PURPOSE: to find out the change and limit of the changes of tibiofemoral joint line, patellar position and other related variables for improved postoperative knee function after PCL retaining TKRA. MATERIALS AND METHODS: The variables mentioned above were measured from the plain radiographs of 101 knees with PCL retaining TKRAs, correlated with clinical outcomes such as HSS score, range of motion and anterior knee pain. Then they were analyzed statistically. RESULTS: Tibiofemoral joint line, patellar height and femoral condylar size affected clinical outcomes. Excellent postoperative knee function resulted when the shift of tibiofemoral joint line position was between 5mm inferiorly to 5mm superiorly, postoperative patellar height between 15mm to 30mm, and the change of the femoral condylar size between 10mm decrease and 5mm increase. CONCLUSION: Excellent clinical results would be expected if the changes of the joint line position are kept within the range suggested in this paper.
Joints ; Knee ; Knee Joint ; Patellofemoral Joint* ; Range of Motion, Articular

A meniscal cyst is not common disease of knee joint. Many cases have been reported but its cause and origin are still pooly understood. We experienced two cases of the cysts on the lateral meniscus. They were treated by arthroscopic partial menisectomy and extraarticular excision of the cyst. The good results were obtained.
Knee Joint ; Knee ; Menisci, Tibial

PURPOSE: To investigate the relationship between tenderness and the MR findings of patellofemoral articular cartilage abnormalities. MATERIALS AND METHODS: We investigated 64 patients, 70 knee joints, who had symptoms of knee pain. We evaluated the correlation between the tenderness and the MR grades at each tender point of the patellar and calculated the sensitivity, specificity and accuracy of the tenderness on the basis of MR imaging. RESULTS: The sensitivity, specificity and accuracy of the tenderness were 49.0% (99/202), 83.8% (279/333), 70.6% (378/535), respectively. The tenderness and the MR grades were moderately correlated in the patellofemoral joint as a whole (r=0.41, p<0.01), and tenderness was substantially correlated with MR grade in the femoral trochlear articular surface (r=0.33, p<0.01) and moderately correlated in the patellar articular surface (r=0.47, p<0.01) with MR grades. CONCLUSION: That of tenderness represents the condition of the articular cartilage of the patellar better than that of the femoral trochlear.
Cartilage, Articular ; Humans ; Knee ; Knee Joint ; Magnetic Resonance Imaging ; Patellofemoral Joint* ; Sensitivity and Specificity

Pigmented villonodular synovitis is a slow, usually monoarticular, progressive proliferative disorder of uncertain etiology involving joint tissue, tendon sheath, and bursae. Pigmented villonodular synovitis has been divided in two forms-diffuse and localized. Localized pigmented villonodular synovitis of the knee joint can present with symptoms of pain, locking and instability. We report a case of a patient who presented with symptoms of recurrent subluxation of patella due to a localized pigmented villonodular synovitis occurring in the medial patellofemoral joint.
Humans ; Joints ; Knee ; Knee Joint ; Patella* ; Patellofemoral Joint ; Synovitis, Pigmented Villonodular* ; Tendons

PURPOSE: To evaluate the influence of degenerative changes in the patellofemoral joint on the clinical results of medial unicompartmental knee arthroplasty (UKA). MATERIALS AND METHODS: Between January and December 2002, we operated on 180 cases of minimally invasive UKA using the Oxford(R) phase 3. Of the 180 cases, 156 were followed up for a minimum period of 5 years. Based on intraoperative degenerative findings of the patellofemoral joint, we classified cases into 4 groups (Group I-78 cases, Group II-40 cases, Group III-27 cases, Group IV-11 cases), and the clinical data were analyzed prospectively. RESULTS: During follow-up, which averaged 6 years and 2 months, the knee score, the knee function score, the range of knee motion and the tibiofemoral angle were improved significantly (p<0.05) in all groups. The preoperative knee score and the tibiofemoral angle in the mild degeneration group (I, II) were higher than in the severe degeneration group (III, IV) (p<0.05). On the other hand, there were no significant differences between the groups in the postoperative knee score, the knee function score, the range of knee motion and the tibiofemoral angle (p>0.05). To date, no complication or failure involving the patellofemoral joint has been observed. CONCLUSION: Clinical results of UKA are satisfactory for all groups, and the severity of patellofemoral degeneration has no influence on clinical outcome. Symptomless degenerative arthritis of the patellofemoral joint is not a contraindication for medial UKA.
Arthroplasty ; Follow-Up Studies ; Hand ; Knee ; Knee Joint ; Osteoarthritis ; Patellofemoral Joint ; Prospective Studies

PURPOSE: The purpose of this study was to evaluate compartmental changes using combined single-photon emission computerized tomography and conventional computerized tomography (SPECT/CT) after open wedge high tibial osteotomy (OWHTO) for providing clinical guidance for proper correction. MATERIALS AND METHODS: Analysis was performed using SPECT/CT from around 1 year after surgery on 22 patients who underwent OWHTO. Postoperative mechanical axis was measured and classified into 3 groups: group I (varus), group II (0°–3° valgus), and group III (>3° valgus). Patella location was evaluated using Blackburne-Peel (BP) ratio. On SPECT/CT, the knee joint was divided into medial, lateral, and patellofemoral compartments and the brighter signal was marked as a positive signal. RESULTS: Increased signal activity in the medial compartment was observed in 12 cases. No correlation was observed between postoperative mechanical axis and medial signal increase. Lateral increased signal activity was observed in 3 cases, and as valgus degree increased, lateral compartment’s signal activity increased. Increased signal activity of the patellofemoral joint was observed in 7 cases, and significant correlation was observed between changes in BP ratio and increased signal activity. CONCLUSIONS: For the treatment of medial osteoarthritis, OWHTO requires overcorrection that does not exceed 3 valgus. In addition, the possibility of a patellofemoral joint problem after OWHTO should be kept in mind.
Humans ; Knee ; Knee Joint ; Osteoarthritis ; Osteotomy ; Patella ; Patellofemoral Joint ; Tomography, Emission-Computed, Single-Photon

In osteoarthritis of the knee with varus deformity, abnormal stress is concentrated in the medial compartment of the knee joint. A logical treatment must decrease and recenter the force acting on the knee in order to distribute the compressive stresses evenly over the largest possible weight-bearing articular surfaces. This can be attained by an overcorrection of the deformity. The technique of a Barrel-Vault osteotomy is the correction of severe angular deformity of the knee and the reduction of the patellofemoral joint pressure simultaneously by an anterior displacement of the distal fragment. From 1986 to 1989, the authors studied the preoperative clinical status and lpostoperative results in twelve knees(nine patients) who had had a Barrel-Vault osteotomy for combined medial and patellofemoral disease. The total Insall Knee Rating Score improved from a preoperative mean 54.1 to 85.4 Points at the last assessment. The pain component score improved from a preoperative mean 6.6 to 26.2 points at the last assessment. Eleven kness had either no pain or occasional mild pain. The tibiofemoral angle was corrected from a preoperative mean of 4.4 degrees of varus to a mean of 11.2 degrees of valgus at the last assessment.
Congenital Abnormalities ; Knee Joint ; Knee ; Logic ; Osteoarthritis ; Osteotomy ; Patellofemoral Joint ; Weight-Bearing

Anterior knee pain is an enigmatic entity with multiple causes, and so the patients, who present with diverse symptoms, require different treatments. A combination of variables, including abnormal lower limb biomechanics, soft-tissue tightness, muscle weakness and excessive exercise, may result in increased cartilage and subchondral bone stress, patellofemoral pain and subtle or more overt patellar maltracking. Because of the multiple forces affecting the patellofemoral joint, the clinical evaluation and treatment of this disorder is quite a challenge. Our extensive search of the literature revealed no single gold-standard test/maneuver to diagnose this disorder, and the reliability of the maneuvers described was generally low or untested. Making a specific and accurate diagnosis of the etiology, based on a thorough physical exam and imaging studies, is essential to create an effective therapeutic approach for the patient's successful return to proper knee function.
Biomechanics ; Cartilage ; Humans ; Knee ; Lower Extremity ; Muscle Tonus ; Patellofemoral Joint

PURPOSE: The purpose of this study were to evaluate the relationship between anterior knee pain and changes of patellofemoral joint in osteoarthritic knee. MATERIALS AND METHODS: We analyzed 200 patients who had undergone total knee arthroplasty and divided them into two groups ; the group 1(100 cases) with anterior knee pain and the group 2(100 cases) without it. We prospectively measured congruence angle and patellar height, and compared radiologic degenerative changes and operative findings(Outerbridge classification) of patella. RESULTS: The average congruence angle of patella was 11.2+/-1.6degrees in the group 1 and 2.8+/-1.3degrees in the group 2(p<0.05). Patellar height had no significant difference between two groups(p=0.62).For radiologic patellofemoral(PF) degenerative change, the group 1 showed mild degenerative change in 16 , moderate change in 47 and severe change in 37 in plain radiographs. The group 2 showed mild degenerative change in 53 and moderate change in 47 in plain radiographs(p<0.05). For cartilage degenerative change in patella(Outerbridge classification), whereas grade 3&4 were dominant in the group 1 with 71 cases, grade 1&2 were representative in the group 2 with 91 cases(p<0.05). CONCLUSION: Anterior knee pain seemed to be related with congruence angle and degenerative changes in radiologic and operative findings.
Arthroplasty ; Cartilage ; Humans ; Knee* ; Osteoarthritis* ; Patella ; Patellofemoral Joint ; Prospective Studies

PURPOSE: To evaluate the clinical and radiologic results in patients with total knee arthroplasty without patellar resur- facing. Subject and Method: In this study, 64 cases of total knee arthroplasty without patellar resurfacing were performed nonselectively by a single surgeon from January 2000 to January 2004, and followed up for more than 2 years(range, 24~72 months). The clinical results according to Hospital for Special Surgery knee score and Feller's patellar score, and radiological evaluations about patellar subluxation were analyzed for the correlation of the two results. RESULT: HSS score improved from 54 to 83 points, and Feller's patellar score improved from 18 to 27 after surgery. In preoperative radiologic evaluation, 61 cases(95.3%) were assessed as 'open laterally', the average patellofemoral index was 1.4(0.6~2.5) and the lateral patellar displacement was 1.2mm. In the latest follow-up, 56 cases(87.5%) were assessed as 'open laterally', the average patellofemoral index was 1.5(0.5~3) and the lateral patellar displacement was 1.5(0~8)mm. In comparison between the clinical and radiologic results, no statistic significance was noted in their correlation(p>0.05). CONCLUSION: Total knee arthroplasty without patellar resurfacing was performed nonselectively, satisfactory clinical outcome was observed despite radiologic changes such as patellar subluxation and displacement. It was considered that there was no significance in correlation between radiological changes and clinical results.
Arthroplasty* ; Follow-Up Studies ; Humans ; Knee* ; Patella* ; Patellofemoral Joint