Dislocations
Patellar Ligament
Patellofemoral Joint
Chondromalacia Patellae
Joint Instability
Hip Dislocation, Congenital
Traction
Lens Subluxation
Reconstruction of the medial patellofemoral ligament for the treatment of habitual or recurrent dislocation of the patella in children. (1/50)
We investigated the clinical outcome of a reconstructive procedure of the medial patellofemoral ligament for the treatment of habitual or recurrent dislocation of the patella in four children (6 knees), with a minimum follow-up of four years. The technique involves transfer of the tendon of semitendinosus to the patella using the posterior one-third of the femoral insertion of the medial collateral ligament as a pulley. There was no recurrence of dislocation after surgery. The mean Kujala score at follow-up was 96.3 points. Radiological assessment showed that the congruence angle, the tilt angle and the lateral shift radio were restored to normal. The lateral and medial stress shift ratios and the Insall-Salvati ratio remained abnormal. We conclude that this technique can be recommended for the treatment of habitual or recurrent patellar dislocation in children, although hypermobility and patella alta are not fully corrected. (+info)Evaluation of patients presenting with knee pain: Part II. Differential diagnosis. (2/50)
Knee pain is a common presenting complaint with many possible causes. An awareness of certain patterns can help the family physician identify the underlying cause more efficiently. Teenage girls and young women are more likely to have patellar tracking problems such as patellar subluxation and patellofemoral pain syndrome, whereas teenage boys and young men are more likely to have knee extensor mechanism problems such as tibial apophysitis (Osgood-Schlatter lesion) and patellar tendonitis. Referred pain resulting from hip joint pathology, such as slipped capital femoral epiphysis, also may cause knee pain. Active patients are more likely to have acute ligamentous sprains and overuse injuries such as pes anserine bursitis and medial plica syndrome. Trauma may result in acute ligamentous rupture or fracture, leading to acute knee joint swelling and hemarthrosis. Septic arthritis may develop in patients of any age, but crystal-induced inflammatory arthropathy is more likely in adults. Osteoarthritis of the knee joint is common in older adults. (+info)Avulsion of the common origin of the medial collateral and medial patello-femoral ligaments. (3/50)
This study documents for the first time avulsion of the common origin of the medial collateral and medial patello-femoral ligaments. (+info)The management of superior dislocation of the patella with interlocking osteophytes--an update on a rare problem. (4/50)
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. (+info)The effects of articular, retinacular, or muscular deficiencies on patellofemoral joint stability: a biomechanical study in vitro. (5/50)
Normal function of the patellofemoral joint is maintained by a complex interaction between soft tissues and articular surfaces. No quantitative data have been found on the relative contributions of these structures to patellar stability. Eight knees were studied using a materials testing machine to displace the patella 10 mm laterally and medially and measure the force required. Patellar stability was tested from 0 degrees to 90 degrees knee flexion with the quadriceps tensed to 175 N. Four conditions were examined: intact, vastus medialis obliquus relaxed, flat lateral condyle, and ruptured medial retinaculae. Abnormal trochlear geometry reduced the lateral stability by 70% at 30 degrees flexion, while relaxation of vastus medialis obliquus caused a 30% reduction. Ruptured medial retinaculae had the largest effect at 0 degrees flexion with 49% reduction. There was no effect on medial stability. There is a complex interaction between these structures, with their contributions to loss of lateral patellar stability varying with knee flexion. (+info)Ultrastructural study of the extra-articular Leeds-Keio ligament prosthesis. (6/50)
BACKGROUND: There have been several histological studies of the Leeds-Keio ligament in anterior cruciate ligament reconstruction, but there have been few of the Leeds-Keio ligament in the extra-articular portion. AIMS/METHODS: To report the histological and ultrastructural findings of two cases of medial patellofemoral ligament reconstruction using the Leeds-Keio ligament, removed 6.1 years and 8.7 years after implantation. RESULTS: In both cases, the tissue over the Leeds-Keio ligament was a ligament-like tissue. Electron microscopy showed that the diameter of the collagen fibrils in the tissue over the Leeds-Keio ligament was unimodal in the case investigated 6.1 years after implantation but bimodal in the case investigated after 8.7 years. CONCLUSIONS: The tissue over the Leeds-Keio ligament may continue to grow with prolonged periods of mechanical stress. (+info)Trochleoplasty in lateral patellar luxation in two calves. (7/50)
Two Holstein Friesian calves were referred to the Animal Medical Center of Chonbuk National University with severe lameness on the hind limb(s), flexed stifle joint and an inability to walk since birth. Based on the clinical history, clinical findings and radiography of the stifle joint, the cases were diagnosed as grade III lateral patellar luxation (LPL). Trochleoplasty along with medial retinacular reinforcement and lateral release were performed in both calves. The calves recovered 3 to 4 weeks after surgery. Trochleoplasty along with medial retinacular reinforcement and lateral release can be an effective technique for the treatment of LPL in calves. (+info)Early results of one-stage knee extensor realignment and autologous osteochondral grafting. (8/50)
We treated 49 patients with recurrent patellar dislocations or persistent patellar subluxations. Chondral defects were graded according to the International Cartilage Repair Society (ICRS). Thirty patients (group I) had chondral defects grade I or II, and 19 patients (group II) had chondral defects grade III or IV. All patients were treated with proximal and distal realignment of the knee extensor mechanism, but group II also had a simultaneous autologous osteochondral grafting of the chondral defect. Patients were followed for 2 years and clinically assessed using the Marshall score comparing the two groups. Apart from a slower recovery in group II, the clinical and functional results were almost the same at the final follow-up. (+info)Patellar dislocation is a medical condition characterized by the displacement of the patella (kneecap) from its normal position in the femoral groove, which is a part of the femur (thighbone). This displacement usually occurs laterally, meaning that the patella moves toward the outer side of the knee.
Patellar dislocation can happen as a result of direct trauma or due to various factors that increase the laxity of the medial patellofemoral ligament and tightness of the lateral structures, leading to abnormal tracking of the patella. These factors include anatomical variations, muscle imbalances, genetic predisposition, or degenerative changes in the knee joint.
Dislocation of the patella can cause pain, swelling, and difficulty in moving the knee. In some cases, it might be associated with other injuries such as fractures or damage to the articular cartilage and surrounding soft tissues. Immediate medical attention is required for proper diagnosis and treatment, which may involve reduction, immobilization, physical therapy, bracing, or even surgery in severe cases.
A dislocation is a condition in which a bone slips out of its normal position in a joint. This can happen as a result of trauma or injury, such as a fall or direct blow to the body. Dislocations can cause pain, swelling, and limited mobility in the affected area. In some cases, a dislocation may also damage surrounding tissues, such as ligaments, tendons, and nerves.
Dislocations are typically treated by reducing the dislocation, which means putting the bone back into its normal position. This is usually done with the help of medication to relieve pain and relaxation techniques to help the person stay still during the reduction. In some cases, surgery may be necessary to repair damaged tissues or if the dislocation cannot be reduced through other methods. After the dislocation has been reduced, the joint may be immobilized with a splint or sling to allow it to heal properly.
It is important to seek medical attention promptly if you suspect that you have a dislocation. If left untreated, a dislocation can lead to further complications, such as joint instability and chronic pain.
The patellar ligament, also known as the patellar tendon, is a strong band of tissue that connects the bottom part of the kneecap (patella) to the top part of the shinbone (tibia). This ligament plays a crucial role in enabling the extension and straightening of the leg during activities such as walking, running, and jumping. Injuries to the patellar ligament, such as tendonitis or tears, can cause pain and difficulty with mobility.
The patella, also known as the kneecap, is a sesamoid bone located at the front of the knee joint. It is embedded in the tendon of the quadriceps muscle and serves to protect the knee joint and increase the leverage of the extensor mechanism, allowing for greater extension force of the lower leg. The patella moves within a groove on the femur called the trochlea during flexion and extension of the knee.
The patellofemoral joint is the articulation between the patella (kneecap) and the femur (thigh bone). It is a synovial joint, which means it is surrounded by a joint capsule containing synovial fluid to lubricate the joint. This joint is responsible for providing stability to the knee extensor mechanism and allows for smooth movement of the patella during activities like walking, running, and jumping. Pain or dysfunction in this joint can result in various conditions such as patellofemoral pain syndrome, chondromalacia patella, or patellar dislocation.
Chondromalacia patellae is a medical condition that refers to the softening and degeneration of the articular cartilage on the undersurface of the patella, or kneecap. This cartilage, which provides a smooth, lubricated surface for joint movement, can become damaged due to various reasons such as overuse, misalignment of the patella, or direct trauma. The resulting damage can cause pain and inflammation in the knee, particularly during activities that involve bending or straightening the leg. In some cases, chondromalacia patellae may also lead to the formation of bone spurs or osteophytes, which can further exacerbate the symptoms and limit joint mobility. Treatment for chondromalacia patellae typically involves a combination of rest, physical therapy, and pain management strategies, such as anti-inflammatory medications or corticosteroid injections. In severe cases, surgery may be required to repair or replace the damaged cartilage.
A hip dislocation is a medical emergency that occurs when the head of the femur (thighbone) slips out of its socket in the pelvis. This can happen due to high-energy trauma, such as a car accident or a severe fall. Hip dislocations can also occur in people with certain health conditions that make their hips more prone to displacement, such as developmental dysplasia of the hip.
There are two main types of hip dislocations: posterior and anterior. In a posterior dislocation, the femur head moves out of the back of the socket, which is the most common type. In an anterior dislocation, the femur head moves out of the front of the socket. Both types of hip dislocations can cause severe pain, swelling, and difficulty moving the affected leg.
Immediate medical attention is necessary for a hip dislocation to realign the bones and prevent further damage. Treatment typically involves sedation or anesthesia to relax the muscles around the joint, followed by a closed reduction procedure to gently guide the femur head back into the socket. In some cases, surgery may be required to repair any associated injuries, such as fractures or damaged ligaments. After treatment, physical therapy and rehabilitation are usually necessary to restore strength, mobility, and function to the affected hip joint.
Tenodesis is a surgical procedure where a damaged or torn tendon is attached to a nearby bone using sutures, anchors, or screws. The term specifically refers to the surgical fixation of a tendon to a bone. This procedure is often performed to treat injuries of the shoulder or wrist, such as rotator cuff tears or distal biceps tendon ruptures.
The goal of tenodesis is to provide stability and restore function to the affected joint by creating a new, stable attachment point for the tendon. This procedure can help reduce pain, improve strength, and enhance overall joint mobility. It is typically recommended when non-surgical treatments have failed or are not appropriate for the patient's injury.
It is important to note that tenodesis should not be confused with tenotomy, which is a surgical procedure where a tendon is cut to release tension and improve mobility in a joint.
Joint instability is a condition characterized by the loss of normal joint function and increased risk of joint injury due to impaired integrity of the supporting structures, such as ligaments, muscles, or cartilage. This can result in excessive movement or laxity within the joint, leading to decreased stability and increased susceptibility to dislocations or subluxations. Joint instability may cause pain, swelling, and limited range of motion, and it can significantly impact a person's mobility and quality of life. It is often caused by trauma, degenerative conditions, or congenital abnormalities and may require medical intervention, such as physical therapy, bracing, or surgery, to restore joint stability.
A cartilage fracture is not a common injury because cartilage itself does not have bones, and it is difficult to fracture something that is not hard. However, there are situations where the term "cartilage fracture" can be used. One such situation is when the articular cartilage, which covers the ends of bones in joints, gets damaged or injured. This type of injury is also known as a chondral fracture or osteochondral fracture (if the bone beneath the cartilage is also involved). These injuries can occur due to trauma, such as a fall or a direct blow to the joint, and can cause pain, swelling, and limited mobility in the affected joint.
Shoulder dislocation is a medical condition where the head of the humerus (upper arm bone) gets displaced from its normal position in the glenoid fossa of the scapula (shoulder blade). This can occur anteriorly, posteriorly, or inferiorly, with anterior dislocations being the most common. It is usually caused by trauma or forceful movement and can result in pain, swelling, bruising, and limited range of motion in the shoulder joint. Immediate medical attention is required to relocate the joint and prevent further damage.
Knee injuries refer to damages or harm caused to the structures surrounding or within the knee joint, which may include the bones (femur, tibia, and patella), cartilage (meniscus and articular cartilage), ligaments (ACL, PCL, MCL, and LCL), tendons (patellar and quadriceps), muscles, bursae, and other soft tissues. These injuries can result from various causes, such as trauma, overuse, degeneration, or sports-related activities. Symptoms may include pain, swelling, stiffness, instability, reduced range of motion, and difficulty walking or bearing weight on the affected knee. Common knee injuries include fractures, dislocations, meniscal tears, ligament sprains or ruptures, and tendonitis. Proper diagnosis and treatment are crucial to ensure optimal recovery and prevent long-term complications.
Arthroscopy is a minimally invasive surgical procedure where an orthopedic surgeon uses an arthroscope (a thin tube with a light and camera on the end) to diagnose and treat problems inside a joint. The surgeon makes a small incision, inserts the arthroscope into the joint, and then uses the attached camera to view the inside of the joint on a monitor. They can then insert other small instruments through additional incisions to repair or remove damaged tissue.
Arthroscopy is most commonly used for joints such as the knee, shoulder, hip, ankle, and wrist. It offers several advantages over traditional open surgery, including smaller incisions, less pain and bleeding, faster recovery time, and reduced risk of infection. The procedure can be used to diagnose and treat a wide range of conditions, including torn ligaments or cartilage, inflamed synovial tissue, loose bone or cartilage fragments, and joint damage caused by arthritis.
Knee dislocation is a serious and uncommon orthopedic injury that occurs when the bones that form the knee joint (femur, tibia, and patella) are forced out of their normal position due to extreme trauma or force. This injury often requires immediate medical attention and reduction (repositioning) by a healthcare professional. If left untreated, it can lead to serious complications such as compartment syndrome, nerve damage, and long-term joint instability. It's important to note that knee dislocation is different from a kneecap (patellar) dislocation, which involves the patella sliding out of its groove in the femur.
The knee joint, also known as the tibiofemoral joint, is the largest and one of the most complex joints in the human body. It is a synovial joint that connects the thighbone (femur) to the shinbone (tibia). The patella (kneecap), which is a sesamoid bone, is located in front of the knee joint and helps in the extension of the leg.
The knee joint is made up of three articulations: the femorotibial joint between the femur and tibia, the femoropatellar joint between the femur and patella, and the tibiofibular joint between the tibia and fibula. These articulations are surrounded by a fibrous capsule that encloses the synovial membrane, which secretes synovial fluid to lubricate the joint.
The knee joint is stabilized by several ligaments, including the medial and lateral collateral ligaments, which provide stability to the sides of the joint, and the anterior and posterior cruciate ligaments, which prevent excessive forward and backward movement of the tibia relative to the femur. The menisci, which are C-shaped fibrocartilaginous structures located between the femoral condyles and tibial plateaus, also help to stabilize the joint by absorbing shock and distributing weight evenly across the articular surfaces.
The knee joint allows for flexion, extension, and a small amount of rotation, making it essential for activities such as walking, running, jumping, and sitting.
Congenital hip dislocation, also known as developmental dysplasia of the hip (DDH), is a condition where the hip joint fails to develop normally in utero or during early infancy. In a healthy hip, the head of the femur (thigh bone) fits snugly into the acetabulum (hip socket). However, in congenital hip dislocation, the femoral head is not held firmly in place within the acetabulum due to abnormal development or laxity of the ligaments that support the joint.
There are two types of congenital hip dislocations:
1. Teratologic dislocation: This type is present at birth and occurs due to abnormalities in the development of the hip joint during fetal growth. The femoral head may be completely outside the acetabulum or partially dislocated.
2. Developmental dysplasia: This type develops after birth, often within the first few months of life, as a result of ligamentous laxity and shallow acetabulum. In some cases, it can progress to a complete hip dislocation if left untreated.
Risk factors for congenital hip dislocation include family history, breech presentation during delivery, and female gender. Early diagnosis and treatment are crucial to prevent long-term complications such as pain, limited mobility, and osteoarthritis. Treatment options may include bracing, closed reduction, or surgical intervention, depending on the severity and age of the child at diagnosis.
The femur is the medical term for the thigh bone, which is the longest and strongest bone in the human body. It connects the hip bone to the knee joint and plays a crucial role in supporting the weight of the body and allowing movement during activities such as walking, running, and jumping. The femur is composed of a rounded head, a long shaft, and two condyles at the lower end that articulate with the tibia and patella to form the knee joint.
Recurrence, in a medical context, refers to the return of symptoms or signs of a disease after a period of improvement or remission. It indicates that the condition has not been fully eradicated and may require further treatment. Recurrence is often used to describe situations where a disease such as cancer comes back after initial treatment, but it can also apply to other medical conditions. The likelihood of recurrence varies depending on the type of disease and individual patient factors.
Traction, in medical terms, refers to the application of a pulling force to distract or align parts of the body, particularly bones, joints, or muscles, with the aim of immobilizing, reducing displacement, or realigning them. This is often achieved through the use of various devices such as tongs, pulleys, weights, or specialized traction tables. Traction may be applied manually or mechanically and can be continuous or intermittent, depending on the specific medical condition being treated. Common indications for traction include fractures, dislocations, spinal cord injuries, and certain neurological conditions.
Lens subluxation, also known as lens dislocation or ectopia lentis, is a condition where the lens of the eye becomes partially or completely displaced from its normal position. The lens is held in place by tiny fibers called zonules, which can become weakened or broken due to various reasons such as genetic disorders (like Marfan syndrome, homocystinuria, and Weill-Marchesani syndrome), trauma, inflammation, or cataract surgery complications. This displacement can lead to symptoms like blurry vision, double vision, sensitivity to light, or the appearance of a shadow in the peripheral vision. In some cases, lens subluxation may not cause any noticeable symptoms and can be discovered during routine eye examinations. Treatment options depend on the severity and underlying cause of the subluxation and may include eyeglasses, contact lenses, or surgical intervention to remove and replace the displaced lens with an intraocular lens (IOL).
The acromioclavicular (AC) joint is the joint located between the acromion process of the scapula (shoulder blade) and the clavicle (collarbone). It allows for a small amount of movement between these two bones and participates in shoulder motion. Injuries to this joint, such as AC joint separations or sprains, are common and can occur due to falls, direct blows, or repetitive motions that cause the ligaments that support the AC joint to become stretched or torn.