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

In a retrospective review of 64 knees (58 patients) treated during a 36-month period by segmental arthroscopic resection of a hypertrophic mediopatellar plica, each patient was questioned and/or examined a minimum of one year after surgery. Medial or retropatellar pain (95%), buckling (32%), swelling (25%), and snapping (16%) were symptoms associated with a hypertrophic mediopatellar plica. Findings during physical examination of medial and retropatellar tenderness (74%) suggest the presence of the condition. Thirty percent of knees had localized chondromalacia of the medial femoral condyle, while in 13% chondromalacia was localized to the medial patellar facet. Good to excellent results were obtained in 86% of knees with a hypertrophic mediopatellar plica, with or without localized chondromalacia. In patients who had associated conditions, the lesions were also treated arthroscopically; good to excellent results were obtained in 69% of these knees.
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PMID:Segmental arthroscopic resection of the hypertrophic mediopatellar plica. 688 49

A 16-year-old girl underwent left and right patellectomies in December 1973 and January 1974 for disabling chondromalacia. Surgery had been performed in 1971 for a chronic left patellar subluxation and in 1973 for a discoid lateral meniscus. There were five postpatellectomy complications, four of which were identical soft tissue cutaneous inflammatory femoral condylar foci which required excision of underlying condylar cartilage and bone; the fifth was a focus of subcutaneous, hemorrhagic fibroadipose tissue with neuroma-like pain in the right knee which responded well to excision. Three years later, there was no limp; stairs were manipulated normally, but there was pain during inclement weather. There was a 5 degree extension lag of the right knee and both knees flexed fully. Multiple scars on both knees have not adversely affected the patient. After four operations and two manipulations of the left knee and five operations and three manipulations of the right knee, the two-year follow-up period has shown that results in both knees are unexpectedly good. The article discusses postpatellectomy complications.
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PMID:Complications and treatment of bilateral patellectomy for chondromalacia in an adolescent girl: a case report. 689 31

The temporomandibular joints are neural structures which develop from the cephalic ectomesenchyme of the neural crests. They are analogous to the effector organs. Their lesional abnormalities have two characteristics:--pain sensation,--"foreign body". A classification is suggested on the basis of clinical characteristics and course of articular signs due to temporo-menisco-condylar stress resulting from occlusion problems, and concomitant lesions of the articular fibrocartilage: closed and open fibro-chondromalacia. Emphasis is placed upon the constant dissociation between articular clinical features and nosography. Spongialisation, or the property of regeneration of fibrocartilage from spongy bone tissue fully justifies the technique of condyloplasty to remodel the temporomandibular joints in the presence of fibro-chondromalacia. The future lies in the distinction between fibro-chondromalacia secondary to occlusive stress and that due to primary ischaemia of bone.
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PMID:[Temporomandibular fibro-chondromalacia. Physiological basis. Classification on the basis of clinical characteristics and course. Spongialisation (author's transl)]. 695 31

Eighty patients with persistent clinical and functional instability of the knee due to anterior cruciate ligament insufficiency underwent the operation reported, in which one-third of the patellar ligament substitutes for the cruciate ligament and extraarticular tendon transfers, medial and lateral, augment the substitution. The patients were followed for a minimum of two years, and fifty returned for personal evaluation. The average follow-up was thirty-three months, with a range of two to five years. There were thirty-five male and fifteen female patients. The average age was twenty-three years. The average interval from initial injury to the index operation was two years. Meniscal tears and articular changes were noted in most of the patients. Forty-three (86 per cent) of the fifty patients had at least one torn meniscus, twenty-seven patients (54 per cent) had significant degenerative articular changes, and fourteen (28 per cent) had patellar articular changes. In the procedure described, eccentric placement of the tibial and femoral tunnels for more accurate placement of the patellar ligament substitute is essential. The over-all results were graded as excellent in thirty knees, good in seventeen, fair in one, and a failure in two. One knee that was classified as a failure showed excellent stability, but the patient had significant pain from chondromalacia of the patella, while significant pain and hyperesthesia from a neuroma was the reason for failure in the second patient.
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PMID:Anterior cruciate ligament reconstruction using one-third of the patellar ligament, augmented by extra-articular tendon transfers. 706 52

In an effort to evaluate the use of a transverse incision and a relatively small elevation (1.25 centimeters) of the tendinous insertion of the patellar ligament into the tibial tubercle, 184 patients were treated with a modified procedure using the Maquet principle. The indications for the procedure were patellofemoral pain and loss of active function. The patients were placed in five groups based on the cause of their symptoms: chondromalacia, patellofemoral arthritis, patellar dislocation, previous trauma, and previous patellectomy. The results were evaluated on the basis of whether or not primary wound-healing was satisfactory and whether or not the patient resumed the ability to ascend stairs and could engage in previously lost athletic function, Eighty-five per cent of the patients achieved these goals of treatment. The disadvantages of the procedure appeared to be the slow return of full function (averaging six months), prominence of the area of the tibial tubercle, and persistence of crepitus on patellofemoral motion.
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PMID:Elevation of the insertion of the patellar ligament for patellofemoral pain. 708 3

Sixty seven patients with pain in the knee were studied. A compound tomography (CT) score indicating chondromalacia was devised, based on the results of CT after arthrography. This score takes account of the regularity, the congruity, and the imbibition of contrast material. Thus the patients could be divided into four groups: those who definitely have chondromalacia (++), probably (+), probably not (+/-), and definitely not (-). These results were compared with the clinical diagnosis based on clinical signs, arthroscopy, or operation. Eighteen patients had clinically proved chondromalacia, CT scored 14++, 3+ and 1+/-. Twenty nine patients had no chondromalacia, CT scored 19-, 8+/-, and 2+. Twenty patients had an uncertain clinical diagnosis. Arthrography was less accurate in detecting chondromalacia.
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PMID:The value of computed tomography scanning in chondromalacia patellae. 711 43

Patella alta is radiologically defined by an Insall index equal to or greater than 1.3. In 50 patients suffering from pain of the femur and patella, roentgenographic studies consisting of a simple profile view and occasionally completed by a view through Smillie's angle with the knee hyperextended, revealed patella alta. The stretching of the patellar tendon is facilitated by excessive tension during growth and by excessively strenuous physical exercises; patella alta can occasionally be complicated by Osgood-Schlatter's or Sinding-Larsen Johansson's disease. Ruptured tendons have occasionally been observed. Genu recurvatum can also lead to patella alta. The joint should be routinely examined for excessive mobility. Patella alta is often associated with various affections of the extensor apparatus of the knee: pathology secondary to injury, external malposition, gonarthrosis, supratrochlear erosions of the femur. The importance of the role of this condition with respect to patellar chondromalacia has been estimated to varying degrees. The diagnosis of patella alta should be considered in all cases of knee pain.
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PMID:[Critical study of patella alta. II. Patella alta and femoropatellar pathology]. 712 23

One hundred and sixty-three patients who underwent arthroscopic studies of the knee have been reviewed in an attempt to better understand the clinical condition present in chondromalacia of the patella. All patients included in the study were found to have either painful knees, patellar chondromalacia, or both, but no other intraarticular pathology. The difference between true chondromalacia of the patella (which may or may not be symptomatic) and other types of pain in the patello-femoral area is emphasized. Although various types of conservative and operative treatment have been described, the symptoms have frequently been found to resolve spontaneously, especially in young patients.
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PMID:Chondromalacia of the patella. 716 92

Chondromalacia patellae is a pathologic diagnosis. The initial diagnosis is patellofemoral pain syndrome, unless actual evidence of chondromalacia is available. The success of a nonoperative treatment program is correlated with improvement of thigh musculature balance. An arduous muscle-strengthening program is part of the treatment protocol. Only eight in a series of 100 patients required surgery. The physician's attitude and the patient's confidence are important elements in the success rate.
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PMID:Chondromalacia patellae and the painful knee. 735 Jul 32

Anterior displacement of the tibial tuberosity combined with shaving of the diseased cartilage was used as treatment for chondromalacia patellae in 32 knees in 28 consecutive patients and in one patient with chondromalacia femoris. The patients were aged 17 to 57 years. One patient had earlier sustained a serious injury to the ligaments of the knee, resulting in instability. All patients except one were unfit for work before the operation. Postoperative extra-articular wound infection was noted in two knees and venous thrombosis occurred in three legs. The postoperative observation period varied from 8 months to 2 years and 10 months. In one knee the anterior displacement of the tibial tuberosity was not maintained. In lateral radiographs the anterior displacement of the tibial tuberosity in the other knees varied from 10 to 23 mm. The relief from pain obtained by the operative treatment was estimated as good in all knees except three, which were unchanged. All patients became fit for work and/or sport.
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PMID:Anterior displacement of the tibial tuberosity in the treatment of chondromalacia patellae. 737 38


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