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A total of 42 cases of patellar pain in subjects aged an average of 17.2 years submitted to arthroscopy are analyzed. Femoropatellar balance, where indicated, led to resolution of disorders with full resumption of sports activity. In the remaining cases chondromalacia showed the features of an affection with a spontaneously favorable course, confirming the common orientation towards conservative treatment. Arthroscopy is effective for a correct classification of cartilaginous lesions, and it is a good instrument to use when attempting to achieve recovery of patellofemoral joint when disorders are caused by a lack of equilibrium.

Relation between quadriceps muscle mass and knee extension strength was investigated after resection of malignant bone tumor and endoprosthetic replacement of the distal femur in 19 patients with patellar resurfacing (Group A) and 16 patients without resurfacing (Group B). In all cases, a modular cementless, hinged prosthesis had been used. Age and follow-up period were comparable in the 2 groups. Muscle mass was measured ultrasonographically and strength was evaluated isokinetically. All the data on the operated side are given as percentage of the non-operated side. There was a positive correlation between muscle mass and strength in both groups. By linear regression analysis, a slightly lower value of strength was predicted in the unresurfaced group than in the resurfaced group. Analysis of covariance revealed that the influence of patellar resurfacing on strength was significant. This factor should also be considered in making a decision about patellar resurfacing with a tumor endoprosthesis.

The results obtained after 4-8 years in 42 patients submitted to arthroscopy for the treatment of medial patellar synovial plica syndrome are analyzed. There was a considerable difference in the values obtained depending on whether the plica was isolated, or associated with meniscal or cartilaginous lesion. In fact, based on the Lysholm score, treatment of isolated plica obtained 17 excellent or good results in 21 patients, while in the 21 cases where the lesion was associated with other pathologies excellent or good results were observed in only 9 subjects. Thus, associated lesions definitely influence long-term results.

A total of 41 patients affected with recurrent subluxations or dislocations of the patella treated with different surgical methods between 1972 and 1981 were examined. Radiographic and clinical monitoring according to Crosby-Insall in 35 patients ranges from 10 to 20 years, with the following results: excellent: 17%; good: 69%; fair: 14%; poor: 0; recurrent dislocations or subluxations: 0.

The adequate treatment for acute patellar dislocation is still controversial. The Authors describe a new surgical arthroscopic technique to repair medial retinaculum rupture, which is the most common lesion in the acute patellar dislocation. Compared to arthrotomy arthroscopic treatment eliminates post-operative pain and shows the same advantages in reducing recurrences.

Traumatic dislocation of the patella is an infrequent occurrence favored by dysplasia of the extensor apparatus of the knee. The problem of diagnosis is at the basis of a choice of treatment, as any pre-existing dysplasia may be worsened by traumatic dislocation. Furthermore, the presence of a patellar or femoral osteochondral fragment, a more frequent finding than is generally believed as demonstrated by arthroscopy, influences surgical treatment. The results of 37 cases are reported, and several details related to surgical method discussed.

An account of the literature data relating to total and partial patellectomy in the management of comminuted kneecap fractures is followed by a theoretical and practical discussion of the pros and cons of the two techniques. It is shown that total resection does not lead to serious functional disturbances in spite of its alteration of the shape of the knee; on the other hand, partial resection, although more in keeping with the physiological situation, may lay the seeds of femoropatellar arthrosis.