Cases reported "Knee Dislocation"

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1/21. Radiologic case study. Traumatic dislocation of the knee.

    Imaging in knee dislocation requires multiple modalities and a comprehensive assessment of ligaments, cartilage, bone, nerve, and vascular anatomy. magnetic resonance imaging is essential in the work-up of these patients and MRA is a promising modality for detecting vascular injury. ( info)

2/21. The use of stereolithography for an unusual patellofemoral disorder.

    A patient with habitual patellar dislocation which was not treated successfully by the Elmslie-Trillat procedure is described. In the knee, a unique morphologic feature of the patellofemoral joint was suspected as a cause, and a stereolithographic model was produced from the patient's computed tomography data to determine the pathologic features. Because the solid model confirmed the speculation, additional surgery was done to modify the geometry of the joint. In the surgery, cancellous bone was removed below the cartilage, and the geometry of the cartilage was modified with the subchondral bone, taking advantage of the elasticity of the bone and cartilage. The second surgery eliminated maltracking of the patella and a satisfactory result was obtained. Therefore, stereolithography is useful for the treatment of atypical patellofemoral disorders, allowing an understanding of the pathologic features and dynamic simulation of the surgery. The surgical procedure could be a promising method to alter the joint geometry without impairing the cartilage. ( info)

3/21. Posterior dislocation after posterior stabilization TKA.

    Posterior dislocation after primary total knee arthroplasty is a rare but serious complication. The authors described an 85-year-old man receiving bilateral total knee arthroplasty, which achieved good flexion arc immediately. Posterior dislocation occurred on right knee one month after operation, which was treated by close reduction and casting. Dislocation recurred in combination with infection. The mechanism of dislocation was checked under vision when performing open reduction and debridement. The tibial spine escaped from femoral cam in slight flexion and external rotation due to flexion laxity and biceps tethering. On the way to pursuit higher flexion angle, which is beyond the ordinary daily demand, excessive soft tissue release and bone resection seems to b e compromised. Flexion instability alsooccurs out of purpose, accompanied with increased risk of dislocation. ( info)

4/21. Posterior tibial subluxation and short-term arthritis resulting from failed posterior cruciate ligament reconstruction.

    Posterior tibial subluxations because of combined or isolated posterior cruciate ligament (PCL) injuries require detailed evaluation. PCL reconstructions are difficult procedures because of the low rate of such injuries and the complex anatomy of the ligament. We report on 2 cases of failed PCL reconstruction because of malpositioned femoral tunnels. These 2 cases support the existing biomechanical evidence that the correct placement of the tunnels, especially in the femur, is a major factor in defining the outcome. It seems that the drilling of the tunnels, especially in the femur, during PCL reconstruction must be performed with accuracy and always be evaluated in cases of graft failure. In addition, failed PCL reconstructions are usually accompanied by a short-term excessive arthritis that results in poor functional outcome. ( info)

5/21. Failure of heat shrinkage for treatment of a posterior cruciate ligament tear.

    Incomplete tears or traumatic elongations of either the native cruciate ligaments or cruciate ligament reconstructions represent a therapeutic dilemma for orthopaedic surgeons. We report a case of a partially torn posterior cruciate ligament that was treated unsuccessfully with an electrothermal shrinkage procedure. Although the use of thermal energy to selectively shrink tissues may ultimately prove to be an invaluable tool, the lack of well-designed, randomized controlled studies to firmly establish its efficacy in the treatment of partial cruciate injuries mandates cautious use of this technique at this time. ( info)

6/21. Instability after total knee replacement with a mobile-bearing prosthesis in a patient with multiple sclerosis.

    We describe a patient with multiple sclerosis (MS), who developed recurrent dislocations after total knee arthroplasty. She had both knees replaced using similar mobile-bearing knee prostheses, but the outcome was worse in the leg which was more severely affected with MS. ( info)

7/21. High-energy knee dislocation without anterior cruciate ligament disruption in a skeletally immature adolescent.

    Knee dislocations are rare injuries in any age group, but even more unusual in skeletally immature individuals. Such injuries often occur from high-energy mechanisms and are commonly associated with disruption of both anterior and posterior cruciate ligaments. Although there are several previous reports of knee dislocation without disruption of the posterior cruciate ligament, there is only one report citing 3 cases of knee dislocation with the anterior cruciate ligament remaining intact, each occurring in skeletally mature individuals. We present a high-energy knee dislocation in a skeletally immature girl without anterior cruciate ligament disruption. We also discuss the evaluation, management, and outcome. Treatment of this condition with arthroscopically assisted posterior cruciate ligament reconstruction using tibialis anterior allograft 2 weeks after the acute injury resulted in complete functional recovery. ( info)

8/21. Isolated complete popliteal artery rupture associated with knee dislocation. case reports.

    Complete dislocation of the knee is a rare injury, and is frequently associated with injuries to other structures in the popliteal fossa. Prompt recognition of associated popliteal artery disruption and early revascularization is paramount for successful and functional results. The necessity for emergency vascular reconstruction markedly complicates an already difficult orthopaedic problem. Arteriography is recommended in all cases of complete dislocation of the knee. ( info)

9/21. Fresh meniscal allograft transplantation and autologous ACL/PCL reconstruction in a patient with complex knee trauma following knee dislocation--a case report.

    Instability of the knee joint, particularly in combination with the loss of one meniscus, regularly leads to the early development of arthritis. This paper describes the case of a 19-year-old male with ruptures of the anterior (ACL) and posterior cruciate ligament (PCL) along with the loss of the medial meniscus due to knee dislocation. Combined, time-delayed reconstruction of both the ACL and PCL and the allogenic fresh meniscal transplantation of the medial meniscus without bone plugs were performed. The control arthroscopy performed 6 months post-transplantation revealed good vitality and integration of the grafts as assessed both macroscopically and histologically. A small portion of the posterior horn had to be refixated, and the anterior horn was atrophic. At 24 months after trauma and 13 months following meniscal transplantation, the patient achieved a Lysholm score of 88 points and clinical examination indicated a stable knee. Fresh meniscal allograft transplantation, in combination with autologous ACL and PCL reconstruction, constitutes--in specialized centers--an alternative treatment option for complex trauma of the knee joint with loss of a meniscus. ( info)

10/21. An unusual knee injury: Isolated tibiofibular dislocation.

    Isolated proximal tibiofibular dislocation is an extremely rare condition with potentially serious complications if missed. The mechanism of injury, clinical presentation and treatment options are discussed. This injury was more common in previous centuries, when horse riding was the preferred method of transport. The young man we present was involved in a pastime that is rising in popularity and it is therefore likely that this injury will be a more common presentation to EDs. ( info)
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