causes

Patella Baja

Aetiology

Congenital

Acquired

- trauma

- post ACL reconstruction / TKR

- chronic quadriceps rupture

Issues

Decreases ROM

Associated with early OA of the PFJ

Diagnosis

Blackburne-Peel ratio at 30 degrees flexion

Definition

Isolated posterior ligament injuries

- PLL / Posterior interspinous ligament / Paraspinal muscles

Excludes fracture / dislocation / HNP

Aetiology

MVA

Sport

Hyperflexion injuries

Symptoms

Large spectrum clinical presentation

- neck ache 

- nausea & vomiting 

- headache 

- visual symptoms

Definition

Non-union

- arrest of progression to union at fracture site 

- > 6-9 /12

- no visible progressive signs of healing for at least three consecutive months

- individualise for each fracture

- when the surgeon believes the fracture has little or no chance to heal

Delayed union

- failure of fracture to unite within expected time

- still may spontaneously unite

Definition

Neurological pain in arm after injury in sport

- usually due to brachial plexus injury

Epidemiology

Contact sports

- ice hockey

- rugby

- american football

- basketball

Pathology

Brachial plexus injury

Cervical nerve root injury

Aetiology

Traction injury

- hit onto shoulder

Types of Instability

1.  AP Instability

2.  Varus Valgus Instability

3.  Global Instability

4. Frank Dislocation

Definition

Repeated dislocation of patella with minimal trauma

- 15-20% of paediatric acute patella dislocations

- more common girls 

- often bilateral

Dislocation occurs unexpectedly when quadriceps contracted with knee in flexion 

Direction

Indications

1.  Loosening

2.  Infection

3.  Instability

4.  Periprosthetic fracture

Causes

Most common

- fascia lata on greater trochanter

- iliopsoas on lesser trochanter

1.  Intra-articular structures

- labrum

- ligamentum Teres

- loose bodies

- synovial chondromatosis

- osteochondoma

2.  Extra-articular structures

- fascia lata on greater trochanter (common)