The Knee
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Aetiology of Osgood-Schlatter disease (OSD) is still unknown. Relative length of the patellar articular surface with the length of the patella, relative height of the tibial tubercle with the sagittal diameter of the tibia, Insall-Salvati, Blackburne-Peel, and Caton-Deschamps indexes, as well as Grelsamer-morphology type of the patella were measured from preoperative plain X-rays in 82 knees of 20-year-old males with OSD and in 87 knees of 20-year-old male controls with normal MRI findings of the knee. Seventy-eight of the OSD patients had separate ossicles. ⋯ Tibial tuberosity was significantly higher among OSD patients, but was not correlated with the lengthening of the patella. An increased patellar height among OSD patients was shown by the Blackburne-Peel and Caton-Deschamps indexes (p<0.001) and the Insall-Salvati index (p=0.018). OSD patients exhibit elongated patellae and patellar tendons which may result from long-standing tension of the extensor apparatus during growth spurt, when femoral growth exceeds that of the anterior structures of the knee.
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The incidence of periprosthetic supracondylar femoral fractures around total knee arthroplasties (TKRs) is increasing. An acceptable treatment is to insert a supracondylar nail, but not all TKRs will permit this. An unofficial table of compatibilities is available from Smith and Nephew, but this has not been peer reviewed. ⋯ We have found that the notch position, rather than the notch size, was the most important factor in determining nail compatibility. Most of the TKRs commonly used in the UK will allow supracondylar nailing for fixation of periprosthetic fractures. There are, however, notable exceptions and our chart provides a quick and easy reference for knee surgeons involved in these cases.