Anterior knee pain is a common symptom in general orthopedic practice and is reported in 8% of women and 2% of men over the age of 55 years. The treatment of isolated patellofemoral arthritis is controversial. Many pa...Anterior knee pain is a common symptom in general orthopedic practice and is reported in 8% of women and 2% of men over the age of 55 years. The treatment of isolated patellofemoral arthritis is controversial. Many patients can be effectively managed conservatively. Analysis was done on 14 patients (17 knees) with symptomatic isolated patellofemoral osteoarthritis between 2001 and 2007. 3 patients had additional procedures like tibial tubercle osteotomy and lateral release, tibial tubercle osteotomy with medical plication and iliotibial band lengthening and lateral retinacular release. The operation should be viewed as a soft-tissue procedure involving resurfacing of the femoral trochlea and the articular surface of the patella. Proper balance of the extensor mechanism must be done at the time of surgery to ensure correct tracking of the patella which in turn results in the best outcome for the replacement.展开更多
Traditionally physicians have advised patients to be non-weight bearing post arthroscopic knee microfracture surgery for at least 2 to 8 weeks. The microfracture procedure is a simple, low-risk method to induce self-c...Traditionally physicians have advised patients to be non-weight bearing post arthroscopic knee microfracture surgery for at least 2 to 8 weeks. The microfracture procedure is a simple, low-risk method to induce self-cartilage regeneration to focal lesions. The procedure has shown that small fractures to the subchondral bone can recruit mesenchymal stem cells and growth factors to regenerate the fibrocartilage without compromising the subchondral plate. With the simplicity of this procedure and the positive effect it can have on patients, it is natural to want to push the bounds of rehabilitation to see what is necessary. The patient in this case report exhibits the potential for positive outcomes with early weight-bearing status in patients receiving microfractures via subchondral drilling. This positive outcome, along with others, should encourage clinicians to consider reestablishing evidence-guided rehabilitation post microfracture with new studies. Shortened rehabilitation time would decrease a barrier to surgery for many patients and would only enhance our treatment with this surgical modality.展开更多
文摘Anterior knee pain is a common symptom in general orthopedic practice and is reported in 8% of women and 2% of men over the age of 55 years. The treatment of isolated patellofemoral arthritis is controversial. Many patients can be effectively managed conservatively. Analysis was done on 14 patients (17 knees) with symptomatic isolated patellofemoral osteoarthritis between 2001 and 2007. 3 patients had additional procedures like tibial tubercle osteotomy and lateral release, tibial tubercle osteotomy with medical plication and iliotibial band lengthening and lateral retinacular release. The operation should be viewed as a soft-tissue procedure involving resurfacing of the femoral trochlea and the articular surface of the patella. Proper balance of the extensor mechanism must be done at the time of surgery to ensure correct tracking of the patella which in turn results in the best outcome for the replacement.
文摘Traditionally physicians have advised patients to be non-weight bearing post arthroscopic knee microfracture surgery for at least 2 to 8 weeks. The microfracture procedure is a simple, low-risk method to induce self-cartilage regeneration to focal lesions. The procedure has shown that small fractures to the subchondral bone can recruit mesenchymal stem cells and growth factors to regenerate the fibrocartilage without compromising the subchondral plate. With the simplicity of this procedure and the positive effect it can have on patients, it is natural to want to push the bounds of rehabilitation to see what is necessary. The patient in this case report exhibits the potential for positive outcomes with early weight-bearing status in patients receiving microfractures via subchondral drilling. This positive outcome, along with others, should encourage clinicians to consider reestablishing evidence-guided rehabilitation post microfracture with new studies. Shortened rehabilitation time would decrease a barrier to surgery for many patients and would only enhance our treatment with this surgical modality.
