1/92. Correction of knee deformity in patients with ellis-van creveld syndrome.Six knees in three patients with ellis-van creveld syndrome were treated with lateral soft tissue release and corrective osteotomy of the tibia at 10 years of age on average. The main feature was valgus deformity with lateral dislocation of the patella. All patellae were reduced. The valgus deformity improved from 35 degrees (range, 48 degrees-20 degrees) to 17 degrees (range, 35 degrees-5 degrees) of the femorotibial angle (FTA) on average, although the FTA in five of six knees was < 5 degrees after surgery. There was one recurrent case and one transient peroneal nerve palsy. The reason for undercorrection was a depression of the lateral tibial plateau. The deformity of the articular surface is the most important problem in correcting the valgus deformity of the knee in this syndrome.- - - - - - - - - - ranking = 1keywords = patella (Clic here for more details about this article) |
2/92. Intra-articular dislocation of the patella: two cases and literature review.Intra-articular dislocation of the patella remains uncommon and is generally thought to be a problem of young adolescent males. This report reminds emergency physicians that it can occur in the arthritic knee, and it should be considered in the differential diagnosis of locked knee in the elderly. Closed reduction should be attempted in these cases, because the dislocation is liable to be held in place by osteophytes rather than impaction of the patella deep in the intercondylar notch and a good functional outcome can be expected.- - - - - - - - - - ranking = 3keywords = patella (Clic here for more details about this article) |
3/92. Irreducible dislocation of the knee.Irreducible knee dislocation is a rare injury. This case report describes a knee dislocation in a 39-year-old male U.S. Army noncommissioned officer who was injured while playing in a softball game. arthroscopy showed the medial collateral ligament and capsule to be locked in the intercondylar notch, covering the medial femoral condyle. Arthrotomy and open reduction were required. Staged posterior cruciate ligament reconstruction using patellar tendon autograft was later performed. review of the magnetic resonance imaging scan showed the irreducible lesion. The diagnostic clinical and radiographic features of this unusual injury are described.- - - - - - - - - - ranking = 0.5keywords = patella (Clic here for more details about this article) |
4/92. Locked lateral patellar dislocation: a rare case of irreducible patellar dislocation requiring open reduction.Irreducible patellar dislocations are rare injuries, but those that do occur are mainly directed intra-articularly. In this case, a 53-year-old woman sustained a locked lateral patellar dislocation when falling from a chair. A preoperative CT-scan revealed bony avulsions at the insertion of the vastus medialis muscle, the medical retinaculum, and partial disruption of the ligamentum patellae from the apex patellae. Open reduction was necessary and the torn structures were reattached with anchor systems and sutures. Postoperative management included intensive physiotherapy. At 1 year after surgery, the patient was without swelling or pain and had a normal gait, but flexion was restricted to 120 degrees. All postoperative radiographs showed the patella correctly placed in the femoral groove.- - - - - - - - - - ranking = 6.5keywords = patella (Clic here for more details about this article) |
5/92. Surgical management of congenital permanent dislocation of the patella in nail patella syndrome by Stanisavljevic procedure.We report a patient with nail patella syndrome associated with congenital permanent dislocation of the patella successfully operated on using a modified Stanisavljevic method. The patient, a 26-year-old woman, complained of inability to completely extend her right knee joint. She had occasionally experienced the "giving way" phenomenon since childhood, but she had not received any treatment since birth. physical examination showed that all fingernails were deformed, with longitudinal striations, while the lunules were of an abnormal triangular shape or were missing. Both patellae were palpably hypoplastic, with the right patella dislocated laterally, and the knee had an extension lag of 90 degrees. thigh and leg muscle were slightly underdeveloped, but quadriceps muscle contraction was good. Several radiographs were taken and they showed bilateral iliac horns and hypoplasia of the bilateral humero-radial joints and of both patellae, and complete dislocation of the right patella. We employed the Stanisavljevic procedure for the reduction of the patella, with Z-lengthening of the rectus femoris and medial translocation of the tibial tuberosity. Four years after the operation, a 30-degree extension lag still exists in the right knee, but the treatment resulted in stable alignment of the quadriceps mechanism, and notably improved gait appearance.- - - - - - - - - - ranking = 7.5keywords = patella (Clic here for more details about this article) |
6/92. A locked knee in extension: a complication of a degenerate knee with patella alta.We present a case of superior dislocation of the patella trapped by interlocked osteophytes. Unlike previous reports, in which the mechanism resulted from a blow to the inferior pole, it is postulated that increased load on the extensor mechanism, combined with patella alta and patellofemoral osteophytes, caused locking of the knee in extension.- - - - - - - - - - ranking = 3keywords = patella (Clic here for more details about this article) |
7/92. Localized pigmented villonodular synovitis presenting as recurrent dislocation of the patella.A 31-year-old woman presented with a 1-year history of recurrent dislocation of the patella. On examination, she was found to have a mass at the medial patellofemoral joint line. arthroscopy showed this to be a vascular synovial tumor extending into the medial patellofemoral joint and causing lateral deviation of the patella. The mass was resected with resolution of her symptoms and histologic examination showed this to be pigmented villonodular synovitis. There are an increasing number of case reports of these lesions causing varying mechanical symptoms in the knee and they should be considered as a differential diagnosis.- - - - - - - - - - ranking = 3keywords = patella (Clic here for more details about this article) |
8/92. Irreducible lateral dislocation of patella due to an intact retinaculum.Lateral dislocation of the patella is a common injury that can be treated successfully nonoperatively. The authors present a patient with lateral dislocation of the patella in which the patella rotated 90 degrees about its vertical axis. The retinaculum had been avulsed from the anterior aspect of the patella but was otherwise intact. Because the intact retinaculum prohibited closed reduction, open reduction was performed. The patient has returned to full, unrestricted activities.- - - - - - - - - - ranking = 4keywords = patella (Clic here for more details about this article) |
9/92. Congenital dislocation of the patella. Part II: orthopaedic management.Five patients (eight knees) with diagnosed congenital dislocation of the patella and well-documented charts were reviewed. Age at diagnosis ranged from 4 days to 6 years. A flexion contracture of the knee and femorotibial rotatory dislocation of varying degrees were present in all the cases. The quadriceps was active in all the cases, producing knee flexion in four cases. Foot deformity was associated in all the cases (clubfoot, calcaneovalgus, or congenital vertical talus). Gradual correction of knee flexion contracture with serial casting was attempted in five cases leading to an almost complete extension in two cases. Treatment of patellar dislocation was surgical in all the cases, consisting in extensive quadriceps release (seven knees) or V-Y lengthening (one knee), division of lateral soft tissues, and reefing of the medial retinaculum and capsule. Intraoperative anomalies were recorded. At an average follow-up of 6.9 years, all the patients are able to walk on their operated limb, and the patella is centered in the trochlea in all the cases. Knee mobility, rotatory dislocation, and daily function were improved in seven cases.- - - - - - - - - - ranking = 3.5keywords = patella (Clic here for more details about this article) |
10/92. Arthroscopic reduction and fixation of osteochondral fracture of the patellar ridge.A method of arthroscopic reduction and anterograde fixation of osteochondral fracture of the patella ridge is described. This type of fracture was previously treated through arthrotomy. An arthroscopic approach is possible using manipulation of the patella in a loosened medial retinaculum. This method was used in a 14-year-old patient with an osteochondral fracture following the dislocation of the patella.- - - - - - - - - - ranking = 3.5keywords = patella (Clic here for more details about this article) |
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