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At least 19 recordsLinked to original sources
PubMed1978

[The relative elongated patellar ligament after identation of the lateral retinacula (author's transl)].

The treatment of the lateralisation of the patella can be done by lateral indentation of the retinaculum patellae (method of Viernstein). Caused by the medialisation of the patella eventually the patellar ligament can be realtively elongated. This leads to insufficiency of the extensors and therefore to prearthrosis of the knee joint. To avoid this and to conserve the sportive ability we recommend the displacement of the tuberositas tibiae to medial and distal.

Adult↗
PubMed1976

Distal disinsertion of the patellar ligament combined with avulsion fractures at the medial and lateral margins of the patella. A case report and an experimental study.

A 12-year-old boy presented with a proximally retracted patella 5 months after an injury to the left knee. The clinical and radiographic features and the findings at operation led to the conclusion that the original lesion had been a distal disinsertion of the patellar ligament combined with avulsion fractures at the medial and lateral margins of the patella, produced by the medial and lateral longitudinal patellar retinacula. Loading experiments on amputation and cadaver specimens showed that these retinacula, apart from being tendons for the vastus medialis and the vastus lateralis, respectively, constitute a direct fibrous connection of considerable strength between the patella and the tibia and thus are capable of producing avulsion fractures.

Adult↗
PubMed1976

[Arterial vascularization of the patellar ligament (ligamentum patellase) and of the Achilles tendon (tendo calcaneous) in man].

Vascularization in ligamentum patellae and tendo calcaneus have been studied by microangiography with micropaque. Can be noted: 1. for the ligamentum patellae : --its dense vascularization, --the existence of a vascularized sheath around the ligament, densely vascularized in the anterior part, --the important vascularization of the entire ligament in the foetus, but the less important vascularization at the middle third in the adult. 2. for the tendo calcaneus : -- a relatively poor vascularization on the whole, -- a vascularized zone at the middle third, -- a periphereal vascularized sheath around the tendon, densely vascularized in the anterior part.

Achilles Tendon↗
PubMed1976

Clinical and experimental experience in reconstruction of the anterior cruciate ligament.

Various methods for reconstruction of the anterior cruciate ligament have been described in the literature. In 1968 Broström et al. described a reconstruction using the medial third of the patellar ligament as a substitute for the cruciate ligament. (The operative procedure is described elsewhere in this book by Eriksson and has also been described by Alm and Gillquist.) The aim of the present investigation was to study the long term clinical results after reconstruction of the anterior cruciate ligament using the medial third of the patellar ligament. The clinical and morphological findings were correlated at various intervals after reconstruction of the ligament. The influence of the rotatory movement of the tibia on the tensile strength and on the elongation of the anterior cruciate ligament was studied experimentally. To clarify the vascular anatomy and morphology of the cruciate ligaments and to study the vascularization and fate of the transposed part of the patellar ligament, experimental surgery was performed in dogs.

Animals↗
PubMedDate not supplied

[External hypertension syndrome of the patella. Its significance in the recognition of arthrosis].

Some chondromalacia are caused by an hyperpressure on the lateral articular facet of the patella. The authors describe the clinical signs and the radiological findings in this condition. It is due to a retraction of the lateral patellar ligament. They have operated on 133 cases and reviewed 115 knees. After a simple section of the lateral patellar ligament, results were satisfactory in 80 percent of the cases. Biopsies of the malacic cartilage were performed and pathological changes were described.

Biomechanical Phenomena↗
PubMed1979

[Intra-articular or extra-articular substitution of cruciate ligament--a critical study (author's transl)].

Intra- and extra-articular methods of cruciate ligament substitution are available for treating old anteromedial knee-joint instability. Twelve patients with intra-articular cruciate ligament substitution (median third of the patellar ligaments as free transplant) and 24 patients with extra-articular cruicate ligament substitution (operation according to Nciholas) were examined with particular reference to improved stability as follow-up examinations, the results being subjected to comparative evaluation. Intra-artricular cruciate ligament substitution reduces or eliminates the pre-operative instability of the joint which is due to insufficiency of the cruciate liagment, whereas the extra-articular cruciate ligament substitution produces a significantly more frequent reduction of elimination of the instability of the valgus position and of the anteromedial instability. The combination of both methods to remove anteromedial instability of the knee joint may seem a very useful solution of the problem, but it should be limited to a restricted group of patients because it involves also contain disadvantages which make it unsuitable for indiscriminate application.

Aftercare↗
PubMed1977

A new technique for the treatment of comminuted, transverse fractures of the patella.

In an attempt to re-establish continuity of the quadriceps mechanism following partial patellectomy more securely in patients with comminuted, transverse fractures of the patella, a technique whereby the patellar ligament is inserted into a transverse groove created in the proximal patellar fragment and this anastomosis is then protected by a tension band wiring, is described and depicted. Using this method, it is possible to provide a larger surface area fro more satisfactory tendon to bone healing and to initiate relatively early motion of the knee, without compromising the site of reconstitution of the extensor mechanism.

Fracture Fixation, Internal↗
PubMedDate not supplied

[Treatment problems in old and recent rupture of the lateral knee ligament].

The authors have treated 31 fresh ruptures of the lateral ligament and 104 cases of chronic instability of the lateral side of the knee. In recent ruptures the results obtained after surgical repair were not as gratifying as those obtained after injuries of the medial ligament. The cases operated upon were tears of the lateral ligament associated with ruptures of one or both cruciate ligaments. The frequency of rupture of the popliteus tendon is emphasized. The authors recommend, when necessary, a double surgical approach both laterally and posteriorly and plaster cast immobilization for more than 6 weeks. Tendon transfer in recent lesions have been done when suture of a cruciate ligament was impossible. The results of several procedures for chronic instability were analysed; transposition of the patellar ligament, transposition of the head of the fibula, or tightening of the lateral structures of the knee (capsule, ligament, popliteus tendon). Associated lesions of the cruciate ligament were treated by tendon transfer. Poor results were obtained in those presenting with fixed varus deformities. The authors conclude that such deformities should be corrected by osteotomy.

Adolescent↗
PubMed1977

[The unstable knee joint--aspects in basic research, diagnosis and therapy (author's transl)].

The increase of knee lesions within the last years has provoked a generally more intensive discussion about the functional anatomy, the biomechanics and the pathophysiology of the capsule and ligaments of the knee joint. Several authors have stressed the importance of the active and passive factors, stabilizing the knee joint. The injury to a single element leads to different instabilities, as proven by meticulous clinical and radiological diagnostic procedures. The progress in the treatment of fresh and old injuries of knee ligaments is connected with the names of O'Domoghue, Slocum, Larson, Hughston, Nicholas and Trillat. For a fresh completely ruptured ligament surgery is recommended. Torn menisci are reattached whenever possible. An initial graft can be necessary for ruptures of the anterior cruciate ligament. Complex injuries, which are found most frequently, have to be dealt with completely. Old injuries of capsule and ligaments may require a plastic reconstruction. For the reconstruction of the anterior cruciate ligament it has been proven useful to take distally attached tendons of the pes anserinus group as well as the free graft from the central 1/3 of the patellar ligament. Rotational instabilities have to be dealt with according to the type of instability. The techniques of Slocum and Larson and the "five in one" reconstruction by Nicholas have to be emphasized as treatment of the anteromedial rotational instabilities. McIntosh has shown a procedure which seems to be successful for anterolateral rotational instabilities. Several techniques have been compared with our own experiences and late results studied. The point is stressed that further progress has to be made for the treatment of injuries to ligaments of the knee.

Adult↗
PubMedDate not supplied

Fluoroscopic technique for double-contrast knee arthrography.

The fluoroscopic double-contrast technique of arthrography of the knee is useful in documenting the extent of suspected injury to the knee. It is of particular value in demonstrating small and large lesions involving the menisci, cruciate ligaments, patellar cartilages, as well as the articular cartilages of the femoral condyles and tibial plateaus. This examination is instrumental in the diagnosis of the patient with an atypical history of injury and unusual physical findings. A simple restraint device allows the fluoroscopist complete control over the stress applied to the knee while positioning the patient for filming. Fluoroscopic spot radiographs of excellent contrast and sharp detail can be obtained of each of the various structures, applying the stress needed. When the radiologic technologist takes a little time to become more knowledgeable about the anatomy of the knee jount, and the rationale for the various views, the knee arthrographic examination is easily understood.

Cartilage, Articular↗
PubMed1978

Mechanics of the knee and problems in reconstructive surgery.

Static force transmission at the knee is analysed using measurements from radiographs showing the position of the line of body weight and also the bones of the knee in their correct orientation during function. With this technique it is possible to suggest values for a variety of forces acting at the knee. During function the degree of knee flexion is not as important as the angle that the thigh makes with the vertical. The tension in the extensor mechanism is not the same above and below the patella. Failure to recognise these two features results in fundamental errors. The patella, the effects of patellectomy and of forward displacement of the attachment of the patellar ligament are discussed. The importance of the transmission of force in the coronal plane is emphasised with particular reference to total knee replacement. It is suggested that small errors of geometry, as seen in the anteroposterior radiograph, can produce large changes of load.

Biomechanical Phenomena↗
PubMed1979

[A technique of patellectomy preserving the extensor apparatus (author's transl)].

The Authors describe a technique of patellectomy preserving the extensor apparatus. The lateral and medial patellar ligaments are divided longitudinally, folded forward and sutured to each other anteriorly, the lateral incision being left open. The authors have used this procedure in 11 knees with satisfactory results. It can be combined with plasties of the femoral condylar groove.

Adult↗
PubMed1977

[Medial-and simultaneous anterior-transfer of the tibial tuberosity (author's transl)].

Because of the triangular cross-section of the tibia medial transfer of the tuberosity according to Hauser and Roux leads to a backward displacement of the insertion of the patellar ligament accompained by rotation. This mechanically unfavourable effect can be made good by a change in technique of removing the tuberosity. It is not removed as a flat disk of bone but as a bone-block of triganular shape in cross-section and fixed on the medial surface of the tibia with a special flat-headed screw. The technique is described in detail.

Humans↗
PubMed1977

Patellar-tendon transfer by the slot-block method for recurrent subluxation and dislocation of the patella.

In sixty-five knees followed for an average of 4.5 years after treatment of subluxation or dislocation of the patella by the slot-block method of medial patellar-tendon transfer, the results were satisfactory in fifty-four (83%) and unsatisfactory in eleven (17%). Recurrent subluxation or dislocation occurred in three (5%) of the knees and was attributed to insufficient displacement. Chondromalacia of the patella became worse after transfer in three of the sixty-two knees in which the distal realignment was technically correct. Two knees (3%) required patellectomy because of patellofemoral symptoms and there were nineteen complications in seventeen knees, including loss of motion in six, wound infection in six, displacement of the bone block in three, recurrent dislocation in three, and rupture of the patellar ligament in one. The method is believed to give superior results but it is technically demanding.

Humans↗