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Sample records for left patellar dislocation

  1. Primary traumatic patellar dislocation

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    Tsai Chun-Hao

    2012-06-01

    Full Text Available Abstract Acute traumatic patellar dislocation is a common injury in the active and young adult populations. MRI of the knee is recommended in all patients who present with acute patellar dislocation. Numerous operative and non-operative methods have been described to treat the injuries; however, the ideal management of the acute traumatic patellar dislocation in young adults is still in debate. This article is intended to review the studies to the subjects of epidemiology, initial examination and management.

  2. Neglected locked vertical patellar dislocation

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    Rakesh Kumar Gupta

    2012-01-01

    Full Text Available Patellar dislocations occurring about the vertical and horizontal axis are rare and irreducible. The neglected patellar dislocation is still rarer. We describe the clinical presentation and management of a case of neglected vertical patellar dislocation in a 6 year-old boy who sustained an external rotational strain with a laterally directed force to his knee. Initially the diagnosis was missed and 2 months later open reduction was done. The increased tension generated by the rotation of the lateral extensor retinaculum kept the patella locked in the lateral gutter even with the knee in full extension. Traumatic patellar dislocation with rotation around a vertical axis has been described earlier, but no such neglected case has been reported to the best of our knowledge.

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

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

    2016-01-01

    Introduction: Locked vertical patellar dislocations are rare and pose a therapeutic challenge. This case is more unusual, as the patient was a known case of recurrent patellar dislocation and presented with an atraumatic locked and vertically rotated patellar dislocation. This type of presentation has never been reported in literature to the best of our knowledge. Case presentation: A 14-year-old healthy male child with previous history of recurrent lateral dislocation of patella presented to accident & emergency department with complaints of inability to walk or bear weight on his left lower limb after he spontaneously dislocated his patella while running on uneven ground. Radiographs revealed a laterally displaced and vertically rotated patella along its long axis with the medial patellar edge locked and dipping into the lateral gutter. Open reduction was performed along with lateral patellar retinacular release with medial patellar retinaculum plication, to achieve satisfactory patellar stability and patellofemoral tracking. Conclusion: We would recommend that in the settings of patella being vertically dislocated and locked, open reduction would be the management of choice, as these types of dislocations are difficult to relocate by closed reduction. Repeated attempts of closed reduction may cause osteochondral damage. Open reduction not only yields better outcomes but also allows the surgeon to perform patellar realignment procedures in order to prevent further patellar dislocations in cases of prior patellar instability. PMID:27703948

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

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    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.

  5. Medial patellar ossification after patellar instability: a radiographic finding indicative of prior patella subluxation/dislocation

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    Jerabek, Seth A. [Harvard Combined Orthopaedic Surgery Residency Program, Boston, MA (United States); Asnis, Peter D.; Poon, Steven K.; Gill, Thomas J. [Massachusetts General Hospital, Department of Orthopaedic Surgery, Boston, MA (United States); Bredella, Miriam A.; Ouellette, Hugue A. [Massachusetts General Hospital, Department of Radiology, Boston, MA (United States)

    2009-08-15

    To describe the correlation between medial patellar ossification and prior patella subluxation and/or dislocation. A retrospective billing database search identified 544 patients who had been diagnosed with patellar instability over a 13-year period. One hundred twenty-eight patients met the inclusion criteria. After review by a staff orthopedic surgeon and two musculoskeletal radiologists, 28 patients were found to have medial patellar ossification. The size and location of medial patellar ossification was recorded. Of the 28 patients (20 males, eight females, age 13-66 years, mean 28 years) who were found to have medial patellar ossification, 22 had radiographs, 16 had magnetic resonance imaging, and ten had both. The medial patellar ossification ranged in size from 2 to 18 mm with an average of 6.8 mm. Twelve were located in the medial patellofemoral ligament (MPFL), 14 in the medial joint capsule, and two in both the MPFL and joint capsule. Twenty-seven of 28 patients had a single ossification, and one patient had two ossifications. The timing from injury to first imaging of the lesion ranged from 10 days to a chronic history ({>=}35 years) of patellar instability. Medial patellar ossification correlates with a history of prior patella subluxation and/or dislocation. The medial ossification can be seen within the MPFL or the medial joint capsule, suggesting remote injury to these structures. The presence of this lesion will prompt physicians to evaluate for patellar instability. (orig.)

  6. Medial patellar ossification after patellar instability: a radiographic finding indicative of prior patella subluxation/dislocation

    International Nuclear Information System (INIS)

    Jerabek, Seth A.; Asnis, Peter D.; Poon, Steven K.; Gill, Thomas J.; Bredella, Miriam A.; Ouellette, Hugue A.

    2009-01-01

    To describe the correlation between medial patellar ossification and prior patella subluxation and/or dislocation. A retrospective billing database search identified 544 patients who had been diagnosed with patellar instability over a 13-year period. One hundred twenty-eight patients met the inclusion criteria. After review by a staff orthopedic surgeon and two musculoskeletal radiologists, 28 patients were found to have medial patellar ossification. The size and location of medial patellar ossification was recorded. Of the 28 patients (20 males, eight females, age 13-66 years, mean 28 years) who were found to have medial patellar ossification, 22 had radiographs, 16 had magnetic resonance imaging, and ten had both. The medial patellar ossification ranged in size from 2 to 18 mm with an average of 6.8 mm. Twelve were located in the medial patellofemoral ligament (MPFL), 14 in the medial joint capsule, and two in both the MPFL and joint capsule. Twenty-seven of 28 patients had a single ossification, and one patient had two ossifications. The timing from injury to first imaging of the lesion ranged from 10 days to a chronic history (≥35 years) of patellar instability. Medial patellar ossification correlates with a history of prior patella subluxation and/or dislocation. The medial ossification can be seen within the MPFL or the medial joint capsule, suggesting remote injury to these structures. The presence of this lesion will prompt physicians to evaluate for patellar instability. (orig.)

  7. Recurrent patellar dislocation: reappraising our approach to surgery.

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    Lim, Andrew K S; Chang, Haw Chong; Hui, James H P

    2008-04-01

    The management of recurrent traumatic patellar dislocation includes surgical realignment. There is no clear distinction whether proximal soft tissue or distal procedures produce superior results. However, distal realignment procedures are commonly associated with greater morbidity. We advocate a distal procedure only for cases which are more severe, such as the presence of patellar maltracking. Between January 2002 and June 2007, all patients who had a history of traumatic patellar dislocation with recurrent symptoms and failed conservative management underwent surgical realignment. Patients who had evidence of lateral patellar subluxation on computed tomography (CT) scan were offered a distal realignment procedure using the Elmslie-Trillat or Roux Goldthwaite procedure. All other patients underwent proximal soft tissue medial patellofemoral ligament (MPFL) reconstruction. Pre and postoperative functional International Knee Documentation Committee (IKDC), Lysholm and Tegner score assessments were performed for a minimum follow-up period of 6 months. The mean scores for each group were analysed using the Wilcoxon Matched-Pairs Signed-Ranks test and the Mann-Whitney U test was used to evaluate the difference between the groups. A total of 23 patients underwent surgery for patellar realignment. Of whom, 14 patients had a distal realignment procedure while 9 patients had a proximal procedure of MPFL reconstruction. There was greater morbidity reported with distal realignment procedures. Pre and postoperative IKDC, Lysholm and Tegner scores showed significant improvement for both treatment arms. However, there was no significant difference between the improvement scores for both groups. Patients with significant patellar maltracking following traumatic patellar dislocation would benefit from distal realignment using the Elmslie-Trillat or Roux Goldthwaite procedure. Otherwise, a proximal soft tissue procedure involving MPFL reconstruction would be adequate. A management

  8. High incidence of acute and recurrent patellar dislocations

    DEFF Research Database (Denmark)

    Gravesen, Kasper Skriver; Kallemose, Thomas; Blønd, Lars

    2017-01-01

    was retrospectively searched from 1994 to 2013 to find the number of acute and recurrent patellar dislocation. National population data were collected from Statistics Denmark. RESULTS: The period 1994-2013 saw a total registration of 24,154 primary patellar dislocations. A mean incidence of 42 (95% CI 37-47) per 100......PURPOSE: The purpose of this study was to investigate the Danish population as a whole from 1994 to 2013 to find the incidence of acute and recurrent patellar dislocation. METHODS: The study was performed as a descriptive epidemiological study. The Danish National Patient Registry......,000 person-years at risk was found, and young females aged 10-17 had the highest incidence of 108 (95% CI 101-116). In a 10-year follow-up, patients were at an overall risk of 22.7% (95% CI 22.2-23.2) of suffering a recurrent dislocation, with young girls aged 10-17 experiencing the highest risk, namely 36...

  9. Traumatic patellar dislocation: nonoperative treatment compared with MPFL reconstruction using patellar tendon.

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    Bitar, Alexandre Carneiro; Demange, Marco Kawamura; D'Elia, Caio Oliveira; Camanho, Gilberto Luis

    2012-01-01

    Over the long term, acute patellar dislocations can result in patellar instability, with high recurrence rates after nonoperative treatment. To compare the results of operative (reconstruction of the medial patellofemoral ligament [MPFL]) versus nonoperative treatment of primary patellar dislocation. Randomized controlled trial; Level of evidence, 1. Thirty-nine patients (41 knees) (mean age, 24.2 years; range, 12-38 years) with acute patellar dislocation were randomized into 2 groups. One group was treated nonoperatively with immobilization and physiotherapy, the other was treated surgically with MPFL reconstruction; both groups were evaluated with minimum follow-up of 2 years. The Kujala questionnaire was applied to assess pain and quality of life, and recurrence was evaluated. Pearson χ(2) or Fisher exact test was used in the statistical evaluation. The statistical analysis showed that the mean Kujala score was significantly lower in the nonoperative group (70.8), when compared with the mean value of the surgical group (88.9; P = .001). The surgical group presented a higher percentage of "good/excellent" results (71.43%) on the Kujala score when compared with the nonoperative group (25.0%; P = .003). The nonoperative group presented a large number of recurrences and subluxations (7 patients; 35% of cases), whereas there were no reports of recurrences or subluxations in the surgical group. Treatment with MPFL reconstruction using the patellar tendon produced better results, based on the analyses of posttreatment recurrences and the better final results of the Kujala questionnaire after a minimum follow-up period of 2 years.

  10. Use of computed tomography to determine the risk of patellar dislocation in 921 patients with patellar instability

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    Schueda MA

    2015-03-01

    Full Text Available Marco Antonio Schueda,1 Diego Costa Astur,2 Rodrigo Schueda Bier,3 Debora Schueda Bier,4 Nelson Astur,5 Moisés Cohen2 1Serviço de Pós Graduação em Cirurgia do Joelho e Artroscopia do IOT e Traumasports de Joinville, Joinville, Santa Catarina, 2Departamento de Ortopedia e Traumatologia da Escola Paulista de Medicina, São Paulo, 3Serviço de Cirurgia do Joelho e Artroscopia do IOT e Traumasports de Joinville, Joinville, Santa Catarina, 4Pontifícea Universidade Católica, Curitiba, 5Faculdade de Ciencias Médicas da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil Abstract: The purpose of this research was to identify reliable tomographic measurements that can detect patellofemoral abnormality and allow quantification of the risk of patellar dislocation in patients with potential patellar instability. A cross-sectional study in 921 patients with anterior pain or knee instability of at least 6 months' duration was conducted from July 2001 to December 2009. All subjects were clinically evaluated and underwent radiography and computed tomography of their knees. According to their degree of dislocating patellar dysplasia, the subjects were classified into groups for statistical comparison. There was a statistically significant difference in all measurements when the groups were compared, except for external tibial torsion angle. The most sensitive and specific measurements for determining patellar instability were the trochlear groove angle, tibial tubercle-trochlear groove distance, average patellar tilt, and average patellar height. Patients with potential patellar instability, increased tibial tubercle-trochlear groove distance, and patellar height, tilt, and deviation measurements had a greater risk for patellar dislocation. The clinical relevance of this study is to determine measurements that are able to tell us about patellar dislocation risk. Keywords: patellofemoral instability, knee, patellofemoral syndrome

  11. An analysis of knee anatomic imaging factors associated with primary lateral patellar dislocations.

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    Arendt, Elizabeth A; England, Kristin; Agel, Julie; Tompkins, Marc A

    2017-10-01

    Various knee anatomic imaging factors have been historically associated with lateral patellar dislocation. The characterization of these anatomic factors in a primary lateral patellar dislocation population has not been well described. Our purpose was to characterize the spectrum of anatomic factors from slice imaging measurements specific to a population of primary lateral patellar dislocation. A secondary purpose was to stratify these data by sex/skeletal maturity to better detail potential dimorphic characteristics. Patients with a history of primary lateral patellar dislocation between 2008 and 2012 were prospectively identified. Ten MRI measurements were analysed with results stratified by sex/skeletal maturity. A '4-factor' analysis was performed to detail the number of 'excessive' anatomic factors within a single individual. This study involved 157 knees (79 M/78 F), and 107 patients were skeletally mature. The measurements demonstrate more anatomic risk factors in this population than historical controls. Patella height and trochlear measurements are the most common 'dysplastic' anatomic factors in this population. There were differences based on sex for some patellar height measurements and for TT-TG; there were no differences based on skeletal maturity. Primary lateral patellar dislocation patients have MRI measurements of knee anatomic factors that are generally more dysplastic than the normal population; however, there is a broad spectrum of anatomic features with no pattern predominating. Characterizing knee anatomic imaging factors in the patient with a primary lateral patellar dislocation is a necessary first step in characterizing the (potential) differences between the primary and recurrent patellar dislocation patient. IV.

  12. Patellofemoral Arthritis After Lateral Patellar Dislocation: A Matched Population-Based Analysis.

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    Sanders, Thomas L; Pareek, Ayoosh; Johnson, Nicholas R; Stuart, Michael J; Dahm, Diane L; Krych, Aaron J

    2017-04-01

    The rate of patellofemoral arthritis after lateral patellar dislocation is unknown. Purpose/Hypothesis: The purpose of this study was to compare the risk of patellofemoral arthritis and knee arthroplasty between patients who experienced a lateral patellar dislocation and matched individuals without a patellar dislocation. Additionally, factors predictive of arthritis after patellar dislocation were examined. The hypothesis was that the rate of arthritis is likely higher among patients who experience a patellar dislocation compared with those who do not. Cohort study; Level of evidence, 3. In this study, 609 patients who had a first-time lateral patellar dislocation between 1990 and 2010 were compared with an age- and sex-matched cohort of patients who did not have a patellar dislocation. Medical records were reviewed to collect information related to the initial injury, recurrent dislocation, treatment, and progression to clinically significant patellofemoral arthritis (defined as symptoms with degenerative changes on patellar sunrise radiographs). Factors associated with arthritis (age, sex, recurrence, osteochondral injury, trochlear dysplasia) were examined. At a mean follow-up of 12.3 ± 6.5 years from initial dislocation, 58 patients (9.5%) in the dislocation cohort were diagnosed with patellofemoral arthritis, corresponding to a cumulative incidence of arthritis of 1.2% at 5 years, 2.7% at 10 years, 8.1% at 15 years, 14.8% at 20 years, and 48.9% at 25 years. In the control cohort, 8 patients (1.3%) were diagnosed with arthritis, corresponding to a cumulative incidence of arthritis of 0% at 5 years, 0% at 10 years, 1.3% at 15 years, 2.9% at 20 years, and 8.3% at 25 years. Therefore, patients who experienced a lateral patellar dislocation had a significantly higher risk of developing arthritis (hazard ratio [HR], 7.8; 95% CI, 3.9-17.6; P arthritis after patellar dislocation. Patellar dislocation is a significant risk factor for patellofemoral arthritis, as

  13. Total knee arthroplasty for treatment of osteoarthritis with prolonged patellar dislocation

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    Kosuke Kumagai, MD, PhD

    2017-03-01

    Full Text Available Prolonged dislocation of the patella is a rare condition and is often related to severe osteoarthritis (OA of the femorotibial (FT joint. For this condition's treatment, numerous surgical techniques using total knee arthroplasty (TKA have been published. To the best of our knowledge, this case report is the first description of the use of lateral release alone to treat recurrent patellar subluxation with TKA. An interesting point in this case is that the patient had a good recovery after TKA in spite of quite a long-term (a duration of almost 55 years dislocation of her patella and development of secondary OA. We describe a case that we treated by TKA for FT-OA with a prolonged patellar dislocation. We were able to obtain good patellar reduction without additional surgery by performing adequate lateral release of the patellar retinaculum. This clinical case indicates the usefulness of lateral patellar retinaculum release for obtaining stable patellar tracking in TKA for FT-OA with remaining lateral patellar dislocation. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/.

  14. Primary patellar dislocations without surgical stabilization or recurrence: how well are these patients really doing?

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    Magnussen, Robert A; Verlage, Megan; Stock, Elizabeth; Zurek, Lauren; Flanigan, David C; Tompkins, Marc; Agel, Julie; Arendt, Elizabeth A

    2017-08-01

    While a significant research has gone into identifying patients at highest risk of recurrence following primary patellar dislocation, there has been little work exploring the outcomes of patients who do not have a recurrent patellar dislocation. We hypothesize that patients without recurrent dislocation episodes will exhibit significantly higher KOOSs than those who suffer recurrent dislocations, but lower scores than published age-matched normative data. A retrospective review of patients with nonoperatively treated primary lateral patellar dislocations was carried out, and patients were contacted at a mean of 3.4 years (range 1.3-5.5 years) post-injury. Information regarding subsequent treatment and recurrent dislocations along with patient-reported outcome scores and activity level was collected. One hundred and eleven patients (29.8 %) of 373 eligible patients agreed to study participation, seven of whom were excluded because they underwent subsequent patellar stabilization surgery on the index knee. Seventy-six patients (73.1 %) reported no further dislocation events, and the mean KOOS subscales at follow-up were: symptoms-80.2 ± 18.8, pain-81.8 ± 16.2, ADL-88.7 ± 15.9, sport/recreation-72.1 ± 24.4, and QOL-63.9 ± 23.8 at a mean follow-up of 3.3 years (range 1.3-5.5 years). No significant differences in any of the KOOS subscales were noted between these patients and the group that reported recurrent patellar dislocations. Only 26.4 % of the patients without further dislocations reported they were able to return to desired sport activities without limitations following their dislocation. Patients who do not report recurrent patellar dislocations following nonoperative treatment of primary patellar dislocations are in many cases limited by this injury 3 years following the initial dislocation event. Retrospective cohort study, Level III.

  15. On establishing coreference in Left Dislocation constructions ...

    African Journals Online (AJOL)

    The phenomenon of left dislocation (LD) has received relatively little attention in the generative literature. In Government & Binding theory and early versions of Minimalist Syntax, the left-dislocated expression is conventionally taken to be base-generated in its sentence-initial surface position and the resumptive pronoun in ...

  16. Anatomic patellar instability risk factors in primary lateral patellar dislocations do not predict injury patterns: an MRI-based study.

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    Tompkins, Marc A; Rohr, Sara R; Agel, Julie; Arendt, Elizabeth A

    2017-02-28

    The primary goal was to describe the injury patterns in a population of primary (first time) lateral patellar dislocators (LPD) to lend clarity to commonly held notions about injury patterns in this population. A prospective study identifying patients presenting with LPD between 2008 and 2012. Inclusion criteria were a history and physical exam consistent with primary LPD, and an MRI consistent with the diagnosis without other significant ligamentous injury. On MRI, location of cartilage, medial patellofemoral ligament (MPFL) injury, and bone bruising were noted. Severity was categorized as partial or complete for MPFL and cartilage lesions. Anatomic patellar instability risk factors (patella alta, trochlear dysplasia, increased TT-TG, and lateral patella tilt) were recorded and compared to the injury patterns. This study involved 157 patients; 107 patients were skeletally mature. Of the 157 patients, 26 had surgery for this injury due to clinician-perceived need for cartilage debridement. MPFL injury severity was complete rupture (N = 69, 44%), partial (N = 67, 43%), and none (N = 19, 13%). MPFL injury location was isolated femoral (N = 16, 10%), isolated patella (N = 26, 17%), isolated mid-substance (0%), multiple locations (N = 95, 61%), and none (N = 20, 13%). Chondral injury location was patella (N = 67, 43%), lateral femoral condyle (N = 11, 7%), multiple locations (N = 53, 34%), and none (N = 26, 17%). A majority (61%) of patellar chondral lesions were at its inferomedial aspect; all medial patellar retinacular partial injuries involved the inferomedial aspect of the patella, consistent with the insertion of the medial patellotibial ligament (MPTL). Skeletally immature patients had a greater risk of isolated patellar MPFL and chondral injury. No clear relationship was found between/across the location and/or severity of bone bruising, MPFL, or chondral injury. Underlying anatomic patellar instability risk factors

  17. A national survey of the physiotherapy management of patients following first-time patellar dislocation.

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    Smith, Toby O; Chester, Rachel; Clark, Allan; Donell, Simon T; Stephenson, Richard

    2011-12-01

    The purpose of this study was to determine how musculoskeletal physiotherapists in acute National Health Service (NHS) hospitals manage patients following a first time patellar dislocation. National survey study. All NHS acute hospitals with an accident and emergency and/or an orthopaedic department were surveyed. 306 institutions were surveyed. Each institution was sent a 14 question self-administered questionnaire pertaining to the assessment, treatment, evaluation and outcome of patients following a first time patellar dislocation. After 3 weeks, all non-respondents were sent a reminder letter. After a further 3 weeks, those who had not responded by this time were sent a final reminder and copy of the questionnaire. The survey response rate was 59%. The respondents indicated that first-time patellar dislocation was not a common musculoskeletal disorder managed by NHS physiotherapists, constituting an average of 2% of caseloads. The results suggested that physiotherapists most commonly assess for reduced quadriceps or VMO capacity, gait, patellar tracking and glide, and knee effusion when examining patients following a first-time patellar dislocation. The most common treatments adopted are reassurance, behaviour modification followed by proprioceptive, knee mobility, quadriceps and specific VMO exercises. Generic lower limb assessment and treatment strategies are widely used to manage this patient group. Given the previous paucity in this literature, further study is now recommended to assess the efficacy of these interventions to provide UK physiotherapists with an evidence-base to justify their management strategies. Copyright © 2011 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  18. Left Dislocation: a typological overview | Westbury | Stellenbosch ...

    African Journals Online (AJOL)

    The Left Dislocation construction is a typologically universal phenomenon that has received detailed analysis, from both formal and functional perspectives, in a number of genetically and areally diverse languages. The present paper aims to provide a general overview of this cross-linguistic research with a concentration ...

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

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    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.

  20. Acute Concomitant Anterior Cruciate Ligament and Patellar Tendon Tears in a Non-dislocated Knee

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    Robert D Wissman

    2012-01-01

    Full Text Available Anterior cruciate ligament (ACL tears are common and may occur in isolation or with other internal derangements of the joint. Tears of the patellar tendon (PT occur less frequently and are rarely associated with intra-articular pathology. Acute combined tears of both the ACL and PT are known complications of high-energy traumatic knee dislocations. We present a case of an acute concomitant ACL and PT tears in a low-energy non-dislocated knee. To our knowledge, this injury has only been described in a limited number of case reports in the orthopedic literature. We present the imaging findings of this combined injury and discuss the importance of magnetic resonance (MR in diagnosis.

  1. Adolescent knee pain and patellar dislocations are associated with patellofemoral osteoarthritis in adulthood: A case control study.

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    Conchie, Henry; Clark, Damian; Metcalfe, Andrew; Eldridge, Jonathan; Whitehouse, Michael

    2016-08-01

    There is a lack of information about the association between patellofemoral osteoarthritis (PFOA) and both adolescent anterior knee pain (AKP) and previous patellar dislocations. This case-control study involved 222 participants from our knee arthroplasty database answering a questionnaire. One hundred and eleven patients suffering from PFOA were 1:1 matched by gender with a unicompartmental tibiofemoral arthritis control group. Multivariate correlation and binary logistic regression analysis were performed, with odds ratios (ORs) and 95% confidence intervals (CIs) calculated. An individual is 7.5 times more likely to develop PFOA if they have suffered from adolescent AKP (OR 7.5, 95% CIs 1.51 to 36.94). Additionally, experiencing a patellar dislocation increases the likelihood of development of PFOA, with an adjusted odds ratio of 3.2 (95% CIs 1.25 to 8.18). A 44-year difference in median age of first dislocation was also observed between the groups. This should bring into question the traditional belief that adolescent anterior knee pain is a benign pathology. Patellar dislocation is also a significant risk factor. These patients merit investigation, we encourage clinical acknowledgement of the potential consequences when encountering patients suffering from anterior knee pain or patellar dislocation. Copyright © 2016. Published by Elsevier B.V.

  2. Revision Surgery in Permanent Patellar Dislocation in DiGeorge Syndrome

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    Massimo Berruto

    2015-01-01

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

  3. [Reconstruction of medial patellofemoral ligament with transposition of great adductor muscular tendon for the treatment of teenagers' recurrent patellar dislocation].

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    Shao, Chuan-Qiang; Chen, Chang-Chun; Zhao, Chun-Cheng; Yang, Hong-Mei; Kang, Yan-Zhong

    2017-06-25

    To investigate surgical method and clinical curative effects of medial patellofemoral ligament (MPFL) reconstruction with great adductor muscular tendon in treating teenagers' recurrent patellar dislocation. From May 2012 to September 2014, 19 patients with recurrent dislocation of patellar, including 6 males and 13 females with an average of 16 years old (ranged from 13 to 17 years), the courses of disease ranged from 3 to 18 months(averaged 6 months). All patients were underwent great adductor muscular tendon transposition to reconstruct medial patellofemoral ligament. The curative effects were evaluated by preoperative and postoperative with Lysholm scores and Patellofemoral angle and Q angle. All patients were followed up from 12 to 18 months with an average of 16.5 months. Primary healing was achieved at stage I. No pain, swelling and patellar dislocation or subluxation occurred. Patellofemoral angle increased from preoperative (-3.8±4.9)° to (10.3±4.1)° postoperatively. Q angle decreased from preoperative(16.4±3.1)° to(10.5±1.2)° postoperatively; Lysholm scores were improved from preoperative (68.6±8.5) to (93.7±6.5) final follow-up ( P teenagers' recurrent patellar dislocation.

  4. Surgical versus conservative treatment of primary patellar dislocation. A systematic review and meta-analysis.

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    Saccomanno, Maristella F; Sircana, Giuseppe; Fodale, Mario; Donati, Fabrizio; Milano, Giuseppe

    2016-11-01

    The purpose of this study was to determine the efficacy of surgical and conservative treatment in the prevention of recurrence after primary patellar dislocation. Studies were searched on MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and CINHAL from their inception to April 2015. All randomized controlled clinical trials comparing surgical versus conservative treatment after first patellar dislocation were included. Primary outcomes were: recurrent dislocation, subluxation, overall instability and subsequent surgery. Secondary outcomes included imaging, and subjective and objective clinical assessment tools. Methodological quality of the studies was assessed using Cochrane Collaboration's "Risk of Bias" tool. Pooled analyses were reported as risk ratio (RR) using a random effects model. Continuous data were reported as standardized mean difference (SMD) and 95 % confidence intervals (CIs). Heterogeneity was assessed using I². Nine studies were included in the meta-analyses. Methodological quality of the studies was moderate to low. Meta-analyses showed that surgical treatment significantly reduces the redislocation rate (RR = 0.62; 95% CI = 0.39, 0.98, p = 0.04) and provides better results on Hughston VAS score (SMD = -0.32; 95% CI = -0.61, -0.03; p = 0.03) and running (OR = -0.52; 95% CI = 0.31, 0.88; p = 0.01). Conservative treatment showed less occurrence of minor complications (OR = 3.46; 95% CI = 2.08, 5.77; p = 0.01) and better results in the figure-of-8 run test (SMD = 0.42; 95% CI = 0.06, 0.77; p = 0.02) and in the squat down test (SMD = -0.45; 95% CI = -0.81, -0.10; p < 0.00001). No other significant differences could be found. Based on the available data, surgical treatment of primary patella dislocation significantly reduces the risk of patella redislocation.

  5. Long-Term Follow-Up of Nonoperatively and Operatively Treated Acute Primary Patellar Dislocation in Skeletally Immature Patients

    Directory of Open Access Journals (Sweden)

    Eva Bengtsson Moström

    2014-01-01

    Full Text Available Purpose. The present study reports a long-term follow-up of acute primary patellar dislocation in patients with open physes. The purpose of the study was to evaluate knee function and recurrence rates after surgical and nonsurgical treatment of patellar dislocation. Methods. A total of 51 patients, including 29 girls and 22 boys, who were 9–14 years of age at the time of injury, were retrospectively evaluated. The minimum follow-up time was 5 years. Thigh muscle torque, range of motion, the squat test, the knee injury and osteoarthritis outcome score (KOOS, the Kujala score, and the recurrence rate were registered. Radiological predisposing factors at the time of injury were determined. Results. Quality of life and sports/recreation were the most affected subscales, according to KOOS, and a reduced Kujala score was also observed in all treatment groups. The surgically treated patients had a significantly lower recurrence rate. Those patients also exhibited reduced muscle performance, with a hamstring to quadriceps ratio (H/Q of 1.03. The recurrence rate was not correlated with knee function. Conclusions. Patellar dislocation in children influences subjective knee function in the long term. Surgery appears to reduce the recurrence rate, but subjective knee function was not restored.

  6. Injury patterns of medial patellofemoral ligament after acute lateral patellar dislocation in children: Correlation analysis with anatomical variants and articular cartilage lesion of the patella

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Guang-ying; Ding, Hong-yu [Shandong Provincial Qianfoshan Hospital of Shandong University, Department of Ultrasonography, Jinan (China); Zheng, Lei; Ji, Bing-jun [Shandong Provincial Corps Hospital of Chinese People' s Armed Police Force, Department of Radiology, Jinan (China); Shi, Hao [Shandong Provincial Qianfoshan Hospital of Shandong University, Department of Radiology, Jinan (China); Feng, Yan [Affiliated Hospital of Binzhou Medical College, Department of Radiology, Binzhou (China)

    2017-03-15

    To assess the relationship between injury patterns of medial patellofemoral ligament (MPFL) and anatomical variants and patellar cartilage lesions after acute lateral patellar dislocation (LPD) in children. MR images were obtained in 140 children with acute LPD. Images were acquired and evaluated using standardised protocols. Fifty-eight cases of partial MPFL tear and 75 cases of complete MPFL tear were identified. Injuries occurred at an isolated patellar insertion (PAT) in 52 cases, an isolated femoral attachment (FEM) in 42 cases and an isolated mid-substance (MID) in five cases. More than one site of injury was identified in 34 cases. Compared with Wiberg patellar type C, Wiberg patellar type B predisposed to complete MPFL tear (P = 0.042). No correlations were identified between injury patterns of MPFL and trochlear dysplasia, patellar height and tibial tuberosity-trochlear groove distance (P > 0.05). Compared with partial MPFL tear, complete MPFL tear predisposed to Grade-IV and Grade-V patellar chondral lesion (P = 0.02). There were no correlations between incidence of patellar cartilage lesion and injury locational-subgroups of MPFL (P = 0.543). MPFL is most easily injured at the PAT in children. Wiberg patellar type B predisposes to complete MPFL tear. Complete MPFL tear predisposes to a higher grade of patellar chondral lesion. (orig.)

  7. Left Dislocation in Arabic: The complexity of form and meaning ...

    African Journals Online (AJOL)

    This paper studies the complexity of L(eft) D(islocation). It demonstrates that the function that is crosslinguistically associated with LD is conveyed in Arabic by a set of LD constructions. In the analyzed corpus, these constructions belong to two main types: Clitic LD and Subject LD. Some LD constructions formally and/or ...

  8. Left Dislocation and its translation in some Germanic languages ...

    African Journals Online (AJOL)

    In terms of the theoretical framework of an influential recent model of Bible translation, Left Dislocation (=LD) can be regarded as a “communicate clue” that translators must try to interpretively resemble in their target text translation. This exploratory study investigates how twenty translations (fifteen English, three Afrikaans, ...

  9. Left Dislocation and its translation in some Germanic languages

    African Journals Online (AJOL)

    Andrason, A, Dr

    In terms of the theoretical framework of an influential recent model of Bible translation, Left. Dislocation (=LD) can be .... its practical value in a major current translation of the Bible in Afrikaans.9 However, Gutt provides little insight into the ..... NBV which reflect some sort of shift from vs.22–26 to vs. 27). Only in the DBV a ...

  10. FRACTURE DISLOCATION OF LEFT SHOULDER: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Mazharuddin Ali

    2015-05-01

    Full Text Available Many systemic disorders present with orthopedic manifestations. A 40 year old male patient was brought in with pain and inability to move his left arm after he regained consciousness. The patient is a known case of Epilepsy since 2 years and had two episodes of seizure like activity and not on any medication. The diagnosis was fracture posterior dislocation of left shoulder following Grand mal Epilepsy. It was a 3 part fracture dislocation of left shoulder emergency closed reduction and 5 percutaneous K wires fixation was done under general anaesthe sia and universal shoulder immobilizer was applied to immobilize the left shoulder in flexion, adduction and internal rotation. Treatment for epilepsy was continued. After four weeks K wires were removed. With physiotherapy, patient regained full range of movements by 8 weeks. We conclude, that a fracture posterior dislocation of left shoulder as a presenting feature should arouse us to evaluate the cause, in our case it was convulsion. Closed reduction and internal fixation with percutaneous k - wires reduces infection rate and hospital stay. Patient recovered well without any complications

  11. Patellar dislocations in children, adolescents and adults: A comparative MRI study of medial patellofemoral ligament injury patterns and trochlear groove anatomy

    Energy Technology Data Exchange (ETDEWEB)

    Balcarek, Peter, E-mail: peter.balcarek@med.uni-goettingen.de [Department of Trauma Surgery, Plastic and Reconstructive Surgery, University Medicine, 37075 Goettingen (Germany); Walde, Tim Alexander; Frosch, Stephan; Schuettrumpf, Jan P.; Wachowski, Martin M.; Stuermer, Klaus M. [Department of Trauma Surgery, Plastic and Reconstructive Surgery, University Medicine, 37075 Goettingen (Germany); Frosch, Karl-Heinz [Department of Trauma and Reconstructive Surgery, Asklepios Clinic St. Georg, Hamburg (Germany)

    2011-09-15

    Purpose: The first aim was to compare medial patellofemoral ligament injury patterns in children and adolescents after first-time lateral patellar dislocations with the injury patterns in adults. The second aim was to evaluate the trochlear groove anatomy at different developmental stages of the growing knee joint. Materials and methods: Knee magnetic resonance (MR) images were collected from 22 patients after first-time patellar dislocations. The patients were aged 14.2 years (a range of 11-15 years). The injury pattern of the medial patellofemoral ligament was analysed, and trochlear dysplasia was evaluated with regard to sulcus angle, trochlear depth and trochlear asymmetry. The control data consisted of MR images from 21 adult patients who were treated for first-time lateral patellar dislocation. Results: After patellar dislocation, injury to the medial patellofemoral ligament was found in 90.2% of the children and in 100% of the adult patients. Injury patterns of the medial patellofemoral ligament were similar between the study group and the control group with regard to injury at the patellar attachment site (Type I), to the midsubstance (Type II) and to injury at the femoral origin (Type III) (all p > 0.05). Combined lesions (Type IV) were significantly less frequently observed in adults when compared to the study group (p = 0.02). The magnitude of trochlear dysplasia was similar in children, adolescents and adults with regard to all three of the measured parameter-values (all p > 0.05). In addition, the articular cartilage had a significant effect on the distal femur geometry in both paediatrics and adults. Conclusion: First, the data from our study indicated that the paediatric medial patellofemoral ligament injury patterns, as seen on MR images, were similar to those in adults. Second, the trochlear groove anatomy and the magnitude of trochlear dysplasia, respectively, did not differ between adults and paediatrics with patellar instability. Thus

  12. Patellar dislocations in children, adolescents and adults: A comparative MRI study of medial patellofemoral ligament injury patterns and trochlear groove anatomy

    International Nuclear Information System (INIS)

    Balcarek, Peter; Walde, Tim Alexander; Frosch, Stephan; Schuettrumpf, Jan P.; Wachowski, Martin M.; Stuermer, Klaus M.; Frosch, Karl-Heinz

    2011-01-01

    Purpose: The first aim was to compare medial patellofemoral ligament injury patterns in children and adolescents after first-time lateral patellar dislocations with the injury patterns in adults. The second aim was to evaluate the trochlear groove anatomy at different developmental stages of the growing knee joint. Materials and methods: Knee magnetic resonance (MR) images were collected from 22 patients after first-time patellar dislocations. The patients were aged 14.2 years (a range of 11-15 years). The injury pattern of the medial patellofemoral ligament was analysed, and trochlear dysplasia was evaluated with regard to sulcus angle, trochlear depth and trochlear asymmetry. The control data consisted of MR images from 21 adult patients who were treated for first-time lateral patellar dislocation. Results: After patellar dislocation, injury to the medial patellofemoral ligament was found in 90.2% of the children and in 100% of the adult patients. Injury patterns of the medial patellofemoral ligament were similar between the study group and the control group with regard to injury at the patellar attachment site (Type I), to the midsubstance (Type II) and to injury at the femoral origin (Type III) (all p > 0.05). Combined lesions (Type IV) were significantly less frequently observed in adults when compared to the study group (p = 0.02). The magnitude of trochlear dysplasia was similar in children, adolescents and adults with regard to all three of the measured parameter-values (all p > 0.05). In addition, the articular cartilage had a significant effect on the distal femur geometry in both paediatrics and adults. Conclusion: First, the data from our study indicated that the paediatric medial patellofemoral ligament injury patterns, as seen on MR images, were similar to those in adults. Second, the trochlear groove anatomy and the magnitude of trochlear dysplasia, respectively, did not differ between adults and paediatrics with patellar instability. Thus

  13. Evaluation of medial patellofemoral ligament tears after acute lateral patellar dislocation: comparison of high-frequency ultrasound and MR

    International Nuclear Information System (INIS)

    Zhang, Guang-Ying; Ding, Hong-Yu; Zheng, Lei; Sun, Bai-Sheng; Li, En-Miao; Shi, Hao

    2015-01-01

    The purpose of this study was to compare the diagnostic performance of high-frequency ultrasound with MR in the evaluation of medial patellofemoral ligament (MPFL) lesions after acute lateral patellar dislocation (LPD). High-frequency ultrasound and MR images were prospectively obtained in 97 consecutive patients with acute LPD. Images were acquired using standardised protocols and were independently evaluated by two radiologists. The MPFL was assessed at three sites (patellar insertion, femoral attachment, and mid-substance) for signs of injury. Of a total of 291 sites in 97 MPFLs, 127 showed proven MPFL tear at surgery, including 51 sites of complete tear and 76 sites of partial tear. In a site-based analysis, the sensitivity, specificity, and accuracy of high-frequency ultrasound was 90.8 %, 96.3 %, and 94.6 %, respectively, for partial MPFL tear and 86.3 %, 96.3 %, and 94 %, respectively, for complete tear. For MR, the sensitivity, specificity, and accuracy was 81.6 %, 95.7 %, and 91.3 %, respectively, for partial MPFL tear and 80.4 %, 95.7 %, and 92.1 %, respectively, for complete tear. There was no statistical difference between high-frequency ultrasound and MR in the assessment of partial (P = 0.1, 0.777, 0.155) or complete (P = 0.425, 0.777, 0.449) MPFL lesions. Interobserver agreement was very good for high-frequency ultrasound and good for MR. Data suggest that high-frequency ultrasound and MR have similar diagnostic performance in the evaluation of MPFL lesions after acute LPD. (orig.)

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

    International Nuclear Information System (INIS)

    Sakuraba, Koji; Miura, Hiromasa; Matsuda, Shuichi; Okazaki, Ken; Iwamoto, Yukihide; Fukuoka, Shinji

    2009-01-01

    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)

  15. Kneecap dislocation - aftercare

    Science.gov (United States)

    Patellar subluxation - aftercare; Patellofemoral subluxation - aftercare; Kneecap subluxation - aftercare ... is twisting motion or a sudden turn. Kneecap subluxation or dislocation may occur more than once. The ...

  16. Patellar subluxation syndrome

    International Nuclear Information System (INIS)

    Yagi, Tomonori; Sasaki, Tetsuto; Susuda, Koichi; Moji, Junichi

    1983-01-01

    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. (Ueda, J.)

  17. Dislocation

    Science.gov (United States)

    ... forcefully on a body part, such as your hip or shoulder. Heredity. Some people are born with ligaments that are looser and more prone to injury ... accidents. These are the most common cause of hip dislocations, especially for people ... the muscles, ligaments and tendons that reinforce the injured joint Nerve ...

  18. Patellar Tendinitis

    Science.gov (United States)

    ... Patellar tendinitis Symptoms & causes Diagnosis & treatment Doctors & departments Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  19. Patellar Tendinitis

    Science.gov (United States)

    ... your running shoes. Tight leg muscles. Tight thigh muscles (quadriceps) and hamstrings, which run up the back of your thighs, can increase strain on your patellar tendon. Muscular imbalance. If some muscles in your legs are much stronger than others, ...

  20. 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.

  1. Patellar Tendinopathy

    OpenAIRE

    Schwartz, Aaron; Watson, Jonathan N.; Hutchinson, Mark R.

    2015-01-01

    Context: Patellar tendinopathy is a common condition. There are a wide variety of treatment options available, the majority of which are nonoperative. No consensus exists on the optimal method of treatment. Evidence Acquisition: PubMed spanning 1962-2014. Study Design: Clinical review. Level of Evidence: Level 4. Results: The majority of cases resolve with nonoperative therapy: rest, physical therapy with eccentric exercises, cryotherapy, anti-inflammatories, corticosteroid injections, extrac...

  2. Patellar Tendinopathy

    Science.gov (United States)

    Schwartz, Aaron; Watson, Jonathan N.; Hutchinson, Mark R.

    2015-01-01

    Context: Patellar tendinopathy is a common condition. There are a wide variety of treatment options available, the majority of which are nonoperative. No consensus exists on the optimal method of treatment. Evidence Acquisition: PubMed spanning 1962-2014. Study Design: Clinical review. Level of Evidence: Level 4. Results: The majority of cases resolve with nonoperative therapy: rest, physical therapy with eccentric exercises, cryotherapy, anti-inflammatories, corticosteroid injections, extracorporeal shockwave therapy, glyceryl trinitrate, platelet-rich plasma injections, and ultrasound-guided sclerosis. Refractory cases may require either open or arthroscopic debridement of the patellar tendon. Corticosteroid injections provide short-term pain relief but increase risk of tendon rupture. Anti-inflammatories and injectable agents have shown mixed results. Surgical treatment is effective in many refractory cases unresponsive to nonoperative modalities. Conclusion: Physical therapy with an eccentric exercise program is the mainstay of treatment for patellar tendinopathy. Platelet-rich plasma has demonstrated mixed results; evidence-based recommendations on its efficacy cannot be made. In the event that nonoperative treatment fails, surgical intervention has produced good to excellent outcomes in the majority of patients. PMID:26502416

  3. Patellar Tendinopathy.

    Science.gov (United States)

    Schwartz, Aaron; Watson, Jonathan N; Hutchinson, Mark R

    2015-01-01

    Patellar tendinopathy is a common condition. There are a wide variety of treatment options available, the majority of which are nonoperative. No consensus exists on the optimal method of treatment. PubMed spanning 1962-2014. Clinical review. Level 4. The majority of cases resolve with nonoperative therapy: rest, physical therapy with eccentric exercises, cryotherapy, anti-inflammatories, corticosteroid injections, extracorporeal shockwave therapy, glyceryl trinitrate, platelet-rich plasma injections, and ultrasound-guided sclerosis. Refractory cases may require either open or arthroscopic debridement of the patellar tendon. Corticosteroid injections provide short-term pain relief but increase risk of tendon rupture. Anti-inflammatories and injectable agents have shown mixed results. Surgical treatment is effective in many refractory cases unresponsive to nonoperative modalities. Physical therapy with an eccentric exercise program is the mainstay of treatment for patellar tendinopathy. Platelet-rich plasma has demonstrated mixed results; evidence-based recommendations on its efficacy cannot be made. In the event that nonoperative treatment fails, surgical intervention has produced good to excellent outcomes in the majority of patients. © 2015 The Author(s).

  4. Patellar osteochondroma: case report,

    Directory of Open Access Journals (Sweden)

    Frederico Barra de Moraes

    2014-04-01

    Full Text Available The aim was to report on a rare case of patellar osteochondroma. A 60-year-old man presented a tumor on his left patella that had developed over a 10-year period, which is a rare occurrence, considering the patient's age and the site at which the tumor appeared. The clinical condition comprised mild pain and the presence of a mass, without limitation of flexion-extension or any neurovascular deficit. The tumor dimensions were 8 cm longitudinally × 6 cm transversally × 3 cm anteroposteriorly. It was hardened and was adhering to the patellar bone plane. On radiographs and tomographic scans, we observed areas of greater density corresponding to bone and other less dense areas that could correspond to slow-growing cartilage, with irregularities on the patellofemoral joint surface. Simple resection of the tumor was performed, and the anatomopathological examination confirmed that it was a patellar osteochondroma. Osteochondroma, or osteocartilaginous exostosis, includes a large proportion of the benign bone tumors. It results from cell alterations that trigger unregulated production of spongy bone. It is basically treated by means of surgical removal of the tumor mass. This is not essential, but is recommended in order to avoid lesions caused by contiguity and the risk of malignant transformation.

  5. a sociolinguistic study of left dislocation in South African Black EngUsh

    African Journals Online (AJOL)

    et al (1984:120) suggest that it is "a particularly legitimate device for emphasising the subject ... for speakers of the New Englishes who do not make the same use of intonation for emphasizing as do some of the speakers of British English'. 3.2 Left Dislocatioii in SABE: An extended example involving LD in context is given.

  6. Perilunate Dislocation

    Directory of Open Access Journals (Sweden)

    John Jiao

    2016-09-01

    Full Text Available History of present illness: A 25-year-old female presented to the emergency department with left wrist pain following a fall off a skateboard. The patient fell on her outstretched left wrist with the wrist dorsiflexed and reported immediate sharp pain to her left wrist that was worse with movement. She denied other trauma. Significant findings: In the left lateral wrist x-ray, the lunate (outlined in blue is dislocated from the rest of the wrist bones (yellow line but still articulates with the radius (red line. The capitate (yellow line does not sit within the distal articulation of the lunate and is displaced dorsally. Additionally, a line drawn through the radius and lunate (green line fails to intersect with the capitate. This is consistent with a perilunate dislocation. This is compared to a lunate dislocation, where the lunate itself is displaced and turned ventrally (spilled teacup and the proximal aspect does not articulate with the radius. Discussion: A perilunate dislocation is a significant closed wrist injury that is easily missed on standard anterior-posterior imaging. These dislocations are relatively rare, involving only 7% of all carpal injuries and are associated with high-energy trauma onto a hyperextended wrist, such as falls from a height, motor vehicle accidents, and sports injuries.1 An untreated perilunate dislocation is associated with high risk of chronic carpal instability and post-traumatic arthritis. If the mechanism of injury is sufficient to suspect perilunate dislocation, multiple radiographic views of the wrist should be ordered. Patients should receive prompt orthopedic consultation for open reduction and ligamentous repair. Even after successful identification and subsequent surgical repair, median nerve neuropathy and post-traumatic arthritis are frequent.2-3

  7. 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.)

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

    International Nuclear Information System (INIS)

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

    2016-01-01

    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. (orig.)

  9. Cine MR imaging before and after realignment surgery for patellar maltracking - comparison with axial radiographs

    International Nuclear Information System (INIS)

    Brossmann, J.; Muhle, C.; Buell, C.C.; Zieplies, J.; Melchert, U.H.; Brinkmann, G.; Schroeder, C.; Heller, M.

    1995-01-01

    Comparison of motion-triggered cine magnetic resonance (MR) imaging and conventional radiographs for the assessment of operative results of patellar realignment. Fifteen patients with recurrent patellar dislocation or patellar subluxation were evaluated with conventional axial radiographs before and after realignment surgery by measuring the congruence angle (CA), lateral patellofemoral angle (LPFA), and lateral displacement (d). In eight patients the patellofemoral joint was additionally evaluated pre- and postoperatively with motion-triggered cine MR imaging by determining the bisect offset (BSO), lateral patellar displacement (LPD), and patellar tilt angle (PTA). Significant differences between the pre- and postoperative measurements were found for all MR imaging parameters (BSO, LPD, PTA: p<0.01) but not for the conventional X-ray parameters (CA: p=0.70, LPFA: p=0.56; d: p=0.04). Motion-triggered cine MR imaging was superior to conventional tangential radiographs for assessing the effectiveness of patellar realignment surgery. (orig.)

  10. Cine MR imaging before and after realignment surgery for patellar maltracking - comparison with axial radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Brossmann, J. [Klinik fuer Radiologische Diagnostik der Univ. Kiel (Germany); Muhle, C. [Klinik fuer Radiologische Diagnostik der Univ. Kiel (Germany); Buell, C.C. [Rheumaklinik, Bad Bramstedt (Germany); Zieplies, J. [Lubinus Klinik, Kiel (Germany); Melchert, U.H. [Klinik fuer Radiologische Diagnostik der Univ. Kiel (Germany); Brinkmann, G. [Klinik fuer Radiologische Diagnostik der Univ. Kiel (Germany); Schroeder, C. [Klinik fuer Radiologische Diagnostik der Univ. Kiel (Germany); Heller, M. [Klinik fuer Radiologische Diagnostik der Univ. Kiel (Germany)

    1995-04-01

    Comparison of motion-triggered cine magnetic resonance (MR) imaging and conventional radiographs for the assessment of operative results of patellar realignment. Fifteen patients with recurrent patellar dislocation or patellar subluxation were evaluated with conventional axial radiographs before and after realignment surgery by measuring the congruence angle (CA), lateral patellofemoral angle (LPFA), and lateral displacement (d). In eight patients the patellofemoral joint was additionally evaluated pre- and postoperatively with motion-triggered cine MR imaging by determining the bisect offset (BSO), lateral patellar displacement (LPD), and patellar tilt angle (PTA). Significant differences between the pre- and postoperative measurements were found for all MR imaging parameters (BSO, LPD, PTA: p<0.01) but not for the conventional X-ray parameters (CA: p=0.70, LPFA: p=0.56; d: p=0.04). Motion-triggered cine MR imaging was superior to conventional tangential radiographs for assessing the effectiveness of patellar realignment surgery. (orig.)

  11. Estudo prospectivo randomizado sobre a luxação traumática de patela: tratamento conservador versus reconstrução do ligamento femoropatelar medial com tendão patelar - mínimo de dois anos de seguimento Randomized prospective study on traumatic patellar dislocation: conservative treatment versus reconstruction of the medial patellofemoral ligament using the patellar tendon, with a minimum of two years of follow-up

    Directory of Open Access Journals (Sweden)

    Alexandre Carneiro Bitar

    2011-01-01

    Full Text Available OBJETIVO: O objetivo deste estudo foi comparar os resultados da cirurgia (reconstrução do ligamento femoropatelar medial; LFPM com os resultados do tratamento conservador da luxação primária de patela. MÉTODOS: Trinta e nove pacientes (41 joelhos com luxação de patela foram randomizados em dois grupos (um grupo foi tratado conservadoramente - imobilização e fisioterapia - e o outro cirurgicamente com a reconstrução do LFPM e foram avaliados com um seguimento mínimo de dois anos. O questionário de Kujala foi aplicado para avaliar dor e qualidade de vida e as recidivas foram avaliadas. Os testes do Qui-quadrado de Pearson e exato de Fisher foram utilizados na avaliação estatística. RESULTADOS: A análise estatística mostrou que a média do escore de Kujala foi significativamente mais baixa no grupo conservador (70,8 quando comparada à média do grupo cirúrgico (88,9, com p = 0,001. O grupo cirúrgico apresentou maior porcentagem de resultados bom/excelente (71,43% no escore de Kujala quando comparados ao grupo conservador (25% com p = 0,003. O grupo conservador apresentou um número maior de recorrências (35% dos casos, enquanto que no grupo cirúrgico não houve relatos de recorrências e/ou subluxações. CONCLUSÕES: O tratamento com a reconstrução do ligamento femoropatelar medial com o tendão patelar produziu melhores resultados, com base na análise das recorrências pós-tratamento e nos resultados finais melhores no questionário de Kujala após um seguimento mínimo de dois anos.OBJECTIVE: The aim of this study was to compare the surgical results from reconstruction of the medial patellofemoral ligament (MPFL with non-operative treatment of primary patellar dislocation. METHODS: Thirty-nine patients (41 knees with patellar dislocation were randomized into two groups. One group was treated conservatively (immobilization and physiotherapy and other was treated surgically with reconstruction of the MPFL, and the

  12. Proximal patellar tendinosis and abnormalities of patellar tracking

    Energy Technology Data Exchange (ETDEWEB)

    Allen, G.M. [Royal Hospital Haslar, Gosport (United Kingdom); Tauro, P.G. [Northern Hospital,Victoria (Australia); Ostlere, S.J. [Nuffield Orthopaedic Hospital, Oxford (United Kingdom)

    1999-04-01

    Objective. To assess whether an association exists between patellar tendinosis and abnormal patellar tracking. Design and patients. The MRI examinations of 630 patients (i.e. 860 knees) referred with anterior knee pain over a 4-year period were assessed in retrospect for the presence of patellar tendinosis and abnormal patellar tracking. The images of the patients with patellar tendinosis were reviewed and the location within the patellar tendon was recorded. Results. There were 44 knees with proximal patellar tendinosis. Twenty-four of these were considered to have normal patellar tracking and 20 to have abnormal patellar tracking. In the group of 816 knees without proximal patellar tendinosis, 581 were considered to have normal patellar tracking and 235 knees to have abnormal patellar tracking. When the two groups were compared there was a statistically significant difference in the ratio of patients with and without abnormal tracking. Conclusion. In patients referred with anterior knee pain or suspected abnormal patellar tracking there is a significant association between proximal patellar tendinosis and abnormal patellar tracking. (orig.) With 2 figs., 5 tabs., 10 refs.

  13. 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.

  14. Injection treatments for patellar tendinopathy

    NARCIS (Netherlands)

    van Ark, Mathijs; Zwerver, Johannes; van den Akker-Scheek, Inge

    2011-01-01

    Objective Injection treatments are increasingly used as treatment for patellar tendinopathy. The aim of this systematic review is to describe the different injection treatments, their rationales and the effectiveness of treating patellar tendinopathy. Methods A computerised search of the Medline,

  15. Right upper limb bud triplication and polythelia, left sided hemihypertrophy and congenital hip dislocation, facial dysmorphism, congenital heart disease, and scoliosis: disorganisation-like spectrum or patterning gene defect?

    Science.gov (United States)

    Sabry, M A; al-Saleh, Q; al-Saw'an, R; al-Awadi, S A; Farag, T I

    1995-07-01

    A Somali female baby with right upper limb triplication, polythelia, left sided hemihypertrophy, congenital hip dislocation, facial dysmorphism, congenital heart disease, and scoliosis is described. It seems that the above described pattern of anomalies has not been reported before. The possible developmental genetic mechanism responsible for this phenotype is briefly discussed.

  16. Is proprioception diminished in patients with patellar tendinopathy?

    Science.gov (United States)

    Groot, H E; van der Worp, H; Nijenbanning, L; Diercks, R L; Zwerver, J; van den Akker-Scheek, I

    2016-03-01

    Patellar tendinopathy is a highly prevalent overuse injury, and most treatments are only effective to some extent. This persistence of complaints could be linked to changed proprioception. One study showed diminished proprioception in athletes with lateral epicondylitis. Aim of this study was to determine differences in proprioception, by measuring threshold to detect passive motion (TTDPM) between recreational athletes diagnosed with patellar tendinopathy and healthy controls. The TTDPM as measure of proprioception was determined in 22 recreational athletes with patellar tendinopathy and 22 healthy recreational athletes using a validated instrument. Amount of knee flexion and extension before the movement was noticed by the subject was determined. 80 measurements per athlete (left and right leg, towards extension and flexion and with two starting angles of 20° and 40° flexion) were performed. Mean TTDPM was compared between groups and among the injured recreational athletes between the affected and unaffected knee. No significant difference in TTDPM was found between recreational athletes with patellar tendinopathy and healthy controls. We did find a significant difference between the injured and non-injured knee in recreational athletes with patellar tendinopathy; mean TTDPM was 0.02° higher in the injured knee (p=0.044). No difference was found in proprioception between recreational athletes with patellar tendinopathy and healthy recreational athletes. It is unclear whether such a small difference in TTDPM between affected and unaffected knee is important in clinical setting. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. Simultaneous bilateral patellar tendon rupture ?

    OpenAIRE

    Moura, Diogo Lino; Marques, Jos? Pedro; Lucas, Francisco Manuel; Fonseca, Fernando Pereira

    2016-01-01

    Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a s...

  18. Gait COP trajectory of left side hip-dislocation and scoliotic patient using ankle-foot orthoses

    Science.gov (United States)

    Chong, Albert K.; Alrikabi, Redha; Milburn, Peter

    2017-07-01

    Plantar pressure-sensing mats and insole plantar sensor pads are ideal low-cost alternatives to force plates for capturing plantar COP excursion during gait. The acquired COP traces, in the form of pedobarographic images are favored by many clinicians and allied health professionals for evaluation of foot loading and balance in relation to foot biomechanics, foot injury, foot deformation, and foot ulceration. Researchers have recommended the use of COP trace for the biomechanical study of the deformed foot and lower-limb to improve orthosis design and testing. A correctly designed orthoses improves mobility and reduces pain in the foot, lower limb and lower spine region during gait. The research was carried out to evaluate the performance of two types of orthosis, namely: a custom-molded orthosis and an over-the-counter molded orthosis to determine the quality of gait of an adult scoliotic patient. COP trace patterns were compared with those of a healthy adult and showed the design of the custom-molded orthosis resulted in an improved quality of movements and provided enhanced stability for the deformed left foot during gait.

  19. MR findings of traumatic transient lateral dislocation of the patellae

    International Nuclear Information System (INIS)

    Lee, Jean Hwa; Kim, Sung Moon; Shin, Myung Jin; Seol, Hae Young; Ahn, Joong Mo

    2001-01-01

    To determine the magnetic resonance (MR) imaging characteristics of traumatic transient lateral dislocation of the patellae. In eight patients (6 males, 2 females, mean age : 22.4 years) in whom transient lateral dislocation of the patella was diagnosed, the distinctive MR imaging findings reflecting known injury mechanism were retrospectively analyzed with regard to bone contusion, chondral defect, fracture, loose body, joint effusion, and the associated soft tissue abnormalities. All of eight patients had bone contusions in the lateral femoral condyle and medial facet of the patella, while in five, chondral defects were present in this latter region. In three patients, fractures of the on lateral femoral condyle (n=2) and medial facet of the patella (n=3) were noted, and in three others loose bodies were noted. Noted. Joint effusion [simple effusion (n=4), lipohemarthrosis (n=3)] was observed in seven patients, and associated soft tissue injuries [to the medial patellar retinaculum (n=8), patellar tendon (n=2), and anterior cruciate ligament (n=1)] in eight. Patellar subluxation was found in seven. MR imaging is a useful technique for the diagnosis of traumatic lateral dislocation of the patella. The significant MR findings are bone contusion in the lateral femoral condyle and medial facet of the patella, chondral defect, fracture, joint effusion, injury to the medial patellar retinaculum, and patellar subluxation

  20. MR findings of traumatic transient lateral dislocation of the patellae

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jean Hwa; Kim, Sung Moon; Shin, Myung Jin [College of Medicine, Univ. of Ulsan, Seoul (Korea, Republic of); Seol, Hae Young [College of Medicine, Korea Univ., Seoul (Korea, Republic of); Ahn, Joong Mo [College of Medicine, Sungkyungkwan Univ., Seoul (Korea, Republic of)

    2001-10-01

    To determine the magnetic resonance (MR) imaging characteristics of traumatic transient lateral dislocation of the patellae. In eight patients (6 males, 2 females, mean age : 22.4 years) in whom transient lateral dislocation of the patella was diagnosed, the distinctive MR imaging findings reflecting known injury mechanism were retrospectively analyzed with regard to bone contusion, chondral defect, fracture, loose body, joint effusion, and the associated soft tissue abnormalities. All of eight patients had bone contusions in the lateral femoral condyle and medial facet of the patella, while in five, chondral defects were present in this latter region. In three patients, fractures of the on lateral femoral condyle (n=2) and medial facet of the patella (n=3) were noted, and in three others loose bodies were noted. Noted. Joint effusion [simple effusion (n=4), lipohemarthrosis (n=3)] was observed in seven patients, and associated soft tissue injuries [to the medial patellar retinaculum (n=8), patellar tendon (n=2), and anterior cruciate ligament (n=1)] in eight. Patellar subluxation was found in seven. MR imaging is a useful technique for the diagnosis of traumatic lateral dislocation of the patella. The significant MR findings are bone contusion in the lateral femoral condyle and medial facet of the patella, chondral defect, fracture, joint effusion, injury to the medial patellar retinaculum, and patellar subluxation.

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

    Directory of Open Access Journals (Sweden)

    Lucie Rouffiange

    2012-01-01

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

  2. Posterior Elbow Dislocation

    Directory of Open Access Journals (Sweden)

    Victoria Oppenheim

    2016-09-01

    Full Text Available History of present illness: A 15-year old female presented with left elbow pain. While competing in a high school wrestling match, she extended her left arm to brace a fall and had immediate onset of sharp pain. She denied weakness or numbness of her left arm. She had no past medical history. Significant findings: Elbow dislocations are classified by the position of the radio-ulnar joint relative to the humerus.1 Images 1, 2, and 3 show a left posterior elbow dislocation; the radius and ulna are displaced posteriorly with respect to the distal humerus. The lateral view of the elbow most clearly shows this: trochlear notch of the ulna is empty and displaced posteriorly relative to the trochlea. There is no associated fracture. Images 4 and 5 show the elbow status-post reduction, demonstrating proper alignment of the distal humerus with the radius and ulna. Discussion: Traumatic dislocations of the elbow are relatively uncommon in pediatric patients, with a peak incidence at 13 to 14 years.1 Dislocations are usually posterior and occur after forced abduction and extension of the elbow.1 It is important to evaluate for an associated fracture or avulsion, which occurs in over 50% of pediatric elbow dislocations. Fractures most commonly involve the medial epicondyle, radial head and neck, or coronoid process.1 One should also consider a neurovascular injury to the ulnar or median nerve or to the brachial artery or its branches.1 Posterior elbow dislocations should be reduced as soon as possible.1 Patients should receive adequate sedation and/or analgesia. One method of reduction is the “puller” technique, during which a practitioner stabilizes the humerus, while a second practitioner applies force against the anterior forearm, with gentle traction distally.1 Post-reduction neurovascular reassessment is important. After successful reduction, patients can be immobilized in a posterior long arm splint.

  3. Simultaneous bilateral patellar tendon rupture.

    Science.gov (United States)

    Moura, Diogo Lino; Marques, José Pedro; Lucas, Francisco Manuel; Fonseca, Fernando Pereira

    2017-01-01

    Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a short immobilization period and intensive rehabilitation program. Five months after surgery, the patient was able to fully participate in sport activities.

  4. Simultaneous bilateral patellar tendon rupture

    Directory of Open Access Journals (Sweden)

    Diogo Lino Moura

    Full Text Available ABSTRACT Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a short immobilization period and intensive rehabilitation program. Five months after surgery, the patient was able to fully participate in sport activities.

  5. Subtalar dislocation

    International Nuclear Information System (INIS)

    El-Khoury, G.Y.; Yousefzadeh, D.K.; Mulligan, G.M.; Moore, T.E.

    1982-01-01

    Over a period of three years we have seen nine patients with subtalar dislocation, all of whom sustained violent trauma to the region of the ankle and hind foot. All but one patient were males. Clinically a subtalar dislocation resembles a complicated fracture dislocation of the ankle but a definitive diagnosis can only be made radiographically. The mechanism of injury and radiographic features of this injury are discussed. (orig.)

  6. Jaw Dislocation

    Science.gov (United States)

    ... used to temporarily stabilize the jaw after a fracture or dislocation. More Information Mouth Healthy Resources In This Article Figure 1 Putting a Dislocated Jaw Back in Place Figure 2 Barton Bandage Urgent Dental Problems Introduction to Urgent Dental Problems Fractured, Loosened, ...

  7. A case report of the management and the outcome of a complete epiphyseal separation and dislocation with left anterior column fracture of the acetabulum

    Directory of Open Access Journals (Sweden)

    Jesús Palencia

    2016-01-01

    Conclusion: Epiphyseal fracture with dislocation of the femoral head is rare among children and adolescents, especially when associated with an acetabular fracture. AVN in such cases can develop, and it represents a challenge to orthopedic surgeons due to the poor prognosis and the future functional limitations of the joint.

  8. Treatment of habitual dislocation of patella in an adult arthritic knee

    Directory of Open Access Journals (Sweden)

    Raghuveer K Reddy

    2013-01-01

    Full Text Available Habitual dislocation of the patella (HDP is a common presentation in pediatric age unlike adults. Many surgical procedures using proximal realignment and distal realignment have been reported to treat HDP in children with satisfactory results. However, late presentation of habitual patellar dislocation with osteoarthritis is rare and treatment plan has not yet been established. We present a case of neglected iatrogenic habitual patellar dislocation with osteoarthritis in a 50-year-old woman. Two-staged procedure was planned, first with patellar realignment and later with definitive total knee arthroplasty. Quadricepsplasty, medial patello-femoral ligament reconstruction, lateral release and tibial tuberosity transfer was done as primary procedure and total knee arthroplasty, which was planned as secondary procedure, was deferred as the patient improved functionally.

  9. Patellar Tendinopathy: Diagnosis and Treatment.

    Science.gov (United States)

    Figueroa, David; Figueroa, Francisco; Calvo, Rafael

    2016-12-01

    Patellar tendinopathy is a common cause of pain in athletes' knees. Historically, it has been related to jumping sports, such as volleyball and basketball. Repetitive jumping generates a considerable load of energy in the extensor mechanism, leading to symptoms. The main pathophysiologic phenomenon in patellar tendinopathy is tendinosis, which is a degenerative disorder rather than an inflammatory disorder; therefore, the other popular term for this disease, tendinitis, is not appropriate. The nonsurgical treatment of patellar tendinopathy is focused on eccentric exercises and often has good results. Other experimental options, with variable levels of evidence, are available for recalcitrant cases. Surgical treatment is indicated for cases that are refractory to nonsurgical treatment. Open or arthroscopic surgery can be performed; the two methods are comparable, but arthroscopic surgery results in a faster recovery time.

  10. Patellar tendon: From tendinopathy to rupture

    Directory of Open Access Journals (Sweden)

    Federica Rosso

    2015-10-01

    Full Text Available Patellar tendinopathy is very common in patients complaining of anterior knee pain. Its aetiology is still unclear, but neovascularisation seems to play a role. Different treatments have been proposed overtime, from rehabilitation to platelet-rich-plasma injections, but there is no agreement on the best treatment protocol. The final stage of patellar tendinopathy is patellar tendon rupture. In these cases surgical treatment is often required. The aim of this literature review is to focus on the aetiology, diagnosis, and treatment of both patellar tendinopathy and rupture. We report the conservative treatments proposed for patellar tendinopathy and the surgical techniques described for its rupture.

  11. Morphology of insertion sites on patellar side of medial patellofemoral ligament.

    Science.gov (United States)

    Kikuchi, Shuhei; Tajima, Goro; Yan, Jun; Kamei, Youichi; Maruyama, Moritaka; Sugawara, Atsushi; Fujino, Kotaro; Takeda, Sanjuro; Doita, Minoru

    2017-08-01

    The purpose of this study was to clarify the insertion sites on the patellar side of the medial patellofemoral ligament (MPFL). A total of 35 nonpaired human cadaveric knees were used in this study. After identification of the MPFL, the insertion sites on the patellar side of the MPFL were marked. Three-dimensional images were created, and the location and morphology of these insertion sites were analysed. The morphology of the insertion sites on the patellar side of the MPFL was consistent. The proximal fibres of the MPFL were inserted to the deep fascia of the vastus medialis obliquus (VMO) and medial margin of the vastus intermedius (VI). The distal fibres of the MPFL were inserted to the medial margin of the patella directly. The insertion lengths of the VMO, VI, and patella were 26.7 ± 5.0, 28.5 ± 4.4, and 18.5 ± 4.4 mm, respectively. The rate of the vertical distance from the superior pole of the patella to the superior edge of the MPFL in relation to the total patellar height was 12 ± 4.4 %. At the distal edge, the rate was 58 ± 9.6 %. The insertion sites on the patellar side of the MPFL were consistent. The MPFL inserted into the VMO and VI was significantly longer than into the patella. The clinical relevance of this study is to improve understanding of the anatomy of the insertion sites on the patellar side of the MPFL and the pathophysiology of patellar dislocation.

  12. Recurrent Dislocation of the Patella

    Science.gov (United States)

    Benítez, Gustavo

    2015-01-01

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

  13. Lunate Dislocation

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    Jonathan Peña

    2017-01-01

    Full Text Available History of present illness: A 28-year-old right-handed male presented to the ED after he fell onto his outstretched right hand after being thrown from his motorcycle at highway speeds. He complained of right wrist pain. On exam, he had a visible deformity of his right wrist with diffuse tenderness to palpation over the wrist. Sensation was intact and he had 2+ radial and ulnar pulses. Significant findings: Plain film of the right wrist showed the classic “spilled teacup” consistent with a lunate dislocation. There is a loss of the normal articulation between the distal radius and lunate (white curved highlights represent expected points of articulation. Discussion: The most common mechanism leading to a dislocation of lunate is a fall onto an outstretched hand with the wrist in extension. Damage to the ligamentous infrastructure (commonly the dorsal radiolunate ligament causes destabilization.1 Lunate dislocations are distinguished from perilunate dislocations by assessing for the preservation of the articulation between the lunate and distal radius. In lunate dislocations, this articulation is disrupted leading to the classic “spilled teacup” appearance as seen above. However, if the articulation between the distal radius and lunate is preserved, but there is displacement of the carpal bones (eg, scaphoid, triquetrum, etc, then the dislocation is referred to as a perilunate dislocation. Plain film radiography oriented in the lateral view is typically the first-line modality for diagnosis. However, advanced imaging such as computed tomography or magnetic resonance imaging may be required to rule out fracture. It is important to keep in mind that the lunate receives its blood supply distally from the anterior interosseous artery; therefore, any injury (eg, fracture that disrupts perfusion places the patient at risk for avascular necrosis.2 As with all orthopedic upper extremity injuries, a thorough neurologic exam should be performed

  14. Surface Area of Patellar Facets: Inferential Statistics in the Iraqi Population

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    Ahmed Al-Imam

    2017-01-01

    Full Text Available Background. The patella is the largest sesamoid bone in the body; its three-dimensional complexity necessitates biomechanical perfection. Numerous pathologies occur at the patellofemoral unit which may end in degenerative changes. This study aims to test the presence of statistical correlation between the surface areas of patellar facets and other patellar morphometric parameters. Materials and Methods. Forty dry human patellae were studied. The morphometry of each patella was measured using a digital Vernier Caliper, electronic balance, and image analyses software known as ImageJ. The patellar facetal surface area was correlated with patellar weight, height, width, and thickness. Results. Inferential statistics proved the existence of linear correlation of total facetal surface area and patellar weight, height, width, and thickness. The correlation was strongest for surface area versus patellar weight. The lateral facetal area was found persistently larger than the medial facetal area, the p value was found to be <0.001 (one-tailed t-test for right patellae, and another significant p value of < 0.001 (one-tailed t-test was found for left patellae. Conclusion. These data are vital for the restoration of the normal biomechanics of the patellofemoral unit; these are to be consulted during knee surgeries and implant designs and can be of an indispensable anthropometric, interethnic, and biometric value.

  15. Tendinopatia patelar Patellar tendinopathy

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    Moisés Cohen

    2008-08-01

    Full Text Available A tendinopatia do patelar ou jumper's knee (joelho do saltador é uma afecção que acomete freqüentemente atletas praticantes de atividades de salto ou aquelas que exigem força de impacto repetitivo. Histologicamente, a sobrecarga excessiva no tendão pode provocar alterações na matriz extracelular, resultando em pequenas lesões que, cronicamente, poderão levar a um quadro de tendinose, principalmente na região do pólo inferior da patela. A dor na região anterior do joelho é o primeiro sintoma relatado pelo paciente portador dessa afecção. Seu início é insidioso e gradual, principalmente após atividade física, mas, com a progressão da doença, pode tornar-se freqüente durante ou já no início da atividade. O diagnóstico de tendinopatia do patelar é eminentemente clínico, caracterizado por dor à palpação no pólo inferior da patela e adjacências e, nos casos mais avançados, nódulo palpável e edema associado podem ser visualizados. Exames complementares, como radiografia, ultra-sonografia (US e ressonância magnética (RM auxiliam no diagnóstico. O US e a RM são os mais indicados, pois podem definir o local exato da lesão, sua extensão, como também identificar a presença ou não de alterações degenerativas, sendo a RM o que fornece melhor resolução. O tratamento inicial da tendinopatia é clínico, com repouso relativo, correção dos fatores etiológicos, além de crioterapia e medidas fisioterápicas. A utilização da medicação analgésica e antiinflamatória é controversa. Nos casos que não respondem ao tratamento clínico, o cirúrgico é opção, e várias técnicas são descritas, a literatura demonstrando índices variados de bons resultados.Patellar tendinopathy, or jumper's knee, is often seen in athletes that practice jumping modalities, or modalities that require repetitive impact strength. Histologically, the excessive load on the tendon may cause changes in the extracellular matrix and

  16. Effect of patellar strap and sports tape on pain in patellar tendinopathy: A randomized controlled trial

    NARCIS (Netherlands)

    de Vries, A.; Zwerver, J.; Diercks, R.; Tak, I.; van Berkel, S.; van Cingel, R.; van der Worp, H.; van den Akker-Scheek, I.

    2016-01-01

    Numerous athletes with patellar tendinopathy (PT) use a patellar strap or sports tape during sports. This study's aim was to investigate the short-term effect of these orthoses on patellar tendon pain. Participants performed the single-leg decline squat, vertical jump test, and triple-hop test under

  17. Effect of patellar strap and sports tape on pain in patellar tendinopathy : A randomized controlled trial

    NARCIS (Netherlands)

    Vries , de A.; Zwerver, J.; Diercks, R.; Tak, I.; van Berkel, S.; van Cingel, R.; van der Worp, H.; van den Akker-Scheek, I.

    2016-01-01

    Numerous athletes with patellar tendinopathy (PT) use a patellar strap or sports tape during sports. This study's aim was to investigate the short-term effect of these orthoses on patellar tendon pain. Participants performed the single-leg decline squat, vertical jump test, and triple-hop test under

  18. Monteggia fracture-dislocation: a case report, its' initial management ...

    African Journals Online (AJOL)

    This is a report and description of initial management of a fracture- dislocation, which was consequent to a sideswipe injury and consisted of a combination of the following injuries; lateral dislocation of the radial head, fractures of the olecranon and proximal ulna in the left forearm. The radial head dislocation and fracture of ...

  19. Isolated Proximal Tibiofibular Dislocation during Soccer

    Directory of Open Access Journals (Sweden)

    Casey Chiu

    2015-01-01

    Full Text Available Proximal tibiofibular dislocations are rarely encountered in the Emergency Department (ED. We present a case involving a man presenting to the ED with left knee pain after making a sharp left turn on the soccer field. His physical exam was only remarkable for tenderness over the lateral fibular head. His X-rays showed subtle abnormalities of the tibiofibular joint. The dislocation was reduced and the patient was discharged from the ED with orthopedic follow-up.

  20. Neglected Ipsilateral Anterior Cruciate Ligament and Patellar ...

    African Journals Online (AJOL)

    Simultaneous ipsilateral ACL and Patellar tendon rupture is a rare entity. Although treatment protocol has been varied and shrouded in controversy, the general consensus is that a 2- staged early repair of patellar tendon with delayed reconstruction of the ACL gives best functional result. The rehabilitation differs depending ...

  1. Patellar tendinopathy : physical therapy and injection treatments

    NARCIS (Netherlands)

    van Ark, Mathijs

    2015-01-01

    Patellar tendinopathy, commonly known as jumper’s knee, is an overuse injury of the patellar tendon. It is a frequent injury, particularly in jumping athletes such as volleyball and basketball players. Jumper’s knee is often a long-lasting injury and can have a major impact on sports and even work

  2. Knee Arthroplasty: With or Without Patellar Component?

    Directory of Open Access Journals (Sweden)

    Árpád Sólyom

    2015-09-01

    Full Text Available Arthroplasty is used when there is irreversible damage to the articular cartilage of the knee. It involves implanting a bicompartimental (femoral and tibial components or a tricompartimental (femoral, tibial and patellar components prosthesis. It is a very invasive and costly operation, so our objective was to evaluate the necessity of the patellar component.

  3. Achilles and Patellar Tendinopathy Loading Programmes

    DEFF Research Database (Denmark)

    Malliaras, Peter; Barton, Christian J; Reeves, Neil D

    2013-01-01

    INTRODUCTION: Achilles and patellar tendinopathy are overuse injuries that are common among athletes. Isolated eccentric muscle training has become the dominant conservative management strategy for Achilles and patellar tendinopathy but, in some cases, up to 45 % of patients may not respond...... of loading also need to be elucidated in order to focus treatment to patient deficits and refine loading programmes in future studies. OBJECTIVES: The objectives of this review are to evaluate the evidence in studies that compare two or more loading programmes in Achilles and patellar tendinopathy...... and patellar tendinopathy. Good-quality studies comparing loading programmes and evaluating clinical and mechanistic outcomes are needed in both Achilles and patellar tendinopathy rehabilitation....

  4. 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.

  5. [Treatment options for patellar tendinopathy].

    Science.gov (United States)

    Duthon, V B; Borloz, S; Ziltener, J-L

    2012-07-25

    Patellar tendinopathy is also called jumper's knee because of its high incidence in athletes with jumping or cutting activities as soccer, basketball, volleyball. Many different treatment methods have been described. However, no consensus exists regarding the optimal treatment for this condition. According to the literature, eccentric exercise-based physical therapy should be proposed first because of its strong scientific evidence. Shockwave therapy and injections may be useful but their real efficacy still has to be proven by randomized controlled study. For patients recalcitrant to more conservative options, operative management may be indicated.

  6. A Rare Case of an Irreducible Patella Dislocation

    Directory of Open Access Journals (Sweden)

    Dimitri E. Delagrammaticas

    2016-01-01

    Full Text Available Reports of irreducible patellar dislocations are exceedingly sparse throughout the literature. Obvious radiographic or physical exam findings including fracture or inversion of the patella are often present to explain the block to reduction. Not described previously in the literature is the instance of an irreducible patella dislocation in the setting of innocuous appearing injury imaging. We present a case of a healthy thirty-two-year-old female who sustained an irreducible lateral patella dislocation while participating in a dance aerobics class. Closed means of reduction were unsuccessful, necessitating open reduction. Intraoperative findings suggest incarceration of a nondisplaced fracture and a chondral defect as the block to reduction. Following open reduction, the patient has had no further episodes of pain or instability related to the patella at one-year follow-up. Irreducible patellar dislocations are exceedingly rare injuries, where associated osseous or chondral lesions may necessitate open reduction despite innocuous appearing initial imaging. A high index of suspicion to proceed with open reduction may limit repeated attempts at closed reduction and further injury.

  7. Femoral trochlear groove development after patellar subluxation and early reduction in growing rabbits.

    Science.gov (United States)

    Wang, Shengjie; Ji, Gang; Yang, Xu; Wang, Xiaomeng; Wang, Ruipeng; Li, Mei; Wang, Fei; Dai, Chengliang; Li, Xiaona

    2016-01-01

    This animal study aimed to investigate whether early reduction in patellar subluxation could minimize femoral trochlear dysplasia in growing rabbits. Sixty rabbits were divided into four groups (N = 30 knees/group). The control group underwent no surgical procedures. The rabbits in the three experimental groups underwent surgical patellar subluxation. Those in the early-reduced group underwent reduction surgery 1 month after patellar subluxation. The late-reduced group underwent reduction surgery 2 months after patellar subluxation. The rabbits in the non-reduced group underwent no reduction surgery. CT scans were performed monthly to measure the sulcus angle and trochlear width and depth. Gross specimen examination and histological observation were performed to investigate anatomical configuration and changes in the trochlear groove cartilage. CT scans demonstrated significant differences in the sulcus angle, trochlear width and trochlear depth by 6 months after subluxation surgery in the late-reduced and non-reduced groups. No obvious differences in these parameters were seen in the early-reduced group compared with the control group. Gross specimen examination and histological investigations showed degenerative changes in the femoral trochlear groove and cartilage by 6 months after subluxation surgery in the late-reduced and non-reduced groups. No degenerative changes were found in the early-reduced group, compared with the control group. Our results indicate that patellar subluxation or dislocation early in an animal's development can lead to femoral trochlear dysplasia or flattening and that early relocation of the patella can prevent femoral trochlear dysplasia in growing rabbits.

  8. Magnetic resonance images of chronic patellar tendinitis

    Energy Technology Data Exchange (ETDEWEB)

    Bodne, D.; Quinn, S.F.; Murray, W.T.; Cochran, C.; Bolton, T.; Rudd, S.; Lewis, K.; Daines, P.; Bishop, J.

    1988-01-01

    Chronic patellar tendinitis can be a frustrating diagnostic and therapeutic problem. This report evaluates seven tendons in five patients with chronic patellar tendinitis. The etiologies included 'jumper's knee' and Osgood-Schlatter disease. In all cases magnetic resonance images (MRI) showed thickening of the tendon. Some of the tendons had focal areas of thickening which helped establish the etiology. All cases had intratendinous areas of increased signal which, in four cases, proved to be chronic tendon tears. MRI is useful in evaluating chronic patellar tendinitis because it establishes the diagnosis, detects associated chronic tears, and may help determine appropriate rehabilitation. (orig.)

  9. Magnetic resonance images of chronic patellar tendinitis

    International Nuclear Information System (INIS)

    Bodne, D.; Murray, W.T.; Cochran, C.; Bolton, T.; Rudd, S.; Lewis, K.; Daines, P.; Bishop, J.

    1988-01-01

    Chronic patellar tendinitis can be a frustrating diagnostic and therapeutic problem. This report evaluates seven tendons in five patients with chronic patellar tendinitis. The etiologies included 'jumper's knee' and Osgood-Schlatter disease. In all cases magnetic resonance images (MRI) showed thickening of the tendon. Some of the tendons had focal areas of thickening which helped establish the etiology. All cases had intratendinous areas of increased signal which, in four cases, proved to be chronic tendon tears. MRI is useful in evaluating chronic patellar tendinitis because it establishes the diagnosis, detects associated chronic tears, and may help determine appropriate rehabilitation. (orig.)

  10. Patellar tendinopathy: physical therapy and injection treatments

    OpenAIRE

    van Ark, Mathijs

    2015-01-01

    Patellar tendinopathy, commonly known as jumper’s knee, is an overuse injury of the patellar tendon. It is a frequent injury, particularly in jumping athletes such as volleyball and basketball players. Jumper’s knee is often a long-lasting injury and can have a major impact on sports and even work participation. The development of jumper’s knee and the best treatment for it are still unclear. The general aim of this thesis was to investigate the development and management of patellar tendinop...

  11. Neglected dorsal dislocation of the scaphoid

    Directory of Open Access Journals (Sweden)

    Amaravati Rajkumar

    2009-01-01

    Full Text Available Isolated dislocation of the scaphoid is very rare. A 45-year old male, industrial worker reported two and half months after injury with wrist pain and swelling on the dorsum of left wrist. He was diagnosed as neglected dorsal dislocation of scaphoid. Proximal row carpectomy with capsular interposition was done stabilizing the distal carpus on the radius using Kirschner wires. At-12 months follow-up the patient had good wrist function and was satisfied with the outcome of the treatment. We hereby report this neglected dorsal dislocation of scaphoid in view of rarity and discuss the various options for management.

  12. The reliability and validity of radiological assessment for patellar instability. A systematic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Toby O. [University of East Anglia, Faculty of Health, Norwich (United Kingdom); Davies, Leigh [Norfolk and Norwich University Hospital, Norwich (United Kingdom); Toms, Andoni P.; Donell, Simon T. [University of East Anglia, Faculty of Health, Norwich (United Kingdom); Norfolk and Norwich University Hospital, Norwich (United Kingdom); Hing, Caroline B. [St George' s Hospital, London (United Kingdom)

    2011-04-15

    To determine the discriminative validity and reliability of the evidence base using meta-analysis. A review of published sources using the databases AMED, CINHAL, EMBASE, MEDLINE, Scopus and the Cochrane Library, and for unpublished material was conducted. All studies assessing the reliability, validity, sensitivity or specificity of magnetic resonance imaging (MRI), computed tomography (CT) or ultrasound (US) of the patellofemoral joint of patients following patellar dislocation, subluxation or instability, were included. A meta-analysis was performed to assess the difference in radiological measurements between healthy controls and subjects with patellar instability in order to assess discrimination validity. A narrative assessment was used to evaluate the inter- and intra-observer reliability as well as the sensitivity and specificity of specific radiological measurements. A total of 27 studies were reviewed. The findings indicated that there was acceptable inter-observer and intra-observer reliability and validity for different methods of assessing patellar height and the sulcus angle with X-ray, MRI and CT methods, and the tibial tubercle-trochlear groove (TT-TG) assessed using CT. There was poor reliability or validity for the assessment of severity of trochlear dysplasia and the sulcus angle using US. There is insufficient evidence to determine the reliability, validity, sensitivity or specificity of tests such as the congruence angle, lateral patellar displacement, lateral patellar tilt, trochlear depth, boss height, the crossing sign or Wiberg patellar classification. A critical appraisal of the literature identified a number of recurrent methodological limitations. Further study is recommended to evaluate the reliability and validity of these radiological outcomes using well-designed radiological trials. (orig.)

  13. The reliability and validity of radiological assessment for patellar instability. A systematic review and meta-analysis

    International Nuclear Information System (INIS)

    Smith, Toby O.; Davies, Leigh; Toms, Andoni P.; Donell, Simon T.; Hing, Caroline B.

    2011-01-01

    To determine the discriminative validity and reliability of the evidence base using meta-analysis. A review of published sources using the databases AMED, CINHAL, EMBASE, MEDLINE, Scopus and the Cochrane Library, and for unpublished material was conducted. All studies assessing the reliability, validity, sensitivity or specificity of magnetic resonance imaging (MRI), computed tomography (CT) or ultrasound (US) of the patellofemoral joint of patients following patellar dislocation, subluxation or instability, were included. A meta-analysis was performed to assess the difference in radiological measurements between healthy controls and subjects with patellar instability in order to assess discrimination validity. A narrative assessment was used to evaluate the inter- and intra-observer reliability as well as the sensitivity and specificity of specific radiological measurements. A total of 27 studies were reviewed. The findings indicated that there was acceptable inter-observer and intra-observer reliability and validity for different methods of assessing patellar height and the sulcus angle with X-ray, MRI and CT methods, and the tibial tubercle-trochlear groove (TT-TG) assessed using CT. There was poor reliability or validity for the assessment of severity of trochlear dysplasia and the sulcus angle using US. There is insufficient evidence to determine the reliability, validity, sensitivity or specificity of tests such as the congruence angle, lateral patellar displacement, lateral patellar tilt, trochlear depth, boss height, the crossing sign or Wiberg patellar classification. A critical appraisal of the literature identified a number of recurrent methodological limitations. Further study is recommended to evaluate the reliability and validity of these radiological outcomes using well-designed radiological trials. (orig.)

  14. The reliability and validity of radiological assessment for patellar instability. A systematic review and meta-analysis.

    Science.gov (United States)

    Smith, Toby O; Davies, Leigh; Toms, Andoni P; Hing, Caroline B; Donell, Simon T

    2011-04-01

    To determine the discriminative validity and reliability of the evidence base using meta-analysis. A review of published sources using the databases AMED, CINHAL, EMBASE, MEDLINE, Scopus and the Cochrane Library, and for unpublished material was conducted. All studies assessing the reliability, validity, sensitivity or specificity of magnetic resonance imaging (MRI), computed tomography (CT) or ultrasound (US) of the patellofemoral joint of patients following patellar dislocation, subluxation or instability, were included. A meta-analysis was performed to assess the difference in radiological measurements between healthy controls and subjects with patellar instability in order to assess discrimination validity. A narrative assessment was used to evaluate the inter- and intra-observer reliability as well as the sensitivity and specificity of specific radiological measurements. A total of 27 studies were reviewed. The findings indicated that there was acceptable inter-observer and intra-observer reliability and validity for different methods of assessing patellar height and the sulcus angle with X-ray, MRI and CT methods, and the tibial tubercle-trochlear groove (TT-TG) assessed using CT. There was poor reliability or validity for the assessment of severity of trochlear dysplasia and the sulcus angle using US. There is insufficient evidence to determine the reliability, validity, sensitivity or specificity of tests such as the congruence angle, lateral patellar displacement, lateral patellar tilt, trochlear depth, boss height, the crossing sign or Wiberg patellar classification. A critical appraisal of the literature identified a number of recurrent methodological limitations. Further study is recommended to evaluate the reliability and validity of these radiological outcomes using well-designed radiological trials.

  15. Management of patellar problems in skeletally mature patients with nail-patella syndrome.

    Science.gov (United States)

    Louboutin, Lucie; Wascher, Daniel; Neyret, Philippe

    2017-10-01

    Nail-patella syndrome (NPS) or hereditary onychoosteodysplasia is a rare autosomal dominant disease, characterized by a tetrad of findings, which include fingernail abnormalities, hypoplasia of the patellae, radial head dislocation and prominent iliac horns. Most of the literature on the treatment of patellar problems in NPS concerns paediatric patients, and there is no standard treatment algorithm for adult patients. We reviewed the charts of skeletally mature patients with NPS who presented to our clinic. We reviewed the presenting complaints, the physical examination findings and the radiographic imaging. We identified seven skeletally mature patients with NPS who presented with patellofemoral complaints. Their symptoms were instability, pain, or a combination of the two. Examination and imaging revealed a wide range of severity but included patellar instability and patellar arthritis. In our series, milder forms of the disease were treated with non-operative measures, but the majority of our patients required surgery including medial patellofemoral ligament reconstruction, tibial tuberosity transposition, patellofemoral and total knee arthroplasty. At midterm follow-up, most patients had good results. Nail-patella syndrome has a wide range of presentations and severity in skeletally mature patients. Knee surgeons should be familiar with the spectrum of clinical presentation and the range of treatment options available in order to provide optimum treatment for patients with this disorder. IV.

  16. Left dislocation: An exploration in linguistic typology

    African Journals Online (AJOL)

    Andrason, A, Dr

    The LD prototype is a linguistic construct. It is derived from typological evidence given the frequency and saliency of certain properties that are crosslinguistically attested. 2) The canonical and non-canonical members of the LD category are connected via family- resemblance relationship. This implies that while two adjacent ...

  17. Left dislocation: An exploration in linguistic typology

    African Journals Online (AJOL)

    Andrason, A, Dr

    E-mail: andrason@sun.ac.za. Josh Westbury. Department of Ancient .... other constructions, such as turn‐constructional bi-propositional expressions on the one hand, and fronting (and subsequently ..... acknowledgement constitutes the second turn in the sequence (see Westbury 2016b of this volume for further discussion).

  18. Medium-term evaluation of total knee arthroplasty without patellar replacement

    Directory of Open Access Journals (Sweden)

    José Wanderley Vasconcelos

    2013-06-01

    Full Text Available OBJECTIVE: To mid-term evaluate patients who were submitted to total knee arthroplasty without patellar resurfacing. METHODS: It was realized a retrospective cross-sectional study of patients who were submitted to total knee arthroplasty without patellar resurfacing. In all patients clinical examination was done based on the protocol of the Knee Society Scoring System, which assessed pain, range of motion, stability, contraction, knee alignment and function, and radiological evaluation. RESULTS: A total of 36 patients were evaluated. Of these, 07 were operated only on left knee, 12 only on right knee and 17 were operated bilaterally, totaling 53 knees. Ages ranged from 26 to 84 years. Of the 53 knees evaluated, 33 (62.26% had no pain. The maximum flexion range of motion averaged 104.7°. No knee had difficulty in active extension. As to the alignment for anatomical axis twelve knees (22.64% showed deviation between 0° and 4° varus. Thirty-nine (75.49% knees showed pace without restriction and the femorotibial angle ranged between 3° varus and 13° valgus with an average of 5° valgus. The patellar index ranged from 0.2 to 1.1. CONCLUSION: Total knee arthroplasty whitout patellar resurfacing provides good results in mid-term evaluation.

  19. Metabolic and cytoprotective effects of in vivo peri-patellar hyaluronic acid injections in cultured tenocytes.

    Science.gov (United States)

    Salamanna, F; Frizziero, A; Pagani, S; Giavaresi, G; Curzi, D; Falcieri, E; Marini, M; Abruzzo, P M; Martini, L; Fini, M

    2015-02-01

    The purpose of this study was to investigate tenocyte mechanobiology after sudden-detraining and to examine the hypothesis that repeated peri-patellar injections of hyaluronic acid (HA) on detrained patellar tendon (PT) may reduce and limit detrained-associated damage in tenocytes. Twenty-four male Sprague-Dawley rats were divided into three groups: Untrained, Trained and Detrained. In the Detrained rats, the left tendon was untreated while the right tendon received repeated peri-patellar injections of either HA or saline (NaCl). Tenocyte morphology, metabolism and synthesis of C-terminal-propeptide of type I collagen, collagen-III, fibronectin, aggrecan, tenascin-c, interleukin-1β, matrix-metalloproteinase-1 and-3 were evaluated after 1, 3, 7 and 10 days of culture. Transmission-electronic-microscopy showed a significant increase in mitochondria and rough endoplasmic reticulum in cultured tenocytes from Detrained-HA with respect to those from Detrained-NaCl. Additionally, Detrained-HA cultures showed a significantly higher proliferation rate and viability, and increased synthesis of C-terminal-Propeptide of type I collagen, fibronectin, aggrecan, tenascin-c and matrix-metalloproteinase-3 with respect to Detrained-NaCl ones, whereas synthesis of matrix-metalloproteinase-1 and interleukin-1β was decreased. Our study demonstrates that discontinuing training activity in the short-term alters tenocyte synthetic and metabolic activity and that repeated peri-patellar infiltrations of HA during detraining allow the maintenance of tenocyte anabolic activity.

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

    International Nuclear Information System (INIS)

    Mirza Toluei, F.; Afshar, A.; Salarilak, S.; Sina, A.

    2005-01-01

    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

  1. Comparison of patellar distraction with patellar glides in female patients with patellofemoral pain syndrom

    International Nuclear Information System (INIS)

    Syed, S.; Chaudhary, M.A.; Noor, R.; Bashir, M.S.; Manzoor, B.

    2017-01-01

    To analyse effectiveness of patellar glides and patellar distraction in the patients with patellofemoral pain syndrome (PFPS). Methodology: This longitudinal interventional comparative study was conducted at Physiotherapy Department, Mayo Hospital Lahore, Pakistan from September 2015 to March 2016. A total of 70 patients were divided into 2 groups randomly; group A received hot pack, quadriceps strengthening exercises and patellar distraction whereas group B received hot pack, quadriceps strengthening exercises and patellar glides. Age of the female patients was 18-40 years. Visual Analogue Scale (VAS) and Knee Injury and osteoarthritis outcome score (KOOS) questionnaire were used to compare the effectiveness of both treatments. The data were analysed using SPSS v. 21.0. Results: There was reduction in pain at VAS and KOOS showed improvement in function as well as the range of motion also increased in both groups. Both treatment techniques were effective in reducing pain in PFPS (P <0.005). Pre-treatment KOOS score in patellar glides group was 34.77+10.84 and post-treatment KOOS score was 62.155+15.75 and for patellar distraction group pre-treatment KOOS score was 35.42+10.07 that increased to 55.77+14.66 after treatment which showed that patellar glides had better effect on PFPS. Conclusion: Both treatments were effective in managing PFPS in terms of decreasing pain and increasing ROM as there was no significant difference between two techniques, however patellar glides were superior as compared to patellar distraction in decreasing pain and increasing ROM. (author)

  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. Endoscopic Resection of Lipoma of the Patellar Tendon

    Science.gov (United States)

    Lui, Tun Hing; Lee, Man Wai

    2015-01-01

    Synovial lipoma of the patellar tendon is a very rare entity. It can be associated with rupture of the patellar tendon. We present a case of synovial lipoma that was successfully resected endoscopically. The other indications for patellar tendoscopy include chronic patellar tendinitis and tendinosis, recalcitrant bursitis around the tendon, Osgood-Schlatter disease, and jumper's knee. The major potential danger of this endoscopic procedure is iatrogenic damage to the patellar insertion during endoscopic debridement in patients with jumper's knee or the tibial insertion during endoscopic debridement in patients with Osgood-Schlatter disease. PMID:25973368

  4. Patellar angle in Osgood-Schlatter disease.

    Science.gov (United States)

    Sen, R K; Sharma, L R; Thakur, S R; Lakhanpal, V P

    1989-02-01

    A new patellar angle is described in lateral radiographs of the knee joint. One line is drawn along the articular surface of the patella and another from the end of the inferior articular cartilage to the patellar apex. The angle formed by these two lines averaged 33 degrees in 68 knees joints afflicted with Osgood-Schlatter disease and 47 degrees in 71 age-matched controls and 198 adult controls. The small angle in Osgood-Schlatter disease is proposed to be an important factor in the pathogenesis of the traction apophysitis.

  5. Lateral patellar luxation: magnetic resonance findings

    International Nuclear Information System (INIS)

    Armesto, V.; Pulpeiro, J.R.

    1995-01-01

    The objective of this article is to present the magnetic resonance (MR) findings associated with lateral patellar luxation. The series consisted of eight patients, all of whom presented joint effusion, damage to the medical retinaculum and cortical contusion or fracture of medical aspect of the patella or of anterolateral surface of the outer condyle. Five patients also presented patellar sub luxation. Diagnosis depends on the technique employed, with axial planes being very useful. Thus, it is recommended that they be used as the standard plane, especially in pathologies that are clinically unsuspicious as in this case. MR can also provide information that leads to surgical treatment rather than the standard conservative treatment. (Author)

  6. The gauge theory of dislocations: A nonuniformly moving screw dislocation

    Energy Technology Data Exchange (ETDEWEB)

    Lazar, Markus, E-mail: lazar@fkp.tu-darmstadt.d [Emmy Noether Research Group, Department of Physics, Darmstadt University of Technology, Hochschulstr. 6, D-64289 Darmstadt (Germany); Department of Physics, Michigan Technological University, Houghton, MI 49931 (United States)

    2010-07-05

    We investigate the nonuniform motion of a straight screw dislocation in infinite media in the framework of the translational gauge theory of dislocations. The equations of motion are derived for an arbitrarily moving screw dislocation. The fields of the elastic velocity, elastic distortion, dislocation density and dislocation current surrounding the arbitrarily moving screw dislocation are derived explicitly in the form of integral representations. We calculate the radiation fields and the fields depending on the dislocation velocities.

  7. Reconstruction and restoration of neglected ruptured patellar tendon using semitendinosus and gracilis tendons with preserved distal insertions: two case reports.

    Science.gov (United States)

    Chen, Bin; Li, Runguang; Zhang, Sheng

    2012-08-01

    Neglected rupture of the patellar tendon is rare but becomes more difficult to repair the longer it is left untreated. The most common rupture sites are the inferior pole of the patella and distal insertion. Proximal retraction of the patella and extensor mechanism adhesions makes the treatment more difficult than acute tendon rupture. We report two patients with neglected patellar tendon rupture treated by reconstruction and restoration using semitendinosus-gracilis (STG) tendons with preserved distal insertions. Preserved distal insertion provided sufficient blood supply to accelerate healing, while combined fixation with tension-reducing wire, offered the initial stability of the closed-loop sutured tendon. Both patients reacquired near normal strength and stability of the patellar tendon and restoration of function after operation and rehabilitation. Copyright © 2011 Elsevier B.V. All rights reserved.

  8. Computed tomographic evaluation of realignment surgery for patellar subluxation

    International Nuclear Information System (INIS)

    Inoue, Masahiro; Shino, Konsei; Maeda, Akira; Nakata, Ken; Ono, Hiroo.

    1994-01-01

    Forty-two patients with patellar subluxation underwent realignment surgery of the knee extensor mechanism. The surgery included, lateral release, advancement and reefing of the vastus medialis and the medial capsule and tibial tubercle transfer (Elmslie-Trillat procedure). The effect of surgery was evaluated using computed tomograms of the pre- and post-operative knees at 0, 15, 30 and 45 degrees of knee flexion. The degree of patellofemoral incongruence on CT was expressed using two parameters of patellar tilt and patellar shift. Thirty-three volunteers without any patello-femoral symptoms served as controls. Postoperatively both the patellar tilt and the patellar shift improved significantly. The average patellar tilt and the patellar shift of the patient group at 45 degrees were comparable with those of controls. However, it was found by CT that the realignment surgery was less effective between 0 and 30 degrees of knee flexion. (author)

  9. Computed tomographic evaluation of realignment surgery for patellar subluxation

    Energy Technology Data Exchange (ETDEWEB)

    Inoue, Masahiro (Kansai Rosai Hospital, Amagasaki (Japan)); Shino, Konsei; Maeda, Akira; Nakata, Ken; Ono, Hiroo

    1994-01-01

    Forty-two patients with patellar subluxation underwent realignment surgery of the knee extensor mechanism. The surgery included, lateral release, advancement and reefing of the vastus medialis and the medial capsule and tibial tubercle transfer (Elmslie-Trillat procedure). The effect of surgery was evaluated using computed tomograms of the pre- and post-operative knees at 0, 15, 30 and 45 degrees of knee flexion. The degree of patellofemoral incongruence on CT was expressed using two parameters of patellar tilt and patellar shift. Thirty-three volunteers without any patello-femoral symptoms served as controls. Postoperatively both the patellar tilt and the patellar shift improved significantly. The average patellar tilt and the patellar shift of the patient group at 45 degrees were comparable with those of controls. However, it was found by CT that the realignment surgery was less effective between 0 and 30 degrees of knee flexion. (author).

  10. Excessive lateral patellar translation on axial computed tomography indicates positive patellar J sign.

    Science.gov (United States)

    Xue, Zhe; Song, Guan-Yang; Liu, Xin; Zhang, Hui; Wu, Guan; Qian, Yi; Feng, Hua

    2018-03-20

    The purpose of the study was to quantify the patellar J sign using traditional computed tomography (CT) scans. Fifty-three patients (fifty-three knees) who suffered from recurrent patellar instability were included and analyzed. The patellar J sign was evaluated pre-operatively during active knee flexion and extension. It was defined as positive when there was obvious lateral patellar translation, and negative when there was not. The CT scans were performed in all patients with full knee extension; and the parameters including bisect offset index (BOI), patellar-trochlear-groove (PTG) distance, and patellar lateral tilt angle (PLTA) were measured on the axial slices. All the three parameters were compared between the J sign-positive group (study group) and the J sign-negative group (control group). In addition, the optimal thresholds of the three CT scan parameters for predicting the positive patellar J sign were determined with receiver operating characteristic (ROC) curves, and the diagnostic values were assessed by the area under the curve (AUC). Among the fifty-three patients (fifty-three knees), thirty-seven (70%) showed obvious lateral patellar translation, which were defined as positive J sign (study group), and the remaining sixteen (30%) who showed no lateral translation were defined as negative J sign (control group). The mean values of the three CT parameters in the study group were all significantly larger compared to the control group, including BOI (121 ± 28% vs 88 ± 12%, P = 0.038), PTG distance (5.2 ± 6.6 mm vs - 4.4 ± 5.2 mm, P J sign was 97.5% (Sensitivity = 83.3%, Specificity = 87.5%). In this study, the prevalence of positive patellar J sign was 70%. The BOI measured from the axial CT scans of the knee joint can be used as an appropriate predictor to differentiate the positive J sign from the negative J sign, highlighting that the excessive lateral patellar translation on axial CT scan indicates positive

  11. An Isolated Medial Patellofemoral Ligament Reconstruction with Patellar Tendon Autograft

    Directory of Open Access Journals (Sweden)

    Dariusz Witoński

    2013-01-01

    Full Text Available The aim of the study was to evaluate the results of the medial patellofemoral ligament reconstruction with a medial strip of patellar tendon autograft after a minimum 2-year followup. Ten patients (10 knees were operated on by one surgeon, according to the modified technique, described by Camanho, without any bone plug at free graft end. The mean age of the patients was 27.2 years (ranging from 18 to 42 years. The mean follow-up period was 3 years and 7 months. All patients were reviewed prospectively. At the last follow-up visit, all the patients demonstrated a significant improvement in terms of patellofemoral joint stability, all aspects of the KOOS questionnaire, and Kujala et al.’s score (59.7 points preoperatively and 84.4 points at the last followup. No patient revealed recurrent dislocation. The SF-36 score revealed a significant improvement in bodily pain, general health, physical role functioning, social role functioning, and physical functioning domains. The described MPFL reconstruction with the use of the medial 1/3rd of patella tendon is an effective procedure that gives satisfactorily patellofemoral joint functions, improves the quality of life, and provides much pain relief. It is relatively simple, surgically not extensive, and economically cost-effective procedure.

  12. Dislocation model of fracture

    International Nuclear Information System (INIS)

    Kull', L.M.

    1987-01-01

    Papers dealing with study on mechanisms of submicricrack formation and propagation using dislocation representations are analyzed. Cases of brittle and ductile fracture of materials as well as models of dislocationless (amorphous) zone at the growing crack tip are considered. Dislocation models of fracture may be used when studying the processes of deformation and accumulation of damages in elements of nuclear facilities

  13. 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.

  14. Patellar tendon reconstruction with ipsilateral free semi-tendinosus and gracilis autograft for neglected patellar tendon rupture

    Directory of Open Access Journals (Sweden)

    Appalaraju Sanaboyina

    2015-01-01

    Full Text Available Chronic patellar tendon ruptures are rare. Diagnosis is usually made on clinical background. The ideal method of treatment is a matter of debate. The management of neglected, chronic patellar tendon must address four difficulties: The proximally retracted patella, reconstruction of the patellar tendon, temporary protection of repair, patello-femoral tracking, and active full range of knee movement. By presenting a case of chronic patellar tendon rupture, the advantages of reconstruction with a free semi-tendinosus and gracilis autograft from an early rehabilitation are described.

  15. T2 mapping in patellar chondromalacia

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-06-15

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

  16. Isolated dorsal dislocation of the tarsal naviculum

    Directory of Open Access Journals (Sweden)

    Kaziz Hamdi

    2015-01-01

    Full Text Available Isolated dislocation of the tarsal naviculum is an unusual injury, scarcely reported in the literature. The naviculum is surrounded by the rigid bony and ligamentous support hence fracture dislocation is more common than isolated dislocation. The mechanism and treatment options remain unclear. In this case report, we describe a 31 year old man who sustained an isolated dorsal dislocation of the left tarsal naviculum, without fracture, when he was involved in a motor vehicle collision. The reported mechanism of the dislocation is a hyper plantar flexion force applied to the midfoot, resulting in a transient disruption of the ligamentous support of the naviculum bone, with dorsal displacement of the bone. The patient was treated with open reduction and Krischner-wire fixation of the navicular after the failure of closed reduction. The wires were removed after 6 weeks postoperatively. Physiotherapy for stiffness and midfoot pain was recommended for 2 months. At 6 months postoperatively, limping, midfoot pain and weakness were reported, no X-ray abnormalities were found. The patient returned to his obvious activities with a normal range of motion.

  17. Isolated dorsal dislocation of the tarsal naviculum.

    Science.gov (United States)

    Hamdi, Kaziz; Hazem, Ben Ghozlen; Yadh, Zitoun; Faouzi, Abid

    2015-01-01

    Isolated dislocation of the tarsal naviculum is an unusual injury, scarcely reported in the literature. The naviculum is surrounded by the rigid bony and ligamentous support hence fracture dislocation is more common than isolated dislocation. The mechanism and treatment options remain unclear. In this case report, we describe a 31 year old man who sustained an isolated dorsal dislocation of the left tarsal naviculum, without fracture, when he was involved in a motor vehicle collision. The reported mechanism of the dislocation is a hyper plantar flexion force applied to the midfoot, resulting in a transient disruption of the ligamentous support of the naviculum bone, with dorsal displacement of the bone. The patient was treated with open reduction and Krischner-wire fixation of the navicular after the failure of closed reduction. The wires were removed after 6 weeks postoperatively. Physiotherapy for stiffness and midfoot pain was recommended for 2 months. At 6 months postoperatively, limping, midfoot pain and weakness were reported, no X-ray abnormalities were found. The patient returned to his obvious activities with a normal range of motion.

  18. Epidemiology of Patellar Tendinopathy in Elite Male Soccer Players

    NARCIS (Netherlands)

    Hägglund, Martin; Zwerver, Johannes; Ekstrand, Jan

    Background: Patellar tendinopathy is common among athletes in jumping sports and in sports with prolonged repetitive stress of the knee extensor apparatus. The epidemiology in soccer is not well described. Purpose: This study was undertaken to investigate and describe the epidemiology of patellar

  19. Patellar tendon ossification after partial patellectomy: a case report

    Directory of Open Access Journals (Sweden)

    Guven Melih

    2010-02-01

    Full Text Available Abstract Introduction Patellar tendon ossification is a rare pathology that may be seen as a complication after sleeve fractures of the tibial tuberosity, total patellectomy during arthroplasty, intramedullary nailing of tibial fractures, anterior cruciate ligament reconstruction with patellar tendon autograft and knee injury without fracture. However, its occurrence after partial patellectomy surgery has never been reported in the literature. Case presentation We present the case of a 35-year-old Turkish man with a comminuted inferior patellar pole fracture that was treated with partial patellectomy. During the follow-up period, his patellar tendon healed with ossification and then ruptured from the inferior attachment to the tibial tubercle. The ossification was excised and the tendon was subsequently repaired. Conclusion To the best of our knowledge, this is the first report of patellar tendon ossification occurring after partial patellectomy. Orthopaedic surgeons are thus cautioned to be conscious of this rare complication after partial patellectomy.

  20. The effect of a patellar strap on knee joint proprioception in healthy participants and athletes with patellar tendinopathy

    NARCIS (Netherlands)

    de Vries, Astrid J.; van den Akker-Scheek, Inge; Diercks, Ron L.; Zwerver, Johannes; van der Worp, Henk

    Objectives: The primary aim of this study is to investigate the effect of the use of a patellar strap on knee joint proprioception in both healthy participants and in patients with patellar tendinopathy (PT). Secondary aims are to examine whether there is a difference in effectiveness of the use of

  1. Lesions in canine stifle joints due to trochleoplasties as treatment for medial patellar luxation

    Directory of Open Access Journals (Sweden)

    Johannes Hans van der Zee

    2015-07-01

    Full Text Available Lesions in canine stifle joints after previous trochleoplasty surgery were documented. Infour clinical cases arthrotomies were performed due to stifle pain after previous trochleardeepening procedures. A small area of hyaline cartilage remained in the groove of the stiflesin cases where previous wedge trochleoplasties had been performed. All of the stifles hadsignificant areas of eburnation on the axial aspect of the medial trochlear ridge. The stifle jointsof a dog that was euthanased due to severe irreversible osteo-arthritis were photographed.The dog had undergone previous surgery for patellar luxation and cranial cruciate ligamentruptures. The trochlear grooves in this dog had almost no visible articular cartilage left.

  2. MANAGEMENT OF POSTERIOR DISLOCATED INTRAOCULAR LENSES IN A TERTIARY HOSPITAL

    OpenAIRE

    Shashidhar; Apoorva Mithrananda; Manasa Penumetcha; Shruthi Chandra

    2016-01-01

    BACKGROUND The aim of this study was to assess and compare the visual outcome of different approaches in the management of dislocated PCIOL. MATERIALS AND METHODS 20 eyes of 20 patients who underwent 3PPPV/anterior vitrectomy to refixate or IOL exchange for dislocation or subluxation of PCIOL from 2012 to 2015. SFIOLs were implanted in 12 patients, IOL refixation was done in four patients and four were left aphakic. This is a retrospective study of 20 eyes of 20 patients ...

  3. Extracorporeal shockwave for chronic patellar tendinopathy.

    Science.gov (United States)

    Wang, Ching-Jen; Ko, Jih-Yang; Chan, Yi-Sheng; Weng, Lin-Hsiu; Hsu, Shan-Lin

    2007-06-01

    Chronic patellar tendinopathy is an overuse syndrome with pathologic changes similar to tendinopathies of the shoulder, elbow, and heel. Extracorporeal shockwave was shown effective in many tendinopathies. Extracorporeal shockwave therapy may be more effective than conservative treatment for chronic patellar tendinopathy. Randomized controlled clinical trial; Level of evidence, 2. This study consisted of 27 patients (30 knees) in the study group and 23 patients (24 knees) in the control group. In the study group, patients were treated with 1500 impulses of extracorporeal shockwave at 14 KV (equivalent to 0.18 mJ/mm(2) energy flux density) to the affected knee at a single session. Patients in the control group were treated with conservative treatments including nonsteroidal anti-inflammatory drugs, physiotherapy, exercise program, and the use of a knee strap. The evaluation parameters included pain score, Victorian Institute of Sports Assessment score, and ultrasonographic examination at 1, 3, 6, and 12 months and then once a year. At the 2- to 3-year follow-up, the overall results for the study group were 43% excellent, 47% good, 10% fair, and none poor. For the control group, the results were none excellent, 50% good, 25% fair, and 25% poor. The mean Victorian Institute of Sports Assessment scores were 42.57 +/- 10.22 and 39.25 +/- 10.85, respectively, before treatment (P = .129) and 92.0 +/- 10.17 and 41.04 +/- 10.96, respectively, after treatment (P Extracorporeal shockwave therapy appeared to be more effective and safer than traditional conservative treatments in the management of patients with chronic patellar tendinopathy.

  4. Appendicular joint dislocations.

    Science.gov (United States)

    Hindle, Paul; Davidson, Eleanor K; Biant, Leela C; Court-Brown, Charles M

    2013-08-01

    This study defines the incidence and epidemiology of joint dislocations and subluxations of the appendicular skeleton. All patients presenting acutely to hospital with a dislocation or subluxation of the appendicular skeleton from a defined population were included in the study. There were 974 dislocations or subluxations over one year between the 1st November 2008 and the 31st October 2009. There was an overall joint dislocation incidence of 157/10(5)/year (188/10(5)/year in males and 128/10(5)/year in females). Males demonstrated a bimodal distribution with a peak incidence of 446/10(5)/year at 15-24 years old and another of 349/10(5)/year in those over 90 years. Females demonstrate an increasing incidence from the seventh decade with a maximum incidence of 520/10(5)/year in those over 90 years. The most commonly affected joints are the glenohumeral (51.2/10(5)/year), the small joints of the hand (29.9/10(5)/year), the patellofemoral joint (21.6/10(5)/year), the prosthetic hip (19.0/10(5)/year), the ankle (11.5/10(5)/year), the acromioclavicular joint (8.9/10(5)/year) and the elbow (5.5/10(5)/year). Unlike fractures, dislocations are more common in the both the most affluent and the most socially deprived sections of the population. Joint disruptions are more common than previously estimated. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Porous tantalum patellar augmentation: the importance of residual bone stock.

    Science.gov (United States)

    Ries, Michael D; Cabalo, Adam; Bozic, Kevin J; Anderson, Martin

    2006-11-01

    Trabecular metal augmentation of bone defects has been associated with favorable bone ingrowth. Animal studies also suggest fibrous tissue attachment to trabecular metal can be achieved. We treated 16 patients with total knee arthroplasty (18 knees) with severe patellar bone loss using trabecular metal patellar reconstruction. The patients were divided into two groups based on the amount of residual patellar bone stock present at the time of surgery: Group 1 (six patients, seven knees) with no patellar bone stock and Group 2 (10 patients, 11 knees) in whom at least 50% of the patellar component surface was covered by host bone. All seven patellar components in Group 1 loosened within 1 year. Two of these developed necrosis of the extensor mechanism leading to extensor mechanism discontinuity. One component in Group 2 became infected and loosened, whereas the remaining 10 components remained stable at minimum 12-month followup. Our results suggest stable fixation of a trabecular metal patellar component can be achieved when residual bone is present for implant fixation, but early loosening is likely to occur when soft tissue is used for fixation to the implant.

  6. Bilateral traumatic patellar fracture: a case report and

    Directory of Open Access Journals (Sweden)

    Vinay Gupta

    2012-06-01

    Full Text Available 【Abstract】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 with-out 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 dis-cussed the injury mechanism, management and rehabilita-tion in such a case and reviewed the available literature regarding such a presentation. Key words: Fractures, bone; Patella; Wounds and injuries

  7. Assessment of patellar maltracking using combined static and dynamic MRI

    International Nuclear Information System (INIS)

    McNally, E.G.; Ostlere, S.J.; Pal, C.; Phillips, A.; Reid, H.; Dodd, C.

    2000-01-01

    Between January 1995 and Jul 1997, 474 patients with anterior knee pain resistant to conservative treatment were referred for MR of the knee. The MR examination consisted of routine sequences with an additional patellofemoral dynamic examination using a technique that has been developed at this institution. The dynamic study examines both knees simultaneously, with the patient supine and the quadriceps loaded. No gating or restraint apparatus is needed. Patellar subluxation or tilt was present in 188(40%) of cases, bilateral in 104 and unilateral in 84 cases (right 39, left 45). It was classified as mild in 51%, moderate in 39% and severe in 10%. Subluxation was more prevalent in females than males (42% vs. 37%) and this was most obvious in the severe group where 68% were female. In 90 knees selected at random, four measurements of patellofemoral morphology were obtained using reconstructed images from a volume gradient echo sequence. These measurements were correlated with the degree of subluxation or tilt. A tibial tubercle distance greater than 20 mm, a femoral sulcus angle greater than 150 degrees, sulcus depth less than 4 mm were specific for subluxation but no measurement proved to be sufficiently sensitive to preclude a tracking study. MRI can be used to define more precisely the anatomy of the extensor mechanism and its relationship to the femur and tibia, in both a static and dynamic setting. In this way, patients with anterior knee pain can be classified more accurately and the outcomes of treatment more reliably assessed. (orig.)

  8. Assessment of patellar maltracking using combined static and dynamic MRI

    Energy Technology Data Exchange (ETDEWEB)

    McNally, E.G.; Ostlere, S.J.; Pal, C.; Phillips, A.; Reid, H. [Department of Radiology, Nuffield Orthopaedic Centre, Headington, Oxford OX3 9JW (United Kingdom); Dodd, C. [Department of Orthopaedic Surgery, Nuffield Orthopaedic Centre, Headington, Oxford OX3 9JW (United Kingdom)

    2000-07-01

    Between January 1995 and Jul 1997, 474 patients with anterior knee pain resistant to conservative treatment were referred for MR of the knee. The MR examination consisted of routine sequences with an additional patellofemoral dynamic examination using a technique that has been developed at this institution. The dynamic study examines both knees simultaneously, with the patient supine and the quadriceps loaded. No gating or restraint apparatus is needed. Patellar subluxation or tilt was present in 188(40%) of cases, bilateral in 104 and unilateral in 84 cases (right 39, left 45). It was classified as mild in 51%, moderate in 39% and severe in 10%. Subluxation was more prevalent in females than males (42% vs. 37%) and this was most obvious in the severe group where 68% were female. In 90 knees selected at random, four measurements of patellofemoral morphology were obtained using reconstructed images from a volume gradient echo sequence. These measurements were correlated with the degree of subluxation or tilt. A tibial tubercle distance greater than 20 mm, a femoral sulcus angle greater than 150 degrees, sulcus depth less than 4 mm were specific for subluxation but no measurement proved to be sufficiently sensitive to preclude a tracking study. MRI can be used to define more precisely the anatomy of the extensor mechanism and its relationship to the femur and tibia, in both a static and dynamic setting. In this way, patients with anterior knee pain can be classified more accurately and the outcomes of treatment more reliably assessed. (orig.)

  9. Traumatic atlantooccipital dislocation.

    Science.gov (United States)

    Van den Bout, A H; Dommisse, G F

    1986-03-01

    A young adult sustained a traumatic atlantooccipital dislocation together with fracture-dislocation at C.4/5 level and had total neurologic deficit below C4 segment. He retained full consciousness but required respiratory support. He developed a stress ulcer with hemorrhage and evidence of "shock lung." He responded to intensive care. Surgery on the 11th day secured reduction and internal fixation at both levels. Death due to respiratory and cardiac arrest followed on the 14th day. Postmortem examination revealed edema of the brain and brainstem.

  10. The efficacy of patellar decompression for improving anterior knee pain following total knee arthroplasty without patellar resurfacing.

    Science.gov (United States)

    Lee, Gun Woo; Lee, Sun-Mi; Jang, Soo-Jin; Son, Jung-Hwan

    2013-04-01

    Anterior knee pain remains common following total knee arthroplasty (TKA). In this study, we evaluated the efficacy of patellar decompression via drilling for the treatment of anterior knee pain following TKA without patellar resurfacing. A prospective cohort study was performed in 271 consecutive patients who underwent primary total knee replacement with patellar decompression (study group, n = 131) or without decompression (control group, n = 140). The patients were assessed according to the Knee Society rating, clinical anterior knee pain score, and British Orthopaedic Association patient-satisfaction score in each group. Each assessment was performed without the examiner knowing whether the patella had been decompressed. Radiographic evaluations were also performed according to the Knee Society scoring system for functional activity and our own severity grade system for patellofemoral articular change. There were no adverse events following patellar decompression. The overall prevalence of anterior knee pain was not significantly different between groups (p = 0.71). However, patients presenting pain over grade II after the operation in the study group were statistically low (p = 0.01). The overall postoperative knee scores were higher in the study group, but there were no significant differences between groups (p = 0.0731). Analyses of the radiographs revealed similar postoperative outcomes in both groups of knees. As we observed significantly lower rates of anterior knee pain and no patellar complications following patellar decompression via drilling in TKA without patellar resurfacing, we recommend performing patellar decompression in cases of total knee replacement without patellar resurfacing.

  11. Finite strain discrete dislocation plasticity

    NARCIS (Netherlands)

    Deshpande, VS; Needleman, A; Van der Giessen, E

    2003-01-01

    A framework for carrying out finite deformation discrete dislocation plasticity calculations is presented. The discrete dislocations are presumed to be adequately represented by the singular linear elastic fields so that the large deformations near dislocation cores are not modeled. The finite

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

    Directory of Open Access Journals (Sweden)

    Guerrero Patrick

    2009-07-01

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

  13. Medial subtalar dislocation

    African Journals Online (AJOL)

    Pr KODO

    A 27- year old female patient suffered from a closed medial subtalar dislocation treated by ... injury. She presented with pain, swelling of and internal rotation of the foot in relation to the knee joint. The talus was prominent dorsolaterally. Globally the clinical appearance was that ... frequently than the lateral ones and can be.

  14. Dislocated Worker Project.

    Science.gov (United States)

    1988

    Due to the severe economic decline in the automobile manufacturing industry in southeastern Michigan, a Dislocated Workers Program has been developed through the partnership of the Flint Area Chamber of Commerce, three community colleges, the National Center for Research in Vocational Education, the Michigan State Department of Education, the…

  15. Smectic meniscus and dislocations

    International Nuclear Information System (INIS)

    Geminard, J.C.; Oswald, P.; Holyst, R.

    1998-01-01

    In ordinary liquids the size of a meniscus and its shape is set by a competition between surface tension and gravity. The thermodynamical process of its creation can be reversible. On the contrary, in smectic liquid crystals the formation of the meniscus is always an irreversible thermodynamic process since it involves the creation of dislocations (therefore it involves friction). Also the meniscus is usually small in experiments with smectics in comparison to the capillary length and therefore the gravity does not play any role in determining the meniscus shape. Here we discuss the relation between dislocations and meniscus in smectics. The theoretical predictions are supported by a recent experiment performed on freely suspended films of smectic liquid crystals. In this experiment the measurement of the meniscus radius of curvature gives the pressure difference, Δp, according to the Laplace law. From the measurements of the growth dynamics of a dislocation loop (governed by Δp) we find the line tension (∼8 x 10 -8 dyn) and the mobility of an elementary edge dislocation (∼4 x 10 - 7 cm 2 s/g). (author)

  16. Bilateral patellar tuberculosis masquerading as infected infrapatellar bursitis.

    Science.gov (United States)

    Sreenivasan, Ravi; Haq, Rehan Ul

    2017-04-01

    A 30-year-old woman presented to our outpatient department with complaints of pain and swelling in bilateral infrapatellar regions and a discharging sinus in the right knee over the duration of one year. Radiographs showed lytic regions in bilateral patellae. Samples sent from material curetted from sinus yielded no organism but histopathology reported granulomatous inflammation. Following a fresh magnetic resonance imaging (MRI) scan that revealed the infrapatellar pad of fat communicating with the patellar lesions, an exploration and evacuation was done. Material sent revealed epithelioid cell granulomas with caseous necrosis consistent with tuberculosis (TB). The patient was put on first line anti-tubercular treatment (ATT) and has responded favourably with healing of sinus and patellar lesions. Bilateral infrapatellar bursitis is not rare. However patellar TB as a cause for OMIT is not a common diagnosis. A bilateral patellar involvement has not been reported in literature to the best of our knowledge.

  17. Investigating Achilles and patellar tendinopathy prevalence in elite athletics.

    Science.gov (United States)

    Janssen, Ina; van der Worp, Henk; Hensing, Sjoerd; Zwerver, Johannes

    2018-01-01

    Although injury surveillance in athletics is routinely conducted, discipline-specific Achilles and patellar tendinopathy prevalence remains unknown. The purpose of this study was to explore discipline-specific tendinopathy prevalence and identify whether injury-specific risk factors differed in athletes. Elite athletes were recruited and provided information on their sport training including Achilles and patellar tendon pain history. In order to ascertain whether between-discipline differences existed, data were categorized into discipline groups. Middle-distance athletes reported the highest prevalence of Achilles tendinopathy and the combined athletes reported the highest patellar tendinopathy prevalence. Greater calf stiffness was reported in athletes who experienced Achilles tendinopathy compared to those who did not. A substantial portion of athletes believed their performance decreased as a result of their tendon pain. In order to develop discipline-specific evidence-based injury prevention programmes, further discipline-specific research is required to quantify the mechanism for Achilles and patellar tendinopathy development in elite athletics.

  18. An Unusual Prepatellar Bursa Swelling: Patellar Button Dissociation and Migration

    Directory of Open Access Journals (Sweden)

    Thomas Hester

    2016-01-01

    Full Text Available Implant loosening is not a new phenomenon, nor is implant migration; however they are rarely seen after knee arthroplasty surgery. Complications with patellar buttons have been reported before with peg failure, loosening, and patella fracture; however extra-articular migration is extremely rare. We report an unusual case of patellar button migration 11 years after total knee arthroplasty to the prepatellar bursa.

  19. 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.)

  20. Transosseous-Equivalent Repair for Distal Patellar Tendon Avulsion

    OpenAIRE

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

    2016-01-01

    Extensor mechanism disruptions are relatively uncommon injuries involving injury to the quadriceps tendon, patella, or patellar tendon. Patellar tendon avulsions from the tibial tubercle in adults are rare; as such, little technical information has been written regarding surgical management of this injury in the adult. Transosseous-equivalent repairs have been described in the management of several types of tendon ruptures, including rotator cuff and distal triceps tendon ruptures, but not pr...

  1. Patellar tendon straps decrease pre-landing quadriceps activation in males with patellar tendinopathy.

    Science.gov (United States)

    Rosen, Adam B; Ko, Jupil; Simpson, Kathy J; Brown, Cathleen N

    2017-03-01

    To determine if patellar tendon straps altered quadriceps' muscle activity during a drop-jump landing in males with and without patellar tendinopathy. Case-control. Biomechanics Research Laboratory. Twenty recreationally-active males participated: ten (age = 21.3 ± 2.4 years, height = 182.8 ± 5.3 cm, mass = 81.7 ± 8.6 kg) with patellar tendinopathy; ten (age = 22.0 ± 1.6 years, height = 185.7 ± 4.5 cm, mass = 82.2 ± 9.8 kg) were healthy with no history of tendinopathy. Electromyography (EMG) data for the vastus medialis (VM), rectus femoris (RF), and vastus lateralis (VL) muscles were collected. Five 2-legged 40 cm drop-jumps were performed wearing a patellar tendon strap and 5 with no-strap in a counterbalanced order. Root-mean square EMG (REMG) values of the VM, RF, and VL were averaged for a pre-landing and post-landing interval. Multiple mixed-model two-way ANOVAs were performed to determine the effect of tendinopathy and strapping condition on REMG values for each muscle. For the pre-landing interval, all participants displayed lesser VL EMG activation (0.44 ± 0.19%, 0.53 ± 0.27%, respectively; p = 0.007, d = 0.39) in the no-strap compared with the strap condition. When wearing a strap, all participants demonstrated lower VL activation prior to landing which may be helpful in reducing tensile stress at the tendon. These effects may be clinically important in modulating pain in those with patellar tendinopathy. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Dechanneling by dislocation loops

    International Nuclear Information System (INIS)

    Chalant, Gerard.

    1976-09-01

    Ion implantation always induces the creation of dislocation loops. When the damage profile is determined by a backscattering technique, the dechanneling by these loops is implicitely at the origin of these measurements. The dechanneling of alpha particles by dislocation loops produced by the coalescence of quenched-in vacancies in aluminium is studied. The dechanneling and the concentration of loops were determined simultaneously. The dechanneling width around dislocation was found equal to lambda=6A, both for perfect and imperfect loops having a mean diameter d=250A. In the latter case, a dechanneling probability chi=0.34 was determined for the stacking fault, in good agreement with previous determination in gold. A general formula is proposed which takes into account the variation of lambda with the curvature (or the diameter d) of the loops. Finally, by a series of isothermal anneals, the self-diffusion energy ΔH of aluminium was measured. The value obtained ΔH=1.32+-0.10eV is in good agreement with the values obtained by other methods [fr

  3. The use of patellar taping in the treatment of a patient with a medial collateral ligament sprain.

    Science.gov (United States)

    Frommer, Chana; Masaracchio, Michael

    2009-05-01

    The medial collateral ligament (MCL) is one of the most frequently injured ligaments in the knee. The purpose of this case report is to describe conservative management of a 13 year-old soccer player with a one year history of untreated intermittent bilateral anterior knee pain who sustained a grade II MCL sprain while playing soccer and returned to competitive play within four weeks. The use of patellar taping as an adjunct to treatment will be introduced. Based on the physical examination findings, the patient's injury was classified as a grade II MCL sprain. The patient was treated successfully with a combination of modalities, manual therapy, and therapeutic exercise. Specifically, patellar taping was added to the traditional physical therapy regimen. Pain scale ratings, strength assessment, and a variety of functional outcome assessment tools were used to determine progression and outcomes. Following one session of modalities, manual therapy, patellar taping, and education in a home exercise program (HEP), the patient reported decreased overall left knee pain and increased comfort with knee active range of motion (AROM). Throughout the four weeks of treatment, the patient was compliant with the HEP. During this time, the patient continued to demonstrate improvement in pain, strength, AROM, and functional activities. Upon discharge, the patient was cleared for full return to sports. The novel intervention in this case report was the taping of the patella medially. This patient returned to sports two weeks earlier than the average athlete with a grade II MCL sprain.

  4. Does the adolescent patellar tendon respond to 5 days of cumulative load during a volleyball tournament?

    NARCIS (Netherlands)

    van Ark, M.; Docking, S.I.; van den Akker-Scheek, I.; Rudavsky, A.; Rio, E.; Zwerver, J.; Cook, J.L.

    Patellar tendinopathy (jumper's knee) has a high prevalence in jumping athletes. Excessive load on the patellar tendon through high volumes of training and competition is an important risk factor. Structural changes in the tendon are related to a higher risk of developing patellar tendinopathy. The

  5. Alterations in mechanical properties of the patellar tendon is associated with pain in athletes with patellar tendinopathy.

    Science.gov (United States)

    Lee, W C; Zhang, Z J; Masci, L; Ng, G Y F; Fu, Siu Ngor

    2017-05-01

    To compare tendon strain and stiffness between athletes with patellar tendinopathy and healthy controls, and explore whether the intensity of pain and dysfunction were related to the mechanical properties of the tendon. Thirty-four male athletes with patellar tendinopathy and 13 healthy controls matched by age and activity levels were recruited. The in vivo mechanical properties of the patellar tendon were examined by ultrasonography and dynamometry. In subjects with patellar tendinopathy, the intensities of self-perceived pain (maximal pain in the past 7 days and pain during a single-legged declined-squat test) using the visual analogue scale and the assessment of functional disability using the Victorian Institute of Sport Assessment-patellar questionnaire, were collected. In subjects with patellar tendinopathy, tendon strain was significantly reduced by 22% (8.9 ± 3.7 vs. 14.3 ± 4.7%, P = 0.005) when compared with healthy controls. There was no significant group difference in tendon stiffness (P = 0.27). Significant negative correlations between tendon strain and the maximal self-perceived pain over 7 days (r = -0.37, P = 0.03), and pain during a single-legged declined-squat test (r = -0.37, P = 0.03) were detected. A trend of significant positive correlation was found between tendon stiffness and pain during a single-legged declined-squat test (r = 0.30, P = 0.09). Our findings show that tendon strain is reduced in athletes with patellar tendinopathy, and a lower tendon strain is associated with a greater magnitude of pain perceived.

  6. Analysis of dislocation loops by means of large-angle convergent beam electron diffraction

    CERN Document Server

    Jäger, C; Morniroli, J P; Jäger, W

    2002-01-01

    Diffusion-induced dislocation loops in GaP and GaAs were analysed by means of large-angle convergent beam electron diffraction (LACBED) and conventional contrast methods of transmission electron microscopy. It is demonstrated that LACBED is perfectly suited for use in analysing dislocation loops. The method combines analyses of the dislocation-induced splitting of Bragg lines in a LACBED pattern for the determination of the Burgers vector with analyses of the loop contrast behaviour in transmission electron microscopy bright-field images during tilt experiments, from which the habit plane of the dislocation loop is determined. Perfect dislocation loops formed by condensation of interstitial atoms or vacancies were found, depending on the diffusion conditions. The loops possess left brace 110 right brace-habit planes and Burgers vectors parallel to (110). The LACBED method findings are compared with results of contrast analyses based on the so-called 'inside-outside' contrast of dislocation loops. Advantages o...

  7. Outcome of surgery for chronic patellar tendinopathy: A systematic review.

    Science.gov (United States)

    Khan, W S; Smart, A

    2016-09-01

    There is no consensus on how to best surgically treat chronic patellar tendinopathy. This systematic review investigates the surgical treatment for chronic patellar tendinopathy, and the outcomes. A database search was performed to identify all relevant articles, to which exclusion criteria were then applied. Data was extracted from 24 studies, and the outcomes were then systematically reviewed. The results showed that the success rate of surgery for patellar tendinopathy is generally over 77%. Return to sports rates are better for proximal tendon patients who undergo bony procedures. Patients return to sports faster if they undergo arthroscopic procedures, and fewer complications are described. Studies that did not involve any procedure on the proximal tendon did not produce a different result to studies where the tendon was operated on. We found no effect of post-operative immobilisation on outcome. Based on the included studies, surgery gives satisfactory results in the treatment of patellar tendinopathy. There is a lack of high-quality evidence on the effects of surgery and post-operative rehabilitation regime on chronic patellar tendinopathy, as well as lack of objective outcome measures.

  8. Tendinopathy alters ultrasound transmission in the patellar tendon during squatting.

    Science.gov (United States)

    Wearing, S C; Hooper, S L; Smeathers, J E; Pourcelot, P; Crevier-Denoix, N; Brauner, T

    2016-12-01

    Measurement of loading patterns of the patellar tendon during activity is important in understanding tendon injury. We used transmission-mode ultrasonography to investigate patellar tendon loading during squatting in adults with and without tendinopathy. It was hypothesized that axial ultrasonic velocity, a surrogate measure of the elastic modulus of tendon, would be lower in tendinopathy. Ultrasound velocity was measured in both patellar tendons of adults with unilateral patellar tendinopathy (n = 9) and in healthy controls (n = 16) during a bilateral squat maneuver. Sagittal knee movement was measured simultaneously with an electrogoniometer. Statistical comparisons between healthy and injured tendons were made using two-way mixed-design ANOVAs. Axial ultrasound velocity in both symptomatic and asymptomatic patellar tendons in tendinopathy was approximately 15% higher than in healthy tendons at the commencement (F 1,23  = 5.2, P tendinopathy and highlight fresh avenues for its clinical management. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. 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.

  10. Prediction of dislocation boundary characteristics

    DEFF Research Database (Denmark)

    Winther, Grethe

    orientation of the grain [1]. For selected boundaries it has been experimentally verified that the boundaries consist of fairly regular networks of dislocations, which come from the active slip systems [2]. The networks have been analyzed within the framework of Low-Energy-Dislocation-Structures (LEDS......, such as the dislocation content and misorientation. The prediction is based on the expected active slip systems and assumptions of mutual stress screening. In general, networks of dislocations with three linearly independent Burgers vectors fulfilling the criterion of mutual stress screening may form on any plane...

  11. Treating Proximal Interphalangeal Joint Dislocations.

    Science.gov (United States)

    Saitta, Bradley Hart; Wolf, Jennifer Moriatis

    2018-05-01

    Proximal interphalangeal (PIP) joint dislocation a common injury. Usually, concentric stable reduction can be achieved with closed reduction. Occasionally, PIP joint dislocations are irreducible and open reduction is necessary. Complications include prolonged splinting and delay in presentation with subluxation or persistent dislocation. Surgery is often recommended for contracture or joint reduction. Surgical techniques focus on contracture release, joint reduction, and range of motion. Techniques have evolved from primary repair to tenodesis and suture anchor reconstruction. Most studies on PIP joint dislocations are retrospective case reports with good outcomes but chronic mild contracture and deformity are consistent in the literature. Copyright © 2018 Elsevier Inc. All rights reserved.

  12. Intraocular lens dislocation after whole-body vibration.

    Science.gov (United States)

    Vela, José I; Andreu, David; Díaz-Cascajosa, Jesús; Buil, José A

    2010-10-01

    We present 2 cases of intraocular lens (IOL) dislocation that appeared shortly after the patients exercised on a vibration platform. The first patient was a 71-year-old woman who presented with lens subluxation in her right eye and a complete posterior IOL dislocation in her left eye. The second case was a 62-year-old woman who presented with unilateral IOL dislocation within the capsular bag in her right eye. Timing from IOL implantation to dislocation was approximately 6 years and 4 years, respectively. Pars plana vitrectomy with removal of the dislocated IOL was performed in both patients. Whole-body vibration training has become increasingly popular as a form of exercise training. It reportedly may provide benefits in physical function and in some diseases, especially in older people. However, evidence-based protocols ensuring safety and efficacy in this population are lacking. We discuss vibration as a cause of late IOL dislocation. Copyright © 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  13. Disassembly and Dislocation of a Bipolar Hip Prosthesis

    Directory of Open Access Journals (Sweden)

    Hsieh-Hsing Lee

    2008-01-01

    Full Text Available Dislocation of a hip prosthesis is a common complication. In usual cases of hip prosthesis dislocation, the prosthetic femoral head comes out from either the natural acetabular cavity in a bipolar hemiarthroplasty or the prosthetic acetabulum in a total hip arthroplasty. Only a few cases of bipolar hip prosthesis dislocation due to dissociation between the polyethylene and inner head of the prosthesis have been reported. We describe a rare case of disassembly of the inner head from the bipolar outer prosthesis in an osteoarthritic acetabulum. A 72-year-old woman had undergone bipolar hemiarthroplasty due to fracture of the left femoral neck about 10 years previously. Recently, she sustained an injury after falling from a chair, and examinations revealed an unusual disassembly−dislocation of the bipolar hip prosthesis. We classified this failure in our patient as a type II failure, representing extreme varus position of the outer head in the acetabulum, dislocation of the inner head from the outer head, and a detached locking ring around the stem neck. This mechanism of failure as shown in our patient rarely occurs in the bipolar prosthesis of the self-centering system. Osteoarthritic change of the acetabulum would place the outer head in the varus position, increasing wear on the beveled rim by impinging the femoral stem neck and causing dislodgment of the inner locking ring and consequent disassembly−dislocation of the inner head.

  14. The effect of a patellar strap on knee joint proprioception in healthy participants and athletes with patellar tendinopathy.

    Science.gov (United States)

    de Vries, Astrid J; van den Akker-Scheek, Inge; Diercks, Ron L; Zwerver, Johannes; van der Worp, Henk

    2016-04-01

    The primary aim of this study is to investigate the effect of the use of a patellar strap on knee joint proprioception in both healthy participants and in patients with patellar tendinopathy (PT). Secondary aims are to examine whether there is a difference in effectiveness of the use of a patellar strap between participants with low and high proprioceptive acuity and if possible predictors of effectiveness can be determined. Case-control. The threshold to detect passive motion with and without a patellar strap was assessed in 22 healthy participants and 21 unilateral PT patients. The results from the mixed model analysis show that in both groups of participants a small but statistically significant improvement in proprioception was found, primarily in those who had low proprioceptive acuity. A notable finding was that in the symptomatic leg of the PT group no improvement in proprioception by wearing a strap could be determined. Male gender and having fewer symptoms were possible predictors of effectiveness in PT patients. As proprioception plays a role in optimising movements and reducing load to joint-related structures like tendons and ligaments, it is considered an important protection mechanism. Although the improvements in proprioception as a result of wearing the strap are small, it might be that the use of a patellar strap can potentially play a role in injury prevention since poor proprioception can be a risk factor for (re)-injury. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  15. MANAGEMENT OF POSTERIOR DISLOCATED INTRAOCULAR LENSES IN A TERTIARY HOSPITAL

    Directory of Open Access Journals (Sweden)

    Shashidhar

    2016-10-01

    Full Text Available BACKGROUND The aim of this study was to assess and compare the visual outcome of different approaches in the management of dislocated PCIOL. MATERIALS AND METHODS 20 eyes of 20 patients who underwent 3PPPV/anterior vitrectomy to refixate or IOL exchange for dislocation or subluxation of PCIOL from 2012 to 2015. SFIOLs were implanted in 12 patients, IOL refixation was done in four patients and four were left aphakic. This is a retrospective study of 20 eyes of 20 patients with dislocated/subluxated PCIOLs in a tertiary hospital from 2012 to 2015. STATISTICAL ANALYSIS Paired t-test statistical method. RESULTS We retrospectively analysed hospital records of patients who had undergone three PPPV/anterior vitrectomy for posteriorly dislocated/subluxated IOLs 20 eyes of 20 patients were analysed. SFIOLs were implanted in 12 patients, IOL refixation was done in four patients and four were left aphakic. Postoperative BCVA of 6/12 or better was achieved in 66.67% in primary SFIOL, secondary SFIOL and IOL refixation groups. BCVA of <6/60 was seen in all patients left aphakic. Early and late complications were most in aphakic patients. IOL refixation procedure had minimum early and late complications. Subluxated PCIOLs do better than dislocated lens where a successful SFIOL was placed. CONCLUSION IOL refixation procedure has the least complication rate. Early complications of SFIOL management resolve with time. Thus, 3PPPV/anterior vitrectomy with SFIOL and IOL refixation procedures offer a novel approach towards visual rehabilitation of patients with subluxated or dislocated PCIOLs.

  16. Current concepts in the management of patellar instability

    Directory of Open Access Journals (Sweden)

    Michael S Laidlaw

    2017-01-01

    Full Text Available Patellar instability is a common presenting clinical entity in the field of orthopedics. This not only can occur from baseline morphologic variability within the patellofemoral articulation and alignment, but also from traumatic injury. While conservative management is many times employed early in the treatment course, symptomatic patellar instability can persist. This article reviews the available indexed published literature regarding patellar instability. Given the debilitating nature of this condition and the long term sequelae that can evolve from its lack of adequate recognition and treatment, this article details the most current methods in the evaluation of this entity as well as reviews the most up-to-date surgical treatment regimens that are available to address this condition.

  17. Patellar SPECT and planar imaging in orthopedic patients with knee pain

    International Nuclear Information System (INIS)

    Dehdashti, F.; Collier, B.D.; Johnson, R.P.; Isitman, A.T.; Hellman, R.S.; Carrera, G.F.; Krasnow, A.Z.

    1987-01-01

    Eighty-five painful knees in 56 patients were independently evaluated clinically, radiographically, and scintigraphically. All patients had an established final diagnosis of osteoarthritis or other predisposing conditions. Results of patellar bone scintigraphy were abnormal in 66 of 85 knees; there were ten isolated findings and 12 cases of medial, nine of lateral, and 35 of triple compartment involvement. Four-quadrant patellar analysis identified nine instances of isolated lateal patellar facet syndrome. Single-photon emission CT was of significant value in localizing patellar abnormalities. Radiographic evaluation disclosed osteoarthritis in 27 of 66 scintigraphically abnormal knees. Patellar bone scintigraphy is more valuable than radiography for evaluating adult orthopedic patients with knee pain

  18. 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.)

  19. Bilateral Hip Dislocation in Unrestrained Driver

    Directory of Open Access Journals (Sweden)

    Samer Assaf

    2017-09-01

    Full Text Available History of present illness: A 24-year-old male was brought in by paramedics status post motor vehicle collision (MVC into an electric pole and tree at high speed. The patient was an unrestrained driver who required extrication. The patient complained of left hip pain, left foot pain, and difficulty extending his bilateral lower extremities. He denied numbness or tingling to his lower extremities. The patient had normal vitals; his bilateral lower extremities were held in flexion at the hips, but otherwise had no obvious injuries. The patient’s pelvis was stable with palpable distal pulses and intact motor and sensory function of his distal lower extremities. Significant findings: The initial radiograph of the pelvis revealed bilateral hip dislocations. Small bony fragments were noted in the right hip joint, suggestive of an underlying fracture. The sacroiliac joints and the pelvic ring were intact. In the emergency department, bilateral hip reductions were performed using the Captain Morgan technique.1 The post-reduction film showed reduction of the bilateral hip dislocations with extensive comminuted and displaced fractures of the right and left acetabula. Discussion: Bilateral hip dislocations are extremely rare, occurring in only 1% of all hip dislocations,2 and require immense force, typically occurring in MVCs (74%.3-7 Associated injuries include fracture of the acetabulum or femoral head, sciatic nerve damage, and obstruction of the blood supply to the femoral head.8 X-ray imaging and CT scans are used to assess the injury and to detect intra-articular fragments.3 Definitive treatment is achieved by closed reduction if possible; otherwise open reduction is utilized.9 Post-reduction therapy includes a non-weight-bearing period of time. Complications include avascular necrosis of the femoral head, osteonecrosis, and posttraumatic arthritis, the occurrence of which can be decreased by early reduction.4,10-12 This patient underwent bilateral

  20. Nature of Dislocations in Silicon

    DEFF Research Database (Denmark)

    Hansen, Lars Bruno; Stokbro, Kurt; Lundqvist, Bengt

    1995-01-01

    Interaction between two partial 90 degrees edge dislocations is studied with atomic-scale simulations using the effective-medium tight-binding method. A large separation between the two dislocations (up to 30 Angstrom), comparable to experimental values, is achieved with a solution of the tight...

  1. Traumatic atlantooccipital dislocation. Case report.

    Science.gov (United States)

    Fruin, A H; Pirotte, T P

    1977-05-01

    A case of traumatic atlantooccipital dislocation is presented and the literature reviewed. This type of traumatic dislocation is probably produced by violent hyperextension of the upper cervical spine. Cranial nerve injuries and spinal cord injuries are common. Early fusion is recommended.

  2. Traumatic hip dislocations in children

    International Nuclear Information System (INIS)

    Minhas, M.S.

    2010-01-01

    Objectives: To evaluate clinical features, treatment and relationship to the time period between dislocation, reduction and early complications of traumatic dislocation of hip in children. Methods: Case series conducted at Jinnah Post Graduate Medical Centre Karachi from July 2005 to August 2009. Children with traumatic hip dislocation up to fifteen years of age who presented in last four years were included in this study. Their clinical information, etiology, associated injuries, duration, method of reduction and early complications are evaluated through emergency room proforma and indoor record. Follow up of patient was updated in outpatient department. Results: We had eight patients, six boys and two girls. Youngest 2.4 years and eldest was 12 years with mean age of 6.2 +- 3.8 years. All presented with posterior hip dislocation. Etiology was road traffic accident in two and history of fall in remaining six patients. Average duration of time between dislocation and reduction was 19 hours range 3-72 hours. Dislocated hips were reduced under General Anaesthesia in two patients and under sedation analgesia in six patients. No complications were noted in eight cases with mean 18.75 +- 13.23 months follows up. Conclusion: Traumatic hip dislocation in children is not rare. Slight trauma causes dislocation in younger age and immediate closed reduction and Immobilization reduces complications. (author

  3. Radiologic study of patellar height in Osgood-Schlatter disease.

    Science.gov (United States)

    Aparicio, G; Abril, J C; Calvo, E; Alvarez, L

    1997-01-01

    There are contradictory reports regarding patellar position in the Osgood-Schlatter disease. We present a prospective statistical study of 17 patients with Osgood-Schlatter disease and 12 adolescents without anterior knee pain. The Caton-Deschamps index was assessed on strictly the lateral radiograph of the knee. The findings indicate a strong association between Osgood-Schlatter disease and patella alta. This increase in patellar height would require an increase in the force needed from the quadriceps to achieve full extension. This mechanism could be responsible for the apophyseal lesion.

  4. Effects of Patellar Taping on the Patella Position in Presence of Quadriceps Contraction in 20-40 Year-Old Women With Patellofemoral Pain Syndrome Using MRI

    Directory of Open Access Journals (Sweden)

    Mahboobeh Banejad

    2016-06-01

    Discussion: Kinesio taping plus quadriceps contraction reduced the PFCA and LPFA. Patellar taping is effective in the correction of the patellar position in contracted quadriceps. Therefore, both neuromuscular and mechanical effects of patellar taping affect the patellar position over a long period. The combination of patellar taping and exercise reduced pain and improved activity faster than either of the treatment alone.

  5. Temporomandibular joint dislocation in Nairobi.

    Science.gov (United States)

    Sang, L K; Mulupi, E; Akama, M K; Muriithi, J M; Macigo, F G; Chindia, M L

    2010-01-01

    Despite the diverse conservative and surgical modalities for the management of temporomandibular joint (TMJ) dislocation and the controversy that surrounds them, very little has been done within the East-African setup in terms of highlighting and provoking greater interest in the epidemiology and management of TMJ dislocation. To audit the pattern of occurrence, demographics, aetiology and enumerate the treatment modalities of TMJ dislocation at the oral and maxillofacial surgery division (OMFS) of the University of Nairobi Dental Hospital. Descriptive cross-sectional study. University of Nairobi Dental Hospital (UNDH) from January 1995 to July 2005. Twenty nine patients had been diagnosed and managed for TMJ dislocation. Twenty (69%) were females and nine (31%) were males. Their ages ranged from 10-95 years with a mean of 42 years. The cases managed were primarily chronic in nature. The most common form being anterior TMJ dislocation, accounting for twenty-five (86.2%) cases. Trauma was implicated as an aetiology in only five (17%) of the cases while the remaining majority of twenty four (83%) cases were spontaneous. Amongst the causes of spontaneous TMJ dislocation, yawning was the most common accounting for fourteen cases (48.3%). Dislocations caused by trauma were found to be 12.6 times more likely to be associated with other injuries than spontaneous dislocations. Anterior TMJ dislocations were found to be 1.3 times more likely to be associated with absence of molars than posterior TMJ dislocations. Anatomical aberrations, as predisposing factors, were not a significant finding in this research. Eight (28%) of the cases were managed conservatively. Twenty one (72%) of the cases were managed surgically. The eminectomy was the most common technique with a 75% success rate. The highest incidence of TMJ dislocation occurs in the 3rd-5th decade with a female preponderance with bilateral anterior TMJ dislocation being the most common. Most of the cases were managed

  6. Avulsion fracture of the tibial tubercle associated with patellar ...

    African Journals Online (AJOL)

    We present a case of combined avulsion fracture of the tibial tubercle (AFTT) and avulsion of the patellar ligament in a 15-year-old boy. This injury was treated by open reduction and fixation of both lesions using staples with satisfactory results. This constellation of injury is rare but a high index of suspicion is needed when ...

  7. Relationship between landing strategy and patellar tendinopathy in volleyball

    NARCIS (Netherlands)

    Bisseling, Rob W.; Hof, At L.; Bredeweg, Steef W.; Zwerver, Johannes; Mulder, Theo

    Objective: The aetiology of patellar tendinopathy ( jumper's knee) remains unclear. To see whether landing strategy might be a risk factor for the development of this injury, this study examined whether landing dynamics from drop jumps differed among healthy volleyball players ( CON) and volleyball

  8. Foot Posture and Patellar Tendon Pain Among Adult Volleyball Players

    NARCIS (Netherlands)

    de Groot, Reinier; Malliaras, Peter; Munteanu, Shannon; Payne, Craig; Morrissey, Dylan; Maffulli, Nicola

    Objective: We hypothesized that individuals with a normal foot posture would be less likely to experience patellar tendon pain and pathology than those with a pronated or supinated foot. Design: Observational study. Setting: Field-based study among competing athletes. Participants: Volleyball

  9. Foot posture and patellar tendon pain among adult volleyball players.

    NARCIS (Netherlands)

    Groot, R. de; Malliaras, P.; Munteanu, S.; Payne, C.; Morrissey, D.; Maffulli, N.

    2012-01-01

    OBJECTIVE: We hypothesized that individuals with a normal foot posture would be less likely to experience patellar tendon pain and pathology than those with a pronated or supinated foot. DESIGN: Observational study. SETTING: Field-based study among competing athletes. PARTICIPANTS: Volleyball

  10. Foot posture and patellar tendon pain among adult volleyball players.

    Science.gov (United States)

    de Groot, Reinier; Malliaras, Peter; Munteanu, Shannon; Payne, Craig; Morrissey, Dylan; Maffulli, Nicola

    2012-03-01

    We hypothesized that individuals with a normal foot posture would be less likely to experience patellar tendon pain and pathology than those with a pronated or supinated foot. Observational study. Field-based study among competing athletes. Volleyball players competing in the Victorian State League, Australia. Patellar tendinopathy (PT) is common in sports involving running and jumping and can severely limit athletes' ability to compete. Several studies have investigated potential etiological factors for the development of PT, but little is known about the association between PT and foot posture. Static foot posture index (FPI), patellar tendon pain during single-leg decline squatting, and gray scale ultrasound imaging were measured in 78 recreational to elite volleyball players (48 men and 30 women). Men with patellar tendon pain were more likely to have a normal foot posture and men without pain were more likely to be pronated according to the FPI (P pain or imaging (P > 0.05). Men with a normal foot posture were more likely to have PT compared to men with a pronated foot type.

  11. Investigating Achilles and patellar tendinopathy prevalence in elite athletics

    NARCIS (Netherlands)

    Janssen, Ina; van der Worp, Henk; Hensing, Sjoerd; Zwerver, Johannes

    2018-01-01

    Although injury surveillance in athletics is routinely conducted, discipline-specific Achilles and patellar tendinopathy prevalence remains unknown. The purpose of this study was to explore discipline-specific tendinopathy prevalence and identify whether injury-specific risk factors differed in

  12. Sex Variation in Patellar Tendon Kinetics During Running

    Directory of Open Access Journals (Sweden)

    Sinclair Jonathan

    2015-06-01

    Full Text Available Purpose. The aim of the current investigation was to determine whether female recreational runners exhibit distinct patellar tendon loading patterns in relation to their male counterparts. Methods. Twelve male (age 26.55 ± 4.11 years, height 1.78 ± 0.11 m, mass 77.11 ± 5.06 kg and twelve female (age 26.67 ± 5.34 years, height 1.67 ± 0.12 m, mass 63.28 ± 9.75 kg runners ran over a force platform at 4.0 m · s-1. Lower limb kinematics were collected using an eight-camera optoelectric motion capture system which operated at 250 Hz. Patellar tendon loads were examined using a predictive algorithm. Sex differences in limb, knee and ankle joint stiffness were examined statistically using independent samples t tests. Results. The results indicate that patellar tendon force (male = 6.49 ± 2.28, female = 7.03 ± 1.35 and patelllar tendon loading rate (male = 92.41 ± 32.51, female = 111.05 ± 48.58 were significantly higher in female runners. Conclusions. Excessive tendon loading in female runners indicates that female runners may be at increased risk of patellar tendon pathologies.

  13. Is proprioception diminished in patients with patellar tendinopathy?

    NARCIS (Netherlands)

    Groot, H.E.; van der Worp, H.; Nijenbanning, L.; Diercks, R.L.; Zwerver, J.; van den Akker-Scheek, I.

    2016-01-01

    PURPOSE: Patellar tendinopathy is a highly prevalent overuse injury, and most treatments are only effective to some extent. This persistence of complaints could be linked to changed proprioception. One study showed diminished proprioception in athletes with lateral epicondylitis. Aim of this study

  14. Bone growth into a revised porous-coated patellar implant

    DEFF Research Database (Denmark)

    Jensen, L N; Lund, B; Gotfredsen, K

    1990-01-01

    A noncemented and clinically stable porous-coated patellar component (PCA) was removed from a patient after 11 months because of infection. It was sectioned and examined histologically in undecalcified, thin-ground sections. The bone ingrowth into the porous space was measured at eight levels. Ea...

  15. 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 ...

  16. Prevalence and genetics of patellar luxation in Kooiker dogs

    NARCIS (Netherlands)

    Wangdee, C.; Leegwater, P.A.J.; Heuven, H.C.M.; Steenbeek, van F.G.; Meutstege, F.J.; Meij, B.P.; Hazewinkel, H.A.W.

    2014-01-01

    The prevalence of patellar luxation (PL) and genetic factors potentially involved in the disorder were investigated in Dutch Kooiker dogs. A cohort of 842 Kooiker dogs, the offspring of 195 sires and 318 dams, was screened for PL from 1994 to 2011. The cohort was included in a pedigree of 1737

  17. Prevalence and genetics of patellar luxation in Kooiker dogs

    NARCIS (Netherlands)

    Wangdee, C; Leegwater, P A J; Heuven, H C M; van Steenbeek, F G; Meutstege, F J; Meij, B P; Hazewinkel, H A W

    The prevalence of patellar luxation (PL) and genetic factors potentially involved in the disorder were investigated in Dutch Kooiker dogs. A cohort of 842 Kooiker dogs, the offspring of 195 sires and 318 dams, was screened for PL from 1994 to 2011. The cohort was included in a pedigree of 1737

  18. Lateral patellar luxation in nine small breed dogs | Dona | Open ...

    African Journals Online (AJOL)

    The objective of this paper was to describe the clinical features, the management and the outcome of nine small breed dogs affected with lateral patella luxation referred during the period between January 2010 and December 2014. Patellar luxations were classified according to: breed, age, sex, weight, and grade of ...

  19. Knee Dislocations in Sports Injuries

    Science.gov (United States)

    Pardiwala, Dinshaw N; Rao, Nandan N; Anand, Karthik; Raut, Alhad

    2017-01-01

    Knee dislocations are devastating when they occur on the athletic field or secondary to motor sports. The complexity of presentation and spectrum of treatment options makes these injuries unique and extremely challenging to even the most experienced knee surgeons. An astute appreciation of the treatment algorithm is essential to plan individualized management since no two complex knee dislocations are ever the same. Moreover, attention to detail and finesse of surgical technique are required to obtain a good functional result and ensure return to play. Over the past 10 years, our service has treated 43 competitive sportsmen with knee dislocations, and this experience forms the basis for this narrative review. PMID:28966379

  20. Traumatic atlantooccipital dislocation with survival.

    Science.gov (United States)

    Woodring, J H; Selke, A C; Duff, D E

    1981-07-01

    Traumatic atlantooccipital dislocation is generally considered incompatible with life. However, there have been isolated survivals from this injury, and a few patients initially have minimal neurologic deficits disproportionate to the gravity of their injury, a feature that has not been adequately stressed. The potentially catastrophic results of delayed therapy make early radiographic detection imperative. Marked retropharyngeal soft-tissue swelling, an abnormal basion-odontoid alignment, and posterior displacement of the atlas are diagnostic of anterior atlantooccipital dislocation. In the more uncommon posterior atlantooccipital dislocation an abnormal basion-odontoid alignment associated with marked soft-tissue swelling should suggest the correct diagnosis. Conventional tomography can be confirmatory.

  1. An Unexpected Complication of Hip Arthroplasty: Knee Dislocation

    Directory of Open Access Journals (Sweden)

    Serdar Yilmaz

    2015-01-01

    Full Text Available An increasing number of patients with hip fracture have been seen with osteoporosis associated with osteoarthritis. Although knee dislocation is related to high-energy trauma, low-grade injuries can also lead to knee dislocation which is defined as “ultra-low velocity dislocation.” The case reported here is of an 82-year-old patient who presented with a left intertrochanteric hip fracture. Partial arthroplasty was planned because of osteoporosis. In the course of surgery, degenerative arthritic knee was dislocated during the hip reduction maneuver with the application of long traction. The neurovascular examination was intact, but the knee was grossly unstable and was dislocated even in a brace; thus a hinged knee prosthesis was applied nine days after surgery. The patient was mobilized with crutches after the knee prosthesis but exercise tolerance was diminished. In conclusion, it should be emphasized that overtraction must be avoided during the hip reduction maneuver in patients with advanced osteoarthritic knee.

  2. Effect of a patellar strap on the joint position sense of the symptomatic knee in athletes with patellar tendinopathy

    NARCIS (Netherlands)

    de Vries, Astrid J.; van den Akker-Scheek, Inge; Haak, Svenja L.; Diercks, Ron L.; van der Worp, Henk; Zwerver, Johannes

    2017-01-01

    Objectives: The primary aim of this study was to investigate the effect of a patellar strap on the proprioception of the symptomatic leg in PT. Secondary aims were to investigate a possible difference in effectiveness between athletes with high and low proprioceptive acuity, and whether predictors

  3. Arthroscopic treatment of acromioclavicular dislocation

    OpenAIRE

    Mihai T. Gavrilă; Ștefan Cristea

    2017-01-01

    A thorough understanding of biomechanical function of both acromioclavicular (AC) and coracoclavicular (CC) ligaments, stimulated surgeons to repair high-grade AC dislocation using arthroscopic technique. This technique necessitates a clear understanding of shoulder anatomy, especially of the structures in proximity to the clavicle and coracoid process and experiences in arthroscopic surgery. The follow case describes an arthroscopic technique used to treat AC dislocation in young man 30 year...

  4. HRTEM studies of dislocations in cubic BN

    International Nuclear Information System (INIS)

    Nistor, L.C.; Tendeloo, G. van; Dinca, G.

    2004-01-01

    The atomic structure of dislocations in cubic boron nitride has been investigated by high resolution transmission electron microscopy. Most of the perfect dislocations, screw and 60 edge, are dissociated. A 60 dislocation which was undissociated has been analysed. Computer simulation is performed in an attempt to characterise the core structure. Twinning dislocations and dislocations resulting from the intersection of stacking faults are also revealed. (copyright 2004 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim) (orig.)

  5. HRTEM studies of dislocations in cubic BN

    Energy Technology Data Exchange (ETDEWEB)

    Nistor, L.C. [National Institute for Materials Physics, P.O. Box MG-7 Magurele, 077125 Bucharest (Romania); Tendeloo, G. van [University of Antwerp, EMAT, Groenenborgerlaan 171, 2020 Antwerp (Belgium); Dinca, G. [Dacia Synthetic Diamond Factory, Timisoara av. 5, P.O. Box 58-52, 077350 Bucharest (Romania)

    2004-09-01

    The atomic structure of dislocations in cubic boron nitride has been investigated by high resolution transmission electron microscopy. Most of the perfect dislocations, screw and 60 edge, are dissociated. A 60 dislocation which was undissociated has been analysed. Computer simulation is performed in an attempt to characterise the core structure. Twinning dislocations and dislocations resulting from the intersection of stacking faults are also revealed. (copyright 2004 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim) (orig.)

  6. Trans-triquetral Perilunate fracture dislocation

    OpenAIRE

    John-Henry Rhind; Abhinav Gulihar; Andrew Smith

    2018-01-01

    Perilunate dislocations and perilunate fracture dislocations are rare and serious injuries. Perilunate dislocations represent less than 10% of all carpal injuries of which 61% represent transcaphoid fractures. Because of their rarity, up to 25% of perilunate dislocations are initially missed on first assessment. We present the case of a 66-year-old-gentleman who sustained an isolated trans-triquetral perilunate fracture dislocation while walking his dog. This was diagnosed in the emergency de...

  7. Perilunar carpal dislocations treatment outcome.

    Science.gov (United States)

    Gagała, Jacek; Tarczyńska, Marta; Kosior, Piotr

    2006-06-30

    Background. The aim of the study was to analyze late outcomes of perilunar carpal dislocations, depending on the type of the injury, time of the diagnosis and the treatment methods. Material and methods. The material is constituted by 37 patients treated in our department between 1981-2004 because of perilunar dislocation. In group were 2 women and 35 men, aged 19-56 (mean 31 years). All patients were asked for control visit. DASH and Mayo score were used to evaluate the outcome. Range of wrist motion, its stability, grip strength and X-ray pictures were analyzed. Results. Better follow-up results were observed in persons with early diagnosed dislocations of the wrist. The best outcomes were observed in group with perilunar early diagnosed dislocations, which were treated by open reduction. Posttraumatic wrist instability often was diagnosed in patients with dislocation of lunar bone and late-diagnosed transscaphoid perilunar carpal dislocations. Conclusions. The data we obtained show, that the consequences of late-diagnosed and late-treated injuries of the wrist are instability, pain, decrease in range of motion and hand skills.

  8. At the interface of syntax and prosody: Differentiating left dislocated ...

    African Journals Online (AJOL)

    A fourth approach views the pronominal element as a “last resort” syntactic strategy—the pronominal element is a pronominal clitic, which provides agreement features for the subject (Naudé 1990, 1993, 1994, 1999, 2002). The pronominal element is obligatory when the nominal predicate is a referring noun phrase—the ...

  9. At the interface of syntax and prosody: Differentiating left dislocated ...

    African Journals Online (AJOL)

    Kate H

    This work is licensed under the Creative Commons Attribution 4.0 International License. Stellenbosch Papers in .... important system is known as the Tiberian Masoretic system and is the product of the work of the Ben Asher family ... punctuation to give a division of the verse into syntactic units (Ofer 2016: 192). Khan (2013: ...

  10. The mosaic evolution of Left Dislocation in Xhosa | Andrason ...

    African Journals Online (AJOL)

    This paper demonstrates that the status of Clitic LD in Xhosa is a result of the mosaic evolution of Xhosa grammar. It emerges as an accumulation and combination of two more individual, distinct and, at least, initially separated developments and characteristics – LD sensu stricto and Object Agreement. This view enables ...

  11. A functional profile of Left Dislocation in Biblical Hebrew | Westbury ...

    African Journals Online (AJOL)

    This functional profile will consist of two complementary parts: 1) the central factors motivating the use of LD, and 2) the prototypical and non-prototypical discourse-pragmatic functions achieved by the construction in discourse. Together with the formal description, this functional explanation reveals a textured profile of the ...

  12. Left Dislocation in North-Eastern Neo-Aramaic dialects

    African Journals Online (AJOL)

    Andrason, A, Dr

    The Jewish Neo-Aramaic Dialect of Sulemaniyya and Ḥalabja. Studies in. Semitic Languages and Linguistics 44. Leiden: Brill. Khan, G. 2007. The North Eastern Neo-Aramaic Dialects. Journal of Semitic Studies 52. 1–20. Khan, G. 2008a. The Jewish Neo-Aramaic Dialect of Urmi. Gorgias Neo-Aramaic Studies. Piscataway: ...

  13. Left Dislocation in Arabic: The complexity of form and meaning

    African Journals Online (AJOL)

    Van der Merwe, CHJ, Prof

    the analyzed corpus, these constructions belong to two main types: Clitic LD and Subject LD. Some LD constructions .... In order to demonstrate the complexity of the LD construction in Arabic and propose a possible solution with which ..... type of LD found in Modern Arabic dialects, consult Abdel-Razaq 2011: 50–65). (3) a.

  14. Patellar tendon re-rupture on the opposite end of the previous site of surgical repair.

    Science.gov (United States)

    Koh, Bryan Thean Howe; Sayampanathan, Andrew A; Lee, Keng Thiam

    2017-01-01

    We describe a rare case of a patellar tendon "re-rupture" at the opposite end of a previous proximal tendon repair. A 32-year-old male with a history of surgically repaired right proximal patellar tendon rupture presented with an acute non-traumatic right knee pain and instability during sports. Magnetic resonance imaging confirmed a complete rupture of his distal patellar tendon at the tibial tuberosity. The patellar tendon was repaired using two 5.5 mm BioCorkscrews (Arthrex) inserted into the tibial tuberosity; the tendon was stitched with the No. 2 fiberwires using Krackow technique. As the patellar tendon was degenerative, the repair was augmented with a semitendinosus tendon harvested using an open tendon stripper, leaving the distal attachment intact. At 2.6 years followup he had mild anterior knee pain, range of motion 0-130° and was able to squat. MRI scan done at followup revealed good healing of repaired patellar tendon.

  15. Fibril morphology and tendon mechanical properties in patellar tendinopathy: effects of heavy slow resistance training

    DEFF Research Database (Denmark)

    Kongsgaard, Mads; Qvortrup, Klaus; Larsen, Jytte Overgaard

    2010-01-01

    BACKGROUND: Patellar tendinopathy is characterized by pathologic abnormalities. Heavy slow resistance training (HSR) is effective in the management of patellar tendinopathy, but the underlying functional mechanisms remain elusive. PURPOSE: To investigate fibril morphology and mechanical properties...... area. Heavy slow resistance training improved the clinical outcome of patellar tendinopathy, and these improvements were associated with normalization of fibril morphology, most likely due to a production of new fibrils....

  16. Decline eccentric squats increases patellar tendon loading compared to standard eccentric squats

    DEFF Research Database (Denmark)

    Kongsgaard, M; Aagaard, P; Roikjaer, S

    2006-01-01

    Recent studies have shown excellent clinical results using eccentric squat training on a 25 degrees decline board to treat patellar tendinopathy. It remains unknown why therapeutic management of patellar tendinopathy using decline eccentric squats offer superior clinical efficacy compared to stan...... to standard horizontal eccentric squats. This study aimed to compare electromyography activity, patellar tendon strain and joint angle kinematics during standard and decline eccentric squats....

  17. [Simultaneous rupture of the anterior cruciate ligament and the patellar tendon: a case report].

    Science.gov (United States)

    Achkoun, Abdessalam; Houjairi, Khalid; Quahtan, Omar; Hassoun, Jalal; Arssi, Mohamed; Rahmi, Mohamed; Garch, Abdelhak

    2016-01-01

    Simultaneous rupture of both the patellar tendon and the anterior cruciate ligament is a relatively rare injury. Its diagnosis can easily be missed during the initial examination. Treatment options include immediate repair of the patellar tendon with either simultaneous or delayed reconstruction of the ACL. We present the case of a combined rupture of the patellar tendon, the anterior cruciate ligament in a 22-year old footballer. A two-stage treatment approach was performed with an excellent functional outcome.

  18. Model predictions of increased knee joint loading in regions of thinner articular cartilage after patellar tendon adhesion.

    Science.gov (United States)

    Fernandez, Justin W; Akbarshahi, Massoud; Crossley, Kay M; Shelburne, Kevin B; Pandy, Marcus G

    2011-08-01

    Patellar tendon adhesion is a complication from anterior cruciate ligament (ACL) reconstruction that may affect patellofemoral and tibiofemoral biomechanics. A computational model was used to investigate the changes in knee joint mechanics due to patellar tendon adhesion under normal physiological loading during gait. The calculations showed that patellar tendon adhesion up to the level of the anterior tibial plateau led to patellar infera, increased patellar flexion, and increased anterior tibial translation. These kinematic changes were associated with increased patellar contact force, a distal shift in peak patellar contact pressure, a posterior shift in peak tibial contact pressure, and increased peak tangential contact sliding distance over one gait cycle (i.e., contact slip). Postadhesion, patellar and tibial contact locations corresponded to regions of thinner cartilage. The predicted distal shift in patellar contact was in contrast to other patellar infera studies. Average patellar and tibial cartilage pressure did not change significantly following patellar tendon adhesion; however, peak medial tibial pressure increased. These results suggest that changes in peak tibial cartilage pressure, contact slip, and the migration of contact to regions of thinner cartilage are associated with patellar tendon adhesion and may be responsible for initiating patellofemoral pain and knee joint structural damage observed following ACL reconstruction. Copyright © 2011 Orthopaedic Research Society.

  19. Open Wedge High Tibial Osteotomy with Distal Tubercle Osteotomy Lessens Change in Patellar Position

    Directory of Open Access Journals (Sweden)

    Hoon Park

    2017-01-01

    Full Text Available The purpose of this study was to investigate the change in patellar position after open wedge high tibial osteotomy (OWHTO with distal tubercle osteotomy (DTO, comparing outcomes of conventional OWHTO in young adults with proximal tibia varus deformity but no arthritic manifestations. Thirty-three patients (mean age, 31.8 years subjected to OWHTO/DTO were matched with 30 patients (mean age, 33.5 years undergoing conventional OWHTO. Patellar position, as measured in pre- and postoperative standing lateral radiographs, was compared. Patellar height was assessed via Insall-Salvati ratio, modified Insall-Salvati ratio, Blackburne-Peel (BP index, Caton-Deschamps (CD index, and modified Miura-Kawamura index. Computed tomography was used to measure lateral patellar tilt and shift. In the OWHTO group, all patellar height indices decreased significantly following surgery. Although mean values of BP and CD indices decreased significantly in the OWHTO/DTO group, other determinants of patellar height showed no significant postoperative differences. Significant postoperative declines in average lateral patellar tilt were also evident in both groups, but pre- and postoperative lateral patellar shift did not differ significantly. OWHTO/DTO can be performed without significant changes in patellar height. The results obtained support that OWHTO/DTO is suitable for relatively young patients with proximal tibia vara but no arthritic change.

  20. Molecular dynamics simulation of cross-slip and the intersection of dislocations in copper

    CERN Document Server

    Li, Maozhen; Gao, K W; Qiao, L J

    2003-01-01

    The molecular dynamics method is used to simulate cross-slip by thermal activation at 30 K and the intersection of dislocations in copper containing 1.6 x 10 sup 6 atoms using the embedded atom method potential. The results show that an extended screw dislocation can recombine through thermal activation at 30 K into a constriction on the surface because of stress imbalance and the constriction will split again in the other slip plane. Removing the constriction along the extended dislocation results in a cross-slip of the screw dislocation at low temperature. After the intersection between a moving right-hand screw dislocation DC and a perpendicular left-hand dislocation BA, whose ends are fixed on the surfaces, an extended jog corresponding to a row of one-third vacancies forms in BA and a trail of vacancies behind DC. If the intersected dislocation is a right-hand screw dislocation AB, the jog formed in AB corresponds to a row of one-third interstitials and the point defects behind DC are interstitials. Afte...

  1. Preverbal subjects in null subject languages are not necessarily dislocated

    Directory of Open Access Journals (Sweden)

    João Costa

    2002-12-01

    Full Text Available In recent work on null subject languages it has been claimed that preverbal subjects are always (clitic-left dislocated. In this paper, we argue against this claim, on the grounds of empirical evidence from European Portuguese concerning agreement facts, asymmetries between preverbal subjects and clitic-left dislocated XPs with respect to minimality effects, the existence of languages with a mixed system (null expletive subjects and full referential ones, language acquisition data, the behavior of negative QPs and interpretation facts, and propose a non-uniform analysis of preverbal subjects and clitic-left dislocated XPs that derives their topic interpretation from a predication rule stated configurationally (section 2. Our account of the SVO and VSO orders displayed in European Portuguese relies on a specific formulation of the EPP parameter, on the locality constraint Attract Closest X and on the independently motivated claim that V-movement targets T in European Portuguese (section 3. Under our analysis, the computational system generates equally economical SVO and VSO derivations and discourse considerations, at the appropriate interface, rule out the unfelicitous ones.

  2. Functional testing and return to sport following stabilization surgery for recurrent lateral patellar instability in competitive athletes.

    Science.gov (United States)

    Krych, Aaron J; O'Malley, Michael P; Johnson, Nick R; Mohan, Rohith; Hewett, Timothy E; Stuart, Michael J; Dahm, Diane L

    2018-03-01

    21.4 ± 14.3%, respectively, compared to the contralateral leg (p < 0.001 for both). Patients who underwent concomitant tibial tubercle osteotomy (p = 0.04), males (p = 0.01) and those with patella alta (p = 0.04) had weaker 6-month isokinetic testing. Thirty-three of the thirty-nine (85%) athletes were able to RTS at a mean of 8.1 ± 3.9 months. Patients undergoing MPFL with concomitant TTO (p = 0.02) returned to sport at a slower rate. One patient (3%) reported an episode of recurrent dislocation requiring revision surgery. Kujala and Tegner scores at final follow-up were 91.1 ± 6.3 and 6 (range, 4-9), respectively. Surgical stabilization including MFPL reconstruction for recurrent lateral patellar instability is an effective procedure for returning athletes to competitive sports. However, strength deficits persist at 6 months after surgery, especially in those undergoing concomitant TTO, which may delay return to sport. Physicians can use these results to counsel patients that return to competitive sports is safe with good clinical outcomes and low rate of recurrence at 4-year follow-up; however, predisposing factors, like a lateralized tibial tubercle, should be addressed if necessary, but athletes should be counselled that a slower recovery and longer return to sport time may be expected. IV.

  3. Imaging assessment of anterior knee pain and patellar maltracking

    Energy Technology Data Exchange (ETDEWEB)

    McNally, E.G. [Nuffield Orthopaedic Centre, Oxford (United Kingdom)

    2001-09-01

    Anterior knee pain is a common complaint in the orthopaedic clinic. The differential diagnosis is wide and the principal goal of initial assessment is to detect remediable causes. The majority of patients do not have a specific disease and increasingly interest has focused on the role of patello-femoro-tibial morphology and of patellar maltracking in the aetiology of anterior knee pain. Classification in this group of patients is poor and there is no uniform agreement on which patient groups benefit from treatment and which treatment is best. Much of the literature involves relatively small numbers of patients, is poorly controlled and there is little agreement on outcome measures [1, 2]. The purpose of this review is to outline the current status of the imaging assessment of recalcitrant anterior knee pain with particular reference to patellar maltracking. (orig.)

  4. Lateral patellar luxation in nine small breed dogs

    Directory of Open Access Journals (Sweden)

    F. Di Dona

    2016-12-01

    Full Text Available The objective of this paper was to describe the clinical features, the management and the outcome of nine small breed dogs affected with lateral patella luxation referred during the period between January 2010 and December 2014. Patellar luxations were classified according to: breed, age, sex, weight, and grade of patellar luxation, as well as if unilateral or bilateral, and concurrent cranial cruciate ligament lesion. In affected dogs, surgical correction consisted in the combination of tibial tuberosity transposition and soft tissue procedure. Adjunctive condroplasty or trochleoplasty was performed as needing. The outcome was found positive after surgical management with low complication rate and complications have been easily managed with high success rate.

  5. Lateral patellar retinacular release: changes over the last ten years

    Directory of Open Access Journals (Sweden)

    Leonardo Pini Rosalem Marciano da Fonseca

    Full Text Available ABSTRACT Lateral retinacular release is a useful resource in knee surgery that can be used for disorders of the extensor mechanism. For many years, it was indiscriminately used in the treatment of the various patellofemoral joint alterations, with conflicting functional results. This study aimed to analyze the changes that have occurred in the indications and clinical effectiveness of lateral retinacular release by reviewing the relevant literature of the past ten years, comparing it to the classic literature on the subject. It was found that less extensive releases decompress the lateral patellar facet, helping with pain control, while decreasing the risks of medial subluxation. Nowadays, there is clear evidence for its indication in the lateral patellar hypercompression syndrome associated with anterior knee pain, as long as there is no related instability; furthermore, it will normally play an adjuvant role in extensor mechanism alignment surgeries for cases of recurrent patellar instability. The initial results for symptomatic patellofemoral osteoarthritis are promising when lateral release is combined with cartilage debridement; in total knee replacement, it is more commonly used for the correction of valgus deformity in order to improve the components’ congruency. Finally, distinguishing the different patellofemoral joint pathologies is seen as crucial in order to indicate this procedure. Further randomized control trials that compare surgical techniques with long-term results are still needed.

  6. Irreducible Galeazzi Fracture-Dislocations.

    Science.gov (United States)

    Yohe, Nicholas J; De Tolla, Jadie; Kaye, Marc B; Edelstein, David M; Choueka, Jack

    2017-11-01

    Fractures of the radial shaft with disruption of the distal radial ulnar joint (DRUJ) or Galeazzi fractures are treated with reduction of the radius followed by stability assessment of the DRUJ. In rare instances, the reduction of the DRUJ is blocked by interposed structures requiring open reduction of this joint. The purpose of this study is to review all cases of irreducible Galeazzi fracture-dislocations reported in the literature to offer guidelines in the diagnosis and management of this rare injury. A search of the MEDLINE database, OVID database, and PubMed database was employed using the terms "Galeazzi" and "fracture." Of the 124 articles the search produced, a total of 12 articles and 17 cases of irreducible Galeazzi fracture-dislocations were found. The age range was 16 to 64 years (mean = 25 years). A high-energy mechanism of injury was the root cause in all cases. More than half of the irreducible DRUJ dislocations were not identified intraoperatively. In a dorsally dislocated DRUJ, a block to reduction in most cases (92.3%) was secondary to entrapment of one or more extensor tendons including the extensor carpi ulnaris, extensor digiti minimi, and extensor digitorum communis, with the remaining cases blocked by fracture fragments. Irreducible volar dislocations due to entrapment of the ulnar head occurred in 17.6% of cases with no tendon entrapment noted. In the presence of a Galeazzi fracture, a reduced/stable DRUJ needs to be critically assessed as more than half of irreducible DRUJs in a Galeazzi fracture-dislocation were missed either pre- or intraoperatively.

  7. Anterior shoulder dislocations in sports.

    Science.gov (United States)

    Aronen, J G

    1986-01-01

    Anterior shoulder dislocations, primary and recurrent, are among the most disabling injuries to the shoulder that can plague the athlete. The diagnosis is easily made by the following: the physical appearance of the shoulder; loss of capability by the athlete to internally and externally rotate the shoulder with the elbow at his side; by evaluating the mechanism of injury; and x-rays. Anterior shoulder dislocations should be reduced as soon as possible after diagnosis, to minimise the stretching effect on the neurovascular structures while the humeral head is dislocated. The reduction is not done to allow the athlete to return immediately to sport. Use of a simple traction method in the first 10 to 15 minutes following the injury will result in a successful reduction in the vast majority of dislocations. Reduction of the humeral head can be confirmed by the athlete regaining the capability to internally and externally rotate his shoulder with his elbow at his side. Following reduction, the athlete should begin a treatment regimen which includes a restrengthening programme emphasising the muscles of internal rotation and adduction plus rigid restrictions of activities until the goals of the rehabilitation programme are satisfied. The author's experience with this treatment regimen with athletes at the United States Naval Academy, has shown a decrease of the recurrence rate of primary anterior shoulder dislocations to 25% versus the 80% recurrence rate we have become familiar with from studies done which did not stress specific rehabilitation programmes. The athlete should also be instructed in a self-performed traction method for reduction should a redislocation occur, to minimise the stretching effect on the neurovascular structures and allow relief from discomfort. Surgery for primary and recurrent anterior dislocations should only be considered when the athlete fails to achieve the desired goals after participating in a specific, progressive, adequate

  8. Irreducible Traumatic Posterior Shoulder Dislocation

    Directory of Open Access Journals (Sweden)

    Blake Collier

    2017-01-01

    Full Text Available History of present illness: A 22-year-old male presented to the Emergency Department complaining of right shoulder pain after a motocross accident. He was traveling at approximately 10 mph around a turn when he lost control and was thrown over the handlebars, landing directly on his right shoulder. On arrival, he was holding his arm in adduction and internal rotation. An area of swelling was noted over his anterior shoulder. He was unable to abduct his shoulder. No humeral gapping was noted. He had normal neuro-vascular status distal to the injury. Significant findings: Radiographs demonstrated posterior displacement of the humeral head on the “Y” view (see white arrow and widening of the glenohumeral joint space on anterior-posterior view (see red arrow. The findings were consistent with posterior dislocation and a Hill-Sachs type deformity. Sedation was performed and reduction was attempted using external rotation, traction counter-traction. An immediate “pop” was felt during the procedure. Post-procedure radiographs revealed a persistent posterior subluxation with interlocking at posterior glenoid. CT revealed posterior dislocation with acute depressed impaction deformity medial to the biceps groove with the humeral head perched on the posterior glenoid, interlocked at reverse Hill-Sachs deformity (see blue arrow. Discussion: Posterior shoulder dislocations are rare and represent only 2% of all shoulder dislocations. Posterior shoulder dislocations are missed on initial diagnosis in more than 60% of cases.1 Posterior shoulder dislocations result from axial loading of the adducted and internally rotated shoulder, violent muscle contractions (resulting from seizures or electrocution, a direct posterior force applied to the anterior shoulder.1 Physical findings include decreased anterior prominence of the humeral head, increased palpable posterior prominence of the humeral head below the acromion, increased palpable prominence of the

  9. Treatment of Patellar Lower Pole Fracture with Modified Titanium Cable Tension Band Plus Patellar Tibial Tunnel Steel "8" Reduction Band.

    Science.gov (United States)

    Li, Jiaming; Wang, Decheng; He, Zhiliang; Shi, Hao

    2018-01-08

    To determine the efficacy of modified titanium tension band plus patellar tendon tunnel steel 8 "reduction band" versus titanium cable tension band fixation for the treatment of patellar lower pole fracture. 58 patients with lower patella fracture were enrolled in this study, including 30 patients treated with modified titanium cable tension band plus patellar tibial tunnel wire "8" tension band internal fixation (modified group), and 28 patients with titanium cable tension band fixation. All patients were followed up for 9∼15 months with an average of 11.6 months. Knee flexion was significantly improved in the modified group than in the titanium cable tension band group (111.33 ± 13 degrees versus 98.21 ± 21.70 degrees, P = 0.004). The fracture healing time showed no significant difference. At the end of the follow-up, the improvement excellent rate was 93.33% in the modified group, and 82.14% in the titanium cable tension band group. Titanium cable tension band internal fixation loosening was found in 2 cases, including 1 case of treatment by two surgeries without loose internal fixation. The modified titanium cable tension band with "8" tension band fixation showed better efficacy for lower patella fractures than titanium cable tension band fixation.

  10. The movement of screw dislocations in tungsten

    Energy Technology Data Exchange (ETDEWEB)

    Tian Xiaogeng; Woo Chungho

    2004-03-25

    Using Acland potential for tungsten, the movement of 1/2a<1 1 1> screw dislocation under shear stress was investigated by molecular dynamics simulation. Equilibrated core structure was obtained by relaxation of screw dislocation with proper boundary conditions. We found that the equilibrium dislocation core has three-fold symmetry and spread out in three <1 1 2> direction on {l_brace}1 1 0{r_brace} planes. The screw dislocation core could not keep the original shape when the shear stress applied. The dislocation could not move until the shear stress became large enough. The dislocation moved in zigzag when the shear stress neared the Peierls stress. When the shear stress became larger, the dislocation moved in zigzag at the beginning and than moved almost in straight line in [2-bar11] direction. The large shear stress applied, the long distance moved before the dislocation stilled in z-direction and the large velocity in y-direction.

  11. Trochlear osteotomy for patellar instability: satisfactory minimum 2-year results in patients with dysplasia of the trochlea.

    NARCIS (Netherlands)

    Koeter, S.; Pakvis, D.F.; Loon, C.J.M. van; Kampen, A. van

    2007-01-01

    Trochlear dysplasia is a predisposing factor for recurrent patellar instability. We evaluated the results of an anterior lateral femoral condyle open wedge osteotomy for treating patellar instability. A total of 16 consecutive patients (19 knees) with symptoms of recurrent patellar instability and

  12. Effect of patellar strap and sports tape on jumper's knee symptoms : Protocol of a randomised controlled trial

    NARCIS (Netherlands)

    De Vries, Astrid J.; den Akker-Scheek, Inge van; Diercks, Ronald; Zwerver, Johannes; der Worp, Henk van

    2013-01-01

    INTRODUCTION: Patellar straps or sports tapes are commonly used by athletes with patellar tendinopathy in order to reduce pain and to continue sports participation. Currently, there is no scientific evidence for the effectiveness of a patellar strap or sports tape in the management of this common

  13. Atomistic simulations of dislocation processes in copper

    DEFF Research Database (Denmark)

    Vegge, T.; Jacobsen, K.W.

    2002-01-01

    We discuss atomistic simulations of dislocation processes in copper based on effective medium theory interatomic potentials. Results on screw dislocation structures and processes are reviewed with particular focus on point defect mobilities and processes involving cross slip. For example, the sta......We discuss atomistic simulations of dislocation processes in copper based on effective medium theory interatomic potentials. Results on screw dislocation structures and processes are reviewed with particular focus on point defect mobilities and processes involving cross slip. For example...

  14. Feasibility and reliability of pain pressure threshold measurements in patellar tendinopathy

    NARCIS (Netherlands)

    van Wilgen, Paul; van der Noord, Robert; Zwerver, Johannes

    2011-01-01

    Patellar tendinopathy is a common and often difficult to treat overuse injury which is characterized by activity-related anterior knee and focal palpation tenderness of the patellar tendon. The clinical diagnosis is mainly based on clinical examination, in which the yardstick is a non-standardized

  15. 21 CFR 888.3580 - Knee joint patellar (hemi-knee) metallic resurfacing uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... resurfacing uncemented prosthesis. 888.3580 Section 888.3580 Food and Drugs FOOD AND DRUG ADMINISTRATION... § 888.3580 Knee joint patellar (hemi-knee) metallic resurfacing uncemented prosthesis. (a) Identification. A knee joint patellar (hemi-knee) metallic resurfacing uncemented prosthesis is a device made of...

  16. Extracorporeal shockwave therapy for patellar tendinopathy : a review of the literature

    NARCIS (Netherlands)

    van Leeuwen, M. T.; Zwerver, J.; van den Akker-Scheek, I.

    Background and purpose: Extracorporeal shockwave therapy (EWST) has become a popular treatment for patellar tendinopathy. The purpose of this review was to study the effectiveness of ESWT treatment for patellar tendinopathy; to draft guidelines for an effective treatment protocol of ESWT treatment;

  17. Atlantooccipital dislocation: a case report.

    Science.gov (United States)

    Williams, M J; Elliott, J L; Nichols, J

    1995-03-01

    We report on a child who suffered an atlantooccipital dislocation and survived. The patient required tracheostomy and feeding gastrostomy due to retropharyngeal swelling from a traumatic pseudomeningocele. He later underwent fusion of his occiput to C3. The complications of such an injury and the anesthetic management are discussed.

  18. Lateral atlantooccipital dislocation: case report.

    Science.gov (United States)

    Watridge, C B; Orrison, W W; Arnold, H; Woods, G A

    1985-08-01

    A case of lateral atlantooccipital dislocation is presented, and its successful management is outlined, demonstrating the importance of the physical examination and the utilization of computed tomography. Open reduction and stabilization with direct visualization of the spinal axis is the preferred method of treatment.

  19. Medial peritalar fracture dislocation of the talar body

    Directory of Open Access Journals (Sweden)

    Jacob B. Stirton

    2015-04-01

    Full Text Available Peritalar fracture dislocations typically involve the talar neck and are classified according to Hawkins. To our knowledge, peritalar fracture dislocation involving the talar body has not been formally reported. In this article, we describe a case of peritalar fracture dislocation of the talar body. Keywords: Peritalar dislocation, Talus fracture, Talar body fracture dislocation, Medial subtalar dislocation

  20. Medial subtalar dislocation: Case report

    Directory of Open Access Journals (Sweden)

    Manojlović Radovan

    2010-01-01

    Full Text Available Introduction. Subtalar dislocation (SI is a term that refers to an injury in which there is dislocation of the talonavicular and talocalcanear joint, although the tibiotalar joint is intact. Case Outline. A case of medial subtalar dislocation as a result of basketball injury, so-called 'basketball foot', is presented. Closed reposition in i.v. anaesthesia was performed with the patient in supine position and a knee flexed at 90 degrees. Longitudinal manual traction in line of deformity was carried out in plantar flexion. The reposition continued with abduction and eversion simultaneously increasing dorsiflexion. It was made in the first attempt and completed instantly. Rehabilitation was initiated after 5 weeks of immobilization. One year after the injury, the functional outcome was excellent with full range of motion and the patient was symptom-free. For better interpretation of roentgenogram, bone model of subtalar dislocation was made using the cadaver bone. Conclusion. Although the treatment of such injury is usually successful, diagnosis can be difficult because it is a rare injury, and moreover, X-ray of the injury can be confusing due to superposition of bones. Radiograms revealed superposition of the calcaneus, tarsal and metatarsal bones which was radiographically visualized in the anterior-posterior projection as one osseous block inward from the talus, and on the lateral view as in an osteal block below the tibial bone. Prompt recognition of these injuries followed by proper, delicately closed reduction under anaesthesia is crucial for achieving a good functional result in case of medial subtalar dislocation.

  1. Unilateral Congenital Knee and Hip Dislocation with Bilateral Clubfoot - A rare Packaging disorder.

    Science.gov (United States)

    Tiwari, Mukesh; Sharma, Nishith

    2013-01-01

    Reduced intrauterine space gives rise to 'packaging disorder' which may involve joint dislocations or contractures. We present an unique case where mutiple joints were dislocated involving left congenital knee dislocation (CDK), bilateral congenital hip dislocation (CDH) and congenital talipes equino varus (CTEV)deformities. A preterm baby boy born to mother with diagnosed oligohydramios presented with left CDK bilateral DDH and CTEV. The knee dislocation was treated first with gradual streaching and weekly above knee cast. At 7th week good flexion was achieved at both knees and abduction splint for DDH (using double diaper) with ponseti cast for CTEV was done. At one year follow up all joints were reduced and maintained well with baby able to stand with support. Packaging disorders may present with multiple dislocations and deformities. Early intervention with serial casting and manipulation minimises disability and prevents ambulatory problems. In our case there was a good response to manipulation and serial casting. This differs from cases with inherent pathology like arthrogryposis where response to treatment is not so good.

  2. Unilateral Congenital Knee and Hip Dislocation with Bilateral Clubfoot – A rare Packaging disorder

    Directory of Open Access Journals (Sweden)

    Mukesh Tiwari

    2013-04-01

    Full Text Available ntroduction: Reduced intrauterine space gives rise to ‘packaging disorder’ which may involve joint dislocations or contractures. We present an unique case where mutiple joints were dislocated involving left congenital knee dislocation (CDK, bilateral congenital hip dislocation (CDH and congenital talipes equino varus (CTEVdeformities. Case Report: A preterm baby boy born to mother with diagnosed oligohydramios presented with left CDK bilateral DDH and CTEV. The knee dislocation was treated first with gradual streaching and weekly above knee cast. At 7th week good flexion was achieved at both knees and abduction splint for DDH (using double diaper with ponseti cast for CTEV was done. At one year follow up all joints were reduced and maintained well with baby able to stand with support. Conclusion: Packaging disorders may present with multiple dislocations and deformities. Early intervention with serial casting and manipulation minimises disability and prevents ambulatory problems. In our case there was a good response to manipulation and serial casting. This differs from cases with inherent pathology like arthrogryposis where response to treatment is not so good. Keywords: Congenital genu recurvatum, Develpmental dysplasia hip, CTEV, Clubfoot, serial manipulation, packaging disorders

  3. Posterior sternoclavicular dislocation: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, So Hwa; Kim, Ki Sun; Kim, Ki Jun [Dept. of Radiology, Incheon St. Mary' s Hospital, The Catholic University of Korea College of Medicine, Incheon (Korea, Republic of)

    2015-02-15

    Traumatic sternoclavicular joint dislocation is an uncommon injury, and posterior sternoclavicular dislocation occurs less frequently compared to anterior sternoclavicular dislocation. However, this type of dislocation has the potential for serious complications due to compression or laceration of the mediastinal structures. The diagnosis can be difficult using plain radiographs alone due to radiographic-anatomic superimposition. Therefore, posterior sternoclavicular dislocation is easily missed at the initial clinical evaluation. Contrast-enhanced computed tomography is required for a definite diagnosis and to assess associated mediastinal injuries.

  4. Patellar tendinopathy in junior basketball players: a controlled clinical and ultrasonographic study of 268 patellar tendons in players aged 14-18 years.

    Science.gov (United States)

    Cook, J L; Khan, K M; Kiss, Z S; Griffiths, L

    2000-08-01

    Anterior knee pain is a common presenting complaint amongst adolescent athletes. We hypothesised that patellar tendinopathy may occur at a younger age than is generally recognised. Thus, we studied the patellar tendons in 134 elite 14- to 18-year-old female (n=64) and male (n=70) basketball players and 29 control swimmers (17 female, 12 male) clinically and with ultrasonography. We found that of 268 tendons, 19 (7%) had current patellar tendinopathy on clinical grounds (11% in males, 2% in females). Twenty-six percent of the basketball players' patellar tendons contained an ultrasonographic hypoechoic region. Ultrasonographic abnormality was more prevalent in the oldest tertile of players (17-18 years) than the youngest tertile (14-15.9 years). Of tendons categorised clinically as 'Never patellar tendinopathy', 22% had an ultrasonographic hypoechoic region nevertheless. This study indicates that patellar tendinopathy can occur in 14- to 18-year-old basketball players. Ultrasonographic tendon abnormality is 3 times as common as clinical symptoms.

  5. Acute, recurrent total knee dislocation: Polyethylene dislocation and malreduction

    Directory of Open Access Journals (Sweden)

    Samuel F. Thompson, BS

    2015-03-01

    Full Text Available A 62-year-old man underwent total knee arthroplasty using a mobile-bearing prosthesis. Four days post-operatively the patient experienced the first of several acute knee dislocations. Closed reduction was performed at an outside hospital a total of three times prior to presentation at this institution. A two-stage exchange of the TKA was recommended due to the clinical suspicion for an infected prosthesis. Upon surgical exploration, it was discovered that the polyethylene insert had spun out completely to 180°. Closed reduction attempts of a posterior dislocation of a mobile-bearing knee prosthesis may contribute to complete 180° spinout of the polyethylene insert.

  6. Theory of interacting dislocations on cylinders.

    Science.gov (United States)

    Amir, Ariel; Paulose, Jayson; Nelson, David R

    2013-04-01

    We study the mechanics and statistical physics of dislocations interacting on cylinders, motivated by the elongation of rod-shaped bacterial cell walls and cylindrical assemblies of colloidal particles subject to external stresses. The interaction energy and forces between dislocations are solved analytically, and analyzed asymptotically. The results of continuum elastic theory agree well with numerical simulations on finite lattices even for relatively small systems. Isolated dislocations on a cylinder act like grain boundaries. With colloidal crystals in mind, we show that saddle points are created by a Peach-Koehler force on the dislocations in the circumferential direction, causing dislocation pairs to unbind. The thermal nucleation rate of dislocation unbinding is calculated, for an arbitrary mobility tensor and external stress, including the case of a twist-induced Peach-Koehler force along the cylinder axis. Surprisingly rich phenomena arise for dislocations on cylinders, despite their vanishing Gaussian curvature.

  7. Dislocation motion in tungsten: Atomistic input to discrete dislocation simulations

    Czech Academy of Sciences Publication Activity Database

    Srivastava, K.; Gröger, Roman; Weygand, D.; Gumbsch, P.

    2013-01-01

    Roč. 47, AUG (2013), s. 126-142 ISSN 0749-6419 R&D Projects: GA ČR GAP204/10/0255; GA MŠk(CZ) ED1.1.00/02.0068 Institutional support: RVO:68081723 Keywords : body -centered cubic * non-Schmid effects * anomalous slip * discrete dislocation dynamics Subject RIV: BM - Solid Matter Physics ; Magnetism; BM - Solid Matter Physics ; Magnetism (UFM-A) Impact factor: 5.971, year: 2013

  8. Chondromalacia induced by patellar subluxation in the rabbit

    DEFF Research Database (Denmark)

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

    1989-01-01

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

  9. Arthroscopic treatment of acromioclavicular dislocation

    Directory of Open Access Journals (Sweden)

    Mihai T. Gavrilă

    2017-11-01

    Full Text Available A thorough understanding of biomechanical function of both acromioclavicular (AC and coracoclavicular (CC ligaments, stimulated surgeons to repair high-grade AC dislocation using arthroscopic technique. This technique necessitates a clear understanding of shoulder anatomy, especially of the structures in proximity to the clavicle and coracoid process and experiences in arthroscopic surgery. The follow case describes an arthroscopic technique used to treat AC dislocation in young man 30 years old, who suffered an injury at right shoulder. Results were similar to those obtained using open surgery and this encouraged us to continue utilization of this method. As a conclusion, arthroscopic treatment of AC separation is one of the best options as surgical treatment. Early results suggested that immediate anatomic reduction of an acute AC separation usually provides satisfactory clinical results at intermediate-term follow-up.

  10. Effect of a patellar strap on the joint position sense of the symptomatic knee in athletes with patellar tendinopathy.

    Science.gov (United States)

    de Vries, Astrid J; van den Akker-Scheek, Inge; Haak, Svenja L; Diercks, Ron L; van der Worp, Henk; Zwerver, Johannes

    2017-11-01

    The primary aim of this study was to investigate the effect of a patellar strap on the proprioception of the symptomatic leg in PT. Secondary aims were to investigate a possible difference in effectiveness between athletes with high and low proprioceptive acuity, and whether predictors of effectiveness could be found. Randomised cross-over pilot study. 24 athletes with PT (age 27.3±9.0, VISA-P 50.6±11.2) performed a joint position sense test with and without a patellar strap. The difference between both conditions was analysed using linear mixed-model analysis. No improvement in the joint position sense using the strap for the whole group was found, while those classified as having low proprioceptive acuity did improve using the strap (p=0.015, 17.2%). A larger knee girth, longer duration of symptoms and more tendon abnormalities were negatively associated with the strap's effectiveness. The use of a patellar strap improves the knee joint proprioception - measured with joint position sense - of the symptomatic leg in athletes with poor proprioceptive acuity. Especially athletes with relatively small knee girth, short duration of symptoms and small tendon abnormalities might benefit from the strap. As proprioception plays an important role in motor control, and deficits in proprioception may put an athlete at risk for (re-)injury, these findings may be relevant for prevention as well as rehabilitation purposes in those PT athletes with low proprioceptive acuity. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  11. Recurrent Dislocation of the Patella

    OpenAIRE

    Ben?tez, Gustavo

    2015-01-01

    Purpose: To evaluate results of medial patellofemoral ligament (MPFL) reconstruction associated with lateral release and advancement of vastus medialis in recurrent dislocation of the patella. Methods: We retrospectively evaluated 11 patients with a mean follow-up of 19 months. Mean age was 23, mainly women. We did MPFL reconstruction with semitendinosus or gracilis tendon depending on BMI, associated with advancement of vastus medialis and lateral release. Results: Mean Kujala score improved...

  12. Superior-inferior position of patellar component affects patellofemoral kinematics and contact forces in computer simulation.

    Science.gov (United States)

    Nakamura, Shinichiro; Tanaka, Yoshihisa; Kuriyama, Shinichi; Nishitani, Kohei; Ito, Hiromu; Furu, Moritoshi; Matsuda, Shuichi

    2017-06-01

    Anterior knee pain has been reported as a major postoperative complication after total knee arthroplasty, which may lead to patient dissatisfaction. Rotational alignment and the medial-lateral position correlate with patellar maltracking, which can cause knee pain postoperatively. However, the superior-inferior position of the patellar component has not been investigated. The purpose of the current study was to investigate the effects of the patellar superior-inferior position on patellofemoral kinematics and kinetics. Superior, central, and inferior models with a dome patellar component were constructed. In the superior and inferior models, the position of the patellar component translated superiorly and inferiorly, respectively, by 3mm, relative to the center model. Kinematics of the patellar component, quadriceps force, and patellofemoral contact force were calculated using a computer simulation during a squatting activity in a weight-bearing deep knee bend. In the inferior model, the flexion angle, relative to the tibial component, was the greatest among all models. The inferior model showed an 18.0%, 36.5%, and 22.7% increase in the maximum quadriceps force, the maximum medial patellofemoral force, and the maximum lateral patellofemoral force, respectively, compared with the superior model. Superior-inferior positions affected patellofemoral kinematic and kinetics. Surgeons should avoid the inferior position of the patellar component, because the inferior positioned model showed greater quadriceps and patellofemoral force, resulting in a potential risk for anterior knee pain and component loosening. Copyright © 2017. Published by Elsevier Ltd.

  13. Dancers with patellar tendinopathy exhibit higher vertical and braking ground reaction forces during landing.

    Science.gov (United States)

    Fietzer, Abbigail Lynn; Chang, Yu-Jen; Kulig, Kornelia

    2012-01-01

    Dancers are exposed to the effects of repetitive jumping and leaping as are other athletes that tend to develop patellar tendinopathy. Greater vertical ground reaction forces occur during landing from a dance leap than during takeoff and during other common athletic activities. The purposes of this study were: (1) to compare the landing ground reaction force profiles of participants with and without clinically diagnosed patellar tendinopathy, and (2) to determine the strength of the relationship between landing angle, and braking impulse. Eighteen elite pre-professional dancers (12 healthy, 6 with patellar tendinopathy; both groups 50% male) performed sauts de chat for kinetic and kinematic analysis. Dancers with patellar tendinopathy demonstrated greater peak vertical ground reaction force and impulse (36% and 15% greater, respectively). Dancers with patellar tendinopathy demonstrated greater peak braking ground reaction force and impulse (82% and 126% greater, respectively). Landing angle explained 67% of the braking impulse. Dancers with patellar tendinopathy exhibited greater vertical and braking impulses than healthy dancers. Braking impulse was strongly correlated with landing angle. While there was no difference between groups in landing angle, dancers with patellar tendinopathy exhibited greater braking impulse than their non-tendinopathic counterparts, even at similar landing angles.

  14. Lattice dislocation in Si nanowires

    Energy Technology Data Exchange (ETDEWEB)

    Omar, M.S., E-mail: dr_m_s_omar@yahoo.co [Department of Physics, College of Science, University of Salahaddin, Arbil, Iraqi Kurdistan (Iraq); Taha, H.T. [Department of Physics, College of Science, University of Salahaddin, Arbil, Iraqi Kurdistan (Iraq)

    2009-12-15

    Modified formulas were used to calculate lattice thermal expansion, specific heat and Bulk modulus for Si nanowires with diameters of 115, 56, 37 and 22 nm. From these values and Gruneisen parameter taken from reference, mean lattice volumes were found to be as 20.03 A{sup 3} for the bulk and 23.63, 29.91, 34.69 and 40.46 A{sup 3} for Si nanowire diameters mentioned above, respectively. Their mean bonding length was calculated to be as 0.235 nm for the bulk and 0.248, 0.269, 0.282 and 0.297 nm for the nanowires diameter mentioned above, respectively. By dividing the nanowires diameter on the mean bonding length, number of layers per each nanowire size was found to be as 230, 104, 65 and 37 for the diameters mentioned above, respectively. Lattice dislocations in 22 nm diameter wire were found to be from 0.00324 nm for the 1st central lattice to 0.2579 nm for the last surface lattice. Such dislocation was smaller for larger wire diameters. Dislocation concentration found to change in Si nanowires according to the proportionalities of surface thickness to nanowire radius ratios.

  15. Sonographically detected costo-chondral dislocation in an abused child - A new sonographic sign to the radiological spectrum of child abuse

    NARCIS (Netherlands)

    A.J. Smeets (A.); S.G.F. Robben (Simon); M. Meradji (Morteza)

    1990-01-01

    textabstractA case of an abused child with fractures of the skull, ribs and long bones is presented. Sonographically a costochondral dislocation of the left lower ribs was detected, which has not been reported in the literature.

  16. Management of displaced comminuted patellar fracture with titanium cable cerclage.

    Science.gov (United States)

    Yang, Li; Yueping, Ouyang; Wen, Yuan

    2010-08-01

    Management of a displaced comminuted patellar fracture is challenging. Tension band wiring and lag screw fixation are not suitable for such a fracture pattern. Stainless steel wiring with various configurations has been the mainstay of treatment. However, issues of loss of fixation and breakage of wire have not been resolved yet. Partial or total patellectomy is the last resort with a detrimental effect on quadriceps power. Braided titanium cable is stronger in tensile strength and better in fatigue resistance than the stainless steel monofilament wire, and the tension of fixation could be controlled by a graded instrument in its application. We used titanium cable to treat 21 consecutive patients with displaced comminuted patellar fracture. Patients were followed up for a mean period of 24 months (12 to 32 months). The mean score at the final follow-up was 27 points (25 to 30) using the Böstman method. There was no complication except breakage of one cable at the sixth week after the operation and the fracture had united despite the breakage. This technique is simple and effective for these difficult fractures and avoided prolonged immobilisation of the knee. Copyright 2010 Elsevier B.V. All rights reserved.

  17. Differences in tendon properties in elite badminton players with or without patellar tendinopathy

    DEFF Research Database (Denmark)

    Couppé, Christian; Kongsgaard, M; Aagaard, Per

    2013-01-01

    The aim of this study was to examine the structural and mechanical properties of the patellar tendon in elite male badminton players with and without patellar tendinopathy. Seven players with unilateral patellar tendinopathy (PT group) on the lead extremity (used for forward lunge) and nine players......) normalized for body weight (mm(2) /kg(2/3) ) was lower in the PT group compared with the CT group on both the non-lead extremity (6.1 ± 0.3 vs 7.4 ± 0.2, P ...

  18. Overuse tendinosis, not tendinitis part 2: applying the new approach to patellar tendinopathy.

    Science.gov (United States)

    Cook, J L; Khan, K M; Maffulli, N; Purdam, C

    2000-06-01

    Patellar tendinopathy causes substantial morbidity in both professional and recreational athletes. The condition is most common in athletes of jumping sports such as basketball and volleyball, but it also occurs in soccer, track, and tennis athletes. The disorder arises most often from collagen breakdown rather than inflammation, a tendinosis rather than a tendinitis. Physicians must address the degenerative pathology underlying patellar tendinopathy because regimens that seek to minimize (nonexistent) inflammation would appear illogical. Suggestions for applying the 'tendinosis paradigm' to patellar tendinopathy management include conservative measures such as load reduction, strengthening exercises, and massage. Surgery should be considered only after a long-term and appropriate conservative regimen has failed.

  19. Five patellar proximodistal positioning indices compared in clinically normal Greenland sled dogs

    DEFF Research Database (Denmark)

    Miles, James E; Dickow, Marlene; Nielsen, Dorte H

    2012-01-01

    Patellar luxation in large-breed dogs is associated with abnormal proximodistal patellar positioning. Using a clinically normal population of Greenland sled dogs, measurement reliability and the effect of limb position were compared for five patellar proximodistal positioning indices based...... on the Insall-Salvati (IS), modified Insall-Salvati (mIS), de Carvalho (dC), patellotrochlear (PT) and Blackburne-Peel (BP) indices. Indices were measured at one knee angle in 44 dogs and two knee angles in 10 dogs. Index susceptibility to error was modelled for different errors in knee angle estimation. Two...

  20. [Isolated traumatic dislocation of the fibula head. A rare injury in soccer].

    Science.gov (United States)

    Bader, D; Schratz, W; Kienzle, H F

    1991-12-01

    The case presented of a rare injury of the left knee joint underlines the necessity for meticulous examination. We report on isolated dislocation of the head of the fibula in a 25-year-old football player; the diagnosis and therapy for this rare injury are presented.

  1. Does different duration of non-operative immobilization have an effect on the redislocation rate of primary patellar dislocation?

    DEFF Research Database (Denmark)

    Kaewkongnok, Bo; Bøvling, Anders; Milandt, Nikolaj

    2018-01-01

    by bandage, four weeks of brace and six weeks of brace with increasing of range of motion. Radiographs were evaluated for trochlear dysplasia (TD), patella alta, trochlear depth and growth zone. Crude analysis and logistic regression adjusted for radiographic assessments, age, gender and rehabilitation...... was done in STATA® with significance p≤0.05. RESULTS: Forty-five point eight percent were between 15 and 19years and 51.4% were male. One hundred sixty-three experienced redislocation (27.1%). Logistic regression was performed at 404 subjects and showed that rehabilitation, gender, TD, patella alta......, and growth zone had no significant odds ratio (OR) on redislocation. The duration of brace demonstrated no significant OR in reducing redislocation. Subjects between 20 and 29years showed lower OR in redislocation (95% CI) of 0.27 (0.11; 0.64, p=0.003). CONCLUSION: This study demonstrated no difference...

  2. Atraumatic Anterior Dislocation of the Hip Joint

    Directory of Open Access Journals (Sweden)

    Tadahiko Ohtsuru

    2015-01-01

    Full Text Available Dislocation of the hip joint in adults is usually caused by high-energy trauma such as road traffic accidents or falls from heights. Posterior dislocation is observed in most cases. However, atraumatic anterior dislocation of the hip joint is extremely rare. We present a case of atraumatic anterior dislocation of the hip joint that was induced by an activity of daily living. The possible causes of this dislocation were anterior capsule insufficiency due to developmental dysplasia of the hip, posterior pelvic tilt following thoracolumbar kyphosis due to vertebral fracture, and acetabular anterior coverage changes by postural factor. Acetabular anterior coverage changes in the sagittal plane were measured using a tomosynthesis imaging system. This system was useful for elucidation of the dislocation mechanism in the present case.

  3. Imaging findings of anterior hip dislocations

    Energy Technology Data Exchange (ETDEWEB)

    Pfeifer, Kyle [Mallinckrodt Institute of Radiology, Department of Radiology, St. Louis, MO (United States); Leslie, Michael [Yale School of Medicine, Department of Orthopedics and Rehabilitation, New Haven, CT (United States); Menn, Kirsten; Haims, Andrew [Yale University School of Medicine, Department of Radiology and Biomedical Imaging, New Haven, CT (United States)

    2017-06-15

    Anterior hip dislocations are rare orthopedic emergencies resulting from high-energy trauma and have unique imaging characteristics on radiography, computed tomography (CT), and magnetic resonance imaging (MRI). Imaging findings on CT and MRI allow for the prompt recognition and classification of anterior hip dislocations, which guides patient management and reduces complications. The purpose of this article is to review imaging findings of anterior hip dislocations, specifically focusing on CT and MRI. (orig.)

  4. Imaging findings of anterior hip dislocations

    International Nuclear Information System (INIS)

    Pfeifer, Kyle; Leslie, Michael; Menn, Kirsten; Haims, Andrew

    2017-01-01

    Anterior hip dislocations are rare orthopedic emergencies resulting from high-energy trauma and have unique imaging characteristics on radiography, computed tomography (CT), and magnetic resonance imaging (MRI). Imaging findings on CT and MRI allow for the prompt recognition and classification of anterior hip dislocations, which guides patient management and reduces complications. The purpose of this article is to review imaging findings of anterior hip dislocations, specifically focusing on CT and MRI. (orig.)

  5. [Traumatic lumbosacral dislocation - an underrated injury].

    Science.gov (United States)

    Schroeter, S; Weise, K; Badke, A

    2009-01-01

    Traumatic lumbosacral dislocations are rare. We report two cases with initially missed posttraumatic lumbosacral dislocations. The reported cases and the review of the literature show that, especially, accident victims with multiple fractures of the lumbar transverses processes may require a CT scan to confirm fractures or dislocations of L5/S1. Follow-up examinations due to persisting pain after physiotherapy should include lateral X-rays of the lumbar spine of the patient standing. According to the literature and our experience, the treatment of traumatic lumbosacral dislocation usually consists of open reduction and postero-lateral or dorso-ventral fusion of the unstable segments.

  6. Structure of the Dislocation in Sapphire

    DEFF Research Database (Denmark)

    Bilde-Sørensen, Jørgen; Thölen, A. R.; Gooch, D. J.

    1976-01-01

    Experimental evidence of the existence of 01 0 dislocations in the {2 0} prism planes in sapphire has been obtained by transmission electron microscopy. By the weak-beam technique it has been shown that the 01 0 dislocations may dissociate into three partials. The partials all have a Burgers vector...... of ⅓ 01 0 and are separated by two identical faults. The distance between two partials is in the range 75-135 Å, corresponding to a fault energy of 320±60 mJ/m2. Perfect 01 0 dislocations have also been observed. These dislocations exhibited either one or two peaks when imaged in the (03 0) reflection...

  7. X-ray scattering from dislocation arrays in GaSb

    CERN Document Server

    Babkevich, A Y; Mason, N J; Weller, S; Stunault, A

    2002-01-01

    The structure of GaSb layers grown epitaxially on GaAs(001) substrates has been studied by high-resolution x-ray diffraction. The samples with thicknesses between 95 and 2845 A were grown in Oxford by metal-organic vapour phase epitaxy. The large lattice mismatch is largely relaxed by two intersecting regular arrays of 90 deg. dislocations along the [110] and [11-bar 0 ] directions. The density of the dislocations changes with the thickness but the dislocations remain localized at the interface and both the GaSb layers and GaAs substrates are distorted. The spacing between the dislocations in both the [110] and [11-bar 0 ] directions decreases while the relaxation increases as the layer thickness increases. We have found the spacing of the dislocations, relaxation and residual in-plane strain along the [110] and [11-bar 0 ] directions and showed a strong asymmetry in dislocation spacing and relaxation between the two directions. This is because adjacent left brace 110 right brace planes in the zincblende stru...

  8. The core structure of a Frank dislocation in Ni3(Al,Nb)

    International Nuclear Information System (INIS)

    Bonnet, R.; Loubradou, M.; Derder, C.; Catana, A.

    1991-01-01

    This paper reports on the core structures of dislocations in L1 2 crystals, in view of understanding the anomalous yield behavior of strength with increasing temperature. Theoretical approaches have been proposed for explaining the dissociations of these dislocations, and experimental evidences have been reported for such dissociations using either the weak beam technique or more recently the HRTEM (High Resolution Transmission Electron Microscopy) technique. Recent HRTEM results show that for Ni 3 A1 the partial dislocations 1/2 left-angle 110 right-angle which limit an APB (Antiphase Boundary) lying on (001) are only split over 0.1 - 0.3 nm along (111) planes, producing very high energy CSF's (Complex Stacking Faults) which limit an SISF (superlattice Intrinsic Stacking Fault) extended on a (111) plane. Concerning the 1/2 left-angle 111 right-angle Frank dislocation, which limits an SESF (Superlattice Extrinsic Stacking Fault), there are no reported results yet. Let us note, however, that for aluminum HRTEM images of Frank dislocation loops have been studied. This lack of information in the L1 2 crystals motivated the present HRTEM study

  9. Previously identified patellar tendinopathy risk factors differ between elite and sub-elite volleyball players.

    Science.gov (United States)

    Janssen, I; Steele, J R; Munro, B J; Brown, N A T

    2015-06-01

    Patellar tendinopathy is the most common knee injury incurred in volleyball, with its prevalence in elite athletes more than three times that of their sub-elite counterparts. The purpose of this study was to determine whether patellar tendinopathy risk factors differed between elite and sub-elite male volleyball players. Nine elite and nine sub-elite male volleyball players performed a lateral stop-jump block movement. Maximum vertical jump, training history, muscle extensibility and strength, three-dimensional landing kinematics (250 Hz), along with lower limb neuromuscular activation patterns (1500 Hz), and patellar tendon loading were collected during each trial. Multivariate analyses of variance (P volleyball players. Interventions designed to reduce landing frequency and improve quadriceps extensibility are recommended to reduce patellar tendinopathy prevalence in volleyball players. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Human syndromes with congenital patellar anomalies and the underlying gene defects.

    NARCIS (Netherlands)

    Bongers, E.M.H.F.; Kampen, A. van; Bokhoven, J.H.L.M. van; Knoers, N.V.A.M.

    2005-01-01

    Genetic disorders characterized by congenital patellar aplasia or hypoplasia belong to a clinically diverse and genetically heterogeneous group of lower limb malformations. Patella development involves different molecular and cellular mechanisms regulating dorso-ventral patterning, cartilage and

  11. The anterior recurrent peroneal nerve entrapment syndrome: a patellar tendinopathy differential diagnosis case report.

    Science.gov (United States)

    Rousseau, Eric

    2013-12-01

    Patellar tendinopathy which is a cause of pain in the inferior patellar region is a relatively common pathology among sports enthusiasts. This paper describes a new pain syndrome identified from clinical observations which is a differential diagnosis to patellar tendinopathy. The pattern is specific and recognizable among many individuals, and it should be considered as its own entity. The new syndrome is discussed in terms of the pain experienced, the diagnostic criteria, treatment and the rationale to explain it. As it is a differential diagnosis to patellar tendinopathy, many sports enthusiasts might benefit from this diagnosis. If identified correctly, treatment might be directed to the correct structures and with the appropriate modalities, ensuring the patients a fast return to their past occupations without pain and without unwarranted treatments. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. Metal working and dislocation structures

    DEFF Research Database (Denmark)

    Hansen, Niels

    2007-01-01

    Microstructural observations are presented for different metals deformed from low to high strain by both traditional and new metal working processes. It is shown that deformation induced dislocation structures can be interpreted and analyzed within a common framework of grain subdivision on a finer...... and finer scale down to the nanometer dimension, which can be reached at ultrahigh strains. It is demonstrated that classical materials science and engineering principles apply from the largest to the smallest structural scale but also that new and unexpected structures and properties characterize metals...

  13. Factors associated with the presence of patellar tendon abnormalities in male athletes.

    Science.gov (United States)

    Mendonça, Luciana D; Verhagen, Evert; Bittencourt, Natália F N; Gonçalves, Gabriela G P; Ocarino, Juliana M; Fonseca, Sérgio T

    2016-05-01

    To investigate the association between lower limb alignment, range of motion/flexibility and muscle strength with the presence of patellar tendon abnormalities in male athletes. This was a cross-sectional study. Thirty-one male basketball and volleyball athletes were assessed for ankle dorsiflexion range of motion, shank-forefoot alignment, iliotibial band flexibility, hip external rotators and abductors isometric torque, passive hip internal rotation range of motion and frontal plane knee and patellar alignment (McConnell and Arno angles). Ultrasonographic evaluations of hypoechoic areas of the patellar tendons were performed in longitudinal and transverse planes. A receiver operating characteristic curve was used to determine clinically relevant cut-off point for each variable. When the area under the curve was statistically significant, Prevalence Ratio (PR) and 95% confidence intervals were calculated to indicate the strength of the association between the independent variable and the presence of patellar tendon abnormalities. Receiver operating characteristic curve showed that iliotibial band flexibility (p=0.006), shank-forefoot alignment (p=0.013) and Arno angle (p=0.046) were associated with patellar tendon abnormalities. Cut-off points were established and only the Prevalence Ratio of iliotibial band flexibility (cut-off point=-0.02°/kg; PR=5.26) and shank-forefoot alignment (cut-off point=24°; PR=4.42) were statistically significant. Athletes with iliotibial band or shank-forefoot alignment above the clinically relevant cut-off point had more chance to have patellar tendon abnormalities compared to athletes under the cut-off point values. These results suggest that such factors could contribute to patellar tendon overload, since patellar tendon abnormalities indicate some level of tissue damage. Both factors might be considered in future prospective studies. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  14. Extracorporeal shockwave therapy for patellar tendinopathy: a review of the literature

    OpenAIRE

    van Leeuwen, M. T.; Zwerver, J.; van den Akker-Scheek, I.

    2009-01-01

    Background and purpose: Extracorporeal shockwave therapy (EWST) has become a popular treatment for patellar tendinopathy. The purpose of this review was to study the effectiveness of ESWT treatment for patellar tendinopathy; to draft guidelines for an effective treatment protocol of ESWT treatment; and to identify topics for further research. Methods: A computerised search of the Medline and Embase databases was conducted on 1 August 2007, to identify studies dealing with the effectiveness of...

  15. Dislocation

    Science.gov (United States)

    ... There is no substitute for close supervision, no matter how safe the environment or situation appears to ... ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow ...

  16. Chronic asymptomatic dislocation of a total hip replacement: a case report

    Directory of Open Access Journals (Sweden)

    Lidder Surjit

    2009-08-01

    Full Text Available Abstract Introduction Dislocation of a prosthetic hip is the second most common complication after thromboembolic disease in patients undergoing total hip arthroplasty, with an incidence reported as 0.5 to 20%. Although the period of greatest risk for dislocation has been reported to be within the first few months after surgery, late dislocation occurs more commonly then previously thought. Case presentation A 60-year-old man underwent a right Exeter cemented total hip replacement and was subsequently discharged after appropriate follow-up. He next presented 8 years later complaining of pain in the left groin. An anterioposterior radiograph of the pelvis revealed degenerative changes in the left hip and a dislocated right total hip replacement. The dislocated femoral component had formed a neoacetabulum within the ilium, in which it was freely articulating. He remained pain-free on this side, had 5 cm of true leg length shortening with a good range of movement and was very pleased with his hip replacement. He was later placed on the waiting list for a left total hip replacement. Conclusion This case illustrates that a dislocated total hip replacement may occasionally not cause symptoms that cause significant discomfort or reduction in range of movement. The prosthetic femoral head can form a neoacetabulum allowing a full range of pain-free movement. Furthermore it emphasises that with an increased trend to earlier hospital discharge and shorter follow-up, potential complications may be missed. We urge a low index of suspicion for potential complications and suggest that regular review with radiographic follow-up should be made.

  17. Patellar denervation in total knee arthroplasty without patellar resurfacing and postoperative anterior knee pain: a meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Li, Tao; Zhou, Lei; Zhuang, Qianyu; Weng, Xisheng; Bian, Yanyan

    2014-12-01

    The aim of this meta-analysis was to investigate whether patellar denervation with electrocautery (PD) after total knee arthroplasty (TKA) could reduce the postoperative anterior knee pain (AKP). Five randomized controlled trials (RCTs) with 572 patients and 657 knees were eligible for this meta-analysis. Our results showed that PD was associated with less AKP, lower visual analogue scale (VAS), higher patellar scores and better knee function compared with no patellar denervation (NPD). Complications did not differ significantly between the two groups. The existing evidence indicates that PD may be a better approach, as it improves both anterior knee pain and knee function after TKA. Future multi-center randomized controlled studies with large sample sizes are required to verify the current findings. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Clinical Applications of Platelet-Rich Plasma in Patellar Tendinopathy

    Science.gov (United States)

    Jeong, D. U.; Lee, C.-R.; Lee, J. H.; Pak, J.; Kang, L.-W.; Jeong, B. C.

    2014-01-01

    Platelet-rich plasma (PRP), a blood derivative with high concentrations of platelets, has been found to have high levels of autologous growth factors (GFs), such as transforming growth factor-β (TGF-β), platelet-derived growth factor (PDGF), fibroblastic growth factor (FGF), vascular endothelial growth factor (VEGF), and epidermal growth factor (EGF). These GFs and other biological active proteins of PRP can promote tissue healing through the regulation of fibrosis and angiogenesis. Moreover, PRP is considered to be safe due to its autologous nature and long-term usage without any reported major complications. Therefore, PRP therapy could be an option in treating overused tendon damage such as chronic tendinopathy. Here, we present a systematic review highlighting the clinical effectiveness of PRP injection therapy in patellar tendinopathy, which is a major cause of athletes to retire from their respective careers. PMID:25136568

  19. Patellar tendon shortening for flexed knee gait in spastic diplegia.

    Science.gov (United States)

    Sossai, Roberto; Vavken, Patrick; Brunner, Reinald; Camathias, Carlo; Graham, H Kerr; Rutz, Erich

    2015-02-01

    We evaluated the outcome of three different approaches to the management of flexed knee gait patients with spastic diplegia. The three surgical procedures were patellar tendon shortening (PTS), PTS combined with rotational osteotomies of the femur and/or tibia, and PTS combined with supracondylar extension osteotomy (SEO) of the distal femur. The primary outcome measure was gait kinematics. The knee gait variable score (GVS) and the gait profile score (GPS) were derived from gait kinematics. 24 patients (16 male and 8 female), mean age 16.1 years (SD 5.8 years), who had surgery between 2002 and 2008, were followed for a mean of 22 months. Knee extension during gait improved by a mean of 20° throughout the gait cycle, with an improvement in the knee GVS of 14° (pspastic diplegia is both feasible and appropriate. Level III. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Does the adolescent patellar tendon respond to 5 days of cumulative load during a volleyball tournament?

    Science.gov (United States)

    van Ark, M; Docking, S I; van den Akker-Scheek, I; Rudavsky, A; Rio, E; Zwerver, J; Cook, J L

    2016-02-01

    Patellar tendinopathy (jumper's knee) has a high prevalence in jumping athletes. Excessive load on the patellar tendon through high volumes of training and competition is an important risk factor. Structural changes in the tendon are related to a higher risk of developing patellar tendinopathy. The critical tendon load that affects tendon structure is unknown. The aim of this study was to investigate patellar tendon structure on each day of a 5-day volleyball tournament in an adolescent population (16-18 years). The right patellar tendon of 41 players in the Australian Volleyball Schools Cup was scanned with ultrasound tissue characterization (UTC) on every day of the tournament (Monday to Friday). UTC can quantify structure of a tendon into four echo types based on the stability of the echo pattern. Generalized estimating equations (GEE) were used to test for change of echo type I and II over the tournament days. Participants played between eight and nine matches during the tournament. GEE analysis showed no significant change of echo type percentages of echo type I (Wald chi-square = 4.603, d.f. = 4, P = 0.331) and echo type II (Wald chi-square = 6.070, d.f. = 4, P = 0.194) over time. This study shows that patellar tendon structure of 16-18-year-old volleyball players is not affected during 5 days of cumulative loading during a volleyball tournament. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Patellar Tendinopathy: Clinical Diagnosis, Load Management, and Advice for Challenging Case Presentations.

    Science.gov (United States)

    Malliaras, Peter; Cook, Jill; Purdam, Craig; Rio, Ebonie

    2015-11-01

    Synopsis The hallmark features of patellar tendinopathy are (1) pain localized to the inferior pole of the patella and (2) load-related pain that increases with the demand on the knee extensors, notably in activities that store and release energy in the patellar tendon. While imaging may assist in differential diagnosis, the diagnosis of patellar tendinopathy remains clinical, as asymptomatic tendon pathology may exist in people who have pain from other anterior knee sources. A thorough examination is required to diagnose patellar tendinopathy and contributing factors. Management of patellar tendinopathy should focus on progressively developing load tolerance of the tendon, the musculoskeletal unit, and the kinetic chain, as well as addressing key biomechanical and other risk factors. Rehabilitation can be slow and sometimes frustrating. This review aims to assist clinicians with key concepts related to examination, diagnosis, and management of patellar tendinopathy. Difficult clinical presentations (eg, highly irritable tendon, systemic comorbidities) as well as common pitfalls, such as unrealistic rehabilitation time frames and overreliance on passive treatments, are also discussed. J Orthop Sports Phys Ther 2015;45(11):887-898. Epub 21 Sep 2015. doi:10.2519/jospt.2015.5987.

  2. Extracorporeal shockwave therapy for patellar tendinopathy: a review of the literature.

    Science.gov (United States)

    van Leeuwen, M T; Zwerver, J; van den Akker-Scheek, I

    2009-03-01

    Extracorporeal shockwave therapy (EWST) has become a popular treatment for patellar tendinopathy. The purpose of this review was to study the effectiveness of ESWT treatment for patellar tendinopathy; to draft guidelines for an effective treatment protocol of ESWT treatment; and to identify topics for further research. A computerised search of the Medline and Embase databases was conducted on 1 August 2007, to identify studies dealing with the effectiveness of ESWT for patellar tendinopathy. Seven articles describing the effectiveness of ESWT on patellar tendinopathy, all published after 2000, were included. These studies included a total of 283 patients (298 tendons), 204 of whom (215 tendons) were assigned to ESWT treatment. The treatment results were positive but most studies had methodological deficiencies, small numbers and/or short follow-up periods. Method of application and shockwave generation, energy level, number and frequency of treatments, use of (local) anaesthesia and method of localisation were variable. ESWT seems to be a safe and promising treatment for patellar tendinopathy with a positive effect on pain and function. Based on current knowledge it is impossible to recommend a specific treatment protocol. Further basic and clinical research into the working mechanism and effectiveness of ESWT for patellar tendinopathy are necessary.

  3. Patellar tendon re-rupture on the opposite end of the previous site of surgical repair

    Directory of Open Access Journals (Sweden)

    Bryan Thean Howe KOH

    2017-01-01

    Full Text Available We describe a rare case of a patellar tendon “re-rupture” at the opposite end of a previous proximal tendon repair. A 32-year-old male with a history of surgically repaired right proximal patellar tendon rupture presented with an acute non-traumatic right knee pain and instability during sports. Magnetic resonance imaging confirmed a complete rupture of his distal patellar tendon at the tibial tuberosity. The patellar tendon was repaired using two 5.5 mm BioCorkscrews (Arthrex inserted into the tibial tuberosity; the tendon was stitched with the No. 2 fiberwires using Krackow technique. As the patellar tendon was degenerative, the repair was augmented with a semitendinosus tendon harvested using an open tendon stripper, leaving the distal attachment intact. At 2.6 years followup he had mild anterior knee pain, range of motion 0-130[0] and was able to squat. MRI scan done at followup revealed good healing of repaired patellar tendon.

  4. Concurrent patellar fracture and lateral collateral ligament avulsion as a result of trauma in three horses.

    Science.gov (United States)

    McLellan, Jonathan; Plevin, Sarah; Taylor, Elizabeth

    2012-05-15

    3 horses were evaluated because of lameness and swelling of the stifle joint subsequent to trauma. All horses had characteristic clinical signs of stifle joint pain and effusion. A medial patellar fracture and lateral collateral ligament avulsion fracture were visible ultrasonographically in each. Radiography, including standard as well as flexed lateromedial, cranioproximal-craniodistal oblique (skyline patellar), and laterally stressed caudocranial views, revealed similar findings. Arthroscopic surgery to remove the patellar fracture was attempted in 1 horse with severe desmitis of the lateral collateral ligament; it remained lame afterward. The other 2 horses, with less severe collateral ligament damage, were managed conservatively and returned to athletic use, despite the lack of surgical intervention to repair the patellar fractures. Special radiographic views were necessary for diagnosis of medial patellar fracture and lateral collateral ligament avulsion fracture in the 3 horses. Ultrasonographic findings pertaining to the collateral ligament may be prognostically important in such situations. The severity of a fracture involving ligament avulsion may be the limiting factor in horses with this combined injury, and this factor should be considered prior to attempting surgical correction of patellar fractures.

  5. Blood circulation of patellar and achilles tendons during contractions and heating.

    Science.gov (United States)

    Kubo, Keitaro; Ikebukuro, Toshihiro

    2012-11-01

    Recent studies using ultrasonography have demonstrated that training-induced changes in the mechanical properties of tendons in plantar flexors (i.e., Achilles tendon) are lower than those in knee extensors (i.e., patellar tendon). However, the mechanisms for these phenomena are unknown. The purpose of this study was to compare changes in blood circulation of patellar and Achilles tendons by repeated muscle contractions and heating. Eleven healthy males participated in this study. During and after repeated muscle contractions (50 repetitions at 50% of the isometric maximum voluntary contraction for 3 s with 3-s relaxations) and heating (20 min), blood volume (total hemoglobin (THb)) and oxygen saturation (StO2) of the patellar and Achilles tendons were measured using red laser lights. During repeated muscle contractions, StO2 of the patellar tendon decreased significantly, but that of the Achilles tendon did not. During heating, THb and StO2 increased significantly for both tendons. Increases in THb and StO2 of the patellar tendon were significantly higher than those of the Achilles tendon (both P heating were higher than those of the Achilles tendon. This result appears to be related to the differences in the plasticity of the mechanical properties of the patellar and Achilles tendons.

  6. Hybrid dislocated control and general hybrid projective dislocated synchronization for the modified Lue chaotic system

    Energy Technology Data Exchange (ETDEWEB)

    Xu Yuhua [College of Information Science and Technology, Donghua University, Shanghai 201620 (China) and Department of Maths, Yunyang Teacher' s College, Hubei 442000 (China)], E-mail: yuhuaxu2004@163.com; Zhou Wuneng [College of Information Science and Technology, Donghua University, Shanghai 201620 (China)], E-mail: wnzhou@163.com; Fang Jianan [College of Information Science and Technology, Donghua University, Shanghai 201620 (China)

    2009-11-15

    This paper introduces a modified Lue chaotic system, and some basic dynamical properties are studied. Based on these properties, we present hybrid dislocated control method for stabilizing chaos to unstable equilibrium and limit cycle. In addition, based on the Lyapunov stability theorem, general hybrid projective dislocated synchronization (GHPDS) is proposed, which includes complete dislocated synchronization, dislocated anti-synchronization and projective dislocated synchronization as its special item. The drive and response systems discussed in this paper can be strictly different dynamical systems (including different dimensional systems). As examples, the modified Lue chaotic system, Chen chaotic system and hyperchaotic Chen system are discussed. Numerical simulations are given to show the effectiveness of these methods.

  7. Knee dislocations: a magnetic resonance imaging study correlated with clinical and operative findings

    International Nuclear Information System (INIS)

    Bui, Kimmie L.; Ilaslan, Hakan; Sundaram, Murali; Parker, Richard D.

    2008-01-01

    Our objectives were to determine retrospectively the prevalence, patients' demographics, mechanism of injury, combination of torn ligaments, associated intra-articular and extra-articular injuries, fractures, bone bruises, femoral-tibial alignment and neurovascular complications of knee dislocations as evaluated by magnetic resonance (MR) imaging. From 17,698 consecutive knee examinations by magnetic resonance imaging (MRI) over a 6-year period, 20 patients with knee dislocations were identified. The medical records of these patients were subsequently reviewed for relevant clinical history, management and operative findings. The prevalence of knee dislocations was 0.11% [95% confidence interval (95% CI) 0.06-0.16]. There were 16 male patients and four female patients, with ages ranging from 15 years to 76 years (mean 31 years). Fifteen patients had low-velocity injuries (75%), of which 11 were amateur sports related and four were from falls. Four patients (20%) had suffered high-velocity trauma (motor vehicle accidents). One patient had no history available. Anatomic alignment was present at imaging in 16 patients (80%). Eighteen patients had three-ligament tears, two had four-ligament tears. The four-ligament tears occurred with low-velocity injuries. The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) were torn in every patient; the lateral collateral ligament (LCL) was torn in 50%, and the medial collateral ligament (MCL) in 60%. Intra-articular injuries included meniscal tears (five in four patients), fractures (eight in seven patients), bone bruises (15 patients), and patellar retinaculum tears (eight partial, two complete). The most common extra-articular injury was a complete biceps femoris tendon tear (five, 25%). There were two popliteal tendon tears and one iliotibial band tear. One patient had received a vascular injury following a motor vehicle accident (MVA) and had been treated prior to undergoing MRI. Bone bruises (unrelated to

  8. Knee dislocations: a magnetic resonance imaging study correlated with clinical and operative findings

    Energy Technology Data Exchange (ETDEWEB)

    Bui, Kimmie L. [Cleveland Clinic, Department of Radiology, Cleveland, OH (United States); Cleveland Clinic, Department of Radiology, HB6, Cleveland, OH (United States); Ilaslan, Hakan; Sundaram, Murali [Cleveland Clinic, Department of Radiology, Cleveland, OH (United States); Parker, Richard D. [Cleveland Clinic, Department of Orthopaedics, Cleveland, OH (United States)

    2008-07-15

    Our objectives were to determine retrospectively the prevalence, patients' demographics, mechanism of injury, combination of torn ligaments, associated intra-articular and extra-articular injuries, fractures, bone bruises, femoral-tibial alignment and neurovascular complications of knee dislocations as evaluated by magnetic resonance (MR) imaging. From 17,698 consecutive knee examinations by magnetic resonance imaging (MRI) over a 6-year period, 20 patients with knee dislocations were identified. The medical records of these patients were subsequently reviewed for relevant clinical history, management and operative findings. The prevalence of knee dislocations was 0.11% [95% confidence interval (95% CI) 0.06-0.16]. There were 16 male patients and four female patients, with ages ranging from 15 years to 76 years (mean 31 years). Fifteen patients had low-velocity injuries (75%), of which 11 were amateur sports related and four were from falls. Four patients (20%) had suffered high-velocity trauma (motor vehicle accidents). One patient had no history available. Anatomic alignment was present at imaging in 16 patients (80%). Eighteen patients had three-ligament tears, two had four-ligament tears. The four-ligament tears occurred with low-velocity injuries. The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) were torn in every patient; the lateral collateral ligament (LCL) was torn in 50%, and the medial collateral ligament (MCL) in 60%. Intra-articular injuries included meniscal tears (five in four patients), fractures (eight in seven patients), bone bruises (15 patients), and patellar retinaculum tears (eight partial, two complete). The most common extra-articular injury was a complete biceps femoris tendon tear (five, 25%). There were two popliteal tendon tears and one iliotibial band tear. One patient had received a vascular injury following a motor vehicle accident (MVA) and had been treated prior to undergoing MRI. Bone bruises

  9. Formation of disorientations in dislocation structures during plastic deformation

    DEFF Research Database (Denmark)

    Pantleon, W.

    2002-01-01

    Disorientations developing during plastic deformation in dislocation structures are investigated. Based on expected mechanisms for the formation of different types of dislocation boundaries (statistical trapping of dislocations or differently activated slip systems) the formation of the disorient......Disorientations developing during plastic deformation in dislocation structures are investigated. Based on expected mechanisms for the formation of different types of dislocation boundaries (statistical trapping of dislocations or differently activated slip systems) the formation...

  10. Anterior bilateral temporomandibular joint dislocation: an ...

    African Journals Online (AJOL)

    Anterior dislocation of the temporomandibular joint (TMJ) though an infrequent presentation at the emergency department; often demands an immediate reduction to relieve discomfort and prevent adverse long-term sequelae. A simple and effective technique to reduce the dislocation is successfully demonstrated by putting ...

  11. Dislocation morphology in deformed and irradiated niobium

    International Nuclear Information System (INIS)

    Chang, C.P.

    1977-06-01

    Niobium foils of moderate purity were examined for the morphology of dislocations or defect clusters in the deformed or neutron-irradiated state by transmission electron microscopy. New evidence has been found for the dissociation of screw dislocations into partials on the (211) slip plane according to the Crussard mechanism: (a/2) [111] → (a/3) [111] + (a/6) [111

  12. Slip systems, lattice rotations and dislocation boundaries

    DEFF Research Database (Denmark)

    Winther, Grethe

    2008-01-01

    of dislocation structure formed, in particular the crystallographic alignment of dislocation boundaries, and the slip pattern are demonstrated. These relations are applied to polycrystals deformed in tension and rolling, producing good agreement with experiment for rolling but less good agreement for tension...

  13. Interactions between Dislocations and Grain Boundaries

    NARCIS (Netherlands)

    Soer, Wouter Anthon

    2006-01-01

    Dislocations (line defects) and grain boundaries (planar defects) are two types of lattice defects that are crucial to the deformation behavior of metals. Permanent deformation of a crystalline material is microscopically associated with the nucleation and propagation of dislocations, and extensive

  14. Traumatic atlantooccipital dislocation: two cases with survival.

    Science.gov (United States)

    Bools, J C; Rose, B S

    1986-01-01

    These two cases with long-term survival after anterior and posterior AO dislocation point out the importance of making the diagnosis. Our simple technique of rapid CT confirmation of AO dislocation is a practical adjuvant procedure, particularly in patients with suspected intracranial injury.

  15. Palmar dislocation of scaphoid and lunate

    Directory of Open Access Journals (Sweden)

    Khalid Koulali Idrissi

    2011-11-01

    Full Text Available A palmar dislocation of scaphoid and lunate is uncommon. We have found only 19 reported cases in the literature. We reported a simultaneous, divergent dislocation. The closed reduction followed by percutaneous pinning has given a good result without avascular necrosis of any carpal bone.

  16. Re-dislocation after revision total hip arthroplasty for recurrent dislocation: a multicentre study.

    Science.gov (United States)

    Yoshimoto, Kensei; Nakashima, Yasuharu; Aota, Shigeo; Kaneuji, Ayumi; Fukui, Kiyokazu; Hirakawa, Kazuo; Nakura, Nariaki; Kinoshita, Koichi; Naito, Masatoshi; Iwamoto, Yukihide

    2017-02-01

    Although most case of dislocations after total hip arthroplasty (THA) can be managed with conservative treatment, recurrent dislocation may require surgical intervention. This multicentre study was conducted to evaluate the re-dislocation rate after revision THA for recurrent dislocation, and to determine the risk factors for re-dislocation. We retrospectively reviewed the 88 hips in 88 patients who underwent revision THA for recurrent dislocation at five institutions between 1995 and 2014. The mean patient age at surgery was 68.5 years and the mean follow-up period was 53.1 months. Multivariate logistic regression was performed to identify risk factors for re-dislocation. Sixteen hips in 16 patients (18.2 %) re-dislocated at a mean of 25.5 months (range, 1-83 months) after revision THA. Multivariate analysis identified osteonecrosis of the femoral head (odds ratio [OR] = 5.62 vs. osteoarthritis) and a femoral head size hips required additional revision THA for re-dislocation. The re-dislocation rate after revision THA for recurrent dislocation remains high, suggesting the need for prevention measures. We recommend the use of a femoral head size ≥ 32 mm.

  17. Estimation of dislocations density and distribution of dislocations during ECAP-Conform process

    Science.gov (United States)

    Derakhshan, Jaber Fakhimi; Parsa, Mohammad Habibi; Ayati, Vahid; Jafarian, Hamidreza

    2018-01-01

    Dislocation density of coarse grain aluminum AA1100 alloy (140 µm) that was severely deformed by Equal Channel Angular Pressing-Conform (ECAP-Conform) are studied at various stages of the process by electron backscattering diffraction (EBSD) method. The geometrically necessary dislocations (GNDs) density and statistically stored dislocations (SSDs) densities were estimate. Then the total dislocations densities are calculated and the dislocation distributions are presented as the contour maps. Estimated average dislocations density for annealed of about 2×1012 m-2 increases to 4×1013 m-2 at the middle of the groove (135° from the entrance), and they reach to 6.4×1013 m-2 at the end of groove just before ECAP region. Calculated average dislocations density for one pass severely deformed Al sample reached to 6.2×1014 m-2. At micrometer scale the behavior of metals especially mechanical properties largely depend on the dislocation density and dislocation distribution. So, yield stresses at different conditions were estimated based on the calculated dislocation densities. Then estimated yield stresses were compared with experimental results and good agreements were found. Although grain size of material did not clearly change, yield stress shown intensive increase due to the development of cell structure. A considerable increase in dislocations density in this process is a good justification for forming subgrains and cell structures during process which it can be reason of increasing in yield stress.

  18. Dislocation evolution during plastic deformation: Equations vs. discrete dislocation dynamics study

    Science.gov (United States)

    Davoudi, Kamyar M.; Vlassak, Joost J.

    2018-02-01

    Equations for dislocation evolution bridge the gap between dislocation properties and continuum descriptions of plastic behavior of crystalline materials. Computer simulations can help us verify these evolution equations and find their fitting parameters. In this paper, we employ discrete dislocation dynamics to establish a continuum-based model for the evolution of the dislocation structure in polycrystalline thin films. Expressions are developed for the density of activated dislocation sources, as well as dislocation nucleation and annihilation rates. We demonstrate how size effect naturally enters the evolution equation. Good agreement between the simulation and the model results is obtained. The current approach is based on a two-dimensional discrete dislocation dynamics model but can be extended to three-dimensional models.

  19. Rules for Forest Interactions between Dislocations

    International Nuclear Information System (INIS)

    Wickham, L. K.; Schwarz, K. W.; Stoelken, J. S.

    1999-01-01

    The dynamical interactions of dislocations existing on intersecting glide planes have been investigated using numerical simulations based on isotropic linear elastic theory. It is found that such dislocations either repel, attract and form growing junctions, or attract and form bound crossed states. Which of these occurs can be predicted from a surprisingly simple analysis of the initial configurations. The outcome is determined primarily by the angles which the dislocations initially make with the glide-plane intersection edge, and is largely independent of the initial distance between the dislocations, their initial curvature, or ambient applied stresses. The results provide a rule for dealing with forest interactions within the context of large multiple-dislocation computations. (c) 1999 The American Physical Society

  20. Dissociated dislocations in Ni: a computational study

    International Nuclear Information System (INIS)

    Szelestey, P.; Patriarca, M.; Kaski, K.

    2005-01-01

    A systematic computational study of the behavior of a (1/2) dissociated screw dislocation in fcc nickel is presented, in which atomic interactions are described through an embedded-atom potential. A suitable external stress is applied on the system, both for modifying the equilibrium separation distance d and moving the dislocation complex. The structure of the dislocation and its corresponding changes during the motion are studied in the framework of the two-dimensional Peierls model, for different values of the ratio d/a', where a' is the period of the Peierls potential. The distance between the edge and screw components of the partials, as well as their widths, undergo a modulation with period a', as the dislocation moves, and the amplitudes of such oscillations are shown to depend on d/a'. The stress profile acting on the dislocation complex is analyzed and the effective Peierls stress is estimated for different values of d/a'

  1. Relationship between the trochlear groove angle and patellar cartilage morphology defined by 3D spoiled gradient-echo imaging

    Energy Technology Data Exchange (ETDEWEB)

    Harada, Yuko; Tokuda, Osamu; Matsunaga, Naofumi [Yamaguchi University Graduate School of Medicine, Department of Radiology, Yamaguchi (Japan); Fukuda, Kouji [Shunan Memorial Hospital, Division of Radiological Technology, Yamaguchi (Japan); Shiraishi, Gen; Motomura, Tetsuhisa [Shunan Memorial Hospital, Department of Orthopedics Surgery, Yamaguchi (Japan); Kimura, Motoichi [Customer Application Gr., GE Healthcare MR Sales and Marketing Department, Osaka (Japan)

    2012-05-15

    To examine whether the femoral trochlear groove angle (TGA) is a determinant of the patellar cartilage volume and patellar cartilage damage. Patellar cartilage was evaluated by MR imaging in 66 patients (22 males and 44 females) with knee pain. Fat-suppressed 3D spoiled gradient-echo images were used to calculate the cartilage volume and to grade the cartilage damage. The proximal and distal TGAs were measured from axial PD-weighted FSE MR images with fat suppression. For every increase in the TGA at the distal femur, the patellar cartilage volume was significantly increased by 6.07 x 10{sup -3} cm{sup 3} (95% CI: 1.27 x 10{sup -3}, 10.9 x 10{sup -3}) after adjustment for age, gender, and patellar bone volume (P < 0.05). The MR grade of medial patellar cartilage damage progressed as the distal TGA became narrower, although there was no significant correlation between the distal TGA and the MR grading of patellar cartilage damage. A more flattened distal TGA was associated with increased patellar cartilage volume. However, there was no association between TGA and patellar cartilage defects. (orig.)

  2. Effect of patellar strap and sports tape on jumper's knee symptoms: protocol of a randomised controlled trial.

    Science.gov (United States)

    de Vries, Astrid J; van den Akker-Scheek, Inge; Diercks, Ron L; Zwerver, Johannes; van der Worp, Henk

    2013-12-01

    Patellar straps or sports tapes are commonly used by athletes with patellar tendinopathy in order to reduce pain and to continue sports participation. Currently, there is no scientific evidence for the effectiveness of a patellar strap or sports tape in the management of this common injury. To investigate the effect of the use of a patellar strap and sports tape on pain and sports participation in subjects with patellar tendinopathy. The study is divided into two parts: a randomised controlled crossover experiment and a randomised controlled trial (parallel group design). 140 patients diagnosed with patellar tendinopathy recruited from sports medical centres and physiotherapist practices. In the first part of the study, participants serve as their own control by performing three functional tests under four different conditions (patellar strap, sports tape, placebo tape, and no orthosis). In the second part, participants keep a log for two weeks (control week and intervention week) about the pain experienced during and after sports and their level of sports participation. In the intervention week participants will use the orthosis assigned to them during training and competition. The amount of pain (both parts of the study) and sports participation (second part only) will be measured. To analyse the effects of the orthoses a Linear Mixed Model will be used. The knowledge gained in this study can be used by practitioners in their advice for athletes with patellar tendinopathy about using patellar strap and sports tape during sports. Copyright © 2013 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

  3. Influence of mobile dislocations on phase separation in binary alloys

    International Nuclear Information System (INIS)

    Haataja, Mikko; Leonard, Francois

    2004-01-01

    We introduce a continuum model to describe the phase separation of a binary alloy in the presence of mobile dislocations. The kinetics of the local composition and dislocation density are coupled through their elastic fields. We show both analytically and numerically that mobile dislocations modify the standard spinodal decomposition process, and lead to several regimes of growth. Depending on the dislocation mobility and observation time, the phase separation may be accelerated, decelerated, or unaffected by mobile dislocations. For any finite dislocation mobility, we show that the domain growth rate asymptotically becomes independent of the dislocation mobility, and is faster than the dislocation-free growth rate

  4. Evolution, Interaction, and Intrinsic Properties of Dislocations in Intermetallics: Anisotropic 3D Dislocation Dynamics Approach

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Qian [Iowa State Univ., Ames, IA (United States)

    2008-01-01

    The generation, motion, and interaction of dislocations play key roles during the plastic deformation process of crystalline solids. 3D Dislocation Dynamics has been employed as a mesoscale simulation algorithm to investigate the collective and cooperative behavior of dislocations. Most current research on 3D Dislocation Dynamics is based on the solutions available in the framework of classical isotropic elasticity. However, due to some degree of elastic anisotropy in almost all crystalline solids, it is very necessary to extend 3D Dislocation Dynamics into anisotropic elasticity. In this study, first, the details of efficient and accurate incorporation of the fully anisotropic elasticity into 3D discrete Dislocation Dynamics by numerically evaluating the derivatives of Green's functions are described. Then the intrinsic properties of perfect dislocations, including their stability, their core properties and disassociation characteristics, in newly discovered rare earth-based intermetallics and in conventional intermetallics are investigated, within the framework of fully anisotropic elasticity supplemented with the atomistic information obtained from the ab initio calculations. Moreover, the evolution and interaction of dislocations in these intermetallics as well as the role of solute segregation are presented by utilizing fully anisotropic 3D dislocation dynamics. The results from this work clearly indicate the role and the importance of elastic anisotropy on the evolution of dislocation microstructures, the overall ductility and the hardening behavior in these systems.

  5. A lower limb assessment tool for athletes at risk of developing patellar tendinopathy.

    Science.gov (United States)

    Mann, Kerry J; Edwards, Suzi; Drinkwater, Eric J; Bird, Stephen P

    2013-03-01

    Patellar tendon abnormality (PTA) on diagnostic imaging is part of the diagnostic criteria for patellar tendinopathy. PTA and altered landing strategies are primary risk factors that increase the likelihood of asymptomatic athletes developing patellar tendinopathy. Therefore, the aim of this study was to examine the risk factors that are predictors of the presence and severity of a PTA in junior pre-elite athletes. Ten junior pre-elite male basketball athletes with a PTA were matched with 10 athletes with normal patellar tendons. Participants had patellar tendon morphology, Victorian Institute of Sport Assessment (VISA) score, body composition, lower limb flexibility, and maximum vertical jump height measured before performing five successful stop-jump tasks. During each stop-jump task, both two-dimensional and three-dimensional kinematics and ground reaction forces were recorded. Multiple regression analyses were used to identify factors for estimating PTA presence and severity, and discriminate analysis was used to classify PTA presence. Sixty-eight percent of variance for presence of a PTA was accounted for by hip joint range of motion (ROM) and knee joint angle at initial foot-ground contact (IC) during stop-jump task and quadriceps flexibility, whereas hip joint ROM during stop-jump task and VISA score accounted for 62% of variance for PTA severity. Prediction of the presence of a PTA was achieved with 95% accuracy and 95% cross-validation. An easily implemented, reliable, and valid movement screening tool composed of three criteria enables coaches and/or clinicians to predict the presence and severity of a PTA in asymptomatic athletes. This enables identification of asymptomatic athletes at higher risk of developing patellar tendinopathy, which allows the development of effective preventative measures to aid in the reduction of patellar tendinopathy injury prevalence.

  6. Validity and reliability of the Dutch translation of the VISA-P questionnaire for patellar tendinopathy

    Directory of Open Access Journals (Sweden)

    van den Akker-Scheek Inge

    2009-08-01

    Full Text Available Abstract Background The VISA-P questionnaire evaluates severity of symptoms, knee function and ability to play sports in athletes with patellar tendinopathy. This English-language self-administered brief patient outcome score was developed in Australia to monitor rehabilitation and to evaluate outcome of clinical studies. Aim of this study was to translate the questionnaire into Dutch and to study the reliability and validity of the Dutch version of the VISA-P. Methods The questionnaire was translated into Dutch according to internationally recommended guidelines. Test-retest reliability was determined in 99 students with a time interval of 2.5 weeks. To determine discriminative validity of the Dutch VISA-P, 18 healthy students, 15 competitive volleyball players (at-risk population, 14 patients with patellar tendinopathy, 6 patients who had surgery for patellar tendinopathy, 17 patients with knee injuries other than patellar tendinopathy, and 9 patients with symptoms unrelated to their knees completed the Dutch VISA-P. Results The Dutch VISA-P questionnaire showed satisfactory test-retest reliability (ICC = 0.74. The mean (± SD VISA-P scores were 95 (± 9 for the healthy students, 89 (± 11 for the volleyball players, 58 (± 19 for patients with patellar tendinopathy, and 56 (± 21 for athletes who had surgery for patellar tendinopathy. Patients with other knee injuries or symptoms unrelated to the knee scored 62 (± 24 and 77 (± 24. Conclusion The translated Dutch version of the VISA-P questionnaire is equivalent to its original version, has satisfactory test-retest reliability and is a valid score to evaluate symptoms, knee function and ability to play sports of Dutch athletes with patellar tendinopathy.

  7. Ultrasonic Study of Dislocation Dynamics in Lithium -

    Science.gov (United States)

    Han, Myeong-Deok

    1987-09-01

    Experimental studies of dislocation dynamics in LiF single crystals, using ultrasonic techniques combined with dynamic loading, were performed to investigate the time evolution of the plastic deformation process under a short stress pulse at room temperature, and the temperature dependence of the dislocation damping mechanism in the temperature range 25 - 300(DEGREES)K. From the former, the time dependence of the ultrasonic attenuation was understood as resulting from dislocation multiplication followed by the evolution of mobile dislocations to immobile ones under large stress. From the latter, the temperature dependence of the ultrasonic attenuation was interpreted as due to the motion of the dislocation loops overcoming the periodic Peierls potential barrier in a manner analogous to the motion of a thermalized sine-Gordon chain under a small stress. The Peierls stress obtained from the experimental results by application of Seeger's relaxation model with exponential dislocation length distribution was 4.26MPa, which is consistent with the lowest stress for the linear relation between the dislocation velocity and stress observed by Flinn and Tinder.

  8. Direct observation of gliding dislocations interactions with defects in irradiated niobium single crystals by means of the high voltage electronic microscopy (HVEM)

    International Nuclear Information System (INIS)

    Otero, M.P.

    1985-01-01

    The interactions of gliding dislocations with defects in irradiated niobium that result in the formation of dislocations channels. The effects in the mechanical behaviour of [941]- and [441]- oriented Nb single crystals due to oxygen addition, neutron and electron irradiation was observed either by macroscopic deformation in a Instron machine or 'in-situ' deformation in the HVEM-High Voltage Electron Microscope. Some specimens were irradiated at IPNS-Intense Pulsed Neutron Source, at 325 K, with 5 x 10 17 n/cm 2 , others were irradiated with electrons in the HVEM. The interactions between gliding dislocations with clusters point defects and dislocations were observed. The primary mechanism for removal of the clusters by the gliding dislocations was the 'sweeping' of the clusters along with the gliding dislocations. As to the point defects, they were 'swept' by the gliding dislocations and left as aligned loops close to the intersections of the gliding dislocations with the upper and lower specimen surfaces. For the illustration of this phenomena, a schematic drawing was made. The mechanism of 'bowing-out' interaction of dislocations with defect clusters was also observed. The reported anomalous slip observed to operate in the [941]- oriented Nb was also directly observed and a qualitive explanation along with a schematic drawing was proposed. This would explain the softenig observed after the yield stress in the [941]- oriented Nb deformed in the Instron machine. (Author) [pt

  9. Simultaneous Dorsal Dislocation of the Proximal and Distal Interphalangeal Joints in the Middle Finger: A Case Report

    Directory of Open Access Journals (Sweden)

    Mohamed Ali Sbai

    2017-07-01

    Full Text Available Introduction Dorsal dislocation of a proximal or distal interphalangeal joint is a common clinical problem. However, simultaneous dislocation of both joints in the same digit is rare. Case Presentation A 32-year-old male injured his left hand third finger while biking. Examination revealed a stepladder deformity. Neurovascular examination was normal. Radiographs revealed dorsal dislocation of both the proximal and distal interphalangeal joints. The finger was reduced easily by longitudinal manual traction under the digital block. The finger was splinted in the intrinsic plus position for 3 weeks accompanied with active range of motion. After 6 months, the patient returned to normal sporting activity without limitation of motion. Conclusions In case of simultaneous dorsal dislocation of a proximal and distal interphalangeal joint, closed reduction is the treatment of choice and it could result in good and normal range of motion.

  10. Distribution of distances between dislocations in different types of dislocation substructures in deformed Cu-Al alloys

    Energy Technology Data Exchange (ETDEWEB)

    Trishkina, L., E-mail: trishkina.53@mail.ru; Zboykova, N.; Koneva, N., E-mail: koneva@tsuab.ru; Kozlov, E. [Tomsk State University of Architecture and Building, 2 Solyanaya St., Tomsk, 634003 (Russian Federation); Cherkasova, T. [Tomsk State University of Architecture and Building, 2 Solyanaya St., Tomsk, 634003 (Russian Federation); National Research Tomsk Polytechnic University, 50 Lenin Ave., Tomsk, 634050 (Russian Federation)

    2016-01-15

    The aim of the investigation was the determination of the statistic description of dislocation distribution in each dislocation substructures component forming after different deformation degrees in the Cu-Al alloys. The dislocation structures were investigated by the transmission diffraction electron microscopy method. In the work the statistic description of distance distribution between the dislocations, dislocation barriers and dislocation tangles in the deformed Cu-Al alloys with different concentration of Al and test temperature at the grain size of 100 µm was carried out. It was established that the above parameters influence the dislocation distribution in different types of the dislocation substructures (DSS): dislocation chaos, dislocation networks without disorientation, nondisoriented and disoriented cells, in the walls and inside the cells. The distributions of the distances between dislocations in the investigated alloys for each DSS type formed at certain deformation degrees and various test temperatures were plotted.

  11. Distribution of distances between dislocations in different types of dislocation substructures in deformed Cu-Al alloys

    Science.gov (United States)

    Trishkina, L.; Cherkasova, T.; Zboykova, N.; Koneva, N.; Kozlov, E.

    2016-01-01

    The aim of the investigation was the determination of the statistic description of dislocation distribution in each dislocation substructures component forming after different deformation degrees in the Cu-Al alloys. The dislocation structures were investigated by the transmission diffraction electron microscopy method. In the work the statistic description of distance distribution between the dislocations, dislocation barriers and dislocation tangles in the deformed Cu-Al alloys with different concentration of Al and test temperature at the grain size of 100 µm was carried out. It was established that the above parameters influence the dislocation distribution in different types of the dislocation substructures (DSS): dislocation chaos, dislocation networks without disorientation, nondisoriented and disoriented cells, in the walls and inside the cells. The distributions of the distances between dislocations in the investigated alloys for each DSS type formed at certain deformation degrees and various test temperatures were plotted.

  12. Thermodynamic theory of dislocation-enabled plasticity

    Science.gov (United States)

    Langer, J. S.

    2017-11-01

    The thermodynamic theory of dislocation-enabled plasticity is based on two unconventional hypotheses. The first of these is that a system of dislocations, driven by external forces and irreversibly exchanging heat with its environment, must be characterized by a thermodynamically defined effective temperature that is not the same as the ordinary temperature. The second hypothesis is that the overwhelmingly dominant mechanism controlling plastic deformation is thermally activated depinning of entangled pairs of dislocations. This paper consists of a systematic reformulation of this theory followed by examples of its use in analyses of experimentally observed phenomena including strain hardening, grain-size (Hall-Petch) effects, yielding transitions, and adiabatic shear banding.

  13. [Anterior dislocation of the fibula resulting from surgical malreduction: a case report].

    Science.gov (United States)

    Wang, Z Y; Wu, X B

    2016-04-18

    Ankle joint fracture is one of the most common types of fracture. There are many researches on the injury mechanism, treatment principles and surgical techniques. A type of injury which combines posterior dislocation of fibula, known as the Bosworth injury, is relatively rare. In 1947, Bosworth first described this type of injury as an unusual ankle fracture dislocation with fixed posterior fracture dislocation of the distal part of the fibula. In this type of fracture, the proximal fibular shaft fragment locks behind the tibialis posterior tubercle. This rare ankle fracture variant is often not recognized in initial radiographs and requires a computed tomographic (CT) scan for verification. But there are already many reports, discussing the injury mechanism, treatment principles and surgical techniques. However, there are few reports of anterior dislocation of the fibula, caused by either injury or surgery. The mechanism of the injury is still not clear. This article reports a case of anterior dislocation of the fibula. We report a patient with left ankle open fracture (Lauge-Hansen pronation-external rotation stage III, Gustilo IIIA). Open reduction and internal fixation was done in the initial surgery, but ended up with poor reduction, resulting in fibula anterior dislocation, anterior dislocation of talus and tibia fibular dislocation. The fibula was dislocated anteriorly of the tibia, which rarely happened. The patient suffered severe ankle joint dysfunction. The second operation took out the original internal fixation, reduced the fracture, and reset the internal fixation. The function of ankle joint was improved obviously after operation. But because of the initial injury and the two operations, the soft tissue around the fracture was greatly damaged. 6 months after the second operation, and the fracture still not healed, so the bone graft was carried out in the third surgery. Two months after the third surgery, the function of the ankle was significantly

  14. The impact of physically demanding work of basketball and volleyball players on the risk for patellar tendinopathy and on work limitations

    NARCIS (Netherlands)

    Van Der Worp, H.; Zwerver, J.; Kuijer, P.P.F.M.; Frings-Dresen, M.H.W.; Van Den Akker-Scheek, I.

    Patellar tendinopathy is a common injury in jumping athletes. Little is known about work-related etiological factors for patellar tendinopathy and related work limitations. The aim of this study was to identify work-related etiological factors for patellar tendinopathy and to determine the relation

  15. The impact of physically demanding work of basketball and volleyball players on the risk for patellar tendinopathy and on work limitations

    NARCIS (Netherlands)

    van der Worp, H.; Zwerver, J.; Kuijer, P. P. F. M.; Frings-Dresen, M. H. W.; van den Akker-Scheek, I.

    2011-01-01

    Patellar tendinopathy is a common injury in jumping athletes. Little is known about work-related etiological factors for patellar tendinopathy and related work limitations. The aim of this study was to identify work-related etiological factors for patellar tendinopathy and to determine the relation

  16. Prismatic dislocation loops and concentric dislocation loops in HPHT-grown diamond single crystals

    International Nuclear Information System (INIS)

    Yin, L.-W.; Li, M.-S.; Zou, Z.-D.; Gong, Z.-G.; Hao, Z.-Y.

    2003-01-01

    As-grown diamond single crystals grown from Fe-Ni-C system under high temperature-high pressure were examined by transmission electron microscopy. There exist prismatic dislocation loops and concentric dislocation loops in the diamond, which are related to the nonequilibrium nature of the diamond synthesis process. The prismatic dislocation loops may be formed by vacancy condensation during rapid cooling from high temperature, and the Burgers vector of the dislocation is determined by diffraction contrast as 1/2 . Moire fringes formed by two overlapping (1 1 1) close-packed planes were used to study concentric dislocation loops. The concentric dislocation loops may be derived from thermal stress caused by the inclusions in the diamond, which cause a strain field due to the thermal contraction difference between the inclusions and the diamond during cooling from high temperature

  17. Effect of pre-existing immobile dislocations on the evolution of geometrically necessary dislocations during fatigue

    Science.gov (United States)

    Irastorza-Landa, Ainara; Grilli, Nicolò; Van Swygenhoven, Helena

    2017-07-01

    The role of pre-existing mobile and immobile dislocation densities on the evolution of geometrical necessary dislocation densities (GNDs) during cyclic fatigue in shear is studied using a continuum dislocation-based model incorporated in a crystal plasticity finite element scheme. Clusters with different immobile dislocation densities are implemented in a homogeneous medium containing a certain mobile dislocation density. It is found that whether GND walls are formed around the initial immobile cluster (or not) strongly depends on the absolute values of initial mobile dislocation density and on the ratio between mobile and immobile densities. The results are discussed in terms of the apparent GND densities experimentally obtained using Laue micro-diffraction.

  18. Canonical Quantization of Crystal Dislocation and Electron-Dislocation Scattering in an Isotropic Media

    Science.gov (United States)

    Li, Mingda; Cui, Wenping; Dresselhaus, M. S.; Chen, Gang; MIT Team; Boston College Team

    Crystal dislocations govern the plastic mechanical properties of materials but also affect the electrical and optical properties. However, a fundamental and decent quantum-mechanical theory of dislocation remains undiscovered for decades. Here we present an exact and manageable Hamiltonian theory for both edge and screw dislocation line in an isotropic media, where the effective Hamiltonian of a single dislocation line can be written in a harmonic-oscillator-like form, with closed-form quantized 1D phonon-like excitation. Moreover a closed-form, position dependent electron-dislocation coupling strength is obtained, from which we obtained good agreement of relaxation time when comparing with classical results. This Hamiltonian provides a platform to study the effect of dislocation to materials' non-mechanical properties from a fundamental Hamiltonian level.

  19. Traumatic hip dislocation; a South East Nigeria hospital experience ...

    African Journals Online (AJOL)

    Background: Hip dislocation is a relatively common orthopaedic emergency. The hip is an inherently stable joint and substantial force is required for dislocation to occur. Thus hip dislocation is said to follow motor vehicle accidents with more than 90% of hip dislocations being posterior. Thompson and Epstein grade I and II ...

  20. Patellar tendon-lateral femoral condyle friction syndrome: MR imaging in 42 patients

    Energy Technology Data Exchange (ETDEWEB)

    Chung, C.B.; Skaf, A.; Campos, J.; Stump, X.; Resnick, D. [Dept. of Radiology, University of California, San Diego (United States); Roger, B. [Service de Radiologie Polyvalente, Groupe Hospitalier Pitie-Salpetriere, Paris (France)

    2001-12-01

    Objective: To demonstrate the MR imaging findings that occur between the posterior inferolateral patellar tendon and the lateral femoral condyle in patients with chronic anterior and or lateral knee pain. Patients and design: A retrospective review of the MR images in 42 patients who presented with chronic anterior or lateral knee pain was performed by two musculoskeletal radiologists. In 15 patients, post-contrast images were available. Results: Sagittal and axial imaging planes best demonstrated the patellar tendon and its relationship with the lateral femoral condyle. In 40 patients, there was obliteration of the fat planes and abnormal signal intensity in the lateral soft tissues of the inferior patellofemoral joint. Enhancement after administration of gadolinium was noted in all cases in which contrast was administered. Eighteen patients showed cystic changes in the soft tissues adjacent to the lateral femoral condyle in addition to fat plane obliteration. In two patients, only cystic changes were noted in the lateral soft tissues. Abnormal patellar alignment was noted in 37 patients. Patellar tendon pathology was seen in nine patients. Conclusion: In evaluating anterior knee symptoms, MR imaging allows identification of changes that may be related to patellar tendon-lateral femoral condyle friction syndrome and that should be distinguished from other causes of anterior or lateral knee pain. (orig.)

  1. Reproducibility and clinical utility of tendon palpation to detect patellar tendinopathy in young basketball players

    Science.gov (United States)

    Cook, J; Khan, K; Kiss, Z; Purdam, C; Griffiths, L

    2001-01-01

    Background—Palpation is an important clinical test for jumper's knee. Objectives—To (a) test the reproducibility of palpation tenderness, (b) evaluate the sensitivity and specificity of palpation in subjects with clinical symptoms of jumper's knee, and (c) determine whether tenderness to palpation may serve as a useful screening test for patellar tendinopathy. The yardstick for diagnosis of patellar tendinopathy was ultrasonographic abnormality. Methods—In 326 junior symptomatic and asymptomatic athletes' tendons, palpation was performed by a single examiner before ultrasonographic examination by a certified ultrasound radiologist. In 58 tendons, palpation was performed twice to test reliability. Tenderness to palpation was scored on a scale from 0 to 3 where 0 represented no pain, and 1, 2, and 3 represented mild, moderate, and severe tenderness respectively. Results—Patellar tendon palpation was a reliable examination for a single examiner (Pearson r = 0.82). In symptomatic tendons, the positive predictive value of palpation was 68%. As a screening examination in asymptomatic subjects, the positive predictive value of tendon palpation was 36–38%. Moderate and severe palpation tenderness were better predictors of ultrasonographic tendon pathology than absent or mild tenderness (ppatellar tendinopathy in a preparticipation examination. In symptomatic tendons, palpation is a moderately sensitive but not specific test. Mild tenderness in the patellar tendons in asymptomatic jumping athletes should be considered normal. Key Words: patellar tendon; ultrasound; palpation; reliability; athletes PMID:11157466

  2. The wrinkled patellar tendon: An indication of abnormality in the extensor mechanism of the knee

    International Nuclear Information System (INIS)

    Berlin, R.C.; Levinsohn, E.M.; Chrisman, H.

    1991-01-01

    Rupture of the quadriceps tendon is an uncommon condition which requires early diagnosis and treatment to avert prolonged disability. In four patients who had surgically confirmed quadriceps tendon rupture, lateral radiographs of the knee and/or sagittal magnetic resonance (MR) images demonstrated a corrugated appearance to the patellar tendon. Sagittal MR images of the knee following patellectomy in one patient and radiographs of a transverse fracture of the patella in another also demonstrated this appearance. MRI has superb contrast resolution which provides optimal visualization of the contour of the patellar tendon on sagittal images. A retrospective review of 50 consecutive knee MRI examinations was carried out to evaluate the appearance of the normal patellar tendon. In 49 of 50 patients, the sagittal images demonstrated a straight or nearly straight patellar tendon. A corrugated appearance of the patellar tendon on sagittal images indicates a reduction in the normal tensile force applied to it and indicates the need for careful evaluation of the patella and quadriceps tendon mechanism. (orig.)

  3. Quantifying the effect of hydrogen on dislocation dynamics: A three-dimensional discrete dislocation dynamics framework

    Science.gov (United States)

    Gu, Yejun; El-Awady, Jaafar A.

    2018-03-01

    We present a new framework to quantify the effect of hydrogen on dislocations using large scale three-dimensional (3D) discrete dislocation dynamics (DDD) simulations. In this model, the first order elastic interaction energy associated with the hydrogen-induced volume change is accounted for. The three-dimensional stress tensor induced by hydrogen concentration, which is in equilibrium with respect to the dislocation stress field, is derived using the Eshelby inclusion model, while the hydrogen bulk diffusion is treated as a continuum process. This newly developed framework is utilized to quantify the effect of different hydrogen concentrations on the dynamics of a glide dislocation in the absence of an applied stress field as well as on the spacing between dislocations in an array of parallel edge dislocations. A shielding effect is observed for materials having a large hydrogen diffusion coefficient, with the shield effect leading to the homogenization of the shrinkage process leading to the glide loop maintaining its circular shape, as well as resulting in a decrease in dislocation separation distances in the array of parallel edge dislocations. On the other hand, for materials having a small hydrogen diffusion coefficient, the high hydrogen concentrations around the edge characters of the dislocations act to pin them. Higher stresses are required to be able to unpin the dislocations from the hydrogen clouds surrounding them. Finally, this new framework can open the door for further large scale studies on the effect of hydrogen on the different aspects of dislocation-mediated plasticity in metals. With minor modifications of the current formulations, the framework can also be extended to account for general inclusion-induced stress field in discrete dislocation dynamics simulations.

  4. Anthropometry, physical performance, and ultrasound patellar tendon abnormality in elite junior basketball players: a cross-sectional study

    OpenAIRE

    Cook, J; Kiss, Z; Khan, K; Purdam, C; Webster, K

    2004-01-01

    Objective: Patellar tendinopathy has been reported to be associated with many intrinsic risk factors. Few have been fully investigated. This cross-sectional study examined the anthropometric and physical performance results of elite junior basketball players with normal or abnormal patellar tendons to see if any measures were associated with changes in tendon morphology.

  5. Jumper's Knee or Lander's Knee? : A Systematic Review of the Relation between Jump Biomechanics and Patellar Tendinopathy

    NARCIS (Netherlands)

    van der Worp, Henk; de Poel, H. J.; Diercks, R. L.; van den Akker-Scheek, I.; Zwerver, J.

    Patellar tendinopathy (jumper's knee) is a common injury in sports that comprise jump actions. This article systematically reviews the literature examining the relation between patellar tendinopathy and take-off and landing kinematics in order to uncover risk factors and potential prevention

  6. Risk factors for patellar tendinopathy in volleyball and basketball players : A survey-based prospective cohort study

    NARCIS (Netherlands)

    de Vries, A. J.; van der Worp, H.; Diercks, R. L.; van den Akker-Scheek, I.; Zwerver, J.

    2015-01-01

    Patellar tendinopathy (PT) is a common overuse injury of the patellar tendon in jumping athletes. In a recent large cross-sectional study from 2008 several factors were identified that may be associated with the etiology of PT. However, because of the study design no conclusions could be drawn about

  7. No effect of extracorporeal shockwave therapy on patellar tendinopathy in jumping athletes during the competitive season : A randomized clinical trial

    NARCIS (Netherlands)

    Zwerver, Johannes; Hartgens, Fred; Verhagen, Evert; van der Worp, Henk; van den Akker-Scheek, Inge; Diercks, Ronald

    Background: Patellar tendinopathy is a common overuse injury among jumping athletes. No evidence-based treatment guidelines exist. Extracorporeal shockwave therapy (ESWT) appears to be a promising treatment but its effectiveness has not been studied in athletes with patellar tendinopathy who have

  8. Patient guided Piezo-electric Extracorporeal Shockwave Therapy as treatment for chronic severe patellar tendinopathy : A pilot study

    NARCIS (Netherlands)

    Zwerver, J.; Dekker, F.; Pepping, G.J.

    2010-01-01

    Background and purpose: Patellar tendinopathy is a common overuse injury for which no evidence-based treatment guidelines exist. Extracorporeal Shock Wave Therapy (ESWT) seems to be an effective treatment for patellar tendinopathy but the most beneficial treatment strategies still need to be

  9. Extracting dislocations and non-dislocation crystal defects from atomistic simulation data

    International Nuclear Information System (INIS)

    Stukowski, Alexander; Albe, Karsten

    2010-01-01

    We describe a novel method for extracting dislocation lines from atomistic simulation data in a fully automated way. The dislocation extraction algorithm (DXA) generates a geometric description of dislocation lines contained in an arbitrary crystalline model structure. Burgers vectors are determined reliably, and the extracted dislocation network fulfills the Burgers vector conservation rule at each node. All remaining crystal defects (grain boundaries, surfaces, etc), which cannot be represented by one-dimensional dislocation lines, are output as triangulated surfaces. This geometric representation is ideal for visualization of complex defect structures, even if they are not related to dislocation activity. In contrast to the recently proposed on-the-fly dislocation detection algorithm (ODDA) Stukowski (2010 Modelling Simul. Mater. Sci. Eng. 18 015012) the new method is extremely robust. While the ODDA was designed for a computationally efficient on-the-fly analysis, the DXA method enables a detailed analysis of dislocation lines even in highly distorted crystal regions, as they occur, for instance, close to grain boundaries or in dense dislocation networks

  10. Mechanisms for decoration of dislocations by small dislocation loops under cascade damage conditions

    DEFF Research Database (Denmark)

    Trinkaus, H.; Singh, B.N.; Foreman, A.J.E.

    1997-01-01

    . This effect may arise as a result of either (a) migration and enhanced agglomeration of single SIAs in the form of loops in the strain field of the dislocation or (b) glide and trapping of SIA loops (produced directly in the cascades) in the strain field of the dislocation, In the present paper, both...... of these possibilities are examined. It is shown that the strain field of the dislocation causes a SIA depletion in the compressive as well as in the dilatational region resulting in a reduced rather than enhanced agglomeration of SIAs. (SIA depletion may, however, induce enhanced vacancy agglomeration near dislocations...

  11. Dislocation nucleation facilitated by atomic segregation

    Science.gov (United States)

    Zou, Lianfeng; Yang, Chaoming; Lei, Yinkai; Zakharov, Dmitri; Wiezorek, Jörg M. K.; Su, Dong; Yin, Qiyue; Li, Jonathan; Liu, Zhenyu; Stach, Eric A.; Yang, Judith C.; Qi, Liang; Wang, Guofeng; Zhou, Guangwen

    2018-01-01

    Surface segregation--the enrichment of one element at the surface, relative to the bulk--is ubiquitous to multi-component materials. Using the example of a Cu-Au solid solution, we demonstrate that compositional variations induced by surface segregation are accompanied by misfit strain and the formation of dislocations in the subsurface region via a surface diffusion and trapping process. The resulting chemically ordered surface regions acts as an effective barrier that inhibits subsequent dislocation annihilation at free surfaces. Using dynamic, atomic-scale resolution electron microscopy observations and theory modelling, we show that the dislocations are highly active, and we delineate the specific atomic-scale mechanisms associated with their nucleation, glide, climb, and annihilation at elevated temperatures. These observations provide mechanistic detail of how dislocations nucleate and migrate at heterointerfaces in dissimilar-material systems.

  12. Dislocations in the Kitaev honeycomb model

    Science.gov (United States)

    Petrova, Olga; Tchernyshyov, Oleg

    2013-03-01

    We study the effects of introducing dislocations into the Kitaev honeycomb model. In the gapped phase, dislocations are Z2 ``twist defects'' associated with the transmutation of electric and magnetic excitations, studied previously in the context of ZN rotor models. We show that each dislocation hosts one unpaired Majorana mode. As a consequence, twist defects have the statistics of Ising anyons. Because dislocations are confined, an additional phase is accumulated due to the change in system's energy during the braiding process. This means that the result of braiding can only be defined up to a phase. Therefore, twists are said to have projective non-Abelian statistics. Research was supported by the U.S. Department of Energy, Office of Basic Energy Sciences, Division of Materials Sciences and Engineering under Award DE-FG02-08ER46544.

  13. LASER APPLICATIONS AND OTHER TOPICS IN QUANTUM ELECTRONICS: Screw dislocations of laser speckle fields in interferograms with a circular line structure

    Science.gov (United States)

    Bobrov, B. D.

    1991-07-01

    Experimental results are used to show that circular interferograms are of interest in studies of screw dislocations of speckle-distorted laser beams because of a close correspondence between the symmetry of these interferograms and defects. The presence of dislocations transforms a system of the usual rings into a split network. Typical structure elements of such interferograms are right- and left-handed spirals connecting singular points of dislocations. Spiral fragments can be used in the diagnostics of dislocations regarded as independent defects. A method is suggested for the formation of highly directed optical beams with a low level of the usual aberrations, but with a complex phase surface topology. Screw dislocations are shown to be a natural analog of helical waves known in optics and capable of deliberate generation.

  14. Prevalence and genetics of patellar luxation in Kooiker dogs.

    Science.gov (United States)

    Wangdee, C; Leegwater, P A J; Heuven, H C M; van Steenbeek, F G; Meutstege, F J; Meij, B P; Hazewinkel, H A W

    2014-09-01

    The prevalence of patellar luxation (PL) and genetic factors potentially involved in the disorder were investigated in Dutch Kooiker dogs. A cohort of 842 Kooiker dogs, the offspring of 195 sires and 318 dams, was screened for PL from 1994 to 2011. The cohort was included in a pedigree of 1737 Kooiker dogs comprising nine generations. PL was present in 24% of screened dogs, with unilateral and bilateral luxation being observed equally frequently. Medial PL was more common (61%) than lateral PL (32%) or bidirectional PL (7%). The frequency of PL was similar in male and female dogs, with a female:male relative risk of 1.15 (95% confidence interval, CI, 0.90-1.48). The heritability of PL in the screened population was 0.27 ± 0.07. Since the start of the screening programme, the prevalence of PL decreased from 28% to 19%. A genome-wide association study of PL with 48 cases and 42 controls suggested the possible involvement of a region on chromosome 3 (Praw = 1.32 × 10(-)(5), Pgenome = 0.142), but the involvement of this region could not be confirmed in a validation group. Breeding programmes for complex diseases, such as PL, would benefit from combining pedigrees, phenotypes and genotypes, i.e. from genomic selection, as is currently the method of choice for breeding of production animals. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Posterior atlantoaxial dislocation without odontoid fracture

    International Nuclear Information System (INIS)

    Chaudhary, Reema; Raut, Abhijit; Chaudhary, Kshitij; Metkar, Umesh; Rathod, Ashok; Sanghvi, Darshana

    2008-01-01

    We report a case of posterior atlantoaxial dislocation without a fracture of the odontoid in a 35-year-old woman. There have been nine reported cases of similar injury in the English literature. The integrity of the transverse ligament following posterior atlantoaxial dislocations has not been well documented in these reports. In the present case, MRI revealed an intact transverse ligament, which probably contributed to the stability of the C1-C2 complex following closed reduction. (orig.)

  16. Dislocation of the proximal tibiofibular joint

    OpenAIRE

    Milankov Miroslav; Kecojević Vaso; Gvozdenović Nemanja; Obradović Mirko

    2013-01-01

    Introduction. Dislocation of the proximal tibiofibular joint is a rare injury. It occurs during a sports activity that includes rough twisting movements of the bent knee. The role of the proximal tibiofibular joint is to reduce torsional loads to the ankle, to distribute the bending moment of the outer side of tibia, and transfer the vertical load while standing. In the literature there is no larger series; only several cases of the proximal tibiofibular joint dislocation treated by dif...

  17. Posterior sternoclavicular dislocation: an American football injury

    DEFF Research Database (Denmark)

    Marker, L B; Klareskov, B

    1996-01-01

    Posterior dislocation of the sternoclavicular joint is uncommon, accounting for less than 0.1% of all dislocations. Since 1824 a little more than 100 cases have been reported, and the majority in the past 20 years. A review of published reports suggests that this injury is seen particularly in co...... in connection with American football. A typical case is described. The importance of this injury is that there is often a delay in diagnosis with potentially serious complications....

  18. Patient guided Piezo-electric Extracorporeal Shockwave Therapy as treatment for chronic severe patellar tendinopathy: A pilot study.

    Science.gov (United States)

    Zwerver, Johannes; Dekker, Femke; Pepping, Gert-Jan

    2010-01-01

    Patellar tendinopathy is a common overuse injury for which no evidence-based treatment guidelines exist. Extracorporeal Shock Wave Therapy (ESWT) seems to be an effective treatment for patellar tendinopathy but the most beneficial treatment strategies still need to be ascertained. Aim of this pilot study was to investigate if patient guided Piezo-electric, focused ESWT, without local anesthesia is a safe and well tolerated treatment which improves pain and function in patients with patellar tendinopathy. Nineteen male athletes with severe chronic patellar tendinopathy received 3 patient guided focused medium to high energy ESWT treatments at a weekly interval. Before and after 3 months VISA-P and VAS (pain) scores were recorded. Data on side effects and complications of treatment were also collected. No serious complications were reported and patients tolerated the treatment well. Mean VISA-P score improved from 36.1 to 50.1 (p patellar tendinopathy.

  19. The epidemiology of shoulder dislocations in Oslo.

    Science.gov (United States)

    Liavaag, S; Svenningsen, S; Reikerås, O; Enger, M; Fjalestad, T; Pripp, A H; Brox, J I

    2011-12-01

    There are few previous studies on the incidence of shoulder dislocation in the general population. The aim of the study was to report the incidence of acute shoulder dislocations in the capital of Norway (Oslo) in 2009. Patients of all ages living in Oslo, sustaining a dislocation of the glenohumeral joint, were identified using electronic diagnosis registers, patient protocols, radiological registers of the hospitals, and the Norwegian Patient Register (NPR). The overall incidence rate was 56.3 [95% confidence interval (CI) 50.2-62.4] per 100,000 person-years, with rates of 82.2 (95% CI 71.7-92.8) and 30.9 (95% CI 24.5-37.3) in men and women, respectively. The incidence of primary dislocations was 26.2 (95% CI 22.1-30.4). The overall incidence of shoulder dislocations in Oslo was higher than previously reported incidences. The incidence of primary dislocations was also higher than that in previously reported studies for the general population but it was close to the incidence reported in Malmø, Sweden. © 2011 John Wiley & Sons A/S.

  20. Generalized dynamics of moving dislocations in quasicrystals

    Energy Technology Data Exchange (ETDEWEB)

    Agiasofitou, Eleni; Lazar, Markus [Emmy Noether Research Group, Department of Physics, Darmstadt University of Technology, Hochschulstrasse 6, D-64289 Darmstadt (Germany); Kirchner, Helmut, E-mail: agiasofitou@mechanik.tu-darmstadt.d, E-mail: lazar@mechanik.tu-darmstadt.d, E-mail: kirchnerhok@hotmail.co [INM-Leibniz Institute for New Materials, Campus D22, D-66123 Saarbruecken (Germany)

    2010-12-15

    A theoretical framework for dislocation dynamics in quasicrystals is provided according to the continuum theory of dislocations. Firstly, we present the fundamental theory for moving dislocations in quasicrystals giving the dislocation density tensors and introducing the dislocation current tensors for the phonon and phason fields, including the Bianchi identities. Next, we give the equations of motion for the incompatible elastodynamics as well as for the incompatible elasto-hydrodynamics of quasicrystals. We continue with the derivation of the balance law of pseudomomentum thereby obtaining the generalized forms of the Eshelby stress tensor, the pseudomomentum vector, the dynamical Peach-Koehler force density and the Cherepanov force density for quasicrystals. The form of the dynamical Peach-Koehler force for a straight dislocation is obtained as well. Moreover, we deduce the balance law of energy that gives rise to the generalized forms of the field intensity vector and the elastic power density of quasicrystals. The above balance laws are produced for both models. The differences between the two models and their consequences are revealed. The influences of the phason fields as well as of the dynamical terms are also discussed.

  1. Adjustable patella grapple versus cannulated screw and cable technique for treatment of transverse patellar fractures.

    Science.gov (United States)

    Yan, Ning; Yang, Anli; Liu, Xiaodong; Cai, Feng; Liu, Liang; Chang, Shimin

    2014-03-01

    Although the cannulated screw and cable (CSC) tension band technique is an effective method for fixation of transverse patellar fractures, it has shortcomings, such as extensive soft tissue damage, osseous substance damage, and complex manipulation. We conducted a retrospective comparison of the adjustable patella grapple (APG) technique and the CSC tension band technique. We retrospectively reviewed 78 patients with transverse patellar fractures (45 in the APG group and 33 in the CSC group). Follow-up was 18 months. Comparison criteria were operation time, fracture reduction, fracture healing time, the knee injury and osteoarthritis outcome score for knee function, and complications. The APG group showed shorter operation time and equal fracture reduction, fracture healing time, and knee function compared with the CSC group. Eleven patients in the APG group experienced skin irritation generated by implants. There was no complication in the CSC group. The APG technique should be considered as an alternative method for treatment of transverse patellar fractures.

  2. An Unusual Knee Trauma: Combined Rupture of Medial Collateral Ligament and Patellar Tendon

    Directory of Open Access Journals (Sweden)

    T. De Baere

    2014-01-01

    Full Text Available We present the case of a combined lesion of the medial collateral ligament (MCL and patellar tendon of the knee in a 45-year-old man, after a fall while skiing. Although there are numerous publications concerning associated tears of MCL and other knee ligaments, a combination of MCL tear with a rupture of the patellar tendon is very rare. After a review of the literature and treatment guidelines about these lesions, the clinical case is described and discussed. This knee trauma was treated with a transosseous reinsertion of the patellar tendon, which was reinforced by an allograft of fascia lata, followed by a direct suture of the MCL, which was reinforced with the lateral semitendinosus tendon.

  3. In vivo Evaluation of Patellar Tendon Stiffness in Individuals with Patellofemoral Pain Syndrome

    Directory of Open Access Journals (Sweden)

    Hsin-Yi Liu

    2008-01-01

    Full Text Available The objective of this study was to utilise an ultrasonic technique to assess the effect of patellofemoral pain syndrome (PFPS on the mechanical properties of the patellar tendon. Seven subjects with PFPS and seven matched control subjects volunteered to participate in this study. Subjects were asked to perform isometric maximal voluntary contractions of the knee extensors while their knee extension torque was monitored and the displacement of the patellar tendon was recorded with an ultrasonic system. Our results showed significantly lower tendon stiffness (by ∼30% in the PFPS subjects. Although tendon secant modulus was lower by 34% in the PFPS subjects, the difference was not statistically significant. Therefore, we conclude that the ultrasonic technique was able to detect a decrease in the structural stiffness of the patellar tendon associated with PFPS. The decrease in tendon stiffness was moderately correlated with the length of symptoms in these individuals.

  4. Tendinopathy alters cumulative transverse strain in the patellar tendon after exercise.

    Science.gov (United States)

    Wearing, Scott C; Locke, Simon; Smeathers, James E; Hooper, Sue L

    2015-02-01

    This research evaluated the effect of tendinopathy on the cumulative transverse strain response of the patellar tendon to a bout of resistive quadriceps exercise. Nine adults with unilateral patellar tendinopathy (age, 18.2 ± 0.7 yr; height, 1.92 ± 0.06 m; weight, 76.8 ± 6.8 kg) and 10 healthy adults free of knee pain (age, 17.8 ± 0.8 yr; height, 1.83 ± 0.05 m; weight, 73.2 ± 7.6 kg) underwent standardized sagittal sonograms (7.2-14 MHz linear array transducer) of both patellar tendons immediately before and after 45 repetitions of a double-leg decline squat exercise performed against a resistance of 145% body weight. Tendon thickness was determined 5 and 25 mm distal to the patellar pole. Transverse Hencky strain was calculated as the natural log of the ratio of post- to preexercise tendon thickness and expressed as percentage. Measures of tendon echogenicity were calculated within the superficial and deep aspects of each tendon site from grayscale profiles. Intratendinous microvessels were evaluated using power Doppler ultrasound. The cumulative transverse strain response to exercise in symptomatic tendinopathy was significantly lower than that in asymptomatic and healthy tendons (P tendinopathy score. This study is the first to show that patellar tendinopathy is associated with altered morphological and mechanical response of the tendon to exercise, which is manifest by reduction in cumulative transverse strain and microvascularity, when present. Research directed toward identifying factors that influence the acute microvascular and transverse strain response of the patellar tendon to exercise in the various stages of tendinopathy is warranted.

  5. Functional capability is enhanced with semitendinosus than patellar tendon ACL repair.

    Science.gov (United States)

    Rudroff, Thorsten

    2003-09-01

    The patellar and semitendinosus tendon autograft are the two most common techniques that orthopedic surgeons use to reconstruct the anterior cruciate ligament (ACL). It has not been established, however, whether either of these techniques provides a greater functional advantage to the patient. To identify patients' functional capabilities after reconstruction of the ACL with a patellar or semitendinosus tendon autograft. Forty male soccer players volunteered for the study and were assigned to three homogeneous groups: individuals who had patellar tendon reconstruction (N = 15), individuals who had semitendinosus tendon reconstruction (N = 15), and a control group (N = 10). All patients had undergone surgery 2 yr before this study and received the same rehabilitation training. The testing procedures included measurement of thigh circumference, maximal isometric strength of quadriceps and hamstrings, two- and one-legged jump, squat and gait analysis. Kinetic, kinematic, and electromyographic data were collected. The patellar tendon group exhibited lower (P < 0.05) coactivation of the agonist and antagonist muscles around the knee joint during the squat movement and lower stabilization- and landing degrees during the jumps. Furthermore, the patellar tendon group had a shorter stance phase and reached the first vertical maximum later with the impaired leg while walking (720.2 +/- 15.6 ms vs 740.3 +/- 14.3 ms, and 24.3 +/- 0.64% vs 22.9 +/- 0.74% of stance phase), which was not observed in the semitendinosus tendon and control groups. Functional performance is compromised in patients who undergo a patellar tendon graft compared with a semitendinosus graft, possibly due to an altered activation of the quadriceps and hamstring muscles.

  6. Bilateral posterior crystalline lens dislocations in an otherwise healthy child

    Directory of Open Access Journals (Sweden)

    AlShehri, Omar A.

    2017-10-01

    Full Text Available Introduction: Ectopia lentis is defined as a crystalline lens displacement, either partially or completely, due to zonular abnormalities. It can be a result of trauma, hereditary ocular disease, or part of systemic diseases, like Marfan syndrome and homocystinuria.Case description: We report a case of a medically free 16-year-old girl, who was referred to our hospital complaining of poor vision and a squint in both eyes since childhood. Her history included a traffic accident when she was one-year-old. She was previously diagnosed with alternating esotropia, which was treated with glasses, alternating patching, and bilateral Botox injections. On examination, she had a visual acuity of 6/7.5 with correction in the right eye and 6/6 with correction in the left eye. She had an esotropia of 60 prism diopters, which was partially corrected to 40 prism diopters for near and distance vision. Fundus examination showed myopic changes in each eye and dislocated lenses in the posterior pole at 6 o’clock. Our case was stable, so we used conservative management with contact lenses.Conclusion: Bilateral posterior lens dislocation is very rare. A proper examination is important and early diagnosis can prevent serious complications, such as retinal detachment or pupillary block glaucoma.

  7. Tear patterns, surgical repair, and clinical outcomes of patellar tendon ruptures after anterior cruciate ligament reconstruction with a bone-patellar tendon-bone autograft.

    Science.gov (United States)

    Benner, Rodney W; Shelbourne, K Donald; Urch, Scott E; Lazarus, David

    2012-08-01

    Patellar tendon ruptures are rare after graft harvest for anterior cruciate ligament (ACL) reconstruction. Few reports are available in the literature. To report the common tear patterns and results of treatment with tendon repair and cable augmentation. Case series; Level of evidence, 4. All tendon ruptures were repaired to bone with suture anchors and augmented with a Dall-Miles cable, followed by an aggressive rehabilitation protocol. The tear location was recorded. Range of motion, strength, and subjective survey testing were conducted preoperatively and postoperatively. Thirteen patellar tendon ruptures were found from our database of 5364 ACL reconstructions, for an incidence of 0.24%. Seven ruptures occurred from the patellar origin medially and the tibial attachment laterally in a Z-shaped pattern. Four were completely distal, and 2 were completely proximal ruptures. All patients exhibited early flexion loss, but 11 of 13 patients maintained full, terminal hyperextension throughout treatment. The mean postoperative side-to-side flexion deficit was 33° at 1 month, 6° at 3 months, and 3° at latest follow-up at a mean of 4.8 years after tendon repair (range, 1-16 years). By International Knee Documentation Committee (IKDC) criteria, 10 patients had normal flexion, and 3 were nearly normal at latest follow-up. Twelve patients had normal extension, and 1 had nearly normal extension at latest follow-up. Mean isokinetic quadriceps muscle strength was 68.7% of the other side at 3 months after repair and 100.0% at latest follow-up, occurring at a mean of 47.5 months (range, 12-120 months). At a mean of 2 years (range, 1-4 years) after repair, the mean modified Noyes subjective score was 89.8 ± 9.2. Patellar tendon ruptures are rare after ACL graft harvest. These ruptures usually occur in either a proximal-medial and distal-lateral pattern or an entirely distal pattern, in contrast to the proximal-only tear pattern commonly observed in unharvested patellar

  8. Anterior knee pain after total knee arthroplasty: does it correlate with patellar blood flow?

    Science.gov (United States)

    Kohl, Sandro; Evangelopoulos, Dimitrios S; Hartel, Maximilian; Kohlhof, Hendrik; Roeder, Christoph; Eggli, Stefan

    2011-09-01

    Total knee arthroplasty (TKA) disturbs patellar blood flow, an unintended accompaniment to TKA that may be a cause of postoperative anterior knee pain. We examine whether disrupted patellar blood flow correlates with anterior knee pain following TKA. In 50 patients (21 men, 29 women) undergoing TKA, we compared patellar blood flow at flexions 0° to 30°, 60°, 90°, and 110° before and after medial parapatellar arthrotomy to pre- and postoperative anterior knee pain scores by means of a laser Doppler flowmeter (LDF) probe. Anterior knee pain was assessed using the pain intensity numeric rating scale (NRS) of 0-10 (0-no, 10-worst pain). Based on the NRS pain values, patients were divided into two main groups: group A (n = 34) with no pain or discomfort (NRS range 0-4) and group B (n = 16) with anterior knee pain (NRS range 5-10). Patients of group B demonstrated a significant decrease in blood flow before arthrotomy at flexions from 0° to 90°, and 110° and from 0° to 60°, 90°, and 110° after arthrotomy. For group A, a significant decrease in blood flow was detected at flexions from 0° to 90°, and 110° before and after arthrotomy. For both groups, medial arthrotomy did not have a statistically significant influence on patellar blood flow (margin of significance P anterior knee pain (mean NRS 7.1 ± 1.7). At 2-year follow-up, pain significantly decreased (NRS 3.1 ± 2.1) and only 4 of the 16 patients (25%) complained of moderate anterior pain (average NRS 5.7 ± 0.5), while 8 of 16 (50%) patients reported discomfort (mean NRS 3.5 ± 1.8) around the patella. Patients in group A also demonstrated a significant decrease in pain intensity (from NRS 1.5 ± 1.4 preoperatively to NRS 0.4 ± 1.5 at 2-year follow-up). Statistical analysis demonstrated no statistically significant correlation between pre-arthrotomy/post-arthrotomy patellar blood flow and the presence of preoperative and postoperative anterior knee pain. Only the degree of flexion had an influence on

  9. MR imaging of patellar cartilage degeneration at 0.02 T

    International Nuclear Information System (INIS)

    Koskinen, S.K.; Komu, M.; Aho, H.J.; Kormano, M.; Turku University Hospital

    1991-01-01

    MR imaging with a 0.02 T resistive magnet was used to establish the correlation between the histologic grading of patellar cartilage degeneration and fat water separation images or T1- and T2-relaxation times. We examined 23 cadaveric patellae. There was a positive correlation between histologically graded cartilage degeneration and T1-relaxation time. Patellar cartilage was well differentiated from surrounding structures on chemical shift water proton images, and an evaluation of cartilage degeneration was possible. No correlation was found between cartilage degeneration damage and T2-relaxation time. Chemical shift imaging at 0.02 T is easy to perform and gives further information of cartilage disorders. (orig.)

  10. [Acute bilateral lesion of the patellar tendon associated to diabetes mellitus. Case report].

    Science.gov (United States)

    Ramírez-Castillo, Héctor David; Carbajal-Contreras, Rubén; González-Morales, Diana Deyanira

    2010-01-01

    The bilateral patellar tendon tear is very infrequent. Various pathological conditions may affect the extensor mechanism including kidney disease, diabetes mellitus, hyperparathyroidism, rheumatoid arthritis, systemic lupus erythematosus, osteomalacia, infection, obesity, corticosteroid therapy and even osteogenesis imperfect. We present the case of a 43-year-old male with a history of type-2 diabetes mellitus, systemic hypertension and exogenous obesity, who sustained a bilateral patellar tendon tear. He received surgical and medical treatment and was followed-up for one year, with satisfactory functional outcomes.

  11. Dislocation Dynamics in Al-Li Alloys. Mean Jump Distance and Activation Length of Moving Dislocations

    NARCIS (Netherlands)

    Hosson, J.Th.M. De; Huis in 't Veld, A.; Tamler, H.; Kanert, O.

    1984-01-01

    Pulsed nuclear magnetic resonance proved to be a complementary new technique for the study of moving dislocations in Al-Li alloys. The NMR technique, in combination with transmission electron microscopy and strain-rate change experiments have been applied to study dislocation motion in Al-2.2 wt% Li

  12. Evaluation of traumatic atlantooccipital dislocations.

    Science.gov (United States)

    Lee, C; Woodring, J H; Goldstein, S J; Daniel, T L; Young, A B; Tibbs, P A

    1987-01-01

    The diagnosis of traumatic atlantooccipital dislocation (AOD) from the cross-table lateral radiograph is difficult because of problems in demonstrating the complex anatomy of this area and the intricate radiographic methods used to diagnose AOD. Although CT or polytomography seem to be the most accurate diagnostic methods, it is often the lateral radiograph from which the diagnosis and further decisions are made. To determine both the best radiographic method for diagnosing AOD from the lateral radiograph and the role of CT and tomography in the diagnosis of AOD, the literature was reviewed concerning how the diagnosis of AOD has been obtained. In addition, the Wholey dens-basion line, the Powers ratio, the Dublin method of diagnosing AOD, and measurement of the atlantooccipital joint width were applied to 12 cases of traumatic AOD; and the Wholey dens-basion line and the Powers ratio were determined in 100 normal adults and 50 normal children. An alternative plain radiographic method for diagnosing AOD was developed, called the X-line method. This was the most accurate of the methods tested, correctly diagnosing AOD in 75% of cases. The Wholey dens-basion line and direct measurement of the atlantooccipital joint width were each correct in 50% of cases, the Powers ratio in 33% of cases, and the Dublin method in only 25% of cases. Ultimately, either CT or polytomography should provide the definitive diagnosis. In this regard high-resolution CT with reformatted coronal and sagittal images generated from 2-mm thin axial slices appeared to have the most promise as the first study of choice.

  13. ARE LEFT HANDED SURGEONS LEFT OUT?

    OpenAIRE

    SriKamkshi Kothandaraman; Balasubramanian Thiagarajan

    2012-01-01

    Being a left-handed surgeon, more specifically a left-handed ENT surgeon, presents a unique pattern of difficulties.This article is an overview of left-handedness and a personal account of the specific difficulties a left-handed ENT surgeon faces.

  14. Hybrid Dislocated Control and General Hybrid Projective Dislocated Synchronization for Memristor Chaotic Oscillator System

    Directory of Open Access Journals (Sweden)

    Junwei Sun

    2014-01-01

    Full Text Available Some important dynamical properties of the memristor chaotic oscillator system have been studied in the paper. A novel hybrid dislocated control method and a general hybrid projective dislocated synchronization scheme have been realized for memristor chaotic oscillator system. The paper firstly presents hybrid dislocated control method for stabilizing chaos to the unstable equilibrium point. Based on the Lyapunov stability theorem, general hybrid projective dislocated synchronization has been studied for the drive memristor chaotic oscillator system and the same response memristor chaotic oscillator system. For the different dimensions, the memristor chaotic oscillator system and the other chaotic system have realized general hybrid projective dislocated synchronization. Numerical simulations are given to show the effectiveness of these methods.

  15. Treatment Options for Patellar Tendinopathy: A Systematic Review.

    Science.gov (United States)

    Everhart, Joshua S; Cole, Devon; Sojka, John H; Higgins, John D; Magnussen, Robert A; Schmitt, Laura C; Flanigan, David C

    2017-04-01

    To compare the efficacy of common invasive and noninvasive patellar tendinopathy (PT) treatment strategies. A systematic search was performed in PubMed, Google Scholar, CINAHL, UptoDate, Cochrane Reviews, and SPORTDiscus. Fifteen studies met the following inclusion criteria: (1) therapeutic outcome trial for PT, and (2) Victorian Institute of Sports Assessment was used to assess symptom severity at follow-up. Methodological quality and reporting bias were evaluated with a modified Coleman score and Begg's and Egger's tests of bias, respectively. A total of 15 studies were included. Reporting quality was high (mean Coleman score 86.0, standard deviation 9.7), and there was no systematic evidence of reporting bias. Increased duration of symptoms resulted in poorer outcomes regardless of treatment (0.9% decrease in improvement per additional month of symptoms; P = .004). Eccentric training with or without core stabilization or stretching improved symptoms (61% improvement in the Victorian Institute of Sports Assessment score, 95% confidence interval [CI] 53% to 69%). Surgery in patients refractory to nonoperative treatment also improved symptoms (57%, 95% CI 52% to 62%) with similar outcomes among arthroscopic and open approaches. Results from shockwave (54%, 95% CI 22% to 87%) and platelet-rich plasma (PRP) studies (55%, 95% CI 5% to 105%) varied widely though PRP may accelerate early recovery. Finally, steroid injection provided no benefit (20%, 95% CI -20% to 60%). Initial treatment of PT can consist of eccentric squat-based therapy, shockwave, or PRP as monotherapy or an adjunct to accelerate recovery. Surgery or shockwave can be considered for patients who fail to improve after 6 months of conservative treatment. Corticosteroid therapy should not be used in the treatment of PT. Level IV, systematic review of Level II-IV studies. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  16. Unusual combination of posterior femoral head dislocation with anterior and posterior wall fractures in the ipsilateral acetabulum.

    Science.gov (United States)

    Chen, Wei; Su, Yanling; Zhang, Yingze; Zhang, Qi; Zheng, Zhanle; Pan, Jinshe

    2010-06-09

    Although hip dislocation combined with acetabular fracture is not an uncommon injury, anterior acetabular wall fractures rarely occur in patients who have posterior fracture-dislocations of the hip. This article presents a unique case of anterior and posterior wall fractures of the ipsilateral acetabulum in a patient who sustained traumatic posterior hip dislocation that resulted from a high-speed motor vehicle accident. The initial imaging evaluation, which did not include the obturator oblique view, revealed no concomitant anterior acetabular wall fracture. Repeated manipulative reductions were unsuccessful in reducing the displaced hip joint. Pelvic computed tomography (CT) scans revealed the initially missed anterior acetabular wall fracture fragments incarcerated in the left hip joint in addition to the hip dislocation and the posterior acetabular wall fracture. The incarcerated bone fragments lay between the anterior wall and the femoral head, and between the posterior wall and the femoral head, which appeared to derive from both anterior and posterior acetabular walls, respectively. Open reduction and internal fixation was performed to manage the posterior dislocation and associated acetabular fractures. Intraoperatively, the major anterior wall fragment was used to reconstruct the defected posterior wall. This case highlights the necessity of suspicion and pre- and postoperative monitoring of the obturator oblique view and CT scans to detect the potentially existing anterior acetabular wall fracture. Early surgical intervention is important to guarantee satisfactory outcomes of such complex fracture-dislocation injuries. Copyright 2010, SLACK Incorporated.

  17. Do Changes in Patellofemoral Joint Offset Lead to Adverse Outcomes in Total Knee Arthroplasty With Patellar Resurfacing? A Radiographic Review.

    Science.gov (United States)

    Matz, Jacob; Howard, James L; Morden, David J; MacDonald, Steven J; Teeter, Matthew G; Lanting, Brent A

    2017-03-01

    Patellofemoral joint biomechanics contribute to anterior knee pain, instability, and dysfunction following total knee arthroplasty (TKA). Information about specific factors leading to anterior knee pain and dysfunction is currently limited. Changes in patellofemoral joint offset (PFO) refers to a mismatch between the preoperative and postoperative anteroposterior geometry of the patellofemoral joint. It remains unclear whether these changes lead to adverse outcomes in TKA. A retrospective radiographic review of 970 knees pre-TKA and post-TKA was completed to correlate the radiographic and clinical outcomes of changing the PFO using a posterior-stabilized single knee design with patellar resurfacing. A total of 970 patients were reviewed. Postoperatively, the anterior femoral offset, anteroposterior femoral size, and anterior patellar offset were changed in 40%, 60%, and 71% of knees, respectively, compared to preoperative values. The Western Ontario and McMasters Osteoarthritis Index total score as well as subscale scores for pain and function were not significantly affected by an increase or decrease in PFO. Similarly, Knee Society Scores and range of motion were not significantly affected. Increased anterior patellar offset was, however, associated with increased postoperative patellar tilt. Postoperative patellar tilt was not correlated with adverse patient satisfaction scores or loss of range of motion. Changes in PFO (decreased, maintained, or increased) are common post-TKA and are not associated with a difference in clinical outcomes. Increases in anterior patellar offset led to increased patellar tilt, which was not associated with adverse patient satisfaction scores. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Patellar tracking and anterior knee pain are similar after medial parapatellar and midvastus approaches in minimally invasive TKA.

    Science.gov (United States)

    Pongcharoen, Boonchana; Pongcharoen, Boonchna; Yakampor, Thanasak; Charoencholvanish, Keerati

    2013-05-01

    Since the medial parapatellar (MPP) approach in conventional TKA can cause patellar maltracking and anterior knee pain, some orthopaedic surgeons use the midvastus (MV) approach instead of the MPP approach to reduce patellar maltracking. Minimally invasive surgical (MIS) TKA has been developed to limit the damage to the surrounding muscle and reduce the necessity of patellar eversion during surgery. Thus, MIS TKA might be associated with proper patellar tracking and a low incidence of anterior knee pain. However, this presumption has not been confirmed. We asked whether the incidence of patellar maltracking and anterior knee pain differed with the MV and MPP in association with MIS TKA. We prospectively followed 59 patients (60 knees) treated with 60 primary cemented MIS TKAs from August 2009 to September 2010. We randomized the patients into two groups: 30 who had a limited MPP approach and 30 who had a mini-MV approach. We recorded the occurrence of anterior knee pain, patellar tilting, and subluxation. The minimum followup was 12 months (mean, 18.03 months; range, 12.00-25.08 months). We found no differences in anterior knee pain (two of 30, 7% versus two of 30, 7%), mean patellar tilt (3.4º ± 2.9º versus 3.0 ± 2.3º), and mean patellar subluxation (1.5 ± 1.1 mm versus 1.1 ± 0.7 mm) between the limited MPP and mini-MV groups, respectively. MIS TKA using either the MPP or MV approach has a low incidence of patellar maltracking and anterior knee pain.

  19. Association between obesity and magnetic resonance imaging defined patellar tendinopathy in community-based adults: a cross-sectional study

    Science.gov (United States)

    2014-01-01

    Background Patellar tendinopathy is a common cause of activity-related anterior knee pain. Evidence is conflicting as to whether obesity is a risk factor for this condition. The aim of this study was to determine the relationship between obesity and prevalence of magnetic resonance imaging (MRI) defined patellar tendinopathy in community-based adults. Methods 297 participants aged 50–79 years with no history of knee pain or injury were recruited from an existing community-based cohort. Measures of obesity included measured weight and body mass index (BMI), self-reported weight at age of 18–21 years and heaviest lifetime weight. Fat-free mass and fat mass were measured using bioelectrical impedance. Participants underwent MRI of the dominant knee. Patellar tendinopathy was defined on both T1- and T2-weighted images. Results The prevalence of MRI defined patellar tendinopathy was 28.3%. Current weight (OR per kg = 1.04, 95% CI 1.01-1.06, P = 0.002), BMI (OR per kg/m2 = 1.10, 95% CI 1.04-1.17, P = 0.002), heaviest lifetime weight (OR per kg = 1.03, 95% CI 1.01-1.05, P = 0.007) and weight at age of 18–21 years (OR per kg = 1.03, 95% CI 1.00-1.07, P = 0.05) were all positively associated with the prevalence of patellar tendinopathy. Neither fat mass nor fat-free mass was associated with patellar tendinopathy. Conclusion MRI defined patellar tendinopathy is common in community-based adults and is associated with current and past history of obesity assessed by BMI or body weight, but not fat mass. The findings suggest a mechanical pathogenesis of patellar tendinopathy and patellar tendinopathy may be one mechanism for obesity related anterior knee pain. PMID:25098796

  20. Rare Inferior Shoulder Dislocation (Luxatio Erecta)

    Science.gov (United States)

    Cift, Hakan; Soylemez, Salih; Demiroglu, Murat; Ozkan, Korhan; Ozden, Vahit Emre; Ozkut, Afsar T.

    2015-01-01

    Although shoulder dislocations have been seen very frequently, inferior dislocation of shoulder constitutes only 0.5% of all shoulder dislocations. We share our 4 patients with luxatio erecta and present their last clinical control. 2 male and 2 female Caucasian patients were diagnosed as luxatio erecta. Patients' ages were 78, 62, 65, and 76. All patients' reduction was done by traction-abduction and contour traction maneuver in the operating room. The patients had no symptoms and no limitation of range of motion of their shoulder at their last control. Luxatio erecta is seen rarely, and these patients may have neurovascular injury. These patients should be carefully examined and treated by the orthopaedic and traumatology surgeons. PMID:25883820

  1. Rare Inferior Shoulder Dislocation (Luxatio Erecta

    Directory of Open Access Journals (Sweden)

    Hakan Cift

    2015-01-01

    Full Text Available Although shoulder dislocations have been seen very frequently, inferior dislocation of shoulder constitutes only 0.5% of all shoulder dislocations. We share our 4 patients with luxatio erecta and present their last clinical control. 2 male and 2 female Caucasian patients were diagnosed as luxatio erecta. Patients’ ages were 78, 62, 65, and 76. All patients’ reduction was done by traction-abduction and contour traction maneuver in the operating room. The patients had no symptoms and no limitation of range of motion of their shoulder at their last control. Luxatio erecta is seen rarely, and these patients may have neurovascular injury. These patients should be carefully examined and treated by the orthopaedic and traumatology surgeons.

  2. Void growth suppression by dislocation impurity atmospheres

    International Nuclear Information System (INIS)

    Weertman, J.; Green, W.V.

    1976-01-01

    A detailed calculation is given of the effect of an impurity atmosphere on void growth under irradiation damage conditions. Norris has proposed that such an atmosphere can suppress void growth. The hydrostatic stress field of a dislocation that is surrounded by an impurity atmosphere was found and used to calculate the change in the effective radius of a dislocation line as a sink for interstitials and vacancies. The calculation of the impurity concentration in a Cottrell cloud takes into account the change in hydrostatic pressure produced by the presence of the cloud itself. It is found that void growth is eliminated whenever dislocations are surrounded by a condensed atmosphere of either oversized substitutional impurity atoms or interstitial impurity atoms. A condensed atmosphere will form whenever the average impurity concentration is larger than a critical concentration

  3. Simulation of thermally activated dislocation glide

    International Nuclear Information System (INIS)

    Roennpagel, D.; Mohles, V.

    1994-01-01

    Solid solution hardening was investigated by simulating the motion of a flexible dislocation in thermal equilibrium while overcoming obstacles by thermal activation. In a first approach, the waiting times before activation were analysed at several temperatures, external stresses and segment lengths. From statistical studies of such activation event, the effective attack frequency, Gibb's free enthalpy of activation and the activation volume were derived in strict analogy to the analysis of experimental data. As a second approach the average velocity of a dislocation gliding over an infinite row of equidistant obstacles was calculated by simulation. The temperature dependence of this speed significantly differs from that of the waiting times, indicating that kinetic effects must not be neglected even at high at high temperatures where dislocation motion is said to be 'overdamped'. (au)

  4. Anterior Cruciate Ligament Reconstruction using Bone Patellar Tendon Bone autograft in ACL deficient Knee

    Directory of Open Access Journals (Sweden)

    Navin Kumar Karn

    2015-12-01

    Full Text Available Background & Objectives: Injury to Anterior Cruciate Ligament (ACL reconstruction has increased because of increased interest in sports. There are various grafts used for reconstruction of ACL, for example, Bone Patellar Tendon Bone, Hamstring etc. The study was conducted to evaluate the results of Bone Patellar Tendon Bone graft used for reconstruction of Anterior Cruciate Ligament.Materials & Methods: 40 patients with chronic ACL deficient knee presenting to Neuro Hospital from July 2011 to June 2013 were included in the study. The patients with intraarticular fracture of knee, severe OA knee, local active or suspected infection and systemic disease that might influence the study results were excluded from the study. Bone patellar tendon bone graft was harvested from ipsilateral knee in all the cases. The patient was followed till 2 year with specified programme of rehabilitation. The pain was assessed using VAS and the function of the knee was assessed using Modified WOMAC knee index.Results: The long term satisfactory results in terms of functional stability, symptom relief and return to preinjury level of activity was seen in 32 cases (80%. Two knees got infected out of which one required arthroscopic debridement. Mean visual analogue scale was 8 and modified WOMAC knee score was 3 at 2 year follow up.Conclusion: Bone patellar tendon bone graft is useful in high demand patients and cost effective option with high patient satisfaction rate for reconstruction of ACL.JCMS Nepal. 2015;11(3:12-15.

  5. Progression of patellar tendinitis following treatment with platelet-rich plasma: case reports

    NARCIS (Netherlands)

    Bowman, Karl F.; Muller, Bart; Middleton, Kellie; Fink, Christian; Harner, Christopher D.; Fu, Freddie H.

    2013-01-01

    The use of platelet-rich plasma (PRP) is becoming more attractive given its favourable side effect profile and autologous nature, leading to rapid clinical adoption in the absence of high-level evidence. We are presenting three patients who developed a progression of patellar tendinitis following

  6. Bilateral fractures through "giant" patellar tendon ossicles: a late sequela of Osgood-Schlatter disease.

    Science.gov (United States)

    Konsens, R M; Seitz, W H

    1988-08-01

    Osgood-Schlatter disease is a common condition which affects many adolescents. It is generally a self-limiting process with a finite clinical course and late sequelae are notably uncommon. In this paper we present a unique case of bilateral fractures through "giant" patellar tendon ossicles in an adult with a history of Osgood-Schlatter disease.

  7. Pain assessment in patellar tendinopathy using pain pressure threshold algometry: : An observational study

    NARCIS (Netherlands)

    Kregel, Jeroen; van Wilgen, Cornelis Paul; Zwerver, Johannes

    2013-01-01

    ObjectiveAssessing pain in patellar tendinopathy (PT) is difficult to perform in a standardized way. With this study, we measured pain in athletes with PT by means of pain pressure threshold (PPT) algometry in a standardized manner. Subsequently, the goal of this study is to determine normative

  8. Lower limb strength and flexibility in athletes with and without patellar tendinopathy.

    Science.gov (United States)

    Scattone Silva, Rodrigo; Nakagawa, Theresa H; Ferreira, Ana Luisa G; Garcia, Luccas C; Santos, José E M; Serrão, Fábio V

    2016-07-01

    To compare the hip, knee and ankle torques, as well as knee and ankle flexibility between athletes with patellar tendinopathy and asymptomatic controls. Cross-sectional study. Laboratory setting. Fourteen male volleyball, basketball or handball athletes, divided into 2 groups, patellar tendinopathy group (TG; n = 7) and asymptomatic control group (CG; n = 7). Hip, knee and ankle isometric torques were measured with a handheld dynamometer. Weight-bearing ankle dorsiflexion, hamstring and quadriceps flexibility were measured with a gravity inclinometer. The TG had 27% lower hip extensor torque when compared to the CG (P = 0.031), with no group differences in knee and ankle torques (P > 0.05). Also, the TG had smaller weight-bearing ankle dorsiflexion (P = 0.038) and hamstring flexibility (P = 0.006) when compared to the CG. Regarding quadriceps flexibility, no group differences were found (P = 0.828). Strength and flexibility deficits might contribute to a greater overload on the knee extensor mechanism, possibly contributing to the origin/perpetuation of patellar tendinopathy. Interventions aiming at increasing hip extensors strength as well as ankle and knee flexibility might be important for the rehabilitation of athletes with patellar tendinopathy. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Risk factors for patellar tendinopathy in basketball and volleyball players : A cross-sectional study

    NARCIS (Netherlands)

    Van der Worp, H.; Van Ark, M.; Zwerver, J.; Van den Akker-Scheek, I.

    2012-01-01

    Patellar tendinopathy (PT) has a multifactorial etiology, and many possible risk factors have been described in the literature. The findings are conflicting, though, and most research has been conducted on elite athletes. The aim of the current study is to determine the risk factors for PT in a

  10. Impact of Patellar Tendinopathy on Knee Proprioception: A Cross-Sectional Study.

    Science.gov (United States)

    Torres, Rui; Ferreira, João; Silva, Diogo; Rodrigues, Elisa; Bessa, Isabel M; Ribeiro, Fernando

    2017-01-01

    To determine whether high-level athletes with patellar tendinopathy have diminished knee proprioceptive acuity. Cross-sectional study. University research laboratory (institutional). Twenty-one basketball and volleyball players with patellar tendinopathy (13 men and 8 women; mean age 24.5 ± 3.6; body mass index = 22.5 ± 2.0 kg/m) and an equal number of athletes without symptoms of patellar tendinopathy injury were included in this study. Participants underwent knee proprioception assessments on a single day. Furthermore, age, sex, height, weight, VISA-P (Victorian Institute of Sport Assessment) questionnaire sports participation, medical history, knee injuries, previous treatment, and medication were obtained. Knee proprioception was evaluated by assessing sense of resistance, using a weight discrimination protocol, and joint position sense (JPS). No significant differences were observed in JPS at 30 and 60 degrees of knee flexion between groups (P = 0.165 and 0.481, respectively). In regard to the ability to discriminate weight, significant differences between the 2 groups were found with the tendinopathy group showing a higher percentage of error (P = 0.009), namely when the set of incremental weights varied by 10% from the standard weight. Athletes with patellar tendinopathy have a diminished perception of force signals required for weight discrimination, whereas JPS remains unaffected in these athletes.

  11. Validity and reliability of the Dutch translation of the VISA-P questionnaire for patellar tendinopathy

    NARCIS (Netherlands)

    Zwerver, Johannes; Kramer, Tamara; van den Akker-Scheek, Inge

    2009-01-01

    Background: The VISA-P questionnaire evaluates severity of symptoms, knee function and ability to play sports in athletes with patellar tendinopathy. This English-language self-administered brief patient outcome score was developed in Australia to monitor rehabilitation and to evaluate outcome of

  12. Treatment of Chronic Patellar Tendinopathy with Autologous Bone Marrow Stem Cells: A 5-Year-Followup

    Directory of Open Access Journals (Sweden)

    Cecilia Pascual-Garrido

    2012-01-01

    Full Text Available The purpose of this study is to determine if patients with chronic patellar tendinopathy will improve clinically after the inoculation of bone marrow mononuclear cells (BM-MNCs. Eight patients with chronic patellar tendinopathy were included. Patients averaged 24 years old (range 14–35. All patients were refractory to conservative treatment for at least 6 months before the procedure. BM-MNCs were harvested from the iliac bone crest and inoculated under ultrasound guide in the patellar tendon lesion. Improvement was assessed through established clinical scores and ultrasound. At 5-year followup, statistically significant improvement was seen for most clinical scores. Seven of eight patients said they would have the procedure again if they had the same problem in the opposite knee and were completely satisfied with the procedure. Seven of 8 patients thought that the results of the procedure were excellent. According to our results, inoculation of BM-MNCs could be considered as a potential therapy for those patients with chronic patellar tendinopathy refractory to nonoperative treatments.

  13. Knee function after anterior cruciate ligament reconstruction with patellar or hamstring tendon: a meta-analysis.

    Science.gov (United States)

    Shi, Dong-Liang; Yao, Zhen-Jun

    2011-12-01

    There is currently no consensus regarding the best graft type for anterior cruciate ligament reconstruction. Therefore, the aim of this study was to investigate the effects of patellar and hamstring tendon grafts on long-term knee function after anterior cruciate ligament reconstruction. This meta-analysis was conducted according to the methodological guidelines outlined by the Cochrane Collaboration. An electronic search of the literature was performed and all trials published between January 1966 and August 2011 comparing knee function after anterior cruciate ligament reconstruction using patellar tendon grafts with knee function after reconstruction with hamstring tendon grafts were pooled. Six studies were included in the final meta-analysis. Anterior cruciate ligament reconstruction using hamstring tendon grafts resulted in greater pain upon kneeling than reconstruction using patellar tendon grafts (P = 0.001). However, both grafts resulted in similar levels of anterior tibial translation, and similar results regarding isokinetic extension/flexion tests, Lysholm scores, and the stair-hop test (P > 0.05). Anterior cruciate ligament reconstruction using patellar or hamstring tendon grafts results in similar long-term knee function.

  14. Corticosteroid injections, eccentric decline squat training and heavy slow resistance training in patellar tendinopathy

    DEFF Research Database (Denmark)

    Kongsgaard, M.; Kovanen, V.; Aagaard, P.

    2009-01-01

    A randomized-controlled single-blind trial was conducted to investigate the clinical, structural and functional effects of peritendinous corticosteroid injections (CORT), eccentric decline squat training (ECC) and heavy slow resistance training (HSR) in patellar tendinopathy. Thirty-nine male...

  15. Trochleoplasty procedures show complication rates similar to other patellar-stabilizing procedures

    NARCIS (Netherlands)

    van Sambeeck, Jordy D.P.; van de Groes, Sebastiaan A.W.; Verdonschot, Nico; Hannink, Gerjon

    2017-01-01

    Purpose: Trochleoplasty aims to restore patellar stability. Various techniques have been described and almost all authors report successful results. However, the procedure has a significant risk of complications. Purpose of this study was to perform a systematic review and meta-analysis of the

  16. Risk factors for patellar tendinopathy : A systematic review of the literature

    NARCIS (Netherlands)

    van der Worp, Henk; van Ark, Mathijs; Roerink, Saskia; Pepping, Gert-Jan; van den Akker-Scheek, Inge; Zwerver, Johannes

    Patellar tendinopathy (PT) is an injury with a high prevalence in sports. Knowledge of risk factors is essential for developing preventive measures and rehabilitation programmes. However, risk factors associated with PT have not yet been systematically studied. This review was undertaken to identify

  17. The impact of patellar tendinopathy on sports and work performance in active athletes

    NARCIS (Netherlands)

    De Vries, Astrid J; Koolhaas, Wendy; Zwerver, Johannes; Diercks, Ron L.; Nieuwenhuis, Kari; Van Der Worp, Henk; Brouwer, Sandra; Van Den Akker-Scheek, Inge

    2017-01-01

    Greater insight into sports and work performance of athletes with patellar tendinopathy (PT) will help establish the severity of this common overuse injury. Primary aim of this study is to investigate the impact of PT on sports and work performance. Seventy seven active athletes with PT (50 males;

  18. Dislocation microstructure evolution in cyclically twisted microsamples: a discrete dislocation dynamics simulation

    International Nuclear Information System (INIS)

    Senger, J; Weygand, D; Kraft, O; Gumbsch, P

    2011-01-01

    Miniaturization in technical devices has increased interest in the investigation of the deformation and fatigue behaviour of metals in the micrometre regime. Due to the small dimensions of these devices, mechanical properties depend on the motion of a marginal number of dislocations. In this paper, the evolution of dislocation microstructure in torsion loaded single crystalline aluminium wires is analysed by three-dimensional discrete dislocation dynamics simulations. It is shown that the size of pile-ups and the number of the active slip systems is significantly influenced by cross-slip events independent of the crystallographic orientation. Dislocations are driven by the stress gradient from the applied loading to move into the centre of the sample. These dislocations cannot escape through the surface because of the reversal of the sign of the stress in the centre of the sample. If the micrometre-sized specimens are untwisted, the remaining dislocation microstructure in these samples depends on the maximum torsion angle reached before unloading. The larger the torsion angle, the higher is the remaining dislocation density in the unloaded specimens. These results are discussed with respect to cyclic deformation mechanisms at small scale

  19. High-temperature discrete dislocation plasticity

    Science.gov (United States)

    Keralavarma, S. M.; Benzerga, A. A.

    2015-09-01

    A framework for solving problems of dislocation-mediated plasticity coupled with point-defect diffusion is presented. The dislocations are modeled as line singularities embedded in a linear elastic medium while the point defects are represented by a concentration field as in continuum diffusion theory. Plastic flow arises due to the collective motion of a large number of dislocations. Both conservative (glide) and nonconservative (diffusion-mediated climb) motions are accounted for. Time scale separation is contingent upon the existence of quasi-equilibrium dislocation configurations. A variational principle is used to derive the coupled governing equations for point-defect diffusion and dislocation climb. Superposition is used to obtain the mechanical fields in terms of the infinite-medium discrete dislocation fields and an image field that enforces the boundary conditions while the point-defect concentration is obtained by solving the stress-dependent diffusion equations on the same finite-element grid. Core-level boundary conditions for the concentration field are avoided by invoking an approximate, yet robust kinetic law. Aspects of the formulation are general but its implementation in a simple plane strain model enables the modeling of high-temperature phenomena such as creep, recovery and relaxation in crystalline materials. With emphasis laid on lattice vacancies, the creep response of planar single crystals in simple tension emerges as a natural outcome in the simulations. A large number of boundary-value problem solutions are obtained which depict transitions from diffusional to power-law creep, in keeping with long-standing phenomenological theories of creep. In addition, some unique experimental aspects of creep in small scale specimens are also reproduced in the simulations.

  20. Positron trapping at dislocations in metals

    International Nuclear Information System (INIS)

    Bergersen, B.; McMullen, T.

    1977-01-01

    The trapping rate of positrons at dislocations in metals, and its temperature dependence, are calculated. Two different trapping processes, with the excess energy absorbed in either electron-hole pair formation or by phonon creation, are considered and the former is found to be the most important. An extension of the theory to include depletion of the positron density around the dislocations in a diffusion approximation is included. The trapping is found to be transition limited if the temperature is low or the trap potential shallow. At room temperature diffusion is important for deep traps. (author)

  1. Corrective surgery for canine patellar luxation in 75 cases (107 limbs: landmark for block recession

    Directory of Open Access Journals (Sweden)

    Mitsuhiro Isaka

    2014-05-01

    Full Text Available Canine medial patellar luxation (MPL is a very common orthopedic disease in small animals. Because the pathophysiology of this disease involves various pathways, the surgical techniques and results vary according to the veterinarian. Further, the landmark for block recession is not completely clear. We retrospectively evaluated 75 dogs (107 limbs with MPL in whom our landmark for block recession was used from July 2008 to May 2013. Information regarding the breed, age, sex, body weight, body condition score (BCS, lateral vs bilateral, pre-operative grading, surgical techniques, removal of implants, concomitance with anterior cruciate ligament (ACL rupture, re-luxation, re-operation, and rehabilitation was obtained from the medical records. The breeds were as follows: Chihuahua (n=23, Pomeranian (n=12, Yorkshire Terrier (n=9, and so on. The study group consisted of 33 males (castrated n=13 and 42 females (spayed n=21. The median age was 53.3±35.9 months (32-146 months; 13 cases were less than 12 months of age (17.3%. The pre-surgical BCSs were as follows: 1 (n=0, 2 (n=20, 3 (n=24, 4 (n=24 and 5 (n=7. The body weight was 4.51±3.48 kg (1.34-23.0 kg; 71 cases (94.7% were less than 10 kg. The MPL grades (each limb were G1 (n=1, G2 (n=18, G3 (n=78, and G4 (n=10; 32 cases were bilateral and 43 cases were unilateral (right n=27; left n=16. The specific surgical procedure (distal femoral osteotomy was 3 stifles in Chihuahuas. Concurrent with ACL rupture was 16/107 stifles (15.0% corrected with the over-the-top method or the extracapsular method in Papillons (5/6, Chihuahuas (5/23, and so on. The occurrences of re-luxation and re-operation were 3 out of 107 stifles (2.8% and 0%, respectively. In this retrospective study, we present a potentially good surgical landmark for block recession of MPL in dogs.

  2. Ipsilateral open anterior hip dislocation and open posterior elbow dislocation in an adult

    Directory of Open Access Journals (Sweden)

    Kumar Sunil

    2014-02-01

    Full Text Available 【Abstract】Open anterior dislocation of the hip is a very rare injury, especially in adults. It is a hyperabduction, external rotation and extension injury. Its combination with open posterior dislocation of the elbow has not been described in English language-based medical literature. Primary resuscitation, debridement, urgent reduction of dislocation, and adequate antibiotic support resulted in good clinical outcome in our patient. At 18 months follow-up, no signs of avascular necrosis of the femoral head or infection were observed.

  3. Elbow fracture-dislocation combined with Galeazzi fracture in adult: A case report and literature review.

    Science.gov (United States)

    Asadollahi, Saeed; Shepherd, David; Hau, Raphael C

    2013-01-01

    Galeazzi fracture associated with ipsilateral posterior elbow dislocation and radial head fracture is a rare pattern of injury. Few reports exist that describes this injury pattern and its treatment. We describe a case report of simultaneous occurrence of Galeazzi fracture and ipsilateral dislocation of elbow. A 58 year-old female presented with Galeazzi fracture and posterior elbow dislocation associated with radial head fracture of left upper extremity. This was managed with closed reduction of the elbow, open reduction and internal fixation of the radial shaft fracture and K-wire stabilisation of the unstable distal radioulnar joint. Prophylactic fasciotomy was performed. At 10 months follow-up, the outcome was favourable with the American shoulder and elbow surgeon score of 92 and the disabilities of the arm, shoulder and hand score of 18. The presumed mechanism of the injury was a forceful axial loading of a hyperpronated forearm and extended elbow. Our literature review shows that this pattern of injury occurs as a result of high energy trauma in young individuals, and successful outcome can be achieved by addressing each component of this complex injury individually. Simultaneous occurrence of elbow dislocation and Galeazzi fracture seems to be the result of extreme axial force and unique position of upper extremity at the time of impact. Individualised approach to each component of this injury can result in favourable outcome. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  4. The impact of physically demanding work of basketball and volleyball players on the risk for patellar tendinopathy and on work limitations.

    Science.gov (United States)

    van der Worp, H; Zwerver, J; Kuijer, P P F M; Frings-Dresen, M H W; van den Akker-Scheek, I

    2011-01-01

    Patellar tendinopathy is a common injury in jumping athletes. Little is known about work-related etiological factors for patellar tendinopathy and related work limitations. The aim of this study was to identify work-related etiological factors for patellar tendinopathy and to determine the relation between patellar tendinopathy and work limitations. Basketball and volleyball players between 18 and 35 years were invited to complete an online-questionnaire concerning knee complaints, etiological risk factors for patellar tendinopathy and related work limitations. A total of 1505 subjects were included in the analysis. Risk factors for patellar tendinopathy were gender and heavy physically demanding work. The odds for having patellar tendinopathy were significantly higher for heavy physically demanding occupations compared to mentally demanding occupations. 30% of subjects with patellar tendinopathy with a physically demanding job reported to be impaired in their work and 17% reported to be less productive. Basketball and volleyball players with heavy physically demanding work seem to have an increased risk for developing patellar tendinopathy. This finding has important clinical relevance in the treatment of this injury. Working activities should be adjusted in order to reduce the total load on the patellar tendon and help prevention and recovery.

  5. The Relationship of Static Tibial Tubercle-Trochlear Groove Measurement and Dynamic Patellar Tracking.

    Science.gov (United States)

    Carlson, Victor R; Sheehan, Frances T; Shen, Aricia; Yao, Lawrence; Jackson, Jennifer N; Boden, Barry P

    2017-07-01

    The tibial tubercle to trochlear groove (TT-TG) distance is used for screening patients with a variety of patellofemoral joint disorders to determine who may benefit from patellar medialization using a tibial tubercle osteotomy. Clinically, the TT-TG distance is predominately based on static imaging with the knee in full extension; however, the predictive ability of this measure for dynamic patellar tracking patterns is unknown. To determine whether the static TT-TG distance can predict dynamic lateral displacement of the patella. Cohort study (Diagnosis); Level of evidence, 2. The static TT-TG distance was measured at full extension for 70 skeletally mature subjects with (n = 32) and without (n = 38) patellofemoral pain. The dynamic patellar tracking patterns were assessed from approximately 45° to 0° of knee flexion by use of dynamic cine-phase contrast magnetic resonance imaging. For each subject, the value of dynamic lateral tracking corresponding to the exact knee angle measured in the static images for that subject was identified. Linear regression analysis determined the predictive ability of static TT-TG distance for dynamic patellar lateral displacement for each cohort. The static TT-TG distance measured with the knee in full extension cannot accurately predict dynamic lateral displacement of the patella. There was weak predictive ability among subjects with patellofemoral pain ( r 2 = 0.18, P = .02) and no predictive capability among controls. Among subjects with patellofemoral pain and static TT-TG distances 15 mm or more, 8 of 13 subjects (62%) demonstrated neutral or medial patellar tracking patterns. The static TT-TG distance cannot accurately predict dynamic lateral displacement of the patella. A large percentage of patients with patellofemoral pain and pathologically large TT-TG distances may have neutral to medial maltracking patterns.

  6. Atomistic simulations of dislocations in a model BCC multicomponent concentrated solid solution alloy

    International Nuclear Information System (INIS)

    Rao, S.I.; Varvenne, C.; Woodward, C.; Parthasarathy, T.A.; Miracle, D.; Senkov, O.N.; Curtin, W.A.

    2017-01-01

    Molecular statics and molecular dynamics simulations are presented for the structure and glide motion of a/2〈111〉 dislocations in a randomly-distributed model-BCC Co 16.67 Fe 36.67 Ni 16.67 Ti 30 alloy. Core structure variations along an individual dislocation line are found for a/2〈111〉 screw and edge dislocations. One reason for the core structure variations is the local variation in composition along the dislocation line. Calculated unstable stacking fault energies on the (110) plane as a function of composition vary significantly, consistent with this assessment. Molecular dynamics simulations of the critical glide stress as a function of temperature show significant strengthening, and much shallower temperature dependence of the strengthening, as compared to pure BCC Fe as well as a reference mean-field BCC alloy material of the same overall composition, lattice and elastic constants as the target alloy. Interpretation of the strength versus temperature in terms of an effective kink-pair activation model shows the random alloy to have a much larger activation energy than the mean-field alloy or BCC Fe. This is interpreted as due to the core structure variations along the dislocation line that are often unfavorable for glide in the direction of the load. The configuration of the gliding dislocation is wavy, and significant debris is left behind, demonstrating the role of local composition and core structure in creating kink pinning (super jogs) and/or deflection of the glide plane of the dislocation. - Graphical abstract: Measured critical resolved shear stress scaled by the (111) shear modulus (39 GPa) necessary to achieve on-going glide as a function of temperature, for the a/2[111] screw dislocation in the model BCC Co 16.67 Fe 36.67 Ni 16.67 Ti 30 alloy. The upper and lower bounds of the critical resolved shear stress is shown in the plot. Also shown in is the measured strength for the mean-field A-atom material and BCC Fe as a function of

  7. Evolution of the patellar sesamoid bone in mammals

    Directory of Open Access Journals (Sweden)

    Mark E. Samuels

    2017-03-01

    Full Text Available The patella is a sesamoid bone located in the major extensor tendon of the knee joint, in the hindlimb of many tetrapods. Although numerous aspects of knee morphology are ancient and conserved among most tetrapods, the evolutionary occurrence of an ossified patella is highly variable. Among extant (crown clade groups it is found in most birds, most lizards, the monotreme mammals and almost all placental mammals, but it is absent in most marsupial mammals as well as many reptiles. Here, we integrate data from the literature and first-hand studies of fossil and recent skeletal remains to reconstruct the evolution of the mammalian patella. We infer that bony patellae most likely evolved between four and six times in crown group Mammalia: in monotremes, in the extinct multituberculates, in one or more stem-mammal genera outside of therian or eutherian mammals and up to three times in therian mammals. Furthermore, an ossified patella was lost several times in mammals, not including those with absent hindlimbs: once or more in marsupials (with some re-acquisition and at least once in bats. Our inferences about patellar evolution in mammals are reciprocally informed by the existence of several human genetic conditions in which the patella is either absent or severely reduced. Clearly, development of the patella is under close genomic control, although its responsiveness to its mechanical environment is also important (and perhaps variable among taxa. Where a bony patella is present it plays an important role in hindlimb function, especially in resisting gravity by providing an enhanced lever system for the knee joint. Yet the evolutionary origins, persistence and modifications of a patella in diverse groups with widely varying habits and habitats—from digging to running to aquatic, small or large body sizes, bipeds or quadrupeds—remain complex and perplexing, impeding a conclusive synthesis of form, function, development and genetics across

  8. Clinical Treatment of Chronic Condylar Dislocation by Restoring Anterior Guidance

    OpenAIRE

    澤田, 宏二; 荒井, 良明; メディナ, ラウル; 河野, 正司; 福井, 忠雄; 花田, 晃治; Sawada, Koji; Arai, Yoshiaki; Medina, Raul; Kohno, Shoji; Fukui, Tadao; Hanada, Kooji

    1997-01-01

    The mechanism of condylar dislocation is not exactly understood. Temporomandibular (TMJ) surgery is a common option in the treatment of chronic condylar dislocation, but some authors have reported disappearance of its symptomatology after occlusal treatment. A case in which condylar dislocation disappeared by changing the location of anterior guidance is presented. The patient was an 18 year-old male with an Angle class Ⅲ malocclusion who had been suffering from condylar dislocation of the ri...

  9. Electron-dislocation interaction at low temperatures. Progress report

    International Nuclear Information System (INIS)

    1978-01-01

    The interaction of mobile dislocations with electrons in copper and copper alloys has shown that dislocation motion in copper, at low temperature, can be treated as an analog of an underdamped oscillator. We have also shown that the viscous drag on mobile dislocations in type II superconductors can be treated as an acoustic attenuation of an elastic wave

  10. A case of posterior shoulder dislocation with ipsilateral humeral ...

    African Journals Online (AJOL)

    A case of posterior shoulder dislocation with ipsilateral humeral shaft fracture. P Sharma, S Meena, D Rastogi, B Chowdhury. Abstract. Posterior shoulder dislocations are rare and represent 2–5% of all traumatic shoulder dislocation. A combination of this injury with ipsilateral humeral shaft fracture is extremely rare event.

  11. Nanoscale dislocation shear loops at static equilibrium and finite temperature

    Science.gov (United States)

    Dang, Khanh; Capolungo, Laurent; Spearot, Douglas E.

    2017-12-01

    Atomistic simulations are used to determine the resolved shear stress necessary for equilibrium and the resulting geometry of nanoscale dislocation shear loops in Al. Dislocation loops with different sizes and shapes are created via superposition of elemental triangular dislocation displacement fields in the presence of an externally imposed shear stress. First, a bisection algorithm is developed to determine systematically the resolved shear stress necessary for equilibrium at 0 K. This approach allows for the identification of dislocation core structure and a correlation between dislocation loop size, shape and the computed shear stress for equilibrium. It is found, in agreement with predictions made by Scattergood and Bacon, that the equilibrium shape of a dislocation loop becomes more circular with increasing loop size. Second, the bisection algorithm is extended to study the influence of temperature on the resolved shear stress necessary for stability. An approach is presented to compute the effective lattice friction stress, including temperature dependence, for dislocation loops in Al. The temperature dependence of the effective lattice friction stress can be reliably computed for dislocation loops larger than 16.2 nm. However, for dislocation loops smaller than this threshold, the effective lattice friction stress shows a dislocation loop size dependence caused by significant overlap of the stress fields on the interior of the dislocation loops. Combined, static and finite temperature atomistic simulations provide essential data to parameterize discrete dislocation dynamics simulations.

  12. An irreducible ankle fracture dislocation: the Bosworth injury

    NARCIS (Netherlands)

    Schepers, Tim; Hagenaars, Tjebbe; den Hartog, Dennis

    2012-01-01

    Irreducible fracture dislocations of the ankle are rare and represent true orthopedic emergencies. We present a case of a fracture dislocation that was irreducible owing to a fixed dislocation of the proximal fibular fragment posterior to the lateral ridge of the tibia. This particular type of

  13. An Irreducible Ankle Fracture Dislocation: The Bosworth Injury

    NARCIS (Netherlands)

    T. Schepers (Tim); T. Hagenaars (Tjebbe); D. den Hartog (Dennis)

    2012-01-01

    textabstractIrreducible fracture dislocations of the ankle are rare and represent true orthopedic emergencies. We present a case of a fracture dislocation that was irreducible owing to a fixed dislocation of the proximal fibular fragment posterior to the lateral ridge of the tibia. This particular

  14. Lack of experience is a significant factor in the missed diagnosis of perilunate fracture dislocation or isolated dislocation

    Directory of Open Access Journals (Sweden)

    Ilker Çolak

    2018-01-01

    Conclusion: The results of this study indicated that lack of experience was the most important factor in the misdiagnosis of perilunate fracture dislocation or isolated dislocation. Level of Evidence: Level IV, diagnostic study.

  15. Screening for congenital dislocation of the hip

    International Nuclear Information System (INIS)

    Fendel, H.

    1987-01-01

    Although the prevalence of (idiopathic) congenital dislocation of the hip (CDH) within the Member States of the European Community is not exactly known, it must be considered as a major problem of public health care and protection. By assessment of available data one can assume that between 1 and 2% of all newborns have dislocation or instability of one or both hips. There is a female predominance of 4:1 and some risk factors are known. The reasons of a higher prevalence in some areas are not yet well understood. Most of instable hips will spontaneously become stable within the first days or weeks of life. However, a considerable number of infants (less than 1%) will remain with instable hips which may dislocate. Dislocation either present at birth or as a result of persistent instability leads to subsequent hip deformation. This is a serious event for each affected individual, and is a heavy load on health care and social costs for the public. Treatment of CDH is easy and usually effective when started early, i.e. before the fourth month of life. The earlier treatment is started the easier, shorter, safer and less expensive it is and its impairment on child development and mother-child interaction can be held to a minimum. Screening for CDH is therefore the most important part of health protection in early infancy. However, this paper concludes that neither sonography nor X-ray examinations are appropriate for CDH screening

  16. managing temporomandibular joint dislocation in ibadan

    African Journals Online (AJOL)

    manoeuvre and IMF. Fifty percent of the chronic cases were successfully managed with the Hippocrates manoeuvre. Follow up was < 2 weeks in 7 of the cases. ... in the above named hospital was anterior dislocation, the female gender predominance, ... also presented very early probably due to an awareness of where to ...

  17. stabilisation of posterior sternoclavicular joint dislocation using

    African Journals Online (AJOL)

    A case is reported where palmaris longus tendon was used to stabilise the joint following open reduction. INTRODUCTION. Posterior Sternoclavicular joint dislocation is a relatively rare injury and is reported to have been first documented by Sir Astley Cooper in 1824 (1, 2). It is a potentially life threatening injury due to the ...

  18. Tendoscopic treatment of recurrent peroneal tendon dislocation

    NARCIS (Netherlands)

    Scholten, Peter E.; Breugem, Stefan J. M.; van Dijk, C. Niek

    2013-01-01

    To study the possibility of tendoscopic treatment of recurrent peroneal tendon dislocation. The case of one patient is described including the tendoscopic technique to deepen the fibular groove. In this single case, there were no complications, recovery time was short, and there was no recurrence of

  19. An isolated cuboid dislocation. A case report

    Directory of Open Access Journals (Sweden)

    K. Sheahan

    2017-01-01

    Conclusion: Our take home message from this case report is that cuboid dislocations are rare injuries and are important to be aware of in reviewing X-rays in the E.D. Particularly in patients with inversion and plantar flexion type injuries to their foot and ankle joint, with an inability to weight bear and lateral midfoot pain following their injury.

  20. Ab initio phonon scattering by dislocations

    Science.gov (United States)

    Wang, Tao; Carrete, Jesús; van Roekeghem, Ambroise; Mingo, Natalio; Madsen, Georg K. H.

    2017-06-01

    Heat management in thermoelectric and power devices as well as in random access memories poses a grand challenge and can make the difference between a working and an abandoned device design. Despite the prevalence of dislocations in all these technologies, the modeling of their thermal resistance is based on 50-year-old analytical approximations, whose simplicity was driven by practical limitations rather than physical insight. We introduce an efficient ab initio approach based on Green's functions computed by two-dimensional reciprocal space integration. By combining elasticity theory and density functional theory, we calculate the scattering strength of a 90∘ misfit edge dislocation in Si. Because of the breakdown of the Born approximation, earlier literature models fail, even qualitatively. We find that a dislocation density larger than 109cm-2 is necessary to substantially influence thermal conductivity at room temperature and above. We quantify how much of the reduction of thermal conductivity measured in nanograined samples can be explained by realistic dislocation concentrations.

  1. Missed isolated volar dislocation of the scaphoid

    DEFF Research Database (Denmark)

    Kolby, Lise; Larsen, Søren; Jørring, Stig

    2007-01-01

    A patient presented with volar dislocation of the scaphoid, the diagnosis of which had been missed for two weeks. He was treated with open reduction through a combined volar and dorsal approach with decompression of the median nerve, internal fixation, and a cast for eight weeks. One year postope...... postoperatively the functional result was good. A radiograph showed no sign of avascular necrosis....

  2. Completion of a Dislocated Metric Space

    Directory of Open Access Journals (Sweden)

    P. Sumati Kumari

    2015-01-01

    Full Text Available We provide a construction for the completion of a dislocated metric space (abbreviated d-metric space; we also prove that the completion of the metric associated with a d-metric coincides with the metric associated with the completion of the d-metric.

  3. Dislocation Microstructures in Fatiqued Copper Polycrystals

    DEFF Research Database (Denmark)

    Winter, A.T.; Pedersen, Ole Bøcker; Rasmussen, K.V.

    1981-01-01

    Dislocation structures characteristic of persistent slip bands were observed in the interior of polycrystalline copper after fatigue. At low strain amplitudes, within the plateau on the cyclic stress-strain curve, only structures identical to those seen in single crystals were observed. This allows...

  4. Tailoring surgical management of dislocated clavicle fractures

    NARCIS (Netherlands)

    Wijdicks, F.J.G.

    2013-01-01

    In this thesis literature research and clinical studies are presented to assist physicians in the decision making process for surgical treatment of dislocated midshaft clavicle fractures (DMCF). In Chapter 1 an introduction is given regarding the background, aim and outline of this thesis. Chapter 2

  5. Computed tomography of traumatic atlantooccipital dislocation.

    Science.gov (United States)

    Gerlock, A J; Mirfakhraee, M; Benzel, E C

    1983-09-01

    Although atlantooccipital dislocation is a well-recognized radiological entity, its computed tomographic (CT) recognition has not been previously described. It is the purpose of this report to show the complementary role of CT in precisely defining the abnormalities in both the coronal and the sagittal reconstruction planes. A case is presented and the literature is reviewed.

  6. Cruciate paralysis secondary to traumatic atlantooccipital dislocation.

    Science.gov (United States)

    Sweet, Jennifer; Ammerman, Joshua; Deshmukh, Vivek; White, Joseph

    2010-01-01

    Cruciate paralysis is a clinical phenomenon thought to result from injury to decussating pyramidal tract fibers at the cervicomedullary junction, producing clinical findings of upper-extremity weakness out of proportion to the lower extremities. The authors present, to their knowledge, the first reported case of cruciate paralysis resulting from atlantooccipital dislocation.

  7. Effectiveness of Shockwave Treatment Combined With Eccentric Training for Patellar Tendinopathy : A Double-Blinded Randomized Study

    NARCIS (Netherlands)

    Thijs, Karin M; Zwerver, Johannes; Backx, Frank J G; Steeneken, Victor; Rayer, Stephan; Groenenboom, Petra; Moen, Maarten H

    OBJECTIVE: To evaluate the effectiveness of a combined treatment of focused shockwave therapy (ESWT) and eccentric training compared with sham-shockwave therapy (placebo) and eccentric training in participants with patellar tendinopathy (PT) after 24 weeks. DESIGN: Randomized controlled trial.

  8. Effectiveness of Shockwave Treatment Combined With Eccentric Training for Patellar Tendinopathy : A Double-Blinded Randomized Study

    NARCIS (Netherlands)

    Thijs, Karin M.; Zwerver, Johannes; Backx, Frank J. G.; Steeneken, Victor; Rayer, Stephan; Groenenboom, Petra; Moen, Maarten H.

    2017-01-01

    OBJECTIVE: To evaluate the effectiveness of a combined treatment of focused shockwave therapy (ESWT) and eccentric training compared with sham-shockwave therapy (placebo) and eccentric training in participants with patellar tendinopathy (PT) after 24 weeks. DESIGN: Randomized controlled trial.

  9. Interaction of 〈1 0 0〉 dislocation loops with dislocations studied by dislocation dynamics in α-iron

    Energy Technology Data Exchange (ETDEWEB)

    Shi, X.J.; Dupuy, L. [CEA, DEN, SRMA, F-91191 Gif-sur-Yvette (France); Devincre, B. [Laboratoire d’Etude des Microstructures, CNRS-ONERA, 29 av. de la Division Leclerc, 92322 Châtillon Cedex (France); Terentyev, D. [SCK–CEN, Nuclear Materials Science Institute, Boeretang 200, B-2400 Mol (Belgium); Vincent, L. [CEA, DEN, SRMA, F-91191 Gif-sur-Yvette (France)

    2015-05-15

    Highlights: • Interactions between edge dislocations and radiation-induced loops were studied by dislocation dynamics. • Dislocation dynamics results are directly compared to molecular dynamics results. • The complex elementary reactions are successfully reproduced. • The critical shear stress to overcome individual loops if reproduced quantitatively. - Abstract: Interstitial dislocation loops with Burgers vector of 〈1 0 0〉 type are formed in α-iron under neutron or heavy ion irradiation. As the density and size of these loops increase with radiation dose and temperature, these defects are thought to play a key role in hardening and subsequent embrittlement of iron-based steels. The aim of the present work is to study the pinning strength of the loops on mobile dislocations. Prior to run massive Dislocation Dynamics (DD) simulations involving experimentally representative array of radiation defects and dislocations, the DD code and its parameterization are validated by comparing the individual loop–dislocation reactions with those obtained from direct atomistic Molecular Dynamics (MD) simulations. Several loop–dislocation reaction mechanisms are successfully reproduced as well as the values of the unpinning stress to detach mobile dislocations from the defects.

  10. Subacute dislocation of the elbow following Galeazzi fracture-dislocation of the radius: A case report.

    Science.gov (United States)

    Rajeev, Aysha; Senevirathna, Shanaka; Harrison, John

    2011-12-20

    The Galeazzi fracture-dislocation was originally described by Sir Astley Cooper in 1822 but was named after Italian surgeon Ricardo Galeazzi in 1934. It is an injury classified as a radial shaft fracture with associated dislocation of the distal radioulnar joint and disruption of the forearm axis joint. The associated distal radioulnar joint injury may be purely ligamentous in nature, tearing the triangular fibrocartilaginous complex, or involve bony tissue (that is, ulnar styloid avulsions) or both. We report this case because of the rare association of posterior dislocation of the elbow along with Galeazzi fracture-dislocation. To the best of our knowledge, this has not been previously reported in the English literature. A 26-year-old Caucasian man presented to our department after a fall from a motorbike. He sustained a closed, isolated Galeazzi fracture-dislocation of the right forearm and no associated elbow injuries, and this necessitated open reduction and internal fixation of the radius. Post-operative radiographs films were satisfactory. However, clinical and radiological evidence of ipsilateral elbow dislocation was noted at a five-week follow-up, subsequently requiring open reduction of the joint and collateral ligament repair. Our patient was noted to have full elbow and forearm function at three months. Although the Galeazzi fracture-dislocation has been classically described as involving only the distal radioulnar joint, traumatic forces can be transmitted to the elbow via the interosseous membrane of the forearm. This can lead to instability of the elbow joint. Therefore, we recommend that, in every case of forearm fracture, both elbow and wrist joints be assessed clinically as well as radiologically for subluxation or dislocation.

  11. Traumatic Testicular Dislocation Associated with Lateral Compression Pelvic Ring Injury and T-Shaped Acetabulum Fracture

    Directory of Open Access Journals (Sweden)

    Daniel Howard Wiznia

    2016-01-01

    Full Text Available We report a case of a unilateral testicular dislocation to the superficial inguinal region associated with a lateral compression type pelvic ring injury (OTA classification 61-C3.3a2, b2, c3 and left T-shaped acetabulum fracture (OTA classification 62-B2 in a 44-year-old male who was in a motorcycle accident. The testicular dislocation was noted during the emergency department primary survey, and its location and viability were verified with ultrasound. The testicle was isolated during surgical stabilization of the left acetabulum through a Pfannenstiel incision and modified-Stoppa approach and returned through the inguinal canal to the scrotum. In follow-up, the patient did not suffer urologic or sexual dysfunction. All motorcycle collision patients presenting with pelvic ring injuries or acetabulum fractures should be worked up for possible testicular dislocation with a scrotal exam. Advanced imaging and a urologic consult may be necessary to detect and treat these injuries.

  12. The Effect of Patellar Taping on Squat Depth and the Perception of Pain in People with Anterior Knee Pain

    OpenAIRE

    Clifford, Amanda M.; Harrington, Elaine

    2013-01-01

    peer-reviewed Patellar taping is a treatment adjunct commonly used in the management of anterior knee pain. The aim of this cross sectional study was to investigate the effects of medial glide patellar taping on sagittal plane lower-limb joint kinematics and knee pain during a unilateral squat in a symptomatic population complaining of anterior knee pain. Ten participants with a history of unilateral or bilateral anterior knee pain were included in the study. Subjects were required to squa...

  13. A soft patellar tendon on ultrasound elastography is associated with pain and functional deficit in volleyball players.

    Science.gov (United States)

    Ooi, Chin Chin; Richards, Paula J; Maffulli, Nicola; Ede, David; Schneider, Michal E; Connell, David; Morrissey, Dylan; Malliaras, Peter

    2016-05-01

    To investigate the diagnostic performance of grey scale Ultrasound (US), power Doppler (PD) and US elastography for diagnosing painful patellar tendinopathy, and to establish their relationship with Victorian Institute of Sport Assessment-Patella (VISA-P) scores in a group of volleyball players with and without symptoms of patellar tendinopathy. Cross-sectional study. Thirty-five volleyball players (70 patellar tendons) were recruited during a national university volleyball competition. Players were imaged with conventional US followed by elastography. The clinical findings of painful patellar tendons were used as the reference standard for diagnosing patellar tendinopathy. In addition, all participants completed the VISA-P questionnaires. Of the 70 patellar tendons, 40 (57.1%) were clinically painful. The diagnostic accuracy of grey scale US, PD and elastography were 60%, 50%, 62.9%, respectively, with sensitivity/specificity of 72.5%/43.3%, 12.5%/100%, and 70%/53.3%, respectively. Combined US elastography and grey scale imaging achieved 82.5% sensitivity, 33.3% specificity and 61.4% accuracy while routine combination technique of PD and grey scale imaging revealed 72.5% sensitivity, 43.3% specificity and 60.0% accuracy. Tendons in players categorized as soft on elastography had statistically significantly greater AP thickness (p<0.001) and lower VISA-P scores (p=0.004) than those categorized as hard. There was no significant association between grey scale US abnormalities (hypoechogenicities and/or fusiform swelling) and VISA-P scores (p=0.098). Soft tendon properties depicted by US elastography may be more related to patellar tendon symptoms compared to grey scale US abnormalities. The supplementation of US elastography to conventional US may enhance the sensitivity for diagnosing patellar tendinopathy in routine clinical practice. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  14. Hydrogen accumulation around dislocation loops and edge dislocations: from atomistic to mesoscopic scales in BCC tungsten

    Science.gov (United States)

    De Backer, A.; Mason, D. R.; Domain, C.; Nguyen-Manh, D.; Marinica, M.-C.; Ventelon, L.; Becquart, C. S.; Dudarev, S. L.

    2017-12-01

    In a fusion tokamak, the plasma interacts with the metallic wall and the divertor. Hydrogen isotopes penetrate and diffuse into the material and interact with defects where they are trapped. Neutrons produced by the fusion reactions in the plasma are stopped in the material, creating defects, including vacancy and interstitial clusters, and dislocation loops. The trapping of hydrogen in vacancies has been extensively investigated. In our recent paper (De Backer et al 2017 Nucl. Fusion), we proposed a multi-scale model for H trapping and accumulation around interstitial defects, dislocation loops and dislocation lines. These defects create a long-range elastic field that attracts and may retain H atoms. A two-shell model with a short-range core region and a long-range elastic shell has been parameterized using a database of density functional theory (DFT) calculations. This model gives the number of H atoms forming the Cottrell atmosphere of a defect at finite temperature. In this paper, we present new DFT calculations of large dislocation loops decorated with up to 80 H, and explore our two-shell model in fusion relevant conditions. We conclude that large dislocation loops and edge dislocations can trap a significant number of hydrogen atoms in the core at temperatures up to 800 K, and also in the elastic field if the background hydrogen concentration is high.

  15. Work softening in nanocrystalline materials induced by dislocation annihilation

    DEFF Research Database (Denmark)

    Ungar, Tamas; Li, Li; Tichy, Geza

    2011-01-01

    Cold rolling reduces the quantity of dislocation densities in Ni–18% Fe alloys prepared by electrochemical deposition. The dislocation density evolution proposed earlier for the linearly decreasing work-hardening rate during stage III is revisited. The solution of the differential equation predicts...... that when the initial dislocation density is smaller or larger than the saturation value, then the dislocation density will increase or decrease during further plastic deformation. The predictions are verified by experimental values of dislocation densities determined by X-ray line-profile analysis....

  16. Gauge Transconjunctival Sutureless Vitrectomy in Eyes with Posteriorly Dislocated Intraocular Lens

    Directory of Open Access Journals (Sweden)

    Hüseyin Dündar

    2013-04-01

    Full Text Available Pur po se: To evaluate the efficacy and safety of 23-gauge (23G pars plana vitrectomy (PPV in dislocated intraocular lens (IOL cases: In early- and late-term follow-up. Ma te ri al and Met hod: In this retrospective study, the medical records of 17 patients who underwent 23 G PPV treatment for dislocated IOL between January 2009 and June 2011 were analyzed. Detailed ophthalmologic examination was performed in all patients; intraoperative and postoperative complications were recorded. Re sults: In this study, mean follow-up time was 9.0 (4-22 months and mean age was 60.8 (8-82 years. Mean time after cataract surgery was variable (mean of 28.3 (0-80 months. Four patients had trauma history, five patients had pseudoexfoliation syndrome, and two patients had pathologic myopia. Dislocated IOL was placed into the sulcus in nine patients (52.9%. In two cases (11.7%, the IOLs were removed, and the patients were left aphakic. In two cases out of other 6 (11.7%, the dislocated IOL was changed with scleral fixation lens, whereas in the other four cases (23.5%, IOL was changed with iris claw lens. One patient (5.8% remained at the same level of vision, while twelve (70.5% cases increased two or more lines in BCVA. The vision was decreased in two cases. Intraocular pressure elevation controlled by medication was observed in one case. For two days, hypotony was observed in one patient. Dis cus si on: 23 G PPV technique is an effective and safe method for removing and repositioning of dislocated IOL in the vitreous. (Turk J Ophthalmol 2013; 43: 99-102

  17. Are unilateral and bilateral patellar tendinopathy distinguished by differences in anthropometry, body composition, or muscle strength in elite female basketball players?

    OpenAIRE

    Gaida, J; Cook, J; Bass, S; Austen, S; Kiss, Z

    2004-01-01

    Background: Overuse injury to the patellar tendon (patellar tendinopathy) is a major reason for interrupted training and competition for elite athletes. In both sexes, the prevalence of unilateral and bilateral tendinopathy has been shown to differ. It has been proposed that bilateral pathology may have a different aetiology from unilateral pathology. Investigation of risk factors that may be unique to unilateral and bilateral patellar tendinopathy in female athletes may reveal insights into ...

  18. The TOPSHOCK study: Effectiveness of radial shockwave therapy compared to focused shockwave therapy for treating patellar tendinopath - design of a randomised controlled trial

    OpenAIRE

    van der Worp, Henk; Zwerver, Johannes; van den Akker-Scheek, Inge; Diercks, Ron L

    2011-01-01

    Abstract Background Patellar tendinopathy is a chronic overuse injury of the patellar tendon that is especially prevalent in people who are involved in jumping activities. Extracorporeal Shockwave Therapy is a relatively new treatment modality for tendinopathies. It seems to be a safe and promising part of the rehabilitation program for patellar tendinopathy. Extracorporeal Shockwave Therapy originally used focused shockwaves. Several years ago a new kind of shockwave therapy was introduced: ...

  19. Bilateral Galeazzi fracture-dislocations: a case report of early rehabilitation.

    Science.gov (United States)

    Komura, Shingo; Nonomura, Hidehiko; Satake, Takashi; Yokoi, Tatsuo

    2012-08-01

    A 24-year-old man had bilateral Galeazzi fracture-dislocations due to a motorcycle accident. The right radius fracture was a simple fracture and was fixed with a limited contact dynamic compression plate. The left radius fracture was a comminuted fracture and was fixed with a long locking compression plate in the bridging plate fashion while maintaining reduction with a temporary external fixator. Postoperative computed tomography under passive rotation of both forearms showed acceptable congruency of the distal radioulnar joints, and early rehabilitation of forearm rotation was started at 2 weeks after the operation. At 13-month follow-up, bone union of both fractures was achieved, and forearm motion was almost restored to normal. Moreover, no subluxation or dislocation of either distal radioulnar joint was observed.

  20. Recombination properties of dislocations in GaN

    Science.gov (United States)

    Yakimov, Eugene B.; Polyakov, Alexander Y.; Lee, In-Hwan; Pearton, Stephen J.

    2018-04-01

    The recombination activity of threading dislocations in n-GaN with different dislocation densities and different doping levels was studied using electron beam induced current (EBIC). The recombination velocity on a dislocation, also known as the dislocation recombination strength, was calculated. The results suggest that dislocations in n-GaN giving contrast in EBIC are charged and surrounded by a space charge region, as evidenced by the observed dependence of dislocation recombination strength on dopant concentration. For moderate (below ˜108 cm-2) dislocation densities, these defects do not primarily determine the average diffusion length of nonequilibrium charge carriers, although locally, dislocations are efficient recombination sites. In general, it is observed that the effect of the growth method [standard metalorganic chemical vapor deposition (MOCVD), epitaxial lateral overgrowth versions of MOCVD, and hydride vapor phase epitaxy] on the recombination activity of dislocations is not very pronounced, although the average diffusion lengths can widely differ for various samples. The glide of basal plane dislocations at room temperature promoted by low energy electron irradiation does not significantly change the recombination properties of dislocations.

  1. Ultrasound as a probe of dislocation density in aluminum

    International Nuclear Information System (INIS)

    Mujica, Nicolás; Cerda, Maria Teresa; Espinoza, Rodrigo; Lisoni, Judit; Lund, Fernando

    2012-01-01

    Graphical abstract: Display Omitted - Abstract: Dislocations are at the heart of the plastic behavior of crystalline materials yet it is notoriously difficult to perform quantitative, non-intrusive measurements of their single or collective properties. Dislocation density is a critical variable that determines dislocation mobility, strength and ductility. On the one hand, individual dislocations can be probed in detail with transmission electron microscopy. On the other hand, their collective properties must be simulated numerically. Here we show that ultrasound technology can be used to measure dislocation density. This development rests on theory—a generalization of the Granato–Lücke theory for the interaction of elastic waves with dislocations—and resonant ultrasound spectroscopy (RUS) measurements. The chosen material is aluminum, to which different dislocation contents were induced through annealing and cold-rolling processes. The dislocation densities obtained with RUS compare favorably with those inferred from X-ray diffraction, using the modified Williamson–Hall method.

  2. BILATERAL PATHOLOGICAL HIP DISLOCATION IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Yuriy E. Garkavenko

    2017-03-01

    Full Text Available Introduction. Pathological dislocation of the hip is one of the most severe complications of acute hematogenous osteomyelitis. The program of treatment for children with pathological hip dislocation is complex, but it has been sufficiently developed and implemented very successfully. At the same time, the available literature provides no cases of treating children with bilateral pathological hip dislocations after hematogenous osteomyelitis. There is no information on the incidence of such cases or in regards to remote functional results. Materials and methods. The results of the treatment of 18 children with bilateral pathological dislocation of the hip after hematogenous osteomyelitis are presented, which constituted 23.1% of the total number of patients (78 who underwent surgery in 2000–2016 for the diagnosis of pathological hip dislocation. Both hip joints were surgically operated on in 12 patients, while one hip joint was operated on in 6 patients. To assess the anatomical and functional state of hip joints, the clinical and roentgenological diagnostic techniques were used. Results and discussion. To stabilize and restore the function of the hip joints, 18 children underwent 30 surgical interventions: simple open hip reduction (19 and open hip reduction with hip arthroplasty with one (6 or two (5 demineralized osteochondral allogeneic grafts. The decision regarding the possibility of performing surgical intervention on the second hip joint was made only after a child's check-up examination was complete and after positive information about the anatomical and functional state of the operated hip joint was obtained. According to these criteria, 14 (77.8% children underwent surgical treatment of the second hip joint 1–1.5 years after the course of conservative measures to restore the range of motion in the previously operated hip joint. Over a period of 1–12 years, 17 patients were examined, 10 of which underwent an operation on both

  3. Traumatic Rupture of an Intermediate Tendon in a Patient with Patellar Duplication

    Directory of Open Access Journals (Sweden)

    Stéphane Pelet

    2017-01-01

    Full Text Available Patellar duplication is a rare asymptomatic condition. The diagnosis is often made following a traumatic event associated with an injury to the knee extensor mechanism. The treatment is often surgical and consists in removal of the smaller part of the patella with tendon reinsertion. The presence and rupture of an intermediate tendon between the two parts of the patella have not been reported in the modern literature. We present a traumatic rupture of an intermediate tendon in a patient with horizontal patellar duplication. The surgical management consisted of tenorrhaphy protected with a figure-of-eight tension band wire approximating the two parts of the patella. The patient recovered full knee range of motion and quadriceps strength at the last 8-month follow-up.

  4. Local trauma in human patellar tendon leads to widespread changes in the tendon gene expression

    DEFF Research Database (Denmark)

    Heinemeier, Katja Maria; Lorentzen, Marc P; Kildevang Jensen, Jacob

    2016-01-01

    Low cellular activity and slow tissue turnover in human tendon may prolong resolution of tendinopathy. This may be stimulated by moderate localized traumas such as needle penetrations, but whether this results in a widespread cellular response in tendons is unknown. In an initial hypothesis......-generating study, a trauma-induced tendon cell activity (increased total RNA and collagen I mRNA) was observed after repeated patellar tendon biopsies in young men. In a subsequent controlled study, 25 young men were treated with two 0.8 mm diameter needle penetrations (n=13, needle-group (NG)) or one 2.1 mm...... diameter needle biopsy (n=12, biopsy-group (BG)) in one patellar tendon. Four weeks later biopsies were taken from treated (5 mm lateral from trauma site) and contralateral tendons for analyses of RNA content (ribogreen assay), DNA content (PCR based), and gene expression for relevant target genes (Real...

  5. Prospective imaging study of asymptomatic patellar tendinopathy in elite junior basketball players.

    Science.gov (United States)

    Cook, J L; Khan, K M; Kiss, Z S; Purdam, C R; Griffiths, L

    2000-07-01

    To evaluate the ability of ultrasonography to predict eventual symptoms in an at-risk population, 52 elite junior basketball players' patellar tendons were studied at baseline and again 16 months later. The group consisted of 10 study tendons (ultrasonographically hypoechoic at baseline) and 42 control tendons (ultrasonographically normal at baseline). By design, all tendons were asymptomatic at baseline. No differences were noted between subjects and controls at baseline for age, height, weight, training hours, and vertical jump. Functional (P patellar tendon changes may resolve, but this is not necessary for an athlete to become asymptomatic. Qualitative or quantitative analysis of baseline ultrasonographic images revealed it was not possible to predict which tendons would develop symptoms or resolve ultrasonographically.

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    Tendons are important for optimal muscle force transfer to bone and play a key role in functional ability. Changes in tendon properties with aging could contribute to declines in physical function commonly associated with aging. We investigated the in vivo mechanical properties of the patellar te...... of the tendon is altered with aging; however, the physiological and functional consequence of this finding requires further study.......Tendons are important for optimal muscle force transfer to bone and play a key role in functional ability. Changes in tendon properties with aging could contribute to declines in physical function commonly associated with aging. We investigated the in vivo mechanical properties of the patellar.......05), respectively, in men compared with women. After normalization of mechanical properties to a common force, no age differences were apparent; however, stress and strain were 26 and 22% higher, respectively, in women compared with men (P

  7. Keblish's lateral surgical approach enhances patellar tilt in valgus knee arthroplasty

    Directory of Open Access Journals (Sweden)

    José Roberto Tonelli Filho

    Full Text Available ABSTRACT OBJECTIVE: To compare the clinical and radiological outcomes of conventional medial and lateral approaches for total knee replacement in the valgus osteoarthritic knee. METHODS: In this randomized controlled trial, 21 patients with valgus knee osteoarthritis were randomized to total knee replacement through medial or lateral approach. The primary outcome was radiographic patellar tilt. Secondary outcomes were visual analog scale of pain, postoperative levels of hemoglobin, and clinical aspect of the operative wound. RESULTS: There were no differences between the groups regarding other clinical variables. Mean lateral tilt of the patella was 3.1 degrees (SD ± 5.3 in the lateral approach group and 18 degrees (SD ± 10.2 in the medial approach group (p = 0.02. There were no differences regarding the secondary outcomes. CONCLUSION: Lateral approach provided better patellar tilt following total knee replacement in valgus osteoarthritic knee.

  8. Quantitative and Qualitative Analysis of the Medial Patellar Ligaments: An Anatomic and Radiographic Study.

    Science.gov (United States)

    Kruckeberg, Bradley M; Chahla, Jorge; Moatshe, Gilbert; Cinque, Mark E; Muckenhirn, Kyle J; Godin, Jonathan A; Ridley, Taylor J; Brady, Alex W; Arendt, Elizabeth A; LaPrade, Robert F

    2018-01-01

    The qualitative and quantitative anatomy of the medial patellar stabilizers has been reported; however, a quantitative analysis of the anatomic and radiographic attachments of all 4 ligaments relative to anatomic and osseous landmarks, as well as to one another, has yet to be performed. To perform a qualitative and quantitative anatomic and radiographic evaluation of the medial patellofemoral ligament (MPFL), medial patellotibial ligament (MPTL), medial patellomeniscal ligament (MPML), and medial quadriceps tendon femoral ligament (MQTFL) attachment sites, with attention to their relationship to pertinent osseous and soft tissue landmarks. Descriptive laboratory study. Ten nonpaired fresh-frozen human cadaveric knees were dissected, and the MPFL, MPTL, MPML, and MQTFL were identified. A coordinate measuring device quantified the attachment areas of each structure and its relationship to pertinent bony landmarks. Radiographic analysis was performed through ligament attachment sites and relevant anatomic structures to assess their locations relative to pertinent bony landmarks. Four separate medial patellar ligaments were identified in all specimens. The center of the MPFL attachments was 14.3 mm proximal and 2.1 mm posterior to the medial epicondyle and 8.3 mm distal and 2.7 mm anterior to the adductor tubercle on the femur and 8.9 mm distal and 19.9 mm medial to the superior pole on the patella. The MQTFL had a mean insertion length of 29.3 mm on the medial aspect of the distal quadriceps tendon. The MPTL and MPML shared a common patellar insertion and were 9.1 mm proximal and 15.4 mm medial to the inferior pole. The MPTL attachment inserted on a newly identified bony ridge, which was located 5.0 mm distal to the joint line. The orientation angles of the MPTL and MPML with respect to the patellar tendon were 8.3° and 22.7°, respectively. The most important findings of this study were the correlative anatomy of 4 distinct medial patellar ligaments (MPFL, MPTL

  9. Mechanical properties of human patellar tendon at the hierarchical levels of tendon and fibril

    DEFF Research Database (Denmark)

    Svensson, René B; Hansen, Philip; Hassenkam, Tue

    2012-01-01

    's modulus was 2.0 ± 0.5 GPa, and the toe region reached 3.3 ± 1.9% strain in whole patellar tendons. Based on dry cross-sectional area, the Young's modulus of isolated collagen fibrils was 2.8 ± 0.3 GPa, and the toe region reached 0.86 ± 0.08% strain. The measured fibril modulus was insufficient to account...... distinct collagen fibrils would display similar mechanical properties. Human patellar tendons (n = 5) were mechanically tested in vivo by ultrasonography. Biopsies were obtained from each tendon, and individual collagen fibrils were dissected and tested mechanically by atomic force microscopy. The Young...... for the modulus of the tendon in vivo when fibril content in the tendon was accounted for. Thus, our original hypothesis was not supported, although the in vitro fibril modulus corresponded well with reported in vitro tendon values. This correspondence together with the fibril modulus not being greater than...

  10. Mechanical properties and collagen cross-linking of the patellar tendon in old and young men

    DEFF Research Database (Denmark)

    Couppé, C; Hansen, P; Kongsgaard, M

    2009-01-01

    were higher in OM than in YM (73 +/- 13 vs. 11 +/- 2 mmol/mol; P appreciably influence the dimensions or mechanical properties of the human patellar tendon in vivo. Collagen concentration was reduced, whereas both enzymatic......Age-related loss in muscle mass and strength impairs daily life function in the elderly. However, it remains unknown whether tendon properties also deteriorate with age. Cross-linking of collagen molecules provides structural integrity to the tendon fibrils and has been shown to change with age...... in animals but has never been examined in humans in vivo. In this study, we examined the mechanical properties and pyridinoline and pentosidine cross-link and collagen concentrations of the patellar tendon in vivo in old (OM) and young men (YM). Seven OM (67 +/- 3 years, 86 +/- 10 kg) and 10 YM (27 +/- 2...

  11. Transtriquetral perihamate fracture-dislocation: case report

    Directory of Open Access Journals (Sweden)

    Frederico Barra de Moraes

    2016-08-01

    Full Text Available ABSTRACT The wrist is a region that is very vulnerable to injuries of the extremities. Among these injuries, fractures of the pyramidal bone (or triquetrum in association with dislocation of the hamate and carpal instability are uncommon. They are generally correlated with high-energy trauma and may be associated with neurovascular deficits, muscle-tendon disorders, skin lesions or injuries to other carpal bones. Thus, in this report, one of these rare cases of transtriquetral perihamate fracture-dislocation with carpal instability is presented, diagnosed by means of radiography on the right wrist of the patient who presented pain, edema and limitation of flexion-extension of the carpus after trauma to the region. The stages of attending to the case are described, from the initial consultation to the surgical treatment and physiotherapy, which culminated in restoration of the strength and range of motion of the wrist.

  12. Prevalence of Achilles and patellar tendinopathy and their association to intratendinous changes in adolescent athletes.

    Science.gov (United States)

    Cassel, M; Baur, H; Hirschmüller, A; Carlsohn, A; Fröhlich, K; Mayer, F

    2015-06-01

    Achilles (AT) and patellar tendons (PT) are commonly affected by tendinopathy in adult athletes but prevalence of symptoms and morphological changes in adolescents is unclear. The study aimed to determine prevalence of tendinopathy and intratendinous changes in ATs and PTs of adolescent athletes. A total of 760 adolescent athletes (13.0 ± 1.9 years; 160 ± 13 cm; 50 ± 14 kg) were examined. History, local clinical examination, and longitudinal Doppler ultrasound analysis for both ATs and PTs were performed including identification of intratendinous echoic changes and vascularization. Diagnosis of tendinopathy was complied clinically in case of positive history of tendon pain and tendon pain on palpation. Achilles tendinopathy was diagnosed in 1.8% and patellar tendinopathy in 5.8%. Vascularizations were visible in 3.0% of ATs and 11.4% of PTs, hypoechogenicities in 0.7% and 3.2% as well as hyperechogenicities in 0% and 0.3%, respectively. Vascularizations and hypoechogenicities were statistically significantly more often in males than in females (P ≤ 0.02). Subjects with patellar tendinopathy had higher prevalence of structural intratendinous changes than those without PT symptoms (P ≤ 0.001). In adolescent athletes, patellar tendinopathy is three times more frequent compared with Achilles tendinopathy. Longitudinal studies are necessary to investigate physiological or pathological origin of vascularizations and its predictive value in development of tendinopathy. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Eccentric Exercise in Treatment of Patellar Tendinopathy in High Level Basketball Players. A Randomized Clinical Trial.

    OpenAIRE

    Sosa, Carlos; Lorenzo Calvo, Alberto; Jiménez, Sergio L.; Bonfanti, Noelia

    2014-01-01

    Chronic patellar tendinopathy is a common pathology in sporting population. To date, there is no agreed upon protocol as election treatment. Eccentric exercises have been used with satisfactory outcomes. The purpose of this trial is compare the effects of two eccentric exercise protocols. 0.146 SJR (2014) Q4, 199/231 Health (social science), 131/169 Physical therapy, sports therapy and rehabilitation, 119/128 Sports sciences UEM

  14. Psychometric properties of a Swedish translation of the VISA-P outcome score for patellar tendinopathy

    OpenAIRE

    Frohm, Anna; Saartok, Tönu; Edman, Gunnar; Renström, Per

    2004-01-01

    Abstract Background Self-administrated patient outcome scores are increasingly recommended for evaluation of primary outcome in clinical studies. The VISA-P score, developed at the Victorian Institute of Sport Assessment in Melbourne, Australia, is a questionnaire developed for patients with patellar tendinopathy and the patients assess severity of symptoms, function and ability to participate in sport. The aim of this study was to translate the questionnaire into Swedish and to study the rel...

  15. MRI evaluation of the patellar articular cartilage in patients with subluxation of the patella

    International Nuclear Information System (INIS)

    Nakanishi, Katsuyuki; Inoue, Masahiro; Harada, Koushi; Murakami, Takamichi; Kim, Shougen; Fujita, Norihiko; Sakurai, Kousuke; Kozuka, Takahiro

    1991-01-01

    In patients with subluxation of the patella, injury of the patellar articular cartilage is frequently observed and correct evaluation is important to manage these patients. We examined 11 patients with subluxation of the patella and five normal volunteers. In 12 patellofemoral joints of seven patients with subluxation of the patella, the abnormalities observed on MRI were compared with those on arthroscopy and/or at operation. MRI was performed with a Magnetom 1.5 T (Siemens) using the round surface coil. Pulse sequences were SE (TR 400 ms/TE 19 ms), FLASH(TR 320 ms/TE 15 ms FA 90deg and 40deg), and SE (TR 2000 ms/TE 26, 70 ms). We analysed MR findings of the 12 abnormal joints and 10 normal joints according to the following classification of abnormalities observed on arthroscopy; normal appearance (n=3 joints), softening and fibrillation (n=6), fragmentation (n=3), and erosion to bone (n=0). In only one of the six cases with softening and fibrillation observed on arthroscopy, MRI could visualize the thickening of patellar articular cartilage, but in all three cases with fragmentation observed on arthroscopy, MRI could visualize the thin inhomogeneous cartilage with irregular surface. The combination of SE (TR 400 ms/TE 19 ms) and FLASH (TR 320 ms/TE 15 ms FA 90deg) are extremely effective pulse sequence to detect the abnormalities of patellar articular cartilage. We conclude that MRI is a useful noninvasive method of detecting advanced changes in patellar articular cartilage. (author)

  16. Traumatic atlantooccipital dislocation injury in children.

    Science.gov (United States)

    Nichols, J; West, J S

    1994-10-01

    The tragedy of trauma turns into triumph when the surgery team members' efforts result in victory for the patient. Nowhere is this more true than in successful pediatric trauma care. Giving a child a second chance at life and the family an opportunity for a new beginning is the highest reward for the trauma team's years of professional training and practice. Traumatic atlantoocipital dislocation injury usually results in death, but recent neurosurgery trauma advances are increasing pediatric survival rates.

  17. Congenital hip dislocation: Radiological screening or diagnosis?

    International Nuclear Information System (INIS)

    Kalifa, G.; Faure, C.

    1987-01-01

    Congenital hip dislocation is a perfect example of public health problems: its incidence is high 0.6, to 2% of newborns in France and an early detection allows an easy and successful treatment. The current situation in our country is not satisfactory for several reasons: - Too many children are treated without reasons because of misleading radiological pictures; - Conversely, some dislocations are discovered only at the walking age, the treatment becoming then more difficult and less effective; - Almost 300,000 radiological examinations of the hip for screening are performed each year and among them 100,000 in newborns. This is not satisfactory as it is commonly admitted now that radiological examination at birth is unreliable and frequently misleading. For all these reasons a special working group has been settled up by the General Direction of Health, including physicians of different practices, from different specialities. The conclusion of this group will be published in a special booklet and can be summarized as follows: The group recommends to perform detection of congenital hip dislocation mainly by the clinical examination. This examination may be difficult but it must be performed very early, the first day of life, repeated several times, at the end of the first week and during the first, second, and third month. Every baby in this country must undergo several clinical examinations up to one year of age

  18. Open Galeazzi fracture with ipsilateral elbow dislocation.

    Science.gov (United States)

    Adanır, Oktay; Yüksel, Serdar; Beytemur, Ozan; Güleç, M Akif

    2016-08-01

    Combination of the Galeazzi fracture and dislocation of the elbow joint in same extremity is very rare. In this article, we report a 26-year-old male patient with a posterolateral dislocation of the elbow and ipsilateral volar type Galeazzi fracture. We performed closed reduction for the elbow dislocation during admission to the emergency department. Patient was taken to the operating room in the sixth hour of his application to emergency department and open wound on the ulnovolar region of the wrist was closed primarily after irrigation and debridement. We performed open reduction and internal fixation of the radial fracture with a dynamic compression plate. After fixation, we evaluated the stability of the elbow joint and distal radioulnar joint. Distal radioulnar joint was unstable under fluoroscopic examination and fixed with one 1.8 mm Kirschner wire in a pronated position. Then, elbow joint was stable. One year after surgery, patient had no pain or sings of instability. At the last follow-up, range of motion of the elbow was 10°-135° and forearm pronation and supination were 70°.

  19. Dislocation movement and hysteresis in Maraging blades

    Energy Technology Data Exchange (ETDEWEB)

    Di Cintio, Arianna; Ascione, Maria; De Salvo, Riccardo [LIGO Laboratory, California Institute of Technology, MS 18-34, 1200 E.California Blvd., Pasadena, CA, 91125 (United States); Marchesoni, Fabio [INFN-VIRGO Project Dipartimento di Fisica, Universita' di Camerino, I-62032 Camerino (Italy); Bhawal, Abhik, E-mail: desalvo@ligo.caltech.ed [Arcadia High School, Arcadia, CA (United States)

    2009-10-21

    All seismic isolation systems developed for gravitational-wave interferometric detectors, such as LIGO, Virgo and TAMA, make use of Maraging steel blades. The dissipation properties of these blades have been studied at low frequencies, by using a geometric anti-spring (GAS) filter, which allowed the exploration of resonant frequencies below 100 mHz. At this frequency an anomalous transfer function was observed in the GAS filter: this is one of several motivations for this work. The many unexpected effects observed and measured are explainable by the collective movement of dislocations inside the material described with the statistic of self-organised criticality. At low frequencies, below 200 mHz, the dissipation mechanism can subtract elasticity from the system even leading to sudden collapse. While Young's modulus is weaker, excess dissipation is observed. At higher frequencies the applied stress is probably too fast to allow the full growth of dislocation avalanches, and less losses are observed, thus explaining the higher Q-factor in this frequency range. The domino effect that leads to the release of entangled dislocations allows the understanding of the random walk of the Virgo and TAMA inverted pendula, the anomalous GAS filter transfer function as well as the loss of predictability of the ring-down decay in the LIGO seismic attenuation system inverted pendula.

  20. Thoracic fractures and dislocations in motorcyclists

    International Nuclear Information System (INIS)

    Daffner, R.H.; Deeb, Z.L.; Rothfus, W.E.

    1987-01-01

    Motorcyclists who are involved in accidents generally suffer severe multiple injuries, some of which are not readily apparent on initial examination. One such subtle injury is fracture, with or without dislocation, in the upper thoracic spine. The severe spinal cord damage produced by the injury is often overshadowed by cerebral or cervical injury. Proper diagnosis is further hampered by the fact that the upper thoracic region is difficult to examine radiographically on plain films, particularly when using portable equipment. Of a group of 14 motorcyclists having 26 fractures and/or dislocations in the thoracic region, 12 had 24 injuries between T3 and T8. These 24 injuries represented 56% of the fractures and/or dislocations encountered in a larger study of trauma to the thoracic vertebral column. All of these were flexion injuries, suffered when the individual was thrown from the motorcycle and struck a large, solid object. In three cases, the diagnosis was delayed as much as 48 h because proper films were not obtained initially. Because of the serious consequences of delayed treatment, we recommended that all motorcyclists who have sustained severe trauma be examined by overpenetrated film of the upper thoracic region. (orig.)

  1. Description of patellar movement by 3D parameters obtained from dynamic CT acquisition

    Science.gov (United States)

    de Sá Rebelo, Marina; Moreno, Ramon Alfredo; Gobbi, Riccardo Gomes; Camanho, Gilberto Luis; de Ávila, Luiz Francisco Rodrigues; Demange, Marco Kawamura; Pecora, Jose Ricardo; Gutierrez, Marco Antonio

    2014-03-01

    The patellofemoral joint is critical in the biomechanics of the knee. The patellofemoral instability is one condition that generates pain, functional impairment and often requires surgery as part of orthopedic treatment. The analysis of the patellofemoral dynamics has been performed by several medical image modalities. The clinical parameters assessed are mainly based on 2D measurements, such as the patellar tilt angle and the lateral shift among others. Besides, the acquisition protocols are mostly performed with the leg laid static at fixed angles. The use of helical multi slice CT scanner can allow the capture and display of the joint's movement performed actively by the patient. However, the orthopedic applications of this scanner have not yet been standardized or widespread. In this work we present a method to evaluate the biomechanics of the patellofemoral joint during active contraction using multi slice CT images. This approach can greatly improve the analysis of patellar instability by displaying the physiology during muscle contraction. The movement was evaluated by computing its 3D displacements and rotations from different knee angles. The first processing step registered the images in both angles based on the femuŕs position. The transformation matrix of the patella from the images was then calculated, which provided the rotations and translations performed by the patella from its position in the first image to its position in the second image. Analysis of these parameters for all frames provided real 3D information about the patellar displacement.

  2. Endoscopic bursectomy for the treatment of septic pre-patellar bursitis: a case series.

    Science.gov (United States)

    Dillon, John P; Freedman, Ilan; Tan, James S M; Mitchell, David; English, Shaun

    2012-07-01

    Operative treatment for septic pre-patellar bursitis generally involves open debridement in addition to an extended course of intravenous antibiotics. Skin necrosis and wound breakdown are potential complications of this procedure in addition to scar sensitivity and a prolonged recovery. We report endoscopic bursectomy for the treatment of septic pre-patellar bursitis in eight patients over a 3-year period. All patients had microbiological confirmation of an infective process. The average age was 36 years (23-68 years). The average hospital stay was 6 days (4-9 days). No patient had a recurrence or complained of tenderness or hypoaesthesia around their wound. No patient experienced wound complications or skin necrosis. The average return to work time was 18 days (7-22 days). We conclude that endoscopic bursectomy is a safe and effective treatment for septic pre-patellar bursitis with a shortened hospital stay and a quicker return to work than conventional open debridement.

  3. Ultrasound-guided sclerosis of neovessels in painful chronic patellar tendinopathy: a randomized controlled trial.

    Science.gov (United States)

    Hoksrud, Aasne; Ohberg, Lars; Alfredson, Håkan; Bahr, Roald

    2006-11-01

    Color Doppler ultrasound examination frequently reveals neovascularization in chronic painful Achilles and patellar tendinopathy. Sclerosing the area with vascular ingrowth using polidocanol has shown promising clinical results in patients with Achilles tendinopathy. To investigate sclerosing treatment using polidocanol on a group of elite athletes with patellar tendinopathy. Randomized controlled trial/cross-over study; Level of evidence, 1. The authors recruited 33 patients (42 tendons), mainly from the Norwegian elite divisions in basketball, team handball, and volleyball. Seventeen patients (23 knees) were randomized to the treatment group (polidocanol injections in the area of neovascularization) and 16 patients (20 knees) to the control group (similar injections with lidocaine/epinephrine). After 4 months of treatment, the control group was crossed over to active treatment. Pain and function were recorded using the Victorian Institute of Sport Assessment score before the start of treatment and 4, 8, and 12 months after the first injection. Victorian Institute of Sport Assessment scores between groups were compared using multivariate analysis of variance for repeated measures. The treatment group reported a significant improvement in Victorian Institute of Sport Assessment score from 51 to 62 after 4 months; there was no change for the control group (group by time interaction, P = .052). After 8 months, when the control group had also received active treatment with polidocanol, they had a greater improvement in Victorian Institute of Sport Assessment score (58-79) than did the treatment group (54-70; group by time interaction, P = .022; time effect, P patellar tendinopathy.

  4. Rehabilitation protocol for patellar tendinopathy applied among 16- to 19-year old volleyball players.

    Science.gov (United States)

    Biernat, Ryszard; Trzaskoma, Zbigniew; Trzaskoma, Lukasz; Czaprowski, Dariusz

    2014-01-01

    The aim of the study was to investigate the efficacy of rehabilitation protocol applied during competitive period for the treatment of patellar tendinopathy. A total of 28 male volleyball players were divided into two groups. Fifteen from experimental group (E) and 13 from control group (C) fulfilled the same tests 3 times: before the training program started (first measurement), after 12 weeks (second measurement) and after 24 weeks (third measurement). The above-mentioned protocol included the following: USG imagining with color Doppler function, clinical testing, pain intensity evaluation with VISA-P questionnaire, leg muscle strength and power and jumping ability measurements. The key element of the rehabilitation program was eccentric squat on decline board with additional unstable surface. The essential factor of the protocol was a set of preventive functional exercises, with focus on eccentric exercises of hamstrings. Patellar tendinopathy was observed in 18% of the tested young volleyball players. Implementation of the presented rehabilitation protocol with eccentric squat on decline board applied during sports season lowered the pain level of the young volleyball players. Presented rehabilitation protocol applied without interrupting the competitive period among young volleyball players together with functional exercises could be an effective method for the treatment of patellar tendinopathy.

  5. PATELLAR REALIGNMENT AND FUNCTIONAL PERFORMANCE IN PATIENTS WITH PATELLOFEMORAL PAIN SYNDROME

    Directory of Open Access Journals (Sweden)

    Abeer Farag Hanafy

    2016-02-01

    Full Text Available Background: Patellar taping is used for pain relief in patients with patello-femoral pain syndrome (PFPS. Yet, there is lack of knowledge regarding its effect on the functional performance. The purpose of the study was to examine the effects of therapeutic patellar taping on the Visual Analogue Scale (VAS pain scores, number of bilateral squats, and stair climbing time in patients with PFPS. Methods: 30 female patients with PFPS with mean age 20.3± 1.46 years, weight 66.1± 9.68 kg, height 165.83 ± 3.89 cm and BMI 23.91 ± 3.50kg/m2 participated in the study. The subjects were tested randomly under three taping conditions;namely therapeutic, placebo and no-tape. The tested limb was determined to be the affected limb in patients with unilateral affection, and the symptomatic limb in patients with bilateral affection. Data was collected using the Visual Analogue Scale (VAS, Bilateral Squat Test and Timed Stair Ambulation Test. Results: Repeated measures Multivariate Analysis of Variance (MANOVA revealed that the number of bilateral squats increased significantly (p0.05 in between for the number of bilateral squats and stair climbing time. Conclusion: The findings indicated that therapeutic patellar taping is effective in improving functional performance and reducing pain in patients with patellofemoral pain syndrome (PFPS.

  6. Comparison of surface coil and knee coil for evaluation of the patellar cartilage by MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Steen, M. van den; Maeseneer, M. de E-mail: midema@belgacom.net; Hoste, M.; Vanderdood, K.; Ridder, F. de; Osteaux, M

    2003-07-01

    Purpose: The aim of this work was to compare the knee coil and the surface coil for the visualisation of the patellar cartilage. Materials and methods: In 28 patients (17 women, 11 men) with an average age of 40 years (range 14-76) with knee pain MR was performed. Transverse images were obtained using a fast spin echo proton density weighted sequence on a Philips Gyroscan Intera 1.5 T clinical system. Transverse images were obtained at the level of the patellar cartilage using both the surface and the knee coil. All images were evaluated by consensus of two radiologists. They evaluated a number of quality criteria on a 4-point scale. Criteria for artefacts were also graded on a 4-point scale. Results: For the visualisation of fluid there was no significant difference between the knee coil and the surface coil (P=0.021). For all other criteria regarding image quality and presence of imaging artefacts there was a significant difference between both coils (P<0.001) with the surface coil obtaining the better result. Conclusion: The use of the surface coil in the visualisation of the patellar cartilage can be recommended at knee MR.

  7. Immediate effects of whole body vibration on patellar tendon properties and knee extension torque.

    Science.gov (United States)

    Rieder, F; Wiesinger, H-P; Kösters, A; Müller, E; Seynnes, O R

    2016-03-01

    Reports about the immediate effects of whole body vibration (WBV) exposure upon torque production capacity are inconsistent. However, the changes in the torque-angle relationship observed by some authors after WBV may hinder the measurement of torque changes at a given angle. Acute changes in tendon mechanical properties do occur after certain types of exercise but this hypothesis has never been tested after a bout of WBV. The purpose of the present study was to investigate whether tendon compliance is altered immediately after WBV, effectively shifting the optimal angle of peak torque towards longer muscle length. Twenty-eight subjects were randomly assigned to either a WBV (n = 14) or a squatting control group (n = 14). Patellar tendon CSA, stiffness and Young's modulus and knee extension torque-angle relationship were measured using ultrasonography and dynamometry 1 day before and directly after the intervention. Tendon CSA was additionally measured 24 h after the intervention to check for possible delayed onset of swelling. The vibration intervention had no effects on patellar tendon CSA, stiffness and Young's modulus or the torque-angle relationship. Peak torque was produced at ~70° knee angle in both groups at pre- and post-test. Additionally, the knee extension torque globally remained unaffected with the exception of a small (-6%) reduction in isometric torque at a joint angle of 60°. The present results indicate that a single bout of vibration exposure does not substantially alter patellar tendon properties or the torque-angle relationship of knee extensors.

  8. Effects of patellar taping on brain activity during knee joint proprioception tests using functional magnetic resonance imaging.

    Science.gov (United States)

    Callaghan, Michael J; McKie, Shane; Richardson, Paul; Oldham, Jacqueline A

    2012-06-01

    Patellar taping is a common treatment modality for physical therapists managing patellofemoral pain. However, the mechanisms of action remain unclear, with much debate as to whether its efficacy is due to a change in patellar alignment or an alteration in sensory input. The purpose of this study was to investigate the sensory input hypothesis using functional magnetic resonance imaging when taping was applied to the knee joint during a proprioception task. This was an observational study with patellar taping intervention. Eight male volunteers who were healthy and right-leg dominant participated in a motor block design study. Each participant performed 2 right knee extension repetitive movement tasks: one simple and one proprioceptive. These tasks were performed with and without patellar taping and were auditorally paced for 400 seconds at 72 beats/min (1.2 Hz). The proprioception task without patellar taping caused a positive blood oxygenation level-dependant (BOLD) response bilaterally in the medial supplementary motor area, the cingulate motor area, the basal ganglion, and the thalamus and medial primary sensory motor cortex. For the proprioception task with patellar taping, there was a decreased BOLD response in these regions. In the lateral primary sensory cortex, there was a negative BOLD response with less activity for the proprioception task with taping. Limitations This study may have been limited by the small sample size, a possible learning effect due to a nonrandom order of tasks, and use of a single-joint knee extension task. This study demonstrated that patellar taping modulates brain activity in several areas of the brain during a proprioception knee movement task.

  9. Effects of In-Season Inertial Resistance Training With Eccentric Overload in a Sports Population at Risk for Patellar Tendinopathy.

    Science.gov (United States)

    Gual, Gabriel; Fort-Vanmeerhaeghe, Azahara; Romero-Rodríguez, Daniel; Tesch, Per A

    2016-07-01

    Gual, G, Fort-Vanmeerhaeghe, A, Romero-Rodríguez, D, and Tesch, PA. Effects of in-season inertial resistance training with eccentric overload in a sports population at risk for patellar tendinopathy. J Strength Cond Res 30(7): 1834-1842, 2016-Volleyball and basketball players can be considered as a population at risk for patellar tendinopathy. Given the paradox that eccentric training elicits therapeutic benefits yet might provoke such injury, we investigated the influence of a weekly bout of inertial squat resistance exercise offering eccentric overload on lower limb muscle power and patellar tendon complaints. Players of 8 (4 basketball and 4 volleyball) teams (38 women and 43 men) were randomly assigned to either the intervention (IG) or control (CG) group. Although IG and CG maintained scheduled in-season training routines over 24 weeks, IG, in addition, performed 1 weekly session of eccentric overload by 4 sets of 8 repetitions of the squat using flywheel inertial resistance. Victorian Institute of Sports Assessment patellar tendinopathy questionnaire (VISA-p), vertical countermovement jump, and squat power, both concentric (Squat-Con) and eccentric (Squat-Ecc), tests were performed before (T1), during (T2), and after (T3) the 24 weeks of intervention. Neither group suffered from patellar tendinopathy during the study period. VISA-p displayed no differences across groups at any measurement period. Countermovement jump scores significantly (p ≤ 0.05) differed between groups in favor of the IG. Both Squat-Con and Squat-Ecc mean scores from the IG were significantly (p training bout to a regular basketball and volleyball exercise routine enhances lower limb muscle power without triggering patellar tendon complaints. Future studies, using the current exercise paradigm, aim to explore its efficacy to prevent or combat patellar tendinopathy in sports calling for frequent explosive jumps.

  10. Spontaneous Rupture of the Patellar and Contralateral Quadriceps Tendons Associated with Secondary Hyperparathyroidism in a Patient Receiving Long-term Dialysis

    Directory of Open Access Journals (Sweden)

    Chiu-Ming Chen

    2006-01-01

    Full Text Available Although spontaneous rupture of the extensor tendon of the knee is more likely to occur in uremic patients with secondary hyperparathyroidism, simultaneous ruptures of bilateral knee extensor tendons is a rarely reported condition. We describe a 30-year-old man with uremia who underwent subtotal parathyroidec-tomy because of secondary hyperparathyroidism with very high serum parathyroid hormone (PTH level (1940.4 pg/mL. Two weeks later, he complained of a sharp pain in both knees without trauma when he walked downstairs with his left knee forward and right knee behind. Spontaneous simultaneous ruptures of the right patellar tendon and the left quadriceps tendon were diagnosed and surgically repaired. The mechanism of spontaneous tendon rupture in uremic patients with secondary hyperparathyroidism seems to be related to high PTH level which results in osteolytic bone resorption at the tendon insertion site. Early surgical repair, control of secondary hyperparathyroidism, early use of vitamin D analogs, and total parathyroidectomy with or without autotransplantation of part of the parathyroid gland, can treat and prevent tendon rupture or re-rupture with satisfactory results.

  11. NEGLECTED PATELLAR TENDON RUPTURE : RECONSTRUCTION USING IPSILATERAL SEMITENDINOSUS AND GRACILIS TENDON GRAFTS AND ETHIBOND AUGMENTATION

    Directory of Open Access Journals (Sweden)

    Buchupalli Bharath Reddy

    2015-02-01

    Full Text Available INTRODUCTION: Neglected rupture of the patellar tendon is a rare disabling injury that is technically difficult to manage. Many different surgical techniques have been described for reconstruction of the disrupted extensor mechanism of the knee. In this study we describe an improved technique for the reconstruction of patellar tendon using semitendinosus and gracilis tendon grafts preserving their t ibial insertion distally and Ethibond suture augmentation instead of stainless steel wire having the added advantage of no further operative intervention needed for removal. MATERIALS AND METHODS: The study included 9 patients (7 male & 2 female with mean age of 40.2 years (+/ - 2 SD presented with pain, instability, difficulty in carrying out Activities of Daily Living (ADL associated with neglected patellar tendon injury. The time since injury ranged from 3months to 2years. All the patients had loss of a ctive extension, extensor lag between 30 0 to 50 0 with an average of 41.1 0 (+/ - 2 SD and severe functional limitation of ADL. All the patients underwent patellar tendon reconstruction using semitendinosus and gracilis tendon grafts. The functional outcome was assessed using Lysholm Knee Score, Visual Analogue Score (VAS and IKDC scoring system. RESULTS: Post - operatively with an average follow - up of 19 months (+/ - 2 SD all the patients had decreased amount of pain, stable knee with active extension of knee without any extension lag with flexion up to 110 0 (90 0 - 125 0 . Out of 9 patients 7 had good and two had fair functional outcome with improvement in ADL with the IKDC score of 83.5 (+/ - SD, Lysholm Knee Score 90.8 (+/ - SD and no/little pain on Visual Anal ogue Scale. CONCLUSION: The results of our study shows that the use of ipsilateral semitendinosus and gracilis tendon grafts preserving their insertions on tibia distally for reconstruction of neglected patellar tendon ruptures along with Ethibond suture a ugmentation provides good

  12. Factors affecting the outcomes of modified tension band wiring techniques in transverse patellar fractures.

    Science.gov (United States)

    Hsu, Kai-Lan; Chang, Wei-Lun; Yang, Chyun-Yu; Yeh, Ming-Long; Chang, Chih-Wei

    2017-12-01

    Modified tension band wiring has been widely used to treat transverse patellar fractures. However, few studies have evaluated the clinical outcomes using different methods of Kirschner wire bending, location of the tension band, and depths of Kirschner wires. Thus, we tried to clarify these factors according to our clinical outcomes. This retrospective cohort study recruited consecutive patients underwent surgical fixation for patellar fractures using modified tension band technique between January 2010 and December 2015. Different factors in this procedure, including the bending manner of the Kirschner wires, their depth, and location of the tension band with respect to the superior and inferior border of the patella were recorded and analysed. The primary outcome was early loss of fixation. The secondary outcomes were minor loss of reduction, implant breakage, deep infection, and the need for implant removal. This study included 170 patients with patellar fractures. Regarding the bending method, similar results were obtained with bilaterally or proximally bent Kirschner wires. Regarding length, the tension band was placed closely (within 25% of the patella length) in 124 patients and distantly in 46 patients. The rates of loss of reduction and implant breakage were significantly higher in the distantly placed tension bands. Regarding depth, 37 patellar fractures were fixed with the Kirschner wires at the superficial one third of the patellae while the K- wires at the middle layer of patella were used in the remaining 133 patellar fractures. A significantly higher rate of minor loss of reduction was obtained using the superficial Kirschner wires. The modified tension band technique for transverse patella fractures provides favourable clinical outcomes, with low failure (5%) and infection (2%) rates. Implant irritation is the major complication, and almost half of cases require implant removal. The location of the tension band with respect to the superior and

  13. Polymorphism of dislocation core structures at the atomic scale.

    Science.gov (United States)

    Wang, Zhongchang; Saito, Mitsuhiro; McKenna, Keith P; Ikuhara, Yuichi

    2014-01-01

    Dislocation defects together with their associated strain fields and segregated impurities are of considerable significance in many areas of materials science. However, their atomic-scale structures have remained extremely challenging to resolve, limiting our understanding of these ubiquitous defects. Here, by developing a complex modelling approach in combination with bicrystal experiments and systematic atomic-resolution imaging, we are now able to pinpoint individual dislocation cores at the atomic scale, leading to the discovery that even simple magnesium oxide can exhibit polymorphism of core structures for a given dislocation species. These polymorphic cores are associated with local variations in strain fields, segregation of defects, and electronic states, adding a new dimension to understanding the properties of dislocations in real materials. The findings advance our fundamental understanding of basic behaviours of dislocations and demonstrate that quantitative prediction and characterization of dislocations in real materials is possible.

  14. Riemann–Cartan Geometry of Nonlinear Dislocation Mechanics

    KAUST Repository

    Yavari, Arash

    2012-03-09

    We present a geometric theory of nonlinear solids with distributed dislocations. In this theory the material manifold-where the body is stress free-is a Weitzenböck manifold, that is, a manifold with a flat affine connection with torsion but vanishing non-metricity. Torsion of the material manifold is identified with the dislocation density tensor of nonlinear dislocation mechanics. Using Cartan\\'s moving frames we construct the material manifold for several examples of bodies with distributed dislocations. We also present non-trivial examples of zero-stress dislocation distributions. More importantly, in this geometric framework we are able to calculate the residual stress fields, assuming that the nonlinear elastic body is incompressible. We derive the governing equations of nonlinear dislocation mechanics covariantly using balance of energy and its covariance. © 2012 Springer-Verlag.

  15. Simulation of structure and annihilation of screw dislocation dipoles

    DEFF Research Database (Denmark)

    Rasmussen, Torben; Vegge, Tejs; Leffers, Torben

    2000-01-01

    Large scale atomistic simulations are used to investigate the properties of screw dislocation dipoles in copper. Spontaneous annihilation is observed for dipole heights less than 1 nm. Equilibrated dipoles of heights larger than 1 nm adopt a skew configuration due to the elastic anisotropy of Cu....... The equilibrium splitting width of the screw dislocations decreases with decreasing dipole height, as expected from elasticity theory. The energy barriers, and corresponding transition states for annihilation of stable dipoles are determined for straight and for flexible dislocations for dipole heights up to 5.......2 nm. In both cases the annihilation is initiated by cross-slip of one of the dislocations. For straight dislocations the activation energy shows a linear dependence on the inverse dipole height, and for flexible dislocations the dependence is roughly linear for the dipoles investigated....

  16. Orbital Blowout Fracture with Complete Dislocation of the Globe into the Maxillary Sinus.

    Science.gov (United States)

    Wang, Joy Mh; Fries, Fabian N; Hendrix, Philipp; Brinker, Titus; Loukas, Marios; Tubbs, R Shane

    2017-09-29

    This rare case report describes the diagnosis and treatment of an isolated left-sided orbital floor fracture with a complete dislocation of the globe into the maxillary sinus and briefly discusses the indications of surgery and recovery for orbital floor fractures in general. Complete herniation of the globe through an orbital blow-out fracture is uncommon. However, the current case illustrates that such an occurrence should be in the differential diagnosis and should be considered, especially following high speed/impact injuries involving a foreign object. In these rare cases, surgical intervention is required.

  17. Closed Reduction of ?Irreducible? Posterolateral Knee Dislocation - A Case Report

    OpenAIRE

    Tateda, Satoshi; Takahashi, Atsushi; Aizawa, Toshimi; Umehara, Jutaro

    2016-01-01

    Introduction: Posterolateral rotary knee dislocation is a rare orthopedic injury that is considered to be irreducible by closed reduction because of soft tissue incarceration. Here, we present a case of posterolateral rotary knee dislocation, which was reduced by closed manipulation. Case report: The patientwas a 33-year-old man who sustained a twisting injury to his right knee that was diagnosed as posterolateral rotary knee dislocation by plain radiographs and the characteristic physical fi...

  18. Static Dislocation Interactions in Thin Channels between Cuboidal Particles

    Czech Academy of Sciences Publication Activity Database

    Dlouhý, Antonín; Probst-Hein, M.; Eggeler, G.

    309-310, - (2001), s. 278-282 ISSN 0921-5093. [Dislocations 2000. Gaithersburg, 19.06.2000-22.06.2000] R&D Projects: GA MŠk OC P3.50 Institutional research plan: CEZ:AV0Z2041904 Keywords : discrete dislocation modeling * single crystal superalloys * .gamma./.gamma.'-interface dislocations Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 0.978, year: 2001

  19. Correlation between Magnetic Resonance Imaging Characteristics of the Patellar Tendon and Clinical Scores in Osgood-Schlatter Disease.

    Science.gov (United States)

    Lee, Dhong Won; Kim, Min Jeong; Kim, Woo Jong; Ha, Jeong Ku; Kim, Jin Goo

    2016-03-01

    This study aims to evaluate magnetic resonance imaging (MRI) findings in young adults with symptomatic Osgood-Schlatter disease (OSD) and compare those in young adults without OSD. We compared MRI findings between young adults with OSD (OS group, n=30) and the equivalent number of young adults without OSD (control group). Visual analog scale scores and Kujala scores were evaluated and correlation analysis was performed in the OS group. In the OS group, MRI revealed that the patellar tendon was attached to the tibia more widely, resulting in a reduced free tendon portion, and more proximally to the articular surface (p<0.001). The correlation analysis between MRI findings and clinical scores showed statistically significant correlations (p<0.01). In the OS group, 43% presented with patellar tendinopathy or bone marrow edema at the distal attachments. Compared to the control group, the relatively small free portion and relatively proximal attachment of the patellar tendon were observed with MRI in the OS group. The free portion of the patellar tendon was positively correlated with the clinical scores. Patellar tendinopathy was also frequently encountered in the OS group.

  20. Clinical improvements are not explained by changes in tendon structure on UTC following an exercise program for patellar tendinopathy.

    Science.gov (United States)

    van Ark, Mathijs; Rio, Ebonie; Cook, Jill; van den Akker-Scheek, Inge; Gaida, James E; Zwerver, Johannes; Docking, Sean

    2018-04-11

    The aim of this study was to investigate the effects of a 4-week in-season exercise program of isometric or isotonic exercises on tendon structure and dimensions as quantified by Ultrasound Tissue Characterization (UTC). Randomized clinical trial. Volleyball and basketball players (16-31 years, n=29) with clinically diagnosed patellar tendinopathy were randomized to a 4-week isometric or isotonic exercise program. The programs were designed to decrease patellar tendon pain. A baseline and 4-week UTC scan was used to evaluate change in tendon structure. No significant change in tendon structure or dimensions on UTC was detected after the exercise program, despite patellar tendinopathy symptoms improving. The percentage and mean cross-sectional area (mCSA) of aligned fibrillar structure (echo-types I+II) (Z=-0.414,p=0.679) as well as disorganized structure (echo-types III + IV) (Z=-0.370,p=0.711) did not change over the 4-week exercise program. Change in tendon structure and dimensions on UTC did not differ significantly between the groups. Structural properties and dimensions of the patellar tendon on UTC did not change after a 4-week isometric or isotonic exercise program for athletes with patellar tendinopathy in-season, despite an improvement of symptoms. It seems that structural improvements are not required for a positive clinical outcome.

  1. Atlantooccipital dislocation in motor vehicle side impact, derivation of the mechanism of injury, and implications for early diagnosis

    Directory of Open Access Journals (Sweden)

    Kevin M Smith

    2010-01-01

    Full Text Available Numerous reports of atlantooccipital dislocations (AODs have been described in frontal impacts and vehicle versus pedestrian collisions. Reports of survival after AOD in conjunction with side impacts have infrequently been reported in the literature. The objective of this study is to present a case of an AOD from a side impact vehicle collision, and deduce the mechanism of injury. A clinical and biomechanical reconstruction of the collision was performed to investigate the mechanism of the dislocation. A 51-year-old female was traveling in a four-door sedan and sustained a side impact collision with a compact pickup truck. At the time of extrication, the patient was neurologically intact with a Glasgow Coma Scale score of 15. After admittance to the hospital, the patient developed a decline in respiratory status, right mild hemiparesis, and left sixth-nerve palsy, and magnetic resonance imaging (MRI and computed tomography (CT reconstructions indicated a craniocervical dislocation. Surgical fixation was performed and all extra-axial hemorrhaging was evacuated. At discharge, the patient was neurologically intact on the left side, had right mild hemiparesis, left sixth-nerve palsy, and minor dysarthria. Survival rates of AODs have recently been increasing. Morbidity is still more prevalent, however. Due to the variety of symptoms that accompany AODs and the inconsistency of diagnostic imaging techniques, a thorough history of the etiology may lead to increased clinical suspicion of this injury and further raise survival rates.

  2. Atlantooccipital dislocation in motor vehicle side impact, derivation of the mechanism of injury, and implications for early diagnosis.

    Science.gov (United States)

    Smith, Kevin M; Yoganandan, Narayan; Pintar, Frank A; Kurpad, Shekar N; Maiman, Dennis J

    2010-07-01

    Numerous reports of atlantooccipital dislocations (AODs) have been described in frontal impacts and vehicle versus pedestrian collisions. Reports of survival after AOD in conjunction with side impacts have infrequently been reported in the literature. The objective of this study is to present a case of an AOD from a side impact vehicle collision, and deduce the mechanism of injury. A clinical and biomechanical reconstruction of the collision was performed to investigate the mechanism of the dislocation. A 51-year-old female was traveling in a four-door sedan and sustained a side impact collision with a compact pickup truck. At the time of extrication, the patient was neurologically intact with a Glasgow Coma Scale score of 15. After admittance to the hospital, the patient developed a decline in respiratory status, right mild hemiparesis, and left sixth-nerve palsy, and magnetic resonance imaging (MRI) and computed tomography (CT) reconstructions indicated a craniocervical dislocation. Surgical fixation was performed and all extra-axial hemorrhaging was evacuated. At discharge, the patient was neurologically intact on the left side, had right mild hemiparesis, left sixth-nerve palsy, and minor dysarthria. Survival rates of AODs have recently been increasing. Morbidity is still more prevalent, however. Due to the variety of symptoms that accompany AODs and the inconsistency of diagnostic imaging techniques, a thorough history of the etiology may lead to increased clinical suspicion of this injury and further raise survival rates.

  3. Orthodontic Mini-implants for Treatment of Long-term Anterior Dislocation of Temporomandibular Joint

    Directory of Open Access Journals (Sweden)

    Amit Dahiya

    2014-01-01

    Full Text Available Acute dislocation of the temporomandibular joint (TMJ is a relatively common occurrence; chronic long-term dislocation is rare. Variance in the duration of dislocation and anatomical considerations make the treatment for long-standing dislocation complex and controversial. This case report describes a new method of conservative management of a long-standing TMJ dislocation using orthodontic mini-implants.

  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. The Relationship Between Atomic Structure and Strain Distribution of Misfit Dislocation Cores at Cubic Heteroepitaxial Interfaces.

    Science.gov (United States)

    Wen, Cai

    2017-06-01

    The atomic reconstruction of a misfit dislocation (MD) core causes change in the strain distribution around the core. Several MD cores at the AlSb/GaAs (001) cubic zincblende interface, including a symmetrical glide set Lomer dislocation (LD), a left-displaced glide set LD, a glide set LD with an atomic step, a symmetrical shuffle set LD, and a 60° dislocation pair, were studied using simulated projected potential and aberration-corrected transmission electron microscope images. Image deconvolution was also used to restore structure images from nonoptimum-defocus images. The corresponding biaxial strain maps, ε xx (in-plane) and ε yy (out-of-plane), were obtained by geometric phase analysis using the GaAs substrate as the reference lattice. The results show that atomic structure characteristics of MD cores can be revealed by the strain maps. The strain maps should be measured from optimum-defocus images or restored structure images. Furthermore, the ε xx strain map has been found more accurate than the ε yy strain map for MD cores, and the specimen thickness should be below the critical thickness due to the influence of dynamical scattering.

  6. Comparison of reliability of five patellar position indices at various stifle joint angles in pelvic limbs obtained from cadavers of red foxes (Vulpes vulpes)

    DEFF Research Database (Denmark)

    Miles, James E; Nielsen, Dorte H; Jensen, Bente Rona

    2012-01-01

    To compare 5 patellar position indices at various stifle joint angles in cadavers of red foxes, determine measurement reliability, and assess the suitability of these indices for clinical use.......To compare 5 patellar position indices at various stifle joint angles in cadavers of red foxes, determine measurement reliability, and assess the suitability of these indices for clinical use....

  7. The TOPSHOCK study : Effectiveness of radial shockwave therapy compared to focused shockwave therapy for treating patellar tendinopath - Design of a randomised controlled trial

    NARCIS (Netherlands)

    van der Worp, H.; Zwerver, J.; van den Akker-Scheek, I.; Diercks, R.L.

    2011-01-01

    Background: Patellar tendinopathy is a chronic overuse injury of the patellar tendon that is especially prevalent in people who are involved in jumping activities. Extracorporeal Shockwave Therapy is a relatively new treatment modality for tendinopathies. It seems to be a safe and promising part of

  8. Simultaneous Bilateral Anterior Shoulder Dislocation Occurred During Sleepwalking

    Directory of Open Access Journals (Sweden)

    fevzi yilmaz

    2013-10-01

    A 17-years-old male presented to our emergency department with a complaint of bilateral shoulder pain and motion restriction. His past medical history was unremarkable for epilepsy or major trauma. His family members said that he was a sleepwalker since he was 5 or 6 years old and sometimes he was going to another place from his bed and when they saw him there were abrasions especially on his face and extremities. It was learned that he left the drugs given by the doctors for his complaint after using a short time. On his physical examination in the emergency department he appeared to be good, he was concious, cooperative and oriented to person, time and place. His vital signs and neurological examination were normal. His extremity examination revealed that his arms were slightly in abduction and external rotation. There was epaulet sign bilateral on his shoulders and his peripheral neurological examination was otherwise normal. The radiological evaluation revealed bilateral subchorocoidal anterior dislocation without signs of fracture (Figure 1.

  9. Interfacial dislocation motion and interactions in single-crystal superalloys

    Energy Technology Data Exchange (ETDEWEB)

    Liu, B. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Raabe, D. [Max Planck Inst. fur Eisenforshung. Dusseldorf (Germany); Roters, F. [Max Planck Inst. fur Eisenforshung. Dusseldorf (Germany); Arsenlis, A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2014-10-01

    The early stage of high-temperature low-stress creep in single-crystal superalloys is characterized by the rapid development of interfacial dislocation networks. Although interfacial motion and dynamic recovery of these dislocation networks have long been expected to control the subsequent creep behavior, direct observation and hence in-depth understanding of such processes has not been achieved. Incorporating recent developments of discrete dislocation dynamics models, we simulate interfacial dislocation motion in the channel structures of single-crystal superalloys, and investigate how interfacial dislocation motion and dynamic recovery are affected by interfacial dislocation interactions and lattice misfit. Different types of dislocation interactions are considered: self, collinear, coplanar, Lomer junction, glissile junction, and Hirth junction. The simulation results show that strong dynamic recovery occurs due to the short-range reactions of collinear annihilation and Lomer junction formation. The misfit stress is found to induce and accelerate dynamic recovery of interfacial dislocation networks involving self-interaction and Hirth junction formation, but slow down the steady interfacial motion of coplanar and glissile junction forming dislocation networks. The insights gained from these simulations on high-temperature low-stress creep of single-crystal superalloys are also discussed.

  10. Dislocation kinetics and the acoustic-wave approximation for liquids

    International Nuclear Information System (INIS)

    Stout, R.B.

    1983-03-01

    A dislocation-dependent model for liquids describes the lattice deformation and the fluidity deformation as additive deformations. The lattice deformation represents distortions of an atom's potential energy structure and is a recoverable deformation response. The fluidity deformation represents discontinuous repositioning of atoms by dislocation kinetics in the lattice structure and is a nonrecoverable deformation response. From this model, one concludes that in liquids the acoustic-wave approximation is a description of a recoverable oscillation deformation that has dissipation because of dislocation kinetics. Other more-complex waves may exist, but such waves would rapidly disappear because of the small thermodynamic potential for dislocation kinetics in liquids

  11. Fabrication of mesoscopic floating Si wires by introducing dislocations

    International Nuclear Information System (INIS)

    Motohashi, Mitsuya; Shimizu, Kazuya; Niwa, Masaaki; Suzuki, Toshiaki

    2014-01-01

    We fabricated a mesoscopic Si wire by introducing dislocations in a silicon wafer before HF anodization. The dislocations formed along the (111) crystal plane. The outline of the dislocation line was an inverted triangle. The resulting wire floated on a bridge girder and had a hybrid structure consisting of a porous layer and crystalline Si. The cross section of the wire had an inverted triangle shape. The wire formation mechanism is discussed in terms of carrier transport, crystal structure, and dislocation formation during anodization. (paper)

  12. Fabrication of mesoscopic floating Si wires by introducing dislocations

    Science.gov (United States)

    Motohashi, Mitsuya; Shimizu, Kazuya; Suzuki, Toshiaki; Niwa, Masaaki

    2014-12-01

    We fabricated a mesoscopic Si wire by introducing dislocations in a silicon wafer before HF anodization. The dislocations formed along the (111) crystal plane. The outline of the dislocation line was an inverted triangle. The resulting wire floated on a bridge girder and had a hybrid structure consisting of a porous layer and crystalline Si. The cross section of the wire had an inverted triangle shape. The wire formation mechanism is discussed in terms of carrier transport, crystal structure, and dislocation formation during anodization.

  13. Harmonic oscillator in an elastic medium with a spiral dislocation

    Science.gov (United States)

    Maia, A. V. D. M.; Bakke, K.

    2018-02-01

    We investigate the behaviour of a two-dimensional harmonic oscillator in an elastic medium that possesses a spiral dislocation (an edge dislocation). We show that the Schrödinger equation for harmonic oscillator in the presence of a spiral dislocation can be solved analytically. Further, we discuss the effects of this topological defect on the confinement to a hard-wall confining potential. In both cases, we analyse if the effects of the topology of the spiral dislocation gives rise to an Aharonov-Bohm-type effect for bound states.

  14. Dislocation and its recurrence after revision total hip arthroplasty.

    Science.gov (United States)

    Yoshimoto, Kensei; Nakashima, Yasuharu; Yamamoto, Takuaki; Fukushi, Jun-Ichi; Motomura, Goro; Ohishi, Masanobu; Hamai, Satoshi; Iwamoto, Yukihide

    2016-08-01

    Dislocation is a leading cause of failure after revision total hip arthroplasty (THA). This study was conducted to examine the risk factors for dislocation as well as their recurrence after revision THA. We retrospectively reviewed 178 revision THAs in 162 patients between 1998 and 2013. The mean patient age was 65.2 years at operation and the mean follow-up period was 6.7 years. Multivariate logistic regression was performed to identify risk factors for dislocation, and further comparison was made between patients with single and recurrent dislocations. Sixteen hips in 15 patients (9.0 %) dislocated at a mean of 9.1 months (range, 0-83 months) after revision THA. Multivariate analysis identified advanced age (odds ratio [OR] = 2.94/10 years) and osteonecrosis of the femoral head (OR = 7.71) as the independent risk factors for any dislocations. Risk factors for recurrent dislocations, which were observed in eight hips (50 %), were later dislocations (≥4 months) and lower BMI. Dislocation is a serious problem after revision THA with multiple risk factors. Although our findings were limited to revision THAs done through posterolateral approach, recognition of these factors is helpful in patient education and surgical planning.

  15. Dislocations and torsion in graphene and related systems

    International Nuclear Information System (INIS)

    Juan, Fernando de; Cortijo, Alberto; Vozmediano, Maria A.H.

    2010-01-01

    A continuum model to study the influence of dislocations on the electronic properties of condensed matter systems is described and analyzed. The model is based on a geometrical formalism that associates a density of dislocations with the torsion tensor and uses the technique of quantum field theory in curved space. When applied to two-dimensional systems with Dirac points like graphene we find that dislocations couple in the form of vector gauge fields similar to these arising from curvature or elastic strain. We also describe the ways to couple dislocations to normal metals with a Fermi surface.

  16. Dislocation and void segregation in copper during neutron irradiation

    DEFF Research Database (Denmark)

    Singh, Bachu Narain; Leffers, Torben; Horsewell, Andy

    1986-01-01

    High-purity (99. 999%) and fully annealed copper specimens have been irradiated in the DR-3 reactor at Riso to doses of 1 multiplied by 10**2**2 and 5 multiplied by 10**2**2 neutrons (fast)m** minus **2(2 multiplied by 10** minus **3 dpa and 1 multiplied by 10** minus **2 dpa, respectively...... were distributed between these walls. The dislocation walls were practically free of voids and generally had a void-denuded zone along them. The density of dislocations (loops and segments) was very low in the region containing voids (i. e. between the dislocation walls). Even with this low dislocation...

  17. Traumatic Anterior Dislocation of Hip in a Child- Case Report

    Directory of Open Access Journals (Sweden)

    S Ahmad

    2015-03-01

    Full Text Available Traumatic hip dislocation in children is relatively rare accounting for about 5% of all hip dislocations. Most of the hip dislocations seen in children are of the posterior type but the much rarer anterior and anterior-inferior (obturator types have also been described. We present the case of an eight years old girl with an obturator type of hip dislocation following trivial trauma. She was treated with closed reduction and immobilisation in skin traction for three weeks. She was followed up closely for one year and did not develop any complications during that period.

  18. New method for cardiac resynchronization therapy: Transapical endocardial lead implantation for left ventricular free wall pacing

    NARCIS (Netherlands)

    I. Kassai (Imre); C. Foldesi (Csaba); A. Szekely (Andrea); T. Szili-Torok (Tamas)

    2008-01-01

    textabstractCoronary sinus lead placement for transvenous left ventricular (LV) pacing in cardiac resynchronization therapy (CRT) has a significant failure rate at implant and a significant dislocation rate during follow-up. For these patients, epicardial pacing lead implantation is the most

  19. Dislocation mediated alignment during metal nanoparticle coalescence

    International Nuclear Information System (INIS)

    Lange, A.P.; Samanta, A.; Majidi, H.; Mahajan, S.; Ging, J.; Olson, T.Y.; Benthem, K. van; Elhadj, S.

    2016-01-01

    Dislocation mediated alignment processes during gold nanoparticle coalescence were studied at low and high temperatures using molecular dynamics simulations and transmission electron microscopy. Particles underwent rigid body rotations immediately following attachment in both low temperature (500 K) simulated coalescence events and low temperature (∼315 K) transmission electron microscopy beam heating experiments. In many low temperature simulations, some degree of misorientation between particles remained after rigid body rotations, which was accommodated by grain boundary dislocation nodes. These dislocations were either sessile and remained at the interface for the duration of the simulation or dissociated and cross-slipped through the adjacent particles, leading to improved co-alignment. Minimal rigid body rotations were observed during or immediately following attachment in high temperature (1100 K) simulations, which is attributed to enhanced diffusion at the particles' interface. However, rotation was eventually induced by {111} slip on planes parallel to the neck groove. These deformation modes led to the formation of single and multi-fold twins whose structures depended on the initial orientation of the particles. The driving force for {111} slip is attributed to high surface stresses near the intersection of low energy {111} facets in the neck region. The details of this twinning process were examined in detail using simulated trajectories, and the results reveal possible mechanisms for the nucleation and propagation of Shockley partials on consecutive planes. Deformation twinning was also observed in-situ using transmission electron microscopy, which resulted in the co-alignment of a set of the particles' {111} planes across their grain boundary and an increase in their dihedral angle. This constitutes the first detailed experimental observation of deformation twinning during nanoparticle coalescence, validating simulation results

  20. A multidisciplinary approach including the use of platelet-rich plasma to treat an elite athlete with patellar tendinopathy – a case report

    Science.gov (United States)

    Rowan, Tracy L.; Drouin, Jillian L.

    2013-01-01

    Objective: Patellar tendinopathy affects a substantial proportion of athletes involved in jumping or kicking activities. Platelet rich plasma (PRP) injections may be a promising treatment used in conjunction with common traditional therapies. Clinical Features: Patellar tendinopathy is often the result of repetitive or excessive overload on the patellar tendon. Activity modification, cryotherapy, eccentric exercises, shockwave therapy, and PRP have been indicated as treatment options during various stages of this condition. Intervention and Outcome: A 23 year old female, elite track and field athlete was managed for patellar tendinopathy with a combination of traditional therapeutic interventions as well as a PRP injection. This athlete returned to pre-injury level of competition six months post-injection. Conclusion: Emerging literature on PRP appears to be promising for patellar tendinopathy, however, it remains unclear which patients may benefit most and whether the stage of the disorder has an impact on the clinical outcome. PMID:24302777

  1. Percutaneous osteosynthesis of Galeazzi fracture-dislocation.

    Science.gov (United States)

    Gadegone, Wasudeo M; Salphale, Yogesh; Magarkar, Ds

    2010-10-01

    A Galeazzi fracture is defined as a fracture of the radius associated with dislocation of the distal radio-ulnar joint (DRUJ). The conventional surgical technique of nailing does not give enough stability and open reduction, internal fixation with the plate is associated with numerous complications. The stacked nailing for the management of these injuries provides adequate stability, maintains the relationship of the DRUJ and promotes uneventful union by closed technique. The purpose of this study is to evaluate the results of simple, user-friendly, low cost elastic stacked nailing for the management of Galeazzi fracture dislocation. We treated 22 young adults with fresh Galeazzi fracture-dislocation of the forearm, from January 2004 to January 2008, by percutaneous fixation of fracture by stacked elastic nailing at our institute. There were 19 males and three females and the age group ranged from 20-56 years (average 35 years). Surgery was performed within 48 to 72 hours under the guidance of image intensifier. Medullary cavity was filled with two elastic titanium nails having unequal lengths and diameter. One nail acts as a reduction nail and the other acts as a stabilizing nail. The results were evaluated using Mikic criteria based on union, alignment, relationship of the DRUJ, and movements at the inferior radio ulnar joint, elbow and wrist. In six cases, following radiological union, nails in the radius were extracted between six to nine months after operation because of discomfort complained by the patient at site of insertion. After one year follow-up, 18 patients had excellent, four had fair results. Closed reduction and internal fixation of Galeazzi fracture by two elastic rods re-establishes the normal relationship of the fractured fragments and the DRUJ without repair of the ligaments. The stability is achieved by the flexibility and elasticity of the nails, crowding of the medullary canal and anchorage they gain in the radial diaphysis. Elastic nailing

  2. Humeral shaft fracture with ipsilateral shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Behera Prateek

    2014-02-01

    Full Text Available 【Abstract】Although fracture of the humeral shaft or dislocation of the shoulder joint is a common injury, a simutaneous injury is rare. We present such a case combined with head injury which took precedence over the skeletal injuries. The postoperative rehabilitation was slowed down by the head injury. This case report makes us aware of some problems when managing the patient with this rare injury and helps us understand the management options better. Also the need for proper follow-up and rehabilitation is emphasized.

  3. Influence of acetaminophen and ibuprofen on in vivo patellar tendon adaptations to knee extensor resistance exercise in older adults

    DEFF Research Database (Denmark)

    Carroll, C C; Dickinson, J M; LeMoine, J K

    2011-01-01

    . These responses were generally uninfluenced by ibuprofen consumption. In the acetaminophen group, tendon deformation and strain increased 20% (P knee extensor resistance training in older...... training. Thirty-six individuals were randomly assigned to a placebo (67 ± 2 yr old), acetaminophen (64 ± 1 yr old; 4,000 mg/day), or ibuprofen (64 ± 1 yr old; 1,200 mg/day) group in a double-blind manner and completed 12 wk of knee extensor resistance training. Before and after training in vivo patellar...... tendon properties were assessed with MRI [cross-sectional area (CSA) and signal intensity] and ultrasonography of patellar tendon deformation coupled with force measurements to obtain stiffness, modulus, stress, and strain. Mean patellar tendon CSA was unchanged (P > 0.05) with training in the placebo...

  4. 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.)

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

    International Nuclear Information System (INIS)

    Kwee, Thomas C.; Sonneveld, Heleen; Nix, Maarten

    2016-01-01

    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.)

  6. Neovascularity in patellar tendinopathy and the response to eccentric training: a case report using Power Doppler ultrasound.

    Science.gov (United States)

    McCreesh, Karen M; Riley, Sara J; Crotty, James M

    2013-12-01

    This report describes the case of an amateur soccer player with chronic patellar tendinopathy who underwent ultrasound imaging before and after engaging in an 8-week programme of eccentric exercise. On initial assessment, greyscale ultrasound imaging demonstrated tendon thickening and reduced echogenicity, while Power Doppler imaging demonstrated a large amount of neovascularity. After 8 weeks of an eccentric loading programme, the patient reported significantly improved symptoms and functional scores, while follow-up imaging demonstrated improvement in the echo appearance of the tendon and complete resolution of the neovascularity. The association between neovascularity and symptoms in tendinopathy research is conflicting, with a paucity of research in the area of patellar tendinopathy. While further research is needed to clarify the significance of greyscale and Power Doppler ultrasound changes in relation to symptoms in patellar tendinopathy, ultrasound imaging was shown to be a useful adjunct to diagnosis and outcome assessment in this case. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Persistent Left Superior Vena Cava, The View of a Rare Case

    Directory of Open Access Journals (Sweden)

    H.Volkan Kara

    2013-10-01

    Full Text Available The glenohumeral joint is the most commonly dislocated joint in the human body. Anterior dislocatin is the most common type and posterior dislocations account for <1% of shoulder dislocations.  A 68-yearold woman was brought to the emergency department by ambulance  with shoulder pain following a fall from stairs. On local physical examination, there was severe pain on the left proximal humerus. The left arm was in internal rotation in the adducted position. Active and passive movements of the left shoulder were painful and limited. The neurovascular examination of the left upper extremity revealed no deficit. Radiographs of her left shoulder were performed and no significant pathology was identified in the left shoulder anteroposterior (AP X-ray (Figure 1. Axillary radiography could not be performed because of painful arm movements. Therefore, CT was performed to clarify any existing shoulder pathology (Figure 2. Closed reduction under conscious sedation was performed with longitudinal and lateral traction on the arm to protect the humeral head. Control CT was performed and this revealed that reduction had improved the shoulder (Figure 3. She was then treated with an arm sling and discharged with an outpatient orthopaedic control visit.

  8. Patellar taping alters knee kinematics during step descent in individuals with a meniscal injury: An exploratory study.

    Science.gov (United States)

    Roy, Nicolas; Gaudreault, Nathaly; Tousignant, Michel; Vézina, François; Boudreau, Nicolas

    2016-01-01

    Meniscus lesions are common musculoskeletal knee injuries which often lead to pain, limitation and compensations during functional tasks, such as descending stairs. This study investigated the effect of patellar taping with tension and without tension on three-dimensional (3D) kinematics of the knee during a slow step descent task in patients with meniscal lesions. Ten patients diagnosed with a meniscal lesion, confirmed by magnetic resonance imaging, underwent five, step descent movements at slow speed under three different conditions: 1) no taping; 2) tension-free taping; and 3) patellar taping with medial tension. 3D kinematic data were recorded from the injured knee using an eight-camera infrared Vicon motion analysis system. Maximum and minimum angle values and total range of motion (maximum/minimum value) in three movement planes during single-limb stance were compared using a repeated measure ANOVA. Results showed a significant increase in the maximum and minimum angle value in the sagittal plane (mean differences=2.4° and 4.2°, respectively) and a decrease in the transverse plane (-6.3° and -2.2°, respectively) for the patellar taping condition compared to the no taping condition. A decreased rotational angle range when comparing the patellar taping to the no taping (-4.1°) and tension-free taping (-3.1°) conditions was also observed. These changes remained significant when pain was considered as a covariate in the analysis. The tension applied to the patellar tape played a role in controlling the sagittal and transverse plane step-down movement among patients in our study. These results support the use of patellar taping with a medially oriented tension to help to reduce the transversal plane movement of the knee in this population and they bring new light to the taping effect. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    DEFF Research Database (Denmark)

    Lykke Hermansen, Lars; Gade Freund, Knud

    2016-01-01

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

  10. Evaluation of anterior stability of knee joint following arthroscopic ACL reconstruction with patellar ligament.

    Science.gov (United States)

    Fibiger, Wojciech; Kukiełka, Radosław T Kukiełka

    2011-01-01

    The aim of the study was to investigate and assess anterior stability of the knee joint before and during 12-month rehabilitation after arthroscopic reconstruction of the anterior cruciate ligament with the central third of the patellar ligament and stabilization with interference screws (Kenneth-Jones method) and to analyse the effectiveness of the surgery and rehabilitation by patient self-assessment of pain and crepitation in the patello-femoral joint. The study involved a group of 46 patients after arthroscopic ACL reconstruction with the patellar ligament performed in 2005 and 2006. All patients underwent examinations of anterior stability of the knee joint using a KT-1000/S arthrometer. Stability measurements were performed on both knees on the day before surgery, and at 3, 6 and 12 months after the operation. Additionally, the patients subjectively evaluated post-operative pain and crepitation in the patello-femoral joint at 3, 6 and 12 months. Knee stability after ACL reconstruction according to the Mazurkiewicz scale using a KT-1000 arthrometer was rated as good and excellent, while the patients subjectively assessed the treatment process in terms of pain and crepitation in the patello-femoral joint at 12 months after the operation as excellent (10.8%), good (74%), and satisfactory (15.2%). Arthroscopic ACL reconstruction with the central third of the patellar ligament and stabilization with interference screws fully restored the lost stability of the knee, but the possibility of pain and crepitations in the patello-femoral joint needs to be taken into account. In the course of rehabilitation, it is natural that an ACL graft may extend as a result of remodeling and the impact of rehabilitation being administered.

  11. [Treatment of septic olecranon and patellar bursitis by excision and vacuum-assisted closure therapy].

    Science.gov (United States)

    Walter, G; Kemmerer, M; Hoffmann, R

    2013-08-01

    Treatment of septic olecranon and patellar bursitis differs considerably and is currently under discussion. We therefore performed a retrospective study of our patients with septic bursitis in the past 5 years. Between March 2007 and February 2012 we treated 79 patients with septic olecranon (n = 43) and patellar (n = 36) bursitis surgically: 61-males, 18 females, age 51 (range: 11-91) years. Four patients had not been treated before, 25 had suffered recurrences after 1-10 previous procedures, and 9 patients had not improved after conservative therapy. 34 patients presented with traumatic rupture or fistula of their bursae. In all cases we performed a radical bursectomy and vacuum-assisted therapy for 4 to 5 days. In addition, patients received systemic antibiotics. We phoned all patients and were successful in 57 cases (72 %). We questioned these patients for range of movement, limitations at work, pain, sensibility disorder, satisfaction with the result and further surgical procedures. In all cases we took tissue specimens for cultures, in 48 preparations histological examination was performed. Microbiological and histological results are discussed in detail. 40 patients were free of complaints, 15 complained of mild pain, 54 of 57 had unlimited range of motion. Minor discomforts at desk work were reported by 5 of 43 patients, 12 out of 36 patient reported discomfort when performing on their knees. There was no recurrence in the period of investigation. We recommend our treatment concept for septic olecranon and patellar bursitis because patient satisfaction is high and recurrences are reliably avoided. The soft tissue is spared, so that plastic covering procedures are seldom necessary. Georg Thieme Verlag KG Stuttgart · New York.

  12. Heated lidocaine/tetracaine patch for treatment of patellar tendinopathy pain

    Directory of Open Access Journals (Sweden)

    Gammaitoni AR

    2013-07-01

    Full Text Available Arnold R Gammaitoni,1 Henry T Goitz,2 Stephanie Marsh,2 Thomas B Marriott,3 Bradley S Galer1 1Pain Group, Nuvo Research US, West Chester, PA, USA; 2Sports Medicine, Detroit Medical Center, Warren, MI, USA; 3Pain Group, Nuvo Research US, Salt Lake City, UT, USA Introduction: The pain of patellar tendinopathy (PT may be mediated by neuronal glutamate and sodium channels. Lidocaine and tetracaine block both of these channels. This study tested the self-heated lidocaine-tetracaine patch (HLT patch in patients with PT confirmed by physical examination to determine if the HLT patch might relieve pain and improve function. Methods: Thirteen patients with PT pain of ≥14 days' duration and baseline average pain scores ≥4 (on a 0–10 scale enrolled in and completed this prospective, single-center pilot study. Patients applied one HLT patch to the affected knee twice daily for 2–4 hours for a total of 14 days. Change in average pain intensity and interference (Victorian Institute of Sport Assessment [VISA] scores from baseline to day 14 were assessed. No statistical inference testing was performed. Results: Average pain scores declined from 5.5 ± 1.3 (mean ± standard deviation at baseline to 3.8 ± 2.5 on day 14. Similarly, VISA scores improved from 45.2 ± 14.4 at baseline to 54.3 ± 24.5 on day 14. A clinically important reduction in pain score (≥30% was demonstrated by 54% of patients. Conclusion: The results of this pilot study suggest that topical treatment that targets neuronal sodium and glutamate channels may be useful in the treatment of PT. Keywords: patellar tendinopathy, patellar tendinosis, heated lidocaine/tetracaine patch, topical analgesic patch, knee pain

  13. Temporomandibular joint dislocation in an epileptic and mentally ...

    African Journals Online (AJOL)

    Temporomandibular joint (TMJ) dislocation is defined as an excessive forward movement of the condyle beyond the articular eminence with complete separation of articular surfaces and fixation in that position.' Theories regarding the pathogenesis of TMJ dislocation propose laxity of TMJ ligaments or capsule, excessive ...

  14. Dislocation multiplication rate in the early stage of germanium plasticity

    Czech Academy of Sciences Publication Activity Database

    Fikar, J.; Dupas, Corinne; Kruml, Tomáš; Jacques, A.; Martin, J. L.

    400-401, - (2005), s. 431-434 ISSN 0921-5093. [Dislocations 2004. La Colle-sur-Loup, 13.09.2004-17.09.2004] Institutional research plan: CEZ:AV0Z2041904 Keywords : dislocation multiplication * germanium * constitutive modelling Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 1.347, year: 2005

  15. Management of neglected traumatic posterior dislocations of the hip ...

    African Journals Online (AJOL)

    Within a period of six months, three men were admitted following falls which had occurred more than one week previously. They had all sustained minor trauma but directly after the injury they were unable to bear weight on the affected limb. All three had Grade 1 posterior dislocations of the hip. Although the dislocation had ...

  16. Ipsilateral dislocation of the shoulder and elbow: A case report

    African Journals Online (AJOL)

    Pr KODO

    There was deformity and painful swelling of the right shoulder and elbow. No neurovascular deficit was found and other clinical. findings were normal. Plain radiograph revealed ipsilateral anterior shoulder and posterior elbow dislocations (Fig 1). Under general anesthesia, the dislocations were readily reduced by closed.

  17. Dislocated ankle fracture complicated by near total distal ischaemia

    Science.gov (United States)

    Duygun, Fatih; Sertkaya, Omer; Aldemir, Cengiz; Dogan, Ali

    2013-01-01

    Total arterial ischaemia is rarely seen following a dislocated ankle fracture but if it does and intervention is not made, it can lead to serious morbidity. We present a 39-year-old woman with almost total occlusion in the arteria tibialis and arteria dorsalis pedis following a dislocated ankle fracture as a result of a bicycle fall. PMID:24248319

  18. Perineal anterior dislocation of the hip with avulsion fracture of ...

    African Journals Online (AJOL)

    Traumatic anterior dislocation of the hip is rare even in children. Very uncommon also is the perineal variant of the inferior type of anterior dislocation with concomitant avulsion fracture of the greater trochanter. We report such a case highlighting the peculiarity of its management. No similar case of triumvirate injury of the hip ...

  19. Results of open reduction for neglected elbow dislocations in adult ...

    African Journals Online (AJOL)

    Objective: To present the results of open reduction of neglected elbow dislocations using a consistent surgical protocol. Patients and methods: Between 2000 and 2005 eight patients with neglected elbow dislocations were operated on using the Speed\\'s posterior approach with lengthening of the triceps by V-Y ...

  20. Isolated posterior dislocation of the radial head in an adult.

    Directory of Open Access Journals (Sweden)

    Negi A

    1992-07-01

    Full Text Available Isolated posterior dislocation of the radial head was detected on X-ray in a patient following a vehicular accident. Such a dislocation without an associated fracture is extremely rare in adults. Immobilization of the elbow in full pronation and 90 degrees flexion for 4 weeks normalized the position of the head of the radius.

  1. Pediatric open elbow dislocation without fracture: A case report

    Directory of Open Access Journals (Sweden)

    Gökhan Polat

    2014-01-01

    CONCLUSION: Pediatric elbow dislocations are rare injuries and the management of these injuries can be technically demanding due to concurrent neurovascular injuries. An open dislocation without fracture is very rare and it should be treated with immediate intervention, an effective teamwork and good rehabilitation.

  2. A Monte Carlo adapted finite element method for dislocation ...

    Indian Academy of Sciences (India)

    Mean and standard deviation values, as well as probability density function of ground surface responses due to the dislocation are computed. Based on analytical and numerical calculation of dislocation, two approaches of Monte Carlo simulations are proposed. Various comparisons are examined to illustrate the capability ...

  3. Superior dislocation hip with anterior column acetabular fracture ...

    African Journals Online (AJOL)

    Superior variety of anterior dislocation of the hip is a rare injury. Its occurrence with acetabular fractures has been documented infrequently. We report a case of superior dislocation of the hip with anterior column acetabular fracture. Open reduction of the hip and internal fixation of the fracture was carried out using a twin ...

  4. Exploring the Limit of Dislocation Based Plasticity in Nanostructured Metals

    DEFF Research Database (Denmark)

    Hughes, D. A.; Hansen, Niels

    2014-01-01

    A twofold decrease to an unexplored scale of 5 nm was produced in Cu by applying a large sliding load in liquid nitrogen. Statistical and universal scaling analyses of deformation induced high angle boundaries, dislocation boundaries, and individual dislocations observed by high resolution electr...

  5. Method to reduce dislocation density in silicon using stress

    Science.gov (United States)

    Buonassisi, Anthony; Bertoni, Mariana; Argon, Ali; Castellanos, Sergio; Fecych, Alexandria; Powell, Douglas; Vogl, Michelle

    2013-03-05

    A crystalline material structure with reduced dislocation density and method of producing same is provided. The crystalline material structure is annealed at temperatures above the brittle-to-ductile transition temperature of the crystalline material structure. One or more stress elements are formed on the crystalline material structure so as to annihilate dislocations or to move them into less harmful locations.

  6. Traumatic posterior dislocation of the hip: distribution and severity of ...

    African Journals Online (AJOL)

    These injuries take precedence in the emergency care of patients with posterior dislocation of the hip. The role of public enlightment on road safety measures cannot be over-emphasized and a case is made for training of the populace in essential basic life support. Keywords: Posterior hip dislocation; associated injuries; ...

  7. Rows of Dislocation Loops in Aluminium Irradiated by Aluminium Ions

    DEFF Research Database (Denmark)

    Henriksen, L.; Johansen, A.; Koch, J.

    1967-01-01

    Single-crystal aluminium specimens, irradiated with 50-keV aluminium ions, contain dislocation loops that are arranged in regular rows along <110 > directions. ©1967 The American Institute of Physics......Single-crystal aluminium specimens, irradiated with 50-keV aluminium ions, contain dislocation loops that are arranged in regular rows along directions. ©1967 The American Institute of Physics...

  8. Klippel–Trenaunay syndrome in combination with congenital dislocation of the hip

    Directory of Open Access Journals (Sweden)

    Peng Hu

    2013-04-01

    Full Text Available Klippel–Trenaunay syndrome (KTS is a rare and sporadic disorder characterized by the triad of capillary malformations, venous varicosities, and limb hypertrophy. The clinical manifestations of KTS are heterogeneous. In this report, we present a unique case of KTS in combination with congenital dislocation of the hip (CDH in a 4-day-old female neonate. The patient had a widespread port-wine stain surrounded by regions of unaffected skin in a mosaic pattern, cutaneous hemangioma on the upper lip, left-sided hemihypertrophy involving the entire body, and also evidence of left CDH (based on the results of a physical examination and radiographic interpretation. We present this case for the rarity of presentation, discuss the relationship between KTS and CDH, and the treatment options available with a brief review of the literature.

  9. Tratamento cirúrgico da tendinite distal da patela Surgical treatment of the distal patellar tendinitis

    Directory of Open Access Journals (Sweden)

    Marco Martins Amatuzzi

    2005-01-01

    Full Text Available A tendinite distal da patela é uma doença que acomete principalmente jovens esportistas e caracteriza-se por dor referida na extremidade distal da patela junto à inserção do ligamento patelar. O tratamento inicial preconizado é sempre conservador com fisioterapia. A grande maioria tem boa resposta a este tipo de conduta, mas em alguns raros casos os sintomas não regridem exigindo uma mudança de conduta. Para este grupo usamos o tratamento cirúrgico com técnica derivada de Trillat que se baseia na utilização de um enxerto de parte do tendão do músculo Grácil implantado dentro do ligamento patelar, inserido intra-ósseo na patela e fixado na tuberosidade anterior da tíbia. Foram operados seis pacientes, sendo que em dois casos a operação foi bilateral, totalizando oito joelhos. O seguimento mínimo foi de três anos, com avaliação final dentro do índice considerado como EXCELENTE, conforme a cotação ARPÉGE, para todos os joelhos.Distal patellar tendinitis is a young athlete's disease characterized by pain at the distal patellar pole, near the patellar ligament insertion. Early treatment recommended is generally conservative, with physical therapy. The great majority of patients present favorable responses to this approach, but, in some cases, the remission of symptoms does not occur, requiring a different approach. For this group, surgical treatment with a technique derived from that of Trillat was used, which is based on the use of a graft removed from a portion of gracillis muscle tendon into patellar ligament, intraosseously inserted in the patella and fixed at the tibial anterior tuberosity. Six patients were operated, bilaterally in two cases, totaling eight knees. The minimum follow-up time was three years, with all knees presenting an EXCELLENT score, according to ARPÉGE evaluation.

  10. 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.

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

    International Nuclear Information System (INIS)

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

    1982-01-01

    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. (orig.) [de

  12. Equivalence of online and clinician administration of a patellar tendinopathy risk factor and severity questionnaire

    DEFF Research Database (Denmark)

    Morton, S; Morrissey, D; Valle, X

    2015-01-01

    The VISA-P is a questionnaire for assessing the severity of patellar tendinopathy (PT). Our study aim was to evaluate the equivalence of self-administration of the VISA-P online with the addition of risk factor questions to develop a tool suitable for high-volume remote use. A crossover study...... design with 107 subjects was used to determine equivalence between online and clinician administration. Three population groups were used to ensure construct validity. Online vs clinician administration revealed an intraclass correlation (ICC) of 0.79 [confidence interval (CI): 0.68-0.86] for the VISA...

  13. SURGICAL CORRECTION OF BILATERAL PATELLAR LUXATION IN AN AMERICAN BLACK BEAR CUB (URSUS AMERICANUS).

    Science.gov (United States)

    Bennett, Katarina R; Desmarchelier, Marion R; Bailey, Trina R

    2015-06-01

    A wild orphaned male American black bear cub ( Ursus americanus ) presented with hind limb gait abnormalities and was found to have bilateral grade 3 laterally luxating patellas. There were no other significant abnormalities detected on neurologic, radiographic, or hematologic examinations. The trochlear grooves were deepened with a chondroplasty, and the redundant soft tissues imbricated. There was a marked improvement in the bear's gait postoperatively, with an apparent full return to function. To the authors' knowledge, patellar luxation has not been reported in the Ursidae family, and the success in this case suggests that this technique may be used in large wild or captive carnivore cubs.

  14. Corticosteroid injections, eccentric decline squat training and heavy slow resistance training in patellar tendinopathy

    DEFF Research Database (Denmark)

    Kongsgaard, M; Kovanen, V; Aagaard, P

    2009-01-01

    A randomized-controlled single-blind trial was conducted to investigate the clinical, structural and functional effects of peritendinous corticosteroid injections (CORT), eccentric decline squat training (ECC) and heavy slow resistance training (HSR) in patellar tendinopathy. Thirty-nine male...... patients were randomized to CORT, ECC or HSR for 12 weeks. We assessed function and symptoms (VISA-p questionnaire), tendon pain during activity (VAS), treatment satisfaction, tendon swelling, tendon vascularization, tendon mechanical properties and collagen crosslink properties. Assessments were made at 0...

  15. Effect of prostaglandin E2 injection on the structural properties of the rat patellar tendon

    Directory of Open Access Journals (Sweden)

    Ferry Scott T

    2012-01-01

    Full Text Available Abstract Background Increased tendon production of the inflammatory mediator prostaglandin E2 (PGE2 has been suggested to be a potential etiologic agent in the development of tendinopathy. Repeated injection of PGE2 into tendon has been proposed as a potential animal model for studying treatments for tendinopathy. In contrast, nonsteroidal anti-inflammatory drugs (NSAIDs which inhibit PGE2 production and are commonly prescribed in treating tendinopathy have been shown to impair the healing of tendon after acute injury in animal models. The contradictory literature suggests the need to better define the functional effects of PGE2 on tendon. Our objective was to characterize the effects of PGE2 injection on the biomechanical and biochemical properties of tendon and the activity of the animals. Our hypothesis was that weekly PGE2 injection to the rat patellar tendon would lead to inferior biomechanical properties. Methods Forty rats were divided equally into four groups. Three groups were followed for 4 weeks with the following peritendinous injection procedures: No injection (control, 4 weekly injections of saline (saline, 4 weekly injections of 800 ng PGE2 (PGE2-4 wks. The fourth group received 4 weekly injections of 800 ng PGE2 initially and was followed for a total of 8 weeks. All animals were injected bilaterally. The main outcome measurements included: the structural and material properties of the patellar tendon under tensile loading to failure, tendon collagen content, and weekly animal activity scores. Results The ultimate load of PGE2-4 wks tendons at 4 weeks was significantly greater than control or saline group tendons. The stiffness and elastic modulus of the PGE2 injected tendons at 8 weeks was significantly greater than the control or saline tendons. No differences in animal activity, collagen content, or mean fibril diameter were observed between groups. Conclusions Four weekly peritendinous injections of PGE2 to the rat patellar

  16. Self-force on dislocation segments in anisotropic crystals

    International Nuclear Information System (INIS)

    Fitzgerald, S P; Aubry, S

    2010-01-01

    A dislocation segment in a crystal experiences a 'self-force', by virtue of the orientation dependence of its elastic energy. If the crystal is elastically isotropic, this force is manifested as a couple acting to rotate the segment toward the lower energy of the pure screw orientation (i.e. acting to align the dislocation line with its Burgers vector). If the crystal is anisotropic, there are additional contributions to the couple, arising from the more complex energy landscape of the lattice itself. These effects can strongly influence the dynamic evolution of dislocation networks, and via their governing role in dislocation multiplication phenomena, control plastic flow in metals. In this paper we develop a model for dislocation self-forces in a general anisotropic crystal, and briefly consider the technologically important example of α-iron, which becomes increasingly anisotropic as the temperature approaches that of the α-γ phase transition at 912 0 C.

  17. Atlantoaxial dislocation with special emphasis on computed tomography findings

    Energy Technology Data Exchange (ETDEWEB)

    Miyasaka, Kazuo; Isu, Toyohiko; Abe, Satoru; Takei, Hidetoshi; Irie, Goro

    1983-01-01

    In this study, the authors evaluated the effectiveness of computed tomography (CT) in the diagnosis of atlantoaxial dislocation (AAD). On the basis of CT evidence of Cl-2 interrelationship, AAD in 26 patients was classified into 4 major types; anteroposterior dislocation in 13 patients, transverse dislocation in 2, anteroposterior-transverse dislocation in 3, and rotatory dislocation in 8. A thick wad of soft tissue on the posterior aspect of the odontoid was found in as many as 38% of the patients and related to compromise the spinal canal. Association of atlantooccipital subluxation with AAD was not rarely encountered in this series (6 out of 26 patients). CT can most optimally and noninvasively demonstrate relationship among the occipitoatlanto-axial complex and associated soft tissue abnormalities. (author).

  18. Small bowel entrapment and ureteropelvic junction disruption associated with L3 Chance fracture-dislocation

    Science.gov (United States)

    Pesenti, Sebastien; Blondel, Benjamin; Faure, Alice; Peltier, Emilie; Launay, Franck; Jouve, Jean-Luc

    2016-01-01

    Paediatric Chance fracture are rare lesions but often associated with abdominal injuries. We herein present the case of a seven years old patient who sustained an entrapment of small bowel and an ureteropelvic disruption associated with a Chance fracture and spine dislocation following a traffic accident. Initial X-rays and computed tomographic (CT) scan showed a Chance fracture with dislocation of L3 vertebra, with an incarceration of a small bowel loop in the spinal canal and a complete section of the left lumbar ureter. Paraplegia was noticed on the initial neurological examination. A posterior L2-L4 osteosynthesis was performed firstly. In a second time she underwent a sus umbilical laparotomy to release the incarcerated jejunum loop in the spinal canal. An end-to-end anastomosis was performed on a JJ probe to suture the left injured ureter. One month after the traumatism, she started to complain of severe headaches related to a leakage of cerebrospinalis fluid. Three months after the traumatism there was a clear regression of the leakage. One year after the trauma, an anterior intervertebral fusion was done. At final follow-up, no neurologic recovery was noticed. In case of Chance fracture, all physicians should think about abdominal injuries even if the patient is asymptomatic. Initial abdominal CT scan and magnetic resonance imaging provide in such case crucial info for management of the spine and the associated lesions. PMID:27672641

  19. Neglected surgically intervened bilateral congenital dislocation of knee in an adolescent

    Directory of Open Access Journals (Sweden)

    Jaswant Kumar

    2014-01-01

    Full Text Available Neglected bilateral congenital dislocation of knee is unusual. A 12 year old boy presented with inability to walk due to buckling of the knee. The symptoms were present since the child learnt walking. He preferred not to walk. Bilateral supracondylar femoral osteotomy was done at the age of 6 years. Patient had a fixed flexion deformity of both knees, 30° in the right (range of flexion from 30° to 45° and 45° fixed flexion deformity in left knee respectively (range of flexion from 45° to 65° when presented to us. The radiological examination revealed bilateral congenital dislocation of knee (CDK. No syndromic association was observed. He was planned for staged treatment. In stage I, the knee joints were distracted by Ilizarov ring fixators and this was followed by open reduction of both the knee joints in stage II. A bilateral supracondylar extension osteotomy was done 18 months after the previous surgery (stage III. The final followup visit at 4 years the patient presented with range of motion 5-100° and 5-80° on the right and left knee respectively with good functional outcome. The case is reported in view of lack of treatment guidelines for long standing neglected CDK in an adolescent child.

  20. Atomistic modeling and HRTEM analysis of misfit dislocations in InN/GaN heterostructures

    Energy Technology Data Exchange (ETDEWEB)

    Kioseoglou, J., E-mail: sifisl@auth.gr [Department of Physics, Aristotle University of Thessaloniki, GR-54124, Thessaloniki (Greece); Kalesaki, E.; Dimitrakopulos, G.P.; Kehagias, Th.; Komninou, Ph.; Karakostas, Th. [Department of Physics, Aristotle University of Thessaloniki, GR-54124, Thessaloniki (Greece)

    2012-11-01

    Highlights: Black-Right-Pointing-Pointer Identification of misfit dislocations (MD) in-plane configuration in InN/GaN interfaces. Black-Right-Pointing-Pointer Energetic mapping designates that MD arrays adopt Left-Pointing-Angle-Bracket 1 1 -2 0 Right-Pointing-Angle-Bracket line directions with b = 1/3 Left-Pointing-Angle-Bracket 2 -1 -1 0 Right-Pointing-Angle-Bracket . Black-Right-Pointing-Pointer Local arrangement of the Moire fringes depends strongly on the thickness of the TEM foil as revealed by HRTEM image simulations. Black-Right-Pointing-Pointer Geometric Phase Analysis on simulated images justifies results obtained by energetic mapping. - Abstract: The enhanced structural mismatch of InN and GaN binary alloys leads in almost spontaneous formation of misfit dislocations (MDs) at the corresponding interfaces, thereby accommodating plastic relaxation. The open issue of the MD array in-plane configuration is addressed through a combination of high resolution transmission electron microscopy (HRTEM) observations with energetic mapping and HRTEM image simulation of InN/GaN interfaces extracted by atomistic modeling. Energetic mapping on the interfacial area of InN/GaN supercells relaxed by the Tersoff interatomic potential, designates that the MD arrays adopt Left-Pointing-Angle-Bracket 112{sup Macron }0 Right-Pointing-Angle-Bracket line directions and their Burgers vectors are b=1/3 Left-Pointing-Angle-Bracket 21{sup Macron }1{sup Macron }0 Right-Pointing-Angle-Bracket . HRTEM image simulations further reveal that the local arrangement of Moire fringes observed in these interfaces depends strongly on the thickness of the TEM foil, thus resolving contradictory experimental reports. Geometric Phase Analysis on the simulated images justifies the results obtained by energetic mapping.