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《Journal of Clinical Orthopaedics and Trauma》2019,10(5):995-998
BackgroundProper patellar tracking is one of the most important aspect of TKA to ensure good functional outcome. A patellar tracking problem noted intraoperatively serves as a warning sign and should prompt the surgeon to reassess position of each component. Various tests are there to assess lateral retinaculum tightness viz. "No thumb test", "Towel clip test". A new test "Vertical patella test" is described to assess lateral retinaculum tightness. A study was conducted to assess the effectiveness, correlation and validity of two techniques.Materials & MethodsPatients >50 years of age and with diagnosis of Osteoarthritis knee having less than 30 varus and flexion deformity going in for primary TKA were selected with a sample size of 100 knees in a tertiary care centre. Revision cases or patients with flexion contracture more than 30, complex knee surgery; with pre existing patellar tilt were excluded from study.ResultsResults of both tests were found to correlate in 75% of case with sensitivity of 96.65% and specificity of 75.00%. Kappa came out to be 0.634 which shows good agreement of vertical patella test and towel clip test. Result was computed using excel and SPSS and was found to be significant with p value< 0.05. Lateral retinaculum release was done in 8 knees.ConclusionsVertical patella test correlates with towel clip test, is easy to perform and saves time. The limitation of our study was small sample size. 相似文献
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Yasuhiro Yamaoka Takatomo Mine Hiroshi Tanaka Yoichiro Ishida Tosihiko Taguchi 《Knee surgery, sports traumatology, arthroscopy》2007,15(11):1346-1349
An avulsion fracture of the tibial tubercle is a common injury in traffic accident. If the fracture is closed, then a comparatively
good prognosis can be expected through reinforcement of the bone via osteosynthesis and the use of artificial ligaments. In
this case, an open wound was observed in the tibial tubercle, and the wound was so polluted that the healing process was significantly
delayed. It was therefore difficult to provide simultaneous surgical treatment and so three operations were required to perform
the reconstruction of the extensor mechanism. The reconstruction of extensor mechanism and the frame fixation between the
patella and tibia was performed. Six months after the injury, the patient was able to walk without aid, had a range of movement
from 5°to 130°, and did not show any indications of ADL disorder. Using this method of frame fixation between the patella
and tibia proved to be an effective technique for the reconstruction of the open knee extension mechanism injury. 相似文献
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目的 探讨CPM在髌骨骨折改良张力带内固定术后的应用效果。方法 早期应用CPM治疗髌骨骨折行改良张力带内固定术后病人156例。结果 所有病例均得到随访,临床疗效优良率为98%。结论 在髌骨骨折行改良张力带内固定术后早期应用CMP,可显著利于膝关节功能恢复,提高治愈率。 相似文献
7.
Summary
In the presented study, knee joint proprioception of 43 patients with a patellar pain syndrome of the knee joint was evaluated.
In a control group, the proprioception of 30 healthy volunteers with clinical and anamnestic inconspicous knee joints was
examined. We tested the proprioceptive capability of the subjects with a passive angle reproduction test. Additionally, all
knee joints were measured with and without an elastic knee bandage. The patient group showed significant deterioration of
angle reproduction capability (13.2 °± 6.1 °) compared to the control group (7.8 °± 2.8 °). After applying an elastic knee
bandage, the angle reproduction capability significantly improved to 9.2 °± 4.5 °. Proprioception of the contralateral, noninvolved
knee joint in the patients (11.6 °± 6.3 °) was worse compared to the control group. Applying an elastic knee bandage did not
significantly improve the proprioception of the uninjured knee joint.
相似文献
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关节镜下经皮张力带钢丝固定治疗髌骨骨折 总被引:1,自引:0,他引:1
目的探索髌骨骨折错位在关节镜下复位、内固定的新方法。方法对56例新鲜闭合性横断型髌骨骨折病例,在关节镜下冲洗关节腔积血,清除骨折断端凝血块,去除小的骨碎片,进行髌骨复位,直接观察关节面复位对合情况。应用胥氏张力带钢丝固定原理,经皮穿入克氏针及钢丝,针孔做1cm小切口,完成内固定。结果术后2周绝大部分患者屈膝可达90°以上,骨折在6~10周达到临床愈合,出现针尾触痛者8例,克氏针松动上移2例,无钢丝断裂及脱落。治疗效果按膝关节损伤患者的功能评定法,优良率为96.4%。结论本术式两枚克氏针各有一根钢丝固定,在关节镜导引下,经皮穿针钢丝固定,不会因两根针位置不对称而产生扭距。操作方法简便、有效,有利于术后早期功能锻炼,为髌骨骨折提供了一种新的手术方法。 相似文献
9.
Closing patellar tendon defects after anterior cruciate ligament reconstruction: absence of any benefit 总被引:4,自引:2,他引:2
Sveinbjörn Brandsson E. Faxén Bengt I. Eriksson Peter Kälebo Leif Swärd Olof Lundin J. Karlsson 《Knee surgery, sports traumatology, arthroscopy》1998,6(2):82-87
The most common graft in anterior cruciate ligament (ACL) surgery involves using the central one-third of the patellar tendon.
Knowledge concerning the postoperative disability after harvesting the patellar tendon is, however, limited. The aim of this
study was to evaluate the impact patellar tendon suture and bone grafting of the patellar bone defect might have in terms
of functional outcome and patellofemoral pain after harvesting the bone-tendon-bone graft, compared with leaving the harvested
site non-sutured and non-grafted. Sixty patients, scheduled for arthroscopically assisted ACL reconstruction, were randomly
allocated to two groups. In group I, suture of the patellar tendon and bone grafting of the patellar defect were performed.
In group II, the tendon gap and the patellar defect were left open. Preoperatively, there was no significant difference between
the groups when comparing objective knee stability, as measured with a KT-1000 laxity meter, Lysholm score, Tegner activity
level, IKDC score, or patellofemoral pain score. Both groups had a significantly improved Lysholm score at the 2-year follow-up,
without any difference between them. Tegner's activity level was significantly lower at follow-up, compared with the pre-injury
level in both groups. The patellofemoral pain score improved significantly after the reconstruction, without any difference
between the groups. Ultrasonography did not reveal any difference between the groups in terms of healing of the tendon gap.
This study revealed no differences in donor site morbidity, functional outcome, patellofemoral pain score or knee joint stability
between the two treatment groups. The conclusion is that suture of the patellar tendon and bone grafting of the patellar defect
do not improve the functional results or reduce donor site morbidity after arthroscopically assisted ACL.
Received: 17 December 1996 Accepted: 30 July 1997 相似文献
10.
The effects of external and internal tibial rotation on patellar motion were investigated using a magnetic 3Space® tracker system (Polhemus, Colchester, VT 05446, USA). Seven fresh-frozen adult cadaver knees were used in this study. The muscle alignment of each quadriceps muscle was measured to determine the direction of loading forces. Three loading patterns were used to simulate the unresisted knee extension during sitting, standing from squatting and the stance phase of walking, with different weights applied to each quadriceps muscle at each knee flexion angle. The position of the patella, along with patellar shift, tilt and rotation was measured and compared to external or internal tibial rotation and neutral rotation. In the sitting and squatting simulations the patella showed at the terminal extension of the knee more lateral shift and a more lateral tilt with tibial external rotation than in a neutral position (P < 0.05). In walking simulation, the patella showed more external rotation with external rotation of the tibia than with a neutral one, at the 0, 72 and 90% of the stance phase of walking (P < 0.05). These results demonstrate the importance of external tibial rotation as a factor in the development of patellar dislocations or subluxations, especially in athletes. 相似文献