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Classification of trochlear dysplasia as predictor of clinical outcome after trochleoplasty.
[trochlear dysplasia]
Sulcus-deepening
trochleoplasty
restores
the
trochlear
groove
in
patients
with
patellofemoral
instability
and
underlying
trochlear
dysplasia
.
There
are
types
of
dysplasia
both
with
(
B
and
D
)
and
without
(
A
and
C
)
a
supratrochlear
spur
.
The
aim
of
this
study
was
to
identify
influencing
factors
for
the
clinical
outcome
following
trochleoplasty
.
Forty
-
four
knees
in
38
patients
who
underwent
trochleoplasty
for
instability
(
type
A
in
9
,
B
in
15
,
C
in
9
and
D
in
11
knees
)
were
assessed
clinically
with
the
Kujala
score
and
radiologically
with
radiographs
and
MRI
.
The
median
follow-up
was
4
(
2
-
7
.
8
)
years
.
At
follow-up
,
the
median
Kujala
score
had
improved
from
68
(
29
-
84
)
to
90
(
42
-
100
)
points
(
P
<
0
.
001
)
.
Instability
(
P
<
0
.
001
)
and
pain
(
P
=
0
.
027
)
decreased
significantly
,
but
in
3
knees
,
pain
was
worse
postoperatively
.
Twenty
-
seven
knees
were
ranked
as
excellent
,
10
as
good
,
2
as
fair
and
5
as
poor
.
Overall
,
dysplasia
types
B
and
D
benefited
more
from
surgery
than
types
A
and
C
.
The
postoperative
MRI
revealed
no
chondrolysis
or
subchondral
necrosis
,
but
deterioration
of
cartilage
on
the
lateral
trochlear
facet
was
identified
.
Trochleoplasty
is
a
useful
and
reliable
surgical
technique
to
improve
patellofemoral
instability
in
patients
with
a
dysplastic
trochlea
.
While
improved
stability
is
predictable
,
pain
is
less
predictable
and
may
even
increase
following
surgery
.
The
overall
results
were
directly
dependent
on
the
type
of
the
dysplasia
,
with
a
significantly
better
clinical
outcome
in
type
B
and
D
.
The
clinical
relevance
of
this
study
is
that
severe
dysplasia
can
successfully
be
treated
with
trochleoplasty
.
III
.
Diseases
Validation
Diseases presenting
"pain"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
adrenomyeloneuropathy
aniridia
aromatase deficiency
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital diaphragmatic hernia
congenital toxoplasmosis
cushing syndrome
cutaneous mastocytosis
cystinuria
dedifferentiated liposarcoma
dentin dysplasia
dracunculiasis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
fabry disease
familial mediterranean fever
focal myositis
hirschsprung disease
hodgkin lymphoma, classical
holt-oram syndrome
junctional epidermolysis bullosa
kabuki syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
malignant atrophic papulosis
neuralgic amyotrophy
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
phenylketonuria
pleomorphic liposarcoma
primary hyperoxaluria type 1
proteus syndrome
pyomyositis
scrub typhus
sneddon syndrome
systemic capillary leak syndrome
thoracic outlet syndrome
trochlear dysplasia
typhoid
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
wolf-hirschhorn syndrome
This symptom has already been validated