Histological comparison of patellar cartilage degeneration between chondromalacia in youth and osteoarthritis in aging

The histological findings of the patellar cartilage were compared between cases of chondromalacia, which occurs predominantly in young persons (22 patients, average age 19.8 years) and cases of osteoarthritis, which is common among the elderly (21 patients, average age 65.4 years). The histological findings of cartilage in the chondromalacia were characterized by increased density and vigorous fibrous metaplasia of chondrocytes. These findings may be considered to represent a reactive change in the chondrocyte. Cartilage degeneration in osteoarthritis, by contrast, is regressive and presents a clearly different histological picture from that of chondromalacia patellae. We conclude that chondromalacia does not easily lead to osteoarthritis. On the other hand, the cartilage was characteristically softened, as observed by gross inspection, and showed rarefaction of the cartilage matrix. It should be noted that the change was not observed in aging, but showed a pattern of cartilage degeneration peculiar to young patients with chondromalacia patellae.     

Rapadilino syndrome

We report on a boy with severe radial hypoplasia, absent thumbs and patellae, short stature, persistent diarrhea, slender nose and normal intelligence as another example of the RAPADILINO syndrome. © 1992 Wiley-Liss, Inc.     

髌骨矢状面截骨术对髌骨倾斜病理应力分布的生物力学影响

目的：研究髌骨矢状面截骨术对髌骨倾斜病理应力分布的影响。方法：采用手术方法将七具新鲜人尸体膝关节标本的髌骨外侧支持带紧缩，造成髌骨过度外侧倾斜，然后进行四个不同截骨角的髌骨矢状面截骨术。股四头肌腱加载200N。分别于正常状态、髌骨倾斜、截骨5°、10°、15°、20°六种工况下，应用压敏片测量髌股关节接触压力与面积。摄屈膝45°Merchant髌骨轴位片，测量髌骨倾斜角，了解髌骨倾斜程度。结果与结论：髌骨倾斜后，髌骨内侧接触面积与压力均减少，外例接触面积与压力均增加，屈膝30°时最显著。截骨10°以上，明显改善了髌骨倾斜的应力分布，其中截骨15°改善较为理想。本实验结果为临床上髌骨矢状面截骨术中截骨角的选择提供了可靠依据。     

Rearthroscopy of the temporomandibular joint: A retrospective study of 600 arthroscopies

Purpose

Arthroscopic surgery is an effective treatment for patients with temporomandibular disorders, releasing symptoms and restoring the mandibular function. In patients with poor arthroscopic outcomes, several options of treatment can be considered such as conservative nonsurgical therapy, open surgery, or a second arthroscopy. The purpose of this study was to evaluate our results after 619 arthroscopies.

Meniscal impingement syndrome

The meniscal impingement syndrome consists of three elements: impaction on the anterior medial femoral condyle by the leading edge of the medial meniscus, articular cartilage damage of at least Outerbridge grade 3, and knee hyperextension of at least 5°. This report reviews this condition in a series of seven knees with an average follow-up of 39 months. The time from the onset of symptoms until surgery averaged 45 months. Treatment consisted of a thorough arthroscopic knee evaluation and debridement of the articular cartilage fragmentation and any impinging synovitis. Postoperative rehabilitation includes extension block bracing, hamstring strengthening, and closed-chain exercise. With this regimen, there was improvement in the Tegner scores and a reduction in postoperative knee hyperextension. Identification of this uncommon condition requires a complete evaluation of the medial femoral condyle in patients with knee hyperextension.     

低场MRI在髌骨软化症的诊断及分级中的应用价值

目的 探讨髌骨软化症（CMP）的低场强MRI诊断及分级价值.方法回顾分析86例CMP的MRI资料.结果 CMP分为四期：I期 10例,II期13例,III期25例,IV期38例.结论 低场强MRI检查能对髌骨软化症做出明确诊断及分级,可作为临床判断患者有无髌骨软化症的首选无创检查方法.     

Osgood-Schlatter's disease,an emphasis on soft tissue changes in roentgen diagnosis

Osgood-Schlatter's disease is a well known entity affecting the adolescent knee. Radiologic examination of the knee has been an integral part of the diagnosis of this condition for decades. However, the soft tissue changes have not been appreciated sufficiently. Emphasis is placed on the use of optimum radiographic technique and xeroradiography in the examination of the soft tissues of the knee.     

Differences in the rehabilitation period following two methods of anterior cruciate ligament replacement: semitendinosus/gracilis tendon vs. ligamentum patellae

This study compared patient outcome during the early rehabilitation phase following two different methods of anterior cruciate ligament (ACL) reconstruction: ligamentum patellae (LP) and semitendinosus/gracilis tendon (SG) based reconstruction. The study included 50 consecutive patients treated by each method, examined 6 weeks and 3, 6 and 12 months after surgery. Patients in the SG group showed significantly better Lysholm scores at 6 and 12 months, Tegner Activity Scale scores at 3 months, and pain profile assessments at 6 weeks and 3 months than those in the LP group. Significant advantages were observed in LP group in the Overall Knee Score at 6 weeks and in range-of-motion at 6 weeks and 3 and 6 months post-surgery. Stability tests revealed no significant differences between patients in the two groups. SG-based reconstruction of the ACL thus demonstrates advantages over LP-based reconstruction regarding pain and function, while LP-based reconstruction was associated with an earlier return of motion.     

玻璃酸钠关节内注射治疗早期原发性髌骨软化症的临床疗效观察

目的探讨玻璃酸钠关节内注射治疗早期原发性髌骨软化症的临床疗效。方法2年中通过膝关节腔注射玻璃酸钠治疗早期原发性髌骨软化症56例患者（65个膝）,每周1次,每次2mL,连续给药5周,注射1个疗程后观察临床疗效。结果有3个膝出现副作用,其余53例,注射5次后,62个膝中,优11膝,占17.7%,良36膝,占58.1%,可11膝,占17.7%,差4膝,占6.5%。结论玻璃酸钠治疗早期原发性髌骨软化症能改善症状,有利于软骨修复,是一种有效的方法。     

中药熏洗加针刺治疗髌骨软骨软化症97例

目的观察中药熏洗及针剌治疗髌骨软骨软化症的，临床疗效。方法采用中药熏洗及针刺治疗两周。结果97例中，治愈63例，占64．9％；好转28例，占28．9％，未愈6例，占6．2％，有效率93．8％。结论中药熏洗及针刺治疗髌骨软骨软化症临床疗效满意.