Abstract
Patellofemoral instability can manifest during flexion, yet most often occurs during early extension when the intrinsic stability of the patellofemoral joint is at a minimum. According to Bohm,1 the developing fetus has a relatively flat patellar articular surface and corresponding femoral trochlea. It is during the course of development, particularly after ambulation begins, that the femoral condyles become more prominent, the sulcus deepens, and the patella assumes its characteristic bifaceted appearance. According to Malkin,2 with terminal knee extension, there is external rotation of the tibia upon the femur, known as the screw home mechanism, which increases the Q angle. This rotational movement increases the pressure of the lateral femoral condyle. As long as this pressure remains within physiologic limits, growth of the anterior lateral trochlea is stimulated.
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References
Bohm M: Das menschliche bein herman gocht (red) deutsche Orthopade 1935.
Malkin SA: Dislocation of the patella. Br Med J 1932; 11: 91–94.
Outerbridge RE: Further studies on the etiology of chondromalacia patellae. J Bone Joint Surg Br 1964; 46B: 179–190.
Brattstrom H: Shape of the intercondylar groove normally and in recurrent dislocation of the patella: A clinical and x-ray anatomical investigation. Acta Orthop Scand 1964; 68 (suppl.): 1.
Wiberg G: Roentgenographic and anatomic studies on the femoro-patellar joint. Acta Orthop Scand 1941; 12: 319–410.
Schultzer SF, Ramsby GR, Fulkerson JP: Computed tomographic classifications of patellofemoral pain patients. Orthop Clin North Am 1986; 17: 235.
Keene GCR, Marans HJ: Osteotomy for patellofemoral dysplasia, in Fox JM, Del Pizzo W (eds.): The Patellofemoral Joint. New York, McGraw-Hill Book Co., 1993, pp. 169–176.
Ficat P: Pathologie Femoro-Patellaire. Paris, Masson et Cie, 1970.
Pollard A: An old dislocation of the patella reduced by an intraarticular operation. Lancet 1891; 1: 988.
Graser E: Behandlung der Lux. pat. inveterata durch Osteotomie am Femur mit Drehung der Epiphyse. Verh Dtsch Ges Chir 1904;33:II:457–466.
Luxembourg H: Zur Behandlung der habit. Pat Lux Med Klin 1914; 10:I:1013–1014.
Albee FM: The bone graft wedge in the treatment of habitual dislocation of the patella. Med Rec 1915; 88: 257–259.
Brissard P: Tactique op. dans le traitement des lux cong. et recidiv. de la rotul. Acta Orthop Belg 1950; 16: 452–456.
Morscher E: Osteotomy of the patella in chondromalacia preliminary report. Arch Orthop Trauma Surg 1978; 92: 139–147.
Peterson L, Karlsson J, Brittberg M: Patellar instability with recurrent dislocation due to patellofemoral dysplasia results after surgical treatment. Bull Hosp Jt Dis 1988; 48: 130–138.
Arnoldi CC, Lemperg RK, Linderholm H: Interosseous hypertension and pain in the knee J Bone Joint Surg 1975; 57B (3): 360–363.
Arnoldi CC, Lemperg RK, Linderholm H: Immediate effect of osteotomy on the intramedullary pressure of the femoral head and neck in patients with degenerative osteoarthritis. Acta Orthop Scand 1971; 42: 454–455.
Björkstrom S, Goldie IF, Wetterquist H: Intramedullary pressure of the patella in chondromalacia. Arch Orthop Trauma Surg 1980; 97: 81–85.
Nerubay J, Katnelson A: Osteotomy of the patella. Clin Orthop 1986; 207: 103–107.
Morscher E: Indikation und moglichkeiten der patella-keilosteomie. Orthopade 1985; 14: 261–265.
Peccina M: Longitudinal osteotomy of the patella and anterior displacement of the patella one stage procedure, in 16th Congress London 1984—poster presentation.
Hejgaard N, Arnoldi CC: Osteotomy of the patella in the patella pain syndrome. Int Orthop 1984; 8: 189–194.
Deliss L: Coronal patellar osteotomy: Preliminary report of its use in chondromalacia patellae. Proc R Soc Med 1977; 70: 257–259.
Vaguero J, and Arriaza R: The patella thinning osteotomy. Int Orthop 1992; 16: 372–376.
Paar O: Vertiefung der trochlea femoris und osteotomie der patella als mögliche kausale therapie der rezidivierenden traumatischen patellaluxation. Unfallchirurgie 1987; 90: 435–440
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Nagel, A., Scuderi, G.R. (1995). Osteotomy of the Patellofemoral Joint. In: Scuderi, G.R. (eds) The Patella. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-4188-1_12
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DOI: https://doi.org/10.1007/978-1-4612-4188-1_12
Publisher Name: Springer, New York, NY
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