• Title/Summary/Keyword: patella

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The Anatomy and Biomechanics of knee joint for orthopedic local taping (슬관절의 정형의학적 국소 테이핑을 위한 해부학과 생체역학에 관한 문헌적 고찰)

  • Lim, Hyun-Dai;Kim, Hye-Won;Kim, Yong-Kwon
    • Journal of Korean Physical Therapy Science
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    • v.9 no.4
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    • pp.177-184
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    • 2002
  • The knee joint is composed of 3 skeletons that is the femoral bone, the tibial bone, and the patella bone. The tibiofemoral pint and patellofemoral pint act with the meniscus, so these function that is maintain the stabilities by the surrounding soft tissue is complex. The protection mechanism(muscle tension) of the surrounding muscles for the joint disease(Arthritis) limits consistently the motion of the pint to decrease the internal pressure of the joint, and these muscle tension acts with abnormal function for the surrounding tissue and the joint, sometimes the contracture is developed, if the joint with disease is not recovery or treated within early time. So we worked out efficient orthopedic local taping for the patient who is complained of the knee pint pain using the literature investigation about the anatomical structure and the biomechanics of the knee pint for the muscle and the pint problem esp, the rotation of the tibia, the dislocation of the patella, and the motion of the meniscus that is developed due to tension of surrounding muscles of the knee pint. And application of the pint mobilization, the stretching, and the muscle strengthening exercise for the pint will become successful treatment for the joint disease.

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Several Hypotrichous Ciliates Inhabiting the Han River in Seoul (서울지역 한강에 서식하는 하모섬유충류)

  • 신만균;김훈수
    • Animal Systematics, Evolution and Diversity
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    • no.nspc2
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    • pp.67-85
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    • 1988
  • The hypotrichous ciliates (Protozoa , Ciliophora, Hypotrichida) inhabiting the Han River in Seoul were systematically investigated. Several Collections were made from 6 November 1986 to 8 November 1987 at 9 sites located in the Han River. Collected protozoans were cultured and characterized cyto-morphologically under the living and/or stained conditions, As a result, 7 species of hypotrichs in 4 families were identified of which 3 species are newly recorded from Korea ; Paraurostyla weissei (Stein, 1859_, Aspidisca cicada(O.F. Mller, 1786) and Euplotes patella (O.f.Mller, 1773). The identified species were redescribed with illustrations and photographs. The morphological similarities among them were numerically analyzed by UPGMA method, and its result of clustering concurs in general with the orthodox classification scheme.

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Comparison of difference in muscle activity ratio, ground reaction force and knee valgus angle during single leg squat and landing according to dynamic taping

  • Ha, Tae-Won;Park, Sam-Ho;Lee, Myung-Mo
    • Physical Therapy Rehabilitation Science
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    • v.9 no.4
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    • pp.281-286
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    • 2020
  • Objective: This study examined the effects of dynamic tape applied to the patellofemoral joint on the knee valgus angle, muscle activity, and ground reaction force during a single leg squat (SLS) and single leg landing (SLL). Design: Cross-sectional study. Methods: Twenty-four subjects (11 male, 13 female) who met the inclusion criteria were screened by the knee palpation and patella compression tests. First, the knee valgus angle and muscle activity during SLS were measured. Second, the knee valgus angle and ground reaction force during SLL were measured. For the intervention, a patella joint loop using dynamic tape was used. The knee valgus angle, muscle activities in SLS and SLL after the intervention, and the ground reaction force were measured in the same way. A paired t-test was used to examine the difference between before and after the intervention. Results: The knee valgus angle showed a statistically significant improvement after dynamic taping application in SLS and SLL (p<0.05). The differences in muscle activity of the VL/VMO and ground reaction forces were not statistically significant after dynamic taping application in SLS and SLL. Conclusions: This study showed that dynamic taping applied around the patellofemoral joint was effective in improving the knee valgus angle in SLS and SLL and had a reduced risk of secondary injury during sports activity.

Factors Affecting Tibial Tuberosity-Trochlear Groove Distance in Recurrent Patellar Dislocation

  • Prakash, Jatin;Seon, Jong-Keun;Ahn, Hyeon-Woon;Cho, Kyu-Jin;Im, Chae-Jin;Song, Eun Kyoo
    • Clinics in Orthopedic Surgery
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    • v.10 no.4
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    • pp.420-426
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    • 2018
  • Background: The tibial tuberosity-trochlear groove (TT-TG) distance is used to determine the necessity of tibial tubercle osteotomy. We conducted this study to determine the extent to which each of the tibial tuberosity lateralization, trochlear groove medialization, and knee rotation angle affects the TT-TG distance in both normal and patella dislocated patients and thereby scrutinize the rationale for tuberosity transfer based on the TT-TG distance. Methods: Retrospective analysis of rotational profile computed tomography was done for patella dislocated and control group patients. Femoral anteversion, tibial torsion, knee rotation angle, tuberosity lateralization, and trochlear groove medialization were assessed in all patients. Relationship of these parameters with the TT-TG distance was investigated to evaluate their effects on the TT-TG distance. Results: We observed that the patellar dislocation group, compared to the control group, had increased TT-TG distance (mean, 19.05 mm vs. 9.02 mm) and greater tuberosity lateralization (mean, 64.1% vs. 60.7%) and tibial external rotation in relation to the femur (mean, $7.9^{\circ}$ vs. $-0.81^{\circ}$). Conclusions: Tuberosity lateralization and knee rotation were factors affecting patellar dislocation. These factors should be considered in addition to the TT-TG distance to determine the need for tibial tubercle osteotomy in patients with patellar dislocation.

Arthroscopically Assisted Lateral Release and Medial Imbrication for Recurrent Patella Dislocation (재발성 슬개골 탈구에서 관절경적 외측 유리술 및 내측부 중첩술)

  • Kang, Sung-Shik;Yoo, Jae-Doo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.2
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    • pp.98-103
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    • 2010
  • Purpose: We reported the results of arthroscopically assisted lateral release and medial imbrication for the recurrent patella dislocation. Materials and Methods: Twenty patients (20 knees) underwent arthroscopically assisted surgery for the recurrent patella dislocation. There were 4 males and 16 female. The average age was 20.2 years. All patients had definite trauma history and average follow-up period was 19 months. The surgical results were evaluated according to the Lysholm knee score and the Kujala score. The congruence angle and lateral patellofemoral angle were measured on plain radiograph and the tibial tubercle-trochlear groove distance was calculated on computerized tomography. Results: The median value of preoperative congruence angle was $16.5^{\circ}$ (range, $0.0{\sim}+34^{\circ}$) and the average final follow-up was $-6.4^{\circ}$ (range, $-19{\sim}10^{\circ}$) with statistically significant improvement (p=0.025). The median value of preoperative Lysholm knee score was 70 (range, 63~81) and the final follow-up score had changed to 88 (range, 80~95) with statistically significant improvement (p=0.0341). The median value of preoperative Kujala score was 72 (range, 65~80) and the average final follow-up score showed 87 (range, 80~92) with statistically significant improvement (p=0.024). Recurrent dislocations after surgery occurred in 2 cases, one case which showed positive "thumb to forearm test" had been treated with medial patellofemoral ligament reconstruction. Conclusion: Arthroscopically assisted lateral release and medial imbrication for recurrent patella dislocation without bony malaligmenent showed the effective treatment, but would be inappropriate for the patients with the generalized joint laxity.

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Limited Lateral Retinacular Release for Treatment of Painful Bipartite Patella (통증이 있는 이분슬개골의 제한적인 외측 지대 유리술 치료)

  • Yi Seung Rim;Hahn Sung Ho;Yang Bo Kyu;Chung Shun Wook;Ha Jung Hyun;Ahn Young Joon;Chung Byung June;Jeon Do Hwan;Bin Sung Woo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.1
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    • pp.60-65
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    • 2004
  • Purpose: The purpose of this study was to evaluate the results of limited vastus lateralis release for treatment of painful bipartite patella. Materials and Methods: From Jan. 1995 to Jun. 2002, we performed limited lateral retinacular release in 14 patients(16 cases) for treatment of painful bipartite patella. All patients were men and mean age was 22.3 years old. The opeative techique was that insertion of the vastus lateralis to the painful patellar fragment is detached subperiosteally. We evaluated the clinical results by degree of pain and level of activity. Also we analyzed the radiologic findings by measuring fragment tilting angle and gap between fragments. The mean follow up period was 14 months. Results: At final follow up, all of the patients showed pain relief and can be returned to more than recreational sports activity after the operation. On radiologic findings, fragment tilting angle and gap between fragments were reduced at statistically significant level. Conclusion: The limited lateral retinacular release for treatment of painful bipartite patella is one of good methods which is less invasive and shows good results in clinical and radiologic findings.

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Results of Surgical Treatment of Patella Dislocation (슬개골 탈구의 수술적 치료 결과)

  • Kim, Hui Taek;Cho, Yoon Jae
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.134-141
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    • 2021
  • Purpose: Patellar dislocations have a range of causes. This study examined the results of treatment aimed at balancing soft tissues around the patella. Materials and Methods: Thirty-two patellar dislocations in 28 patients (21 females and seven males) were examined. The mean patient age at the time of surgery was 11.5 years, and the mean follow-up period was 4.6 years. Dislocations were 19 chronic, six habitual, six congenital, and one acute. Soft tissue balancing surgery included lateral capsular release, medial capsular plication, and inferolateral transfer of the vastus medialis obliquus. Medial transfer of the patellar tendon, partial strip of the rectus femoris and patella tendon, and distal femoral osteotomy were also performed selectively. The preoperative Q angle, femoral anteversion angle, tibial external rotation angle, tibial tubercle-trochlear groove distance (TT-TG distance), mechanical femoral-tibial angle, and femoral trochlear dysplasia according to Dejour were measured, and the pre- and postoperative Lysholm-Tegner scores were used to analyze the clinical results. Results: The mean preoperative Q angle, TT-TG distance, femoral anteversion angle, tibial external rotation angle, mechanical femoraltibia angle, and Lysholm-Tegner score were 9.3°, 15.5 mm, 25.6°, 30.4°, 3.0°, and 75.8, respectively. Eleven patients had systemic ligament laxity with a Beighton score of five or more. Twenty-two patients had femoral trochlear dysplasia: four type A (3 patients), 16 type B (15 patients), one type C (1 patient), and four type D (3 patients). Of the 32 cases, 28 were corrected successfully by the first operation. Of four cases of postoperative subluxation, three were corrected by the second operation, and one of them was corrected after a third operation. The last patient is currently being followed-up. The mean Lysholm-Tegner score improved to 85.6 after the operation. Conclusion: Correcting all the causes of patella dislocation simultaneously is difficult. Nevertheless, satisfactory outcomes were obtained with soft tissue balancing surgery around the patella and a corrective osteotomy for an abnormal mechanical axis of the femur-tibia and torsion.

Comparison of the Patella Baja in Patients With and Without Anterior Cruciate Ligament Injury (전방 십자 인대 손상군과 정상군에서 슬개골 저위증의 비교)

  • Lee, Woo-Suk;Kim, Sung-Hun;Cho, Sung-Jin;Lim, Ji-Hyuk;Chung, Whan-Young;Hwang, Cheol-Mog
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.39-44
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    • 2006
  • Purpose: The object of this study is to compare the Insall-Salvati ratio and Carton index between the patients who have an anterior cruciate ligament (ACL) tear and the patients who have no ACL tear. Materials and Methods: The study group included 114 patients who had an ACL tear and received arthroscopic reconstruction. The group I was acute ACL tear group, within 3 weeks after injury. The group II was chronic ACL tear group who had MRI was done after 3 weeks from injury. The group III was normal control group. We measured the Insall-Salvati ratio and Carton index on Magnetic Resonance Images (MRI) for all patients. Results: The Insall-Salvati ratio of control group was $1.02{\pm}0.12$ and Carton index of control group was $1.14{\pm}0.16$. The ACL-tear study group was $0.91{\pm}0.12\;and\;0.89{\pm}0.20$ respectively. The Insall-Salvati ratio and Caton index in ACL tear group was significantly less than those of control group. There were no significant differences in comparing with acute and chronic ACL tear group. Conclusion: Our study show that patella baja has an association with ACL tears, therefore in patients with an ACL tear who had patella baja, ideal graft for reconstruction was seriously considered.

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Effects of Manual Intervention and Self-Corrective Exercise Models of the General Coordinative Manipulation on Balance Restoration of Spine and Extremities Joints

  • Moon, Sang Eun;Kim, Mi Hwa
    • Journal of International Academy of Physical Therapy Research
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    • v.4 no.2
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    • pp.573-587
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    • 2013
  • The purpose of this study was conducted in order to analyze the effects of the manual intervention and self-corrective exercise models of general coordinative manipulation(GCM) on the balance restoration of spine & extremities joints with distortions and mal-alignment areas. The subjects were the members who visited GCM Musculoskeletal Prevent Exercise Center from March 1 2012 to December 31 2013 because of spine & extremities joints distortion and mal-alignments, poor posture, and body type correction. All subjects were diagnosed with the four types of the GBT diagnosis. And according to the standards of the mobility vs stability types of the upper & lower body, they were classified into Group 1(40 persons) and Group 2(24 persons). For every other day for three times a week, GCM intervention models were applied to all subjects for four weeks, adding up to 12 times in total. Then the balance restoration effects were re-evaluated with the same methods. The results are as follows. 1) Balance restoration effects of VASdp(Visual analysis scale pain & discomfort) and ER(Equilibrium reaction: ER) came out higher in GCM body type(GBT) II III IV of Group 1. 2) In case of balance restoration effects in Moire and postural evaluation areas, Group 1 was higher and cervical and scapular girdle were higher in Group 2. The balance restoration of the four GBT types was significant in all regions(p<.05), and the scapular girdle came out as high in the order of GBTII IV I. 3) In case of thoracic-lumbar scoliosis and head rotation facial asymmetric cervical scoliosis ribcage forward, the balance restoration effects of the upper body postural evaluation areas came out the highest in Group 1 and Group 2, respectively. The balance restoration effects of the four GBT types were significant in all regions(p<.05), and came out the highest in lumbar scoliosis GBTIII I, ribcage forward and thoracic scoliosis GBTII IV. 4) The balance restoration effects of the lower body postural evaluation areas came out higher in Group 1 and Group 2 for pelvis girdle deviation patella high umbilicus tilt and hallux valgus foot longitudinal arch: FLA patella direction, respectively. The balance restoration effects of the four GBT types were significant in all regions(p<.05), and came out the highest in pelvis girdle deviation GBTIII I and patella high-direction GBTIV II I. 5) The balance restoration effects between the same GBT came out significant (p<.05) in all evaluation areas and items. The conclusions of this study was the manual intervention and self-corrective exercise models of the GCM about the mal-alignment of the spine & extremities joints across the whole body indicated high balance restoration effects(p<.05) in spine & extremities joints in all evaluation areas.

Arthroscopic Medial Plication using Pull-out Suture for the Treatment of Acute or Recurrent Patellar Dislocation - Technical Note - (급성 또는 재발성 슬개골 탈구의 치료에 있어서 견인 봉합술을 이용한 관절경적 내측 관절막 중첩술 - 수술 술기 -)

  • Ahn, Jin-Hwan;Kim, Jae-Hoon;Ha, Hae-Chan
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.214-218
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    • 2006
  • Purpose: We describe a new technique of arthroscopic medial plication using pull-out suture with consideration of anatomical location of medial patellofemoral ligament for the treatment of acute or recurrent patellar dislocation. Operative technique: Under arthroscopic examination, sutures are passed through the medial capsule, at which medial patellofemoral ligament is located, from outside to inside of knee joint. Three guide wires are inserted from anterior surface of the patella to upper half of its medial border. Intraarticular portions of sutures are pulled out toward anterior surface of the patella through bony tunnels. Under appropriate tension, the sutures are tied after performing lateral retinacular release. Conclusion: As suturing medial patellofemoral ligament, this technique can maximize the effect of medial plication and can correct subluxation and tilt of the patella. It seems to be a minimally invasive, easy and effective method for the treatment of acute or recurrent patellar dislocation.

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