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Anterior Knee Pain (anterior + knee_pain)
Selected AbstractsOsteoid osteoma of the tibial tubercle , an unusual cause of anterior knee painINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 10 2004A. Lakdawala Summary This case report describes an atypical cause of anterior knee pain in an adolescent male. The osteoid osteoma was located in the tibial apophysis. [source] Clinical manifestations of chondromalacia patella in 260 Iranian patientsINTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, Issue 2 2005I. SALEHI Abstract Background and aim:, Chondromalacia patella, which is characterized by softening of the patellar cartilage, is the most common cause of anterior knee pain in young women. The aim of this study was to identify the clinical features of patients with chondromalacia patella in Iran. Methods:, All patients under 40 years, complaining of mechanical knee pain who were referred to Amir A'lam Rheumatology Unit, with positive shrug sign and normal knee X-rays during the period September 2000 to September 2002, were included in this study. After physical examination and knee radiography, patients with knee arthritis, knee osteoarthritis and knee periarthritis were excluded. Patients with the clinical diagnosis of chondromalacia patella were studied. The demographic data, clinical disease characteristics and disease course were recorded. Results:, There were 260 patients. They were predominantly female (F : M, 2.6 : 1), in the third decade of life and a mean age of 22.8 years at the onset of disease. Bilateral involvement was found in 92% of patients. The first manifestation was knee pain. The history of trauma or swelling of the knee occurred in about 20% of cases. The history of dislocation was 3%. Sitting with flexed knees, stairs, and the use of Turkish WCs aggravated the knee pain. About one-third had knee malalignment, mostly mild genu varus. Patella alta was seen in 1.6%. Q-angle more than 15° was seen in 90.8%. Mean Q-angle was 21.9°, mean patellar angle was 122.6°, and mean intercondylar angle was 141.5°. All patients had the shrug sign. About 90% had Rabot test and crepitation, 3.5% had knee effusion, and 1% had knee laxity. Lower limb discrepancy was seen in 6.2% and spinal deformity in 10%. Ninety-three percent of the patients were treated by conservative (medical) therapy. Conclusion:, So the classic case of chondromalacia patella is a woman in her third decade of life with mechanical knee pain and positive shrug test. [source] Patellar blood flow during knee arthroplasty surgical exposure: Intraoperative monitoring by laser doppler flowmetryJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 10 2007Axel Hempfing Abstract Patellofemoral complications following knee arthroplasty are a well-known problem. Patellar ischemia has been suspected to be causative for fracture, anterior knee pain, and patella component failure. The purpose of this study was to assess the influence of knee arthroplasty surgical dissection on patellar blood flow. Patellar blood flow was measured by means of intraosseous laser Doppler flowmetry (LDF) in 10 patients undergoing total knee arthroplasty by a standard medial parapatellar approach. The initial blood flow was 121.6,±,114.7 AU. The signal significantly decreased by 71% (p,=,0.0051) when the knee was flexed and lost the pulsatile signal pattern in 80%. After arthrotomy, the signal was 100.1,±,120.3 AU in extension. The lowest signal was found in flexion and eversion of the patella (mean, 18,±,10.7 AU) and all signals lost pulsatility. As compared to the initial values, completion of the soft tissue dissection did not lead to a significant change of the blood flow signal (121.3,±,104.8; p,=,0.6835). Flexion of the knee joint markedly reduced patellar perfusion. Standard medial parapatellar approach did not significantly change patellar blood flow. This study does not support the theory of postoperative patellar ischemia as a cause of anterior knee pain or patellofemoral problems. © 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 25:1389,1394, 2007 [source] Prolonged vastus lateralis denervation after botulinum toxin type A injectionMOVEMENT DISORDERS, Issue 3 2010FRACP, John W Dunne MBBS (Hons) Abstract Intramuscular injection of botulinum toxin (BoNT) produces reversible blockade of neuromuscular transmission. In animal experimental models, recovery begins within four weeks and is usually complete by twelve weeks. We present evidence of prolonged denervation following BoNT injection of the vastus lateralis (VL) muscle to correct quadriceps muscle imbalance in patients with chronic anterior knee pain. Needle electromyography data were obtained from 10 subjects who had received a single BoNT treatment 5 to 19 months earlier as part of a clinical trial. Insertional and spontaneous activity, recruitment, and motor unit action potentials were examined. Clear differences between the injected and non-injected VL muscles, which correlated with the time since injection, were identified in all subjects. All 10 subjects studied with needle EMG showed evidence of persisting denervation in the BoNT-A injected VL muscle beyond the period of neuromotor recovery expected from animal experimental studies. © 2010 Movement Disorder Society [source] The need for patellar resurfacing in total knee arthroplasty: a literature reviewANZ JOURNAL OF SURGERY, Issue 4 2010John D. Swan Abstract The controversy over whether or not to routinely resurface the patella during a total knee arthroplasty has persisted despite three decades of successful joint replacement procedures. Advocates for routine patellar resurfacing admit the occasional need for secondary patellar resurfacing and declare increased incidence of anterior knee pain in patients with non-resurfaced patellae as a cause for worry. Surgeons that leave the patella unresurfaced cite avoidance of complications that include patellar fracture, avascular necrosis, patellar tendon injury and instability. This review discusses the available literature on patellar resurfacing through an evidence-based analysis of randomized and pseudo-randomized controlled trials and published meta-analyses to date. The published literature seems to favour resurfacing the patellar routinely. Selective patellar resurfacing would be the ideal solution if sound pre-operative criteria could be established. So far, a method for accurately predicting which patients can avoid patellar resurfacing has not been found. Future research looking at patellar resurfacing should concentrate on developing criteria for selecting those patients that would benefit from patellar resurfacing and those that would do as well without resurfacing, and thus, limiting potential surgical complications. [source] | ||||||||||