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Patella femoral pain

S Konan, F S Haddad
AIMS: Medial unicompartmental knee arthroplasty (UKA) is associated with successful outcomes in carefully selected patient cohorts. We hypothesised that severity and location of patellofemoral cartilage lesions significantly influences functional outcome after Oxford medial compartmental knee arthroplasty. PATIENTS AND METHODS: We reviewed 100 consecutive UKAs at minimum eight-year follow-up (96 to 132). A single surgeon performed all procedures. Patients were selected based on clinical and plain radiographic assessment...
October 2016: Bone & Joint Journal
Ali Babaei Jandaghi, Mohsen Mardani-Kivi, Ahmadreza Mirbolook, Mohammad Kazem Emami-Meybodi, Solmaz Mohammadzadeh, Maral Farahmand
BACKGROUND: Knee pain is a common problem in the general population. In order to determine the extent of the injury and the appropriate treatment, MRI provides the most accurate imaging method. This may be done through conventional MRI techniques or by injecting a contrast material (MR arthrography). OBJECTIVES: The purpose of this study was to compare the diagnostic value of these two methods. PATIENTS AND METHODS: The study involved the diagnostic evaluation on 60 patients with knee pain who received treatment over the course of a one-year period...
May 2016: Trauma Monthly
Arissara Iamaroon, Suwitcha Tamrongchote, Busara Sirivanasandha, Pathom Halilamien, Pisit Lertwanich, Sudkanoung Surachetpong, Paweenus Rungwattanakit
BACKGROUND: Adequate analgesia and early rehabilitation is necessary for arthroscopic anterior cruciate ligament reconstruction (A CLR) surgery. OBJECTIVE: To compare analgesia and quadriceps strength after femoral nerve block (FNB) with intra-articular infiltration (IA) using 0.25% bupivacaine for ACLR with patella tendon graft. MATERIAL AND METHOD: Forty patients were randomized to receive FNB under ultrasound guidance with 20 mL of bupivacaine or IA with 15 mL of bupivacaine into the knee joint and 5 mL infiltrated along the incision sites including portal sites at the end of surgery...
May 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Serafín García-Mata, Angel Hidalgo-Ovejero
Double-layered patella (DLP) is a rare patella-formation abnormality reported in association with multiple epiphyseal dysplasia. DLP is one of the five types of bipartite patella, caused by a coronal septum that divides the patella into anterior and posterior segments. Although the double layer of bone has been reported as complete, it may also manifest as partial, as in our case. A 13-year-old male patient attended A&E after accidentally falling and sustaining a direct injury to his left knee, with pain in the anterior surface of the right patella...
November 2016: Journal of Pediatric Orthopedics. Part B
Mohd Fairudz Bin Mohd Miswan, Mohamed Zubair Mohamed Al-Fayyadh, Teo Seow Hui, Mohamed Razif Bin Mohamed Ali, Wuey Min Ng
A patient with patellar instability frequently presents with anterior knee pain, patellar subluxation, or dislocation. Medial patellofemoral ligament (MPFL) has a key role for normal patella tracking and stability. Reconstruction of the MPFL using a hamstring graft is a commonly used procedure for the treatment of chronic lateral subluxation of patella. Anchor sutures and bony tunnels are used for the patellar attachment of the graft. This can be associated with complications such as patella fracture; besides, it does not produce an anatomical reconstruction for the native MPFL that can alter the direction of tension applied on the patella...
April 2016: Arthroscopy Techniques
A Lamotte, T Neri, A Kawaye, B Boyer, F Farizon, R Philippot
INTRODUCTION: Patellar instability is a frequent cause of total knee arthroplasty (TKA) failure. In cases of post-arthroplasty patellar instability, the medial structures may be damaged. The objective of this study was to study the effectiveness of medial patellofemoral ligament (MPFL) reconstruction. We hypothesized that MPFL reconstruction will effectively realign the patella, making it a viable treatment option for managing post-arthroplasty patellar instability. MATERIAL AND METHODS: In this retrospective study of six patients treated by four different surgeons, patients were included if they had a recurring or permanent patellar dislocation after undergoing TKA...
September 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Yubao Gong, Chen Yang, Yang Liu, Jianguo Liu, Xin Qi
Hereditary onycho-osteodysplasia, also known as nail-patella syndrome (NPS), is a rare genetic disorder that is primarily characterized by poorly developed nails and patella. Patients with NPS frequently suffer from patellar instability that requires surgical management. The present case report describes a 25-year-old man with NPS. The patient presented with left knee pain and was found to have recurrent left patellar dislocation. The knee pain was first reported 1-year after a minor knee trauma incident. Following complete evaluation, a diagnosis of NPS was reached...
June 2016: Experimental and Therapeutic Medicine
Vicente Sanchis-Alfonso, Marc Tey, Joan Carles Monllau
We present a case of a patient with chronic anterior knee pain (AKP) recalcitrant to conservative treatment who returned to our office for severe hip pain secondary to Cam femoroacetabular impingement (Cam FAI) at 10 months after the onset of knee pain. This case highlights the fact that the main problem is not in the patella but in the hip in some patients with AKP. We hypothesize that there is an external femoral rotation in order to avoid the impingement and therefore the hip pain in patients with Cam FAI...
2016: Case Reports in Orthopedics
Ahmed Ezzat, Christopher Iobst
A 15-year-old boy presented with a 35° femoral valgus deformity, leg-length discrepancy, painful retained hardware, and a lateral dislocation of the patella 4 years after undergoing lateral plate fixation of a distal femur fracture. Femoral valgus is a possible complication of lateral plate fixation in up to 30% of pediatric distal femur fractures. With this patient's unusual combination of deformities as an example, we suggest early hardware removal after fracture union to prevent the development of deformity...
July 2016: Journal of Pediatric Orthopedics. Part B
Hans-Peter W van Jonbergen, Ashvin V Boeddha, Jos J A M van Raaij
When secondary patellar resurfacing is performed, a uniformly and widely used scoring system that is validated for anterior knee pain caused by a retropatellar degeneration will give more insight into the results of this procedure. The cause of anterior knee pain following total knee arthroplasty (TKA) is not always related to the patella itself. Other causes have been identified, such as an insufficient posterior cruciate ligament in the case of a posterior cruciate-retaining TKA or an internally rotated femoral and/or tibial component...
September 1, 2016: Orthopedics
K-D Heller
BACKGROUND: Patellofemoral complications after total knee arthroplasty are responsible for a variety of surgical revisions. OBJECTIVE: The causes of the various types of instability of the patella are listed in a differentiated way and the importance of clinical and imaging diagnostics as well as preventive strategies are elaborated. MATERIAL AND METHODS: This article is based on a selective literature search in the PubMed database and on the long-standing experience of the author...
May 2016: Der Orthopäde
Mauricio Etchebehere, Patrick P Lin, Justin E Bird, Robert L Satcher, Bryan S Moon, Jun Yu, Liang Li, Valerae O Lewis
BACKGROUND: Patellar resurfacing after routine arthroplasty remains controversial. Few studies have specifically examined the effect of patellar resurfacing on outcomes after resection of the distal part of the femur and reconstruction with a megaprosthesis. Our objective was to compare the outcomes of megaprosthesis reconstructions of the distal part of the femur with and without patellar resurfacing after resection of a distal femoral tumor. METHODS: We retrospectively reviewed the clinical records of patients with a femoral tumor who underwent resection of the distal part of the femur and endoprosthetic reconstruction between 1993 and 2013...
April 6, 2016: Journal of Bone and Joint Surgery. American Volume
Tadato Kido, Koichiro Okuyama, Mitsuho Chiba, Hiroshi Sasaki, Nobutoshi Seki, Keiji Kamo, Naohisa Miyakoshi, Yoichi Shimada
OBJECTIVE: The purpose of this study is to disclose the characteristic symptoms and signs in L2, L3 and L4 nerve root disturbance. MATERIALS AND METHODS: Fifty eight patients who underwent lateral herniotomy were analyzed. Breakdowns are 15 patients with L2/3 lateral disc herniation (group A), 20 patients with L3/4 lateral disc herniation (group B), and 23 patients with L4/5 lateral disc herniation (group C). The following items were examined: 1) localization of the subjective pain and numbness, 2) objective neurological findings, including deep tendon reflex, manual muscle strength (MMT), straight leg raising test (SLRT) and femoral nerve stretch test (FNST)...
July 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Tatsunori Kataoka, Norishige Iizawa, Shinro Takai
Superior dislocation of the patella without patellar ligament injury is an extremely rare condition. A review of the English-language literature found only 23 reported cases. In addition, the primary factor for dislocation in most of these cases was considered to be osteophytes in the inferior pole of the patella and the anterior surface of the femoral condyle; only 1 case had no osteophytes. We treated a 19-year-old woman who sustained a painful locking of the left knee after colliding with a friend. Plain radiography and computed tomography showed superior-lateral dislocation of the patella and an interlocking between notches in the inferior pole of the patella and the anterior surface of the femoral condyle...
2016: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
Mohsen Akbari Shandiz, Paul Boulos, Stefan Karl Saevarsson, Sam Yoo, Stephen Miller, Carolyn Anglin
Total knee arthroplasty (TKA) changes the knee joint in both intentional and unintentional, known and unknown, ways. Patellofemoral and tibiofemoral kinematics play an important role in postoperative pain, function, satisfaction and revision, yet are largely unknown. Preoperative kinematics, postoperative kinematics or changes in kinematics may help identify causes of poor clinical outcome. Patellofemoral kinematics are challenging to record since the patella is obscured by the metal femoral component in X-ray and moves under the skin...
April 2016: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
Michael S Patzkowski
Ehlers-Danlos syndrome is an inherited disorder of collagen production that results in multiorgan dysfunction. Patients with hypermobility type display skin hyperextensibility and joint laxity, which can result in chronic joint instability, dislocation, peripheral neuropathy, and severe musculoskeletal pain. A bleeding diathesis can be found in all subtypes of varying severity despite a normal coagulation profile. There have also been reports of resistance to local anesthetics in these patients. Several sources advise against the use of regional anesthesia in these patients citing the 2 previous features...
March 2016: Journal of Clinical Anesthesia
Daniel S Chan, Rafael Serrano-Riera, Rebecca Griffing, Barbara Steverson, Anthony Infante, David Watson, H Claude Sagi, Roy W Sanders
PURPOSE: The purpose of this OTA-approved pilot study was to compare the clinical and functional outcomes of the knee joint after infrapatellar (IP) versus suprapatellar (SP) tibial nail insertion. DESIGN: Prospective, randomized. SETTING: Level I trauma center. METHODS: After institutional review board approval, skeletally mature patients with OTA 42 tibial shaft fractures were randomized into either an IP or SP nail insertion group after informed consent was obtained...
March 2016: Journal of Orthopaedic Trauma
Armin Keshmiri, Hans Robert Springorum, Clemens Baier, Florian Zeman, Joachim Grifka, Günther Maderbacher
PURPOSE: Patellar maltracking due to incorrect component alignment is considered as a main reason for anterior knee pain after total knee arthroplasty (TKA). In contrast to coronal and axial component placement, the influence of sagittal component alignment on patellar kinematics has not been investigated so far. METHODS: In ten lower cadaveric limbs, TKAs were implanted using a commercial computer navigation system. In six knees, the femoral component was aligned in 5° and in four knees in 0° of flexion, respectively...
March 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Allison J Rao, Brandon J Erickson, Gregory L Cvetanovich, Adam B Yanke, Bernard R Bach, Brian J Cole
Meniscal tears are the most common knee injury, and partial meniscectomies are the most common orthopaedic surgical procedure. The injured meniscus has an impaired ability to distribute load and resist tibial translation. Partial or complete loss of the meniscus promotes early development of chondromalacia and osteoarthritis. The primary goal of treatment for meniscus-deficient knees is to provide symptomatic relief, ideally to delay advanced joint space narrowing, and ultimately, joint replacement. Surgical treatments, including meniscal allograft transplantation (MAT), high tibial osteotomy (HTO), and distal femoral osteotomy (DFO), are options that attempt to decrease the loads on the articular cartilage of the meniscus-deficient compartment by replacing meniscal tissue or altering joint alignment...
October 2015: Orthopaedic Journal of Sports Medicine
Todd P Pierce, Julio J Jauregui, Jeffrey J Cherian, Randa K Elmallah, Steven F Harwin, Michael A Mont
Orthopedic surgeons resurface the patella during total knee arthroplasty to avoid complications such as pain, patello-femoral arthritis, and patellar maltracking and to reduce the risk for reoperation. However, many complications, such as decreased range of motion, increased fractures, and polyethylene wear, have been described with this procedure. One determinant when resurfacing a patella is the thickness of its cuts. This review aims to investigate the relationship between patellar thickness and outcome parameters such as range of motion, patient-reported outcomes, periprosthetic fractures, and reoperations...
January 2016: Orthopedics
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