1/6. Recurrent inferior patellar dislocation in an osteo-arthritic knee.A case of inferior dislocation of the patella in an 80-year-old woman with an osteo-arthritic knee is presented. This is a rare injury in the degenerate knee and the first case in which recurrence, the need for operative reduction and intra-articular damage has been demonstrated.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
2/6. The management of superior dislocation of the patella with interlocking osteophytes--an update on a rare problem.The superior dislocation of the patella with interlocking osteophytes is a rare condition. A review of the English literature revealed only 12 reported cases. The purpose of reviewing these case reports is to highlight the unusual presentation and the injury mechanism in 2 of our patients, and to present our treatment algorithm. Closed reduction with manipulation of the patella, with or without anaesthesia, was performed without difficulty. We recommend an intermediate step of trying a regional nerve block before proceeding to general anaesthesia. Our patients had full range-of-motion after reduction and they were symptom-free after 3 years of follow-up. There were no recurrent dislocations in our patients.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
3/6. Osteochondral injury to the mid-lateral weight-bearing portion of the lateral femoral condyle associated with patella dislocation.We report on a series of 7 patients who presented with patella dislocation and were found to have osteochondral fracture (OCF) of the weight-bearing portion of the lateral femoral condyle either through preoperative studies or by identification of the lesion during arthroscopy. Treatments included open reduction and internal fixation, debridement, and microfracture of the lateral femoral condyle. Although not as common as osteochondral injuries to the medial facet of the patella and the anterior lateral portion of the lateral femoral condyle, osteochondral injury to the weight-bearing portion of the mid-lateral femoral condyle does occur with patella dislocation and was recognized in these 7 patients. The surgeon who treats known patellofemoral dislocations should be aware of this uncommon lesion to ensure detection and appropriate treatment. Also, in the case of uncertainty about the mechanism of injury, recognition of this lesion should heighten suspicion of patellofemoral dislocation.- - - - - - - - - - ranking = 6keywords = injury (Clic here for more details about this article) |
4/6. Lateral patella dislocation associated with an irreducible posterolateral knee dislocation: literature review.Posterolateral dislocations involve significant injury to the medial structures of the knee, therefore particular attention should be paid to repairing the medial patella stabilizers at the time of open reduction.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
5/6. Reconstruction of the medial patellofemoral ligament for painful patellar subluxation in distal torsional malalignment: a case report.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.- - - - - - - - - - ranking = 1603.6337414157keywords = trochlear (Clic here for more details about this article) |
6/6. patients with Ehlers Danlos syndrome and CRPS: a possible association?Rare patients are left with chronic pain, vasodysregulation, and other symptoms that define complex regional pain syndrome (CRPS), after limb traumas. The predisposing factors are unknown. Genetic factors undoubtedly contribute, but have not yet been identified. We report four CRPS patients also diagnosed with the classical or hypermobility forms of Ehlers Danlos syndrome (EDS), inherited disorders of connective tissue. These patients had been diagnosed using standard diagnostic criteria for CRPS and for EDS. All had sustained joint injury; in three this had been surgically treated. The association of these two diagnoses leads us to hypothesize that EDS might contribute to the development of CRPS in one or more of the following ways: via stretch injury to nerves traversing hypermobile joints, increased fragility of nerve connective tissue, or nerve trauma from more frequent surgery. We review the clinical presentation of the different Ehlers Danlos syndromes and provide clinical criteria that can be used to screen CRPS patients for EDS for clinical or research purposes.- - - - - - - - - - ranking = 2keywords = injury (Clic here for more details about this article) |