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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three squash racquets and one badminton player presented with pain in the base of the hypothenar eminence, due to minor degrees of subluxation of the pisiform bone. Two of them also showed chondromalacia of the articular cartilage of the pisotriquetral joint. All four patients were relieved by excision of the pisiform bone and had returned to their normal daily and sporting activities within three months of their operation.
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PMID:Chronic overuse injuries of the piso-triquetral joint in racquet game players. 44 6

We are just beginning to fully appreciate the significant role of the patellofemoral joint in total knee replacement surgery. Most of the new generation prostheses have a flanged femoral component. The tendency is to make the flange more anatomic in shape as more attention is paid to patellar tracking. Most systems have an optional polyethylene button to resurface the patellar side of the patellofemoral joint, and indications for its use are increasing. Although pain relief with patellar buttons seems uniform, the potential complications of stress fracture, loosening, and wear must temper our enthusiasm for their use until there is longer follow-up. Vitallium hemiarthroplasty of the patella is available in prostheses with and without the requirement for cement fixation. Most investigators have good results in chondromalacia (as a secondary procedure), but the experience in the literature is small. Results have been poor when the femoral side of the joint has been involved. Metal to plastic isolated patellofemoral prostheses have been designed to treat disease on both sides of the patellofemoral joint or to salvage unflanged total knee replacements with residual patellofemoral symptoms. Short term experience has been promising.
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PMID:Prosthetic replacement of the patellofemoral joint. 45 Mar 94

The spectrum of patellofemoral disorders ranging from chondromalacia of the patella to degenerative arthritis is a difficult, often vexing problem. Many methods of treatment, both surgical and nonsurgical, have been used without uniform or predictable success. The infrapatella strap, a new concept in nonsurgical management of patellofemoral pain, can be effective in 77% of patients. Its simplicity and comfort, patients' acceptance, and the apparent lack of contraindications when it is worn as instructed justify further clinical trials.
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PMID:Use of the infrapatella strap in the treatment of patellofemoral pain. 45 39

Chondromalacia of the patella should be considered a separate entity and not the necessary precursor of osteoarthrosis. It is rarely associated with significant discomfort. Isolated softening, fibrillation of the central medial facet, and a diagnosis of chondromalacia of the patella should be limited, in our view, to isolated fibrillation occurring in the central medial facet and is probably asymptomatic. Symptomatic patellar pain can be treated by realignment if the patella is malaligned, by lateral release and synovial fringe excision if there is an anomalous facet or synovial fringe entrapment syndrome, and by drilling and curettage and stress-relieving operations (if necessary) if there is an osteochondral injury. For osteoarthrosis stress can be relieved on a permanent basis by the Maquet anterior tibial tubercle advancement operation. We recommend approaching patellofemoral pain by establishing a specific diagnosis and applying a specific treatment.
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PMID:A rational approach to the treatment of patellofemoral pain. 53 12

In 26 knees treated by semitendinosus tenodesis, there was no recurrence of dislocation, but fair and poor results totaled 38% due to persistent pain because of chondromalacia of the patella. Poor results are also more common in the patients with generalized ligamentous laxity. Postoperative complications in wound healing suggest that the medial parapatellar skin incision is less than adequate. Semitendinosus tenodesis with or without modifications is a useful procedure to prevent recurrent dislocations and subluxation during the growth period.
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PMID:Semitendinosus tenodesis for recurrent subluxation or dislocation of the patella. 53 41

Twenty cases of patellectomy for fracture and 14 cases of patellectomy for chondromalacia evaluated for postoperative strength, endurance, pain and functional complaints, revealed satisfactory results in 85% of the fracture group and 79% of the chondromalacia group. Some quadriceps weakness was usually present, but quadriceps strengthening overcame the loss of mechanical efficiency caused by patellectomy. A vigorous rehabilitation program should be followed for at least one year after surgery to secure the fullest recovery of function.
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PMID:Function after patellectomy. 67 37

There are many factors involved in the aetiology of chondromalacia of the patella. If possible, the appropriate operative procedure should be chosen for each patient, hence attempting to eliminate the cause of softening of the cartilage. Increased pressure over the lateral facet, with or without reduced pressure over the medial facet of the patella, resulting from lateral positioning or tilting of the patella, the Wiberg/Baumgartl-types III and IV, and the "Hunter's Hat" form are important causes. With reduced pressure, the cartilage is inadequately stressed and consequently receives insufficient nourishment. As the medial facet is particularly thick and has little contact with the femoral condyle, nutritional disturbance is almost a normal occurrence. Longitudinal osteotomy of the patella has been found to improve the contact of the medial surface of the patella with the femoral condylar groove. The analgesic effect of this surgical procedure may derive from the resultant reduction in subchondral interstitial pressure, presuming that the pain in chondromalacia patellae, like that of osteoarthritis, is a manifestation of raised intramedullary pressure. To ensure an improvement in patellar tracking the osteotomy is combined with a lateral capsular release.
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PMID:Osteotomy of the patella in chondromalacia. Preliminary report. 71 95

Cartilaginous changes on the patella are common and were demonstrated in 50 out of 100 patients who underwent operation for intraarticular disease of the knee joint. In order to clarify further the signs of this condition, the physical signs were related to the operative findings. Retropatellar crepitation was present in most cases, but cannot be called pathognomonic. Pain on grating and tenderness on palpation of the patella in fact occurred together only in cases with cartilaginous changes on the patella. On the other hand, cartilaginous changes were found in several cases without such signs, a condition which perhaps should be interpreted as cartilaginous changes only, not as the symptom complex chondromalacia of the patella in which there ought to be a history of symptoms.
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PMID:Chondromalacia of the patella. Physical signs in relation to operative findings. 118 29

Surgical modifications of the biomechanics of osteoarthritic and chondromalacic patellofemoral joints reduce the joint pressure by distributing pressure evenly along the articular surfaces. Forward displacement of the patella tendon lengthens the lever arm of the tendon. It also increases the angle formed by the forces exerted by the quadriceps muscle and by the patella tendon. As a result, the compressive forces transmitted from the femur to the tibia and from the patella to the femur are decreased. If the anterior tuberosity of the tibia is displaced forward and medially, the subluxated patella is brought back into the intercondylar groove and the weight-bearing areas of the patello-femoral joint are increased. Consequently the operation much reduces the compressive stresses in the joint. In osteoarthritis of the patellofemoral joint and in chondromalacia of the patella, surgical displacement of the patella tendon forward consistently relieved pain.
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PMID:Advancement of the tibial tuberosity. 125 88

Seventy-nine arthroscopies of the knee were performed between January 1989 and March 1992. There were sixty-one males and eighteen females. The age range was from 12 to 78 years and the mean age was thirty-four years. Fifty patients had torn menisci. The menisci were removed arthroscopically in forty cases, arthrotomy being needed in the other ten cases. Following arthroscopic meniscectomies, patients returned to work in seven days, and to sporting activities in eight to ten weeks. Chondromalacia of the patella and femoral condyles were diagnosed in nineteen cases. These were treated by arthroscopic shaving and drilling of the irregular articular surfaces. In two cases, the procedure was used for assessment prior to other operations. Arthroscopy failed in two other patients due to pain and swelling and was normal in the remaining six cases.
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PMID:Arthroscopic surgery of the knee. 129 Feb 36


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