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By Vicente Sanchis-Alfonso

Clinically orientated and richly illustrated, this e-book presents whole counsel at the surgical and non-surgical administration of the anterior knee discomfort syndrome and is aimed toward orthopedic surgeons, activities drugs practitioners, knee experts and actual therapists.

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Example text

In 1940, Karlson46 wrote the following about chondromalacia patellae: “The diagnosis is difficult to make and the differential diagnosis of injury to the meniscus . . ” Just think of the sheer amount of arthroscopies performed unnecessarily on the basis of a complaint of anterior knee pain! Nowadays this problem has been magnified because of the relative ease with which meniscectomies are indicated and performed thanks to the benefits of arthroscopy. 62 It is therefore essential to underscore the importance of physically examining the patient (see Chapter 6).

To obtain a homogeneous population, we included in the study group only those cases with the following criteria: (1) PFM demonstrated with CT at 0° of knee flexion; (2) no previous knee surgery; (3) no associated intraarticular pathology (such as synovial plica, meniscal tears, ACL/PCL tears or osteoarthrosis) confirmed arthroscopically or by x-rays; and (4) IPR as an isolated surgical procedure. Moreover, we excluded patients involved in workman’s compensation or other pending litigation claims and patients who had recurrent dislocation of the patella associated with Down syndrome.

5%), the onset of symptoms occurred spontaneously without injury. Surgery was performed after a mean of 24 months following onset of symptoms (range 2 months–11 years). 5%). Therefore, two populations were analyzed in this study: “patellar pain patients with PFM” (group I) and “patellar instability patients with PFM” (group II). For the purposes of this paper, the term patellar instability is used to describe giving way as a result of the patella partially slipping out of the trochlea, and dislocation (complete displacement of the patella out of the trochlea).

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