My name is Lakitta Beverly. I am a junior at Mississippi State University majoring in Kinesiology with a concentration in CLEP (Clinical Exercise Physiology). Throughout high school, I experienced patellar dislocation, which is the topic for today’s Technical Research Report. Patellar dislocation is an injury of the knee. Typically, it is caused by a direct blow or a sudden twist of the leg. It occurs when the patellar slips out of its normal position in the Patellofemoral groove and causes intense pain and swelling of the knee. Patellar dislocation can be characterized as objective patellar instability, potential patellar instability, and episodic patellar instability. (Cerciello, 1) Episodic patellar instability is one of the major categories …show more content…
of patellar instability that will be emphasized the most. It is one or more patellar dislocation with no major damage to the patellofemoral joint. (Cerciello, 1) Patellar dislocation is most frequently associated with sporting and physical activities because of the stress placed on the knee during rotation. Furthermore, there are some factors that put you at risk for experiencing patellar dislocation. The factors are as follows: Patellar dysplasia, genu valgum, muscular imbalance of the thigh, malposition of the patellar after trauma, decentering of the patellar, abnormality high level of the patellar, and an abnormality of the sliding groove of the patellar. (Panni, 1) Even though there is a disagreement about the causes of patellar dislocation, patients who experience recurrent episodes should receive operative treatment. Types of Treatments for Patellar Dislocation: There are two kinds of treatments for patellar dislocation: Operative and Non-operative treatments. Operative treatments can also be called surgeries. These surgeries can be used to fix problems of the knee. Sprains, strains, ligament tears, breaks, damages to the meniscus, and patellar dislocations are a few examples of problems of the knee. Non-operative treatments are measures that you can take to prevent the chance of surgery. Physical therapy, exercises, braces, and patellar taping are some of the measures that can be used to prevent patellar dislocation. Operative Treatment: There are four kinds of operative treatments: Lateral Release, Medical Imbrication, Medial Patellofemoral Ligament Repair/ Reconstruction, and Bone Realignment. The first operative treatment is Lateral Release. Lateral Release is the simplest most common performed surgery that addresses patellar dislocation. The surgeon will loosen the pull to the outside and better center the patella within the patellofemoral groove. The patella is rotated and elevated up to 90 degrees in relation to the epicondyle axis. (Hinckel, 4) The second operative treatment is Medial Imbrication. It is the most common method of tightening the medial side of the knee. During the procedure, the surgeon tightens the tissue on the inner side of the knee to advance the attachment of the quadriceps muscles. The third operative treatment is Medial Patellofemoral Ligament Repair or Reconstruction. It is the most modern procedure being performed. A new ligament is made using other ligaments or tendons from elsewhere in the body. The fourth operative treatment is Bone Realignment. It is also known as Fulkerson Procedure. During this procedure, the extremities of the knee are realigned. Non-Operative Treatments: Non-operative treatments consist of physical therapy, ice and heat application, Electrical Stimulation, Braces and Patellar taping.
The first non-operative treatment is physical therapy, which is the treatment of disease, injury, or deformity by physical methods. The methods include massages, heat treatments, and different exercises. The second non-operative treatment is ice and heat application. This method includes the use of ice and heat to stimulate blood flow and decrease swelling. The use of ice applied with compression and elevation treat patellar dislocation. (Arbuthnot, 1) In the same way, Heat is also used. Heating therapies are considered to be superficial or deep. Deep heating involves conversion of energy from one form to another within the tissues such as acoustic energy or diathermy. Superficial heating occurs by conduction such as hot pack, hot spa, and radiation. (Arbuthnot, 2) The third non-operative treatment is electrical stimulation. Electrical stimulation is a therapy that passes an electrical current to an affected area of the body. This type of stimulation alters muscle’s contractility which then increases blood flow to the tissues of the thigh. The picture below shows a patient who is receiving electrical stimulation. The fourth non-operative treatments are braces and patellar taping. Braces are used to restore proper alignment. Similarly, Patellar taping is used to provide stability for the knee. It seems to be a safe and effective way to treat patellar dislocation. (Aminaka,
7) Conclusion: In conclusions, patient should receive operative treatments. Patients who have been treated with non-operative treatments experience recurrent patella dislocations. Because patients have experience re-dislocation, the medial patellofemoral ligament has been stretched out. (Smith, 1) As a result, the percentages of recurrent patellar dislocations have increase. Re-dislocation occur 40 to 60% of the time. (Smith, 2) As shown in the graph below, women experience the most recurrences. The percentage for women who have experienced recurrent patellar dislocation is 54.3% and 45.7% of recurrences are men. In addition to recurrences, age is also a factor. The graph indicates that the average age of recurrences is between 11-56 years old which is 25.9% of people who has experience recurrence. Other researcher such as Dath says that patellar dislocation can also occur when a person trips over an object or slips on a slick surface, especially if that person have predisposing factors. He concluded that the average age of recurrences is between the ages of 16 to 20. (Dath, 1) Patients who received operative treatment for patellar dislocation has a lower risk of recurrences. (Smith, 8) In addition to the lower risk of recurrences, surgeons can go into the knee and fix any damage that is done; they can remove any bone fragments that could have been left behind. Operative treatment is the best for patients who have experience recurrences, especially patients who play sports that requires pivoting, cutting, or jumping. Recommendations Researchers recommend that patient, who has experience recurrent patellar dislocation, receives operative and non-operative treatment. Patient should receive both because operative treatment can be used to fix damages that have been done in the knee and non-operative treatment can be used to strengthen muscles and help the knee remain stable. After operative treatments, patients have to receive non-operative treatment in order to be able to maintain daily activities. Both treatments lower the risk of a patient experiencing recurrent patellar re-dislocation. In other words, one treatment helps the other.
The most common knee injury in sports is damage to the anterior cruciate ligament (ACL) through tears or sprains. “They occur in high demand sports that involve planting and cutting, jumping with a poor landing, and stopping immediately or changing directions” (University of Colorado Hospital). The ACL is a ligament that runs diagonally in the middle of the knee and found at the front of the patellar bone. Its function involves controlling the back and forth motion of the knee, preventing the tibia from sliding out in front of the femur, and providing rational stability to the knee. Interestingly, women are more prone to ACL injuries than men. The occurrence is four to six times greater in female athletes.
Therapeutic stretches of the gastrocnemius and soleus muscles. If the ligament are weakened, cross fiber friction them to try to regain some of the integrity of the ankle back.
Nisell R. (1985) Mechanics of the knee: A study of joint and muscle load with clinical applications. Acta Orthop Scand 216; 1-42.
It is their greatest fear. Bibliography:.. Works Cited A Patient’s Guide to Knee Problems. d. (November 19, 1997). Sechrest, MD: Medical Multimedia Group.
Graston instrument-assisted soft tissue mobilization (GITSM) is a tool used by therapist and chiropractors to help break up the scar tissue and replace it with fibroblast allowing for faster recoveries (Black 2010). A series of heat, GISTM, then strength and flexibility training are required (Black 2010). Numerous studies have been conducted, by certified therapist qualified in GISTM, to examine the styles and recovery periods after an injury. After going through the treatment, patients are measured by their range of motion (ROM) to see if the treatments were effective or not (Black 2010). ROM can vary depending on the region of the body that is being treated, but the overall goal of GISTM is to allow a person to get back to their regular routines they had before their injury. A study conducted by Logan College of Chiropractic shows that plantar fasciitis (foot) can be treated by GISTM on the first day of treatment (Daniels and Morrell 2012). Another study by Duke University shows that GISTM can be effective for patients after surgery that had an injury in the Patellar tendon (knee) (Black 2010). After several treatments, GISTM can, also, be used to treat a compression fracture in the lumbar (back) (Papa 2012). Each study shows the method of GISTM, the patient’s recovery period along with the methods of recovery.
“The purpose of a doctor or any human in general should not be to simply delay the death of a patient, but to increase the person’s quality of life.” Orthopedic surgeons treat a number of conditions that affect the bones, joints, muscles, tendons, and nerves. The training to become an orthopedic surgeon requires multiple years of hard work and studying, but in the end, the success is worth all the stress and struggle experienced on the way. Most doctors must dedicate every fiber of their being, countless hours of work, and years of stress in their chosen profession. Medicine is only for those who can’t imagine doing anything else.
Ligaments are tough, non-stretchable fibers that hold bones together. Damage to cruciate ligaments, which crisscross the knee to give it stability, is one of the most common sports injuries. The “tear” occurs from changing direction rapidly, slowing down from running, or landing from a jump improperly. The A.C.L tear is one injury that worries athletes in all sports at all levels because of its devastating effects. People ages 15-25 that participate in basketball and other sports that require pivoting are especially at risk.
I have chosen to compare a personal story to the story I Am Not a Patella in the book Privileged Presence. I found that these two stories illustrate two completely different approaches to an injury. In the situation in the story I Am Not a Patella, the writer found that she was ignored as a person and she was defined as her injury. In contrast, the doctor attending to my injury took the time to see me as a whole person. I feel personally that the way my injury was handled was much more effective. As a result, a large portion of this paper will discuss the importance of developing a therapeutic relationship with patients. There will also be a focus on treating a patient as a whole person with a life story and a family instead of a collection
An ankle fracture is a break in one or more of the three bones that make up the ankle joint. The ankle joint is made up by the lower (distal) sections of your lower leg bones (tibia and fibula) along with a bone in your foot (talus). Depending on how bad the break is and if more than one ankle joint bone is broken, a cast or splint is used to protect and keep your injured bone from moving while it heals. Sometimes, surgery is required to help the fracture heal properly.
The word patella comes from the great latin language meaning shallow pan or shallow dish. The description of that word could not be more correct, it was meant in reference to balance of food but in anatomy’s case a balance of the body. The patella is a small bone located in front of the knee joint where the thigh bone (femur) and shinbone (tibia) meet. It protects the knee and connects the muscles in the front of the thigh to the tibia. The patella is one of two sesamoid bones found in the body, roughly triangular shaped in size. It’s thick consistency allows for the articulation of the femur, which in turn allows for body support and balance. The patella has multiple body functions with the primary being knee extension. The patella is essential for basic body functions including locomotion;
As we are creating a rehabilitation routine using modalities and therapeutic exercises, we have to remember each athlete is different and find the best option for them. Just as there are several causes of patellofemoral pain, there are several ways to treat and manage the pain, but which treatments are best. You can strengthen the quadriceps muscles specifically the vastus medialis and vastus lateralis or you can focus on strengthening ...
In order to understand how the menisci can be injured, you must understand the basic anatomy of the menisci and why they are important. The menisci are two oval (semilunar) fibrocartilages that deepen the articular facets of the tibia and cushion any stresses placed on the knee joint. They enhance the total stability of the knee, assist in the control of normal knee motion, and provide shock absorption against compression forces between the tibia and the femur (Booher, 2000). Articular cartilage covers the ends of the bones that make up the joint. The articular cartilage surface is a tough, very slick material that allows the surfaces to slide against one another without damage to either surface. This ability of the meniscus to spread out the force on the joint surfaces as we walk is important because it protects the articular cartilage from excessive forces occurring in any one area on the joint surface, leading to degeneration over time (Sutton, 1999).
"Chapter 37." Operative Techniques in Orthopaedic Surgery. Ed. Sam Wiesel. 4th ed. Vol. 2. Lippincott Williams & Wilkins, 2011. eBook.
* Heat and Cold Therapy has been used for centuries to manage soft tissue and joint injuries while relieving pain.
Traumatic injuries seem to occur a lot in the sport of football. Knee injuries seem to be one of the most occurring traumatic injuries in football (Become an Advocate for Sports Safety). The main types of traumatic knee injuries are: tearing/spraining of the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and the meniscus, which is the cartilage that is in the knee (Become an Advocate for Sports Safety). The anterior cruciate ligament (ACL) is a very vital ligament in the knee. It is the main stabilizer of the knee. Surprisingly usually the anterior cruciate ligament is torn from a non-contact twisting of the knee (5 Most Common Football injuries (and How to Prevent Them)). The knee normally pops and it will begin to swell and it may feel unstable (5 Most Common Football injuries (and How to Prevent Them)). Swelling depends on the severity in the tear of the ligament. The anterior cruciate ligament is one of the four main ligaments that provide stability to the knee joint (Common Football Injuries). It is the most important out of the four. Injuries to any of the cruciate ligaments in the knee are most of the time sprains (Common Football Injuries). The anterior cruciate ligament being the most often stretched, strained, sprained or either tore (Common Football Injuries). Most of the knee injuries that occur in footbal...