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排序方式: 共有671条查询结果,搜索用时 31 毫秒
1.
Yi Zhao Qianqian Zhang Helin Feng Xiyan Zhu 《The Journal of international medical research》2021,49(4)
The incidence of tumours found in the patella, including primary and metastatic tumours, is low. Solitary metastasis of oesophageal carcinoma (OC) in the patella is even rarer. A 50-year-old man presented to our clinic because of pain and limited range of motion in the right knee for 4 hours and after a fall. On the basis of the patient’s medical history, he was diagnosed with OC 2 months previously and underwent two cycles of paclitaxel liposome combined with tiggio chemotherapy (oral tiggio, 40 mg, two times/day, with a treatment cycle of 3 weeks). A 99mTc-methylene diphosphonate bone scintigraphy scan showed increased radioactivity in the right patella. A right knee biopsy showed the presence of patellar metastasis from OC. Unfortunately, the patient denied additional treatment and was discharged for personal reasons. At the 1-month follow-up, which was conducted by a telephone survey, we learned that the patient had died of acute pulmonary embolism. X-rays and computed tomography are useful for diagnosing patellar metastases, but 99mTc-methylene diphosphonate bone scintigraphy can help physicians diagnose patellar metastasis of OC more rapidly. Biopsy with pathology is the gold standard for diagnosing patellar metastases. Additionally, timely surgical treatment prolongs the survival time of these patients. 相似文献
2.
《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
3.
《The Journal of arthroplasty》2020,35(2):557-562
BackgroundThe available evidence on pseudo-patella baja (PPB) is limited. The purpose of this study is to investigate prospectively the occurrence of PPB after primary total knee arthroplasty and its clinical consequences in a large series of patients with a minimum follow-up of 2 years. PPB was defined as a patella distally displaced in relationship to the femoral trochlea with absence of patellar tendon shortening (Grelsamer RP. J Arthroplasty 2002;17:66-69) due to elevation of the joint line.MethodsThis study is a prospective case series of 354 patients with a mean age of 71.7 (range 52-87) years. Clinical evaluation was performed by the Knee Society Scores (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Short-Form 12-item (SF12), and range of motion. Patellar height was assessed by the Insall-Salvati and Blackburne-Peel ratios.ResultsThe mean follow-up was 3.6 (range 2.0-6.6) years. Postoperatively, 286 (80.7%) patients had a normal patellar height, 17 (4.8%) had true patella baja (TPB), and 51 (14.4%) had PPB. There were no significant differences between the 3 groups in mean KSS-function (P = .107), range of motion (P = .408), WOMAC-pain (P = .095), WOMAC-stiffness (P = .279), or SF12-mental (P = .363). Between normal and PPB groups, there were no significant differences in mean KSS-knee (P = .903), WOMAC-function (P = .294), or SF12-physical (P = .940). However, the TPB group had significantly lower mean KSS-knee (P = .031), WOMAC-function (P = .018), and SF12-physical (P = .005) as compared with either 2 other groups.ConclusionPPB was a relatively common finding, but no significant differences in terms of clinical outcomes were found as compared to patients with postoperative normal patellar height. TPB was infrequent, but these patients had significantly worse clinical outcomes than those with PPB or normal patellar height. 相似文献
4.
《The Knee》2020,27(6):1931-1941
BackgroundThe patellofemoral joint is often affected by torsional disorders of the lower limb, causing pain, instability and knee degeneration. The aims of this study were to determine functional outcomes of patients who underwent a high tibial derotation osteotomy (HTDO) for symptomatic squinting patella due to increased external tibial torsion. Moreover, factors associated with inferior clinical outcomes were investigated.MethodsPatients with symptomatic squinting patella, increased external tibial torsion (>30°) treated with this technique, and with 2 years of follow up were included. Fulkerson and Kujala patellofemoral joint scores were assessed. Age, body mass index, history of prior surgery, increased femoral anteversion, association of lateral retinaculum release and patellar cartilage lesions were analysed.ResultsSixty HTDOs were included in this retrospective study with an average of 66 months of follow up. The mean Kujala score improved from 47.5 preoperatively to 93 postoperatively. The mean Fulkerson score improved from 40.6 to 91.6. Kujala subscores for pain improved from 8.6 to 30.4, for instability improved from 6.4 to 17.9, and their ability to climb stairs increased from 6.9 to 17.9 (all P < 0.0001). Multivariate logistic regression model identified that patient age (P < 0.005) and advanced chondral damage (P < 0.001) were the dominant factors predicting inferior clinical outcomes using Kujala’s score.ConclusionHTDO provided good results regarding the pain symptoms, instability and the ability to climb stairs. Advanced chondral damage and advanced age had negative effects on outcomes. 相似文献
5.
《Surgery (Oxford)》2020,38(2):79-83
This article is intended as a guide to help improve and perfect your knee examination technique for the MRCS examination. The knee is a joint frequently assessed in the MRCS OSCE, due to the presence of reliable clinical signs in the chronic patient, who can easily attend for repeated examinations. The article will guide the reader through important aspects of the history and physical examination and how these can inform the clinical reasoning process and subsequent diagnosis and management. 相似文献
6.
Peter B. White Mrinal Sharma Ahmed Siddiqi James R. Satalich Amar S. Ranawat Chitranjan S. Ranawat 《The Journal of arthroplasty》2019,34(5):887-892
Background
Anterior knee pain (AKP) remains a complex issue affecting patient satisfaction after total knee arthroplasty. Several radiographic parameters have been shown to be causative factors with various designs. The aim of this study is to evaluate the known radiographic parameters of AKP and clinical outcomes (ie, AKP) in the setting of a modern prosthesis with an anatomic patella button.Methods
Between July 2012 and December 2013, 90 total knee arthroplasties received 3 skyline views taken at 30°, 45°, and 60°. A patient-administered questionnaire was administered at 2-year follow-up to assess the incidence of AKP, painless noise, and satisfaction. Radiographs were analyzed for patellofemoral overstuffing, patellar tilt, and patellar displacement, and evaluated the patella resection angle.Results
On the patient-administered questionnaire, 10 (11.1%) patients reported AKP of a mild-to-moderate nature. Thirty-one had the best view at 30 Merchant views, 24 had best views at 45, and 35 had best views at 60. We found that patellar resection angle correlated with AKP (odds ratio 1.21, P = .044) and painless noise (odds ratio 1.22, P = .034). Patellar displacement and patellofemoral stuffing did not correlate with AKP or painless noise. No radiographic measurements correlated with changes in Knee Society Score pain or function scores or range of motion.Conclusion
We found that a patellar resection angle correlated with the incidence of AKP and painless noise at 2-year follow-up. We failed to find any correlation with patellofemoral overstuffing, patellar displacement, or patellar tilt with clinical outcomes. We recommend the use of 3 Merchant views to fully evaluate the patellofemoral joint. 相似文献7.
目的 探讨改良单图像法手工测量髌骨不稳患者胫骨结节-股骨滑车沟(tibial tuberosity-trochlear groove,TT-TG)间距的可行性。
方法 选取髌骨不稳患者30例。高年资手术医师A、B,使用改良单图像法手工测量髌骨不稳患者TT-TG间距,对比高资年影像学医师C,使用双图法测量髌骨不稳患者TT-TG间距。应用Cronbach′s alpha系数评价结果的可信度。应用组内相关系数(intraclass correlation coefficient,ICC)评价结果的可重复性。使用Bland-Altman分析图评价结果的一致性。
结果 高年资手术医师A、B使用改良单图像法手工测量髌骨不稳患者TT-TG间距分别和高年资影像学医师C使用双图法测量髌骨不稳患者TT-TG间距比较,Cronbach′s alpha系数分别为0.913和0.959,组内相关系数分别为0.913和0.958。Bland-Altman分析图显示,TT-TG间距差值(mm)的均值为-0.276(95%CI:-3.526~2.974)和0.143(95%CI:-3.110~3.397)。A、B医师之间使用改良单图像法手工测量髌骨不稳患者TT-TG间距比较,Cronbach′s alpha系数为0.891,组内相关系数为0.891。Bland-Altman分析图显示TT-TG间距差值(mm)的均值为-0.276(95%CI:-3.526~2.974)。
结论 改良单图像法手工测量髌骨不稳患者TT-TG间距操作简单,可以准确测量出髌骨不稳患者的TT-TG间距,该方法和双图法可以相互替换使用。 相似文献
8.
9.
Nimrod Snir Ran Schwarzkopf Brian Diskin Richelle Takemoto Mathew Hamula Patrick A. Meere 《The Journal of arthroplasty》2014
The geometry of the intercondylar box plays a significant role in the development of patellar clunk syndrome. We reviewed the incidence of patella clunk at mid-to-long-term follow-up of a rotating high-flex versus fixed bearing posterior stabilized TKA design. 188-mobile and 223-fixed bearing TKAs were reviewed for complications, incidence of patellar clunk, treatment, recurrence rates, range of motion, and patient satisfaction. Patellar clunk developed in 22 knees in the mobile (11.7%) and in 4 (1.8%) in the fixed bearing group (P < 0.001). 23 out of 26 cases resolved with a single arthroscopic treatment and 2 resolved with a second procedure. The mean postoperative range of motion was 122.4°. All but one patient reported overall satisfaction with the index procedure. In contrast with other recent studies we found a significant incidence of patellar clunk in high-flex mobile bearings. Despite the high rate of patellar clunk syndrome, overall patients did well and were satisfied with their outcomes. 相似文献
10.
Geoffrey F. Dervin Timothy Whitehead Phil Poitras Milton Parai Hakim Louati 《The Journal of arthroplasty》2014
Patellar tendon avulsion is a risk with difficult exposure in a stiff knee, patella baja or previous tibial osteotomy. We sought to define a safe amount of release of the patellar tendon insertion for such cases. Eleven pairs of fresh frozen cadaveric lower limb specimens were acquired and randomized to either intact or partial release of the distal tibial insertion. Partial release of the tibial insertion of the tendon increased lateral exposure a mean 29% ± 15% (P = 0.002) while reducing ultimate strength to a mean of 80% that of the intact contralateral tendon. Measured patella release increased lateral patella translation and can be performed without risk of catastrophic rupture with basic activities of daily living following TKA. 相似文献