WorldWideScience

Sample records for chondromalacia patellae

  1. Diagnosis of chondromalacia patellae using CT arthrography

    Energy Technology Data Exchange (ETDEWEB)

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

    1982-08-01

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

  2. The MRI study of correlation between patella location and chondromalacia

    International Nuclear Information System (INIS)

    Objective: To discuss the relationship between patella location and chondromalacia patella, explore its mechanism and clinical significance. Methods: Knee joint MRI was performed in 1052 patients (506 men and 546 female). Among them, there were 299 patients (100 men and 199 female) with chondromalacia patella. They were divide into the group of 1-19, the group of 20-39, the group of 40-59 years old and the group of older than 60 years to compute the positive rate respectively. Insall-Salvati method was used to measure the length of chondromalacia ligaments (L) and the length of chondromalacia path (P). The relationship between patella location and chondromalacia was tested by using t test and χ2 test. Results: The total positive rate of chondromalacia patella was 28.4% (299/1052). In female it was 36.4% (199/546) and in men was 19.8% (100/506). The group of 1-19 years old had 16 patients (16.8%, 16/95). The group of 20-39 years old had 71 patients (17.9%, 71/396). The group of 40- 59 years old had 116 patients (33.2%, 116/349). The group of older than 60 years had 96 patients (45.3%, 96/212). The positive rate of chondromalacia patella increased with age. The L/P value of normal group and chondromalacia patella group were 1.15±0.15 and 1.24±0.17 respectively. The L/P value of normal group of men and women were 1.13±0.15 and 1.17±0.14 respectively. The L/P value of chondromalacia patella group of men and women were 1.20±0.17 and 1.26±0.16 respectively. The Insall- Salvati index of age groups showed significant differences. The L/P value of pathological changes group and normal group of 1-19 years old were 1.38±0.25 and 1.24±0.16 respectively. The L/P value of pathological changes group and normal group of 20-39 years old were 1.24±0.17 and 1.15±0.16 respectively. The L/P value of pathological changes group and normal group of 40-59 years old were 1.24±0.16 and 1.12±0.12 respectively. The L/P value of pathological changes group and normal group of older

  3. 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)

  4. 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.

  5. Value of computed tomography scanning in chondromalacia patellae

    Energy Technology Data Exchange (ETDEWEB)

    Boven, F.; Bellemans, M.A.; Geurts, J.; de Boeck, H.; Potvliege, R.

    1982-06-01

    Sixtyseven patients with pain in the knee were studied. A computed tomography (CT) score indicating chondromalacia was devised, based on the results of CT after arthrography. This score takes account of the regularity, the congruity, and the imbibition of contrast material. Thus the patients could be divided into four groups: those who definitely have chondromalacia (++), probably (+), probably not (+-), and definitely not (-). These results were compared with the clinical diagnosis based on clinical signs, arthroscopy, or operation. Eighteen patients had clinically proved chondromalacia, CT scored 14++, 3+ and 1+-. Twentynine patients had no chondromalacia, CT scored 19-, 8+-, and 2+. Twenty patients had an uncertain clinical diagnosis. Arthrography was less accurate in detecting chondromalacia.

  6. 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.

  7. Chondromalacia patellae: an in vitro study. Comparison of MR criteria with histologic and macroscopic findings

    Energy Technology Data Exchange (ETDEWEB)

    Leersum, M. van [Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Schweitzer, M.E. [Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Gannon, F. [Department of Pathology, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Finkel, G. [Department of Pathology, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Vinitski, S. [Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Mitchell, D.G. [Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA (United States)

    1996-11-01

    Objective. To develop MR criteria for grades of chondromalacia patellae and to assess the accuracy of these grades. Design. Fat-suppressed T2-weighted double-echo, fat-suppressed T2-weighted fast spin echo, fat-suppressed T1-weighted, and gradient echo sequences were performed at 1.5 T for the evaluation of chondromalacia. A total of 1000 MR, 200 histologic, and 200 surface locations were graded for chondromalacia and statistically compared. Results. Compared with gross inspection as well as with histology the most accurate sequences were fat-suppressed T2-weighted conventional spin echo and fat suppressed T2-weighted fast spin echo, although the T1-weighted and proton density images also correlated well. The most accurate MR criteria applied to the severe grades of chondromalacia, with less accurate results for lesser grades. Conclusions. This study demonstrates that fat-suppressed routine T2-weighted and fast spin echo T2-weighted sequences seem to be more accurate than proton density, T1-weighted, and gradient echo sequences in grading chondromalacia. Good histologic and macroscopic correlation was seen in more severe grades of chondromalacia, but problems remain for the early grades in all sequences studied. (orig.). With 2 figs., 3 tabs.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-02-01

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

  9. MR-specific staging of chondromalacia patellae using a special knee compressor: Comparison with arthroscopic findings. MRT-spezifische Einteilung der Chondromalacia patellae unter Zuhilfenahme eines speziellen Kniekompressors: Gegenueberstellung mit dem arthroskopischen Befund

    Energy Technology Data Exchange (ETDEWEB)

    Andresen, R. (Klinik fuer Radiologie, Abt. Radiologische Diagnostik, Universitaetsklinik Steglitz, FU Berlin (Germany)); Radmer, S. (Orthopaedisches Fachinst., Berlin (Germany)); Koenig, H. (Klinik fuer Radiologie, Abt. Radiologische Diagnostik, Universitaetsklinik Steglitz, FU Berlin (Germany)); Wolf, K.J. (Klinik fuer Radiologie, Abt. Radiologische Diagnostik, Universitaetsklinik Steglitz, FU Berlin (Germany))

    1993-12-01

    The present study proposes a new MRI-specific staging of chondromalacia patellae (CMP) which is based on cartilage thickness decrease and signal intensity behaviour under compression as well as cartilage morphology in the plain image. The investigation was performed in 30 patients with varying knee complaints who underwent arthroscopy after MR imaging. It was demonstrated that three CMP stages can already be differentiated by MRI under compression in arthroscopically healthy cartilage. This proves a marked improvement in the early diagnosis of CMP. (orig.)

  10. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-02-15

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

  12. 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.

  13. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1987-04-15

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

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

    Directory of Open Access Journals (Sweden)

    Klauber Dalcero Pompeo

    2012-06-01

    Full Text Available A inibição muscular (IM tem sido reportada como um dos fatores associados à fraqueza muscular presente na osteoartrite (OA e condromalácia patelar (CP, sendo inclusive associada com a etiologia e a progressão. Entretanto, parece existir uma lacuna na literatura em relação a estudos de revisão que avaliaram o grau de IM de sujeitos acometidos por CP e OA. O objetivo do estudo foi reunir os resultados de estudos que investigaram o grau de IM na OA e CP e identificar possíveis diferenças na IM que estejam associadas aos estágios do processo degenerativo. Foram incluídos nesta revisão sistemática estudos transversais e/ou experimentais publicados nas bases de dados PubMed, Scopus, SciELO e Cochrane entre 1990 e 2010 que avaliaram a IM por meio da técnica de interpolação de abalo publicados. Os dados referentes à população, protocolo de IM, qualidade dos estudos e resultados de IM foram sumariados e apresentados em Tabelas. Para análise da qualidade, utilizou-se a escala de PEDro. Após a aplicação dos critérios de inclusão, 13 artigos foram incluídos na revisão sistemática (OA=9 e CP=4. A partir da análise dos dados, observou-se uma IM maior na CP em comparação à OA. Contudo, a variabilidade metodológica e a falta de informações sobre os protocolos de IM indicam a necessidade de novos estudos experimentais a fim de que se possa determinar com maior precisão a relação entre a IM e as doenças degenerativas articulares.Muscle inhibition (MI has been reported as one of the factors associated with muscle weakness present in osteoarthritis (OA and chondromalacia patellae (CP, including being associated with the etiology and progression. However, there seems to be a gap in the literature regarding the review studies that assessed the degree of IM subjects affected by CP and OA. The main objective of study was bringing together the results of studies that investigated the degree of OA in the MI and CP and to identify

  16. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Kaufmann, J.; Langlotz, M.

    1984-10-01

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

  18. 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

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

    Directory of Open Access Journals (Sweden)

    Maxime Figueiredo de Oliveira Freire

    2006-06-01

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

  20. 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.

  1. 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.

  2. 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.)

  3. Evaluation of chondromalacia of the patellofemoral compartment with axial magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Brown, T.R. (Dept. of Radiology, Oregon Health Sciences Univ., Portland, OR (United States)); Quinn, S.F. (Dept. of Radiology, Good Samaritan Hospital and Medical Center, Portland, OR (United States))

    1993-01-01

    Axial magnetic resonance (MR) imaging of the patellofemoral compartment was performed in 75 patients with arthroscopic correlation. Proton density and T2(2500/20/80) weighted images were obtained in all patients. Chondromalacia in stages I and II could not be reliably identified with MR imaging. For the evaluation of stage III and IV chondromalacia, the accuracy of MR was 89%. Focal or diffuse areas of increased or decreased signal alterations of the hyaline cartilage without a contour deformity or cartilaginous thinning do not correlate reliably with arthrosopic staging of chondromalacia. A normal signal intensity is no assurance that softening of the cartilage is not present. The most reliable indicators of chondromalacia are focal contour irregularities of the hyaline cartilage and/or thinning of the hyaline cartilage associated with high signal intensity changes within frank defects or contour irregularities with T2-weighted images. The poor MR-arthroscopic correlation in earlier stages of chondromalacia may be due in part to the subjective basis of the arthroscopic diagnosis. In conclusion, stage I and II chondromalacia of the patellofemoral compartment cannot be reliably evaluated with MR imaging. Stage III and IV chondromalacia is reliably evaluated with MR using the combination of proton density and T2-weighted images. (orig.)

  4. Signs of patellar chondromalacia on sagittal T2-weighted magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    De Smet, A.A.; Monu, J.U.; Fisher, D.R. (Univ. of Wisconsin Hospital and Clinics, Dept. of Radiology, Madison, WI (United States)); Keene, J.S.; Graf, B.K. (Univ. of Wisconsin Hospital and Clinics, Div. of Orthopedic Surgery, Madison, WI (United States))

    1992-02-01

    We incidentally noted distinctive high signal defects or fissures in the patellar articular cartilage on sagittal T2-weighted magnetic resonance (MR) images in 4 patients. At subsequent arthroscopy all 4 patients were found to have patellar chondromalacia. To determine the reliabilty of these signs, we retrospectively evaluated, in a blinded manner, sagittal T2-weighted MR images of the knee in 75 patients who were undergoing arthroscopic assessment of their patellar articular cartilage. We indentified high signal defects of fissures in the patellar cartilage of 5 patients. Patellar chondromalacia was noted at arthroscopy in all 5 patients. Arthroscopy demonstrated patellar chondromalacia in an additional 21 patients with normal MR images. We conclude that high signal defects or fissures on sagittal T2-weighted images are usefull signs of patellar chondromalacia. This single imaging sequence will, however, detect only a small number of the cartilage lesions that may be present. (orig.).

  5. Dorsal defect of the patella and infection

    International Nuclear Information System (INIS)

    Lesions of the patella are relatively rare, although a large variety of etiologies have been reported. To our knowledge this is only the second reported case of a Brodie's abcess of the patella. Its radiologic appearance was identical to that described for the common dorsal defect of the patella. (orig.)

  6. 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)

  7. Intraosseous ganglion of the patella

    International Nuclear Information System (INIS)

    Osteolytic cystic lesions of the patella are rare lesions. A review of the literature revealed only one previously reported example. The pathogenesis and radiological and pathological features of intraosseous ganglion cysts are discussed. In addition, the differential diagnosis of lytic patellar lesions is discussed. (orig.). With 5 figs

  8. Intraosseous ganglion of the patella

    Energy Technology Data Exchange (ETDEWEB)

    Tam, W. [Department of Radiology, Veterans Administration Medical Center, 3350 La Jolla Village Drive, San Diego, CA 92161 (United States); Resnick, D. [Department of Radiology, Veterans Administration Medical Center, 3350 La Jolla Village Drive, San Diego, CA 92161 (United States); Haghighi, P. [Department of Pathology, Veterans Administration Medical Center, San Diego, California (United States); Vaughan, L. [Department of Orthopedic Surgery, Scripps Green Clinic and Research Center, La Jolla, California (United States)

    1996-08-01

    Osteolytic cystic lesions of the patella are rare lesions. A review of the literature revealed only one previously reported example. The pathogenesis and radiological and pathological features of intraosseous ganglion cysts are discussed. In addition, the differential diagnosis of lytic patellar lesions is discussed. (orig.). With 5 figs.

  9. 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...

  10. 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

  11. Imaging tumors of the patella

    International Nuclear Information System (INIS)

    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

  12. TUBERCULOSIS OF THE PATELLA (A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Ahmed

    2013-05-01

    Full Text Available ABSTRACT: Isolated involvement of patella as extra pulmonary Tuberculosis is very rare. We report a rare case of Tuberculosis patella in an eight yea r old baby girl. She was complaining of pain, swelling and joint stiff ness around her right knee. Diagnosis was based on biopsy. She was treated by surgical debridement and curettage, Anti-tubercu lar treatment (ATT with early mobilization of joint.

  13. 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.

  14. 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.

  15. Dorsal defect of the patella: Concept of its origin and relationship with bipartite and multipartite patella

    Energy Technology Data Exchange (ETDEWEB)

    Holsbeeck, M. van; Marchal, G.; Baert, A.L.; Vandamme, B.; Martens, M.; Victor, J.

    1987-06-01

    In a series of 2286 single radiographic examinations of the knee in 1985, 6 dorsal defects of the patella (DDP) were detected. The diagnosis was made if a round lucent lesion of the dorsal superolateral surface of the patella was found abutting against articular cartilage. In four of our patients, an association with a multipartite patella (MP) was found. Biopsy of one lesion showed dense connective tissue and areas of bone necrosis. In one patient, the pattern of reossification of the lesion could be demonstrated. Our observations provide further evidence that the DDP is a stress-induced anomaly of ossification rather than a post-traumatic subarticular cyst of the patella, a diagnosis sometimes suggested by the clinical context. The initial lesion is probably a traction lesion at the insertion of the vastus lateralis muscle rather than ulceration of articular cartilage. We suggest a possible relationship between dysfunction of the quadriceps mechanism, patellar subluxation, and the genesis of the DDP.

  16. Dorsal defect of the patella: Concept of its origin and relationship with bipartite and multipartite patella

    International Nuclear Information System (INIS)

    In a series of 2286 single radiographic examinations of the knee in 1985, 6 dorsal defects of the patella (DDP) were detected. The diagnosis was made if a round lucent lesion of the dorsal superolateral surface of the patella was found abutting against articular cartilage. In four of our patients, an association with a multipartite patella (MP) was found. Biopsy of one lesion showed dense connective tissue and areas of bone necrosis. In one patient, the pattern of reossification of the lesion could be demonstrated. Our observations provide further evidence that the DDP is a stress-induced anomaly of ossification rather than a post-traumatic subarticular cyst of the patella, a diagnosis sometimes suggested by the clinical context. The initial lesion is probably a traction lesion at the insertion of the vastus lateralis muscle rather than ulceration of articular cartilage. We suggest a possible relationship between dysfunction of the quadriceps mechanism, patellar subluxation, and the genesis of the DDP. (orig.)

  17. 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...

  18. 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

  19. 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.

  20. 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.

  1. 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.

  2. 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...

  3. TUBERCULOUS OSTEOMYELITIS OF PATELLA: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Babu B

    2015-10-01

    Full Text Available The knee joint is the third most frequent skeletal location for tuberculosis after spine and hip. Isolated patellar osteomyelitis of tubercular etiology is rare with literature reporting an incidence of 0.09% to 0.15%. Here we report a case of tuberculous osteomyelitis affecting the patella. CASE REPORT: A 24 year old young male o f Indian origin, working in Australia for a period of 3 years, presented with complaints of pain in the left knee since 3 months. There was minimal swelling of left knee and tenderness over medial border of patella. There were no signs of involvement of kn ee joint proper. Diagnosis was confirmed by imaging and histopathology studies. Curettage followed by anti - tubercular treatment was given for 9 months. CONCLUSIONS: Tuberculosis of the patella is a rare finding. The diagnosis frequently is delayed because of its rarity and variable presentation, which may be acute with systemic signs or insidious with mild local signs. Surgical debridement combined with ATT for 9 months ensures recovery.

  4. 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

  5. Evaluation of chondromalacia in the knee joint using three dimensional Fourier transformation constructive interference in steady state (CISS)

    International Nuclear Information System (INIS)

    To assess the usefulness of three-dimensional Fourier transformation constructive interference in steady state (CISS) for the evaluation of chondromalacia. In 110 knee joints which underwent both MR imaging and arthroscopy, the findings were retrospectively reviewed. MR imaging sequences included two-dimensional dual-echo turbo spin-echo imaging along the sagittal and coronal planes, two-dimensional fast low-angle shot (FLASH) with magnetization transfer along the axial plane, and three-dimensional CISS along the sagittal plane. After the cartilage surfaces of each joint were divided into eight areas (each medial and lateral area of patellar facets, trochlear surfaces, femoral condyles, and tibial plateaux), a total of 880 areas were assessed. Using both combined two-dimensional (2-D turbo spin-echo and FLASH) and CISS imaging during different sessions, each chondromalacia case was assigned one of five grades. Arthroscopy revealed the presence of chondromalacia in 162 areas. This was first grade in 77 areas, second grade in 38, third grade in 21, and fourth grade in 26. The sensitivity, specificity, and accuracy of 2-D and CISS imaging were 48.1%, 93.7% and 85.3%, and 45.7%, 95.3% and 86.1%, respectively. Agreement between MR and arthroscopic staging occurred in 81.48% of 2-D imaging procedures and 82.16% of CISS procedures. If a difference of one grade was accepted, these proportions rose to 84.32% and 85.22%, respectively, though this increase was statistically insignificant. Though CISS imaging was less sensitive than 2-D imaging in the grading of chondromalacia, additional CISS imaging can help improve the accuracy of this grading

  6. Evaluation of chondromalacia in the knee joint using three dimensional Fourier transformation constructive interference in steady state (CISS)

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Sam Hyun; Ha, Doo Hoe; Kwak, Jin Young [College of Medicine, Pochon CHA University, Sungnam (Korea, Republic of); Lee, Young Soo [Pundang CHA General Hospital, College of Medicine, Pochon CHA University, Seoul (Korea, Republic of)

    2000-10-01

    To assess the usefulness of three-dimensional Fourier transformation constructive interference in steady state (CISS) for the evaluation of chondromalacia. In 110 knee joints which underwent both MR imaging and arthroscopy, the findings were retrospectively reviewed. MR imaging sequences included two-dimensional dual-echo turbo spin-echo imaging along the sagittal and coronal planes, two-dimensional fast low-angle shot (FLASH) with magnetization transfer along the axial plane, and three-dimensional CISS along the sagittal plane. After the cartilage surfaces of each joint were divided into eight areas (each medial and lateral area of patellar facets, trochlear surfaces, femoral condyles, and tibial plateaux), a total of 880 areas were assessed. Using both combined two-dimensional (2-D turbo spin-echo and FLASH) and CISS imaging during different sessions, each chondromalacia case was assigned one of five grades. Arthroscopy revealed the presence of chondromalacia in 162 areas. This was first grade in 77 areas, second grade in 38, third grade in 21, and fourth grade in 26. The sensitivity, specificity, and accuracy of 2-D and CISS imaging were 48.1%, 93.7% and 85.3%, and 45.7%, 95.3% and 86.1%, respectively. Agreement between MR and arthroscopic staging occurred in 81.48% of 2-D imaging procedures and 82.16% of CISS procedures. If a difference of one grade was accepted, these proportions rose to 84.32% and 85.22%, respectively, though this increase was statistically insignificant. Though CISS imaging was less sensitive than 2-D imaging in the grading of chondromalacia, additional CISS imaging can help improve the accuracy of this grading.

  7. 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

  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. 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.)

  10. 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

  11. 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

  12. 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 ...

  13. 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

  14. 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...

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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

  20. 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...

  1. Bilateral recurrent discloation of the patella associated with below knee amputation: A case report

    Directory of Open Access Journals (Sweden)

    Lenka Prasanna

    2005-02-01

    Full Text Available Abstract Background Recurrent dislocation of the patella in patients with below knee amputation is a known entity. Abnormally high-riding patella (patella alta and medial patellofemoral ligament insufficiency in these patients predisposes them to patellar instability. The established treatment of this problem is surgical realignment. Case presentation A 25 year old male patient with bilateral below knee amputation presented with bilateral recurrent dislocation of the patella while walking on knees on uneven ground. Clinical and radiographic studies showed patella alta. A simple shoe modification was used to treat this patient. Conclusions A simple shoe modification can be used to treat such a condition which is otherwise treated surgically.

  2. 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.

  3. 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.

  4. 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

  5. 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.

  6. 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.

  7. [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

  8. 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.

  9. 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...

  10. 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.

  11. 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.

  12. Radiographic abnormalities of the inferior pole of the patella in juvenile athletes

    International Nuclear Information System (INIS)

    We examined radiographs of the inferior pole of the patella in seven juvenile athletes diagnosed as having Sinding-Larsen-Johansson disease (SLJD) and discussed the etiology of the syndrome. Eight knees had tenderness at the inferior pole of the patella accompanied by radiographic abnormalities. A regular or irregular calcification was found at the inferior pole of the patella in three knees; coalescence of the calcification was found in two knees; incorporation of the calcification into the patella to yield a normal radiographic configuration of the area was found in two knees; and a small calcification separated from the patella was found in one knee. All of these findings varied and did not always correspond to the radiographic stages of the disease process identified by Medlar. One case was not clearly distinguished from either osteochondritis or stress fracture, and one case had a similar symptom to tendinitis. Thus, the etiology of the syndrome seems not to be unified, and the differential diagnosis between SLJD and osteochondritis, stress fracture, or tendinitis was difficult to arrive at. We were only able to conclude that the radiographic abnormalities and consequently the etiology of the syndrome vary, and therefore there is a limitation to call the syndrome accompanied by abnormal findings of the inferior pole of the patella under the umbrella term of SLJD. (author)

  13. 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

  14. Galeazzi's modified technique for recurrent patella dislocation in skeletally immature patients

    International Nuclear Information System (INIS)

    A large number of surgical techniques have been proposed for the treatment of recurrent patellar dislocation in adolescents, one of the most famous being Galeazzi's semitendinosus tenodesis as modified by Baker. The aim of this study was to verify the mid-term results of this technique, the effectiveness of restoring the patellofemoral congruency, by both static and dynamic computed tomography (CT), and to determine whether the preoperative type of patellofemoral relationship affects the results. The study included 14 patients (16 knees), with a mean age of 11.6 years, Tanner stage ≤3, with at least two to three episodes of patellar dislocation. The patients underwent surgery using Baker's modification of Galeazzi's technique. All 14 patients were evaluated preoperatively and at least 4 years afterward by static and dynamic CT. Clinical evaluation at follow-up was performed using the criteria described by Crosby and Insall. Clinical results at follow-up were excellent in 62.5% and good in 37.5%. As preoperative evaluation showed a high patella in 7 out of 16 knees, two groups were considered: A, high patella; B, not high patella. The data obtained with static CT show that the patella reached a satisfactory congruence in all knees. The data obtained with dynamic CT showed different results between group A and B. A preoperative high patella remains high with quadriceps contraction and again shows the change of tilt and subluxation. In group B, the data obtained with dynamic CT are comparable with those obtained with static CT. This technique produces good mid-term clinical results. However, the dynamic CT showed that in those patients with high patellas, semitendinosus tenodesis alone is not enough to stabilize the patella. (author)

  15. 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.

  16. Magnetic resonance imaging of bilateral lateral congenital dislocations of unossified patellae

    Energy Technology Data Exchange (ETDEWEB)

    Calisir, Cuneyt; Yilmaz, Oguzhan [Osmangazi University, Medical Faculty, Department of Radiology, Eskisehir (Turkey); Inan, Ulukan [Osmangazi University, Medical Faculty, Department of Orthopaedic and Trauma Surgery, Eskisehir (Turkey)

    2006-06-15

    We describe our experience using magnetic resonance imaging (MRI) to evaluate the unossified dislocated cartilaginous patella in a 6-year-old male patient with restricted extension and flexion deformity of both knees. MRI is used widely in the visualization of cartilage since it can show cartilage directly. In addition, FS FLASH 3D sequence has recently been accepted as a suitable sequence in the evaluation of hyaline cartilage. MRI makes it possible to evaluate ligamentous, tendinous, muscular, and cartilaginous structures as well as the abnormalities related to them. We applied this technique in our case and found it very effective in locating the unossified dislocated cartilaginous patella. We also observed structural changes such as bilateral lateral displacement of short quadriceps tendon inserting into diminutive patella, insertion of bilateral patellar tendons into anterolateral tibia, and a stretching of the medial collateral ligament associated with valgus stress. (orig.)

  17. 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

  18. 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.

  19. 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

  20. Pulsatile and steady-state hemodynamics of the human patella bone by diffuse optical spectroscopy

    International Nuclear Information System (INIS)

    The cardiac cycle related pulsatile behavior of the absorption and scattering coefficients of diffuse light and the corresponding alterations in hemoglobin concentrations in the human patella was studied. The pulsations in scattering is considerably smaller than absorption. The difference in amplitude of absorption coefficient pulsations for different wavelengths was translated to pulsations in oxygenated and deoxygenated hemoglobin, which leads to strong pulsations in the total hemoglobin concentration and oxygen saturation. The physiological origin of the observed signals was confirmed by applying a thigh-cuff. Moreover, we have investigated the optical and physiological properties of the patella bone and their changes in response to arterial cuff occlusion. (paper)

  1. 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...

  2. Giant cell tumor of the patella with a secondary aneurysmal bone cyst: A case report

    Science.gov (United States)

    SONG, MINGZHI; DAI, WEI; SUN, RAN; LIANG, HONGFENG; LIU, BINGWU; WU, YUXUAN; MA, KAI; LU, MING

    2016-01-01

    The substance of the patella is an uncommon location for tumor occurrence and development. The present study reports a case of giant cell tumor (GCT) of the patella, combined with an aneurysmal bone cyst (ABC). To the best of our knowledge, this is the second report of GCT with ABC published in English. GCT is the most common type of benign tumor. Secondary ABC is frequently associated with GCT, but this symbiotic tumor rarely occurs in the patella. A 27-year-old male patient was examined at the outpatient clinic, and clinicopathological characteristics of the tumor were observed. X-ray and computed tomography (CT) scans revealed a lytic lesion located in the center of the right patella. Curettage, followed by autogenic and allograft bone grafting, was performed. Histopathologically, the lesion was diagnosed as a GCT with secondary ABC. No recurrence or metastasis was identified during the 1-year follow-up period. The present study reports a case of GCT with secondary ABC, and discusses the rare location and histopathological type of this tumor, in order to improve diagnosis and treatment of patellar tumors in general. PMID:27313738

  3. Chondroblastoma of the patella presentation of a case - National Institute of Cancerology ESE

    International Nuclear Information System (INIS)

    Chondroblastomas are infrequent neoplasic tumors, the world literature reports around seven hundred cases and only nine were located at the patella. We present the plain films and MR findings in a case of fifteen years old patient evaluated at the national cancer institute. The diagnosis was confirmed with pathologic analysis

  4. 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

  5. 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

  6. Case history of a painful, obscure defect of a child's patella

    International Nuclear Information System (INIS)

    The case history reported is that of a 12-year-old boy who suffered from an obscure, painful, unilateral defect at the patella. The X-ray and MRI morphologies of the lesion are described, and the aspects of possible differential diagnoses are discussed. (orig./CB)

  7. 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....

  8. 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

  9. 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)

  10. Genitopatellar syndrome: a new condition comprising absent patellae, scrotal hypoplasia, renal anomalies, facial dysmorphism, and mental retardation

    OpenAIRE

    Cormier-Daire, V.; Chauvet, M.; Lyonnet, S; Briard, M.; Munnich, A; Le Merrer, M

    2000-01-01

    We report on the association of absent patellae, genital and renal anomalies, dysmorphic features, and mental retardation in seven children (six boys and one girl) belonging to five unrelated families. Flexion deformities of the knees and hips with club feet and absent patellae were consistently observed and scrotal hypoplasia and cryptorchidism were present in all boys (6/6). Dysmorphic features included a coarse face, a large nose with a high nasal bridge, and microcephaly. Other features i...

  11. 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.

  12. 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.)

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

    International Nuclear Information System (INIS)

    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.)

  14. 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 ...

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

    Directory of Open Access Journals (Sweden)

    I. PRUSINA

    2015-07-01

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

  16. 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.

  17. 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

  18. 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

  19. 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...

  20. 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

  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. 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

  3. 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.

  4. 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. PMID:26845705

  5. Contamination of limpets (Patella vulgata) following the Sea Empress oil spill

    Energy Technology Data Exchange (ETDEWEB)

    Glegg, G.A.; Hickman, L. [Plymouth Univ., Inst. of Marine Studies, Plymouth (United Kingdom); Rowland, S.J. [Plymouth Univ., Dept. of Environmental Sciences, Plymouth (United Kingdom)

    1999-07-01

    Following the grounding of the Sea Empress oil tanker at the entrance to Milford Haven, UK, in February 1997, samples of limpets (Patella vulgata) were collected from local coastal sites (after 2 weeks and 4 and 7 months) and analysed for oil contamination. Initially, relatively high concentrations of volatile two and three ring aromatic hydrocarbons (up to 86 {mu}g g{sup -1} dry weight) were found which decreased by order of magnitude between surveys. These results are compared with a similar rapid decrease in concentrations of volatile hydrocarbons while loss of heavier components is slower. An assessment of the non-volatile fingerprint sterane hydrocarbons showed limpet samples to be contaminated with hydrocarbons but was inconclusive about the source of those hydrocarbons. Another common fingerprint, the pristane:phytane ratio was investigated but this was found to be masked by the presence of natural biogenic compounds. (Author)

  6. Contamination of limpets (Patella vulgata) following the Sea Empress oil spill

    International Nuclear Information System (INIS)

    Following the grounding of the Sea Empress oil tanker at the entrance to Milford Haven, UK, in February 1997, samples of limpets (Patella vulgata) were collected from local coastal sites (after 2 weeks and 4 and 7 months) and analysed for oil contamination. Initially, relatively high concentrations of volatile two and three ring aromatic hydrocarbons (up to 86 μg g-1 dry weight) were found which decreased by order of magnitude between surveys. These results are compared with a similar rapid decrease in concentrations of volatile hydrocarbons while loss of heavier components is slower. An assessment of the non-volatile fingerprint sterane hydrocarbons showed limpet samples to be contaminated with hydrocarbons but was inconclusive about the source of those hydrocarbons. Another common fingerprint, the pristane:phytane ratio was investigated but this was found to be masked by the presence of natural biogenic compounds. (Author)

  7. Knee pain and swelling: An atypical presentation of metastatic colon cancer to the patella

    Directory of Open Access Journals (Sweden)

    Bethany Gasagranda, DO

    2014-01-01

    Full Text Available Knee pain is a common reason for a patient to seek medical evaluation. Of the many causes of knee pain, malignancy is one of the least common. When malignancy is the etiology of the pain, it is usually due to a primary tumor of the osseous structures or soft tissues of the knee joint. Metastatic disease involving the knee joint is uncommon, with few cases reported in the literature. Of these reported cases, metastatic colon cancer is exceedingly rare. However, in a patient with new onset knee pain and the proper clinical history, metastatic disease should be considered as a potential explanation of symptoms. We report a case of knee pain and swelling due to metastatic colon cancer to the patella.

  8. 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 ...

  9. Anterior knee pain

    Science.gov (United States)

    Patellofemoral syndrome; Chondromalacia patella; Runner's knee; Patellar tendinitis; Jumper's knee ... or playing soccer). You have flat feet. Anterior knee pain is more ... skiers, bicyclists, and soccer players who exercise often ...

  10. Clinical and radiographic features, treatment and outcome in 15 horses with fracture of the medial aspect of the patella

    International Nuclear Information System (INIS)

    A sagittal fracture of the medial aspect of the patella was identified in 15 horses, 2 of which had been kicked and 12 of which had hit a fixed fence while jumping. Eight horses showed concurrent fragmentation of the base of the patella, and 2 had sustained a concurrent fracture of the distal end of the lateral trochlear ridge of the femur. A cranioproximal-craniodistal oblique radiographic view was essential to identify the site of the medial patellar fracture and to determine its configuration. Fourteen horses were treated by surgical removal of the medial patellar fracture fragment(s). Of 12 horses (83%) without evidence of pre-existing degenerative joint disease, 10 were treated successfully with return to full athletic function

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

    OpenAIRE

    Coppa, S.; De Lucia, G. A.; Massaro, G.; Magni, P.

    2012-01-01

    The endemic limpet Patella ferruginea is the most endangered invertebrate of the Mediterranean Sea. Our study examined a population of P. ferruginea in the Marine Protected Area of Penisola del Sinis - Isola di Mal di Ventre (western Sardinia, Italy). During the summer 2009, we carried out a systematic census of P. ferruginea along a 8114 m georeferenced perimeter of coast in the no take-no entry zone to assess its density, spatial distribution, and morphometric characteristics. Our aim was t...

  12. 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

  13. 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.

  14. 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; Jørgensen, Uffe; Hölmich, Per

    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 in a...... prospective randomized controlled trial. Three senior knee surgeons, experienced in both types of ACL surgery, performed all the operations. A standardized and supervised rehabilitation programme was used for both groups for 6 months. Thirty patients received the ITB reconstruction, and 30 received the BPTB...

  15. 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

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

    Science.gov (United States)

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

    2007-10-01

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

  17. 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...

  18. 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.

  19. MRI Evaluation of Patella Alignment Before and After Anatomical Reconstruction of ACL Undergoing Unified Rehabilitation Programme Introduced by CMC Physical Therapy Team

    Science.gov (United States)

    Straszewski, Dariusz; Plenzler, Marcin; Szczepaniak, Joanna; Śmigielski, Robert; Ciszkowska-Łysoń, Beata; Popieluch, Marcin; Kopko, Szymon

    2014-01-01

    Objectives: The aim of the study was to asses the impact of the functional rehabilitation on patella alignment with MRI imaging in patients who underwent the ACL reconstruction. The surgical approach with the use of patellar tendon graft is known to carry the risk of lowering patella height (patella baja), which, in turn, may lead to accelerated cartilage wear in patellofemoral joint. Methods: 30 patients after the anatomical reconstruction of ACL took part in this study (23 male, and 7 female, mean age = 28 ± 10,6 years). During the procedure a patellar tendon graft was used. The Insali-Salvati ratio measured with MRI (images taken pre-procedural, and 9 months after the surgery) was used for the assessment of patellar alignment. The measurements were taken by one radiology specialist on MRI scans in sagittal view in PD sequence. During the examination, patellar joint was in flexion (approx.10 degrees). As the point of reference for patella’s position ISR ratio was in the range of 0.8 - 1.2. All patients were operated on by the same team of surgeons and underwent an unified rehabilitation programme led by a team of selected physiotherapists. The main features of the programme were: an early muscle activation (second day after the procedure); mobilisation of the patella and tissues of the anterior compartment of the knee; weight bearing co-contraction exercises, and the sensomotoric training of the entire kinetic chain of the lower limb. The data recorded was statistically analysed using the Wilcoxon signed-rank test in order to establish parameters’ changes within the study group.. Results: The mean ISR value before the procedure was 0.84 (± 0,1), whereas 9 months after the surgery it was 0.85 (± 0,1). The results’ analysis did not show any statistically significant changes between ISR values. Nine months after the procedure patella baja has not been observed in any of the evaluated patients. Conclusion: The functional rehabilitation programme designed by

  20. 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.)

  1. 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.)

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

    Directory of Open Access Journals (Sweden)

    S. COPPA

    2012-12-01

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

  3. 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

  4. 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.

  5. 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.

  6. 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

  7. 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.

  8. 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

  9. 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

  10. Postoperative evaluation of the position of interference screws, boneblocks and ligamentum patellae autografts in anterlor cruciate ligament replacement

    International Nuclear Information System (INIS)

    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)

  11. 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.

  12. 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.

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

    OpenAIRE

    Johannes Struewer; Turgay Efe; Thomas Manfred Frangen; Tim Schwarting; Benjamin Buecking; Steffen Ruchholtz; Karl Friedrich Schüttler; Ewgeni Ziring

    2012-01-01

    The aim of the present study was to evaluate incidence, degree and impact of tibial tunnel widening (TW) on patient-reported long-term clinical outcome, knee joint stability and prevalence of osteoarthritis (OA) after isolated anterior cruciate ligament (ACL) reconstruction. On average, 13.5 years after ACL reconstruction via patella-bone-tendon-bone autograft, 73 patients have been re-evaluated. Inclusion criteria consisted of an isolated anterior cruciate ligament rupture and reconstructio...

  14. 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...

  15. The comparison of anterior knee pain in severe and non severe arthritis of the lateral facet of the patella following a mobile bearing unicompartmental knee arthroplasty

    OpenAIRE

    Pongcharoen, Boonchana; Reutiwarangkoon, Chaivet

    2016-01-01

    In the past, medial osteoarthritis (OA) knee with symptomatic patellofemoral (PF) arthritis has not been recommended for a unicompartmental knee arthroplasty (UKA). However, recent studies have reported that UKA has shown good results in patients with medial OA of the knee, including those with PF arthritis. The purpose of this study is to compare the results between patients with medial OA knees; those with severe arthritis of the lateral facet of the patella and patients without severe arth...

  16. 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

  17. The comparison of anterior knee pain in severe and non severe arthritis of the lateral facet of the patella following a mobile bearing unicompartmental knee arthroplasty.

    Science.gov (United States)

    Pongcharoen, Boonchana; Reutiwarangkoon, Chaivet

    2016-01-01

    In the past, medial osteoarthritis (OA) knee with symptomatic patellofemoral (PF) arthritis has not been recommended for a unicompartmental knee arthroplasty (UKA). However, recent studies have reported that UKA has shown good results in patients with medial OA of the knee, including those with PF arthritis. The purpose of this study is to compare the results between patients with medial OA knees; those with severe arthritis of the lateral facet of the patella and patients without severe arthritis of the lateral facet of the patella following mobile bearing UKA. We have prospectively evaluated 104 patients (114 knees) who had undergone an Oxford mobile bearing UKA. The mean follow-up was 19.05 months (range 12.30-29.70 months). The patients were divided into two groups: group I consisted of eighty patients (88 knees) who did not have severe arthritis of the lateral facet (Outerbridge grade 0-2) and group II had twenty-four patients (26 knees) who had severe arthritis of the lateral facet (Outerbridge grade 3, 4). We recorded the incidence of anterior knee pain, knee scores, pain scores, and functional scores in comparison of the two groups. The visual analog scale (VAS) and incidence of post-operative anterior knee pain had not shown any significant differences. The VAS for post-operative anterior knee pain was 0.11 (SD 0.56, range 0-3 point) versus 0.12 (SD 0.59, range 0-3 point) for group I and group II patients, respectively (P = 0.98). The incidence of post-operative anterior knee pain was 4.5 versus 3.8 % for group I and group II patients, respectively (P = 0.88). The pain scores and functional scores had not exhibited any differences. However, the knee scores of patients with severe arthritis of the lateral facet of the patella was worse than those seen in patients without severe arthritis of the lateral facet of the patella with a statistical significance. It was scored as 96.78 (SD 4.56, range 85-100) versus 94.43 (SD 4.50, range 81-100) for group I

  18. Radioisotope diagnosis of the insufficient femoropatellar joint

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-01-01

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

  19. Radioisotope diagnosis of the insufficient femoropatellar joint

    International Nuclear Information System (INIS)

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

  20. Brachidontes variabilis and Patella sp. as quantitative biological indicators for cadmium, lead and mercury in the Lebanese coastal waters

    International Nuclear Information System (INIS)

    The mussel, Brachidontes variabilis, and the limpet, Patella sp., were used as indicators to monitor cadmium, lead and mercury concentrations along the Lebanese coast. Studies were carried out in order to define the best strategy for assessing and minimizing the effects of size and physiological condition on the metal contents of the molluscs, and corrective models were constructed. Metal concentrations in surface water were measured to estimate bioconcentration factors (BCFs). The BCFs varied from 8.3 x 103 to 3.4 x 104, from 7.5 x 103 to 8.0 x 103 and from 3.0 x 104 to 3.2 x 104, for Cd, Pb and Hg, respectively. For limpets, BCFs varied from 1.7 x 104 to 7.4 x 104 for Cd, from 2.5 x 103 to 6 x 103 for Pb and remained fairly constant at around 104 for Hg. The highest BCFs were associated with lowest contamination levels. The results of the geographical survey exhibited a similar large-scale spatial pattern for the two species and followed the metal concentration distributions measured in the waters. - Two molluscs were effective bioindicators for metal pollution in waters along the Lebanese coast

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2010-04-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-11-30

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

  4. Plutonium and americium in Arctic waters, the North Sea and Scottish and Irish coastal zones (in Fucus, Mytilus and Patella)

    International Nuclear Information System (INIS)

    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 collected from the Irish coast in 1983. Fallout is found to dominate as a source of 239+240Pu north of latitude 650N, while for 238Pu a substantial fraction originates from European nuclear fuel reprocessing facilities. The 238Pu/239+240Pu isotope ratio provides clear evidence of the transport of effluent 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 of the Irish Sea) to Spitsbergen. 241Am found in Arctic waters probably originates from the decay of fallout 241Pu and, like Pu, tentatively has a residence time of the order of several years. Americium from Sellafield has an estimated mean residence time of 4-6 months in Scottish waters. (author)

  5. 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

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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

  11. 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

  12. 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.

  13. The use of enzymatic biomarkers in two marine invertebrates Nereis diversicolor and Patella vulgata for the biomonitoring of Tangier's bay (Morocco).

    Science.gov (United States)

    Douhri, Hikmat; Sayah, Fouad

    2009-02-01

    The fast increase of anthropogenic activities has led to a continual influx of xenobiotics into the marine ecosystems. Quantifying biochemical parameters in marine invertebrates makes possible the evaluation of pollutants' damaging effect. In fact, to examine the health state of Tangier's bay, we focused on the study of catalase, esterase, acetylcholinesterase and alpha-amylase activities as biomarkers in two species of marine invertebrates Nereis diversicolor (Polychaeta, Nereidae) and Patella vulgata (Mollusca, Prosobranchia), collected from different sites along the Mediterranean coastline of Tangier. Our results showed that these biochemical parameters are disturbed following the level of decreasing environmental quality, and for this reason they are promising in the biomonitoring studies of the Moroccan marine environment. PMID:18786724

  14. 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.

  15. 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)

  16. 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.

  17. 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...

  18. Cross-cultural Adaptation and Validation of the Victorian Institute of Sport Assessment-Patella Questionnaire for French-Speaking Patients With Patellar Tendinopathy.

    Science.gov (United States)

    Kaux, Jean-François; Delvaux, François; Oppong-Kyei, Julian; Beaudart, Charlotte; Buckinx, Fanny; Croisier, Jean-Louis; Forthomme, Bénédicte; Crielaard, Jean-Michel; Bruyère, Olivier

    2016-05-01

    Study Design Clinical measurement study. Background The Victorian Institute of Sport Assessment-Patella (VISA-P), originally developed in English, assesses the severity of patellar tendinopathy symptoms. To date, no French version of the questionnaire exists. Objectives The aim of our study was to translate the VISA-P into French and verify its psychometric properties. Methods The translation and cultural adaptation were performed according to international recommendations in 6 steps: initial translation, translation merging, back translation to the original language, use of an expert committee to reach a prefinal version, test of the prefinal version, and expert committee appraisal of a final version. Afterward, the psychometric properties of the final French version (VISA-PF) were assessed in 92 subjects, divided into 3 groups: pathological subjects (n = 28), asymptomatic subjects (n = 22), and sports-risk subjects (n = 42). Results All members of the expert committee agreed with the final version. On a scale ranging from 0 to 100, with 100 representing an asymptomatic subject, the average ± SD scores on the VISA-PF were 53 ± 17 for the pathological group, 99 ± 2 for the healthy group, and 86 ± 14 for the sports-risk group. The test-retest reliability of the VISA-PF was excellent, with good internal consistency. Correlations between the VISA-PF and divergent validity of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) were low, and the correlation coefficient values measured between the VISA-PF scores and converged items of the SF-36 were higher. Conclusion The VISA-PF is understandable, valid, and suitable for French-speaking patients with patellar tendinopathy. J Orthop Sports Phys Ther 2016;46(5):384-390. Epub 21 Mar 2016. doi:10.2519/jospt.2016.5937. PMID:26999409

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

    Directory of Open Access Journals (Sweden)

    Johannes Struewer

    2012-06-01

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

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

    Science.gov (United States)

    Struewer, Johannes; Efe, Turgay; Frangen, Thomas Manfred; Schwarting, Tim; Buecking, Benjamin; Ruchholtz, Steffen; Schüttler, Karl Friedrich; Ziring, Ewgeni

    2012-05-01

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

  1. 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

  2. Magnetic resonance in cartilaginous lesions of the knee joint with three-dimensional gradient-echo imaging

    Energy Technology Data Exchange (ETDEWEB)

    Reiser, M.F.; Bongartz, G.; Erlemann, R.; Gaebert, K.; Stoeber, U.; Peters, P.E.; Strobel, M.; Pauly, T.

    1988-10-01

    Diagnosis of chondromalacia of the patellofemoral joint using three-dimensional gradient-echo sequences was investigated in 41 patients, with arthroscopic verification in 25 patients. In vitro examinations in human caderveric patellae were performed in order to determine optimal imaging parameters. FLASH (T/sub R/=40 ms, T/sub E/=10 ms, flip angle=30/sup 0/) and FISP (T/sub R/=40 ms, T/sub E/=10 ms, flip angle=40/sup 0/) were used in clinical studies. The therapeutically relevant differentiation of major and minor degrees of chondromalacia seems to be possible. 30/sup 0/ FLASH-images in the axial plane proved to be the most efficacious technique for the diagnosis of chondromalacia. (orig./GDG).

  3. 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

  4. Pathology of the region of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Aufdermaur, M.

    1981-09-01

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

  5. 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-...

  6. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1982-01-21

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

  8. 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.

  9. 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.

  10. 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

  11. 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.

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

    Directory of Open Access Journals (Sweden)

    K. O. Ladly

    1993-07-01

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

  13. 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.

  14. 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.

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

    Directory of Open Access Journals (Sweden)

    Saurabh

    2013-02-01

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

  16. 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

  17. 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.

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

    International Nuclear Information System (INIS)

    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 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.)

  19. 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

  20. 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

  1. 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

  2. Technical considerations in total knee surgery. Management of patella problems.

    Science.gov (United States)

    Goldberg, V M; Figgie, H E; Figgie, M P

    1989-04-01

    Patellofemoral symptoms are now the most common cause of aseptic knee revision; however, the majority of patello-femoral problems are self-limited and may be managed symptomatically and nonoperatively. A trial of anti-inflammatory medications, stretching exercises, and appropriate bracing is always indicated. Patellofemoral symptoms are usually related to mechanical malalignment of all three components of the total knee arthroplasty. Attention to the fundamental principles of total knee arthroplasty, including restoration of the bony mechanical alignment, soft tissue stability, and maintenance of the anatomic joint line, prevents many of the problems. Meticulous preoperative planning and anatomic placement of the component parts are important for a satisfactory long-term outcome. Present research is directed to providing kinematic analysis of the patellofemoral tracking mechanism and to minimizing patellofemoral contact stresses with appropriate new designs. PMID:2646562

  3. 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...... legs. 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....

  4. 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.

  5. 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

  6. MR diagnosis of retropatellar chondral lesions under compression. A comparison with histological findings

    International Nuclear Information System (INIS)

    Purpose: The aim of the study was to improve the chondromalacia patellae (CMP) diagnosis by MR imaging under defined compression of the retropatellar cartilage, using a specially designed knee compressor. The results were compared with histological findings to obtain an MR classification of CMP. Method: MR imaging was performed in in vitro studies of 25 knees from cadavers to investigate the effects of compression on the rentropatellar articular cartilage. The results were verified by subsequent histological evaluations. Results: There was significant difference in cartilage thickness reduction and signal intensity behaviour under compression according to the stage of CMP. Conclusion: Based on the decrease in cartilage thickness, signal intensity behaviour under compression, and cartilage morphology, the studies permitted and MR classifiction of CMP into stages I-IV in line with the histological findings. Healthy cartilage was clearly distinguished, a finding which may optimize CMP diagnosis. (orig.)

  7. Use of radiographic projections of knee

    Energy Technology Data Exchange (ETDEWEB)

    Cockshott, W.P.; Burrows, D.A.; Ferrier, M.; Racoveanu, N.T.

    1985-02-01

    A study to determine the routine radiography practice for the investigation of acute trauma cases and those with suspected arthritis of the knee was carried out by questionnaires sent to radiologists in 41 countries. The role of radiology in the investigation of chondromalacia patellae was also ascertained. Some of the reasons for the diversities of practice are discussed. The necessity for further views of the knee to supplement the two standard projections was assessed for various diagnostic entities. It became clear that if occult fractures were not to be missed, patients with knee effusions following acute trauma required additional views if a lesion was not shown by the anteroposterior (AP) and lateral views. In contrast, two views of the knee sufficed for examination of most entities affecting the knee.

  8. Single photon emission computed tomography scanning in the diagnosis of knee pathology.

    Directory of Open Access Journals (Sweden)

    Vellala RP

    2004-06-01

    Full Text Available PURPOSE. To evaluate the role of single photon emission computed tomography (SPECT bone scan for the diagnosis of knee lesions in routine clinical practice. METHODS. 40 consecutive case records were examined in patients who underwent a SPECT scan prior to knee arthroscopy in routine clinical practice. The accuracy of clinical examination, SPECT scan results, and arthroscopic findings (as the gold standard in diagnosing knee lesions were compared. RESULTS. The sensitivity of SPECT scans in detecting medial meniscal, lateral meniscal, anterior cruciate ligament lesions, osteochondral defects, and chondromalacia patellae was 77%, 14%, 33%, 50%, and 74%, respectively. The specificities for the same structural lesions were high at 89%, 94%, 97%, 94%, and 69%, respectively. CONCLUSION. SPECT bone scan appears to be useful in the diagnosis of knee pathology in routine practice and in selecting patients for arthroscopy, especially most useful for the diagnosis of medial meniscal tears.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-06-01

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

  10. MR diagnosis of retropatellar chondral lesions under compression. A comparison with histological findings

    Energy Technology Data Exchange (ETDEWEB)

    Andresen, R. [Dept. of Radiology, Div. of Radiodiagnostics, Steglitz Medical Centre, Free Univ. of Berlin (Germany); Radmer, S. [Dept. of Radiology and Nuclear Medicine, Behring Municipal Hospital, Academic Teaching Hospital, Free Univ. of Berlin (Germany); Koenig, H. [Dept. of Radiology, Div. of Radiodiagnostics, Steglitz Medical Centre, Free Univ. of Berlin (Germany); Banzer, D. [Dept. of Radiology and Nuclear Medicine, Behring Municipal Hospital, Academic Teaching Hospital, Free Univ. of Berlin (Germany); Wolf, K.J. [Dept. of Radiology, Div. of Radiodiagnostics, Steglitz Medical Centre, Free Univ. of Berlin (Germany)

    1996-01-01

    Purpose: The aim of the study was to improve the chondromalacia patellae (CMP) diagnosis by MR imaging under defined compression of the retropatellar cartilage, using a specially designed knee compressor. The results were compared with histological findings to obtain an MR classification of CMP. Method: MR imaging was performed in in vitro studies of 25 knees from cadavers to investigate the effects of compression on the rentropatellar articular cartilage. The results were verified by subsequent histological evaluations. Results: There was significant difference in cartilage thickness reduction and signal intensity behaviour under compression according to the stage of CMP. Conclusion: Based on the decrease in cartilage thickness, signal intensity behaviour under compression, and cartilage morphology, the studies permitted and MR classifiction of CMP into stages I-IV in line with the histological findings. Healthy cartilage was clearly distinguished, a finding which may optimize CMP diagnosis. (orig.).

  11. 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)

  12. 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.)

  13. 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...

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

    OpenAIRE

    MM. Tahmasbi; F. Farahmand , AA. Amis

    1999-01-01

     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 ■ ...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-07-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Szanto, D.

    1982-07-01

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

  17. Nail-Patella Syndrome - GeneReviews - NCBI Bookshelf [GeneReviews

    Lifescience Database Archive (English)

    Full Text Available p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .body-content h2 {border ... the radial head, hypoplasia of the lateral epicondyle an d capitellum, and prominence of the medial epicond ... ures has also been reported. General appearance. A lean ... body habitus may be associated with NPS and affect ...

  18. 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.

  19. Normal findings and pathological changes of the ligamentum patellae in the computer tomogram

    International Nuclear Information System (INIS)

    In the computer tomogram, the normal patellar ligament appears as a flat band with an average density of 110 HE. After trauma and also after chronic overloading, the cross-section increases, whereas the density decreases. CT is superior to conventional X-ray diagnosis and to sonography in respect of detecting and differentiating of circumscript changes in the patellar ligament. (orig.)

  20. 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.

  1. Kinematic CT and MR imaging of the patellofemoral joint

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-04-01

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

  2. 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

  3. 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...

  4. 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.

  5. Routine patellar resurfacing using an inset patellar technique.

    LENUS (Irish Health Repository)

    Hurson, Conor

    2012-02-01

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

  6. 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.

  7. 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...

  8. Características clinicoepidemiológicas y endoscópicas de la plica sinovial en pacientes operados mediante artroscopia Clinical, epidemiological and endoscopic characteristics of the synovial plica in patients with arthroscopy

    Directory of Open Access Journals (Sweden)

    Osvaldo Calisté Manzano

    2011-08-01

    Full Text Available Se realizó un estudio prospectivo de pacientes intervenidos quirúrgicamente de la rodilla mediante artroscopia en el Servicio de Reumatología, perteneciente al Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora" de Santiago de Cuba durante los años 2000-2009; decenio en el cual fueron operadas 663 rodillas y, como muestra, 208 a causa de plica sinovial. Esta última resultó ser la enfermedad más frecuente, con primacía en el sexo femenino y las edades de 16 a 25 años. Hubo una marcada correspondencia clinicoartroscópica. Los diagnósticos preoperatorios estuvieron dados por lesión del menisco interno, condromalacia de rótula y sinovitis, por lo cual deben tenerse en cuenta como diagnosis diferencial en este síndrome. La forma de cicatrizar la sección quirúrgica de la plica sinovial es motivo de recidiva sintomática y reintervención quirúrgica, como ocurrió en 54,0 % de los integrantes de la casuística, predominantemente atribuible a fibrosis en la zona de la herida.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.

  9. 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.

  10. 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 ...

  11. 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

  12. 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.

  13. 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.

  14. 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

  15. 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

  16. 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)

  17. 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...

  18. 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.

  19. Orthopedic services

    Science.gov (United States)

    ... Rotator cuff tendinitis Separation Torn labrum SLAP tears Knee: Cartilage and meniscus injuries Dislocation of the kneecap (patella) Ligament sprains or tears (anterior cruciate, posterior cruciate, medial collateral, ...

  20. Is intra-articular pathology associated with MCL edema on MR imaging of the non-traumatic knee?

    International Nuclear Information System (INIS)

    Edema surrounding the medial collateral ligament (MCL) is seen on MR imaging in patients with MCL injuries and in patients with radiographic osteoarthritis in the non-traumatic knee. Because we noted MCL edema in patients without prior trauma or osteoarthritis, we studied the association between intra-articular pathology and MCL edema in patients without knee trauma. We evaluated the MR examinations of 247 consecutive patients (121 male, 126 female with a mean age of 44 years) without recent trauma for the presence of edema surrounding the MCL, meniscal and ACL tears, medial meniscal extrusion, medial compartment chondromalacia, and osteoarthritis. The percentages of patients illustrating MCL edema with and without each type of pathology were compared using Fisher's exact test to determine if there was a statistically significant association. We found MCL edema in 60% of 247 patients. MCL edema was present in 67% of patients with medial meniscal tears, 35% with lateral meniscal tears, 100% with meniscal extrusion of 3 mm or more, 78% with femoral chondromalacia, 82% with tibial chondromalacia, and 50% with osteoarthritis. The percentage of patients with edema increased with the severity of the chondromalacia. These associations were all statistically significant (p <0.02). The mean age of those with MCL edema was 49.7 years compared with 34.9 years without MCL edema (p <0.001). Patient gender and ACL tear did not correlate with MCL edema. Nine (4%) of the 247 patients had MCL edema without intra-articular pathology. None of these 9 patients had MCL tenderness or joint laxity on physical examination. We confirmed that MCL edema is associated with osteoarthritis, but is also associated with meniscal tears, meniscal extrusion, and chondromalacia. In addition, MCL edema can be seen in patients without intra-articular pathology, recent trauma or MCL abnormality on physical examination. (orig.)

  1. Is intra-articular pathology associated with MCL edema on MR imaging of the non-traumatic knee?

    Energy Technology Data Exchange (ETDEWEB)

    Blankenbaker, Donna G.; De Smet, Arthur A. [University of Wisconsin Medical School, Division of Musculoskeletal Imaging, Department of Radiology, Madison (United States); Fine, Jason P. [University of Wisconsin, Department of Statistics, Madison (United States); University of Wisconsin, Department of Biostatistics and Informatics, Madison (United States)

    2005-08-01

    Edema surrounding the medial collateral ligament (MCL) is seen on MR imaging in patients with MCL injuries and in patients with radiographic osteoarthritis in the non-traumatic knee. Because we noted MCL edema in patients without prior trauma or osteoarthritis, we studied the association between intra-articular pathology and MCL edema in patients without knee trauma. We evaluated the MR examinations of 247 consecutive patients (121 male, 126 female with a mean age of 44 years) without recent trauma for the presence of edema surrounding the MCL, meniscal and ACL tears, medial meniscal extrusion, medial compartment chondromalacia, and osteoarthritis. The percentages of patients illustrating MCL edema with and without each type of pathology were compared using Fisher's exact test to determine if there was a statistically significant association. We found MCL edema in 60% of 247 patients. MCL edema was present in 67% of patients with medial meniscal tears, 35% with lateral meniscal tears, 100% with meniscal extrusion of 3 mm or more, 78% with femoral chondromalacia, 82% with tibial chondromalacia, and 50% with osteoarthritis. The percentage of patients with edema increased with the severity of the chondromalacia. These associations were all statistically significant (p <0.02). The mean age of those with MCL edema was 49.7 years compared with 34.9 years without MCL edema (p <0.001). Patient gender and ACL tear did not correlate with MCL edema. Nine (4%) of the 247 patients had MCL edema without intra-articular pathology. None of these 9 patients had MCL tenderness or joint laxity on physical examination. We confirmed that MCL edema is associated with osteoarthritis, but is also associated with meniscal tears, meniscal extrusion, and chondromalacia. In addition, MCL edema can be seen in patients without intra-articular pathology, recent trauma or MCL abnormality on physical examination. (orig.)

  2. 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 ...

  3. 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

  4. 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.

  5. 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

  6. Ballet injuries: the Australian experience.

    Science.gov (United States)

    Quirk, R

    1983-11-01

    There is a distinct difference between ballet injuries and sports injuries in general, and the sports medicine physician needs to study the technique of dance and the specific injuries that it may produce in order to treat dancers effectively. In Australia, which is typical of other countries where ballet is performed, ballet injuries include strained lumbar muscles, sprained ankle, Achilles tendinitis, clicking hip, jumper's knee, chondromalacia, stress fractures, patellar subluxation, and other knee and tendon problems. PMID:6652700

  7. 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.

  8. 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...

  9. 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.

  10. 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

  11. Adaptación transcultural de la escala Victorian Institute of Sport Assessment - Patella (VISA-P) para la valoración de la gravedad de los síntomas en población deportista española con tendinopatía rotuliana

    OpenAIRE

    Hernández Sánchez, Sergio

    2015-01-01

    Las tendinopatías en el deporte poseen una prevalencia considerable, especialmente las de la extremidad inferior. Estas lesiones ocasionan una limitación funcional en el desplazamiento corporal y la práctica deportiva. En la valoración y monitorización de su evolución clínica se suele emplear la ecografía como medio de valoración estructural. Sin embargo, el uso de instrumentos de medida de resultados de salud autoreportados ha adquirido relevancia en este proceso, ya que permiten reflej...

  12. 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.

  13. 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。

  14. Total Knee Replacement for Women

    Medline Plus

    Full Text Available ... m in the infrapatellar bursa, releasing the fat pad and the ligamentum mucosum. Now at this point ... resected the anterior third of the patella fat pad so I could see down into my lateral ...

  15. 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 ...

  16. Disease: H00464 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available the nail-patella syndrome. Pediatr Radiol. 27:432-5 (1997) PMID:12666288 (description) Sferopoulos NK, Tsit...a syndrome. Overview on clinical and molecular findings. Pediatr Nephrol 17:703-12 (2002) PMID:11175791 (des

  17. Minimally Invasive Total Knee Arthroplasty

    Medline Plus

    Full Text Available ... loose. We can rather easily and without much trauma evert the patella. I tend to use two ... a very nice controlled fashion, with very little trauma to the polyethylene. The other way to put ...

  18. Reconstruction of medial patellofemoral ligament for chronic patellar instability

    Directory of Open Access Journals (Sweden)

    K Raghuveer Reddy

    2012-01-01

    Conclusion: MPFL reconstruction using the semitendinosus tendon gives good results in patients with chronic patellar instability without predisposing factors like severe patella alta and high-grade trochlear dysplasia, and for revision cases.

  19. 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 ...

  20. Total Knee Replacement for Women

    Medline Plus

    Full Text Available ... m removing some lateral osteophytes, which, again, will help me getting my patella subluxated laterally. Now I ... with computer navigation. I believe that that does help with the overall alignment of the knee. We’ ...

  1. Total Knee Replacement for Women

    Medline Plus

    Full Text Available ... see that the medial wear pattern present, as well as some posterior osteophytes on the femur that ... our plan is to resurface the patella as well. So if you can go ahead and we’ ...

  2. Minimally Invasive Total Knee Arthroplasty

    Medline Plus

    Full Text Available ... we can see pretty much all the oblique fibers here of our vastus medialis. I’m simply ... only going to come to where these vastus fibers begin to insert into the patella. I'm ...

  3. Measured technetium-99 activities in waste waters, seawater and two bio-indicators (English Channel Coast, 1983)

    International Nuclear Information System (INIS)

    The article reports the first results of Tc-99 determinations on: (1) radioactive waste waters discharged by the La Hague plant; (2) seawater at a point 5 km north of the discharge point and along the Channel coast at various distances from the discharge point; (3) in specimens of Fucus and Patella; (4) in specimens of Fucus and Patella from the Atlantic coast of France as controls. (U.K.)

  4. 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.

  5. Neue Aspekte in der Behandlung der patellofemoralen Instabilität

    OpenAIRE

    Schöttle, Philip Bastian

    2010-01-01

    Although patellofemoral instability is one of the most common pathologie of the knee, there was no consensus about the pathoetiology, an optimal diagnosis or an adequate therapy. Recently, new findings allowed us to understand more about mophologies, taking influence onto the joint kinetics. These findings gave an understanding of the different stabilisers, guiding and keeping the patella in the trochlea as well as the mechanisms, how these stabilisers can fail and the patella dislocates. ...

  6. Systematic review of patellar resurfacing in total knee arthroplasty

    OpenAIRE

    Li, Shuzhen; Chen, Yueping; Su, Wei; Zhao, Jinmin; He, Shunqing; Luo, Xiangping

    2010-01-01

    Controversies existing over resurfacing the patella in total knee arthroplasty remain in the literature. The purpose of this review was to evaluate the effectiveness of resurfacing versus nonresurfacing the patella in total knee arthroplasty. We searched the Cochrane Library, MEDLINE and EMBASE for published randomised clinical trials relevant to patellar resurfacing. The relative risk of reoperation was significantly lower for the patellar resurfacing group than for the nonresurfacing group ...

  7. 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

  8. 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

  9. Articular cartilage defect detectability in human knees with MR-arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Engel, A. [Orthopaedic Clinic, Univ. of Vienna (Austria); Kramer, J. [MR-Inst., Univ. of Vienna (Austria); Stiglbauer, R. [MR-Inst., Univ. of Vienna (Austria); Hajek, P.C. [MR-Inst., Univ. of Vienna (Austria); Imhof, H. [MR-Inst., Univ. of Vienna (Austria)

    1993-04-01

    One hundred and thirteen knee joints were examined, of which 48 showed damage of the hyaline cartilage in one or more locations. For the evaluation of the magnetic resonance (MR) arthrographic images we used the macroscopic staging according to Outerbridge, the defect staging according to Bauer, as well as a new MR-arthrographic staging. The results of the evaluation were compared with the surgical findings in 61 knee joints. This revealed a sensitivity of 86 %, a specificity of 100 % and accuracy of 90 %. All lesions that could not be classified on MR-arthrography were of stage-I chondromalacia. (orig.)

  10. 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

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

    Science.gov (United States)

    Meyers, Arthur B; Laor, Tal; Sharafinski, Mark; Zbojniewicz, Andrew M

    2016-05-01

    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. PMID:26860094

  12. 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.)

  13. Femoropatellar gliding movement during active stretching of the knee. Imaging with movement-triggered MR tomography. Die femoropatellare Gleitbewegung waehrend aktiver Kniestreckung. Darstellung mit bewegungsgetriggerter MR-Tomographie

    Energy Technology Data Exchange (ETDEWEB)

    Brossmann, J.; Muhle, C.; Melchert, U.H.; Spielmann, R.P. (Universitaet Kiel, Klinik fuer Radiologische Diagnostik (Germany)); Schroeder, C. (Universitaets-Kinderklinik Kiel, Roentgenabteilung (Germany)); Hassenpflug, J. (Orthopaedische Universitaetsklinik Kiel (Germany))

    1992-06-01

    By means of motion-triggered MRT it has been possible for the first time to demonstrate movements in the patello-femoral joint by means of MRT. Patello-femoral movement was studied during active extension of the knee between 30deg flexion and complete extension. The knees of 5 normal females and 7 normal males were studied together with 2 women with recurrent lateral patellar luxation. In normal women there was an average 16deg (10 to 18deg), in men an average of 12deg (10 to 14deg) of lateralisation of the patella during complete extension of the knee. In 1 patient there was 10deg medial displacement of the patella before extension. In 2 knees with recurrent lateral subluxation there was a 20 and 24deg displacement of the patella. (orig.).

  14. Femoropatellar gliding movement during active stretching of the knee

    International Nuclear Information System (INIS)

    By means of motion-triggered MRT it has been possible for the first time to demonstrate movements in the patello-femoral joint by means of MRT. Patello-femoral movement was studied during active extension of the knee between 30deg flexion and complete extension. The knees of 5 normal females and 7 normal males were studied together with 2 women with recurrent lateral patellar luxation. In normal women there was an average 16deg (10 to 18deg), in men an average of 12deg (10 to 14deg) of lateralisation of the patella during complete extension of the knee. In 1 patient there was 10deg medial displacement of the patella before extension. In 2 knees with recurrent lateral subluxation there was a 20 and 24deg displacement of the patella. (orig.)

  15. 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.

  16. 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.)

  17. 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.

  18. La influencia de la superficie articular y la membrana sinovial en la evolución de pacientes afectos por bloqueo crónico de la articulación temporomandibular tratados mediante artroscopia Influence of the joint surface and the synovial membrane on the evolution of patients affected by chronic temporomandibular joint block who were treated with arthroscopic surgery

    Directory of Open Access Journals (Sweden)

    R. González-García

    2010-03-01

    joints met the criteria for chronic block of the TMJ. One hundred and seventy-two patients with unilateral affectation were selected for this study. Synovitis and chondromalacia are the parameters chosen to evaluate the synovitis membrane and joint surface, respectively. Two groups of patients were formed: a patients with light affectation: level I/II synovitis and level I/II chondromalacia, and b patients with severe affectation: level III/IV synovitis and level III/ IV chondromalacia. The dependent variables were pain and interincisal maximum oral opening (MOO. All of the patients had post operative follow-up at 1, 3, 6, 12, and 24 months. The "t" Student test was used before and after surgery to match evidence to compare the average values of visual analogical scale (VAS and function (MOO. The "t" Student test was used for independent samples to compare the different groups that were established. A value of p < 0.05 was considered statistically significant. Results: Level I/II synovitis was seen using arthroscopy in 87 (50.58% patients, and level III/ IV synovitis was seen in 54 (31.39% of patients, while level I/II chondromalacia was observed in 66 (38.37% patients and level III/IV chondromalacia was observed in 54 (31.39%. During the follow-up period a significant decrease in pain and a parallel increase in oral opening were observed after arthroscopy in patients affected by level I/II and III/IV synovitis and level I/II and III/IV chondromalacia. There was a significant statistical difference in relation to observed pain in patients with level I/II synovitis and in patients with level III/IV synovitis in the sixth month after surgery. However this difference did not continue in the rest of the follow-up period. Nor were there any statistical differences related to the MOO related to synovitis during follow-up. There were no differences in pain or oral opening between patients with level I/II chondromalacia and patients with level III/IV chondromalacia at any time

  19. Evaluation of patellar cartilage surface lesions: comparison of CT arthrography and fat-suppressed FLASH 3D MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Daenen, B.R.; Ferrara, M.A.; Marcelis, S.; Dondelinger, R.F. [Department of Medical Imaging, University Hospital Sart-Tilman, Liege (Belgium)

    1998-07-01

    The aim of this study was to evaluate the sensitivity and specificity of fat-suppressed fast low-angle shot (FLASH) 3D MR imaging in the detection of patellar cartilage surface lesions in comparison with CT arthrography. Fifty patients, with or without symptoms of chondromalacia, were prospectively examined by CT arthrography and fat-suppressed 3D gradient-echo MR imaging. All MR examinations were evaluated by three observers, two of them reaching a consensus interpretation. The lesions were graded according to their morphology and their extent. The CT arthrography was considered as the reference examination. For both sets of observers, the final diagnosis of chondromalacia was obtained in 92.5 %. The specificity was 60 % on a patient-by-patient basis. Fissures were missed in 83 and 60 %, respectively, but were isolated findings only in 2.5 % of the cases. Considering ulcers involving more than 50 % of the cartilage thickness, 65 and 88 %, respectively, were recognized. Fat-suppressed FLASH 3D is an adequate pulse sequence for the detection of patellar cartilage ulcers. It can be applied on a routine clinical basis, but it does not show as many fissures as CT arthrography and is less precise for grading of lesions. (orig.) With 4 figs., 3 tabs., 21 refs.

  20. MRI findings in renal transplant recipients with hip and knee pain

    International Nuclear Information System (INIS)

    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.

  1. 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

  2. Is There an Ideal Patellar Thickness Following Total Knee Arthroplasty?

    Science.gov (United States)

    Pierce, Todd P; Jauregui, Julio J; Cherian, Jeffrey J; Elmallah, Randa K; Harwin, Steven F; Mont, Michael A

    2016-01-01

    Orthopedic surgeons resurface the patella during total knee arthroplasty to avoid complications such as pain, patello-femoral arthritis, and patellar maltracking and to reduce the risk for reoperation. However, many complications, such as decreased range of motion, increased fractures, and polyethylene wear, have been described with this procedure. One determinant when resurfacing a patella is the thickness of its cuts. This review aims to investigate the relationship between patellar thickness and outcome parameters such as range of motion, patient-reported outcomes, periprosthetic fractures, and reoperations. PMID:26726982

  3. 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.

  4. 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,…

  5. 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.

  6. Patellofemoral ligament reconstruction in a patient with Rubinstein-Taybi syndrome.

    OpenAIRE

    Fardin Mirzatolooei

    2014-01-01

    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.

  7. Patellofemoral ligament reconstruction in a patient with Rubinstein-Taybi syndrome.

    Science.gov (United States)

    Mirzatolooei, Fardin

    2014-01-01

    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. PMID:24901727

  8. 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.

  9. 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.

  10. X-ray diagnosis of retropatellar diseases

    International Nuclear Information System (INIS)

    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. (orig.)

  11. 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.

  12. Total Knee Replacement for Women

    Medline Plus

    Full Text Available ... it’s much simpler so you just make the decision whether you’re posterior cruciate ligament is functioning ... being placed. So I don’t make any decision on the patella tracking at this point. This ...

  13. 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.

  14. Clinical application in the improved method of whirbone axial view X-ray photography and synthetical evaluation of various survey methods

    International Nuclear Information System (INIS)

    Objective: To summarize the improved method of photographing axial view of the patella by genuflex at 25 degree angle and evaluate synthetically various measures. Methods: Special projection frame was made to photograph in the study. Thirty normal people were enrolled as controls and 154 patients with fore-knee pain were included in the patient group. The patients were found to be abnormal in the arrangement of the patella by patella axial view photographs. Measures included sulcus angle (SA), congruence angle (CA), lateral shift (LS), later patellofemoral angle (LPFA), patellofemoral index (PFI), and lateral patellar displacement (LPD). Results: The average value of the parameter of two groups respectively are comparison group of SA 137.38 degree, CA -10.73 degree, LS 10.49%, LPFA 13.70 degree, PFI 0.48, LPD 0.45 mm and observation group of: SA 142.38 degree, CA -0.71 degree, LS 19.68%, LPFA 12.12 degree, PFI 1.13, LPD 0.42 mm. There was significant difference between the control group and patients for most measures except LPD (P<0.01). The measures of PFI, CA, LS, LPTA and LPD were sensitive to the disarrangement of the patella, with sensitivity of 71.66%, 63.33%, 56.66%, 21.60%, 16.66% respectively. Conclusions: The method of photographing axial view of the patella by genuflex at 25 degree angle is effective. It increases distinctness of the photographs. Furthermore, the method makes line-drawing more easily and measuring more accurately. (authors)

  15. 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...

  16. 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

  17. 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

  18. 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 and...... similar endoscopic procedure and accelerated postoperative rehabilitation. Tunnel widening was determined using standardized anteroposterior (AP) and lateral X-rays adjusted for magnification. A limited series of MRIs was performed to validate these measurements. There was a significant difference in the...... degree of tunnel widening between the two groups. The mean increase in femoral tunnel area in the hamstring group was 100.4% compared with a decrease of 25% in the patella tendon group (P = <0.0001). In the tibial tunnel the mean increase in the hamstring group was 73.9% compared with a decrease of 2...

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

    Directory of Open Access Journals (Sweden)

    Meena Sanjay

    2013-06-01

    Full Text Available 【Abstract】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 bro-ken 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 of patellar fractures can migrate into the posterior compartment of the knee and cause clini-cal symptoms. Close clinical and radiological follow-up af-ter internal fixation to identify the presence of hardware breakage or movement and removal of wires once fracture has united can avert such complications. Key words: Patella; Fracture fixation, internal; Bone wires

  20. 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.

  1. Radiographic evaluation of new orthopedic surgical techniques for cruciate and medial collateral ligament knee reconstruction

    International Nuclear Information System (INIS)

    The normal postoperative radiographic appearance of ligamentous knee reconstructions, postoperative complications, and potential pitfalls are presented. Anterior cruciate ligament repair with bone-patella tendon-bone grafts is evaluated in terms of hardware position, location of the drill holes, and change in position, fracture, or healing of the bone graft itself. Posterior cruciate ligament injuries may be repaired similarly with a bone-patella tendon-bone graft or may involve entirely soft-tissue reconstruction, in which case they are evaluated by location of the drill holes and hardware position. Medial collateral ligament repairs are evaluated entirely by hardware position, based on an anatomic understanding of the normal origin and insertion of the ligament

  2. 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

  3. 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.

  4. 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.

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  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. Effects of Low-Level Laser Therapy and Eccentric Exercises in the Treatment of Patellar Tendinopathy

    OpenAIRE

    Xiao-Guang Liu; Lin Cheng; Ji-Mei Song

    2014-01-01

    The study aims to investigate if low-level laser therapy (LLLT) combined with eccentric exercises could more effectively treat patellar tendinopathy than LLLT alone and eccentric exercises alone. Twenty-one patients with patellar tendinopathy were randomized to three groups: laser alone, exercise alone, or laser plus exercise, with seven in each group. Laser irradiations were administered at the inferior pole of the patella and the two acupoints of Extra 36 (Xiyan) with the intensity of 1592 ...

  13. 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 ...

  14. Radiographic appearance of the equine stifle from birth to 6 months

    International Nuclear Information System (INIS)

    Lateromedial radiographs of 74 stifles from foals with no stifle swelling or lameness were evaluated to determine the range of normal variation. Foals ranged in age from 0 to 25 weeks with approximately one half of the foals being younger than 11 weeks of age. Nine breeds were represented, with Standardbred and Quarter horse being the most common. Femoral trochlear ridges and patellas were graded on a scale of 1–4 from regular and well defined (1) to very irregular (4). Femoral and tibial condyles were evaluated for irregularity. Twelve stifles were evaluated at necropsy. Irregular to very irregular patellas and trochlear ridges were found in foals up to 20 weeks of age. In foals younger than 11 weeks of age, 77% of bone borders were irregular or very irregular, whereas only 23% of bone borders from foals 11–25 weeks of age had irregular borders. A grade of very irregular was found in 33% of bone borders of foals younger than 11 weeks old, whereas only 1.25% of bone borders of older foals were graded very irregular. Asymmetry in the bone borders between left and right stifle was evident in 36% of the studies, but did not vary by more than one grade. Femoral and tibial condyles were nearly all regular and well defined regardless of age. These findings suggest that obvious irregularities of the femoral or tibial condyles in foals should be interpreted as pathologic. Patellas and trochlear ridges were ranked smooth in 3% of foals younger than 11 weeks of age and in 55% of bone borders of foals 11–25 weeks of age. Obvious irregularities of the patellas or femoral trochlear ridges may be well within normal limits in foals younger than 5 months. Consistent and diagnostic radiographic studies can be obtained safely in most standing foals with little or no sedation

  15. 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...

  16. Patellar tendinopathy: etiology and treatment

    OpenAIRE

    van der Worp, Hendrik

    2012-01-01

    Bestaande behandeling jumper’s knee niet effectief Zo’n tienduizend Nederlanders hebben last van een jumper’s knee (patella tendinopathie). Deze blessure komt vooral voor bij basketbal, volleybal en andere sporten waarin veel gesprongen wordt. De blessure heeft vaak langdurige gevolgen en is moeilijk te behandelen. Het onderzoek van Henk van der Worp verschaft nader inzicht in de oorzaken van de aandoening en levert suggesties ter verbetering van de behandeling. Van der Worp stelt vast dat he...

  17. Recurrent giant cell tumor of bone with simultaneous regional lymph node and pulmonary metastases

    Energy Technology Data Exchange (ETDEWEB)

    Qureshi, Sajid S.; Puri, Ajay; Agarwal, Manish [Tata Memorial Hospital, Department of Bone and Soft Tissue, Bombay (India); Desai, Saral; Jambhekar, Nirmala [Tata Memorial Hospital, Department of Pathology, Bombay (India)

    2005-04-01

    Giant cell tumors of bone are known for their unpredictable behavior characterized occasionally even by metastases. Most metastases lodge in the lungs but other rare sites are regional lymph nodes, mediastinum, skin, scalp and the pelvis. In this case report we document a case of giant cell tumor of the patella in which, associated with local recurrence, there were simultaneous metastases to lymph nodes and lungs. (orig.)

  18. 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.

  19. Clinical signs and anatomical correlation of patellar tendinitis

    OpenAIRE

    Rath Ehud; Schwarzkopf Ran; Richmond John

    2010-01-01

    Background: Patellar tendinitis is one of the several differential diagnosis of anterior knee pain. The clinical diagnosis of patellar tendinitis is based on tenderness to palpation at the inferior pole of the patella. The tenderness has been noted to be maximal when the knee is extended and the quadriceps relaxed, but a definite clinical sign for diagnosis is lacking. The accuracy of two clinical signs was assesed by a two-stage study which included physical examination, MRI and a cadaveric ...

  20. 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...

  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. Using Electromyography to Detect the Weightings of the Local Muscle Factors to the Increase of Perceived Exertion During Stepping Exercise

    OpenAIRE

    Miao-Ju Hsu; Peih-Ling Tsaih; Cheng-Hsiang Lin; Chin-Chih Liu; Ya-Ju Chang

    2008-01-01

    Rate of perceived exertion (RPE) is a clinically convenient indicator for monitoring exercise intensity in cardiopulmonary rehabilitation. It might not be sensitive enough for clinicians to determine the patients’ physiological status because its association with the cardiovascular system and local muscle factors is unknown. This study used the electromyographic sensor to detect the local muscle fatigue and stabilization of patella, and analyzed the relationship between various local mus...

  4. Ten year follow-up study comparing conservative versus operative treatment of anterior cruciate ligament ruptures. A matched-pair analysis of high level athletes

    OpenAIRE

    Meuffels, Duncan; Favejee, Marein; Vissers, Maaike; Heijboer, Rien; Reijman, Max; Verhaar, Jan

    2009-01-01

    textabstractOBJECTIVE: To compare long term outcome of highly active patients with anterior cruciate ligament ruptures treated operatively versus non-operatively. DESIGN: We reviewed high level athletes with an anterior cruciate ligament rupture on either MRI or arthroscopic evaluation more than 10 years previously, who were treated conservatively. They were pair-matched with patients who had had an anterior cruciate ligament reconstruction with bone-patella-tendon-bone, with respect to age, ...

  5. 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...

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

    OpenAIRE

    Gholamhossein Ghaffarpour; Alireza Faghihi; Mohammadreza Ghasemi; Gelareh Ghaffarpour

    2014-01-01

    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, su...

  7. 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...

  8. 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

  9. 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

  10. 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.

  11. 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

  12. 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

  13. Genesis Ⅱ与PFC两种假体全膝关节置换术后膝前痛的比较研究%Comparison of anterior knee pain after total knee arthroplasty using Genesis Ⅱ and PFC knee prostheses

    Institute of Scientific and Technical Information of China (English)

    吴伟东; 严世贵; 吴立东; 吴浩波; 何荣新

    2012-01-01

    Objective To explore relationship between anterior knee pain after total knee arthroplasty and patella resurfacing and prosthesis design,and to evaluate which femoral prosthesis is more friendly with patella:Genesis Ⅱ or PFC knee prostheses.Methods Data of 145 patients (145 knees) who had undergone primary total knee arthroplasty for treating osteoarthritis were retrospectively analyzed.Posterior-cruciate-substituting total knee prostheses were used in all patients.Among 74 patients who had undergone patella resurfacing,Genesis Ⅱ knee prosthesis was used in 32 patients and PFC knee prosthesis in 42 patients.Among 71 patients who had not undergone patella resurfacing,Genesis Ⅱ knee prosthesis was used in 38 patients and PFC knee prosthesis in 33 patients.The Hospital for Special Surgery(HSS) score,patella score,patellar function score,range of motion of knee,anterior knee pain scale,and patient satisfaction were used to evaluate clinical outcomes.At the same time,the imaging results were evaluated by X-rays.Results 144 patients were successfully followed up for 21 to 43 months (average,33 months).There was no significant difference in incidence of anterior knee pain between the group with patella resurfacing and the group without patella resurfacing,while a significant difference was found between patients receiving Genesis Ⅱ knee prosthesis and those receiving PFC knee prosthesis.Four patients who had undergone total knee arthroplasty using PFC prosthesis underwent reoperation.There were no significant differences in postoperative HSS score,range of motion of knee and patient satisfaction between the Genesis Ⅱ group and the PFC group,while there were significant differences in patella score and patellar function score between them.Conclusion Postoperative anterior knee pain was related to the prosthesis design,rather than to the patella resurfacing.Genesis Ⅱ knee prosthesis was more friendly with patella than PFC knee prosthesis.%目的 探讨全膝关

  14. Arthroscopic management of painful first metatarsophalangeal joint

    Directory of Open Access Journals (Sweden)

    Debnath U

    2005-01-01

    Full Text Available Background: Arthroscopy of the great toe MTP joint has been practiced with favourable outcomes. A range of indications have been described ranging from synovitis to osteochondral defects. The purpose of the present study was to describe our technique and to assess the functional outcome following arthroscopic management of Hallux MTP disorders using AOFAS scoring system. Methods: We describe the technique of Hallux MTP joint arthroscopy in twenty patients. Indications included hallux rigidus with osteophytes, chondromalacia, OCDs, loose bodies, arthrofibrosis, synovitis, tophaceous gout arthritis and intra-articular fractures of MTP joint. All patients had been evaluated clinically and radiologically with record of their AOFAS scores pre-operatively. At a minimum follow-up of two years the clinical assessment was carried out with AOFAS scores. Results: The mean pre-operative and post-operative AOFAS score were 47 (range 10-78 and 97 (87 -100 respectively. The patient with intra-articular fracture had an excellent outcome following arthroscopic reduction of the fracture. Conclusion: Arthroscopic management of painful hallucial MTP joint is a specialized technique, which if performed for the right indications, gives a favourable outcome with minimal complications.

  15. CT and MR imaging of the knee joint in the ''plica syndrome''

    International Nuclear Information System (INIS)

    ''Synovial plicae'' are present in 60% of adult knees and can be the cause of a nonspecific clinical picture known as the plica syndrome. Direct high-resolution CT and MR imaging were performed on 30 patients with serious clinical signs of plica syndrome. All patients underwent anthroscopy. Twelve infrapetallar, eight suprapatellar, and 22 medical synovial plicae were shown (in 12 cases two different plicae were present). In seven cases there were other associated lesions: one case of patellar tendinitis, three medial meniscus lesions, one lateral diskoid meniscus, and two patellar subluxations. The diagnostic accuracy of both CT and MR imaging were compared with arthroscopy. CT always showed the plicae and defined their types, locations, and associations with other lesions. MR imaging was superior to CT in characterizing the morphology of the plica (related with symptomatology) and in showing the femoral and patellar chondromalacia secondary to the plica itself. MR imaging was equally accurate in revealing the tendinitis and the patellar subluxations, but CT was superior in displaying the meniscal lesions and the diskoid meniscus

  16. A retrospective study of the relationship between tracheal collapse and bronchiectasis in dogs.

    Science.gov (United States)

    Marolf, Angela; Blaik, Margaret; Specht, Andrew

    2007-01-01

    Tracheal collapse is common in middle age toy and miniature breed dogs. Cartilaginous defects have been identified histologically and are considered a form of chondromalacia. In addition to tracheal cartilaginous changes, concurrent lower airway histologic changes indicative of inflammation have been noted in dogs with tracheal collapse and these changes may lead t o concurrent bronchiectasis. The purpose of this study was to investigate the prevalence of bronchiectasis in dogs with a previous radiographic diagnosis of tracheal collapse. The thoracic radiographs of 60 dogs with tracheal collapse were evaluated for evidence of concurrent bronchiectasis. Eighteen of 60 (30%) dogs had evidence of bronchiectasis, and all were cylindrical in morphology. The signalment of affected dogs was similar to that previously reported. The occurrence of bronchiectasis in this group of dogs with tracheal collapse (18 dogs) was six times higher (P dogs). The results of this study provide evidence of a link between tracheal collapse and bronchiectasis. A finding of bronchiectasis with tracheal collapse should encourage further evaluation for chronic lower airway disease in these patients. PMID:17508504

  17. Fracture of articular cartilage.

    Science.gov (United States)

    Chin-Purcell, M V; Lewis, J L

    1996-11-01

    Crack formation and propagation is a significant element of the degeneration process in articular cartilage. In order to understand this process, and separate the relative importance of structural overload and material failure, methods for measuring the fracture toughness of cartilage are needed. In this paper, two such methods are described and used to measure fracture properties of cartilage from the canine patella. A modified single edge notch (MSEN) specimen was used to measure J, and a trouser tear test was used to measure T, both measures of fracture toughness with units of kN/m. A pseudo-elastic modulus was also obtained from the MSEN test. Several potential error sources were examined, and results for the MSEN test compared with another method for measuring the fracture parameter for urethane rubber. Good agreement was found. The two test methods were used to measure properties of cartilage from the patellae of 12 canines: 4-9 specimens from each of 12 patellae, with 5 right-left pairs were tested. Values of J ranged from 0.14-1.2 kN/m. J values correlated with T and were an average of 1.7 times larger than T. A variety of failure responses was seen in the MSEN tests, consequently a grade of 0 to 3 was assigned to each test, where 0 represented a brittle-like crack with minimal opening and 3 represented plastic flow with no crack formation. The initial cracks in 12/82 specimens did not propagate and were assigned to grade 3. The method for reducing data in the MSEN test assumed pseudo-elastic response and could not be used for the grade 3 specimens. Stiffness did not correlate with J. Neither J nor T was statistically different between right-left pairs, but varied between animals. The test methods appear useful for providing a quantitative measure of fracture toughness for cartilage and other soft materials. PMID:8950659

  18. 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.)

  19. 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

  20. 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.)

  1. 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

  2. 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

  3. 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.)

  4. Magnetic resonance imaging of patellofemoral relationships

    International Nuclear Information System (INIS)

    Patellofemoral relationships were analyzed in 11 patients (13 knees) with patellar dislocation and 15 asymptomatic subjects (15 knees) at 0 and 20 of flexion. The measurements were made from five consecutive axial images through the patellofemoral joint. The six indices measured were lateral patellar tilt (LPT), lateral patellofemoral angle (LPA), lateral patellar displacement (LPD), patella-lateral condyle index (L/PW), congruence angle (CA), and sulcus angle (SA). The reproducibility of the method was evaluated. The difference between the two study groups was more evident at 0 than at 20 of knee flexion. Significant differences were noted between measurements made at different levels of the joint, particularly in the controls. Isometric contraction of the quadriceps muscle lateralized and tilted the patella slightly in both groups. L/PW with and without quadriceps muscle contraction, and LPA with reference to the anterior condyles differentiated between the two study groups most clearly. LPT and LPA with reference to the anterior condyles differentiated the study groups better than LPT and LPA with reference to the posterior condyles. The reproducibility was good except for interobserver comparison of CA and SA. The use of an imaging plane selected at the midpoint of the patellar articular cartilage increases the sensitivity of the measurements, since it takes into account both the height of the patella and the tendency towards lateralization. These results indicate that patellar tilt is best measured with the LPA index and patellar lateralization with the L/PW index at 0 knee flexion. This study should always include isometric contraction of the quadriceps muscle. (orig.)

  5. [Patellar osteochondral injury as onset of patellar instability].

    Science.gov (United States)

    Cepero-Campà, S; Ullot-Font, R; Pérez-López, L M

    2012-01-01

    Patellar osteochondral fractures with no dislocation are uncommon and usually affect the centromedial facet of the patella. We present the case of a 10 year-old, overweight, female patient. She was seen in the emergency room after suffering an accidental fall, assessed as an osteochondral fracture-dislocation of the right patella with upper-outer displaced free fragments. By patient interview, she referred to no previous episodes of patellar dislocation. To complete the study, we performed an MRI which showed a medial facet patellar fracture, with two osteochondral fragments located in the sub-quadricipital recess, associated with other lesions suggesting patellar subluxation. We considered that the best treatment was surgery, so the following was performed: an open reduction and internal fixation with absorbable bars, lateral patellar release (Ficat technique), patellar coverage by medial portion of quadriceps (Insall technique) and internal moving of the lateral half of the patellar tendon (Goldwaith technique). The injury was checked one year later using arthroscopy. It confirmed a good reconstruction of the articular surface, and right patellar centering. At follow-up, during the physiotherapy period, the patient began to have repeated episodes of instability in the contralateral patella. The CT scan confirmed the patellar lateralisation (TAGT 17). Centering surgery was indicated due to the occurrence of multiple dislocation episodes. The patient currently carries out normal physical activity and she has a complete range of movement. Patellar osteochondral fracture is an injury frequently associated with patellar instability, which may onset in the first episode. The medial location of the lesions and the involvement of the system of medial knee stability is a fundamental finding. This fact reinforces the diagnosis of pre-fracture patellar dislocation. This is not a fracture-dislocation, but a dislocation-fracture. We may, therefore, treat the injury and its

  6. The relationship between patellofemoral and tibiofemoral morphology and gait biomechanics following arthroscopic partial medial meniscectomy

    DEFF Research Database (Denmark)

    Dempsey, Alasdair R.; Wang, Yuanyuan; Thorlund, Jonas Bloch;

    2013-01-01

    Purpose To examine the relationship between tibiofemoral and patellofemoral joint articular cartilage and subchondral bone in the medial and gait biomechanics following partial medial meniscectomy. Methods For this cross-sectional study, 122 patients aged 30–55 years, without evidence of knee...... with decreased patella cartilage volume (B = −17.9 (95 % CI −35.4, −0.4) p = 0.045) while knee adduction moment impulse was associated with increased medial tibial plateau area (B = 7.7 (95 % CI 0.9, 13.3) p = 0.025). A number of other variables approached significance. Conclusions Knee joint biomechanics...

  7. Modeling of the mechanical behavior of the human femur: Stress analysis and strain

    Science.gov (United States)

    Belaid, Dalila; Bouchoucha, Ali

    2015-12-01

    The strength of bone depends on its state of mineralization, its geometry, and even supported loads. The femur is the longest bone, the largest and strongest of the human skeleton. It provides standing and walking and running, due to its hip joints with the one side, and with the patella and tibia across. The approach of this paper is to numerically model the mechanical behavior of the femur to determine the stress and strain distribution field. Modeling is performed on the ANSYS software. The results show the influence of different positions of the femur in different cases of postures.

  8. 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...

  9. 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

  10. 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

  11. Canine hip dysplasia evaluation: a positioning and labeling guide for radiographs to be submitted to the Orthopedic Foundation for Animals

    International Nuclear Information System (INIS)

    The ventrodorsal radiograph of the pelvis and femurs with the hind limbs extended, femurs parallel to each other, patellae superimposed over the distal femurs, and the pelvis symmetrical has become the standard method by which to evaluate animals for hip dysplasia. The following illustrated guide details the methods of positioning recommended by the American Veterinary Medical Association and used by the Orthopedic Foundation for Animals (OFA). Additionally, some commonly encountered positioning errors and methods of labeling radiographs are shown. The authors stress positioning requirements and aids they feel are necessary to produce an adequately positioned radiograph

  12. Effectiveness of Orthoses and Foot Training in patients with Patellofemoral Pain and hyperpronation

    DEFF Research Database (Denmark)

    Mølgaard, Carsten; Kaalund, Søren; Christensen, Marianne;

    .   Methods and Measures: Forty patellofemoral patients, with excessive foot pronation were prospectively randomised to undergo a regimen of supervised exercise once a week for 3 months or to a control group. Both groups received a standard regimen of three supervised session with a physiotherapist over 3...... the knee slightly bended. • Pain by palpation of the parapatellar regions lateral or medial. • Pain by compression of patella against femur. • Pain by concentric contraction of quadriceps against resistance. All participants were clinically defined as excessive pronators, when the calcaneus angle was...

  13. 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...

  14. 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.

  15. THE GEM IN GASTROCNEMIUS: THE FABELLA

    Directory of Open Access Journals (Sweden)

    Ashfaq Ul Hassan

    2013-09-01

    Full Text Available Sesamoid bones are small seed like bones which can be found in the hand, knee, and foot. Their unique structure works to protect the tendon, and to increase its mechanical effect. Examples of sesamoid bones include the os acromiale, os styloideum, metacarpal and hallux sesamoids, patella, os trigonum, os calcaneus secundarius, accessory navicular, os peroneum, and os intermetatarseum. The Sesamoid bones are so named because they resemble a sesame seed. WE present a brief description about Fabella , a small Sesamoid bone occasionally found in the lateral head of Gastrocnemius muscle, its surgical and medical importance .Presence of Fabella can be confused with certain Orthopedic Problems.

  16. 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...

  17. 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.

  18. 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; Holm, E.; Boelskifte, S.; Duniec, S.; Persson, B.

    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 of...

  19. 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...

  20. 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

  1. 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:

  2. A 3D kinematics measurement of knee joint using X-ray projection images

    International Nuclear Information System (INIS)

    Most of previous studies about joint kinematic analysis using X-ray image needed totally clear outline bones. However, to obtain the clear outline is not easy in clinical because X-ray image of knee often overlaps with bones. In this study, the method of kinetic analysis that uses the outline, which was not totally clear, was proposed. In order to achieve the aim, P type Fourier Descriptor that can be used in an open curve was applied. And, the library database was preliminary selected using feature vectors which were based on shape feature, initial point and terminal point of the outline. After an outline of the object was divided in three parts, template pattern matching was performed. In results, the standard deviation of errors of patella were θx=1.00±0.84 deg, θy=0.55±0.65 deg and θz=0.62±0.12 deg. As to femur, tibia and patella, a part of divided outlines influenced the accuracy of our proposal method. This result shows that, even if all outline of bone is not clear on X-ray image, 3D kinematic analysis can be carried out. (author)

  3. 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.

  4. The informative value of radionative diagnostics in cases of patellar chondropathy

    International Nuclear Information System (INIS)

    The present study of 64 patients analyzes the diagnosticability of patellar chondropathy on the basis of X-ray native images. The results were confirmed intraoperatively or arthroscopically. We evaluated images of both knees in a.p. and lateral projection and walking images with 30, 60, and 900 of joint bending. In all cases of chondropathy of third degree, radiomorphologic changes could be delineated; in stage I this was possible in 66% of the cases. The summarizing assessment of structural irregularities as discontinued contours of the subchondral osseous lamella, spot-like or diffuse demineralisation, osteophyteous peripheral serration, disintegration in the insertion area of the quadriceps tendo, soft-tissue swelling and hemarthrosis is significant for establishing the diagnosis. Whereas there is a causal relationship between defective axial positions of the patella or particularly posttraumatic defect and the development of a chrondropathy, we could not detect in the investigated patient-group a significantly higher incidence of chondropathy in cases of dysplasia of the patella or of the femoral condyles. A simple scheme - applicable in arthroscopy and radiology - is introduced: it shall help to record chondromalacious regions and considers the most frequently affected areas. (orig.)

  5. 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

  6. 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.

  7. 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.

  8. Clinical signs and anatomical correlation of patellar tendinitis

    Directory of Open Access Journals (Sweden)

    Rath Ehud

    2010-01-01

    Full Text Available Background: Patellar tendinitis is one of the several differential diagnosis of anterior knee pain. The clinical diagnosis of patellar tendinitis is based on tenderness to palpation at the inferior pole of the patella. The tenderness has been noted to be maximal when the knee is extended and the quadriceps relaxed, but a definite clinical sign for diagnosis is lacking. The accuracy of two clinical signs was assesed by a two-stage study which included physical examination, MRI and a cadaveric study. Materials and Methods: Two clinical signs, the "passive flexion-extension sign" and the "standing active quadriceps sign" were assessed in 10 consecutive patients with presumed patellar tendinitis. Five patients had an MRI, showed focal abnormality in the tendon. The location of the MRI finding corresponded, to the region of maximal tenderness. A cadaveric dissection was undertaken to describe the anatomy of the patella and the patellar tendon during these tests. Results: Both tests showed a significant decrease in tenderness at the area of inflammation when the patellar tendon was under tension. The cadaveric dissection showed that when the knee is flexed to 90΀ or when the quadriceps is tensioned the deep fibers of the tendon do not deform to anteriorly applied pressure. Conclusion: We suggest using these studies routinely in the evaluation of patients with anterior knee pain.

  9. 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)

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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

  15. Patellofemoral pain: Challenging current practice - A case report.

    Science.gov (United States)

    Smith, Benjamin E; Hendrick, Paul; Logan, Pip

    2016-04-01

    Patellofemoral pain (PFP) is a common problem in young people, with 1 in 6 suffering at any one time. It is unclear which management approach is the optimal method for treating PFP in the long term, with traditional physiotherapy examination focusing on assessing for specific structural dysfunction. A rationale for a different assessment and treatment approach, one that moves the focus away from a biomedical/tissue pathology model towards one directed at the neurophysiology of pain, has been suggested. The patient was a 21 year old male with a 6 year history of PFP with previous failed physiotherapeutic treatment. He reported previous multiple healthcare practitioners' advice to avoid activities that were painful as reasons for being unable to participate in sporting activities. No specific structural testing was performed, such as specific muscle strength, length, foot position, patella movement and position, or movement patterns. Descriptions of tissue based pathology models of pain, e.g. patella mal-tracking, were actively discouraged and challenged. The patient was taught to perform one uncomfortable/painful exercise as part of his rehabilitation programme twice a day. The patient achieved 80% improvement in his symptoms over 7 appointments and a return to physical activity following a 5 month rehabilitation programme purposively designed to elicit pain by means of gradually exercising and loading the tissues. This case report highlights the need for further research into exercise protocols for patients suffering with PFP based upon neurophysiology models of pain. PMID:26394748

  16. 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.

  17. [Comparative study of echography and conventional radiology in the evaluation of the Insall-Salvati index].

    Science.gov (United States)

    Martino, F; Ettorre, G C; Macarini, L; Tritto, D; Patella, V; Moretti, B; Pesce, V

    1992-12-01

    For the study of painful patello-femoral syndromes, the authors suggest the use of US for the evaluation of the so-called Insall-Salvati ratio--i.e., length of patellar ligament/patellar length--whose alteration is suggestive of vertical patello-femoral malalignement (patella alta and patella infera). Ten normal volunteers (20 knees) were examined by means of both US and conventional radiology, and the Insall-Salvati ratio was calculated for each knee. US and radiologic measurements were statistically compared by the correlation-coefficient method: the result was 0.802. US measurements were repeated twice with 0.778 interobserver variability according to the Spearman correlation index. Based on their results, the authors conclude that, in the evaluation of the Insall-Salvati ratio, the diagnostic accuracy of US is almost the same as that of conventional radiology; the former method may even be preferred for it is a simple, quick and repeatable technique not needing ionizing radiations. PMID:1494674

  18. 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

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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)

  4. Apophysitis of the lower limbs: imaging findings; Apofisites dos membros inferiores: aspectos de imagem

    Energy Technology Data Exchange (ETDEWEB)

    Barbosa, Priscila Rodrigues; Santos, Durval C. Barros; Longo, Carlos Henrique; Luna, Rodrigo de Castro; Kim, Nelson Ji Tae; Rosemberg, Laercio A.; Funari, Marcelo Gusmao Buarque [Hospital Israelita Albert Einstein, Sao Paulo, SP (Brazil). Dept. de Imagem]. E-mail: pill-rb@uol.com.br

    2005-07-01

    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)

  5. 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.

  6. 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.)

  7. 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.)

  8. 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.

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

    DEFF Research Database (Denmark)

    Kristiansen, Maja Sofie; Uhrbrand, Anders; Hansen, Mette; Shiguetomi Medina, Juan Manuel; Vissing, K; Stødkilde-Jørgensen, H; Langberg, Henning

    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...

  10. Variation of activity levels, isotope ratios, concentration factors in space and time of plutonium in seaweed and mollusc species along the coast of the English Channel

    International Nuclear Information System (INIS)

    A study was carried out on the spatial and temporal variation of plutonium isotopes (238PU, 239-240Pu) in bio-indicator species (Fucus serratus, Patella sp., Mytilus edulis) sampled along the coast of the English Channel. Several periods of time were considered, covering 1982-1983, 1990-1993 and the year 1996. The activity levels of the radionuclides in question were less than 1 Bq kg-1 dry basis. A decrease in these activities has been observed over a number of years in relation to a reduction in the amounts of plutonium released from the establishment of La Hague. Long-shore gradients are apparent in the radionuclide distribution for Fucus. The discrepancy between the isotope ratios measured in the bio-indicator species and the releases from industrial sources leads to a discussion of the various source-terms affecting plutonium activities. Then concentration factors are defined. (author)

  11. Patellofemoral morphometry in patients with idiopathic patellofemoral pain syndrome

    International Nuclear Information System (INIS)

    Purpose: To compare clinical and computed tomography (CT) measures in extension, 20o and 30o 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.

  12. Outcomes of a Newer-Generation Cementless Total Knee Arthroplasty Design.

    Science.gov (United States)

    Harwin, Steven F; Elmallah, Randa K; Jauregui, Julio J; Cherian, Jeffrey J; Mont, Michael A

    2015-10-01

    Newer-generation cementless total knee arthroplasties (TKAs) aim to improve durability, function, and longevity. In a large series of cementless TKAs at a mean 4-year follow-up, the authors evaluated (1) survivorship, (2) range of motion, (3) patient-reported outcomes, and (4) complications. Mean age was 66 years (range, 34-88 years) and mean body mass index was 32.5 kg/m(2) (range, 20-54 kg/m(2)). Aseptic and septic implant survivorships were 99.6% and 99.5%, respectively. Mean extension, flexion, and Knee Society scores improved significantly. There were 3 septic failures. Aseptic failures included 3 aseptic loosenings, 1 polyethylene revision, and 1 revision to a cemented patella. This study showed excellent clinical and patient-reported outcomes of cementless TKA. PMID:26488775

  13. 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.)

  14. 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

  15. 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.

  16. Influence of waste water from oil refinery on species and biomass of microzoon in rootzone of water hyacinth

    International Nuclear Information System (INIS)

    There are lots of biological species in rootzone of water hyacinth, which can purify waste water from oil refinery. Rootzone of water hyacinth is an ecological subsystem. There are 20 microzoon species including 13 protozoa, 3 rotifer and 4 others. The main species are Vorticella convallaria, Rotaria rotatoria and Lepadella patella with percentages of 18.5%, 17.5% and 34.5%, respectively. The longer retention time of the waste water is in the oxidation pond, the more species and the bigger population of microzoon in rootzone of water hyacinth. The total biomass increases along with waste water flow. The maximum value of the population is 1.91 x 107 ind/m2. There is no microzoon except Englena which is an autotrophic organism in control pond. Increase of retention time of waste water is beneficial to biomass of microzoon and has no effect on the content of aerobic and facultative aerobic microbes in oxidation pond

  17. 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.

  18. 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.

  19. 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.

  20. 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

  1. 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.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...... rotator cuff tendinopathy will be recruited from three outpatient shoulder departments in Denmark, and randomised to either 12 weeks of progressive high-load strength training or to general low-load exercises. Patients will receive six individually guided exercise sessions with a physiotherapist and...... of this trial is to compare the efficacy of progressive high-load exercises with traditional low-load exercises in patients with rotator cuff tendinopathy. Methods/Design: The current study is a randomised, participant- and assessor-blinded, controlled multicentre trial. A total of 260 patients with...

  3. 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.

  4. 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.

  5. Cartilage volume quantification with multi echo data image combination sequence in swine knee at 3.0 T MRI

    International Nuclear Information System (INIS)

    Objective: To investigate the accuracy and reproducibility of multi echo data imagine combination (MEDIC) sequence with water excitation at 3.0 T in swine knee cartilage. Methods: Sagittal MEDIC sequences (0.6 mm slice thickness, isotropic) were acquired twice at 3.0 T MRI in 30 swine knees. The knee cartilage was then removed and the volume was directly measured with water substitution method. The cartilage volume was also determined with a validated open source image software OsiriX by two observers (A and B). The cartilage volumes obtained by two methods were compared. The reproducibility of MEDIC for quantitative measurement was accessed by the root-mean-square (RMS) of variation coefficient. Interobserver and intraobserver precision errors were compared using a paired students t-test. The accuracy of MEDIC for quantitative measurement was determined by the random pairwise differences, systematic pairwise differences and the Pearson, correlation coefficients. Time of semiautomatic and manual segmentation were recorded. Results: Time was saved about 75% by using semiautomatic segmentation methods [(4.0± 1.5) min] versus manual segmentation [(16.0±0.9) min]. Interobserver precision errors (RMS CV% for paired analysis) between A and B for cartilage volume measurement were (2.66±0.82) ml and(2.61± 0.81) ml, t=0.24, P=0.81 (patella); (2.40±0.69) ml and (2.49±0.85) ml, t=-0.45, P=0.65 (medial femoral condyle); (2.28±0.74) ml and(2.41±0.78) ml, t=-0.66, P=0.51 (lateral femoral condyle); (3.43±1.28) ml and (3.51±1.08) ml, t=-0.26, P=0.79 (femora trochlea) with sagittal MEDIC. Intraobserver precision errors (RMS CV% for paired analysis) of observer A for the first and second cartilage volume measurement were (2.64±0.62) ml and (2.67±0.60) ml, t=-0.19, P=0.85 (patella); (2.43±0.60) ml and (2.39±0.59) ml, t=0.26, P=0.80 (medial femoral condyle); (2.26±0.56) ml and (2.30±0.57) ml, t=-0.27, P=0.78 (lateral femoral condyle); (3.40± 1.20) ml and (3.47±1

  6. 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

  7. 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.

  8. Checklist and distribution of ciliates from the family Euplotidae Ehrenberg, 1838 (Protista: Ciliophora: Spirotrichea) in Slovakia, Central Europe.

    Science.gov (United States)

    Tirjaková, Eva; Botlíková, Simona; Vďačný, Peter

    2015-01-01

    A checklist of ciliates from the family Euplotidae recorded in the territory of Slovakia, Central Europe was assembled. Altogether, 11 species belonging to three genera of the family Euplotidae have been reported there: Euplotes alatus, Euplotes charon, Euplotes moebiusi, Euplotoides aediculatus, Euplotoides eurystomus, Euplotoides patella, Euplotoides woodruffi, Euplotopsis affinis, Euplotopsis finki, Euplotopsis muscicola, and Euplotopsis novemcarinata. However, records of the marine species E. alatus and E. charon are doubtful and very likely represent misidentifications of E. moebiusi. Since the euryhaline species E. woodruffi was found for the first time in Slovakia, its morphology is described. Based on the literature data and our own observations, the present checklist is also accompanied with distribution data on the 11 aforementioned species. As concerns ecology, Slovak euplotids typically occurred in freshwater bodies having higher trophic levels. Only two species, E. finki and E. muscicola, were isolated from terrestrial habitats, especially, from mosses, leaf-litter, and decaying wood mass. PMID:25781253

  9. 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'.

  10. 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)

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

    International Nuclear Information System (INIS)

    Normal and degenerated cartilages have different magnetic resonance (MR) capillary permeability (Ktrans) and interstitial interchangeable volume (ve). 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 trans at 6 months (-54.4 ± 21.2% vs 126.7 ± 56.9%, p trans, allowing its proposal as a surrogate imaging biomarker after 6 months of treatment. (orig.)

  12. 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

  13. Imaging methods for knee-joint diagnostics

    International Nuclear Information System (INIS)

    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)

  14. 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.

  15. 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.

  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. 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. 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.

  19. 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

  20. 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

  1. 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.

  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. 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.)

  4. 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)

  5. 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.)

  6. 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 pwill help contribute to the understanding of the body's management of lead toxicity and to KXRF techniques currently used in physics research.

  7. The Results of Intraosseous Drilling and Decompression in the Treatment of Chronic Anterior Knee Pain

    Directory of Open Access Journals (Sweden)

    Saberi S

    2012-01-01

    Full Text Available Background: Anterior knee pain is one of the most common complaints of patients in orthopedic clinics. The first step in the treatment of this problem is conservative treatment which includes administration of anti-inflammatory drugs, exercise and changes in life style. Many patients respond well to these measures in about six months, but a small number of patients may not respond to the conservative treatment; therefore, surgical procedures such as Maquet osteotomy or lateral retinacular release may be needed in these cases. The aim of this study was to determine the efficacy of intraosseous drilling and decompression of patella in the treatment of chronic anterior knee pain.Methods : This study was performed as a case series on ten patients with chronic anterior knee pain attending the Orthopedic Clinic of Imam Khomeini Hospital, in Tehran, Iran in 2009-2010. Eight of the patients were male and the rest were female. The patients met the inclusion criteria and were followed up for at least 12 months after the surgery. Results : The mean age of the patients was 27.8±4.66 yr and their mean BMI was 22.5±1.71 kg/m2. The mean pain severity before the interventions was 8.2±0.78 based on VAS but it decreased to 2.5±1.26 post-surgically. An average reduction of 5.7 scores were noticed in pain severity depicting a significant reduction of pain (P<0.0001.Conclusion: It may be concluded that intraosseous drilling and decompression of patella is a safe and effective method in the treatment of chronic anterior knee pain not responding to conservative treatment.

  8. 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

  9. 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

  10. 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.    

  11. 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.)

  12. 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

  13. 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

  14. 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

  15. 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.

  16. 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.)

  17. 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

  18. 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

  19. [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

  20. 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

  1. 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

  2. 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.

  3. 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

  4. 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

  5. Comparing different post-mortem human samples as DNA sources for downstream genotyping and identification.

    Science.gov (United States)

    Calacal, Gayvelline C; Apaga, Dame Loveliness T; Salvador, Jazelyn M; Jimenez, Joseph Andrew D; Lagat, Ludivino J; Villacorta, Renato Pio F; Lim, Maria Cecilia F; Fortun, Raquel D R; Datar, Francisco A; De Ungria, Maria Corazon A

    2015-11-01

    The capability of DNA laboratories to perform genotyping procedures from post-mortem remains, including those that had undergone putrefaction, continues to be a challenge in the Philippines, a country characterized by very humid and warm conditions all year round. These environmental conditions accelerate the decomposition of human remains that were recovered after a disaster and those that were left abandoned after a crime. When considerable tissue decomposition of human remains has taken place, there is no other option but to extract DNA from bone and/or teeth samples. Routinely, femur shafts are obtained from recovered bodies for human identification because the calcium matrix protects the DNA contained in the osteocytes. In the Philippines, there is difficulty in collecting femur samples after natural disasters or even human-made disasters, because these events are usually characterized by a large number of fatalities. Identification of casualties is further delayed by limitation in human and material resources. Hence, it is imperative to test other types of biological samples that are easier to collect, transport, process and store. We analyzed DNA that were obtained from body fluid, bone marrow, muscle tissue, clavicle, femur, metatarsal, patella, rib and vertebral samples from five recently deceased untreated male cadavers and seven male human remains that were embalmed, buried for ∼ 1 month and then exhumed. The bodies had undergone different environmental conditions and were in various stages of putrefaction. A DNA extraction method utilizing a detergent-washing step followed by an organic procedure was used. The utility of bone marrow and vitreous fluid including bone marrow and vitreous fluid that was transferred on FTA(®) cards and subjected to autosomal STR and Y-STR DNA typing were also evaluated. DNA yield was measured and the presence or absence of PCR inhibitors in DNA extracts was assessed using Plexor(®)HY. All samples were amplified using

  6. 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.

  7. 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

  8. Imaging diagnosis of the articular cartilage disorders

    International Nuclear Information System (INIS)

    Objective: To evaluate the diagnosis and differential diagnosis among the chronic osteoarthritis, rheumatoid arthritis and other chronic cartilage lesions on the plain films and MR images. Methods: Eighty-nine cases, including 115 joints, underwent plain film and MRI examination, and enhanced MRI scan was performed on 32 of them, including 44 joints. MRI scan sequences consisted of T1WI, T2WI + PDWI, STIR, and 3D FS SPGR. There were 90 knee joints in this group and each of the articular cartilage was divided into four parts: patella, femoral medial condyle, femoral lateral condyle, and tibia facet on MR images. The cartilage disorders were classified according to the outerbridge method. In addition, 61 cases including 75 joints were observed as a control group on the plain films and MR images. Results: 115 cartilage lesions were found on MR images, in which thinness of the cartilage (58 cases, 50.4%), bone changes under the cartilage (22 cases, 19.7%), medullar edema (22 cases, 19.7%), and synovial hyperplasia (52 cases, 45.2%) were seen. The patella cartilage was the most likely affected part (81/90, 90%). So the patellar cartilage lesions were divided as group 1 (grade I-II) and group 2 (grade III-IV) on MR images, which were compared with the plain film signs. The narrowing of the joint space and saccules under the articular surface were statistically significant with each other, and χ2 values were 9.349 and 9.885, respectively (P=0.002). Conclusion: No constant signs could be seen on the plain films with grade I-II cartilage disorders. While the narrowing joint space and saccules under the joint surface could be seen on them with grade III-IV cartilage disorders, which were mainly correlated with the cartilage disorders and bone changes under the articular cartilages. A combination of the plain films and MR images is the best imaging method for examining the joints and joint cartilages. Enhanced MRI scan is very helpful on the diagnosis and differential

  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. 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

  11. Avaliação da altura patelar em atletas com tendinopatia crônica do aparelho extensor do joelho Evaluation of the patellar height in athletes with diagnosed with chronic tendinopathy of the knee extensor mechanism

    Directory of Open Access Journals (Sweden)

    Emerson Garms

    2011-01-01

    Full Text Available OBJETIVO: Avaliar radiograficamente a altura patelar de atletas com diagnóstico de tendinopatia crônica do aparelho extensor do joelho (TCAE. MÉTODOS: Na amostra foram avaliados radiograficamente 65 pacientes (110 joelhos com idade entre 15 e 40 anos e de diferentes modalidades esportivas com e sem diagnóstico de tendinopatia crônica do aparelho extensor do joelho (jumper's knee. Os atletas foram divididos em dois grupos: aqueles com diagnóstico de TCAE (grupo 1: 38 atletas - 56 joelhos e um grupo que denominamos de controle (grupo 2: 27 atletas - 54 joelhos. RESULTADOS: No grupo 1 tivemos 18 atletas que apresentavam a doença bilateralmente na ocasião dos exames. Para a medida da altura patelar utilizamos os índices radiográficos de Insall e Salvati e Blackburne e Peel. CONCLUSÃO: A presença de patela alta no grupo de atletas com tendinopatia crônica do aparelho extensor do joelho foi significante maior do que a observada no grupo controle.OBJECTIVES: To carry out a radiographic evaluation of patellar height in athletes diagnosed with chronic tendinopathy of the knee extensor mechanism; METHODS: Radiographic assessments were carried out on 65 patients (110 knees aged between 15 and 40 years, who practiced different kinds of sports, some with of chronic tendinopathy of the knee extensor mechanism (jumper's knee and others without. The athletes were divided into two groups: those with diagnosed "jumper's knee" (group 1:38 athletes - 56 knees and a control group (group 2:27 athletes - 54 knees. In group 1, 18 of the athletes presented the condition in both knees on examination. The height of the patella was measured using the Insall-Salvati and Blackburne-Peel x-ray methods. CONCLUSION: The presence of a high patella in the group of athletes with chronic tendinopathy of the knee extensor mechanism was significantly higher than in the control group.

  12. 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

  13. 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

  14. 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

  15. 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。

  16. 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

  17. High-Risk Stress Fractures: Diagnosis and Management.

    Science.gov (United States)

    McInnis, Kelly C; Ramey, Lindsay N

    2016-03-01

    Stress fractures are common overuse injuries in athletes. They occur during periods of increased training without adequate rest, disrupting normal bone reparative mechanisms. There are a host of intrinsic and extrinsic factors, including biochemical and biomechanical, that put athletes at risk. In most stress fractures, the diagnosis is primarily clinical, with imaging indicated at times, and management focused on symptom-free relative rest with advancement of activity as tolerated. Overall, stress fractures in athletes have an excellent prognosis for return to sport, with little risk of complication. There is a subset of injuries that have a greater risk of fracture progression, delayed healing, and nonunion and are generally more challenging to treat with nonoperative care. Specific locations of high-risk stress fracture include the femoral neck (tension side), patella, anterior tibia, medial malleolus, talus, tarsal navicular, proximal fifth metatarsal, and great toe sesamoids. These sites share a characteristic region of high tensile load and low blood flow. High-risk stress fractures require a more aggressive approach to evaluation, with imaging often necessary, to confirm early and accurate diagnosis and initiate immediate treatment. Treatment consists of nonweight-bearing immobilization, often with a prolonged period away from sport, and a more methodic and careful reintroduction to athletic activity. These stress fractures may require surgical intervention. A high index of suspicion is essential to avoid delayed diagnosis and optimize outcomes in this subset of stress fractures. PMID:26972260

  18. Basic principles of aggressive rehabilitation after anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Dubljanin-Raspopović Emilija

    2005-01-01

    Full Text Available Rehabilitation after ACL (anterior cruciate ligament reconstruction has drastically changed over the last decade, with the adoption of a more aggressive approach, right from the first day after surgery. Progress in the effectiveness of rehabilitation is based on improvements in operative techniques, as well as on the encouraging results of histological studies regarding graft healing. Despite a huge amount of research papers on this topic, a rehabilitation golden standard still has not been established, due to the complexity of this problem. In this review, we point out the basic principles of rehabilitation after arthroscopically assisted ACL reconstruction based on actual practices, as well as the importance of specific procedures for the prevention of complications during the postoperative period. The importance of range-of-motion exercises, early weight bearing, an appropriate gait scheme, patella mobilisation, pain and oedema control, as well as stretching and balance exercises is explained. The functional advantages of closed kinetic chain exercises, as well as their influence on the graft are also described, in comparison to open kinetic chain exercises. The fundamentals of returning to sports are revealed and the specific aspects of rehabilitation regarding graft choice are pointed out. While waiting for new clinical investigations, which are expected to enable the establishment of a rehabilitation golden standard, the outlined principles should be followed. The complexity of this injury requires treatment in highly specialised institutions.

  19. Nuclear energy - Radiation protection - Individual thermoluminescence dosemeters for extremities and eyes

    International Nuclear Information System (INIS)

    This International Standard provides performance criteria and tests for determining the performance of thermoluminescence dosemeters intended to be used for the measurement of radiation doses to the eyes and extremities (fingers, and limbs defined as hands, feet, forearms including the elbow, and leg including the patella), for photons from 15 keV to 3 MeV and beta radiation from 0,5 MeV to 3 MeV. It is conditional upon the use of an appropriate reader, procedures and ancillary equipment. It does not cover information access and data processing. This International Standard provides performance criteria and tests for dosemeters intended to measure dose equivalent at depths of 7 mg cm-2 in tissue for fingers and limbs and 300 mg cm-2 in tissue for the eyes, including provision for the use of dosemeters only intended to be used once. Appropriate phantoms and dose conversion coefficients are recommended but others are not precluded. In all cases, performance is assessed under laboratory conditions which may not adequately simulate conditions actually experienced in personal dosimetry. For example, it may be necessary to sterilize dosemeters for medical applications. Therefore, caution is necessary in applying the results of these performance tests in real situations

  20. 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.

  1. 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

  2. Retrospective Evaluation Of MRI Findings Of Knee Joint In 255 Patients

    Directory of Open Access Journals (Sweden)

    Ahmet Mete

    2003-03-01

    Full Text Available Retrospective evaluation of knee MRI obtained from 255 cases and to demonstrate most common knee joint pathologies in our region.In our study knee joints of 255 cases who admitted to different clinics of our hospital with various complains of knee between October 1996 and December 1998 were examined in wide spectrum with MRI. Via 1.0 Tesla MRI device and special knee coil in sagittal, coronal and axial plains MRI images were obtained. The number of male and female patients were 173 and 82 and their ages were ranged between 14 and 70, and the mean age was 3413.The most common knee pathologies were intra-articular fluid (%58.04, medial (%46,66 and lateral (%12.55 meniscal injuries, anterior cruciate ligament injury (%17.25 and osteoarthritis (%14.9. The other important lesions were degeneration of medial and lateral meniscus, Baker’s cyst, bursitis, posterior cruciate ligament injury , medial and lateral collateral ligament injuries, synovial hypertrophy, chondromalasia of patella, and contusion.In our images of knee the most common lesions were injuries of meniscus and ligament. Because of being noninvasive technique for knee joint pathologies, capacity of multiplanar imaging, high contrast resolution and chance of detailed anatomic evaluation MR imaging was found to be most appropriate imaging technique for knee joint pathologies.

  3. 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.)

  4. Determination of trace metal baseline values in Posidonia oceanica, Cystoseira sp., and other marine environmental biomonitors: a quality control method for a study in South Tyrrhenian coastal areas.

    Science.gov (United States)

    Conti, Marcelo Enrique; Mecozzi, Mauro; Finoia, Maria Grazia

    2015-03-01

    In this study, we investigated Cd, Cr, Cu, Pb, and Zn in the seagrass Posidonia oceanica (L.) Delile leaves and in the brown algae Cystoseira sp. sampled along a 280-km transect in the Tyrrhenian Sea, from the Ustica to Linosa Islands (Sicily, Italy) with the aim to determine their control charts (baseline levels). By applying the Johnson's (Biometrika 36:149-175, 1949) probabilistic method, we determined the metal concentration overlap ranges in a group of five biomonitors. Here, we propose the use of the indexes of bioaccumulation with respect to the lowest (L'i) and the highest (L i) extreme values of the overlap metal concentration ranges. These indexes allow the identification of the most opportune organism (or a suite of them) to better managing particular environmental conditions. Posidonia leaves have generally high L i indexes for Cd, Cu, Pb, and Zn, and this suggests its use as biomonitor for baseline marine areas. Our results confirm the high aptitude of Patella as a good biomonitor for Cd levels in seawater. From this study, Ustica resulted with higher levels of Cd, Cu, Pb, and Zn than the other Sicilian Islands. PMID:25253055

  5. Trace metals in seagrass, algae and molluscs from an uncontaminated area in the Mediterranean.

    Science.gov (United States)

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

    2001-01-01

    The concentrations of Cd, Cr, Cu, Pb and Zn were measured in specimens of four marine organisms--the seagrass Posidonia oceanica (L.) Delile, the brown algae Padina pavonica (L.) Thivy, and the two gastropod molluscs Monodonta turbinata Born and Patella caerulea L.--selected as possible cosmopolitan biomonitors of trace metals in the Mediterranean area. The organisms were collected at five coastal sites in Favignana Island (Sicily, Italy), an area virtually uninfluenced by anthropogenic activities. In order to gain a more complete picture of both the environmental conditions of the experimental area and the bioaccumulation patterns of the selected organisms, soluble and total metal concentrations were determined in coastal water samples collected at the same stations. The picture of bioavailable metal loads in the different sites of the selected area provided by the four species was rather univocal. An overall trend of increased metal concentrations at the station in which the local harbour is located was clear. On the other hand, the metal concentrations recorded at the 'clean' stations generally fall in the range of the lowest values available in the literature and may be considered as useful background levels to which to refer for intraspecific comparison within the Mediterranean area. Implications in biomonitoring of the observed accumulation patterns, especially in the different tissues of Posidonia oceanica, are discussed. PMID:11202705

  6. 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

  7. Present status of the endangered limpet Cymbula nigra (Gastropoda, Patellidae in Ceuta: how do substrate heterogeneity and area accessibility affect population structure?

    Directory of Open Access Journals (Sweden)

    Rivera–Ingraham, G. A.

    2011-12-01

    Full Text Available Cymbula nigra (Gastropoda, Patellidae is a threatened giant patellid limpet found on the North African coast from Namibia to Algeria. The objective of this study was to estimate the total number of individuals present in Ceuta (Strait of Gibraltar and to determine the effect of certain physical parameters on population structure and abundance. Between 2006 and 2010 we conducted an exhaustive census in the area. Results indicate that Ceuta could be home to 48,473 individuals. The most important populations were recorded on the North Bay, characterized by its Atlantic influence. While for other similar species, such as Patella ferruginea, human accessibility to the area plays an important role in determining the structure of populations, we found that substrate roughness (small scale topographic heterogeneity is the main determining factor in this species. Populations located on medium to low topographic heterogeneity substrates showed higher percentages of medium and large size individuals. However, recruitment rates did not differ between substrata of different roughness. Finally, and through the analysis of the C. nigra populations located on some recently constructed jetties, we obtained interesting new data regarding individual growth rates, thus contributing to our knowledge of the population structure of the species.

  8. How reliable is MRI in diagnosing cartilaginous lesions in patients with first and recurrent lateral patellar dislocations?

    Directory of Open Access Journals (Sweden)

    Haage Patrick

    2010-07-01

    Full Text Available Abstract Background Lateral dislocation of the patella (LPD leads to cartilaginous injuries, which have been reported to be associated with retropatellar complaints and the development of patellofemoral osteoarthritis. Therefore, the purpose of this study was to determine the reliability of MRI for cartilage diagnostics after a first and recurrent LPD. Methods After an average of 4.7 days following an acute LPD, 40 patients (21 with first LPDs and 19 with recurrent LPDs underwent standardized 1.5 Tesla MRI (sagittal T1-TSE, coronal STIR-TSE, transversal fat-suppressed PD-TSE, sagittal fat-suppressed PD-TSE. MRI grading was compared to arthroscopic assessment of the cartilage. Results Sensitivities and positive predictive values for grade 3 and 4 lesions were markedly higher in the patient group with first LPDs compared to the group with recurrent LPDs. Similarly, intra- and inter-observer agreement yielded higher kappa values in patients with first LPDs compared to those with recurrent LPDs. All grade 4 lesions affecting the subchondral bone (osteochondral defects, such as a fissuring or erosion, were correctly assessed on MRI. Conclusions This study demonstrated a comparatively good diagnostic performance for MRI in the evaluation of first and recurrent LPDs, and we therefore recommend MRI for the cartilage assessment after a LPD.

  9. Biochemical (T2, T2* and magnetisation transfer ratio) MRI of knee cartilage: feasibility at ultra-high field (7T) compared with high field (3T) strength

    Energy Technology Data Exchange (ETDEWEB)

    Welsch, Goetz H. [Medical University of Vienna, MR Center, Department of Radiology, Vienna (Austria); University of Erlangen, Department of Trauma Surgery, Erlangen (Germany); Apprich, Sebastian; Zbyn, Stefan; Trattnig, Siegfried [Medical University of Vienna, MR Center, Department of Radiology, Vienna (Austria); Mamisch, Tallal C. [Medical University of Vienna, MR Center, Department of Radiology, Vienna (Austria); University of Berne, Department of Orthopedic Surgery, Berne (Switzerland); Mlynarik, Vladimir [Ecole Polytechnique Federale de Lausanne, Laboratory of Functional and Metabolic imaging, Lausanne (Switzerland); Scheffler, Klaus; Bieri, Oliver [University Hospital Basel, Division of Radiological Physics, Institute of Radiology, Basel (Switzerland)

    2011-06-15

    This study compares the performance and the reproducibility of quantitative T2, T2* and the magnetisation transfer ratio (MTR) of articular cartilage at 7T and 3T. Axial MRI of the patella was performed in 17 knees of healthy volunteers (25.8 {+-} 5.7 years) at 3T and 7T using a comparable surface coil and whole-body MR systems from the same vendor, side-by-side. Thirteen knee joints were assessed once, and four knee joints were measured three times to assess reproducibility. T2 relaxation was prepared by a multi-echo, spin-echo sequence and T2* relaxation by a multi-echo, gradient-echo sequence. MTR was based on a magnetisation transfer-sensitized, steady-state free precession approach. Statistical analysis-of-variance and coefficient-of-variation (CV) were prepared. For T2 and T2*, global values were significantly lower at 7T compared with 3T; the zonal evaluation revealed significantly less pronounced stratification at 7T (p<0.05). MTR provided higher values at 7T (p<0.05). CV, indicating reproducibility, showed slightly lower values at 7T, but only for T2 and T2*. Although lower T2 and T2* relaxation times were expected at 7T, the differences in stratification between the field strengths were reported for the first time. The assessment of MT is feasible at 7T, but requires further investigation. (orig.)

  10. Outcome Following Surgical Correction of Grade 4 Medial Patellar Luxation in Dogs: 47 Stifles (2001-2012).

    Science.gov (United States)

    Hans, Eric C; Kerwin, Sharon C; Elliott, Alan C; Butler, Ryan; Saunders, W Brian; Hulse, Don A

    2016-01-01

    Grade 4/4 medial patellar luxation (MPL) is a complex disease of the canine stifle that often requires surgical realignment of the patella to resolve clinical lameness. Outcome following surgery remains poorly described. Medical records were retrospectively reviewed for surgical correction of grade 4 MPL. Signalment and exam findings, surgical procedures performed, complications, and clinical outcome were reported. Data was statistically analyzed for association with major complication occurrence and unacceptable function following surgery. Forty-seven stifles from 41 dogs were included. The surgical procedures most frequently utilized for patellar realignment were the combination of femoral trochleoplasty, tibial tuberosity transposition, and joint capsule modification. Median in-hospital veterinary examination was performed at 69 days (range 30-179 days) following surgery. Full function was reported for 42.6% of cases (n=20). Acceptable function was reported for 40.4% of cases (n=19). Unacceptable function was reported for 17% of cases (n=8). The overall complication rate was 25.5% (n=12), with revision surgery for major complications required in 12.8% of cases (n=6). Corrective osteotomies were associated with major complications (P return to full function should be considered guarded. PMID:27008322

  11. 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

  12. Growth and maturational changes in dense fibrous connective tissue following 14 days of rhGH supplementation in the dwarf rat

    Science.gov (United States)

    Kyparos, Antonios; Orth, Michael W.; Vailas, Arthur C.; Martinez, Daniel A.

    2002-01-01

    The purpose of this study was to investigate the impact of recombinant human growth hormone (rhGH) on patella tendon (PT), medial collateral ligament (MCL), and lateral collateral ligament (LCL) on collagen growth and maturational changes in dwarf GH-deficient rats. Twenty male Lewis mutant dwarf rats, 37 days of age, were randomly assigned to Dwarf + rhGH (n = 10) and Dwarf + vehicle (n = 10) groups. The GH group received 1.25 mg rhGH/kg body wt twice daily for 14 days. rhGH administration stimulated dense fibrous connective tissue growth, as demonstrated by significant increases in hydroxyproline specific activity and significant decreases in the non-reducible hydroxylysylpyridinoline (HP) collagen cross-link contents. The increase in the accumulation of newly accreted collagen was 114, 67, and 117% for PT, MCL, and LCL, respectively, in 72 h. These findings suggest that a short course rhGH treatment can affect the rate of new collagen production. However, the maturation of the tendon and ligament tissues decreased 18-25% during the rapid accumulation of de novo collagen. We conclude that acute rhGH administration in a dwarf rat can up-regulate new collagen accretion in dense fibrous connective tissues, while causing a reduction in collagen maturation. Copyright 2002 Elsevier Science Ltd.

  13. Clinical value of SPECT/CT for evaluation of patients with painful knees after total knee arthroplasty- a new dimension of diagnostics?

    Directory of Open Access Journals (Sweden)

    Rasch Helmut

    2011-02-01

    Full Text Available Abstract Background The purpose of our study was to evaluate the clinical value of hybrid SPECT/CT for the assessment of patients with painful total knee arthroplasty (TKA. Methods Twenty-three painful knees in patients following primary TKA were assessed using Tc-99m-HDP-SPECT/CT. Rotational, sagittal and coronal position of the TKA was assessed on 3D-CT reconstructions. The level of the SPECT-tracer uptake (0-10 and its anatomical distribution was mapped using a validated localization scheme. Univariate analysis (Wilcoxon-Mann-Whitney, Spearmean`s-rho test, p Results SPECT/CT imaging changed the suspected diagnosis and the proposed treatment in 19/23 (83% knees. Progression of patellofemoral OA (n = 11, loosening of the tibial (n = 3 and loosening of the femoral component (n = 2 were identified as the leading causes of pain after TKA. Patients with externally rotated tibial trays showed higher tracer uptake in the medial patellar facet (p = 0.049 and in the femur (p = 0.051. Patients with knee pain due to patellofemoral OA showed significantly higher tracer uptake in the patella than others (p Conclusions SPECT/CT was very helpful in establishing the diagnosis and guiding subsequent management in patients with painful knees after TKA, particularly in patients with patellofemoral problems and malpositioned or loose TKA.

  14. The variability in the external rotation axis of the distal femur: an MRI-based anatomical study.

    Science.gov (United States)

    Jones, Carl; Nawaz, Zuhair; Hassan, Abdel; White, Simon; Khaleel, Arshad

    2016-02-01

    Commonly used total knee arthroplasty (TKA) systems utilising measured resection techniques default to 5°-7° valgus for the distal cut relative to the anatomical axis and 3° external rotation of the femoral component relative to posterior condylar axis (PCA). Rotational errors of the femoral component are associated with pain, patella maltracking and a poorer outcome. We analysed MRI scans from patients undergoing TKA using patient-specific instrumentation to assess coronal and rotational alignment from landmarks identified on the scans. One hundred and eight scans in 59 males and 49 females were studied with age range 35-93 years (mean 67.9 years). We found 91 % of patients had a femoral valgus angle between 5° and 7° (mean angles 5.9°), while only 24 % had an external rotation angle between 2.5° and 3.5° relative to PCA. There was no statistical significance in rotation between males and females although outliers tended to be female. Mean Whiteside's angle was 92.9° (87.8-98). This study highlights the variations in external rotation between patients undergoing TKA using the PCA as a reference for rotation. This may be a contributing factor in implant malalignment and patient dissatisfaction. PMID:26530410

  15. Static and dynamic analysis of patellofemoral joint arthritis using computed tomography

    International Nuclear Information System (INIS)

    Twelve parameters of the knee were evaluated using computed tomography to analyze possible etiological mechanisms leading to patello-femoral arthritis (PF-OA). Sixteen normal knees and 14 knees with PF-OA were tested. CT scans were taken at the level of the femoral epicondyles, the tibial tubercle and the malleoli of the ankle joint at full extension and 30deg of flexion. The slices were superimposed and three parameters; tibial tubercle rotation angle (TT angle), malleolar line rotation angle (ML angle) and tibial tubercle and lateral condyle angle (TT-LC angle) were measured with the central point of the medial and lateral epicondyle line as the fiducial point. Differences in each parameter between full extension and 30deg of flexion were also evaluated as dynamic factors. Three other parameters, lateral condyle rotation angle (LC angle). Lateral and medial condyle angle (LC-MC angle) and lateral condyle and patellar groove angle (LC-S) were also measured to evaluate the anatomical configuration. The position of the tibial tubercle at full extension relative to the femoral condyle was almost the same in both groups. The results, however, demonstrated that, in the PF-OA knee, the tibial tubercle stayed more lateral compared with the normal knee at 30deg of flexion. It is obvious that the tibial tubercle exists laterally in knee flexion and the patella impinges against the lateral femoral condyle in knee flexion which will cause PF-OA. (author)

  16. The value of water-excitation 3D FLASH and fat-saturated PDw TSE MR imaging for detecting and grading articular cartilage lesions of the knee

    International Nuclear Information System (INIS)

    To evaluate the diagnostic accuracy of water-excitation (WE) 3D FLASH and fat-saturated (FS) proton density-weighted (PDw) TSE MR imaging for detecting, grading, and sizing articular cartilage lesions of the knee. A total of 26 patients underwent MR imaging prior to arthroscopy with the following sequences: (1) WE 3D FLASH: 28/11 ms, scan time: 4 min 58 s, flip angle: 40 ; (2) FS PDw TSE: 3433/15 ms, scan time: 6 min 15 s, flip angle: 180 . Grade and size of the detected lesions were quantified and compared with the results of arthroscopy for each compartment. The sensitivity, specificity, positive and negative predictive values, and accuracy for detecting cartilage lesions were 46%, 92%, 81%, 71% and 74% for WE 3D FLASH and 91%, 98%, 96%, 94% and 95% for FS PDw TSE MR imaging. WE 3D FLASH correlated significantly with arthroscopy for grading on the patella (P<0.0001) and the femoral trochlea (P=0.02) and for sizing on the femoral trochlea (P=0.03). FS PDw correlated significantly (P<0.0001) with arthroscopy for grading and sizing on all compartments. FS PDw TSE is an accurate method for detecting, grading and sizing articular cartilage lesions of the knee and yielded superior results relative to WE 3D FLASH MR imaging. (orig.)

  17. Ganglion Cyst of Knee from Hoffa’s Fat Pad Protruding Anterolaterally Through Retinacular Rent: A Case Report

    Science.gov (United States)

    Saha, Partha; Bandyopadhyay, Utpal; Mukhopadhyay, Anindya S.; Kundu, Srikanta; Mandal, Subhadip

    2015-01-01

    Introduction: Intra-articular ganglion cysts of the knee joint are rare occurrences. They are usually encountered as incidental findings in magnetic resonance imaging (MRI), or in arthroscopy. They may originate from both the cruciate ligaments and the menisci, from the popliteus tendon and alar folds, infrapatellar fat pad of Hoffa, and subchondral bone cysts. Those arising from the Hoffa’s fat pad, usually present as palpable mass at anterior aspect of the knee joint. We report a case of intraarticular ganglion cyst of knee arising from the infrapatellar fat pad and protruding anterolaterally through retinacular rent into the subcutaneous plane. Case Report: A 19-year-old young man, presented with a painless gradually increasing swelling at the anterior aspect of left knee of 9 months duration. MRI scan revealed a multilobulated, cyst with septations within the anterior aspect of the knee joint, just inferolateral to the patella, with deep extension into the infrapatellar fat pad, and superficial extension into the subcutaneous space across the retinaculum. After diagnostic arthroscopy, we performed an open excision of the cystic mass and confirmed the retinacular rent pre-operatively. Conclusion: Arthroscopic resection and debridement is the gold standard treatment in ganglion cyst of the knee. However, a subcutaneous extension may lead to incomplete arthroscopic resection: Leaving behind the residual tissue which may cause recurrence. Therefore, proper pre-operative evaluation of MR images of these cases is very important. PMID:27299075

  18. COL5A1: Fine genetic mapping, intron/exon organization, and exclusion as candidate gene in families with tuberous sclerosis complex 1, hereditary hemorrhagic telangiectasia, and Ehlers-Danlos syndrome type II

    Energy Technology Data Exchange (ETDEWEB)

    Greenspan, D.S. [Univ. of Wisconsin, Madison, WI (United States); Papenberg, K.A.; Marchuk, D.A. [Duke Univ., Durham, NC (United States)] [and others

    1994-09-01

    Type V collagen is the only fibrillar collagen which has yet to be implicated in the pathogenesis of genetic diseases in humans or mice. To begin examining the possible role of type V collagen in genetic disease, we have previously mapped COL5A1, the gene for the {alpha}1 chain of type V collagen, to 9q23.2{r_arrow}q34.3 and described two restriction site polymorphisms which allowed us to exclude COL5A1 as candidate gene for nail-patella syndrome. We have now used these polymorphisms to exclude COL5A1 as candidate gene for tuberous sclerosis complex 1 and Ehlers-Danlos syndrome type II. In addition, we describe a CA repeat, with observed heterozygosity of about 0.5, in a COL5A1 intron, which has allowed us to exclude COL5A1 as a candidate gene in hereditary hemorrhagic telangiectasia and to place COL5A1 on the CEPH family genetic map between markers D9S66 and D9S67. We have also determined the entire intron/exon organization of COL5A1, which will facilitate characterization of mutations in genetic diseases with which COL5A1 may be linked in future studies.

  19. Three-dimensional evaluation of cartilage thickness and cartilage volume in the knee joint with MR imaging: reproducibility in volunteers

    International Nuclear Information System (INIS)

    Objective: To determine the reproductibility of three-dimensional volume and thickness measurements of the knee joint cartilage with MRI in volunteers. Methods: The knees of 7 healthy individuals (ages 23 to 58 yrs.) were sagitally imaged with a resolution of 2x0.31x0.31 mm3, using a fat-suppressed FLASH-3 D sequence. The knee was repositioned in between replicate acquisitions, 6 data sets being obtained in each case. After semiautomatic segmentation and three-dimensional reconstruction of the cartilage, the thickness was determined independent of the original section orientation. The coefficient of variation for repeated volume measurements and the deviations of the maximal cartilage thickness values were calculated subsequently. Results: The mean variation of the cartilage volumes of the replicate measurements was 1.4% (±0.8%) in the patella, 1.7% (±1.5%) in the femur, 3.0% (±1.2%) in the medial tibial plateau and 3.5% (±2.0%) in the lateral tibial plateau. The comparison of the distribution patterns of cartilage thickness yielded a high degree of agreement. Only in rare cases deviations of more than 0.5 mm were observed. Conclusions: The results show that the presented method for determining the quantitative distribution of articular cartilage yields a high degree of precision. It offers new possibilities in screening risk groups, monitoring the course of degenerative joint disease and the investigation of functional adaptation of the cartilage to mechanical loading. (orig.)

  20. Three-dimensional thickness and volume measurements of knee joint cartilage with MRI. Validation in anatomical specimens via CT arthrography

    International Nuclear Information System (INIS)

    Purpose: In the present study we intended to validate knee joint cartilage volume and thickness measurements with MRI. Methods: Ten fresh cadaver knees (age 29 to 64 yrs.) were sagitally imaged, using a fat-suppressed FLASH-3D sequence with a resolution of 2x0,31x0,31 mm3. Then a contrast agent was injected and the specimens submitted to CT arthrography. From both modalities the patellar, femoral, and tibial cartilages were segmented semiautomatically and reconstructed three-dimensionally. The cartilage thickness was determined independently of the sectional plane, based on a 'minimal distance algorithm'. Results: The volumes and the regional distribution patterns yielded a very high degree of similarity on direct comparison of both imaging modalities. The average volume error between MRI and CT was 3.8% (±3.0%), the correlation 0.998, the slope of the regression line 1.04 and the y-intercept -80 mm3. The analysis yielded no significant differences between the two methods (Wilcoxon signed rank test, 5% level) in the patella, femur, medial, and lateral tibia. (orig.)

  1. Knee-joint articular cartilage demonstrated by magnetic resonance tomography. MR chondrovolumetry using a fat-suppressed FLASH-3D sequence

    International Nuclear Information System (INIS)

    A fat-suppressed FLASH-3D sequence was optimized on healthy volunteers. A fresh cardaveric knee joint was removed from a 82-year-old man and immediately imaged without being frozen or fixed. MRT was carried out at 1.5 T and 25 mT/m (Vision, Siemens, Erlangen, Germany) with a conventional CP knee coil. Sagittal and transverse sections were acquired perpendicular to the articular surfaces, and then, parallel to these imaging planes, anatomical sections were obtained with a diamond band saw. The volumes of the patellar, tibial and femoral cartilages were determined from both the images and the sections, using an image analysing system. Signal intensities and contrast-to-noise ratios depend on the parameters used. The highest contrast between the cartilage and the periarticular tissues was obtained at a flip angel of 30 (TR=60 ms, TE=11 ms). However, a flip angle of 60 was judged to provide optimal subjective image quality. Using these parameters, the deviations between the radiological and the anatomical cartilage volumes were -4.7% in the patella, -3.1% in the tibial plateau and -4.2% in the femur. The volumes of the knee-joint cartilages may be accurately determined with MRT if an appropriate pulse sequence is chosen. (orig./VHE)

  2. Relationship of Height to Site-Specific Fracture Risk in Postmenopausal Women.

    Science.gov (United States)

    Armstrong, Miranda Eg; Kirichek, Oksana; Cairns, Benjamin J; Green, Jane; Reeves, Gillian K

    2016-04-01

    Height has been associated with increased risk of fracture of the neck of femur. However, information on the association of height with fractures at other sites is limited and conflicting. A total of 796,081 postmenopausal women, who reported on health and lifestyle factors including a history of previous fractures and osteoporosis, were followed for 8 years for incident fracture at various sites by record linkage to National Health Service hospital admission data. Adjusted relative risks of fracture at different sites per 10-cm increase in height were estimated using Cox regression. Numbers with site-specific fractures were: humerus (3036 cases), radius and/or ulna (1775), wrist (9684), neck of femur (5734), femur (not neck) (713), patella (649), tibia and/or fibula (1811), ankle (5523), and clavicle/spine/rib (2174). The risk of fracture of the neck of femur increased with increasing height (relative risk [RR] = 1.48 per 10-cm increase, 99% confidence interval [CI] 1.39-1.57) and the proportional increase in risk was significantly greater than for all other fracture sites (pheterogeneity < 0.001). For the other sites, fracture risk also increased with height (RR = 1.15 per 10 cm, CI 1.12-1.18), but there was only very weak evidence of a possible difference in risk between the sites (pheterogeneity = 0.03). In conclusion, taller women are at increased risk of fracture, especially of the neck of femur. PMID:26572496

  3. Bilateral simultaneous complete quadriceps rupture following chronic symptomatic tendinopathy: a case report

    Directory of Open Access Journals (Sweden)

    Arumilli Buchi

    2009-09-01

    Full Text Available Abstract Introduction Quadriceps rupture is a disabling injury mostly seen in men over 40 years of age. Bilateral quadriceps rupture is a rare injury that is often secondary to predisposing medical conditions. Ultrasound is a cheap and reliable tool for diagnosis but is operator dependent. Thus, magnetic resonance imaging is the preferred method of investigation despite its cost and availability. Prompt diagnosis and early surgical repair are needed for an optimal end result. Case presentation We report the case of a healthy 54-year-old Caucasian male farmer who presented with bilateral simultaneous complete quadriceps rupture, which was managed surgically and he was followed up for three years. He was previously under our care for enthesopathy of the quadriceps on both sides. We believe that chronic enthesopathy of the superior pole of patella made his quadriceps susceptible to complete rupture on eccentric loading. Conclusion Only a few cases of bilateral simultaneous complete quadriceps rupture in patients with symptomatic enthesopathy have been previously reported. We stress the importance of warning patients of the risk of developing complete tendon rupture when they present with an enthesopathy around the knee.

  4. Bacterial diversity and tetrodotoxin analysis in the viscera of the gastropods from Portuguese coast.

    Science.gov (United States)

    Pratheepa, Vijayakumari; Alex, Anoop; Silva, Marisa; Vasconcelos, Vitor

    2016-09-01

    To trace the pathway of tetrodotoxin (TTX) producing microorganism in the Atlantic coast of Portugal, culture-dependent evaluation of the bacterial isolates from the viscera of the gastropods Monodonta lineata, Gibbula umbilicalis, Nucella lapillus and Patella intermedia, and from the environmental samples (biofilm and surrounding sea water) was carried out. Samples were collected from eight different coastal locations of Northern Portugal. A total of 311 isolates were identified. The observed bacterial diversity was distributed over five different classes (Gammaproteobacteria, Alphaproteobacteria, Flavobacteria, Bacilli and Actinobacteria) with the greatest number of 16S rRNA gene sequence derived from the Gammaproteobacteria (75%). Phylogenetic analysis based on the 16S rRNA gene showed that bacterial isolates were highly diverse and most of which were found in other marine environment. Among the different species isolated, Vibrio was found abundant. Eventhough TTX was not detected (UPLC-MS/MS) in the isolates from this study, PCR screening identified some natural product biosynthesis genes (PKS and NRPS) involved in its assembly. Further PCR screening of the TTX producing two ATCC Vibrio sp. reveals that NRPS might be involved in the biosynthesis of TTX through the incorporation of arginine. PMID:27312988

  5. 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)

  6. 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).

  7. Clinical evaluation of stress fractures using bone scintigraphy

    International Nuclear Information System (INIS)

    Clinical evaluation of stress fractures were performed in 58 athletes using bone scintigraphy with sup(99m)Tc-MDP. Stress fractures of the tibia were most often seen in the males with running type sports. They occurred more often in the proximal tibia and on the right side. Stress fractures of the fibula were most often seen in females with jumping type sports, such as volley ball. They occurred more often in the distal fibula and on the right side. Tarsal bone fractures were seen most often rugby players. Metatarsal fractures occurred in the third fourth and fifth metatarsals. No lesion was seen in the first and second metatarsals. We feel that stress fractures of the femur can be differentiated from osteosarcoma by small loculated radionuclide accumulation as well as symptome, course and tomographic and CT finding. Bilateral involvement was seen in two cases in patellae and calcanei. Most of the other fractures were seen on the right side. Negative radiographs were seen in 36% of the patients and occurred most commonly in the tarsal bones excluding calcaneus. Bone scintigrams were positive in all cases and were most useful in fractures of the tarsal bones excluding calcaneus. (author)

  8. Combined lateral retinacular release with drilling chondroplasty for treatment of patellofemoral osteoarthritis associated with patellar malalignment in elderly patients.

    Science.gov (United States)

    Wu, Chi-Chuan

    2011-01-01

    This paper described a less invasive surgical technique that was performed for treatment of elderly patients with isolated patellofemoral (PF) osteoarthritis (OA) associated with patellar malalignment, although their tibiofemoral joints are minimally osteoarthritic. Two hundred and thirty-four knees in 126 consecutive elderly patients (average, 72 yrs) diagnosed with combined disorders were treated by lateral retinacular release with drilling chondroplasty. The inclusion criteria were patient age ≥ 65 yrs, isolated stage 2 or 3 PF-OA (modified Iwano staging by radiology), and a laterally subluxed patella shown on a Merchant's axial radiograph. Outcome was judged by three parameters: clinical PF function (modified Kujala scoring), congruence angle, and PF-OA staging. Two hundred and one knees in 107 patients were followed-up for an average of 4.2 yrs (range, 2.1-7.5 yrs) and 19 patients were lost to follow-up. No surgical complications occurred through the course of treatment. Clinical PF function improved in knees that showed unsatisfactory performance (modified Kujala scoring angle improved in 85.6% of the knees and PF-OA staging improved in 77.1% of the knees. Combined lateral retinacular release with drilling chondroplasty is a feasible alternative for treatment of PF-OA associated with patellar malalignment in elderly patients where knee arthroplasty cannot be performed by various reasons. Advantages of this combined surgical technique include a less invasive procedure, minimal complication rate, and an acceptable success rate (78%, modified Kujala scoring≥32). PMID:20171107

  9. Value of radiographic examination of the knee joint for the orthopedic surgeon; Wertigkeit der radiologischen Bildgebung beim Kniegelenk fuer den Orthopaeden

    Energy Technology Data Exchange (ETDEWEB)

    Pietsch, M.; Hofmann, S. [Allgemeines und Orthopaedisches LKH Stolzalpe (Austria). Abteilung fuer Orthopaedie und orthopaedische Chirurgie

    2006-01-01

    Extended radiographic examinations offer excellent options for diagnosis and strategy for treatment of the knee joint. The whole-leg radiograph is indispensable in measuring alignment for osteotomy or total knee arthroplasty (TKA). Fluoroscopically assisted varus-valgus stress radiographs provide the possibility for verifying mechanical function of the implanted knee prosthesis. Ultrasound examinations have been widely replaced by magnetic resonance imaging (MRI). MRI is the golden standard to examine intra-articular structures of the knee (meniscus, ligaments, cartilage) and surrounding soft tissue. For evaluating femoral and tibial torsion and determining axial rotation of TKA, computed tomography (CT) is best qualified. Imaging of the patellofemoral joint (patella instability) is difficult; CT scans in combination with true lateral radiographs seem to be helpful. (orig.) [German] Die erweiterte Roentgendiagnostik bietet gute Moeglichkeiten der Diagnose und Therapieplanung beim Kniegelenk. Das Ganzbeinroentgen ist unabdingbar zur Achsvermessung bei der Planung einer Umstellungsosteotomie oder der Implantation einer Knietotalendoprothese (KTEP). Varus-/Valgusaufnahmen unter Bildwandler gestatten die Ueberpruefung der Mechanik einer liegenden KTEP. Sonographische Untersuchungen des Kniegelenks sind weitgehend durch die Magnetresonanztomographie (MRT) ersetzt. Die MRT ist die Methode der Wahl zur Beurteilung der Kniebinnenstrukturen (Meniskus, Baender, Knorpel) und der umgebenden Weichteile. Zur Bestimmung der Torsion von Femur und Tibia sowie der Rotation der Komponenten einer KTEP ist die Computertomographie (CT) am besten geeignet. Die Beurteilung des Femorpatellargelenks (Patellainstabilitaet) ist schwierig, am vielversprechendsten erscheint die CT in Kombination mit streng seitlichen Roentgenbildern. (orig.)

  10. Development and Validation of a Novel LC-MS/MS Opioid Confirmation Assay: Evaluation of β-glucuronidase Enzymes and Sample Cleanup Methods.

    Science.gov (United States)

    Yang, He S; Wu, Alan H B; Lynch, Kara L

    2016-06-01

    With the rise in the use and misuse of prescription opioids, there is an increasing need for the confirmed identification of opioid analgesics in toxicology laboratories. The goals of this study were to (i) systematically evaluate the hydrolysis efficiency of four β-glucuronidase enzymes under optimized condition; (ii) evaluate compound recovery, matrix effects and precision of three protein precipitation plates and (iii) develop and validate a qualitative liquid-chromatography mass spectrometry (LC-MS/MS) assay to identify 13 opioids in urine. A recombinant β-glucuronidase exhibited the best overall hydrolysis efficiency for seven opioid glucuronide conjugates compared with β-glucuronidase from red abalone, Escherichia coli and Patella vulgata One of the protein precipitation plates tested exhibited overall better recovery of the opioids and lower ion suppression compared with the other two plates. An ESI positive mode LC-MS/MS assay for qualitative opioid analysis was developed and validated. Linearity, LOD, precision, matrix effect, recovery, carryover and interference of the method were evaluated. Sixty-two patient samples were analyzed by both a legacy GC-MS opioid method and the LC-MS/MS method, and 22 samples were analyzed by the LC-MS/MS and an LC-MS/MS reference method. The results of the comparisons showed good concordance. Overall, we described an efficient sample preparation procedure for a sensitive qualitative opioid confirmation assay in urine. PMID:27121711

  11. Neural Anatomy of the Anterolateral Thigh Flap.

    Science.gov (United States)

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

    2015-06-01

    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 cm centered on the midpoint of the former line were used for the surface landmarks. At the intersection point of the axial line and the 10-cm circle, the main lateral femoral cutaneous nerve (LFCN) and its anterior branch were located within 1 and 2.4 cm, respectively. At the intersection point of the axial line and the 5-cm circle, the anterior branch of the LFCN was located within 2.8 cm. The anterior branch of the LFCN can be detected within 3 cm from the central perforator pedicle in all specimens. The posterior branch of the LFCN, superior perforator nerve, and median perforator nerve were found in more variable locations. The findings from our study provide additional information for clinical use in the planning of sensate ALT flap harvest. PMID:26078503

  12. Metals in molluscs and algae: A north-south Tyrrhenian Sea baseline

    International Nuclear Information System (INIS)

    We develop a 800 km long relative baseline of metal pollution for the Tyrrhenian Sea, from the north of Naples to south of Sicily (Italy), based on spatio-temporal (1997-2004) concentrations of trace metals in marine organisms and on the bioaccumulative properties of those organisms. The study concerns sites in the gulf of Gaeta-Formia, near Naples, and three islands north, west, and south of Sicily: Ustica, Favignana and Linosa. The five metals are: cadmium, chromium, copper, lead, and zinc; the species include: Monodonta turbinata (n = 161), Patella caerulea (n = 244) and the algae Padina pavonica (n = 84). We use Johnson's (1949) probabilistic method to determine the type of distribution that accounts for our data. It is a system of frequency curves that represents the transformation of the standard normal curves. We find an N-S pollution gradient in molluscs considered: the lowest metal pollution occurs around the Sicilian islands. Our method can accurately characterize marine pollution by contributing to: policy-making, coastal resources management, the assessments of environmental damages from marine accidents and other events. The method here presented is a useful tool for pollution comparisons purposes among ecosystems (i.e., risk monitoring) and it is an ideal starting point for its application on a global scale.

  13. Functional MRI of the patellofemoral joint: comparison of ultrafast MRI, motion-triggered cine MRI and static MRI

    Energy Technology Data Exchange (ETDEWEB)

    Muhle, C. [Klinik fuer Radiologische Diagnostik, Univ. Kiel (Germany); Brossmann, J. [Klinik fuer Radiologische Diagnostik, Univ. Kiel (Germany); Melchert, U.H. [Klinik fuer Radiologische Diagnostik, Univ. Kiel (Germany); Schroeder, C. [Radiologische Abt., Universitaets-Kinderklinik, Christian-Albrechts-Universitaet, Kiel (Germany); Boer, R. de [Philips Medical Systems, Best (Netherlands); Spielmann, R.P. [Klinik fuer Radiologische Diagnostik, Univ. Kiel (Germany); Heller, M. [Klinik fuer Radiologische Diagnostik, Univ. Kiel (Germany)

    1995-12-31

    To evaluate the feasibility and usefulness of ultrafast MRI (u), patellar tracking from 30 of flexion to knee extension (0 ) was analysed and compared with motion-triggered cine MRI (m) and a static MRI technique (s). The different imaging methods were compared in respect of the patellofemoral relationship, the examination time and image quality. Eight healthy subjects and four patients (in total 18 joints) with patellar subluxation or luxation were examined. Significant differences between the static MRI series without quadriceps contraction and the functional MRI studies (motion-triggered cine MRI and ultrafast MRI) were found for the patellar tilt angle. In the dynamic joint studies there was no statistical difference of the regression coefficients between the motion-triggered cine MRI studies and the ultrafast MRI studies. The findings of the functional MRI studies compared with the static MRI images were significantly different for the lateralisation of the patella, expressed by the lateral patellar displacement and bisect offset. No significant differences in patellar lateralisation were found between motion-triggered cine MRI and ultrafast MRI. Ultrafast MRI was superior to motion-triggered cine MRI in terms of the reduction in imaging time and improvement of the image quality. (orig.)

  14. Functional MRI of the patellofemoral joint: comparison of ultrafast MRI, motion-triggered cine MRI and static MRI

    International Nuclear Information System (INIS)

    To evaluate the feasibility and usefulness of ultrafast MRI (u), patellar tracking from 30 of flexion to knee extension (0 ) was analysed and compared with motion-triggered cine MRI (m) and a static MRI technique (s). The different imaging methods were compared in respect of the patellofemoral relationship, the examination time and image quality. Eight healthy subjects and four patients (in total 18 joints) with patellar subluxation or luxation were examined. Significant differences between the static MRI series without quadriceps contraction and the functional MRI studies (motion-triggered cine MRI and ultrafast MRI) were found for the patellar tilt angle. In the dynamic joint studies there was no statistical difference of the regression coefficients between the motion-triggered cine MRI studies and the ultrafast MRI studies. The findings of the functional MRI studies compared with the static MRI images were significantly different for the lateralisation of the patella, expressed by the lateral patellar displacement and bisect offset. No significant differences in patellar lateralisation were found between motion-triggered cine MRI and ultrafast MRI. Ultrafast MRI was superior to motion-triggered cine MRI in terms of the reduction in imaging time and improvement of the image quality. (orig.)

  15. Automatic segmentation of the bone and extraction of the bone-cartilage interface from magnetic resonance images of the knee

    International Nuclear Information System (INIS)

    The accurate segmentation of the articular cartilages from magnetic resonance (MR) images of the knee is important for clinical studies and drug trials into conditions like osteoarthritis. Currently, segmentations are obtained using time-consuming manual or semi-automatic algorithms which have high inter- and intra-observer variabilities. This paper presents an important step towards obtaining automatic and accurate segmentations of the cartilages, namely an approach to automatically segment the bones and extract the bone-cartilage interfaces (BCI) in the knee. The segmentation is performed using three-dimensional active shape models, which are initialized using an affine registration to an atlas. The BCI are then extracted using image information and prior knowledge about the likelihood of each point belonging to the interface. The accuracy and robustness of the approach was experimentally validated using an MR database of fat suppressed spoiled gradient recall images. The (femur, tibia, patella) bone segmentation had a median Dice similarity coefficient of (0.96, 0.96, 0.89) and an average point-to-surface error of 0.16 mm on the BCI. The extracted BCI had a median surface overlap of 0.94 with the real interface, demonstrating its usefulness for subsequent cartilage segmentation or quantitative analysis

  16. Impact induced failure of cartilage-on-bone following creep loading: a microstructural and fracture mechanics study.

    Science.gov (United States)

    Thambyah, Ashvin; Zhang, Geran; Kim, Woong; Broom, Neil D

    2012-10-01

    Cartilage-on-bone samples obtained from healthy bovine patellae, with or without prior static compression (i.e. creep) at 2MPa for 3h, were delivered a single impact via an instrumented pendulum indenter at a velocity of 1.13m/s and an energy of 2.2J. Mechanical data was obtained and microstructural assessment of the region of failure was carried out using differential interference contrast (DIC) optical imaging. In addition, a fibrillar-level structural analysis using scanning electron microscopy (SEM) was conducted on a control batch of non-impacted samples that were subjected to either creep or non-creep loading protocols. Arising from the impact event the deepest levels of crack penetration into the articular cartilage occurred in those samples subjected to prior creep loading. Further the crack depth was inversely proportional to the rebound velocity of the indenter. By contrast, those impacted samples not subjected to prior creep loading had only short obliquely patterned microcracks confined to the upper one-third of the full cartilage depth. Ultrastructurally the creep-loaded cartilage matrix exhibited a substantial radial collapse or compaction of the fibrillar network in its primary radial zone. The increase in crack length in the prior creep-loaded cartilage is consistent with a reduction in its dissipative properties as indicated by a reduction in rebound velocity. An interpretation is offered in terms of classical fracture mechanics theory. PMID:22784816

  17. Subvastus and medial parapatellar approaches in TKA: comparison of functional results.

    Science.gov (United States)

    Dutka, Julian; Skowronek, Michal; Sosin, Pawel; Skowronek, Pawel

    2011-06-01

    The purpose of this study was to compare the clinical results of total knee arthroplasty (TKA) in the early and late postoperative period using subvastus and medial parapatellar approach. A prospective randomized controlled study was conducted in a group of 169 patients (180 TKAs) with 2-year follow-up. Patients were divided into a study group (97 TKAs) with a subvastus approach and a control group (83 TKAs) with a parapatellar approach. Assessment of the results of both operating approaches was based on functional, clinical Knee Society Score, and pain (visual analog scale). Patients in the subvastus group achieved full active extension, better range of motion, and better Knee Society Score results at 12 days, 6 weeks, and 12 weeks earlier than patients in the medial parapatellar group. They also had less pain at 12 days. No statistically significant differences existed between assessed end points in both groups at 24- and 52-weeks, and 24-months postoperatively. The subvastus approach has given patients better early clinical results; however, at longer follow-up, both groups had similar outcomes. The potential benefits of the subvastus approach are: protection of the extensor mechanism from damage, less risk of damaging the blood supply to the patella, earlier clinical recovery, and less pain in the early postoperative period. The subvastus approach is an alternative to the standard medial parapatellar approach in TKA. It can be used with equally good results, especially taking into consideration positive clinical aspects in the early postoperative period. PMID:21667899

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

    Energy Technology Data Exchange (ETDEWEB)

    Horng, Annie; Stockinger, M.; Notohamiprodjo, M. [Ludwig-Maximilians-University Hospital Munich, Institute for Clinical Radiology, Munich (Germany); Raya, J.G. [New York University Langone Medical Center, Center for Biomedical Imaging, New York, NY (United States); Pietschmann, M. [Ludwig-Maximilians-University Hospital Munich, Department of Orthopedic Surgery, Munich (Germany); Hoehne-Hueckstaedt, U.; Glitsch, U.; Ellegast, R. [Institute for Occupational Safety and Health of the German Social Accident Insurance (IFA), Sankt Augustin (Germany); Hering, K.G. [Miner' s Hospital, Department of Diagnostic Radiology, Dortmund (Germany); Glaser, C. [Ludwig-Maximilians-University Hospital Munich, Institute for Clinical Radiology, Munich (Germany); RZM Zentrum, Munich (Germany)

    2015-06-01

    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.)

  19. A Novel Association between Femoroacetabular Impingement and Anterior Knee Pain

    Directory of Open Access Journals (Sweden)

    Vicente Sanchis-Alfonso

    2015-01-01

    Full Text Available Background. For a long time it has been accepted that the main problem in the anterior knee pain (AKP patient is in the patella. Currently, literature supports the link between abnormal hip function and AKP. Objective. Our objective is to investigate if Cam femoroacetabular impingement (FAI resolution is related to the outcome in pain and disability in patients with chronic AKP recalcitrant to conservative treatment associated with Cam FAI. Material and Methods. A retrospective study on 7 patients with chronic AKP associated with FAI type Cam was performed. Knee and hip pain were measured with the visual analogue scale (VAS, knee disability with the Kujala scale, and hip disability with the Nonarthritic Hip Score (NAHS. Results. The VAS knee pain score and VAS hip pain score had a significant improvement postoperatively. At final follow-up, there was significant improvement in all functional scores (Kujala score and NAHS. Conclusion. Our finding supports the link between Cam FAI and AKP in some young patients. Assessment of Cam FAI should be considered as a part of the physical examination of patients with AKP, mainly in cases with pain recalcitrant to conservative treatment.

  20. LUXAÇÃO UNILATERAL CONGÊNITA DA PATELA EM FELINO: RELATO DE CASO

    Directory of Open Access Journals (Sweden)

    Patrícia Franciscone Mendes

    2011-05-01

    Full Text Available A luxação patelar caracteriza-se pelo deslocamento medial ou lateral, intermitente ou permanente da patela, pode ocorrer devido à hipoplasia do sulco troclear, deslocamento do quadríceps ou da crista tibial. Esta afecção pode ser de origem congênita, traumática, evolutiva ou sedentária, apresentando maior prevalência em cães de raças de pequeno porte sendo raramente diagnosticada em gatos. A sintomatologia é variável conforme o grau de luxação. O tratamento conservativo contempla repouso, administração de analgésicos e fisioterapia, o tratamento cirúrgico é mais comumente realizado, visto que na maioria das vezes os sinais clínicos manifestados pelos animais são mais evidentes somente em uma fase tardia da doença.The patellar luxation is characterized by the medial or lateral dislocation, intermittent or permanent of patella, it occur due to hypoplasia of the trochlear grooves, quadriceps or tibial crest displacement. It can have a congenital, traumatic, evolutive or sedentary origin, which more prevalent in small dogs breeds andrarely in cats. The symptomatology varies with the degree of luxation. The conservative treatment consists in repose, analgesic administration and fisiotherapy, the surgical treatment is more common because the majority of the clinical signs manifested by the animals are evident just in a late phase of the disease.

  1. Emergent littoral deposits in the eastern Canary Islands

    Science.gov (United States)

    Meco, Joaquin; Stearns, Charles E.

    1981-03-01

    K-Ar ages ( A. Abdel-Monem, P. D. Watkins, and P. W. Gast, 1971, American Journal of Science271, 490-521; this paper) and revised paleontological determinations ( J. Meco, 1977, "Los Strombus neogenos y cuatenarios del Atlantico euroafricano", Las Palmas, Ediciones del Excmo. Cabildo Insular de Gran Canaria) show that "Quaternary" ( R. Crofts, 1967, Quaternaria 9, 247-260; G. Lecointre, K. J. Tinkler, and G. Richards, 1967, Academy of Natural Science of Philadelphia Proceedings119, 325-344) littoral deposits on Lanzarote and Fuerteventura are early Pliocene and late Pleistocene. Early and middle Pleistocene strand lines are not represented. Early Pliocene littoral and marine deposits contain a characteristic fossil assemblage: Strombus coronatus, Nerità emiliana, Gryphaea virleti, Patella cf. intermedia, and Rothpletzia rudista. Differences in elevation record differential post-Pliocene uplift of the coastal platforms on which they lie. Late Pleistocene beach deposits at low elevations belong to two groups, an older with Strombus bubonius and a younger without. Differences in elevation of early Pliocene littoral deposits are reflected by differences in elevation of late Pleistocene beach deposits nearby.

  2. Taxonomic revision of the genus Mayazomus Reddell & Cokendolpher, 1995 (Schizomida: Hubbardiidae), with description of five new species from Chiapas, Mexico.

    Science.gov (United States)

    Monjaraz-Ruedas, Rodrigo; Francke, Oscar F

    2015-01-01

    The genus Mayazomus currently contains two species from southeastern Mexico. It was originally characterized by a strongly elongated pedipalp trochanter, united in its entire width to the femur; the patella strongly curved; the tibia with a large mesal apophysis opposable to tarsus; the spermathecae with two pairs of thin lobes subequal in length; and the presence of four or more setae on tergite II. In the present contribution, the species of the genus Mayazomus are revised and new diagnostic characters for the genus are proposed, including the correction that the female flagellum bears three rather than two annuli. The two known species are redescribed based on examination of the holotypes, plus newly acquired material representing both sexes (female previously unknown for one). Five new species from the Mexican state of Chiapas are described, based on adult males and females: Mayazomus tzotzil new species, Mayazomus aluxe new species, Mayazomus kaamuul new species, Mayazomus yaax new species, and Mayazomus loobil new species. Dimorphism in male pedipalps is reported for the first time for the genus. A dichotomous key is provided for identification of the seven species in the genus; and a distribution map is included.  PMID:25662138

  3. 大学生篮球运动员膝关节损伤分析%Analysis on the Knee Joint Injury of College Student Bas-ketball Players

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

      本文以大学生篮球运动员膝关节损伤为研究对象,通过文献资料法、逻辑分析法及实地观察法对大学生篮球运动员膝关节损伤进行分析。结果表明其损伤类型主要有半月板损伤、髌骨劳损、内侧副韧带损伤等,损伤原因主要由膝关节解剖结构与生理特点及训练三方面构成,并为预防损伤提出建议。%In this paper, the knee joint injury of basketball players in colleges is researched by literature, logical analysis and field observations. The results show that the type of injury include meniscus injury, patella strain, medial collateral ligament injury, and so on, and the reasons contain the knee joint anatomical structures, physiological characteristics and the way of basketball training. At last, some proposals are raised.

  4. Tourniquet-Related Iatrogenic Femoral Nerve Palsy after Knee Surgery: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Juan Mingo-Robinet

    2013-01-01

    Full Text Available Purpose. Tourniquet-induced nerve injuries have been reported in the literature, but even if electromyography abnormalities in knee surgery are frequent, only two cases of permanent femoral nerve palsies have been reported, both after prolonged tourniquet time. We report a case of tourniquet-related permanent femoral nerve palsy after knee surgery. Case Report. We report a case of a 58-year-old woman who underwent surgical treatment of a patella fracture. Tourniquet was inflated to 310 mmHg for 45 minutes. After surgery, patient complained about paralysis of the quadriceps femoris with inability to extend the knee. Electromyography and nerve conduction study showed a severe axonal neuropathy of the left femoral nerve, without clinical remission after several months. Discussion. Even if complications are not rare, safe duration and pressure for tourniquet use remain a controversy. Nevertheless, subtle clinical lesions of the femoral nerve or even subclinical lesions only detectable by nerve conduction and EMG activity are frequent, so persistent neurologic dysfunction, even if rare, may be an underreported complication of tourniquet application. Elderly persons with muscle atrophy and flaccid, loose skin might be in risk for iatrogenic nerve injury secondary to tourniquet.

  5. Multi-factorial analysis of time efficiency in total knee arthroplasty.

    Science.gov (United States)

    Stiehl, James B; Jackson, Scott; Szabo, Aniko

    2009-01-01

    The objective of this retrospective review was to determine whether time efficiency could be gained by optimizing the navigation protocol based on a surgeon's specific technique and work flow. Three groups of 30 consecutive patients operated on by the same surgeon were studied. The groups were from three distinct periods between 2002 and 2008. The first group consisted of patients in which no navigation was performed (the control group); the second group consisted of patients in which navigation was performed using a standard protocol; and the third group consisted of patients in which navigation was performed using a customized protocol that eliminated certain steps. Statistical analysis considered analysis of variance for covariates of total time in the operating room, duration of the procedure, and tourniquet time. Chi-square analysis considered categorical variables of age, gender, body mass index (BMI), Knee Society score, and patellar resurfacing against the surgical group. Multiple linear regression analysis evaluated surgical time adjusted for preoperative deformity, BMI, and patellar resurfacing. In the adjusted model, the customized navigation protocol significantly reduced the surgical time by 10 minutes compared to the non-customized navigation. Not resurfacing the patella significantly reduced the surgical time by 9 minutes. Variables of age, gender, BMI, preoperative deformity and Knee Society score were not related to differences in operating time. Time efficiency may be gained with the use of improved computer navigation protocols and patellar non-resurfacing. PMID:19557583

  6. Investigation on biokinetics of 134Cs and 241Am radionuclides in three different organisms and a new evaluation by using discrete time model

    International Nuclear Information System (INIS)

    In this study, 134Cs and 241Am biokinetic experiments have been observed originally for Black Sea condition with using the gastropod Patella coerulea and the macro algae Enteremorpha linza and the common mussel Mytilus galloprovlncialis as bio indicator organisms. The experiments that have at least three originality, have been carried out very carefully and biokinetic parameters have been calculated by using classical model. The results are compared with the proportionally similar experiments in the literature globally. In this thesis, a new model application has proposed for the biokinetic evaluation for loss experiments of organisms. That is discrete time model. Loss experiments can be evaluated proportionally in a quick and easy way by using this model. Then, it can be observed that the calculated decreasing factor (r) by discrete time model, shows the loss process quality. Moreover, the loss experiments can be stopped when the decreasing factor goes to 1. So, the loss experiment can be evaluated rapidly and quickly with the adequate reliability by using discrete time model. Furthermore, the loss process in the organisms becomes slower and biologic half-lives becomes longer, when the decreasing factor (r) goes to 1. On the other hand, the biological depuration rate (k) goes to nearly zero. So, the proposed discrete time model that is applied in this thesis originally for biokinetic, can be evident that it has an adequate reliability for the biokinetic evaluation

  7. The MRI appearance of cystic lesions around the knee

    International Nuclear Information System (INIS)

    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.)

  8. Evaluation of influence of proteoglycans on hydration of articular cartilage with the use of ultrasound

    Directory of Open Access Journals (Sweden)

    Yi-yi YANG

    2015-04-01

    Full Text Available Objective To monitor the changes in hydration behaviour of articular cartilage induced by degradation of proteoglycans, and to explore the effect of proteoglycans on hydration behaviour of articular cartilage by using high-frequency ultrasound. Methods Twelve porcine patellae with smooth cartilage surface were prepared and equally divided into two groups: normal group without any enzyme treatment, and trypsin group they were treated with 0.25% trypsin for 8h to digest proteoglycan in the cartilage. The hydration behaviour of the cartilage tissue was scanned by high-frequency ultrasound system with a central frequency of 25MHz. Parameters including cartilage hydration strain and cartilage thickness were measured. The histopathological changes in the articular cartilage were observed under a light microscope. Results It took approximately 20min to reach equilibrium during the hydration process in the normal cartilages, while proteoglycan-degraded cartilage took only about 5min to achieve equilibrium. The equilibrium strain of normal cartilage was 3.5%±0.5%. The degradation of proteoglycans induced a significant decrease in equilibrium strain (1.8%±0.2%, P0.05. Conclusion Proteoglycans play an important role in hydration behaviour of articular cartilage. The degradation of proteoglycans could induce degeneration of cartilage structure and decrease in hydration behaviour after dehydration. DOI: 10.11855/j.issn.0577-7402.2015.03.03

  9. 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.

  10. Short-term results of medial patellofemoral ligament reconstruction for patellar dislocation

    International Nuclear Information System (INIS)

    The short-term results of medial patellofemoral ligament (MPFL) reconstruction were reviewed. MPFL reconstruction surgery was performed on 13 patients (13 knees, three male, five female, mean age 24.1 years) with recurrent and habitual dislocation of the patella. After average 18.5 month follow-up, there has been no recurrence of dislocation and limitation of range of motion except for one case. The mean Kujula score was 60±20.2 preoperatively and 91±15 postoperatively. According to the Crosby and Insall grading system, six ceses were excellent, six cases were good, and one case was fair to poor. On axial radiographs, the mean congruence angle was 31.3±21.4deg preoperatively and -3.65±20.72deg postoperatively. The mean tilting angle was 32.1±7.9deg preoperatively and 21.9±8.39deg postoperatively. The mean lateral shift was 41.6±9.7% preoperatively and 24.5±9.9% postoperatively. These results demonstrate the short-term effectiveness of MPFL reconstruction. (author)

  11. Arthropathy of neonatal onset multisystem inflammatory disease (NOMID/CINCA)

    Energy Technology Data Exchange (ETDEWEB)

    Hill, Suvimol C.; Dwyer, Andrew [Warren G. Magnuson Clinical Center, Diagnostic Radiology, National Institutes of Health (NIH), Bethesda, MD (United States); Namde, Madjimbaye; Canna, Scott; Goldbach-Mansky, Raphaela [National Institutes of Health (NIH), National Institute of Arthritis and Musculoskeletal and Skin Diseases, Bethesda, MD (United States); Poznanski, Andrew [Northwestern University, Department of Radiology, Medical Imaging, Children' s Memorial Hospital, Chicago, IL (United States)

    2007-02-15

    Neonatal onset multisystem inflammatory disease (NOMID), an autoinflammatory disease, is characterized by fever, chronic urticarial rash, CNS manifestations, and arthropathy. Approximately 50% of patients with NOMID have de novo missense mutations in CIAS1, which is associated with modulation of the IL-1b and apoptotic pathways. Approximately 60% of NOMID patients have prominent arthropathy, most commonly involving the knees, the cause of which remains poorly understood. To more fully describe the findings of NOMID arthropathy on MRI and radiography and to provide a better understanding of the origin of the bony lesions. We imaged 20 patients with NOMID to further investigate NOMID-associated bony lesions. Bony abnormalities were seen in the knees of 11/20 patients. The knee findings included enlarged, deformed femora and patellae in all and tibiae in the majority, without evidence of synovitis. Some patients had other joint involvement. Most had short stature and valgus or varus knee deformities. No association was noted between bony abnormalities and CIAS1 mutations. The abnormalities appeared to be the result of a mass-producing process. The resulting heterogeneously calcified masses appeared to originate in the physis and deformed the adjacent metaphysis and epiphysis. These findings suggest that the arthropathy of NOMID is the result of abnormal endochondral bone growth. Further investigation is needed to determine whether this deformity is triggered by inflammation early in development or by CIAS1 mutations causing abnormal chondrocyte apoptosis. (orig.)

  12. Arthropathy of neonatal onset multisystem inflammatory disease (NOMID/CINCA)

    International Nuclear Information System (INIS)

    Neonatal onset multisystem inflammatory disease (NOMID), an autoinflammatory disease, is characterized by fever, chronic urticarial rash, CNS manifestations, and arthropathy. Approximately 50% of patients with NOMID have de novo missense mutations in CIAS1, which is associated with modulation of the IL-1b and apoptotic pathways. Approximately 60% of NOMID patients have prominent arthropathy, most commonly involving the knees, the cause of which remains poorly understood. To more fully describe the findings of NOMID arthropathy on MRI and radiography and to provide a better understanding of the origin of the bony lesions. We imaged 20 patients with NOMID to further investigate NOMID-associated bony lesions. Bony abnormalities were seen in the knees of 11/20 patients. The knee findings included enlarged, deformed femora and patellae in all and tibiae in the majority, without evidence of synovitis. Some patients had other joint involvement. Most had short stature and valgus or varus knee deformities. No association was noted between bony abnormalities and CIAS1 mutations. The abnormalities appeared to be the result of a mass-producing process. The resulting heterogeneously calcified masses appeared to originate in the physis and deformed the adjacent metaphysis and epiphysis. These findings suggest that the arthropathy of NOMID is the result of abnormal endochondral bone growth. Further investigation is needed to determine whether this deformity is triggered by inflammation early in development or by CIAS1 mutations causing abnormal chondrocyte apoptosis. (orig.)

  13. 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.)

  14. The relationship of bone and blood lead to hypertension: Further analyses of the normative aging study data

    Energy Technology Data Exchange (ETDEWEB)

    Hu, H.; Kim, Rokho; Korrick, S. [Harvard Medical School, Boston, MA (United States)]|[Harvard Health of Public Health, Boston, MA (United States); Rotnitzky, A. [Harvard School of Public Health, Boston, MA (United States)] [and others

    1996-12-31

    In an earlier report based on participants in the Veterans Administration Normative Aging Study, we found a significant association between the risk of hypertension and lead levels in tibia. To examine the possible confounding effects of education and occupation, we considered in this study five levels of education and three levels of occupation as independent variables in the statistical model. Of 1,171 active subjects seen between August 1991 and December 1994, 563 provided complete data for this analysis. In the initial logistic regression model, acre and body mass index, family history of hypertension, and dietary sodium intake, but neither cumulative smoking nor alcohol ingestion, conferred increased odds ratios for being hypertensive that were statistically significant. When the lead biomarkers were added separately to this initial logistic model, tibia lead and patella lead levels were associated with significantly elevated odds ratios for hypertension. In the final backward elimination logistic regression model that included categorical variables for education and occupation, the only variables retained were body mass index, family history of hypertension, and tibia lead level. We conclude that education and occupation variables were not confounding the association between the lead biomarkers and hypertension that we reported previously. 27 refs., 3 tabs.

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

    International Nuclear Information System (INIS)

    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)

  16. Pulmonary embolism. A case report

    Directory of Open Access Journals (Sweden)

    Pedro J. Barrios Fuentes

    2010-12-01

    Full Text Available The case of a male, white skin, 38 years old patient who came to the emergency department because of a severe respiratory distress is reported. The left patella fracture history was collected and an immobilization cast was implemented. The posterior to anterior chest X-ray showed opacities in the form of a veil at the base of the left hemithorax as well as increased cardiothoracic rates. A lung computed tomography angiography scan was performed using a SIEMENS SESATION 64 multislice computed tomography scanner. The study was rebuilt using volume rendering technique and 3D applications with virtual angioscopy. Thrombus occlusion was evident at the trunk of the left pulmonary artery and its branches. The patient was admitted for anticoagulation treatment. Patients with patellar fracture as a trigger for this serious condition involving life-risk had not been treated in this hospital, that is why it was decided to publish this case, as well as for the implementation of such an innovative, useful and quick diagnosis aided by multislice computed tomography angiography.

  17. Acute traumatic patellar dislocation.

    Science.gov (United States)

    Duthon, V B

    2015-02-01

    Inaugural traumatic patellar dislocation is most often due to trauma sustained during physical or sports activity. Two-thirds of acute patellar dislocations occur in young active patients (less than 20 years old). Non-contact knee sprain in flexion and valgus is the leading mechanism in patellar dislocation, accounting for as many as 93% of all cases. The strong displacement of the patella tears the medial stabilizing structures, and notably the medial patellofemoral ligament (MPFL), which is almost always injured in acute patellar dislocation, most frequently at its femoral attachment. Lateral patellar glide can be assessed with the knee in extension or 20° flexion. Displacement by more than 50% of the patellar width is considered abnormal and may induce apprehension. Plain X-ray and CT are mandatory to diagnose bony risk factors for patellar dislocation, such as trochlear dysplasia or increased tibial tubercle-trochlear groove distance (TT-TG), and plan correction. MRI gives information on cartilage and capsulo-ligamentous status for treatment planning: free bodies or osteochondral fracture have to be treated surgically. If patellar dislocation occurs in an anatomically normal knee and osteochondral fracture is ruled out on MRI, non-operative treatment is usually recommended. PMID:25592052

  18. Aggregated and dispersed configuration of microhabitats in coastal defenses: Implications for restoration of populations

    Directory of Open Access Journals (Sweden)

    Eva Cacabelos

    2014-06-01

    Full Text Available The additions of artificial structures to the landscape are usually translated into habitat loss and fragmentation, since they provide homogeneous habitats less diverse in types and number of microhabitats. Moreover, the smooth surface of artificial structures increases the degree of environmental stress (e.g. desiccation experienced by intertidal organisms. Local biodiversity can be increased with microhabitats availability by attracting or supporting species of macrofauna and seaweeds. E.g., distribution and survival of the mollusc Patella candei, a limpet exploited in intertidal coasts of Açores, has been showed to be strongly influenced by availability of microhabitats. We experimentally analyzed the influence of microhabitat aggregation and dispersion on the distribution of several species of gastropods on midshores of artificial substrates. Data were compared with distributions within unmanipulated plots. Effects were found among treatments and control plots in densities of Tectarius striatus and at the different life-history stages of limpets (recruits, immature and adult individuals inhabiting artificial substrata with manipulated aggregation levels. In case of Melaraphe neritoides, only in site 2 numbers of were greater in manipulated than in control plots. Configurations with different dispersion levels also showed greater densities than controls. Both aggregation and dispersion effects were more evident at site 2; however, due to the high variability among examined plots, no clear significant responses were found among the different treatments.

  19. 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.)

  20. Over-exposure correction in knee cone-beam CT imaging with automatic exposure control using a partial low dose scan

    Science.gov (United States)

    Choi, Jang-Hwan; Muller, Kerstin; Hsieh, Scott; Maier, Andreas; Gold, Garry; Levenston, Marc; Fahrig, Rebecca

    2016-03-01

    C-arm-based cone-beam CT (CBCT) systems with flat-panel detectors are suitable for diagnostic knee imaging due to their potentially flexible selection of CT trajectories and wide volumetric beam coverage. In knee CT imaging, over-exposure artifacts can occur because of limitations in the dynamic range of the flat panel detectors present on most CBCT systems. We developed a straightforward but effective method for correction and detection of over-exposure for an Automatic Exposure Control (AEC)-enabled standard knee scan incorporating a prior low dose scan. The radiation dose associated with the low dose scan was negligible (0.0042mSv, 2.8% increase) which was enabled by partially sampling the projection images considering the geometry of the knees and lowering the dose further to be able to just see the skin-air interface. We combined the line integrals from the AEC and low dose scans after detecting over-exposed regions by comparing the line profiles of the two scans detector row-wise. The combined line integrals were reconstructed into a volumetric image using filtered back projection. We evaluated our method using in vivo human subject knee data. The proposed method effectively corrected and detected over-exposure, and thus recovered the visibility of exterior tissues (e.g., the shape and density of the patella, and the patellar tendon), incorporating a prior low dose scan with a negligible increase in radiation exposure.