Chondromalacia of the Patella: Physical Signs in Relation to Operative Findings

Stougård, J.

doi:10.3109/17453677508989251

Cited by 30 publications

(8 citation statements)

References 8 publications

(4 reference statements)

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“…Lateralization of the patella may cause longitudinal stress fractures to the patella, as in one case of the present material and suggested earlier by Iwaya and Takatori [ 19]. Patellofemoral malalignment may lead to pain from chondromalacia and cartilage damage [12,14,22,35]. Normalization of the excessive patellar lateralization can relieve the patients' symptoms [12,20,21].…”

Section: Discussionsupporting

confidence: 67%

“…Anterior knee pain during athletic activities is often associated with overuse [3,21,27]. Overuse syndromes can be divided into different patellofemoral joint problems [12,14,22,35], patellar and quadriceps tendon pains [2,10,32,33], and intra-articular plicae and synovial problems [1,4,34]. Stress fracture of the patella is one of the least common reasons for anterior knee pain [5,6,15,19,24,31,36,37].…”

Section: Introductionmentioning

confidence: 99%

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Diagnosis and treatment of stress fracture of the patella in atheletes

Orava¹,

Taimela²,

Kvist³

et al. 1996

Knee Surg, Sports traumatol, Arthroscopy

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Five cases of stress fracture of the patella in athletes are presented. Four of these occurred transversally in the lower part and one longitudinally in the lateral part of the patella. Three of the patients were females (endurance runner, high jumper, and orienteerer) and two males (volleyball and soccer player). The diagnosis was made 2-8 months from the onset of the symptoms. Conservative treatment was successful in only one patient; all others were treated surgically, with good end result. Drilling of the fracture line was performed twice with metal wire cerclage fixation, excision of the lateral fragment was carried out once, and a bone graft with K wires and cerclage compression (tension band) was performed once. In all cases the patellar retinaculum was intact, indicating a stress injury. Stress fracture of the patella is a rare overuse injury, and therefore difficulties and delays in the diagnosis and treatment may occur. In cases with delayed diagnosis we recommend operative treatment.

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Section: Discussionsupporting

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Diagnosis and treatment of stress fracture of the patella in atheletes

Orava¹,

Taimela²,

Kvist³

et al. 1996

Knee Surg, Sports traumatol, Arthroscopy

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“…Cases with typical patellar peritendinitis were distinguished (33) and excluded from this group. The main diagnostic criteria of patellar chondropathy (group C) were pain when the knee functions under load in flexion, pain during prolonged sitting with the knee flexed and pain when the patella was compressed and rubbed against the femoral condyles (22,26,50). People with patellar subluxations and dislocations were excluded from the material on the basis of clinical history and the apprehension test (11).…”

Section: Methodsmentioning

confidence: 99%

Lower Limb Asymmetry and Patellofemoral Joint Incongruence in the Etiology of Knee Exertion Injuries in Athletes

et al. 1987

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The association between different knee exertion injuries and lower limb malalignments was studied in 121 male athletes with knee exertion injuries and in 20 male athletes without knee symptoms. The associations between different malalignments was also analyzed. Leg length inequality (LLI), knee valgus, and different indexes of patellofemoral joint congruence were measured using radiological methods. Male athletes with patellar apicitis (n = 59) had significantly more LLI (P less than 0.001) and patella alta (P less than 0.05) than athletes without knee symptoms. The knee valgus was of the same numerical value in the shorter and longer leg sides in subjects with LLI of at least 5 mm (n = 58). A positive correlation was found between lateral patellar displacement (LPD) and patella alta (LT/LP) (P less than 0.001). Negative correlations were found between the sulcus angle (SA) and the lateral patello-femoral angle (LPA) (P less than 0.001) as well as between the LPD and the LPA (P less than 0.001).

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“…These tissues include the retinaculum, synovium, fat pad and, in some circumstances, bone. However, these changes may be present without symptoms, and some painful knees may have an apparently normal articular surface [5,26,35,36]. For lateral retinaculum this relationship was not so statistically strong (P < 0.02) and was equal in comparison between anterior knee pain patients (group I) and group II or group III.…”

mentioning

confidence: 94%

Distribution of substance-P nerve fibers in the knee joint in patients with anterior knee pain syndrome

Witoński

1999

Knee Surgery, Sports Traumatology, Arthroscopy

120

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The etiology of pain in anterior knee pain syndrome is a matter of controversy. The normal, articular cartilage is aneural, so defects in the surface are not thought to produce pain. Some authors have sought the origin of the pain in soft tissue structures around the knee. Knowledge of the distribution of nociceptive nerve fibers around the knee would provide insight for treating anterior knee pain syndrome. Twenty consecutive patients (28 knees), all women, with anterior knee pain syndrome (group I) participated in the study. For comparison we used two groups of patients: 20 patients with an osteoarthritic knee (group II) and 20 patients with anterior cruciate ligament rupture or meniscal lesion with no history of pain in the anterior compartment (group III). Immunohistochemical techniques using a monoclonal antibody to substance-P (SP) were employed to identify nociceptive fibers. For statistical analyses we used the one-way ANOVA test, which was corrected with the LSD test, at the level of significance P < 0.05. Results of the study demonstrate that SP-immunoreactive nerve fibers are widespread within the soft tissues around the knee. These tissues include the retinaculum, synovium, fat pad and, in some circumstances, bone. In cases of anterior knee pain, the presence of neuropeptide-containing fibers was statistically significant in the medial retinaculum (P < 0.005) and in the fat pad (P < 0.001) compared to group III, and compared to group II (P < 0.05 and P < 0.007, respectively). For lateral retinaculum this relationship was not so statistically strong (P < 0.02) and was equal in comparison between anterior knee pain patients (group I) and group II or group III. There were no statistically significant differences in the distribution of substance-P nerve fibers in the fat pad, lateral and medial retinaculum or synovium between groups II and III. The results of this study provide immunohistochemical evidence suggesting that pain may originate in the fat pad and medial retinaculum of many patients with anterior knee pain syndrome.

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Chondromalacia of the Patella: Physical Signs in Relation to Operative Findings

Cited by 30 publications

References 8 publications

Diagnosis and treatment of stress fracture of the patella in atheletes

Diagnosis and treatment of stress fracture of the patella in atheletes

Lower Limb Asymmetry and Patellofemoral Joint Incongruence in the Etiology of Knee Exertion Injuries in Athletes

Distribution of substance-P nerve fibers in the knee joint in patients with anterior knee pain syndrome

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