scholarly journals Primary hypertrophic osteoarthropathy and bilateral transient lateral patellar dislocation in an adolescent

2021 ◽  
Author(s):  
Sharenja Jeyabaladevan ◽  
Emmanouil Astrinakis ◽  
Margaret Callan ◽  
Paul Anthony Sookur

This case report is of the index case of bilateral transient patellar dislocation in a patient with primary hypertrophic osteoarthropathy. Primary hypertrophic osteoarthropathy is a rare complex disorder with variable presentation and thus frequently delayed diagnosis. Notably this disease has multiple skeletal manifestations and, of relevance to this case, a proportion of patients suffer from osteitis. Our patient had serial imaging of the knee joints demonstrating osteitis and associated alteration of the femoral trochlea morphology, predisposing to bilateral transient lateral patellar dislocation. The patient’s clinical presentation, diagnosis and management are discussed. Classification of the disease and its diagnostic parameters are summarised along with key imaging features amongst various imaging modalities.

Radiology ◽  
2016 ◽  
Vol 281 (3) ◽  
pp. 907-918 ◽  
Author(s):  
Philipp Kickingereder ◽  
David Bonekamp ◽  
Martha Nowosielski ◽  
Annekathrin Kratz ◽  
Martin Sill ◽  
...  

2006 ◽  
Vol 73 (4) ◽  
pp. 477-479 ◽  
Author(s):  
Mohamed Younes ◽  
Mongi Touzi ◽  
Ismail Béjia ◽  
Saoussen Zrour-Hassen ◽  
Najeh Amara ◽  
...  

Author(s):  
Elizabeth A Arendt ◽  
Simon T Donell ◽  
Petri J Sillanpää ◽  
Julian A Feller

2016 ◽  
Vol 45 (5) ◽  
pp. 1012-1017 ◽  
Author(s):  
Thomas L. Sanders ◽  
Ayoosh Pareek ◽  
Nicholas R. Johnson ◽  
Michael J. Stuart ◽  
Diane L. Dahm ◽  
...  

Background: The rate of patellofemoral arthritis after lateral patellar dislocation is unknown. Purpose/Hypothesis: The purpose of this study was to compare the risk of patellofemoral arthritis and knee arthroplasty between patients who experienced a lateral patellar dislocation and matched individuals without a patellar dislocation. Additionally, factors predictive of arthritis after patellar dislocation were examined. The hypothesis was that the rate of arthritis is likely higher among patients who experience a patellar dislocation compared with those who do not. Study Design: Cohort study; Level of evidence, 3. Methods: In this study, 609 patients who had a first-time lateral patellar dislocation between 1990 and 2010 were compared with an age- and sex-matched cohort of patients who did not have a patellar dislocation. Medical records were reviewed to collect information related to the initial injury, recurrent dislocation, treatment, and progression to clinically significant patellofemoral arthritis (defined as symptoms with degenerative changes on patellar sunrise radiographs). Factors associated with arthritis (age, sex, recurrence, osteochondral injury, trochlear dysplasia) were examined. Results: At a mean follow-up of 12.3 ± 6.5 years from initial dislocation, 58 patients (9.5%) in the dislocation cohort were diagnosed with patellofemoral arthritis, corresponding to a cumulative incidence of arthritis of 1.2% at 5 years, 2.7% at 10 years, 8.1% at 15 years, 14.8% at 20 years, and 48.9% at 25 years. In the control cohort, 8 patients (1.3%) were diagnosed with arthritis, corresponding to a cumulative incidence of arthritis of 0% at 5 years, 0% at 10 years, 1.3% at 15 years, 2.9% at 20 years, and 8.3% at 25 years. Therefore, patients who experienced a lateral patellar dislocation had a significantly higher risk of developing arthritis (hazard ratio [HR], 7.8; 95% CI, 3.9-17.6; P < .001) than individuals without a patellar dislocation. However, the risk of knee arthroplasty was similar between groups (HR, 2.8; 95% CI, 0.6-19.7; P = .2). Recurrent patellar dislocations (HR, 4.5; 95% CI, 1.6-12.6), osteochondral injury (HR, 11.3; 95% CI, 5.0-26.6), and trochlear dysplasia (HR, 3.6; 95% CI, 1.3-10.0) were associated with arthritis after patellar dislocation. Conclusion: Patellar dislocation is a significant risk factor for patellofemoral arthritis, as nearly half of patients have symptoms and radiographic changes consistent with arthritis at 25 years after lateral patellar dislocation. Osteochondral injury, recurrent patellar instability, and trochlear dysplasia are associated with the development of arthritis.


2021 ◽  
pp. 6-14
Author(s):  
О. О. Bespalova ◽  
P. F. Rybalko ◽  
A. M. Sitovskyi ◽  
T. Y. Tsjupak ◽  
I. V. Savchuk

Excessive training loads during sports cause chronic functional overload of the joints and their trauma, which reduces the quality of life of athletes, limits activity and participation, termination of sports careers, and in severe cases - disability. In sports practice, one of the most common sites of osteoarthritis is the knee joints (gonarthrosis). Gonarthrosis of the knee joint is a degenerative-dystrophic disease in which the destruction of hyaline cartilage, deformation of bone tissue and the qualitative composition of synovial fluid. A key link in the development of an individual program of rehabilitation intervention is the formulation of a rehabilitation diagnosis. The aim of the research: to determine the rehabilitation diagnosis of patients with gonarthrosis of the knee joints on the basis of the International Classification of Functioning, Restriction of Life and Health (ICF). Materials and methods: theoretical (analysis and generalization of scientific-methodical and clinical literature); clinical (analysis of medical records, communication, palpation, clinical and functional testing; physical examination); scale methods for assessing the condition of patients (Leken index, pain scale, depression scale (CES-D), assessment of quality of life according to the SF-36 questionnaire); instrumental (goniometry, manual-muscular testing). The research involved 7 veteran athletes aged 45 to 49 years with primary gonarthrosis stage II. Inclusion criteria: current athletes - men of different specializations; primary gonarthrosis of the second radiological stage according to Kellgren; duration of pain not less than 4 months; the level of pain when walking on the scale of YOUR 45 and more; age of patients older than 45 years; informational consent of patients to participate in the research. Inclusion criteria: secondary gonarthrosis of the knee joint; the presence of comorbidities; severe condition of the patient; knee surgery; planning of arthroplasty of the knee joint; intra-articular injections; lack of information consent. Rehabilitation diagnosis is the most complete reflection of the patient's current problems, which affect the level of his functioning, activity and participation, and are significant for him. It is established by all members of the multidisciplinary team, and is based on the results of comprehensive rehabilitation diagnostics. The main tool for establishing a rehabilitation diagnosis are the categories and domains of IFF. Rehabilitation diagnosis of patients with gonarthrosis: moderate structural changes in the knee joints (s750.2), episodic moderate pain (b28014.2), short-term morning stiffness (b7800.2), decreased mobility of the knee joint (b710.2), his stability (b7150.2) and support function, decrease in muscle tone (b7350.2) and strength of the quadriceps femoris (b7300.2), which limits domestic activity and prolongs it over time (d450.1); difficulties in changing body position (d410.2), moving up stairs and moving long distances (d460.3), which limits participation in active forms of recreation. Patients report poor mood, depression due to health and forced restriction of participation (b152. 1), and concerns about future careers. Conclusions. Rehabilitation care is provided to patients in several stages, one of which is the formulation of a rehabilitation diagnosis. Rehabilitation diagnosis was established, in which the current problems of patients at the level of structure and function, activity and participation, as well as contextual factors that contribute, limit or prevent the achievement of the desired level of functional independence, allow individualization of rehabilitation intervention to bring this level to the maximum possible.


2019 ◽  
Vol 26 (3) ◽  
pp. 31-36
Author(s):  
G. P Kotel’nikov ◽  
Yu. V Lartsev ◽  
A. K Povelihin ◽  
P. V Ryzhov ◽  
D. S Kudashev ◽  
...  

The aim of the study: was to improve the results of treatment in children with recurrent severe patellar dislocation, through the development of a differentiated approach to preoperative planning. Material and Methods. In SLLP Clinics Samara state medical University from 2014 to 2018 was observed 54 patients with this disease. In 37 patients recurrent severe dislocation. The average age of patients is 14.2 years. The patients underwent postural radiography of the lower extremities, radiography of the knee joint in the lateral projection, computed tomography of the knee joints, computed tomography of the hip joints. Research patients measured parameters, confirming mnohopocetny dysplastic changes of the joint angle Q, the index Insall-Salvati, the congruence angle on Merchant and anticarsia of the femoral head. Because of the severe degree of the disease, bone plastic surgery is indicated. Patients underwent corrective supracondylar derotation-dialysisa osteotomy of the femur in combination with medialization and distalization of the tibial tuberosity. During this operation, it is possible to perform a correction in all three planes. Results. In the postoperative period, 32 patients have no complications, 1 patient has relapse, 4 patients have contracture. In the long-term postoperative period 86.5% of positive results and 13.5% of unsatisfactory results, which is much lower than 36.1% - the percentage of complications according to the medical literature. Conclusion. The proposed personalized approach in preoperative planning for recurrent dislocation of the patella of severe degree, allows you to choose the best option for surgery.


2008 ◽  
Vol 40 (7) ◽  
pp. 927-927
Author(s):  
Sandeep Uppal ◽  
Christine P Diggle ◽  
Ian M Carr ◽  
Colin W G Fishwick ◽  
Mushtaq Ahmed ◽  
...  

1993 ◽  
Vol 14 (3) ◽  
pp. 181-182 ◽  
Author(s):  
Manuel Mart�nez-Lav�n ◽  
Carlos Pineda ◽  
Carmen Navarro ◽  
Alfonso Buend�a ◽  
Carlos Zabal

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