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Does form follow function in trochlear dysplasia? Case report of patellar instability in a below-knee amputee.

Salzmann GM, Dovi-Akue D, Wätzig K, Südkamp NP, Niemeyer P - Int J Surg Case Rep (2013)

Bottom Line: One major static compound is found to be in trochlear dysplasia.Against this assumption, we hypothesize that subjects may devise a flattened trochlea when there is no significant biomechanical interplay and thus input between the patella and the distal femur during developmental growth; according to the assumption form follows function.One has to consider that a certain biomechanical input may be required for the development of a physiologic trochlear groove.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic and Trauma Surgery, University Medical Center, Albert-Ludwigs University Freiburg, Freiburg, Germany. Electronic address: giansalzmann@yahoo.com.

No MeSH data available.


Related in: MedlinePlus

Arthroscopic view, right-sided knee joint, from anterolateral portal. Snapshot of medial-sided patellofemoral articluation before MPFL (Pre, left-sided image) and after MPFL (Post, right-sided image) replacement in full knee extension. While the patella is clearly laterally displaced before ligament substitution (Pre), normal appearing patellofemoral articulation postoperatively (Post).
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fig0025: Arthroscopic view, right-sided knee joint, from anterolateral portal. Snapshot of medial-sided patellofemoral articluation before MPFL (Pre, left-sided image) and after MPFL (Post, right-sided image) replacement in full knee extension. While the patella is clearly laterally displaced before ligament substitution (Pre), normal appearing patellofemoral articulation postoperatively (Post).

Mentions: In supine decubitus initial diagnostic arthroscopy revealed a clearly flattened trochlea presenting with no identifiable sulcus and a medial-sided cliff appearing pattern as within trochlea dysplasia type D. This information contradicted previous collected MRI data. The patella was strongly lateralized in extension and tended to dip physiologically not before 30–50° of knee flexion. Patellofemoral cartilage and the remaining joint appeared normal. Following contralateral tendon harvest we performed standard MPFL surgery as previously described.11 Final arthroscopy showed normal patellofemoral articulation already in full extension with full range of free motion and no signs of increased patellofemoral pressure (Fig. 5).


Does form follow function in trochlear dysplasia? Case report of patellar instability in a below-knee amputee.

Salzmann GM, Dovi-Akue D, Wätzig K, Südkamp NP, Niemeyer P - Int J Surg Case Rep (2013)

Arthroscopic view, right-sided knee joint, from anterolateral portal. Snapshot of medial-sided patellofemoral articluation before MPFL (Pre, left-sided image) and after MPFL (Post, right-sided image) replacement in full knee extension. While the patella is clearly laterally displaced before ligament substitution (Pre), normal appearing patellofemoral articulation postoperatively (Post).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3921661&req=5

fig0025: Arthroscopic view, right-sided knee joint, from anterolateral portal. Snapshot of medial-sided patellofemoral articluation before MPFL (Pre, left-sided image) and after MPFL (Post, right-sided image) replacement in full knee extension. While the patella is clearly laterally displaced before ligament substitution (Pre), normal appearing patellofemoral articulation postoperatively (Post).
Mentions: In supine decubitus initial diagnostic arthroscopy revealed a clearly flattened trochlea presenting with no identifiable sulcus and a medial-sided cliff appearing pattern as within trochlea dysplasia type D. This information contradicted previous collected MRI data. The patella was strongly lateralized in extension and tended to dip physiologically not before 30–50° of knee flexion. Patellofemoral cartilage and the remaining joint appeared normal. Following contralateral tendon harvest we performed standard MPFL surgery as previously described.11 Final arthroscopy showed normal patellofemoral articulation already in full extension with full range of free motion and no signs of increased patellofemoral pressure (Fig. 5).

Bottom Line: One major static compound is found to be in trochlear dysplasia.Against this assumption, we hypothesize that subjects may devise a flattened trochlea when there is no significant biomechanical interplay and thus input between the patella and the distal femur during developmental growth; according to the assumption form follows function.One has to consider that a certain biomechanical input may be required for the development of a physiologic trochlear groove.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic and Trauma Surgery, University Medical Center, Albert-Ludwigs University Freiburg, Freiburg, Germany. Electronic address: giansalzmann@yahoo.com.

No MeSH data available.


Related in: MedlinePlus