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Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_I | Pages 80 - 80
1 Mar 2010
Alameda SL Lòpez PM Gonzalez-Herranz P de la Fuente C Torre MC
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Introduction and Objectives: Sinding-Larsen-Johansson (SLJ) syndrome is a frequent entity in which there is pain on the anterior aspect of the patella in young athletes. Its etiopathogenesis is not well defined and it is considered a traction apophysitis. Our objective was to analyze the association of SLJ syndrome with the presentation of elevated patella.

Materials and Methods: We carried out a prospective study of 15 knees with evident clinical and radiological signs of SLJ syndrome and another 15 knees without any previous pathological condition. We used X-rays to measure the Caton-Deschamps index, the modified Insall index, and the posterior angle of inclination of the proximal surface of the tibia; we also took clinical measurements of the popliteal angle.

Results: We studied 15 knees in 14 patients. The percentage of males was 85.7% and the mean age of appearance of this pathological condition was 10.86 years (+/− 1.61) Analysis of the data shows that there were no significant differences (p> 0.5) between the groups in relation to the Caton index and the modified Insall index. In relation to the measurements of the popliteal angle of damaged knees, we did find significant differences (mean value: 32.50 d.t.:8.90) with reference to the control group (mean value: 17.67 (+/−. 8.21), and the same was true for the measurements of the posterior inclination angle (mean value: 10.47 (+/− 2.82) in comparison with the knees of the control cases (mean value: 8.33 (+/− 1,40).

Discussion and Conclusions: In conclusion, we found a statistically significant relationship between SLJ syndrome and shortening of the hamstring and increase in the posterior angle of inclination of the tibia.


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_II | Pages 327 - 327
1 May 2006
González-Herranz P de la Fuente C Torre MC
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Introduction and purpose: Femoral osteochondritis dissecans (OCD) is a process of unpredictable clinical course and uncertain aetiology (vascular, post-traumatic or microtraumatic). Its prognosis is based on diagnostic imaging (MRI and scintillation scanning) and age (Multicentre EPOS OCD Study). In our study we analysed the influence of the alignment of the lower limbs in femoral OCD.

Materials and methods: From 2000–2004 we studied 22 cases in 19 patients with femoral OCD. We carried out a tele-radiographic study of the lower limbs with weight-bearing, recording the location of the OCD according to Cahill, the femorotibial angle (n=87.5° ±2°) and the mechanical axis of the limb, which was considered normal when it went through the two tibial spines (Cahill zone 3).

Results: The mean age was 13.4 years (r: 10–28). The OCD was located in the medial condyle in 16 cases and the lateral in 6. We found changes in the femorotibial angle in 12/22 (55%) and of the mechanical axis in 18/22 (82%). In the cases with worst prognosis and loose bodies (7 cases), 100% showed changes in the mechanical axis.

Conclusions: There is a strong relation between OCD and changes in the lower limb alignment. The most sensitive radiological measurement is the mechanical or weight-bearing axis. This finding confirms the good prognosis of the lesion in children, since they undergo physiological changes in the femorotibial angle and constant changes of the mechanical axis until growth is complete.