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

This study reviews 34 of 37 original patients who were reviewed in 1981 after previously undergoing percutaneous lateral retinacular release. Short-term satisfactory results regarding reduction of pain and prevention of dislocation were maintained on this second followup (average, 48 months). With this increase in postoperative time, patients with recurrent subluxation developed an increase in patellar slipping. Patients with chondromalacia and degenerative joint disease are less suited for long-term treatment. Long-term problems occurred in 1 of 34 patients (3%).
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PMID:The percutaneous lateral retinacular release. 367 71

We measured the patellofemoral congruence in tangential radiographic projections according to Merchant in 64 patients with unilateral patellar pain. The congruence angle was usually within normal limits. However, compared with the asymptomatic side, the angle was increased in chondromalacia and instability of the patella. A comparison of congruence angles of the two knees seems more valuable than a comparison with normal values.
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PMID:Patellofemoral incongruence in chondromalacia and instability of the patella. 373 64

Fabellectomy gave immediate and continued relief of symptoms to a patient with pain of long duration in the lateral aspect of both popliteal fossae. Attention should be given to pathologic changes of the fabella in cases with intermittent posterolateral knee pain and normal examination of the knee, except for tenderness on pressure over the fabella. The clinical importance of the fabella is discussed with special regard to chondromalacia.
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PMID:Painful fabella. A case report with review of the literature. 381 95

A 46-year-old man suffered from chondromalacia of the fabella after minor trauma to the back of the knee. The condition was misdiagnosed initially as fasciitis, tendinitis, a Baker's cyst and a herniated lumbar intervertebral disc. Pathognomonic signs were pain behind the lateral femoral condyle on palpation and compression of the fabella and also on passive extension of the knee. Conservative management was unsuccessful. Excision of the fabella gave quick and lasting relief.
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PMID:Chondromalacia of the fabella: a case report. 395 58

The authors discuss the pathomechanics of abnormal patellar tracking and excessive patellofemoral contact force that results in patellofemoral pain, chondromalacia, and patellofemoral arthrosis. An understanding of the pathomechanics implies a rational approach to treatment that includes methods to correct the tracking problem and reduce the load on the patellofemoral joint.
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PMID:Scientific basis of extensor mechanism disorders. 398 27

Thirty-six wrists of 35 patients were treated with distal ulnar recession for pain and limitation of motion associated with chondromalacia of the ulnar head, triangular fibrocartilage complex tears, ulnocarpal impingement, and instability of the distal radioulnar joint. Contributing factors were positive ulnar variance in 31 wrists, fracture of the distal radius in five, sprains in 14, premature closure of the distal radial epiphysis in five, and lax ligamentous habitus in five. The ages of the patients averaged 33 years. Clinical findings were local tenderness, crepitus, and instability evident by a positive "piano key" effect. Roentgenographic findings were positive ulnar variance (29 of 36), zero ulnar variance (four), negative ulnar variance (three), positive arthrogram (11 of 19), and "forme fruste" Madelung's deformity (two). The surgical procedure is a modification of the Milch cuff resection with the use of a dynamic compression plate. Recession ranged from 2 to 13 mm (average of 4 mm). Findings at surgery included chondromalacia of the ulnar head (19), tears of the triangular fibrocartilage complex (11), and excessive mobility of the ulnar head (10). At an average follow-up of 24.5 months, results were excellent in 7 wrists, good in 21, fair in four, and poor in four. Poor results in two wrists were upgraded to good after osteosynthesis of a nonunion in one and recessional osteotomy of the radial sigmoid notch in the other. Ulnar recession offers a less destructive alternative to disorders of the distal radioulnar joint than the Darrach resection.
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PMID:Distal ulnar recession for disorders of the distal radioulnar joint. 402 58

We studied the results in forty-seven knees in thirty-seven patients - ten male and twenty-seven female - who had recurrent dislocation of the patella and were treated by a modified Roux-Goldthwait procedure (lateral retinacular release, medial transfer of the lateral patellar tendon without advancement, plication of the medial retinaculum, and advancement of the vastus medialis). Ten of the female patients had bilateral dislocation. The results were analyzed after follow-ups ranging from 3.0 to 16.3 years (average, 5.8 years). The study confirmed that a tangential radiograph of the patellofemoral joint, made with the knee in 20 degrees of flexion, is reliable in determining patellar displacement. The results were excellent in twelve knees, good in thirty-one, fair in one, and poor in three. The fair and poor ratings were due to pain caused by severe chondromalacia patellae. The patient with a fair result had had recurrent dislocations after the Roux-Goldthwait procedure due to a very lax synovial and capsular sac. Reoperation with tightening of the sac medially and laterally eliminated hypermobility of the patella in this patient and established straight patellar tracking. There was one serious complication, a large subcutaneous hematoma with necrosis of a skin flap. The patients with mild chondromalacia improved and showed no progressive patellofemoral arthritis after simple realignment, while those with severe chondromalacia were not improved by shaving, drilling, and realignment. Preliminary results indicated that a modified Maquet procedure, in addition to realignment, may be indicated for patients with severe chondromalacia. This study demonstrated that the modified Roux-Goldthwait procedure, without advancement of the tibial attachment of the patellar ligament, can stabilize the patella without increasing patellofemoral compression. The procedure does not relieve the symptoms of severe chondromalacia of the patella but realignment is the first step in treatment of any form of patellofemoral arthrosis.
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PMID:Recurrent dislocation of the patella treated by the modified Roux-Goldthwait procedure. A prospective study of forty-seven knees. 403 Aug 42

Chronic wrist pain has many causes, the diagnosis of which is often difficult. Clinical and anatomical research in this area has replaced the diagnosis of "wrist sprain" with a differential diagnosis including carpal chondromalacia, dynamic carpal instability, positive and negative ulnar variance, triangular fibrocartilage complex injuries, and early carpal avascular necrosis. The ubiquitous dorsal ganglion can also cause chronic wrist discomfort and the diagnosis of "occult dorsal carpal ganglion" should be included in the differential diagnosis. Nine patients with chronic wrist pain were diagnosed clinically as having an occult dorsal carpal ganglion despite the absence of a palpable mass. Each was treated by limited dorsal capsulectomy with excision of a small portion of the dorsal scapho-lunate ligament, and small intracapsular ganglia and/or cystic mucinous degeneration of the capsule were found in all nine patients. Of the eight patients available for follow-up examination, the preoperative pain was relieved in seven of the eight and no recurrences were noted at follow-up averaging six months.
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PMID:The occult dorsal carpal ganglion. 403 18

Sixty-seven painful pisotriquetral joints were treated by excision of the pisiform over a 30-year period. Forty-two patients had a previous history of trauma. Ulnar neuropathy was noted in 22 patients, particularly in those with associated wrist-hand fractures and subluxations or dislocations of the pisiform. The abductor and flexor digiti minimi and the palmar carpal ligament with their common fibrous origin were the most common compressing structures on the ulnar nerve. Chondromalacia was found in 29 and osteoarthritis in 20 pisotriquetral joints. Excision of the pisiform provided complete relief of localized hypothenar pain in 65 wrists with no loss of wrist motion or strength. Neurolysis produced full sensory recovery in all 22 patients and full motor recovery in five of six. No late problems associated with the flexor carpi ulnaris tendon were found after excision of the pisiform.
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PMID:Dysfunction of the pisotriquetral joint: treatment by excision of the pisiform. 404 52

Thirty-seven cases of patellofemoral pain in young, active military recruits were studied. All patients were provided with an infrapatellar brace as a method of treatment. Nine patients (24%) demonstrated some improvement in symptoms at 1 week following application. Eight patients (22%) with maximum relief at 1 week were also shown to be symptom free at 1 year. Twelve patients (32%) with poor results were arthroscoped; eleven of these (92%) were found to have chondromalacia of the patella. Our success rate for subjective symptoms, after using the infrapatellar brace in this study, does not compare favorably with those reported by Levine using the same device.
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PMID:Patellofemoral pain and the infrapatellar brace. A military view. 405 Oct 88


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