Aims

Although knee osteoarthritis (OA) is diagnosed and monitored radiologically, actual full-thickness cartilage loss (FTCL) has rarely been correlated with radiological classification. This study aims to analyze which classification system correlates best with FTCL and to assess their reliability.

Aims

A pragmatic, single-centre, double-blind randomized clinical trial was conducted in a NHS teaching hospital to evaluate whether there is a difference in functional knee scores, quality-of-life outcome assessments, and complications at one-year after intervention between total knee arthroplasty (TKA) and patellofemoral arthroplasty (PFA) in patients with severe isolated patellofemoral arthritis.

We describe a syndrome combining abnormalities of the pelvis, knee and foot in three related patients with a familial history of small dislocated patellae. The clinical and radiological appearance of the patella and pelvis is consistent with the ‘small-patella’ syndrome, a rare autosomal dominant disorder. There were also previously unreported deformities affecting the feet

Aims

The aim of this study was to compare the incidence of anterior knee pain after antegrade tibial nailing using suprapatellar and infrapatellar surgical approaches

We report our experience of surgical treatment for instability of flail knees after poliomyelitis in 228 patients. We made carefully selective use of soft-tissue release, extension osteotomy of the femur, and a patellar bone block for hyperextension. After six to nine years follow-up, 87% of the patients had retained significant improvement in stability and walking ability

Joint débridement, by excision of synovial membrane, osteophytes, degenerate cartilage, loose bodies, and frequently the patella, has relieved the symptoms of osteoarthritis of the knee joint twenty-three times in a series of thirty-five operations reviewed after periods of one to nine years. The operation is considered a useful measure when symptoms resist conservative treatment

Aim

There has been a significant reduction in unicompartmental knee arthroplasty (UKA) procedures recorded in Australia. This follows several national joint registry studies documenting high UKA revision rates when compared to total knee arthroplasty (TKA). With the recent introduction of robotically assisted UKA procedures, it is hoped that outcomes improve. This study examines the cumulative revision rate of UKA procedures implanted with a newly introduced robotic system and compares the results to one of the best performing non-robotically assisted UKA prostheses, as well as all other non-robotically assisted UKA procedures.

1. Contracture of parts of the quadriceps muscle is not uncommon and is often accompanied by tightness of the ilio-tibial tract. It is suggested that this may follow intramuscular injections. 2. Recurrent dislocation of the patella can be a consequence of this muscle contracture. 3. Division of the ilio-tibial tract and lengthening of the fibrotic elements of the quadriceps can prevent further dislocation and restore good function

1. Chondromalacia of the patella starts most frequently on the medial facet. 2. The anatomy of the medial femoral condyle is described, including the rim at its superior border, and the different arrangement at the upper border of the lateral femoral condyle. 3. Rubbing of the medial patellar facet on the rim at the upper border of the medial femoral condyle can explain in part the etiology of chondromalacia

Two men, aged 21 and 50 years, were seen with ossification of the patellar tendon after injury to the knee in adolescence. They complained of pain and had patella alta. Large bony masses were excised from below the affected patellae. The patellar tendon was then reconstructed using a Leeds-Keio ligament. The results at six and ten years, respectively, were good, with neither patient having pain or an extension lag

Aims

We aimed to examine the long-term mechanical survivorship, describe the modes of all-cause failure, and identify risk factors for mechanical failure of all-polyethylene tibial components in endoprosthetic reconstruction.

Objectives

Bioresorbable orthopaedic devices with calcium phosphate (CaP) fillers are commercially available on the assumption that increased calcium (Ca) locally drives new bone formation, but the clinical benefits are unknown. Electron beam (EB) irradiation of polymer devices has been shown to enhance the release of Ca. The aims of this study were to: 1) establish the biological safety of EB surface-modified bioresorbable devices; 2) test the release kinetics of CaP from a polymer device; and 3) establish any subsequent beneficial effects on bone repair in vivo.

1. It is suggested that abruptness of the condylar ridges on the femur plays a major role in the etiology of chondromalacia patellae. The medial condylar ridge is always abrupt in these cases, and indeed in many knees with no evidence of chondromalacia patellae. The lateral condylar ridge is rarely abrupt. 2. The short-term results of forty operations for reduction of femoral ridges in thirty-eight patients, with preservation of the patella in thirty-two cases, are satisfactory

We have compared the results of simple patellectomy (group A, n = 16) and patellectomy with advancement of the vastus medialis obliquus (group B, n = 12) in a prospective, randomised trial, with a minimum follow-up of three years. The results in group B were significantly better (p < 0.001) than those in group A. Although the patella should be preserved if possible, we advocate advancement of the vastus medialis obliquus when patellectomy is necessary

1. The importance of recognising osteochondral fractures of the femoral condyle in the adolescent knee joint is emphasised. 2. The mechanism of the formation of the fractures is discussed. Essentially, a powerful rotary and compressive force shears off cartilage and subchondral bone. The absence of lateral condylar lesions in the experimental group lends support to the theory that the patella may cause the fracture by impingement. 3. On the basis of the mechanism a clinical classification of osteochondral fractures of the femoral condyles is presented. 4. Early surgery is recommended. The arguments for removal or replacement of the fragment are discussed

1. The cases of six Chinese children affected by so-called congenital fibrosis of the vastus intermedius muscle are described. The reasons for the choice of name are discussed. 2. Reasons for early operation are put forward: in young children simple division of the tendon of the vastus intermedius is adequate. 3. With increasing age severe changes in all the joint tissues occur, notably in the articular cartilage of the patella. These changes are likely to vitiate the result after operation. 4. The importance of getting as much flexion as possible in children of Asiatic race is stressed

Aims

The primary aim of the study was to compare the knee-specific functional outcome of robotic unicompartmental knee arthroplasty (rUKA) with manual total knee arthroplasty (mTKA) for the management of isolated medial compartment osteoarthritis. Secondary aims were to compare length of hospital stay, general health improvement, and satisfaction between rUKA and mTKA.

The articular cartilage of the patella was studied in 100 knees at necropsy. In twenty-one of these knees the cartilage changes were related to the trabecular architecture of the underlying bone. It would appear that the initiation and location of cartilage damage and its rate and degree of progression are related to the relative stiffness of the underlying cancellous bone. On the basis of our observations we suggest that the diagnosis "chondromalacia of the patella" should be reserved for patients with asymptomatic or transiently symptomatic fibrillation of the articular cartilage of the central medial patellar facet. Those patients with persistent patellofemoral pain should be considered to have some other syndrome

A retrospective survey of 135 posterior dislocations and fracture-dislocations of the hip was carried out in order to define the pattern of associated knee injuries. Thirty-five patients had sustained a significant injury to the knee, of which twenty-five were clearly attributable to a direct blow on the front of the knee (fractured patella, traumatic chondromalacia, fractures of femoral and tibial condyles) and ten were compatible with valgus, yams or rotational forces (medial, lateral and cruciate ligament tears). The second type of injury has not been widely recognised but it is important that it should not be overlooked

1. Previous reports of the role of the quadriceps in producing limitation of movement or dislocation of the patella have tended to implicate one particular part of the complex. Experience gained in thirty-five quadricepsplasties in children has shown that all parts of the quadriceps (except vastus medialis) and the ilio-tibial band also may play a part and that each of these must be attended to if a satisfactory result is to be obtained. 2. A simple technique of operation is described and illustrated. 3. Since this paper was prepared, a patient showing features of particular interest has been seen and treated