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: 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

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

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

The displacement of patellar components, such as dislocation or subluxation, causes polyethylene wear and further induces metallosis of the metal-backed patella. We compared two different patellar components, onset(Miller-Galante I) and inset(Whiteside-Ortholoc I)type, to understand the differences in patellar tracking according to their designs. Patellar prosthesis position in 43 primary total knee arthroplasties was evaluated with patellar tilt, patellar displacement from the center of the trochlear groove, medial placement, patellar thickness, and joint line height. For the MG(Miller-Galante I)group, the patellar displacement was laterally 50.0% and for the Ortholoc group, it was 33.3%. In the MG group, 4 cases of revision of the patellar component due to excessive polyethylene wear were performed, but there was no excessive wear of polyethylene in Ortholoc group. One of the primary factors which influence tracking of the patellofemoral joint is the difference in design between the patellar component and the femoral component. But in the opinion of the authors, the slope or lateral displacement of the patellar component have no correlation with each other under radiological measurements. However, the inset-type patellar component is a design that maintains the bony flange within the lateral flange, therefore relieving the shear stress and rotational forces loaded on the patellofemoral joint and protecting the metal-backing from exposure. Thereby, even if dislocation or subluxation of the patellar component should occur, polyethylene wear or metallosis caused by excessive wearing can be minimal.
Arthroplasty* ; Dislocations ; Joints ; Knee* ; Patella ; Patellofemoral Joint ; Polyethylene ; Prostheses and Implants

PURPOSE: The purpose of this study was to analyze sex- and laterality-specific patellofemoral alignment using three-dimensional computed tomography (3D-CT) in normal Korean patients. MATERIALS AND METHODS: The study included 90 patients (45 men, 45 women; 180 knees) with no history of anterior knee pain or malalignment by physical examination. The mean patient age was 42.2 years (Range: 24~66 years). 3D-CT scanning was performed with each patient in the supine position with 15degrees of knee flexion. Patellofemoral joint alignment was evaluated by measuring the sulcus angle, congruence angle, lateral patellofemoral angle, condyle-patellar angle, and condyle-lateral angle. RESULTS: Comparing men and women, respectively, the sulcus angles were 145.9degrees+/-8.9 and 149.4degrees+/-9.7, the congruence angles were 12.6degrees+/-22.7 and 12.0degrees+/-19.6, the lateral patellofemoral angles were 9.9degrees+/-6.0 and 8.5degrees+/-4.3, the condyle-patellar angles (lateral facets) were 14.2degrees+/-7.1 and 11.8degrees+/-4.8, the condyle-patellar angles (patellar axes) were -8.5degrees+/-7.7 and -10.6degrees+/-6.1, and the condyle-lateral angles were 15.5degrees+/-7.6 and 16.4degrees+/-4.0. There was no significant difference in these measurements between left and right knees, but there was a significant difference in the sulcus angle and condyle-patellar angle between men and women (p<0.05). CONCLUSION: These data will hopefully serve as a basis for evaluating normal patellofemoral alignment and for diagnosing patellofemoral malalignment in Korean patients.
Female ; Humans ; Knee ; Male ; Patellofemoral Joint ; Physical Examination ; Supine Position

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