We investigated the clinical and radiological outcome of trochleaplasty for recurrent patellar dislocation in association with trochlear dysplasia in 38 consecutive patients (45 knees) with a mean follow-up of 8.3 years (4 to 14). None had recurrence of dislocation after trochleaplasty. Post-operatively, patellofemoral pain, present pre-operatively in only 35 knees, became worse in 15 (33.4%), remained unchanged in four (8.8%) and improved in 22 (49%). Four knees which had no pain pre-operatively (8.8%) continued to have no pain. A total of 33 knees were available for radiological assessment. Post-operatively, all but two knees (93.9%) had correction of trochlear dysplasia radiologically but degenerative changes of the patellofemoral joint developed in 30% (10) of the knees. We conclude that recurrent patellar dislocation associated with trochlear dysplasia can be treated successfully by trochleaplasty, but the impact on patellofemoral pain and the development of patellofemoral osteoarthritis is less predictable. Overall, subjective patient satisfaction with restored patellofemoral stability after trochleaplasty appeared to outweigh its possible sequelae.
Our data suggest that working exposure increases the risk or leads to the clinical manifestation of rotator cuff tears. Although a detailed analysis of individual physical exposure is not available yet, the statistical results indicate that rotator cuff tears must be taken into consideration as a result of ergonomic exposure.
ZusammenfassungStudierende der Humanmedizin müssen sich im Rahmen ihrer universitären Ausbildung ein umfangreiches Wissen zunächst aus den Grundlagenwissenschaften und später aus den verschiedensten medizinischen Fachgebieten aneignen. Für Vertiefungen, insbesondere in kleinere, aber dennoch hochinteressante Fachbereiche − etwa der Nuklearmedizin – bleibt dabei oft wenig Zeit. Eine Option, Vertiefungen über den in Seminaren und Vorlesungen vermittelten, vorwiegend klinisch orientierten Stoff zu ermöglichen, bieten Wahlfächer. Die Klinik und Poliklinik für Nuklearmedizin des Universitätsklinikums Leipzig hat in diesem Jahr ein zusätzliches Wahlfach etabliert („Nuklearmedizin universal“), welches v. a. auf die Vermittlung des interdisziplinären Zusammenwirkens von Ärzten, Radiochemikern, Medizinphysikern/-technikern und Medizinisch-technischen Assistenten innerhalb der Nuklearmedizin abzielt. Das entsprechende Curriculum sowie die ersten Erfahrungen werden beschrieben und reflektiert.
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