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41.
42.
Bilateral patellar tendon rupture in a child: a case report 总被引:1,自引:0,他引:1
Hasan Hilmi Muratli Levent Çelebi Onur Hapa Ali Biçimoğlu 《Knee surgery, sports traumatology, arthroscopy》2005,13(8):677-682
Patellar tendon rupture in children is very rare. When it occurs, patellar tendon is usually ruptured either from the upper end as a sleeve fracture of the patella or from lower end as an avulsion fracture of the tibial tuberosity. In this report, we present the case of an otherwise healthy 9-years-old boy who had subsequent bilateral patellar tendon ruptures through the midparts, which has not been published previously in the literature. Treatment was performed with primary end-to-end repair, reinforcement with cerclage wires and fresh-frozen achilles tendon augmentation for both sides. 相似文献
43.
Mohamed Shafi Young Yul Kim Yeon Soo Lee Jin Young Kim Chang Whan Han 《Knee surgery, sports traumatology, arthroscopy》2005,13(6):472-475
The patellar component of a total knee replacement (TKR) is the most frequent source of non-septic complications after total knee arthroplasty. Fracture of patellar pegs in all polyethylene patellar components is a very rare occurrence. We report such a case of a patellar polyethylene fracture in a 72-year-old female patient 10 years after TKR. Due to patellar malalignment and high level of activity, the patellar components failed in this patient. This was treated arthroscopically by removing the components that failed and leaving the patella unresurfaced. We followed up the patient postoperatively and her symptoms were substantially resolved. 相似文献
44.
Complex two-level rotational malalignment of the lower extremity can cause maltracking of the patella with anterior knee pain. Double derotation osteotomy would correct the underlying pathology. However, it carries a high risk of complications such as nerve and vessel damage. We report a case of rotational malalignment in the femur and the tibia associated with trochlear dysplasia, which causes painful patellar instability. The patient was successfully treated with reconstruction of the medial patellofemoral ligament and lateral release. Although the malrotation was not addressed, the position of the patella was corrected, and no dislocation occurred during a follow-up of 10 months. 相似文献
45.
Tibial tunnel area changes following arthroscopic anterior cruciate ligament reconstructions with autogenous patellar tendon graft 总被引:2,自引:1,他引:1
Hyunchul?Jo Deuk?Soo?Jun Dong?Yeon?Lee Sang?Hoon?Lee Sang?Cheol?Seong Myung?Chul?LeeEmail author 《Knee surgery, sports traumatology, arthroscopy》2004,12(4):311-316
We investigated radiographic changes in tibial tunnel area after ACL reconstructions with autogenous patellar tendon grafts on anteroposterior and lateral radiographs over 3 years. Fifty patients followed up for at least 1 year were included in the study. Radiographs were taken on the day of surgery and 3, 6, 9, 12, 24, and 36 months postoperatively. Tibial tunnels on both radiographs were divided into proximal, middle, and distal one-third. The area of each one-third and the greatest diameter of the tibial tunnel on both radiographs was measured using an image-processing software. According to the tunnel area changes, the shape of tibial tunnel was classified into one of four shapes; cylinder, mallet, reverse bottle, and reverse triangle. The correlations between area, diameter and shape of the tunnel, and clinical variables including arthrometer measurement and clinical score were determined. The areas of each one-third of the tibial tunnels on lateral radiographs was always greater than that on anteroposterior radiographs, although the diameters on the two radiographs did not differ significantly. The area of proximal one-third largest and that of distal one-third smallest on both radiographs at any time point. The enlargement and reduction occurred within 3 months and tended to continue for 9 months. Thereafter the tunnel change stabilized on both radiographs. The most common shape of the enlarged tunnels was cylindrical on anteroposterior radiographs reverse triangle on lateral radiographs. No negative effects of enlarged area, diameter, or tunnel shape on clinical results were found in our study. 相似文献
46.
Patients with lateral tracking patella have better pain relief following CT-guided tuberosity transfer than patients with unstable patella 总被引:4,自引:1,他引:3
M.?J.?F.?DiksEmail author A.?B.?Wymenga P.?G.?Anderson 《Knee surgery, sports traumatology, arthroscopy》2003,11(6):384-388
In patients with either lateral tracking patella or unstable patella the pathological lateral position of the tuberosity can be corrected by a medial transfer. This study compared the results of subtle CT-guided correction of the tuberosity for objective unstable patella (n=27) with the results for lateral tracking patella (potential instability) as described by Dejour (n=16). Follow-up was 37 months. CT revealed a pathological lateralization of the tibial tuberosity–trochlear groove greater than 15 mm in 41 knees. These patients underwent medialization of the tibial tuberosity up to 10–12 mm lateral from the trochlear groove, and 28 patients underwent a distalization to normalize the Caton index to 1.0–1.2. Results were evaluated using Cox' method. Patients with objective patellar instability were rated as 11% excellent, 52% good, 33% fair, and 4% poor. All patients became stable except one who had a 6° valgus alignment. Although 96% had improved stability, 33% of the patients still had pain. The patients with lateral tracking patella (potential instability) were rated as 37.5% excellent, 44% good, and 19% fair. The lower proportion of pain relief in patients with unstable patella is likely the result of the cartilage damage experienced by these patients following multiple dislocations. Thus the patient with lateral tracking patella without patella dislocations must be differentiated from the one with unstable patella. Their prognosis in pain relief is better. 相似文献
47.
48.
Olaf Lorbach Andreas Diamantopoulos Klaus-Peter Kammerer Hans H. Paessler 《Knee surgery, sports traumatology, arthroscopy》2008,16(4):348-352
Resection of the lower patellar pole provides good results in the treatment of jumper’s knee. Therefore we hypothesized that
the length of the lower patellar pole is increased in patients with chronic patellar tendinopathy. Cohort study, level of
evidence 2. Between 2000 and 2005, 25 patients with chronic patellar tendinopathy underwent conservative and surgical treatment
in our clinic. All of them had preoperative MRI were three independent examiners measured the Caton Index, the length and
the ratio of the articular and non-articular patellar surface, tendon length and thickness and the thickness and length of
the hypodens lesions in the patellar tendon. The measurements were compared with 50 MRI of a control group with no clinical
patellofemoral disorders or patellar tendinopathy. Significant changes in tendon thickness (9.42 ± 2.87 vs. 4.88 ± 1.13; P < 0.0001), a longer non-articular surface of the patella (10.62 ± 2.86 vs. 7.098 ± 2.53; P < 0.0001) and significant higher ratio between the articular and the non-articular patellar surface (0.32 vs. 0.24; P < 0.0001) were found in the jumper’s knee group. No significant changes were seen in the length of the articular surface
or the Caton Index. The development of chronic patellar tendinopathy in athletes might be associated with a longer lower patellar
pole as patients with jumper’s knee showed a longer non-articular patellar surface compared with the control group. 相似文献
49.
Toby O. Smith Simon T. Donell Rachel Chester Allan Clark Richard Stephenson 《The Knee》2011,18(5):333-339
Patellar instability is a disabling musculoskeletal condition. Whilst previous texts have suggested that twisting activities may cause patients to experience instability symptoms, no studies have assessed which activities are related to the patient's perceived instability. The purpose of this study was to determine which activities and with what frequency patients with patellar instability symptoms, perceive their patella to be unstable. Ninety patients referred because of recurrent patellar instability were asked to assess the frequency with which they perceived patellar instability for 19 everyday and sporting activities. The results indicated that sporting and multi-directional twisting activities were more frequently related to patellar instability symptoms, compared to lower energy, uni-planar activities. Females and those without a family history of patellar instability reported more frequent patellar instability symptoms, compared to males, or those with a family history of this disorder. Further study is now recommended to determine whether these results reflect that of patients with milder subluxation disorders, and whether factors such as hypermobility have an impact on perceived patellar instability for this patient group. 相似文献
50.
Total knee arthroplasty (TKA) surgery is a widely used treatment and has a high success rate. Despite its success, the patello-femoral articulation has been overlooked as a contributor to the successful outcome of TKA. Patello-femoral complications remain the leading cause of failed knee replacement, accounting for up to 10% of complications. To understand the concept of patellar mal-tracking, we explore the normal anatomy and biomechanics of the patello-femoral articulation, and review the surgical factors and complications related to patellar tracking, with an aim to discussing the concepts on how to avoid such complications. Surgeons should be aware of the frequent occurrence of abnormal patellar tracking, and should pay particular attention to the patello-femoral component of knee replacement surgery. 相似文献