Cases reported "Knee Injuries"

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1/120. A technique for reconstruction of the medial patellofemoral ligament.

    Additional medial patellofemoral ligament reconstruction was performed successfully on six consecutive patients with recurrent dislocation of the patella because of residual patellar instability after medial transfer of the tibial tubercle. A technique for medial patellofemoral ligament reconstruction is described, and complications and postoperative management are discussed. The reconstruction was performed using a double strand hamstring tendon graft in five patients and iliotibial allograft in one. Good stabilization of the patella was achieved in all six patients, resulting in improved confidence in higher levels of activity. The satisfactory outcome of additional medial patellofemoral ligament reconstruction suggests the possibility that the procedure may be part of the optional procedure in proximal realignment for recurrent dislocation of the patella.
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ranking = 1
keywords = tibia
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2/120. Distal disinsertion of the patellar ligament combined with avulsion fractures at the medial and lateral margins of the patella. A case report and an experimental study.

    A 12-year-old boy presented with a proximally retracted patella 5 months after an injury to the left knee. The clinical and radiographic features and the findings at operation led to the conclusion that the original lesion had been a distal disinsertion of the patellar ligament combined with avulsion fractures at the medial and lateral margins of the patella, produced by the medial and lateral longitudinal patellar retinacula. Loading experiments on amputation and cadaver specimens showed that these retinacula, apart from being tendons for the vastus medialis and the vastus lateralis, respectively, constitute a direct fibrous connection of considerable strength between the patella and the tibia and thus are capable of producing avulsion fractures.
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ranking = 0.5
keywords = tibia
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3/120. Uncommon causes of anterior knee pain: a case report of infrapatellar contracture syndrome.

    The uncommon causes of anterior knee pain should always be considered in the differential diagnosis of a painful knee when treatment of common origins become ineffective. A case is presented in which the revised diagnosis of infrapatellar contracture syndrome was made after noting delayed progress in the rehabilitation of an active female patient with a presumed anterior horn medial meniscus tear and a contracted patellar tendon. The patient improved after the treatment program was augmented with closed manipulation under arthroscopy and infrapatellar injection of both corticosteroids and a local anesthetic. Infrapatellar contraction syndrome and other uncommon sources of anterior knee pain, including arthrofibrosis, Hoffa's syndrome, tibial collateral ligament bursitis, saphenous nerve palsy, isolated ganglions of the anterior cruciate ligament, slipped capital femoral epiphysis, and knee tumors, are subsequently discussed. Delayed functional advancement in a rehabilitation program requires full reassessment of the patient's diagnosis and treatment plan. Alternative diagnoses of knee pain are not always of common origins. Ample knowledge of uncommon causes of anterior knee pain is necessary to form a full differential diagnosis in patients with challenging presentations.
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ranking = 0.5
keywords = tibia
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4/120. knee dislocation following anterior cruciate ligament disruption without any other ligament tears.

    We report a rare case of complete knee dislocation following anterior cruciate ligament (ACL) disruption without any other ligament tears. The pathology of the knee joint was torn ACL, intact other ligaments, osteochondral fractures and bone bruise of the lateral femoral condyle, and torn lateral meniscus. In this case, osteochondral fracture resulting from the anteriorly sublaxiation of the tibia following ACL disruption was considered to prevent from spontaneous reduction. This case suggests that anterolateral knee dislocation and spontaneous reduction may occur in ACL injuries.
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ranking = 0.5
keywords = tibia
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5/120. Tibial tuberosity avulsion fracture combined with meniscal tear.

    Avulsion fractures of the tibial tuberosity are uncommon injuries. They usually occur during athletic activities in adolescents. The classification of these injuries has been divided into three types. Only two cases of avulsion fractures of tibial tuberosity have previously been reported with associated damages to menisci. We report a type III fracture of the tibial tuberosity associated with tear of the medial meniscus.
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ranking = 1.5
keywords = tibia
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6/120. Clinics in diagnostic imaging (40). iliotibial band syndrome.

    A 51-year-old male cyclist presented with a mass over the lateral portion of his knee. MR scans showed a cystic collection deep to the iliotibial band (ITB). diagnosis of the ITB syndrome and its differentiation from other cause of painful lateral knee masses, such as meniscal cyst, lateral collateral ligament injury and Segond fracture, are discussed.
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ranking = 2.5
keywords = tibia
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7/120. Irreducible posterolateral dislocation of the knee.

    Traumatic knee dislocations are relatively rare, often associated with neurovascular injury, and almost always amenable to closed reduction. However, over the years, several authors have recognized that the rare knee dislocation not reducible by closed manipulation usually involves posterolateral dislocation of the tibia and button-holing of the medial femoral condyle through the medial retinaculum. These cases present with a dimple sign, a characteristic invagination of tissues at the medial joint line. Open reduction entails extraction of the soft-tissue collar that becomes incarcerated in the trochlea and intercondylar notch. We present an interesting case of irreducible posterolateral knee dislocation and review many of the salient points associated with this entity. Additionally, we include intraoperative video footage available on the Journal Web site to promote a better appreciation of the dramatic visual presentation and physical examination of this unusual injury.
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ranking = 0.5
keywords = tibia
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8/120. anterior cruciate ligament injury in indoor ball games.

    Three videorecorded incidents of knee injuries inflicted during indoor ball games are reported. Injuries and especially anterior cruciate ligament ruptures seemed to be triggered in varus loaded knees by femural external rotation, or in valgus loaded knees by femural internal rotation with the pivot shifted to the lateral femurotibial compartment. The observations suggest that it may be to the players' advantage to be trained in not letting their knees sag medially or laterally during side-stepping or sudden changes in speed.
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ranking = 0.5
keywords = tibia
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9/120. Recurrent posterior dislocation following primary posterior-stabilized total knee arthroplasty.

    In our series of 136 patients with primary total knee arthroplasty using posterior-stabilized prosthesis, a female patient with parkinson disease developed posterior dislocation of the knee 9 months after surgery. Eventually, the dislocation became recurrent, occurring several times a day. The patient made the reposition always by herself. Two months after the first dislocation, we performed the revision of the polyethylene tibial insert and found wearing of the tibial insert's cam as an hitherto unreported cause of the mechanical instability of the total knee prosthesis.
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ranking = 1
keywords = tibia
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10/120. Frozen allogenic spongy bone grafts in filling the defects caused by fractures of proximal tibia.

    The authors present the way of using the allogenic, frozen, radio-sterilized, spongy bone grafts in operational filling of defects after infra-articular fracture of proximal tibia. Fifteen patients (11 men and 4 women) classified between 30 and 66 years old were evaluated. These patients were operated from 1996 to 1998. The operational treatment with using frozen spongy bone grafts was performed on patients with comminuted split fracture of lateral condyle and depression of tibial plateau. In each case after elevating depressed fragment of tibial plateau bone grafts and screws were used to create a stable joint surface. In the same time other injured structures of the joint (ligaments, meniscus) were being reconstructed. To evaluate the stage of grafts incorporation, radiological examinations were made in; 4 weeks, 8 weeks, 6 months, 1 year from the date of the operation. We observed the process of calcification and forming trabeculac in bone grafts. The mechanical abilities of the reconstructed joint were evaluated according to the IKDS and Lysholm score. In all cases the spongy bone grafts in the joint were reconstructed and rebuild successfully. Thirteen patients had good and very good results in further clinical examinations. We claim that frozen, allogenic grafts of the spongy bone are very useful in filing detects of that bone caused by complicated injuries. This method of treatment with its good results is recommended.
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ranking = 3.5
keywords = tibia
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