Information of China (English)

    Sanjay Meena; Hira Lal Nag; Senthil Kumar; Nilesh Barwar; Samarth Mittal; Amit Singla

    2013-01-01

    Breakage of K-wires and stainless steel wires which are used for fracture fixation is not uncommon,but migration is rare.We report a case of migration of broken K-wire used for patella tension band wiring to the popliteal fossa.The broken hardware was removed surgically.We would like to suggest that K-wire and wire fixation used for treatment ofpatellar fractures can migrate into the posterior compartment of the knee and cause clinical symptoms.Close clinical and radiological follow-up after internal fixation to identify the presence of hardware breakage or movement and removal of wires once fracture has united can avert such complications.

  14. First evidence of a Late Upper Palaeolithic human presence in Ireland

    Science.gov (United States)

    Dowd, Marion; Carden, Ruth F.

    2016-05-01

    The colonisation of North West Europe by humans and fauna following the Last Glacial Maximum (LGM) has been the subject of considerable discussion in recent decades and within multiple disciplines. Here we present new evidence that pushes back the date of human footfall in Ireland by up to 2500 cal BP to the Upper Palaeolithic. An assemblage of animal bones recovered from a cave in the west of Ireland during antiquarian excavations in 1903 included a butchered brown bear bone (patella) which was recently subjected to two independent radiocarbon dating processes; the resultant dates were in agreement: 12,810-12,590 cal BP and 12,810-12,685 cal BP. This find rewrites the antiquity of human occupation of Ireland and challenges the traditional paradigm that certain biota may have naturally colonised the island prior to human arrival.

  15. [Diagnosis and treatment of patellar chondroblastoma].

    Science.gov (United States)

    Cheng, Qiang; Huang, Wei

    2013-12-01

    Chondroblastoma of the patella, rare occurred in patellar,is a kind of an uncommon benign bone tumor. Compared with giant cell tumor, the morbidity of chondroblastoma is lower. Meanwhile, its clinical manifestations are various, and images are very complicated. Therefore, the understanding of this kind of tumors may be limited even to the orthopedist. The differences of patellar chondroblastoma between other tumor in X-ray, CT and MRI is a spot in recent years. Sometimes patellar chondroblastoma coexists with aneurysmal bone cyst, which is a challenge to obtain an accurate pathological and radiological diagnosis. For the treatment, curettage and bone grafting is one the most popular method, but whether to perform a biopsy before surgery still remain controversy. Some new technique still has an unknown prospect for the treatment such as radiofrequency ablation.

  16. Progressive high-load strength training compared with general low-load exercises in patients with rotator cuff tendinopathy

    DEFF Research Database (Denmark)

    Ingwersen, Kim G; Christensen, Robin; Sørensen, Lilli;

    2015-01-01

    subgroups of SIS and have often had methodological flaws, making it difficult to specifically design target treatment for patients diagnosed with SIS. Therefore, it was considered important to focus on a subgroup such as tendinopathy, with a specific tailored intervention strategy based on evidence from...... tendinopathy. Exercise is often considered the primary treatment option for rotator cuff tendinopathy, but there is no consensus on which exercise strategy is the most effective. As eccentric and high-load strength training have been shown to have a positive effect on patella and Achilles tendinopathy, the aim...... home-based exercises three times a week. The primary outcome measure will be change from baseline to 12 weeks in the patient-reported outcome Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Discussion: Previous studies of exercise treatment for SIS have not differentiated between...

  17. Patellar tendinopathy - recent developments toward treatment.

    Science.gov (United States)

    Christian, Robert A; Rossy, William H; Sherman, Orrin H

    2014-01-01

    Patellar tendinopathy (PT) is a clinical and chronic overuse condition of unknown pathogenesis and etiology marked by anterior knee pain typically manifested at the inferior pole of the patella. PT has been referred to as "jumper's knee" since it is particularly common among populations of jumping athletes, such as basketball and volleyball players. Due to its common refractory response to conservative treatment, a variety of new treatments have emerged recently that include dry-needling, sclerosing injections, platelet-rich plasma therapy, arthroscopic surgical procedures, surgical resection of the inferior patellar pole, extracorporeal shock wave treatment, and hyperthermia thermotherapy. Since PT has an unknown pathogenesis and etiology, PT treatment is more a result of physician experience than evidence-based science. This review will summarize the current literature on this topic, identify current research efforts aimed to understand the pathological changes in abnormal tendons, provide exposure to the emerging treatment techniques, and provide suggested direction for future research. PMID:25429390

  18. Hemophilic arthropathy

    Directory of Open Access Journals (Sweden)

    Sham Santhanam

    2015-01-01

    Full Text Available A 16-year-old boy, born through non-consanguineous marriage, presented with acute onset of left knee joint pain and swelling with no history of fever or trauma. He was a known case of hemophilia A with recurrent attacks of hemarthrosis since 3 years of age involving only the knee joints. His symptoms used to subside when receiving multiple (on demand factor VIII infusions. Clinical examination revealed that the joints were warm, tender, and swollen. His knee radiography revealed subchondral cysts, widening of intercondylar notch, soft tissue swelling, flattened intercondylar surfaces, erosions, generalized osteopenia on anteroposterior view, and squaring of patella on lateral view (Fig.1 and 2. The findings were suggestive of chronic hemophilic arthropathy.

  19. Bilateral patellar tendon rupture associated with statin use.

    Science.gov (United States)

    Kearns, Marie C; Singh, Vinay K

    2016-01-01

    Patellar tendon rupture is an uncommon clinical presentation, which generally affects the under 40s who are active in sport. Bilateral rupture of both tendons is much rarer. It occurs most frequently in patients with predisposing factors such as corticosteroid use or systemic diseases. The authors present the case of a 56-year-old male on long-term statin therapy who sustained this injury following a fall on ice. He had no known risk factors for tendon rupture. Surgical treatment involved tendon repair using Krakow suture via bony tunnels in the patella. Statins have previously been associated with tendon ruptures at other sites but there have been no published cases of bilateral patellar tendon rupture linked to statin use. We review the literature regarding the association between statins and tendon rupture. PMID:27165749

  20. [Diagnosis and treatment of patellar chondroblastoma].

    Science.gov (United States)

    Cheng, Qiang; Huang, Wei

    2013-12-01

    Chondroblastoma of the patella, rare occurred in patellar,is a kind of an uncommon benign bone tumor. Compared with giant cell tumor, the morbidity of chondroblastoma is lower. Meanwhile, its clinical manifestations are various, and images are very complicated. Therefore, the understanding of this kind of tumors may be limited even to the orthopedist. The differences of patellar chondroblastoma between other tumor in X-ray, CT and MRI is a spot in recent years. Sometimes patellar chondroblastoma coexists with aneurysmal bone cyst, which is a challenge to obtain an accurate pathological and radiological diagnosis. For the treatment, curettage and bone grafting is one the most popular method, but whether to perform a biopsy before surgery still remain controversy. Some new technique still has an unknown prospect for the treatment such as radiofrequency ablation. PMID:24654528

  1. Some observations on Seabirds breeding in the Tsitsikamma Coastal National Park.

    Directory of Open Access Journals (Sweden)

    R. J. M Crawford

    1983-12-01

    Full Text Available In 1980 and 1981 more than 50 pairs of kelp gulls Lams dominicanus, 70 of Cape cormorants Phalacrocorax capensis and 20 of whitebreasted cormorants P. carbo nested in the Tsitsikamma Coastal National Park. Kelp gulls were breeding in the Park in the mid 1960's but no records could be found of breeding by Cape cormorants prior to 1980. The earliest record for nesting by whitebreasted cormorants was 1971 and the population apparently increased in the late 1970's. Small numbers of African black oystercatchers Haematopus moquini nested in the park in 1980 and 1981. Brown mussels Perna perna and limpets Patella spp. dominated their hardshelled diet. Whereas oystercatchers at St Croix Island fed mainly on organisms from the mid intertidal region, those at Tsitsikamma appear to have favoured molluscs from the lower tidal range.

  2. Forty-seven Cases of Gonitis Treated by A Combined Therapy of Chinese Drugs and Acupuncture

    Institute of Scientific and Technical Information of China (English)

    杨文鹤

    2001-01-01

    @@Osteoarthritis, a nonspecific inflammatory lesion, is a commonly seen joint disease. Clinically, it is mainly characterized by arthralgia, swelling, and motor impairment. Since the knee joint is the load-bearing joint of the human body, and is susceptible to trauma, gonitis tends to have the highest morbidity in the four limbs, which manifests itself arthritis of patella and femur at the early stage; narrowness or disappearance of the medial joint space at the mid stage; and damage of the cartilage accompanied with flexion deformity at the late stage. In recent years, based on the experience of Prof. Cao Yiming, the author has treated 47 cases of gonitis by combined use of Chinese drugs and acupuncture, and obtained satisfactory therapeutic results as reported in the following.

  3. Ultrasound Backscattering Is Anisotropic in Bovine Articular Cartilage.

    Science.gov (United States)

    Inkinen, Satu I; Liukkonen, Jukka; Tiitu, Virpi; Virén, Tuomas; Jurvelin, Jukka S; Töyräs, Juha

    2015-07-01

    Collagen, proteoglycans and chondrocytes can contribute to ultrasound scattering in articular cartilage. However, anisotropy of ultrasound scattering in cartilage is not fully characterized. We investigate this using a clinical intravascular ultrasound device with ultrasound frequencies of 9 and 40 MHz. Osteochondral samples were obtained from intact bovine patellas, and cartilage was imaged in two perpendicular directions: through articular and lateral surfaces. At both frequencies, ultrasound backscattering was higher (p < 0.05) when measured through the lateral surface of cartilage. In addition, the composition and structure of articular cartilage were investigated with multiple reference methods involving light microscopy, digital densitometry, polarized light microscopy and Fourier infrared imaging. Reference methods indicated that acoustic anisotropy of ultrasound scattering arises mainly from non-uniform distribution of chondrocytes and anisotropic orientation of collagen fibers. To conclude, ultrasound backscattering in articular cartilage was found to be anisotropic and dependent on the frequency in use. PMID:25933711

  4. Analysis of patellar baja after primary total knee arthoplasty%初次全膝关节表面置换术后关节线抬高的探讨

    Institute of Scientific and Technical Information of China (English)

    李亚非; 杨传忠; 方崇瑞; 潘德锦; 邹宇纬; 李东超; 陈研; 李永; 胡振中; 刘立华

    2010-01-01

    Objective To investigate the reasons uly patella baja occurred after primary total knee arthoplasty(TKA). Methods We retrospectively studied 380 primary TKA knees of 260 cases.Insall-salvati index was indicated to measure the height of patella and the variation of the joint line.We recognized such an clinical positive sign as the value of insall-salvati index >0.8 and proximally transfering joint line >4 mm.In mean term of follow up,subjects was divided to two groups according to HSS.The two groups took 75 score as a sorting baseline to analyze the correlation of patellar baja with the insall-salvati index and the proximally transfering joint line. Results There is no evdence of patellar baja in group of high scores of 352 knees.22 knees occurred patellar baja in group of low scores of 28 knees which joint line elevated(7 ± 2.0)mm.Patella baja were correlated with insall-salvati's index and elevation of joint line. Conclusions Patella baja occurred after TKA is multifactorial.We keep the original joint line maximally during TKA and stont knee rehabilitation as soon as possible after TKA.%目的 分析研究初次全膝关节表面置换术后并发髌骨低位的机制. 方法 回顾性研究我科自2003年7月至2010年7月收治的260例380个膝关节表面置换术患者的资料.把insall-salvati指数大于0.8和关节线抬高4 mm定义为有临床意义.按照HSS膝关节评分(以75分为标准)将患者分成2组,观察高分组和低分组术后低位髌骨发生的情况.对2组的评分进行比较. 结果 高分组352膝,未发现低位髌骨患者;低分组28膝,其中22膝关节线抬高平均(7.0±2.0)mm.HSS膝关节评分结果:低位髌骨组评分低于正常组(P<0.05). 结论 在初次全膝关节表面置换术中要最大程度地恢复原有的膝关节线位置,并加强早期的膝关节功能锻炼.

  5. Temporal trending of lead and cadmium contamination in the Vigo estuary intertidal area

    Directory of Open Access Journals (Sweden)

    M. Pérez López

    2004-12-01

    Full Text Available At the present work, limpet (Patella vulgata L. and seaweed (Ulva lactuca specimens have been monthly sampled at the same point from the Vigo estuary, during a year. Heavy metal (cadmium and lead content has been determined by means of differential pulse anodic stripping voltammetry in both limpet and seaweed tissues, as well as in seawater. The obtained results have shown the main heavy metal content in limpet soft tissues with respect to shell, with maximum concentrations of 3 ppm (limpet shell for lead, whereas the highest content for cadmium was identified in seaweed samples (1.1 ppm. The statistical study revealed the existence of a clear correlation between cadmium and lead concentrations in seaweed samples.

  6. Apophysitis of the lower limbs: imaging findings

    International Nuclear Information System (INIS)

    Apophyses are secondary ossification centers that appear during growth. These ossification centers are under traction forces because of insertion of muscles and ligaments. When traction stress become greater in magnitude and frequency irritation of physis (growth plate) may occur resulting in apophysitis. Apophysitis injuries typically occur in active adolescents and usually presents as peri-articular pain associated with growth, skeletal immaturity, repetitive microtrauma and muscle-tendon imbalance. The most common types of apophysitis of the include Osgood-Schlatter disease (tibial tuberosity), apophysitis of the hip (iliac crest, ischial tuberosity), Sever's disease (posterior calcaneus), Sindig-Larsen-Johansson syndrome (inferior patella), and Iselin's disease (fifth metarsal base). The aim of this study was to show the main magnetic resonance imaging and X-rays findings in patients with these diseases and to discuss the frequent differential diagnosis. (author)

  7. A new species of Pterinopelma (Araneae: Theraphosidae from the highlands of the state of Minas Gerais, Brazil and description of the male of P. sazimai

    Directory of Open Access Journals (Sweden)

    Rogério Bertani

    2016-01-01

    Full Text Available ABSTRACT We describe a new species of tarantula from the highlands of the state of Minas Gerais, Brazil. Males of the new species can be distinguished from congeners by having palpal bulb keels weakly developed, and metatarsus I strongly curved, touching apex of retrolateral spur when folded. Females can be distinguished by the color pattern, carapace and legs black with conspicuous white rings on distal femora, patellae, tibiae, and metatarsi. The male of Pterinopelma felipeleitei sp. nov. was previously misidentified and described under the name Pterinopelma sazimai Bertani, Nagahama & Fukushima, 2011. The true male of P. sazimai is herein described from a specimen collected near the type locality. Similar to the conspecific female, this male has characteristic blue iridescent setae covering the carapace, chelicerae, legs, and palps. The new species is sympatric with P. sazimai . Both species inhabit a habitat locally known as 'campos rupestres'.

  8. Nail bed expansion: A new technique for correction of multiple isolated congenital micronychia

    Directory of Open Access Journals (Sweden)

    Gholamhossein Ghaffarpour

    2014-01-01

    Full Text Available Congenital micronychia may involve big toes or may involve other nails. The etiology of micronychia is not clear but amniotic bands, teratogens (drugs, alcohol, Nail Patella Syndrome etc. A 44-year-old woman with multiple isolated congenital micronychia over her hands and feet was selected. The major affected nails were thumbs and Index fingers. Surgical method were done step by step: Anesthesia of the area, extraction of short nail, elevation of nail bed, longitudinal nail bed incisions, suturing the lateral nail bed to the nail wall, covering the nail bed by a splint of plastic suction tube, bandage with gauze Vaseline. Finally, we hypnotized that in congenital micronychia, the main pathology is in nail bed; through this theory by nail bed expansion better outcomes are coming.

  9. Total knee arthroplasty in patients with a previous patellectomy.

    Science.gov (United States)

    Maslow, Jed; Zuckerman, Joseph D; Immerman, Igor

    2013-01-01

    Post-patellectomy patients represent a specific subgroup of patients that may develop arthritis and persistent knee pain and potentially require treatment with total knee arthroplasty. This article reviews the treatment and functional outcomes following total knee arthroplasty in patients with prior patellectomy. A case report is presented as an example of the clinical management of a post-patellectomy patient with significant knee pain and disability treated with total knee arthroplasty. Emphasis will be placed in decision- making, specifically with the use of a posterior stabilized implant. In addition, postoperative strengthening of the quadriceps is essential to compensate for the lack of the patella and increase the success of total knee arthroplasty in this subgroup of patients. PMID:24151951

  10. The use of stereolithography for an unusual patellofemoral disorder.

    Science.gov (United States)

    Fukui, Naoshi; Ueno, Takeshi; Fukuda, Akira; Nakamura, Kozo

    2003-04-01

    A patient with habitual patellar dislocation which was not treated successfully by the Elmslie-Trillat procedure is described. In the knee, a unique morphologic feature of the patellofemoral joint was suspected as a cause, and a stereolithographic model was produced from the patient's computed tomography data to determine the pathologic features. Because the solid model confirmed the speculation, additional surgery was done to modify the geometry of the joint. In the surgery, cancellous bone was removed below the cartilage, and the geometry of the cartilage was modified with the subchondral bone, taking advantage of the elasticity of the bone and cartilage. The second surgery eliminated maltracking of the patella and a satisfactory result was obtained. Therefore, stereolithography is useful for the treatment of atypical patellofemoral disorders, allowing an understanding of the pathologic features and dynamic simulation of the surgery. The surgical procedure could be a promising method to alter the joint geometry without impairing the cartilage.

  11. Evidence Based Conservative Management of Patello-femoral Syndrome

    Directory of Open Access Journals (Sweden)

    E. Carlos Rodriguez-Merchan

    2014-03-01

    Full Text Available Background:   Patellofemoral pain syndrome (PFPS is defined as pain surrounding the patella when sitting with bent knees for prolonged periods of time or when performing activities like ascending or descending stairs, squatting or   athletic activities. Patella dislocation is not included in PFPS.     Purpose:   This review analyzes the evidence based conservative management of PFPS.   Methods:   A Cochrane Library search related to PFPS was performed until 18 January 2014. The key words were: patellofemoral pain syndrome. Eight papers were found, of which three were reviewed because they were focused   on the topic of the article. We also searched the PubMed using the following keywords: evidence based conservative   management of patellofemoral pain syndrome. Twelve articles were found, of which seven were reviewed because   they were focused on the topic of the article. Overall ten articles were analyzed.     Results:   Different treatments can be tried for PFPS, including pharmacotherapy, therapeutic ultrasound, exercise therapy, and taping and braces.     Conclusions:   Non-steroidal anti-inflammatory drugs (NSAIDs may reduce pain in the short term, but pain does not improve after three months. Therapeutic ultrasound appears not to have a clinically important effect on pain relief for   patients with PFPS. The evidence that exercise therapy is more effective in treating PFPS than no exercise is limited   with respect to pain reduction, and conflicting with respect to functional improvement. No significant difference has   been found between taping and non-taping. The role of knee braces is still controversial. More well-designed studies are needed.    

  12. Evidence Based Conservative Management of Patello-femoral Syndrome

    Directory of Open Access Journals (Sweden)

    E. Carlos Rodriguez-Merchan

    2014-03-01

    Full Text Available Background:   Patellofemoral pain syndrome (PFPS is defined as pain surrounding the patella when sitting with bent knees for prolonged periods of time or when performing activities like ascending or descending stairs, squatting or   athletic activities. Patella dislocation is not included in PFPS.     Purpose:   This review analyzes the evidence based conservative management of PFPS.   Methods:   A Cochrane Library search related to PFPS was performed until 18 January 2014. The key words were: patellofemoral pain syndrome. Eight papers were found, of which three were reviewed because they were focused   on the topic of the article. We also searched the PubMed using the following keywords: evidence based conservative   management of patellofemoral pain syndrome. Twelve articles were found, of which seven were reviewed because   they were focused on the topic of the article. Overall ten articles were analyzed.     Results:   Different treatments can be tried for PFPS, including pharmacotherapy, therapeutic ultrasound, exercise therapy, and taping and braces.     Conclusions:   Non-steroidal anti-inflammatory drugs (NSAIDs may reduce pain in the short term, but pain does not improve after three months. Therapeutic ultrasound appears not to have a clinically important effect on pain relief for   patients with PFPS. The evidence that exercise therapy is more effective in treating PFPS than no exercise is limited   with respect to pain reduction, and conflicting with respect to functional improvement. No significant difference has   been found between taping and non-taping. The role of knee braces is still controversial. More well-designed studies are needed.

  13. MRI findings associated with development of incident knee pain over 48 months: data from the osteoarthritis initiative

    International Nuclear Information System (INIS)

    The purpose of this nested case-control study was to identify baseline, incident, and progressive MRI findings visible on standard MRI clinical sequences that were associated with development of incident knee pain in subjects at risk for OA over a period of 48 months. We analyzed 60 case knees developing incident pain (WOMACpain = 0 at baseline and WOMACpain ≥ 5 at 48 months) and 60 control knees (WOMACpain = 0 at baseline and WOMACpain = 0 at 48 months) from the Osteoarthritis Initiative. 3 T knee MRIs were analyzed using a modified WORMS score (cartilage, meniscus, bone marrow) at baseline and after 48 months. Baseline and longitudinal findings were grouped into logistic regression models and compared using likelihood-ratio tests. For each model that was significant, a stepwise elimination was used to isolate significant MRI findings. One baseline MRI finding and three findings that changed from baseline to 48 months were associated with the development of pain: at baseline, the severity of a cartilage lesion in the medial tibia was associated with incident pain - (odds ratio (OR) for incident pain = 3.05; P = 0.030). Longitudinally, an incident effusion (OR = 9.78; P = 0.005), a progressive cartilage lesion of the patella (OR = 4.59; P = 0.009), and an incident medial meniscus tear (OR = 4.91; P = 0.028) were associated with the development of pain. Our results demonstrate that baseline abnormalities of the medial tibia cartilage as well as an incident joint effusion, progressive patella cartilage defects, and an incident medial meniscus tear over 48 months may be associated with incident knee pain. Clinically, this study helps identify MRI findings that are associated with the development of knee pain. (orig.)

  14. Temporal trending of lead and cadmium contamination in the Vigo estuary intertidal area Evolución temporal de la contaminación por plomo y cadmio en la zona intermareal de la ría de Vigo

    Directory of Open Access Journals (Sweden)

    J. Alonso Díaz

    2004-12-01

    Full Text Available At the present work, limpet (Patella vulgata L. and seaweed (Ulva lactuca specimens have been monthly sampled at the same point from the Vigo estuary, during a year. Heavy metal (cadmium and lead content has been determined by means of differential pulse anodic stripping voltammetry in both limpet and seaweed tissues, as well as in seawater. The obtained results have shown the main heavy metal content in limpet soft tissues with respect to shell, with maximum concentrations of 3 ppm (limpet shell for lead, whereas the highest content for cadmium was identified in seaweed samples (1.1 ppm. The statistical study revealed the existence of a clear correlation between cadmium and lead concentrations in seaweed samples.En el presente trabajo se han recogido muestras de lapa (Patella vulgata L. y alga verde (Ulva lactuca en un mismo punto de muestreo de la ría de Vigo, con una periodicidad mensual, a lo largo de un año, analizándose por medio de voltamperometría de redisolución anódica la concentración en dos metales pesados con claras repercusiones toxicológicas, cadmio y plomo, en estas muestras, así como en el agua marina. Los resultados obtenidos mostraron la mayor concentración de ambos metales en los tejidos blandos de las lapas frente a las valvas de estos moluscos, con valores máximos en el caso del plomo próximos a 3 ppm (valva de lapa, mientras que para el cadmio se situó en torno a 1,1 ppm (alga verde. El estudio estadístico permitió poner en evidencia una clara correlación estadística entre los valores de cadmio y plomo cuantificados en las muestras de algas.

  15. MRI findings associated with development of incident knee pain over 48 months: data from the osteoarthritis initiative

    Energy Technology Data Exchange (ETDEWEB)

    Joseph, Gabby B.; Hou, Stephanie W.; Nardo, Lorenzo; Heilmeier, Ursula; Link, Thomas M. [University of California, San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Nevitt, Michael C.; McCulloch, Charles E. [University of California, San Francisco, Department of Epidemiology and Biostatistics, San Francisco, CA (United States)

    2016-05-15

    The purpose of this nested case-control study was to identify baseline, incident, and progressive MRI findings visible on standard MRI clinical sequences that were associated with development of incident knee pain in subjects at risk for OA over a period of 48 months. We analyzed 60 case knees developing incident pain (WOMAC{sub pain} = 0 at baseline and WOMAC{sub pain} ≥ 5 at 48 months) and 60 control knees (WOMAC{sub pain} = 0 at baseline and WOMAC{sub pain} = 0 at 48 months) from the Osteoarthritis Initiative. 3 T knee MRIs were analyzed using a modified WORMS score (cartilage, meniscus, bone marrow) at baseline and after 48 months. Baseline and longitudinal findings were grouped into logistic regression models and compared using likelihood-ratio tests. For each model that was significant, a stepwise elimination was used to isolate significant MRI findings. One baseline MRI finding and three findings that changed from baseline to 48 months were associated with the development of pain: at baseline, the severity of a cartilage lesion in the medial tibia was associated with incident pain - (odds ratio (OR) for incident pain = 3.05; P = 0.030). Longitudinally, an incident effusion (OR = 9.78; P = 0.005), a progressive cartilage lesion of the patella (OR = 4.59; P = 0.009), and an incident medial meniscus tear (OR = 4.91; P = 0.028) were associated with the development of pain. Our results demonstrate that baseline abnormalities of the medial tibia cartilage as well as an incident joint effusion, progressive patella cartilage defects, and an incident medial meniscus tear over 48 months may be associated with incident knee pain. Clinically, this study helps identify MRI findings that are associated with the development of knee pain. (orig.)

  16. Acute and old ruptures of the extensor apparatus of the knee in adults (excluding knee replacement).

    Science.gov (United States)

    Saragaglia, D; Pison, A; Rubens-Duval, B

    2013-02-01

    Rupture of the extensor apparatus of the knee in adults is infrequent and dominated by patellar fracture, which in our experience is six times as frequent as quadriceps or patellar tendon tear. Patellar fracture poses few diagnostic problems and treatment is now well codified. Tension-band osteosynthesis is generally used, involving two longitudinal K-wires and wire in a figure-of-eight pattern looped over the anterior patella; sometimes, for more complex fractures, cerclage wiring is added to the tension band. Non-union is rare and generally well tolerated. Quadriceps tendon tear mainly affects patients over 40 years of age, in a context of systemic disease. Diagnosis is easily suggested by inability to actively extend the knee, but is unfortunately still often overlooked in emergency. In most cases, early surgical management is needed to reinsert the tendon at the proximal pole of the patella by bone suture. For chronic lesions, it is often necessary to lengthen the quadriceps tendon by V-Y plasty or the Codivilla technique. Patellar tendon tear, on the other hand, typically occurs in patients under 40 years of age, often involved in sports. Diagnosis is again clinically straightforward, but again may be missed in emergency, especially in case of incomplete tear. Surgery is mandatory in all cases. The procedure depends on the type of lesion: either end-to-end suture or transosseous reinsertion. In most cases repair is protected by tendon augmentation. Old lesions often require tendon graft or a tendon-bone-tendon-bone graft taken from the opposite side.

  17. In vivo patellar tracking induced by individual quadriceps components in individuals with patellofemoral pain.

    Science.gov (United States)

    Lin, Fang; Wilson, Nicole A; Makhsous, Mohsen; Press, Joel M; Koh, Jason L; Nuber, Gordon W; Zhang, Li-Qun

    2010-01-19

    Patellofemoral pain is a common knee disorder with a multi-factorial etiology related to abnormal patellar tracking. Our hypothesis was that the pattern of three-dimensional rotation and translation of the patella induced by selective activation of individual quadriceps components would differ between subjects with patellofemoral pain and healthy subjects. Nine female subjects with patellofemoral pain and seven healthy female subjects underwent electrical stimulation to selectively activate individual quadriceps components (vastus medialis obliquus, VMO; vastus medialis lateralis, VML; vastus lateralis, VL) with the knee at 0 degrees and 20 degrees flexion, while three-dimensional patellar tracking was recorded. Normalized direction of rotation and direction of translation characterized the relative amplitudes of each component of patellar movement. VMO activation in patellofemoral pain caused greater medial patellar rotation (distal patellar pole rotates medially in frontal plane) at both knee positions (p<0.01), and both VMO and VML activation caused increased anterior patellar translation (p<0.001) in patellofemoral pain compared to healthy subjects at 20 degrees knee flexion. VL activation caused more lateral patellar translation (p<0.001) in patellofemoral pain compared to healthy subjects. In healthy subjects the 3-D mechanical action of the VMO is actively modulated with knee flexion angle while such modulation was not observed in PFP subjects. This could be due to anatomical differences in the VMO insertion on the patella and medial quadriceps weakness. Quantitative evaluation of the influence of individual quadriceps components on patellar tracking will aid understanding of the knee extensor mechanism and provide insight into the etiology of patellofemoral pain. PMID:19878947

  18. Knee muscle strength correlates with joint cartilage T2 relaxation time in young participants with risk factors for osteoarthritis.

    Science.gov (United States)

    Macías-Hernández, Salvador Israel; Miranda-Duarte, Antonio; Ramírez-Mora, Isabel; Cortés-González, Socorro; Morones-Alba, Juan Daniel; Olascoaga-Gómez, Andrea; Coronado-Zarco, Roberto; Soria-Bastida, María de Los Angeles; Nava-Bringas, Tania Inés; Cruz-Medina, Eva

    2016-08-01

    The objective of this study is to correlate T2 relaxation time (T2RT), measured by magnetic resonance imaging (MRI) with quadriceps and hamstring strength in young participants with risk factors for knee osteoarthritis (OA). A descriptive cross-sectional study was conducted with participants between 20 and 40 years of age, without diagnosis of knee OA. Their T2 relaxation time was measured through MRI, and their muscle strength (MS) was measured with an isokinetic dynamometer. Seventy-one participants were recruited, with an average age of 28.3 ± 5.5 years; 39 (55 %) were females. Negative correlations were found between T2RT and quadriceps peak torque (QPT) in males in the femur r = -0.46 (p = 0.01), tibia r = -0.49 (p = 0.02), and patella r = -0.44 (p = 0.01). In women, correlations were found among the femur r = -0.43 (p = 0.01), tibia r = -0.61 (p = 0.01), and patella r = -0.32 (p = 0.05) and among hamstring peak torque (HPT), in the femur r = -0.46 (p = 0.01), hamstring total work (HTW) r = -0.42 (p = 0.03), and tibia r = -0.33 (p = 0.04). Linear regression models showed good capacity to predict T2RT through QPT in both genders. The present study shows that early changes in femoral, tibial, and patellar cartilage are significantly correlated with MS, mainly QPT, and that these early changes might be explained by MS, which could play an important role in pre-clinical phases of the disease.

  19. Quadriceps tendon rupture: a biomechanical comparison of transosseous equivalent double-row suture anchor versus transosseous tunnel repair.

    Science.gov (United States)

    Hart, Nathan D; Wallace, Matthew K; Scovell, J Field; Krupp, Ryan J; Cook, Chad; Wyland, Douglas J

    2012-09-01

    Quadriceps rupture off the patella is traditionally repaired by a transosseous tunnel technique, although a single-row suture anchor repair has recently been described. This study biomechanically tested a new transosseous equivalent (TE) double-row suture anchor technique compared with the transosseous repair for quadriceps repair. After simulated quadriceps-patella avulsion in 10 matched cadaveric knees, repairs were completed by either a three tunnel transosseous (TT = 5) or a TE suture anchor (TE = 5) technique. Double-row repairs were done using two 5.5 Bio-Corkscrew FT (fully threaded) (Arthrex, Inc., Naples, FL, USA) and two 3.5 Bio-PushLock anchors (Arthrex, Inc., Naples, FL, USA) with all 10 repairs done with #2 FiberWire suture (Arthrex, Inc., Naples, FL). Cyclic testing from 50 to 250 N for 250 cycles and pull to failure load (1 mm/s) were undertaken. Gap formation and ultimate tensile load (N) were recorded and stiffness data (N/mm) were calculated. Statistical analysis was performed using a Mann-Whitney U test and survival characteristics examined with Kaplan-Meier test. No significant difference was found between the TE and TT groups in stiffness (TE = 134 +/- 15 N/mm, TT = 132 +/- 26 N/mm, p = 0.28). The TE group had significantly less ultimate tensile load (N) compared with the TT group (TE = 447 +/- 86 N, TT = 591 +/- 84 N, p = 0.04), with all failures occurring at the suture eyelets. Although both quadriceps repairs were sufficiently strong, the transosseous repairs were stronger than the TE suture anchor repairs. The repair stiffness and gap formation were similar between the groups.

  20. Interactive scan control for kinematic study in open MRI

    International Nuclear Information System (INIS)

    A tool to support the subject is generally used for kinematic joint imaging with an open MRI apparatus because of difficulty setting the image plane correctly. However, use of a support tool requires a complicated procedure to position the subject, and setting the image plane when the joint angle changes is time consuming. Allowing the subject to move freely enables better diagnoses when kinematic joint imaging is performed. We therefore developed an interactive scan control (ISC) to facilitate the easy, quick, and accurate setting of the image plane even when a support tool is not used. We used a 0.4T magnetic resonance (MR) imaging system open in the horizontal direction. The ISC determines the image plane interactively on the basis of fluoroscopy images displayed on a user interface. The imaging pulse is a balanced steady-state acquisition with rewound gradient echo (SARGE) sequence with update time less than 2 s. Without using a tool to support the knee, we positioned the knee of a healthy volunteer at 4 different joint angles and set the image plane through the patella and femur at each of the angles. Lumbar imaging is also demonstrated with ISC. Setting the image plane was easy and quick at all knee angles, and images obtained clearly showed the patella and femur. Total imaging time was less than 10 min, a fourth of the time needed when a support tool is used. We also used our ISC in kinematic imaging of the lumbar. The ISC shortens total time for kinematic joint imaging, and because a support tool is not needed, imaging can be done more freely in an open MR imaging apparatus. (author)

  1. Magnetic resonance evaluation of the knee in children and adolescents with achondroplasia

    International Nuclear Information System (INIS)

    Achondroplasia is the most common form of skeletal dysplasia. Although the radiographic features are well described, MRI features of the knee in achondroplasia have not been reported. To describe common MRI characteristics of the knee joint in symptomatic children and adolescents with achondroplasia. We retrospectively evaluated 10 knee MRI examinations in 8 children and young adults (age range 11-20 years, mean 16.3 years) with achondroplasia. We measured modified Insall-Salvati index, knee flexion angle, anterior cruciate ligament (ACL)-Blumensaat line angle, ACL-tibial angle, posterior cruciate ligament (PCL) angle, intercondylar notch width index, and intercondylar notch depth index. We compared our findings with an age- and gender-matched control group of 20 children (age range 15-18 years; mean 16 years) with normal knee MRIs. All 10 knees in the achondroplasia group had discoid lateral meniscus; 8 meniscal tears were identified. Patella baja was present in half of the study cases. Greater knee flexion and increased ACL-Blumensaat line and PCL angles were seen in all achondroplasia knees. ACL-tibial angle was similar in the study and in the control group. Children with achondroplasia had deeper A-shape femoral notches that extended more anteriorly than those seen in the control group. MRI findings were confirmed in all seven knees with arthroscopic correlation. Discoid lateral meniscus, often with tear, is a consistent feature in knee MRIs of symptomatic children and adolescents with achondroplasia. Other findings include patella baja, knee flexion, deep A-shape intercondylar notch, increased ACL-Blumensaat line angle and taut PCL. (orig.)

  2. Femoropatellar radiographic alterations in cases of anterior cruciate ligament failure

    Directory of Open Access Journals (Sweden)

    Diego Protásio de Vasconcelos

    2015-02-01

    Full Text Available OBJECTIVE: To make a comparative analysis on three femoropatellar radiographic parameters, between knees with chronic failure of the anterior cruciate ligament (ACL and normal knees.METHODS: Thirty volunteer patients with a diagnosis of unilateral isolated chronic ACL injury for more than one year and a normal contralateral knee were selected. Digital radiographs were produced for all the patients, on both knees in absolute lateral view at 30° of flexion, with and without load-bearing on one leg, and in axial view of the patella at 30°. The Caton-Deschamps patellar height index, Merchant patellar congruence angle and Laurin lateral patellar tilt angle were measured on the radiographs obtained from the normal knees and knees with ACL injuries, and comparative analysis was performed between these two groups.RESULTS: The patellar height was statistically significantly lower (p< 0.001 in the knees with ACL failure than in the normal knees, both on radiographs without loading and on those with single-foot loading. The Merchant patellar congruence angle was significantly smaller (p < 0.001 in the normal knees and the lateral patellar tilt angle was smaller (p < 0.001 in the knees with ACL failure.CONCLUSION: Chronic ACL failure gave rise to a statistically significant change in the femoropatellar radiographic values studied (p < 0.001. Knees with injuries to this ligament presented lower patellar height values, greater tilt and lateral displacement of the patella, in relation to the femoral trochlea, in comparison with the normal contralateral knees.

  3. The application of k-shell x-ray fluorescence to determine bone lead burden and its correlation with hypertension among African Americans in Gadsden County, Florida

    Science.gov (United States)

    Jackson-Edwards, Patrice

    Photons from k shell x-ray fluorescence illuminates lead atoms by measuring the characteristic x-rays which indicate the abundance of 210Pb present in a sample. The measurement utilizes a 109Cd source and a low-energy germanium detector, which has emerged as the best available technique for estimating cumulative exposure to lead in adults and for predicting lead-associated risks for adult chronic disease outcomes such as hypertension. The main focus of this study, was to show the correlation between bone lead concentration at the tibia (mean +/- standard deviation of 7+/-1 ppm) and patella (mean +/- standard deviation of 6+/-1 ppm) bone sites and hypertension (mean +/- standard deviation of the systolic standing 143+/-18mmHg, systolic sitting 140+/-17mmHg, diastolic standing 88+/-14 mmHg, and diastolic sitting 81+/-9 mmHg), among the 67 Gadsden County subjects that participated in this study. This was accomplished using FAMU's setup for the detector. The gamma rays emitted by the 109Cd source are scattered by atomic electrons in the k-shell. Excited electrons in the k-shell then spontaneously fluoresce at 88 keV as a signature of lead in the bone. The 88 keV photons are then detected at an angle of 180 degrees with respect to the incident x-ray direction and are detected by the Canberra Germanium solid-state detector bathed in liquid nitrogen. Results show that in this population all lead biomarkers (tibia lead, patella lead, and blood lead) were not significant contributors to the occurrence of hypertension. In the final logistic regression analysis, age and gender were predictors for the occurrence of hypertension at the p<0.05 level in the overall population. This study will help contribute to the understanding of the body's management of lead toxicity and to KXRF techniques currently used in physics research.

  4. Size-dependent concentrations of trace metals in four Mediterranean gastropods.

    Science.gov (United States)

    Cubadda, F; Conti, M E; Campanella, L

    2001-11-01

    In order to gain more information on the possible use of four gastropod species as metal biomonitors for the Mediterranean area, the influence of body weight upon Cd, Cr, Cu, Pb and Zn concentrations was studied in specimens collected at locations with different degrees of environmental pollution. The selected species were the marine snails Monodonta turbinata Born and Monodonta mutabilis Philippi, and the limpets Patella caerulea L. and Patella lusitanica Gmelin. Significant differences between metal concentrations in individuals from different stations were tested by ANCOVA on log-transformed data with log body weight as covariate. For all species a positive correlation between metal concentrations and body weight was observed, which means that the largest individuals contained the highest levels of metals. The inclusion of body weight as covariate in the statistical analysis explained from 81% to 99% of the metal variability within the organisms and enabled the achievement of improvements in the detection of differences among sites. The four selected species provided a rather univocal picture of bioavailable metal loads at the different stations of the experimental area. Except for Cd, the metal concentrations recorded at the clean stations were found to lie in the range of the lowest values reported in the literature and can be employed as useful background levels which can be referred to for intraspecific comparison within the Mediterranean area. It is concluded that in view of its distribution, unambiguous identification, resistance to pollution and accumulation patterns M. turbinata has considerable potential as a biomonitor of trace metals over the Mediterranean. PMID:11680752

  5. Radiological findings, evaluation and treatment of patellofemoral pain after total knee arthroplasty; Radiologische Diagnostik, Beurteilung und Behandlung des patellofemoralen Schmerzes nach primaerer Knieendoprothetik

    Energy Technology Data Exchange (ETDEWEB)

    Springorum, H.R.; Keshmiri, A.; Heers, G.; Renkawitz, T.; Grifka, J.; Baier, C. [Asklepios Klinikum Bad Abbach, Orthopaedische Klinik fuer die Universitaet Regensburg, Bad Abbach (Germany)

    2012-11-15

    Total knee arthroplasty (TKA) is one of the most successful operative procedures over the last decades in orthopedic surgery; however, some patients suffer from pain, limited range of motion, instability, infections or other complications postoperatively. Patellofemoral pain (PFP) in particular is a common problem after TKA and often necessitates revision surgery. Mainly increasing and localized contact pressure and patella maltracking are held responsible for PFP but the reasons vary. Diagnostics and therapy of PFP is not easy to manage and should be treated following a clinical pathway. The authors suggest that patients with PFP should be categorized after basic diagnostic measures according to the suspected diagnosis: (1) tendinosis, (2) mechanical reasons, (3) intra-articular non-mechanical reasons and (4) neurogenic/psychiatric reasons. Efficient application of special diagnostic measures and further therapy is facilitated by this classification. (orig.) [German] Die endoprothetische Versorgung des Kniegelenks ist eine Operation mit hohem Zugewinn an Lebensqualitaet. Dennoch sind je nach Literaturstelle bis zu 50% der Patienten von Schmerzen, Bewegungseinschraenkung, Instabilitaet, Infektion oder anderen Komplikationen betroffen. Insbesondere der patellofemorale Schmerz (PFS) ist eine haeufige Komplikation nach primaerer Knieendoprothetik und wird je nach Literatur mit 1-50% der Faelle angegeben. Insbesondere der erhoehte retropatellare Anpressdruck und eine schlechte Fuehrung der Patella werden fuer den PFS verantwortlich gemacht, doch die Ursachen sind vielfaeltig. Diagnostik und Behandlung sind komplex und sollten strukturiert durchgefuehrt werden. Nach der Basisdiagnostik schlagen die Autoren daher eine Einteilung in eine der 4 Gruppen vor: (1) Tendinosen, (2) mechanische Probleme, (3) intraartikulaere nichtmechanische Probleme, (4) neurogene/psychische Probleme. Durch die Einteilung in diese verschiedenen Gruppen werden eine effiziente spezielle

  6. Effects of low-intensity pulsed ultrasound on new trabecular bone during bone-tendon junction healing in a rabbit model: a synchrotron radiation micro-CT study.

    Directory of Open Access Journals (Sweden)

    Hongbin Lu

    Full Text Available This study was designed to evaluate the effects of low-intensity pulsed ultrasound on bone regeneration during the bone-tendon junction healing process and to explore the application of synchrotron radiation micro computed tomography in three dimensional visualization of the bone-tendon junction to evaluate the microarchitecture of new trabecular bone. Twenty four mature New Zealand rabbits underwent partial patellectomy to establish a bone-tendon junction injury model at the patella-patellar tendon complex. Animals were then divided into low-intensity pulsed ultrasound treatment (20 min/day, 7 times/week and placebo control groups, and were euthanized at week 8 and 16 postoperatively (n = 6 for each group and time point. The patella-patellar tendon specimens were harvested for radiographic, histological and synchrotron radiation micro computed tomography detection. The area of the newly formed bone in the ultrasound group was significantly greater than that of control group at postoperative week 8 and 16. The high resolution three dimensional visualization images of the bone-tendon junction were acquired by synchrotron radiation micro computed tomography. Low-intensity pulsed ultrasound treatment promoted dense and irregular woven bone formation at week 8 with greater bone volume fraction, number and thickness of new trabecular bone but with lower separation. At week 16, ultrasound group specimens contained mature lamellar bone with higher bone volume fraction and thicker trabeculae than that of control group; however, there was no significant difference in separation and number of the new trabecular bone. This study confirms that low-intensity pulsed ultrasound treatment is able to promote bone formation and remodeling of new trabecular bone during the bone-tendon junction healing process in a rabbit model, and the synchrotron radiation micro computed tomography could be applied for three dimensional visualization to quantitatively evaluate

  7. The effect of exercise on vastus medialis oblique muscle architecture: An ultrasound investigation.

    Science.gov (United States)

    Khoshkhoo, M; Killingback, A; Robertson, C J; Adds, P J

    2016-09-01

    The vastus medialis oblique (VMO) is thought to be implicated in patellofemoral pain (PFP), and weakness in this portion of the vastus medialis muscle may lead to PFP. Management includes physiotherapy to strengthen the VMO. Although this intervention has been shown to be effective, the effects on the architecture of the muscle have not been investigated. This study aims to determine the changes in VMO architecture following a program of strengthening exercises. Twenty-one male participants underwent an initial ultrasound scan to measure the fiber angle and the insertion level of the VMO on the patella. Each subject then undertook a 6-week quadriceps femoris strengthening program; the scan and measurements were then repeated. A significant increase in VMO fiber angle and insertion length was observed. Average fiber angle increased by 5.24°; average insertion length increased by 2.7 mm. There was found to be a significant negative correlation between the initial values and the degree of change. Pearson's coefficient of correlation for measurements of patella length taken before and after exercise was 0.921, indicating a high degree of reliability. There was a significant positive correlation between fiber angle change and declared level of compliance (R(2)  = 0.796). The results reported here indicate that physiotherapy leads to a significant change in VMO morphology. Given the inverse correlation noted between initial architectural parameters and the degree of change, we suggest that patients who would benefit most from physiotherapy can be identified in clinic using a simple ultrasound technique. Clin. Anat. 29:752-758, 2016. © 2016 Wiley Periodicals, Inc. PMID:26940378

  8. Magnetic resonance evaluation of the knee in children and adolescents with achondroplasia

    Energy Technology Data Exchange (ETDEWEB)

    Akyol, Yakup; Averill, Lauren W. [Nemours/Alfred I. duPont Hospital for Children, Department of Medical Imaging, Wilmington, DE (United States); Atanda, Alfred; Mackenzie, William G. [Nemours/Alfred I. duPont Hospital for Children, Department of Orthopedics, Wilmington, DE (United States); Kecskemethy, Heidi H. [Nemours/Alfred I. duPont Hospital for Children, Department of Medical Imaging, Wilmington, DE (United States); Nemours/Alfred I. duPont Hospital for Children, Department of Biomedical Research, Wilmington, DE (United States); Bober, Michael B. [Nemours/Alfred I. duPont Hospital for Children, Division of Genetics, Department of Pediatrics, Wilmington, DE (United States)

    2015-06-15

    Achondroplasia is the most common form of skeletal dysplasia. Although the radiographic features are well described, MRI features of the knee in achondroplasia have not been reported. To describe common MRI characteristics of the knee joint in symptomatic children and adolescents with achondroplasia. We retrospectively evaluated 10 knee MRI examinations in 8 children and young adults (age range 11-20 years, mean 16.3 years) with achondroplasia. We measured modified Insall-Salvati index, knee flexion angle, anterior cruciate ligament (ACL)-Blumensaat line angle, ACL-tibial angle, posterior cruciate ligament (PCL) angle, intercondylar notch width index, and intercondylar notch depth index. We compared our findings with an age- and gender-matched control group of 20 children (age range 15-18 years; mean 16 years) with normal knee MRIs. All 10 knees in the achondroplasia group had discoid lateral meniscus; 8 meniscal tears were identified. Patella baja was present in half of the study cases. Greater knee flexion and increased ACL-Blumensaat line and PCL angles were seen in all achondroplasia knees. ACL-tibial angle was similar in the study and in the control group. Children with achondroplasia had deeper A-shape femoral notches that extended more anteriorly than those seen in the control group. MRI findings were confirmed in all seven knees with arthroscopic correlation. Discoid lateral meniscus, often with tear, is a consistent feature in knee MRIs of symptomatic children and adolescents with achondroplasia. Other findings include patella baja, knee flexion, deep A-shape intercondylar notch, increased ACL-Blumensaat line angle and taut PCL. (orig.)

  9. [Arthroscopic management of recent or chronic lesions of triangular fibrocartilage complex of the wrist].

    Science.gov (United States)

    Fontès, D

    2006-11-01

    Lesions of the triangular fibrocartilage complex of the wrist (TFCC) have perfectly been dismembered by Andrew Palmer and have largely benefited from progress of arthroscopy of the wrist. One distinguishes thus traumatic lesions (class 1) individualized according to their localization, central (1-A), ulnar (1-B), radial (1-D) or distal (1-C). Central lesions are classically associated to a positive ulnar variance. The clinical symptomatology evokes a meniscal like syndrome of the wrist. In case of failure of the medical treatment, it will be necessary to propose a surgical procedure guided by histopathology of the triangular complex. Thus, ulnar peripheral richly vascularized lesions (1-B) could therefore potentially heal and will have to benefit by an attempt of surgical reattachment (arthroscopic technique of Whipple, Poehling or other techniques) or by an osteosynthesis in case of fracture on the basis on the ulnar styloid process. Central fibrocartilage lesions (1-A) or radial avulsions (1-D) are less vascularized and have therefore little probability to heal; they will benefit then ideally from the endoscopic debridement of unstable flaps of the central portion of TFCC. No immobilization is required and rehabilitation is immediately undertaken. Less frequent class 1-C lesions justify in our practice a simple arthroscopic regularization, alone complete ruptures could have necessitate a direct suture. Class 2 degenerative lesions are graduated (A to E) according to evolution of the chondromalacia of the ulnar head and carpal bone, perforation of the central disc and lunotriquetral ligament degeneration. They are usually associated with a constitutional or an acquired ulnar plus variance syndrome, for example after a distal radius fracture malunion. The clinical symptomatology needs to differentiate them from the simple frequent physiological perforations after the age of 50 years. Arthroscopy will allow to regularize unstable non-vascularized lesions and to

  10. Analysis of the load on the knee joint and vertebral column with changes in squatting depth and weight load.

    Science.gov (United States)

    Hartmann, Hagen; Wirth, Klaus; Klusemann, Markus

    2013-10-01

    It has been suggested that deep squats could cause an increased injury risk of the lumbar spine and the knee joints. Avoiding deep flexion has been recommended to minimize the magnitude of knee-joint forces. Unfortunately this suggestion has not taken the influence of the wrapping effect, functional adaptations and soft tissue contact between the back of thigh and calf into account. The aim of this literature review is to assess whether squats with less knee flexion (half/quarter squats) are safer on the musculoskeletal system than deep squats. A search of relevant scientific publications was conducted between March 2011 and January 2013 using PubMed. Over 164 articles were included in the review. There are no realistic estimations of knee-joint forces for knee-flexion angles beyond 50° in the deep squat. Based on biomechanical calculations and measurements of cadaver knee joints, the highest retropatellar compressive forces and stresses can be seen at 90°. With increasing flexion, the wrapping effect contributes to an enhanced load distribution and enhanced force transfer with lower retropatellar compressive forces. Additionally, with further flexion of the knee joint a cranial displacement of facet contact areas with continuous enlargement of the retropatellar articulating surface occurs. Both lead to lower retropatellar compressive stresses. Menisci and cartilage, ligaments and bones are susceptible to anabolic metabolic processes and functional structural adaptations in response to increased activity and mechanical influences. Concerns about degenerative changes of the tendofemoral complex and the apparent higher risk for chondromalacia, osteoarthritis, and osteochondritis in deep squats are unfounded. With the same load configuration as in the deep squat, half and quarter squat training with comparatively supra-maximal loads will favour degenerative changes in the knee joints and spinal joints in the long term. Provided that technique is learned accurately

  11. Avanços no uso de células-tronco em ortopedia Advances in the use of stem cells in orthopedics

    Directory of Open Access Journals (Sweden)

    Alexandre Fogaça Cristante

    2011-01-01

    Full Text Available As células primordiais, ou células-tronco, são células indiferenciadas multipotentes com a capacidade de originar qualquer tipo de tecido no organismo. Podem ter origem no blastocisto, sendo classificadas como embriônicas, ou em tecidos desenvolvidos de fetos, recém-nascidos ou adultos, conhecidas como célulastronco somáticas. Como um dos principais locais de isolamento da célula primordial está a medula óssea, tendo duas linhagens: células progenitoras hematopoéticas e mesenquimais. Existem diversos usos dessas células indiferenciadas na ortopedia, desde lesões cartilaginosas em patologias como osteoartrose, osteocondrite dissecante, condromalácia patelar, lesões ósseas como em pseudoartroses ou em perdas ósseas, ou em lesões nervosas como em trauma raquimedular. O estudo das células-tronco é provavelmente o campo de estudo mais promissor de toda a medicina que, em um espaço curto de tempo, irá revolucionar todas as especialidades médicas, tanto clínicas quanto cirúrgicas, solucionando patologias hoje de difícil abordagem.Primordial cells or stem cells are multipotent undifferentiated cells with the capacity to originate any type of cell in the organism. They may have their origins in the blastocyst and thus are classified as embryonic, or tissues developed in fetuses, newborns or adults and thus are known as somatic stem cells. Bone marrow is one of the main locations for isolating primordial cells, and there are two lineages: hematopoietic and mesenchymal progenitor cells. There are several uses for these undifferentiated cells in orthopedics, going from cartilaginous lesions in osteoarthrosis, osteochondritis dissecans and patellar chondromalacia, to bone lesions like in pseudarthrosis or bone losses, or nerve lesions like in spinal cord trauma. Studying stem cells is probably the most promising field of study of all within medicine, and this is shortly going to revolutionize all medical specialties (both clinical

  12. 关节镜辅助治疗急性髌骨脱位%ARTHROSCOPICALLY ASSISTED TREATMENT FOR ACUTE PATELLAR DISLOCATION

    Institute of Scientific and Technical Information of China (English)

    唐恒涛; 苏训同; 王义隽; 金大地; 赵亮

    2011-01-01

    目的 探讨关节镜辅助下外侧支持带松解、内侧支持带紧缩治疗急性髌骨脱何的疗效.方法 2006年4月-2009年3月,应用关节镜辅助下改良髌外侧支持带松解、内侧支持带紧缩治疗急性髌骨脱位22例25膝.男5例,女17例;年龄14~34岁,平均23.6岁.均突发于屈膝活动过程中.左侧11膝,右侧14膝.出现症状至入院时间为1~10 d,平均5.9 d.患者均为外侧脱位,其中14例脱位后自行复位,8例入院时仍呈脱位状态,给予手法闭合复位.检查示膝关节脱位恐惧试验均为阳性,被动活动受限,其中15例浮髌试验阳性.结果 术后切口均Ⅰ期愈合.22例均获随访,随访时间12~36个月,平均17个月.术后3个月内,12膝出现髌骨内侧皮肤穿刺处凹陷,10膝出现髌骨外侧疼痛,15膝出现髌骨内侧紧绷牵拉感,经理疗康复后均逐渐自行消失或好转.随访期间无复发性髌骨脱位.术后1年膝关节Lysholm评分为(96.6±4.5)分,高于术前的(67.3±5.7)分,差异有统计学意义(t=3.241,P=0.003);疼痛视觉模拟评分(VAS)为(1.8±0.4)分,低于术前的(6.5±0.5)分,差异有统计学意义(t=2.154,P=0.040).术后1年患膝功能采用Insall评分标准,获优18膝,良5膝,可2膝,优良率92%.结论 关节镜辅助下外侧支持带松解、内侧支持带紧缩治疗急性髌骨脱位,创伤小,恢复快,早期临床疗效满意.%Objective To evaluate an improving operative procedure and the clinical results of arthroscopically assisted treatment for acute patellar dislocation. Methods Between April 2006 and March 2009, 22 patients (25 knees) with primary acute complete dislocation of the patella underwent an improving arthroscopic operation, rdease of lateral retinaculum and suture of medial capsule and retinaculum structure. There were 5 males and 17 females with an average age of 23.6 years (range, 14-34 years). Three patients had bilateral procedure. Eleven left knees and 14 right knees were involved. The

  13. 关节镜治疗急性滑脱性髌股关节撞击综合征的临床疗效%Arthroscopic surgery for treatment of acute patellofemoral joint impingent

    Institute of Scientific and Technical Information of China (English)

    李烨; 汤洁; 胡勇; 赵胜豪; 黎清波; 彭永海

    2012-01-01

    Objective To evaluate the clinical effects of arthroscopic technique in managing acute patellofemoral joint impingent syndrome.Methods Retrospective analysis was made on clinical data of 19 cases of patients with acute patellofemoral joint impact syndrome in orthopedic in our hospital from August 2006 to December 2009.Results 3 knees were done debridement in this group; 13 knees were done debridement + patella medial band suture;5 knees were done debridement + patella medial band suture + lateral with lysis.12 cases were torn out of 17 the intra-articular fracture of block.All patients did not occur to blood vessels,nerve damage and infection or other complications.All patients with follow-up period did not recur in the dislocation of the patella,without dislocation of the fear of weight-bearing exercises,12 months after operation were followed up for joint activity can resume normal,18 patients were followed up for 12 months after recovery to pre-injury exercise level,only 1 case after double knee injury exercise levels were affected,but did not affect their daily lives.Lysholm clinical scoring system to assess knee function excellent were 17 knees,good were 3 knees,excellent rate of 95.2%.Conclusion The method is simple and effective of arthroscopic treatment of acute patellofemoral joint impingement syndrome,should be used in clinical practice.%目的 探索膝关节镜治疗急性滑脱性髌股关节撞击综合征的临床疗效.方法 回顾性分析2006年8月至2009年12月该院骨科采用膝关节镜治疗急性滑脱性髌股关节撞击综合征19例患者的临床资料.结果 本组3膝行清理术;13膝行清理术加髌骨内侧支持带缝合术;5膝行清理术加髌骨内侧支持带缝合术加外侧支持带松解术.全部患者均未发生血管、神经损伤和感染等并发症,无术后关节内出血而再次手术者.全部患者随访期内未再发生髌骨脱位,负重练习后无脱位恐惧感,术后12个月复诊时关

  14. Dispositivo de proteção após reparação das rupturas do mecanismo extensor do joelho Protection device on the repair of ruptures of knee extensor mechanism

    Directory of Open Access Journals (Sweden)

    Carlos Francisco Arguello Frutos

    2009-02-01

    Full Text Available OBJETIVO: Avaliar os resultados obtidos com a realização da técnica de dispositivo de proteção nos pacientes submetidos à osteossíntese ou sutura de lesões do mecanismo extensor. MÉTODOS: Foram avaliados 18 prontuários de pacientes que sofreram lesões traumáticas do aparelho extensor interessando a região entre a tuberosidade anterior da tíbia (TAT e o ápice da patela submetido à técnica de dispositivo de proteção. A idade variou de 22 a 69 anos, com média de 44 anos. Houve predomínio do sexo masculino em 67 % dos casos. O local mais acometido em 83 % dos casos foi o 1/3 apical da patela. Foi elaborado um protocolo para coleta dos dados informativos relacionando os pacientes e a sua evolução obtida em seus prontuários. RESULTADOS: Observamos a consolidação da fratura de patela em todos os 17 pacientes, e a cicatrização do ligamento patelar num único caso. A dor esteve presente em quatro pacientes, sendo que não observamos nenhuma outra complicação relacionada com a técnica cirúrgica. CONCLUSÃO: O dispositivo de proteção é eficiente quando aplicado no tratamento operatório das lesões que se localizam entre o ápice da patela e a TAT propiciando movimentação ativa e passiva no pós-operatório imediato.OBJECTIVE: To evaluate results obtained using the protection device technique for osteosintesis or suture of extensor mechanism lesions. MATERIAL AND METHODS: The authors reviewed 18 charts of patients submitted to protection device technique due to traumatic lesion of extensor mechanism that had occurred between the anterior tibial tuberosity and the apical portion of patella. Age ranged from 22 to 69 years, with a mean of 44 years. Male patients prevailed, with 67% of the cases. The most affected spot was, in 83% of the cases, the apical distal third. A protocol was created to collect data, listing the patients and the clinical history from their medical records. RESULTS: The authors observed consolidation

  15. MR Findings of Acute Injury in Medial Patellofemoral Ligament%内侧髌股韧带及其急性损伤的MRI研究

    Institute of Scientific and Technical Information of China (English)

    黄耀渠; 赵晓梅; 陈卫国

    2011-01-01

    Objective To explore the MRI findings of normal and acute injured medial patellofemoral ligament( MP-FL). Materials and Methods MR findings of 30 normal and 25 surgically confirmed acute injured MPFLs were retrospectively reviewed. Results The normal MPFLs were presented as a band of low signal intensity extending from medial femoral epicondyle to the medial margin of the patella, which could be best visualized on transaxial images. MRI appearances of the ruptured MPFL were hyperintensity,thickening,and completely or partly discontinuance of the fibrous bundle, which was observed best on axial images. MPFL injury was observed in 23 (92% ) of the 25 knees,and MPFL injury types could be accurately diagnosed in 18 of 23 knees using MR imaging, subluxation/ dislocation were found in 18 patients, bone contusion involving both the inferomedial patella and the anterolateral femoral condyle were found in 24 cases,ehondral injuries were identified at 22 cases,injuries of vastus medialis oblique were found in 19 cases, medial collateral ligament injury were found in 10 patients. Conclusion MR imaging can clearly demonstrate the structure of the MPFLs, diagnose and classify the ligament injury accurately. Bone contusion involving both the inferomedial patella and the anterolateral femoral condyle is a suggestive secondary sign in diagnosing acute MPFL injury,and transaxial MR examination is recommended to evaluate MPFL injury.%目的 探讨正常和急性损伤的内侧髌股韧带(MPFL)的MRI表现.资料与方法 对30名正常志愿者和25例经手术证实的急性MPFL损伤患者的膝关节MRI表现进行回顾性分析.结果 MPFL在横断面显示最佳,正常MPFL在MRI上表现为自股骨内上髁向髌骨内缘走行的条状低信号,急性损伤表现为韧带信号增高、肿胀、变细或中断.MRI准确诊断并分级18例,漏诊2例,另5例能诊断但不能准确分级.急性MPFL损伤伴发的其他损伤包括髌骨半脱位或脱位18例、髌骨内

  16. A retrospective study on incidence of lameness in domestic animals

    Directory of Open Access Journals (Sweden)

    A. Mohsina

    2014-08-01

    Full Text Available Aim: To study the incidence of lameness among different species of animals presented to the Veterinary Polyclinic, Indian Veterinary Research Institute, Izatnagar. Materials and Methods: Outpatient department (OPD records for the period from January 2006 to December 2010 were referred and information was collected regarding number of lameness in different species, breeds, type of injury, limb affected, gender, age at onset, treatment offered, outcome and any reoccurrence. In this study, fractured cases were not included. Results: The incidence of lameness among different species were recorded: canine (56%, equine (21%, caprine (7%, feline (3%, cattle (7%, buffalo (5.47%, sheep (0.6%, monkey (0.39% and swine (0.19%. In dog, the different conditions were reported with hind quarter weakness recording 55% of lameness followed by right hind limb lameness (14.7%, left hind limb lameness (12.6%, left forelimb lameness (12%, hip dislocation (6.3% and hip dysplasia (4.2%. In caprines, important causes of lameness were right forelimb lameness (23%, right hind limb lameness (12%, left forelimb lameness (12%, posterior paresis (9%, left shoulder dislocation (14% and right shoulder dislocation (6%. In cattle, 34.28% of cases with right hind limb lameness, 28.5% cases were due to HQW, 14.28% had hip dysplasia, 8.57% suffered left hind limb lameness, 6% cases were recorded with obturator nerve paralysis and 8.57% cases suffered contracted tendon in calves. In buffaloes, cases reported were right carpal arthritis, foot rot and left hind limb lameness (14.28% each, due to bilateral upward luxation of patella and due bilateral purulent wound in stifle (18% each and hip dislocation (21.4%. In equines, lameness were reported with right hind limb affection (13%, left forelimb affection (11%, right forelimb affection (17%, 4% each due to disease of right shoulder, HQW and both forelimb affection, lateral dislocation of patella (3%, affection of both hind limbs (9%, 5

  17. Two kinds of cable fixation methods for treatment of patellar fractures%两种线缆不同内固定方法治疗髌骨骨折疗效比较

    Institute of Scientific and Technical Information of China (English)

    赖爱宁; 黄飞; 王佳孜; 戴志元; 郭龙

    2013-01-01

    Objective To investigate the clinical efficacy of two different methods,needle with tail hole cable and cable for treatment of patella fracture.Methods All of 40 cases of patella fracture were selected,including 18 routine with tail hole needle cable system treatment (needle cable group),and regular cable ring firm fixation for (cable group).With reference to Bostman standard,the clinical curative effect was evaluated.Results The operation time of needle cable group was (40.15~56.52)min,and cable group was (42.22~53.21)min,there's no significant difference (P >0.05); the fracture healing time of needle cable group was (10±2)weeks,shorter than cable group's (14±2)weeks,there's significant difference(P <0.05); needle cable group was followed up for (12.00±4.34)months,acceptance rate was 100.0%; cable group was followed up for (16.46±2.82)months,acceptance rate was 90.9%,there's significant difference (P <0.05).There's no postoperative infection case.Conclusion The tail hole needle cable system treatment for patella fracture has fewer complications,and postoperative fracture healing time is short,with the advantages of knee functional recovery,popularization.%目的 探讨采用带尾孔针缆及线缆固定两种不同方法治疗髌骨骨折的临床疗效.方法 选取40例髌骨骨折,其中18例行带尾孔针缆系统治疗(针缆组),22例行线缆环扎固定治疗(线缆组).参照Bostman标准评价两组的临床疗效.结果 针缆组手术时间为40.15~56.52 min,与线缆组的42.22~53.21 min比较差异无统计学意义(P>0.05);针缆组骨折愈合时间(10±2)周短于线缆组(14±2)周,差异有统计学意义(P<0.05);针缆组获随访(12.00±4.34)个月,Bostman评分优良率100.0%;线缆组随访(16.46±2.82)个月,Bostman评分优良率90.9%,两组优良率比较差异有统计学意义(P<0.05),两组术后无一例发生感染.结论 采用带尾孔针缆系统治疗髌骨骨折具有固定牢固、并发

  18. Outcomes of Autologous Chondrocyte Implantation in the Knee following Failed Microfracture

    Science.gov (United States)

    Riff, Andrew Joseph; Yanke, Adam Blair; Tilton, Annemarie K.; Cole, Brian J.

    2016-01-01

    Objectives: Marrow stimulation techniques such as drilling or microfracture are first-line treatment options for symptomatic cartilage defects of the knee. For young patients who have failed microfracture, cartilage restoration techniques such as autologous chondrocyte implantation (ACI), OATS, and osteochondral allograft and are frequently employed. Nevertheless, there a few reports in the literature evaluating the results of ACI following failed microfracture and those available suggest inferior outcomes compared to primary ACI. This study was performed to evaluate the clinical outcomes of autologous chondrocyte implantation (ACI) following failed microfracture in the knee and compare these outcomes to those of primary ACI. Methods: Patients were identified who underwent autologous chondrocyte implantation for symptomatic chondral lesions of the knee refractory to previous microfracture. Postoperative data were collected using several subjective scoring systems (Noyes, Tegner, Lysholm, IKDC, KOOS, SF12). An age-matched cohort of 103 patients who underwent primary ACI of the knee was used as a control group. Statistics were performed in a paired manner using a Student’s t-test for ordinal data and chi-square test for categorical data. Results: Ninety-two patients met the inclusion criteria. The average patient age was 30.1 years (range, 14-49 years) at the time of ACI. The average duration from microfracture to ACI was 21.2 months (range, 1-88 months). ACI was performed in the tibiofemoral compartment in 42 patients, the patellofemoral compartments in 38 patients, and in both in 12 patients. The primary lesion treated with ACI involved the MFC in 38 patients, the trochlea in 25 patients, the patella in 19 patients, and the LFC in 10 patients. The lesions averaged 467mm3 in the trochlea, 445mm3 in the LFC, 265mm3 in the patella, and 295mm3 in the patella. Nineteen patients underwent concurrent ACI to multiple lesions. Thirty-one patients underwent concomitant

  19. Application of mobile bearing total knee system In the total knee arthroplasty%旋转平台假体在全膝关节置换术中的应用及早期疗效观察

    Institute of Scientific and Technical Information of China (English)

    冯贵喜; 阚世廉

    2011-01-01

    [ Objective ] To investigate the clinical effects of mobile bearing total knee arthroplasty (TKA) . [ Methods]Seventy - nine patients ( ninety - three knees) received TKA midline incision and medial parapatella approaches, the patella was treated with denervation and reparation, and then the prosthesis was inserted without replacements of patella. The fixation of prosthesis was observed by X-ray, the knee score and knee function score were evaluated by KSS scoring, and the complications were observed. [ Results ] The patients were followed up for 33.61 ± 7.34 months (24 to 48 months) . At final follow -up examination, the average total range of knee motion improved from 68.76° (0° ~ 100°) preoperatively to 107.53°(90°~120°) postoperatively. The average Knee Society knee scores improved from 37.53 scores (20 ~ 55 scores) preoperatively to 91.87 points (75 to 100 scores), and the average Knee Society function scores improved from 32. 96 scores ( 15 ~65 scores) preoperatively to 80.84 (75 to 95 scores) . X - rays showed no prosthesis loosening or patella dislocation. Six of the fifty - eight knees with OA and four of the thirty - five knees with RA had lucencies around the tibial prosthesis (P >0. 05), but the radiolucencies were < 2 mm and were nonprogressive. [ Conclusion ] The short term effect of TKA by mobile bearing total knee replacement is definite, but the long term effect needs further follow up studies.%[目的]观察旋转平台人工膝关节置换术的临床疗效.[方法]对79例患者93膝行TKA,采用正中切口髌旁内侧入路,安装假体,膝关节均未进行髌骨置换.术后复查X线片观察假体固定情况,采用美国膝关节学会评分(KSS评分)评定膝评分及膝功能评分,观察并发症发生情况.[结果]本组平均随访时间(33.61±7.34)个月(24~48个月).末次随访时,关节总活动度明显增加,由术前68.76°增加至术后107.53°(P

  20. 3D Modelling and monitoring of denervated muscle under Functional Electrical Stimulation treatment and associated bone structural changes

    Directory of Open Access Journals (Sweden)

    Paolo Gargiulo

    2011-03-01

    muscle mass and the improved quality of the muscle tissue was observed and measured on whole muscle volume. The 3-dimensional approach proposed in this work allows the geometrical changes in denervated muscle to be measured. Central lines in rectus femoris are calculated during the treatment and the relative curvature indexes are used to quantify differences between data sets. The result shows a correlation between degeneration status and changes in shape; the differences in curvature between control and denervated muscle diminish with the growth. Furthermore, bone mineral density is measured on the femur to monitor the structural changes induced by the current flow and to evaluate the effect on the patella bone density due to the quadriceps contraction. Though the evidences aren’t yet statistically relevant a kind of structural change in the femur is measured as secondary effect from the muscle stimulation. Beside, the force applied on the patella through the elicited contraction seems also to have a beneficial effect on bone density. Indeed the mineral loss in the patella is remarkably slowed down.

  1. Patellar resurfacing versus nonresurfacing in total knee arthroplasty for osteoarthritis: experience at a tertiary care institution in Pakistan

    Directory of Open Access Journals (Sweden)

    Lakdawala RH

    2012-02-01

    Full Text Available Akil Fazal1, Riaz H Lakdawala21Clinical Fellow, NYU Hospital for Joint Disease, New York, US; 2Associate Professor and Chief, Section of Orthopedics, Department of Surgery, The Aga Khan University Hospital, Karachi, PakistanObjective: To determine the effect of patellar resurfacing in patients offered total knee arthroplasty for osteoarthritis.Design: Randomized control study.Place and duration of study: The Aga Khan University Hospital, Karachi, Pakistan from January 3, 2005 to January 9, 2010.Patients and methods: Patients undergoing primary total knee arthroplasty for osteoarthritis were assigned to either the patellar resurfacing or nonresurfacing arm using systematic sampling. This consisted of patients undergoing unilateral and bilateral knee arthroplasty. Preoperatively, Knee Society Knee and Function Scores were calculated. After a minimum of 3 years postoperatively Knee Society Knee and Function Scores as well as the Clinical Anterior Knee Pain Rating were calculated and analysis done to check for differences.Results: Seventy-five patients were recruited in each arm; 135 patients had bilateral and 15 had unilateral knee arthroplasty. The mean preoperative knee score was 40.4 for the resurfacing group and 40.60 for the nonresurfacing group (P = 0.45. This improved postoperatively to 93.67 and 94.23 respectively, with no difference between the two groups (P = 0.67. The mean preoperative function score was 45.50 for resurfaced patellae and 45.83 for nonresurfaced. This improved to 89.67 and 90.50, respectively, again with no difference (P = 0.51. Postoperative Clinical Anterior Knee Pain Rating was a mean of 0.1 for resurfaced and 0.13 for nonresurfaced patellas, with no difference on analysis (P = 0.06. However, patients who had bilateral knee arthroplasty had a slightly higher Clinical Anterior Knee Pain Rating than those who had single knee surgery (P = 0.046 irrespective of whether the patellar was resurfaced or not.Conclusion: In

  2. 早期功能锻炼对髌骨骨折术后膝关节功能恢复的影响%The impact of early functional exercise on the knee function of postoperative patient of patellar fracture

    Institute of Scientific and Technical Information of China (English)

    朱志中; 王志强; 于洋

    2014-01-01

    Objective To observe the effects of early rehabilitation on knee function after patella fracture surgery. Method 60 cases of patellar fracture patients were randomly divided into two groups:the rehabilitation group and the control group each of 30 patients,two groups underwent patellar fixation aggregator surgery,after conventional medical and nursing treatment. The control group only had usual care,the rehabilitation group was given joint function training,strength training and physical therapy. After treatment using the WOMAC score to evaluate the patient's knee function. Results The WOMAC score of the rehabilitation group was significantly higher than that of the controlgroup(P<0. 05). Conclusion Early rehabilitation has a significant role in promoting the knee function after the patella fracture sur-gery.%目的:观察髌骨骨折术后早期康复治疗对膝关节功能的影响。方法:髌骨骨折术后患者60例,随机分为康复组30例与对照组30例,两组均行髌骨聚合器内固定术,术后常规抗感染、消肿止痛、促进骨折愈合等药物治疗。对照组常规护理,康复组术后进行关节功能训练、肌力训练;并于术后配合物理因子等治疗。于治疗后采用WOMAC骨关节炎指数评分评价患者的膝功能。结果:康复组WOMAC膝关节评分明显高于对照组( P<0.05)。结论:髌骨骨折术后早期功能锻炼对膝关节功能恢复有显著促进作用。

  3. Characterization of calcium and zinc spatial distributions at the fibrocartilage zone of bone–tendon junction by synchrotron radiation-based micro X-ray fluorescence analysis combined with backscattered electron imaging

    International Nuclear Information System (INIS)

    Tendon attaches to bone through a functionally graded fibrocartilage zone, including uncalcified fibrocartilage (UF), tidemark (TM) and calcified fibrocartilage (CF). This transition zone plays a pivotal role in relaxing load transfer between tendon and bone, and serves as a boundary between otherwise structurally and functionally distinct tissue types. Calcium and zinc are believed to play important roles in the normal growth, mineralization, and repair of the fibrocartilage zone of bone–tendon junction (BTJ). However, spatial distributions of calcium and zinc at the fibrocartilage zone of BTJ and their distribution–function relationship are not totally understood. Thus, synchrotron radiation-based micro X-ray fluorescence analysis (SR-μXRF) in combination with backscattered electron imaging (BEI) was employed to characterize the distributions of calcium and zinc at the fibrocartilage zone of rabbit patella–patellar tendon complex (PPTC). For the first time, the unique distributions of calcium and zinc at the fibrocartilage zone of the PPTC were clearly mapped by this method. The distributions of calcium and zinc at the fibrocartilage zone of the PPTC were inhomogeneous. A significant accumulation of zinc was exhibited in the transition region between UF and CF. The highest zinc content (3.17 times of that of patellar tendon) was found in the TM of fibrocartilage zone. The calcium content began to increase near the TM and increased exponentially across the calcified fibrocartilage region towards the patella. The highest calcium content (43.14 times of that of patellar tendon) was in the transitional zone of calcified fibrocartilage region and the patella, approximately 69 μm from the location with the highest zinc content. This study indicated, for the first time, that there is a differential distribution of calcium and zinc at the fibrocartilage zone of PPTC. These observations reveal new insights into region-dependent changes across the fibrocartilage

  4. Reconstruction of medial patellofemoral ligament using quadriceps tendon combined with reconstruction of medial patellotibial ligament using patellar tendon: initial experience☆

    Science.gov (United States)

    Hinckel, Betina Bremer; Gobbi, Riccardo Gomes; Bonadio, Marcelo Batista; Demange, Marco Kawamura; Pécora, José Ricardo; Camanho, Gilberto Luis

    2016-01-01

    Objective To describe a surgical technique for anatomical reconstruction of the medial patellofemoral ligament using the quadriceps tendon, combined with reconstruction of the medial patellotibial ligament using the patellar tendon; and to present the initial results from a case series. Method The proposed technique was used on a series of cases of patients with diagnoses of patellofemoral instability and indications for surgical treatment, who were attended by the Knee Group of HC-IOT, University of São Paulo. The following were evaluated before and after the operation: range of motion (ROM), apprehension test, lateral translation test, patellar inclination test, inverted J sign, subluxation upon extension, pain from compression of the patella and pain from contraction of the quadriceps. After the operation, the patients were asked whether any new episode of dislocation had occurred, what their degree of satisfaction with the surgery was (on a scale from 0 to 10) and whether they would be prepared to go through this operation again. Results Seven knees were operated, in seven patients, with a mean follow-up of 5.46 months (±2.07). Four patients who presented apprehension before the operation did not show this after the operation. The lateral translation test became normal for all the patients, while the patellar inclination test remained positive for two patients. The patients with an inverted J sign continued to be positive for this sign. Five patients were positive for subluxation upon extension before the operation, but all patients were negative for this after the operation. None of the patients presented any new episode of dislocation of the patella. All of them stated that they were satisfied: five gave a satisfaction score of 9 and two, a score of 10. All of them said that they would undergo the operation again. Only one patient presented a postoperative complication: dehiscence of the wound. Conclusion Reconstruction of the medial patellofemoral ligament

  5. Characterization of calcium and zinc spatial distributions at the fibrocartilage zone of bone–tendon junction by synchrotron radiation-based micro X-ray fluorescence analysis combined with backscattered electron imaging

    Energy Technology Data Exchange (ETDEWEB)

    Lu, Hongbin; Chen, Can; Wang, Zhanwen; Qu, Jin; Xu, Daqi [Department of Sports Medicine, Research Center of Sports Medicine, Xiangya Hospital, Central South University, Changsha 410008 (China); Wu, Tianding; Cao, Yong [Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha 410008 (China); Zhou, Jingyong; Zheng, Cheng [Department of Sports Medicine, Research Center of Sports Medicine, Xiangya Hospital, Central South University, Changsha 410008 (China); Hu, Jianzhong, E-mail: jianzhonghu@hotmail.com [Department of Sports Medicine, Research Center of Sports Medicine, Xiangya Hospital, Central South University, Changsha 410008 (China); Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha 410008 (China)

    2015-09-01

    Tendon attaches to bone through a functionally graded fibrocartilage zone, including uncalcified fibrocartilage (UF), tidemark (TM) and calcified fibrocartilage (CF). This transition zone plays a pivotal role in relaxing load transfer between tendon and bone, and serves as a boundary between otherwise structurally and functionally distinct tissue types. Calcium and zinc are believed to play important roles in the normal growth, mineralization, and repair of the fibrocartilage zone of bone–tendon junction (BTJ). However, spatial distributions of calcium and zinc at the fibrocartilage zone of BTJ and their distribution–function relationship are not totally understood. Thus, synchrotron radiation-based micro X-ray fluorescence analysis (SR-μXRF) in combination with backscattered electron imaging (BEI) was employed to characterize the distributions of calcium and zinc at the fibrocartilage zone of rabbit patella–patellar tendon complex (PPTC). For the first time, the unique distributions of calcium and zinc at the fibrocartilage zone of the PPTC were clearly mapped by this method. The distributions of calcium and zinc at the fibrocartilage zone of the PPTC were inhomogeneous. A significant accumulation of zinc was exhibited in the transition region between UF and CF. The highest zinc content (3.17 times of that of patellar tendon) was found in the TM of fibrocartilage zone. The calcium content began to increase near the TM and increased exponentially across the calcified fibrocartilage region towards the patella. The highest calcium content (43.14 times of that of patellar tendon) was in the transitional zone of calcified fibrocartilage region and the patella, approximately 69 μm from the location with the highest zinc content. This study indicated, for the first time, that there is a differential distribution of calcium and zinc at the fibrocartilage zone of PPTC. These observations reveal new insights into region-dependent changes across the fibrocartilage

  6. The TOPGAME-study: effectiveness of extracorporeal shockwave therapy in jumping athletes with patellar tendinopathy. Design of a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Diercks Ron L

    2010-02-01

    Full Text Available Abstract Background Patellar tendinopathy is a major problem for many athletes, especially those involved in jumping activities. Despite its frequency and negative impact on athletic careers, no evidence-based guidelines for management of this overuse injury exist. Since functional outcomes of conservative and surgical treatments remain suboptimal, new diagnostic and therapeutic strategies have to be developed and evaluated. Extracorporeal shockwave therapy (ESWT appears to be a promising treatment in patients with chronic patellar tendinopathy. ESWT is most often applied after the known conservative treatments have failed. However, its effectiveness as primary therapy has not been studied in athletes who keep playing sports despite having patellar tendon pain. The aim of this study is to determine the effectiveness of ESWT in athletes with patellar tendinopathy who are still in training and competition. Methods/design The TOPGAME-study (Tendinopathy of Patella Groningen Amsterdam Maastricht ESWT is a multicentre two-armed randomised controlled trial with blinded participants and outcome assessors, in which the effectiveness of patient-guided focussed ESWT treatment (compared to placebo ESWT on pain reduction and recovery of function in athletes with patellar tendinopathy will be investigated. Participants are volleyball, handball and basketball players with symptoms of patellar tendinopathy for a minimum of 3 to a maximum duration of 12 months who are still able to train and compete. The intervention group receives three patient-guided focussed medium-energy density ESWT treatments without local anaesthesia at a weekly interval in the first half of the competition. The control group receives placebo treatment. The follow-up measurements take place 1, 12 and 22 weeks after the final ESWT or placebo treatment, when athletes are still in competition. Primary outcome measure is the VISA-P (Victorian Institute of Sport Assessment - patella score

  7. Clinical outcomes after repair of quadriceps tendon rupture: a systematic review.

    Science.gov (United States)

    Ciriello, Vincenzo; Gudipati, Suribabu; Tosounidis, Theodoros; Soucacos, P N; Giannoudis, Peter V

    2012-11-01

    The existing evidence regarding the management of quadriceps tendon rupture remains obscure. The aim of the current review is to investigate the characteristics, the different techniques employed and to analyse the clinical outcomes following surgical repair of quadriceps tendon rupture. An Internet based search of the English literature of the last 25 years was carried out. Case reports and non-clinical studies were excluded. The methodological quality of the included studies was assessed using the Coleman Methodology Score. All data regarding mechanism and site of rupture, type of treatment, time elapsed between diagnosis and repair, patients' satisfaction, clinical outcome, return to pre-injury activities, complications and recurrence rates were extracted and analysed. Out of 474 studies identified, 12 met the inclusion criteria. The average of Coleman Methodology Score was 50.46/100. In total 319 patients were analysed with a mean age of 57 years (16-85). The mean time of follow-up was 47.5 months (3 months to 24 years). The most common mechanism of injury was simple fall (61.5%). Spontaneous ruptures were reported in 3.2% of cases. The most common sites of tear were noted between 1cm and 2 cm of the superior pole of the patella and, in the older people, at the osseotendinous junction. The most frequently used repair technique was patella drill holes (50% of patients). Simple sutures were used in mid-substance ruptures. Several reinforcement techniques were employed in case of poor quality or retraction of the torn ends of tendon. The affected limb was immobilised in a cast for a period of 3-10 weeks. Quadriceps muscular atrophy and muscle strength deficit were present in most of the cases. Worst results were noted in delayed repairs. Reported complications included heterotopic ossifications in 6.9% of patients, deep venous thrombosis or pulmonary embolism in 2.5%, superficial infection in 1.2% and deep infection in 1.1%. It appears that the type of surgical

  8. Reconstruction of medial patellofemoral ligament using quadriceps tendon combined with reconstruction of medial patellotibial ligament using patellar tendon: initial experience

    Directory of Open Access Journals (Sweden)

    Betina Bremer Hinckel

    2016-02-01

    Full Text Available ABSTRACT OBJECTIVE: To describe a surgical technique for anatomical reconstruction of the medial patellofemoral ligament using the quadriceps tendon, combined with reconstruction of the medial patellotibial ligament using the patellar tendon; and to present the initial results from a case series. METHOD: The proposed technique was used on a series of cases of patients with diagnoses of patellofemoral instability and indications for surgical treatment, who were attended by the Knee Group of HC-IOT, University of São Paulo. The following were evaluated before and after the operation: range of motion (ROM, apprehension test, lateral translation test, patellar inclination test, inverted J sign, subluxation upon extension, pain from compression of the patella and pain from contraction of the quadriceps. After the operation, the patients were asked whether any new episode of dislocation had occurred, what their degree of satisfaction with the surgery was (on a scale from 0 to 10 and whether they would be prepared to go through this operation again. RESULTS: Seven knees were operated, in seven patients, with a mean follow-up of 5.46 months (±2.07. Four patients who presented apprehension before the operation did not show this after the operation. The lateral translation test became normal for all the patients, while the patellar inclination test remained positive for two patients. The patients with an inverted J sign continued to be positive for this sign. Five patients were positive for subluxation upon extension before the operation, but all patients were negative for this after the operation. None of the patients presented any new episode of dislocation of the patella. All of them stated that they were satisfied: five gave a satisfaction score of 9 and two, a score of 10. All of them said that they would undergo the operation again. Only one patient presented a postoperative complication: dehiscence of the wound. CONCLUSION: Reconstruction of the

  9. Accuracy and Precision in the Detection of Articular Cartilage Lesions Using Magnetic Resonance Imaging at 1.5 Tesla in an In Vitro Study with Orthopedic and Histopathologic Correlation

    International Nuclear Information System (INIS)

    Background: Magnetic resonance (MR) sequences for cartilage visualization have been the target of numerous studies, and the optimal sequence for cartilage imaging remains a matter of debate in the literature. Purpose: To compare MR findings with different MR sequences for the detection of cartilage lesions in fresh deep-frozen human cadaveric patellae in an in vitro setting. Material and Methods: Ten cadaveric patellae were imaged on a 1.5T MR scanner with a 2 x 2 channel carotid sandwich coil and a conventional knee coil, and compared with orthopedic findings and gold-standard histopathology. MR sequences were: a) fat-saturated (FS) proton density-weighted (PDw) turbo spin-echo (TSE) sequence (TR/TE 4000/39 ms); b) T2-weighted (T2w) double-echo steady-state (DESS) 3D water-excitation (we) sequence (TR/TE 17/4.7 ms); c) 3D-PDw-SPACE (sampling perfection with application-optimized contrasts using different flip-angle evolutions)-we sequence (TR/TE 1800/19 ms). Accuracy, Kendall's tau-b correlation, and weighted kappa coefficients were calculated. Results: Accuracy for cartilage lesion detection with the FS PDw-TSE sequence and the carotid coil was 78.3%, and with the knee coil 73.9%. For the T2wDESS-3D-we sequence, the corresponding values were 69.5% and 65.2%, and for the 3D-PDw-SPACE-we sequence 65.2% and 60.8%, respectively. Kendall's tau-b correlation ranged between 0.508 for the 3D-PDw-SPACE-we sequence (knee coil) and 0.720 for the FS PDw-TSE sequence (carotid and knee coil). Weighted kappa coefficient was lowest for the 3D-PDw-SPACE-we sequence (knee coil) at 0.607, and highest for the carotid coil and FS PDw-TSE sequence at 0.779. Conclusion: The evaluated FS PDw-TSE sequences are superior in comparison to the T2wDESS-3D-we and 3D-PDw-SPACE-we sequences in the in vitro setting for the detection of cartilage lesions, and are comparable to results reported in the literature

  10. Martin-Gruher anastomosis:a case report and review of the literature%正中神经与尺神经交通支1例报告及文献回顾

    Institute of Scientific and Technical Information of China (English)

    潘伟波; 陈海啸; 梁军波; 叶招明

    2011-01-01

    Objective:To investigate therapeutic effects of mini-incision assisted by arthroscope for the treatment of ankylosis of knee. Methods: From July 2007 to August 2009,18 patients with ankylosis of knee were treated with mini-incision assisted by arthroscope. Among the patients, 15 patients were male and 3 patients were female,ranging in age from 27 to 56 years, with an average of 33.6 years. Before operation, 5 patients had comminuted fractures in the distal end of femur (including 1 patient with open fracture),9 patients had comminuted fractures of tibial plateau,2 patients had comminuted fractures of patella, 1 patient had comminuted fractures of patella combined with comminuted fracture of capitulum fibulae and injuries of complex structure at lateral knee,and 1 patient had floating knee. The duration between the primary operation and the arthrolysis ranged from 6 to 31 months (averaged, 10.6 months). The therapeutic effects were evaluated according to Judet criteria. Results : All the patients were followed up,and the duration ranged from 3 to 25 months (averaged, 11.4 months). All the patients had incision healing at the first stage without infection,wound dehiscence and liquifaction necrosis. The preoperative knee flexed motion ranged from 30° to 80° ,with a mean of(44.72±l 1.60)° ;and postoperative knee flexed range of motion improved to an average of (109.17±10.31)° (ranged,95° to 135°). According to Judet evaluation, 16 patients got an excellent result,2 good. Conclusion:Treatment of ankylosis of the knee through a mini-incision assisted by arthroscope has advantages such as reducing the complications of incision on knee, little trauma and early recovery, which is a good operative mode to treat ankylosis of the knee after operation or trauma.%@@ 肘关节水平的尺神经损伤,常导致患者手内在肌的功能障碍.笔者遇到1例肘部尺神经沟内尺神经完全断裂的患者,手内在肌无明显功能障碍,后经肌电图检查证实

  11. Effect of Joint Line Elevation after Posterior-stabilized and Cruciate-retaining Total Knee Arthroplasty on Clinical Function and Kinematics

    Institute of Scientific and Technical Information of China (English)

    Song-Jie Ji; Yi-Xin Zhou; Xu Jiang; Zhi-Yuan Cheng; Guang-Zhi Wang; Hui Ding; Ming-Lei Yang

    2015-01-01

    Background:Joint line (JL) is a very important factor for total knee arthroplasty (TKA) to restore.The objective of this study was to evaluate the early clinical and kinematic results of TKAs with posterior-stabilized (PS) or cruciate retaining (CR) implants in which the JL was elevated postoperatively.Methods:Data were collected from patients who underwent TKA in our department between April 2011 and April 2014.The patients were divided into two groups based on the prosthesis they received (PS or CR).At 1-year postoperatively,clinical outcomes were evaluated by the American Knee Society (AKS) knee score,AKS function score,and patella score.In vivo kinematic analysis after TKA was performed on all patients and a previously validated three-dimensional to two-dimensional image registration technique was used to obtain the kinematic data.Anteroposterior (AP) translation of the medial and lateral femoral condyles,and axial rotation relative to the tibial plateau,were analyzed.The data were assessed using the Mann-Whitney test.Results:At time of follow-up,there were differences in the AKS knee scores (P =0.005),AKS function scores (P =0.025),patella scores (P =0.015),and postoperative range of motions (P =0.004) between the PS group and the CR group.In the PS group,the magnitude of AP translation for the medial and lateral condyle was 4.9 ± 3.0 mm and 12.8 ± 3.3 mm,respectively.Axial rotation of the tibial component relative to the femoral component was 12.9 ± 4.5°.In the CR group,the magnitude of AP translation for the medial and lateral condyle was 4.3 ± 3.5 mm and 7.9 ± 4.2 mm,respectively.The axial rotation was 6.7 ± 5.9°.There were statistically different between PS group and CR group in kinematics postoperatively.Conclusion:Our results demonstrate that postoperative JL elevation had more adverse effects on the clinical and kinematic outcomes of CR TKAs than PS TKAs.

  12. Effect of Joint Line Elevation after Posterior-stabilized and Cruciate-retaining Total Knee Arthroplasty on Clinical Function and Kinematics

    Directory of Open Access Journals (Sweden)

    Song-Jie Ji

    2015-01-01

    Full Text Available Background: Joint line (JL is a very important factor for total knee arthroplasty (TKA to restore. The objective of this study was to evaluate the early clinical and kinematic results of TKAs with posterior-stabilized (PS or cruciate retaining (CR implants in which the JL was elevated postoperatively. Methods: Data were collected from patients who underwent TKA in our department between April 2011 and April 2014. The patients were divided into two groups based on the prosthesis they received (PS or CR. At 1-year postoperatively, clinical outcomes were evaluated by the American Knee Society (AKS knee score, AKS function score, and patella score. In vivo kinematic analysis after TKA was performed on all patients and a previously validated three-dimensional to two-dimensional image registration technique was used to obtain the kinematic data. Anteroposterior (AP translation of the medial and lateral femoral condyles, and axial rotation relative to the tibial plateau, were analyzed. The data were assessed using the Mann-Whitney test. Results: At time of follow-up, there were differences in the AKS knee scores (P = 0.005, AKS function scores (P = 0.025, patella scores (P = 0.015, and postoperative range of motions (P = 0.004 between the PS group and the CR group. In the PS group, the magnitude of AP translation for the medial and lateral condyle was 4.9 ± 3.0 mm and 12.8 ± 3.3 mm, respectively. Axial rotation of the tibial component relative to the femoral component was 12.9 ± 4.5°. In the CR group, the magnitude of AP translation for the medial and lateral condyle was 4.3 ± 3.5 mm and 7.9 ± 4.2 mm, respectively. The axial rotation was 6.7 ± 5.9°. There were statistically different between PS group and CR group in kinematics postoperatively. Conclusion: Our results demonstrate that postoperative JL elevation had more adverse effects on the clinical and kinematic outcomes of CR TKAs than PS TKAs.

  13. 尺骨撞击综合征的MRI表现%MRI Findings in Ulnar Impaction Syndrome

    Institute of Scientific and Technical Information of China (English)

    Remaan Younis Mohiuddin; 何如; 汪益; 金志高; 宦坚

    2015-01-01

    目的:回顾性分析39例尺骨撞击综合征患者的MRI表现,以提高对尺骨撞击综合征患者腕部损伤的影像认知,降低患者月骨和/或三角骨坏死的发生。方法采用Gelberman等的平行线法,对39例尺骨撞击综合征患者腕部MRI图像进行测量及分析。结果尺骨阳性变异29例(74.4%),变异范围为2~4.26 mm,尺骨阴性变异8例(20.5%),变异范围为0.75~1.77 mm,尺骨中性变异2例。其中月骨损伤28例,三角骨损伤11例,三角纤维软骨盘损伤38例。MRI显示损伤主要位于月骨尺侧部和三角骨腰部,且除1例之外,其余患者均伴有三角纤维软骨的损伤。结论 MRI可早期发现尺骨撞击综合征月骨、三角骨损伤的改变,并且对于仅有三角纤维软骨盘损伤者,如果伴有临床症状或相应的临床病史,要高度怀疑尺骨撞击综合征,以提高该病的诊断率及降低月骨和/或三角骨坏死的发生率。%ObjectiveA retrospective analysis of MRI findings in 39 cases of ulnar impaction syndrome, to improve the image perception in ulnar impaction syndrome wrist injury, reduce patients with lunate and/or triangular bone necrosis.Methods By using Gelberman parallel line method, MRI ifnding analysis is done in 39 cases of ulnar impaction syndrome patients.Results Of 29 cases of ulnar positive variance (approximately 74.4%), the positive variance is in the range of 2~4.26 mm; Of 8 cases of ulnar negative variance (approximately 20.5%), the negative variance is in the range of 0.75~1.77 mm and 2 cases of ulnar neutral variance. As in 28 cases there were lunate bone injury, 11 cases of triquetrum bone injury, triangular ifbrocartilage complex (TFCC) disc injury in 38 cases. MRI shows chondromalacia of the lunate was presented on the side of ulnar and the triquetrum bone and almost all the patients with damage to the TFCC.Conclusion MRI can suggest early detection of ulnar impaction syndrome, lunate

  14. Patellofemoral Pain Syndrome in Iranian Female Athletes

    Directory of Open Access Journals (Sweden)

    Hamid Reza Baradaran

    2011-03-01

    Full Text Available Patellofemoral pain syndrome (PFPS is the most common overuse syndrome in athletes. It is one of the causes of anterior knee pain in athletic population who come to the sports medicine clinic. Patellofemoral pain is more common among female athletes especially adolescents and young adults. Symptoms include: persistent pain behind the patella or peripatella. Pain increases on ascending and descending stairs and squatting and prolonged sitting. The aim of this study was to evaluate the prevalence of PFPS in Iranian female athletes. 418 female athletes aged 15-35 years were examined in five sports: Soccer (190, volleyball (103, running (42, fencing (45 and rock climbing (38. The athletes who had non- traumatic onset anterior knee pain of at least 3 months that increased in descending and ascending stairs and squatting, had no other causes of anterior knee pain such as ligament instability, bursitis, meniscal injury, tendonitis and arthritis and no history of knee surgery during the one past year were diagnosed as PFPS. 26/190 (13.68 % soccer players, 21/103(20.38 % volleyball players, 7/42 (16.66 % runners, 6/45(13.33 % fencers and 10/38 (26.31% rock climbers had patellofemoral pain. Among the 418 female athletes who were evaluated 70 had PFPS. Rock climbers were the most common athletes with PFPS followed by volleyball players and runners.

  15. Revision Surgery in Permanent Patellar Dislocation in DiGeorge Syndrome

    Directory of Open Access Journals (Sweden)

    Massimo Berruto

    2015-01-01

    Full Text Available A 29-year-old patient, suffering from DiGeorge syndrome, came to our attention with a history of persistent pain and patellar instability in the left knee after failure of arthroscopic lateral release and Elmslie-Trillat procedure. The patient was unable to walk without crutches and severely limited in daily living activities. Because of arthritic changes of the patellofemoral joint and the failure of previous surgeries it was decided to perform only an open lateral release and medial patellofemoral ligament (MPFL reconstruction using a biosynthetic ligament in order to obtain patellofemoral stability. At one year post-op range of motion (ROM was 0–120 with a firm end point at medial patellar mobilization; patella was stable throughout the entire ROM. All the scores improved and she could be able to perform daily activity without sensation of instability. Bilateral patellar subluxation and systemic hyperlaxity are characteristics of syndromic patients and according to literature can be also present in DiGeorge syndrome. MPFL reconstruction with lateral release was demonstrated to be the correct solution in the treatment of patellar instability in this complex case. The choice of an artificial ligament to reconstruct the MPFL was useful in this specific patient with important tissue laxity due to her congenital syndrome.

  16. Usefulness of the skyline view in the assessment of acute knee trauma in children

    International Nuclear Information System (INIS)

    We report a retrospective analysis of all cases of acute knee injuries in children presenting to the Winnipeg Children's Hospital, University of Manitoba, between Jan. 1, 1994, and Jan. 1, 1995. The mechanism of injury was recorded and all 3 radiographic views (i.e., anterioposterior, lateral and skyline) were available for 171 of 256 total cases. We found a significant association between mechanism of injury and visualization of damage on skyline view radiographs (p < 0.01). The skyline view showed damage in only 1 of the 158 cases involving direct or indirect injury not involving subluxation or dislocation. However, damage was visualized on skyline view radiographs in 7 (54%) of the 13 cases that included a history of subluxation or dislocation. We conclude that in acute knee trauma in children, a skyline view radiograph of the patella should be obtained only when the mechanism of injury includes subluxation or dislocation. When the mechanism does not suggest subluxation or dislocation, the skyline view is unlikely to reveal damage; it adds unnecessary radiation, cost and possible added discomfort for the child. (author)

  17. The computed tomographic evaluation of patellofemoral joint in patellar fractures treated with open reduction and internal fixation

    Energy Technology Data Exchange (ETDEWEB)

    Benli, I.T.; Akalin, S.; Mumcu, E.F.; Citak, M.; Kilic, M.; Pasaoglu, E. (Ankara Social Security Hospital (Turkey))

    1992-08-01

    In this study, we examined 97 patella fractures in which open reduction and internal fixation had been performed at the 1st Orthopaedics and Trauma Clinic of Social Security Ankara Hospital between January 1983 and December 1988. After 24 to 96 months, on an average of 48.4 months follow-up period, the cases were evaluated clinically for knee function complaints and by CT and roentgenography for patellofemoral articulation. In 11 of the patients (11.5%) there was patellar displacement, 2 of the patients had patellar tilt (2.1%) and in 14 patients (14.5%) there was malalignment in which 1 patient (1.1%) had both patellar tilt and displacement. This data was obtained by measuring femoral trochlear angle (FTA) and patellar tilt angle (PTA) by CT at various degrees of knee flexion. Thirty three patients (34%) had slight and 19 patients (19.6%) had severe degenerative changes in the patellofemoral articulation. It is found that there is close relation between the variability of the pain complaints of the patients and the type of the fracture and the time of management and the postoperative rehabilitation. (author).

  18. MR imaging of plica synovialis mediopatellaris. Efficacy of intraarticular MR arthrography with saline administration

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Yuko; Yamamoto, Kanae [Nippon Medical School, Tokyo (Japan). Tama-Nagayama Hospital; Tajima, Natsuki; Kumazaki, Tatsuo

    1997-10-01

    In order to determine the efficacy of MR imaging with intraarticular administration of saline (saline-MR arthrography) for detecting and diagnosing plica synovialis mediopatellaris (PSM), saline-MR arthrography was performed on 12 knees of 10 patients with arthroscopically proven PSM. Conventional MRI was also performed on 8 knees of 6 patients. On T{sub 2}-weighted images, evidence of PSM was detected in 10 knees using saline-MR arthrography as a low signal intensity band between the patella and the medial femoral condyle, whereas evidence of PSM was detected in only 2 knees using conventional MRI. Comparing arthroscopic findings with MRI findings, saline-MR arthrographic findings concurred with arthroscopic findings in 9 of 12 knees with PSM, whereas conventional MRI findings concurred with arthroscopic findings in only 2 of the 12 knees with PSM. In conclusion, our findings suggest that saline-MR arthrography is more useful than conventional MRI for detection of PSM, and shows better correlation with arthroscopic findings. (author)

  19. Differential concentration of Technetium-99 (99Tc) in common intertidal molluscs with different food habits.

    Science.gov (United States)

    Sjøtun, K; Heldal, H E; Brakstad, D S

    2011-11-01

    Concentration of 99Tc has been measured in fucoids and molluscs, sampled in a sheltered intertidal at the southwest coast of Norway from February to November 2006. The concentrations of 99Tc in molluscs differed significantly between species. The filtering bivalve Mytilus edulis had the lowest concentrations with averages of 2.3-5.9 Bq kg(-1) d.w., while the herbivorous gastropods Littorinalittorina, Littorina obtusata and Patella vulgata had higher concentrations. P. vulgata and L. obtusata had the highest concentrations, 40-47 and 26-30 Bq kg(-1)d.w., respectively. L. obtusata has a specialized habit of living, and prefers to feed on fucoids. P. vulgata can graze extensively on the fucoid Ascophyllum nodosum when available. Fucoids are known to have very high uptake of 99Tc, and this was also found in the present study. The high 99Tc-concentrations of L. obtusata and P. vulgata are most likely due to their habit of feeding on fucoids. PMID:21925686

  20. High elastic modulus nanoparticles: a novel tool for subfailure connective tissue matrix damage.

    Science.gov (United States)

    Empson, Yvonne M; Ekwueme, Emmanuel C; Hong, Jung K; Paynter, Danielle M; Kwansa, Albert L; Brown, Chalmers; Pekkanen, Allison M; Roman, Maren; Rylander, Nichole M; Brolinson, Gunnar P; Freeman, Joseph W

    2014-09-01

    Subfailure matrix injuries such as sprains and strains account for a considerable portion of ligament and tendon pathologies. In addition to the lack of a robust biological healing response, these types of injuries are often characterized by seriously diminished matrix biomechanics. Recent work has shown nanosized particles, such as nanocarbons and nanocellulose, to be effective in modulating cell and biological matrix responses for biomedical applications. In this article, we investigate the feasibility and effect of using high stiffness nanostructures of varying size and shape as nanofillers to mechanically reinforce damaged soft tissue matrices. To this end, nanoparticles (NPs) were characterized using atomic force microscopy and dynamic light scattering techniques. Next, we used a uniaxial tensile injury model to test connective tissue (porcine skin and tendon) biomechanical response to NP injections. After injection into damaged skin and tendon specimens, the NPs, more notably nanocarbons in skin, led to an increase in elastic moduli and yield strength. Furthermore, rat primary patella tendon fibroblast cell activity evaluated using the metabolic water soluble tetrazolium salt assay showed no cytotoxicity of the NPs studied, instead after 21 days nanocellulose-treated tenocytes exhibited significantly higher cell activity when compared with nontreated control tenocytes. Dispersion of nanocarbons injected by solution into tendon tissue was investigated through histologic studies, revealing effective dispersion and infiltration in the treated region. Such results suggest that these high modulus NPs could be used as a tool for damaged connective tissue repair.

  1. Glucosamine sulfate effect on the degenerated patellar cartilage: preliminary findings by pharmacokinetic magnetic resonance modeling

    Energy Technology Data Exchange (ETDEWEB)

    Marti-Bonmati, Luis [Dr Peset University Hospital, Radiology Department, Valencia (Spain); Hospital Quiron Valencia, Radiology Department, Valencia (Spain); Sanz-Requena, Roberto; Alberich-Bayarri, Angel [Hospital Quiron Valencia, Radiology Department, Valencia (Spain); Rodrigo, Jose Luis [Dr Peset University Hospital, Traumatology and Orthopedics Surgery Department, Valencia (Spain); Carot, Jose Miguel [Universidad Politecnica de Valencia, EIO Department, Valencia (Spain)

    2009-06-15

    Normal and degenerated cartilages have different magnetic resonance (MR) capillary permeability (K{sup trans}) and interstitial interchangeable volume (v{sub e}). Our hypothesis was that glucosamine sulfate treatment modifies these neovascularity abnormalities in osteoarthritis. Sixteen patients with patella degeneration, randomly distributed into glucosamine or control groups, underwent two 1.5-Tesla dynamic contrast-enhanced MR imaging studies (treatment initiation and after 6 months). The pain visual analog scale (VAS) and American Knee Society (AKS) score were used. A two-compartment pharmacokinetic model was used. Percentages of variations (postreatment-pretreatment/pretreatment) were compared (t-test for independent data). In the glucosamine group, pain and functional outcomes statistically improved (VAS: 7.3 {+-} 1.1 to 3.6 {+-} 1.3, p < 0.001; AKS: 18.6 {+-} 6.9 to 42.9 {+-} 2.7, p < 0.01). Glucosamine significantly increased K{sup trans} at 6 months (-54.4 {+-} 21.2% vs 126.7 {+-} 56.9%, p < 0.001, control vs glucosamine). In conclusion, glucosamine sulfate decreases pain while improving functional outcome in patients with cartilage degeneration. Glucosamine sulfate increases K{sup trans}, allowing its proposal as a surrogate imaging biomarker after 6 months of treatment. (orig.)

  2. The femoral sulcus in total knee arthroplasty.

    Science.gov (United States)

    Lingaraj, Krishna; Bartlett, John

    2009-05-01

    The position of the femoral sulcus relative to the midline of the distal femoral resection in total knee arthroplasty (TKA) was studied to determine if centralized placement of the femoral component on the distal femur was justified in terms of aligning the prosthetic sulcus with the native femoral sulcus. The location of the femoral sulcus was studied in 112 consecutive patients undergoing TKA. The mean sulcus position was 0.7 mm lateral to the midline of the distal femoral resection (SD 1.4, 95% CI, 0.5-1.0 mm). However, the variation in sulcus positions ranged from 4 mm medial to 4 mm lateral to the midline. The mean sulcus position in valgus knees was 1.0 mm lateral to the midline (SD 1.8), and that in varus knees was 0.7 mm lateral to the midline (SD 1.2) (P = 0.501). It appears prudent to centre the femoral component on the native sulcus rather than the midline of the distal femoral resection, so as to ensure accurate alignment of the prosthetic sulcus with the native sulcus and to encourage normal patella tracking.

  3. Limpets counteract ocean acidification induced shell corrosion by thickening of aragonitic shell layers

    Directory of Open Access Journals (Sweden)

    G. Langer

    2014-08-01

    Full Text Available Specimens of the patellogastropod limpet Patella caerulea were collected within (pHlow-shells and outside (pHn-shells a CO2 vent site at Ischia, Italy. Four pHlow-shells and four pHn-shells were sectioned transversally and scanned for polymorph distribution by means of confocal Raman microscopy. The pHlow-shells displayed a twofold increase in aragonite area fraction and size normalised aragonite area. Size normalised calcite area was halved in pHlow-shells. Taken together with the increased apical and the decreased flank size normalised thickness of the pHlow-shells, these data led us to conclude that low pH exposed P. caerulea specimens counteract shell dissolution by enhanced shell production. The latter is different from normal elongation growth and proceeds through addition of aragonitic layers only, while the production of calcitic layers is confined to elongation growth. Therefore aragonite cannot be regarded as a per se disadvantageous polymorph under ocean acidification conditions.

  4. Limpets counteract ocean acidification induced shell corrosion by thickening of aragonitic shell layers

    Science.gov (United States)

    Langer, G.; Nehrke, G.; Baggini, C.; Rodolfo-Metalpa, R.; Hall-Spencer, J. M.; Bijma, J.

    2014-12-01

    Specimens of the patellogastropod limpet Patella caerulea were collected within (pHlow-shells) and outside (pHn-shells) a CO2 vent site at Ischia, Italy. Four pHlow-shells and four pHn-shells were sectioned transversally and scanned for polymorph distribution by means of confocal Raman microscopy. The pHlow-shells displayed a twofold increase in aragonite area fraction and size-normalised aragonite area. Size-normalised calcite area was halved in pHlow-shells. Taken together with the increased apical and the decreased flank size-normalised thickness of the pHlow-shells, these data led us to conclude that low-pH-exposed P. caerulea specimens counteract shell dissolution by enhanced shell production. This is different from normal elongation growth and proceeds through addition of aragonitic parts only, while the production of calcitic parts is confined to elongation growth. Therefore, aragonite cannot be regarded as a disadvantageous polymorph per se under ocean acidification conditions.

  5. Effects of open and closed kinetic chains of sling exercise therapy on the muscle activity of the vastus medialis oblique and vastus lateralis.

    Science.gov (United States)

    Chang, Wen-Dien; Huang, Wei-Syuan; Lee, Chia-Lun; Lin, Hung-Yu; Lai, Ping-Tung

    2014-09-01

    [Purpose] The muscle strength of the quadriceps muscle is critical in patellofemoral pain syndrome. The quadriceps muscle supplies the power for dynamic patellar movement, and the vastus medialis oblique (VMO) and vastus lateralis (VL) enable the patella to stabilize during tracking. We followed the theories about open and closed kinetic chain exercises to design two exercises, sling open chain knee extension (SOCKE) exercise and sling closed chain knee extension (SCCKE) exercise. The purpose of our study was to research the changes in quadriceps muscle activity during both exercises. [Methods] Electromyographic analysis was used to explore the different effects of the two exercises. The MVC% was calculated for the VMO and VL during exercise for analysis. [Results] We found that the mean MVC% values of the VMO and VL during the SOCKE exercise were higher than those during the SCCKE exercise. The ratio of the VMO to VL was 1.0 ± 0.19 during the SOCKE exercise and 1.11 ± 0.15 during the SCCKE exercise. [Conclusions] The SOCKE exercise is targeted at quadriceps muscle training and has a recruitment effect on the VMO. The beneficial effect of the SOCKE exercise is better than that of the SCCKE exercise. PMID:25276016

  6. Nuclear medicine solutions in winter sports problems

    International Nuclear Information System (INIS)

    Full text: The diagnostic workup of acute Winter Sports injuries is done by Conventional X Ray, CT and MRI. Chronic injuries as stress reactions are best investigated by Nuclear Medicine procedures: Snow Boarding: In Snow-Boarding chronic injuries are mostly seen as local increased uptake laterally in the lower third of the Fibula of the front leg together with Tibial increase medially in the other leg. Skiing: Chronic Skiing injuries are less asymmetrical and mostly seen on the apex of the patella. Chronic Feet Problems: A different chronic problem is the reduced blood perfusion in the feet if hard, tightened boots are used for longer time by professional ski instructors and racers. Flow difference between the foot in the boot and the other without boot are dramatic as measured by Nuclear Medicine Procedures and MRI. Pulmonary Embolism: Acute pulmonary embolism caused by thrombi originating at the site of constant pressure on the back rim of ski boots is not uncommon in older skiers (seek and you will find), but never seen in the younger group of Snow-Boarders. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  7. Identification of a New Hesperornithiform from the Cretaceous Niobrara Chalk and Implications for Ecologic Diversity among Early Diving Birds.

    Directory of Open Access Journals (Sweden)

    Alyssa Bell

    Full Text Available The Smoky Hill Member of the Niobrara Chalk in Kansas (USA has yielded the remains of numerous members of the Hesperornithiformes, toothed diving birds from the late Early to Late Cretaceous. This study presents a new taxon of hesperornithiform from the Smoky Hill Member, Fumicollis hoffmani, the holotype of which is among the more complete hesperornithiform skeletons. Fumicollis has a unique combination of primitive (e.g. proximal and distal ends of femur not expanded, elongate pre-acetabular ilium, small and pyramidal patella and derived (e.g. dorsal ridge on metatarsal IV, plantarly-projected curve in the distal shaft of phalanx III:1 hesperornithiform characters, suggesting it was more specialized than small hesperornithiforms like Baptornis advenus but not as highly derived as the larger Hesperornis regalis. The identification of Fumicollis highlights once again the significant diversity of hesperornithiforms that existed in the Late Cretaceous Western Interior Seaway. This diversity points to the existence of a complex ecosystem, perhaps with a high degree of niche partitioning, as indicated by the varying degrees of diving specializations among these birds.

  8. Climate-related environmental stress in intertidal grazers: scaling-up biochemical responses to assemblage-level processes

    Science.gov (United States)

    Cappiello, Mario; Del Corso, Antonella; Lenzarini, Francesca; Peroni, Eleonora; Benedetti-Cecchi, Lisandro

    2016-01-01

    Background Organisms are facing increasing levels of environmental stress under climate change that may severely affect the functioning of biological systems at different levels of organization. Growing evidence suggests that reduction in body size is a universal response of organisms to global warming. However, a clear understanding of whether extreme climate events will impose selection directly on phenotypic plastic responses and how these responses affect ecological interactions has remained elusive. Methods We experimentally investigated the effects of extreme desiccation events on antioxidant defense mechanisms of a rocky intertidal gastropod (Patella ulyssiponensis), and evaluated how these effects scaled-up at the population and assemblage levels. Results With increasing levels of desiccation stress, limpets showed significant lower levels of total glutathione, tended to grow less and had reduced per capita interaction strength on their resources. Discussion Results suggested that phenotypic plasticity (i.e., reduction in adults’ body size) allowed buffering biochemical responses to stress to scale-up at the assemblage level. Unveiling the linkages among different levels of biological organization is key to develop indicators that can anticipate large-scale ecological impacts of climate change. PMID:27781156

  9. Greater trochanter apophysitis in the adolescent athlete.

    Science.gov (United States)

    Young, Simon W; Safran, Marc R

    2015-05-01

    Lower limb traction apophysitis is common in young athletes, occurring at sites such as the tibial tubercle (Osgood-Schlatter disease) and distal patella (Sinding-Larsen-Johansson disease). Around the hip, iliac apophysitis is well recognized, but no cases of greater trochanter apophysitis have previously been reported. We describe the case of a 15-year-old male basketball player with a 2-month history of the right hip pain and significant functional limitation. X-rays revealed widening of the greater trochanter apophysis with subchondral sclerosis, consistent with a diagnosis of traction apophysitis. The patient was treated with a period of relative rest and anti-inflammatory medication. He gradually returned to full athletic activity, including basketball, without recurrence of pain or limitation. We describe the first reported case of traction apophysitis of the greater trochanter. The unique muscular anatomy of this apophysis with balanced forces explains the rarity of this condition. If encountered, rest and activity modification is the recommended treatment.

  10. Increasing lateral tibial slope: is there an association with articular cartilage changes in the knee?

    Energy Technology Data Exchange (ETDEWEB)

    Khan, Nasir; Shepel, Michael; Leswick, David A.; Obaid, Haron [University of Saskatchewan, Department of Medical Imaging, Royal University Hospital, and College of Medicine, Saskatoon, Saskatchewan (Canada)

    2014-04-15

    The geometry of the lateral tibial slope (LTS) plays an important role in the overall biomechanics of the knee. Through this study, we aim to assess the impact of LTS on cartilage degeneration in the knee. A retrospective analysis of 93 knee MRI scans (1.5 T or 3 T) for patients aged 20-45 years with no history of trauma or knee surgery, and absence of internal derangement. The LTS was calculated using the circle method. Chondropathy was graded from 0 (normal) to 3 (severe). Linear regression analysis was used for statistical analysis (p < 0.05). In our cohort of patients, a statistically significant association was seen between increasing LTS and worsening cartilage degenerative changes in the medial patellar articular surface and the lateral tibial articular surface (p < 0.05). There was no statistically significant association between increasing LTS and worsening chondropathy of the lateral patellar, medial trochlea, lateral trochlea, medial femoral, lateral femoral, and medial tibial articular surfaces. Our results show a statistically significant association between increasing LTS and worsening cartilage degenerative changes in the medial patella and the lateral tibial plateau. We speculate that increased LTS may result in increased femoral glide over the lateral tibial plateau with subsequent increased external rotation of the femur predisposing to patellofemoral articular changes. Future arthroscopic studies are needed to further confirm our findings. (orig.)

  11. Iliotibial band syndrome: a common source of knee pain.

    Science.gov (United States)

    Khaund, Razib; Flynn, Sharon H

    2005-04-15

    Iliotibial band syndrome is a common knee injury. The most common symptom is lateral knee pain caused by inflammation of the distal portion of the iliotibial band. The iliotibial band is a thick band of fascia that crosses the hip joint and extends distally to insert on the patella, tibia, and biceps femoris tendon. In some athletes, repetitive flexion and extension of the knee causes the distal iliotibial band to become irritated and inflamed resulting in diffuse lateral knee pain. Iliotibial band syndrome can cause significant morbidity and lead to cessation of exercise. Although iliotibial band syndrome is easily diagnosed clinically, it can be extremely challenging to treat. Treatment requires active patient participation and compliance with activity modification. Most patients respond to conservative treatment involving stretching of the iliotibial band, strengthening of the gluteus medius, and altering training regimens. Corticosteroid injections should be considered if visible swelling or pain with ambulation persists for more than three days after initiating treatment. A small percentage of patients are refractory to conservative treatment and may require surgical release of the iliotibial band.

  12. Porous tantalum in reconstructive surgery of the knee: a review.

    Science.gov (United States)

    Levine, Brett; Sporer, Scott; Della Valle, Craig J; Jacobs, Joshua J; Paprosky, Wayne

    2007-07-01

    Porous tantalum represents an alternative metal for primary and revision total knee arthroplasty (TKA) with several unique properties. Tantalum is a transition metal, which in its bulk form has shown excellent biocompatibility and is safe to use in vivo as evidenced by its current application in pacemaker electrodes, cranioplasty plates, and as radiopaque markers. Current designs for orthopedic implants maintain a high volumetric porosity (70%-80%), low modulus of elasticity (3 MPa), and high frictional characteristics, making this metal conducive to biologic fixation. The low modulus of elasticity of such components allows for more physiologic load transfer and relative preservation of bone stock. Its more bioactive nature and ingrowth properties have led to its use in primary as well as revision knee components with good early clinical results reported. In revision arthroplasty, it has been used as a structural bone graft substitute. Formation of a bone-like apatite coating in vivo affords strong fibrous ingrowth properties and allows for substantial soft-tissue attachment with the potential for use in cases such as mega-prostheses and patella salvage. Although porous tantalum is in its early stages of evolution, the initial clinical data and basic science studies support its use as an alternative to traditional orthopedic implant materials. PMID:17665779

  13. Elevated corticospinal excitability in patellar tendinopathy compared with other anterior knee pain or no pain.

    Science.gov (United States)

    Rio, E; Kidgell, D; Moseley, G L; Cook, J

    2016-09-01

    Anterior knee pain (AKP) is a frequent clinical presentation in jumping athletes and may be aggravated by sustained sitting, stair use, and loading of the quadriceps. Corticospinal activation of the quadriceps in athletes with AKP has not yet been investigated, but is important in guiding efficacious treatment. This cross-sectional study assessed corticospinal excitability (CSE) of the quadriceps in jumping athletes using transcranial magnetic stimulation (TMS). Groups consisted of Control (no knee pain); patellar tendinopathy (PT) [localized inferior pole pain on single-leg decline squat (SLDS)]; and other AKP (nonlocalized pain around the patella). SLDS (numerical score of pain 0-10), Victorian Institute of Sport Assessment Patellar tendon (VISA-P), maximal voluntary isometric contraction (MVIC), active motor threshold (AMT), CSE, and Mmax were tested. Twenty nine athletes participated; control n = 8, PT n = 11, AKP n = 10. There were no group differences in age (P = 0.23), body mass index (P = 0.16), MVIC (P = 0.38) or weekly activity (P = 0.22). PT had elevated CSE compared with controls and other AKP (P < 0.001), but no differences were detected between AKP and controls (P = 0.47). CSE appears to be greater in PT than controls and other AKP. An improved understanding of the corticospinal responses in different sources of knee pain may direct better treatment approaches. PMID:26369282

  14. Topographic deformation patterns of knee cartilage after exercises with high knee flexion: an in vivo 3D MRI study using voxel-based analysis at 3T

    International Nuclear Information System (INIS)

    To implement a novel voxel-based technique to identify statistically significant local cartilage deformation and analyze in-vivo topographic knee cartilage deformation patterns using a voxel-based thickness map approach for high-flexion postures. Sagittal 3T 3D-T1w-FLASH-WE-sequences of 10 healthy knees were acquired before and immediately after loading (kneeling/squatting/heel sitting/knee bends). After cartilage segmentation, 3D-reconstruction and 3D-registration, colour-coded deformation maps were generated by voxel-based subtraction of loaded from unloaded datasets to visualize cartilage thickness changes in all knee compartments. Compression areas were found bifocal at the peripheral medial/caudolateral patella, both posterior femoral condyles and both anterior/central tibiae. Local cartilage thickening were found adjacent to the compression areas. Significant local strain ranged from +13 to -15 %. Changes were most pronounced after squatting, least after knee bends. Shape and location of deformation areas varied slightly with the loading paradigm, but followed a similar pattern consistent between different individuals. Voxel-based deformation maps identify individual in-vivo load-specific and posture-associated strain distribution in the articular cartilage. The data facilitate understanding individual knee loading properties and contribute to improve biomechanical 3 models. They lay a base to investigate the relationship between cartilage degeneration patterns in common osteoarthritis and areas at risk of cartilage wear due to mechanical loading in work-related activities. (orig.)

  15. Increasing lateral tibial slope: is there an association with articular cartilage changes in the knee?

    International Nuclear Information System (INIS)

    The geometry of the lateral tibial slope (LTS) plays an important role in the overall biomechanics of the knee. Through this study, we aim to assess the impact of LTS on cartilage degeneration in the knee. A retrospective analysis of 93 knee MRI scans (1.5 T or 3 T) for patients aged 20-45 years with no history of trauma or knee surgery, and absence of internal derangement. The LTS was calculated using the circle method. Chondropathy was graded from 0 (normal) to 3 (severe). Linear regression analysis was used for statistical analysis (p < 0.05). In our cohort of patients, a statistically significant association was seen between increasing LTS and worsening cartilage degenerative changes in the medial patellar articular surface and the lateral tibial articular surface (p < 0.05). There was no statistically significant association between increasing LTS and worsening chondropathy of the lateral patellar, medial trochlea, lateral trochlea, medial femoral, lateral femoral, and medial tibial articular surfaces. Our results show a statistically significant association between increasing LTS and worsening cartilage degenerative changes in the medial patella and the lateral tibial plateau. We speculate that increased LTS may result in increased femoral glide over the lateral tibial plateau with subsequent increased external rotation of the femur predisposing to patellofemoral articular changes. Future arthroscopic studies are needed to further confirm our findings. (orig.)

  16. Integrated assessment of oil pollution using biological monitoring and chemical fingerprinting.

    Science.gov (United States)

    Lewis, Ceri; Guitart, Carlos; Pook, Chris; Scarlett, Alan; Readman, James W; Galloway, Tamara S

    2010-06-01

    A full assessment of the impact of oil and chemical spills at sea requires the identification of both the polluting chemicals and the biological effects they cause. Here, a combination of chemical fingerprinting of surface oils, tissue residue analysis, and biological effects measures was used to explore the relationship between spilled oil and biological impact following the grounding of the MSC Napoli container ship in Lyme Bay, England in January 2007. Initially, oil contamination remained restricted to a surface slick in the vicinity of the wreck, and there was no chemical evidence to link biological impairment of animals (the common limpet, Patella vulgata) on the shore adjacent to the oil spill. Secondary oil contamination associated with salvage activities in July 2007 was also assessed. Chemical analyses of aliphatic hydrocarbons and terpanes in shell swabs taken from limpet shells provided an unequivocal match with the fuel oil carried by the ship. Corresponding chemical analysis of limpet tissues revealed increased concentrations of polycyclic aromatic hydrocarbons (PAHs) dominated by phenanthrene and C1 to C3 phenanthrenes with smaller contributions from heavier molecular weight PAHs. Concurrent ecotoxicological tests indicated impairment of cellular viability (p oiled animals. These results illustrate the value of combining biological monitoring with chemical fingerprinting for the rapid identification of spilled oils and their sublethal impacts on biota in situ.

  17. The MRI appearance of cystic lesions around the knee

    Energy Technology Data Exchange (ETDEWEB)

    McCarthy, Catherine L.; McNally, Eugene G. [Department of Radiology, Nuffield Orthopaedic Centre, Windmill Road, OX3 7LD, Headington, Oxford (United Kingdom)

    2004-04-01

    This review presents a comprehensive illustrated overview of the wide variety of cystic lesions around the knee. The aetiology, clinical presentation, MRI appearances and differential diagnosis are discussed. Bursae include those related to the patella as well as pes anserine, tibial collateral ligament, semimembranosus-tibial collateral ligament, iliotibial and fibular collateral ligament-biceps femoris. The anatomical extension, imaging features and clinical significance of meniscal cysts are illustrated. Review of ganglia includes intra-articular, extra-articular, intraosseous and periosteal ganglia, highlighting imaging findings and differential diagnoses. The relationship between proximal tibiofibular joint cysts and intraneural peroneal nerve ganglia is discussed. Intraosseous cystic lesions, including insertional and degenerative cysts, as well as lesions mimicking cysts of the knee are described and illustrated. Knowledge of the location, characteristic appearance and distinguishing features of cystic masses around the knee as well as potential imaging pitfalls such as normal anatomical recesses and atypical cyst contents on MR imaging aids in allowing a specific diagnosis to be made. This will prevent unnecessary additional investigations and determine whether intra-articular surgery or conservative management is appropriate. (orig.)

  18. Study on characteristics of fractures from road traffic accidents in 306 cases

    Institute of Scientific and Technical Information of China (English)

    侯树勋; 章亚东; 吴闻文

    2002-01-01

    Objective: To investigate the characteristics of bone fractures from road traffic accidents and analyze their injury mechanisms so as to provide reference for the research and medical care of traffic trauma.   Methods: Three hundred and six patients with fractures from road traffic accidents were included into this study. A total of 507 fractures were identified and the injury mechanism, location distribution and frequency were analyzed.   Results: The most common location of fractures was the lower extremities, followed by the upper extremities, skull and maxillofacial region, and the rarest was the spine. A total of 56% of the patients suffered from multiple fractures. The fractures of the patella, femur and pelvis and the fractures of the olecranon, humerus and shoulder often happened simultaneously.   Conclusions: The injury mechanisms can be classified into four types: impact, incoordinate movement, stretch injury and crush and extrusion. The fractures from traffic accidents have the following characteristics: centrifugal distribution of the injuries, multiple fractures, force transmission and ipsilateral occurrence.

  19. Die Makrofauna und ihre Verteilung im Nordost-Felswatt von Helgoland

    Science.gov (United States)

    Janke, Klaus

    1986-03-01

    The macrofauna and its distribution in the sheltered, rocky intertidal zone of Helgoland (North Sea) was studied at 9 vertically and/or morphologically different stations from March to September in 1984. Seasonal variations in the communities were described based on each species' “conspicuousness”. A total of 172 species was found. The macrofauna shows a zoned pattern, but also the different substrata, for example, affect its distribution. The number of species increases from the upper intertidal to the upper sublittoral zone from 23 to 133 species. The upper intertidal is characterized by Littorina saxatilis, Chaetogrammarus marinus and Hyale nilssonii. Typical and abundant species of the middle and lower intertidal are Flustrellidra hispida, Littorina mariae/obtusata, Littorina littorea, Mytilus edulis and Spirorbis spirorbis. The upper sublittoral zone is characterized by Gibbula cineraria and increasing species numbers of Bryozoa, Nemertini and Opisthobranchia. Only few species (e.g. Dynamena pumila, Laomedea flexuosa, Polydora ciliata, Fabricia sabella, Jaera albifrons, Carcinus maenas) occur in the entire intertidal zone. In comparison to other very sheltered shores in Great Britain, which are also dominated by Fucaceae, the macrofauna in the Helgoland intertidal zone lacks several littoral species, such as Patella spp., Monodonta lineata, Gibbula umbilicalis, Littorina neritoides, Chthamalus spp., whereas Littorina littorea and Gibbula cineraria are highly abundant.

  20. A Peculiar New Pampatheriidae (Mammalia: Xenarthra: Cingulata) from the Pleistocene of Argentina and Comments on Pampatheriidae Diversity

    Science.gov (United States)

    Scillato-Yané, Gustavo Juan; Soibelzon, Esteban

    2015-01-01

    Pampatheriidae are a group of cingulates native to South American that are known from the middle Miocene to the lower Holocene. Two genera have been recognized between the lower Pleistocene and the lower Holocene: Pampatherium Gervais and Ameghino (Ensenadan, Bonaerian and Lujanian, lower Pleistocene–lower Holocene) and Holmesina Simpson (Blancan, Irvingtonian, upper Pliocene–lower Holocene). They have been mainly differentiated by their osteoderm morphology and cranio-dental characters. These taxa had a wide latitudinal distribution, extending from the southern part of South America (Península Valdés, Argentina) to North America (Florida, USA). In this contribution, we describe a new genus and species of Pampatheriidae for the lower and middle Pleistocene of Buenos Aires Province and for the upper Pleistocene of Santa Fe Province (Argentina).The new taxon is represented by disarticulated osteoderms, one skull element, two thoracic vertebrae and a right femur and patella. It has extremely complex osteoderm ornamentations and particular morphological characters of the cranial element and femur that are not found in any other species of the family. This new taxon, recorded in the lower–middle Pleistocene (Ensenadan Stage/Age) and in the upper Pleistocene–early Holocene (Lujanian Stage/Age), is incorporated to the Pleistocene mammal assemblage of South America. Finally, the Pampatheriidae diversity is greater during the Lujanian Stage/Age than the Ensenadan Stage/Age. PMID:26083486