ABSTRACT
Background@#The mechanism of injury (MoI) for a patellar dislocation has not been fully established. The aim of this study was to use systematic video analysis to determine the MoI of a patella dislocation. @*Methods@#A systematic search was conducted of three video sharing websites and three popular search engines to identify videos demonstrating a patellar dislocation. Videos were reviewed by three surgeons trained in systematic video analysis, who commented on the position of the lower limb and the situation in which the injury occurred.The results were reviewed to build a consensus of the MoI for each video. Statistical analysis was conducted for interobserver agreement (p < 0.05). @*Results@#Initial search yielded 603 videos with 13 meeting the inclusion criteria. The injuries were sustained performing a sporting activity (n = 9) or whilst dancing (n = 4). The injury was predominantly sustained during a non-contact situation (n = 10). The most common mechanism was an unbalanced individual with a flexed hip sustaining a valgus force to their flexed knee with the tibia externally rotated. @*Conclusions@#This study provides some insight into the MoI for a patellar dislocation and the findings may assist in developing injury prevention programmes and rehabilitation protocols as well as guiding future research.
ABSTRACT
Value of surgery and prognostic indicators for pulmonary metastases were studied to establish appropriate criteria for patient selection influencing long-term survival at Hairmyres Hospital, East Kilbride Glasgow, U.K. Between 1988 and 1996, 28 patients were treated for pulmonary metastases mainly with metastasectomy, 21 patients had resections with curative intent. Unfortunately, 7 patients were unsuitable for surgery. At subsequent relapse, 2 patients had second stage surgery, while 15 patients had adjuvant thera pies [chemotherapy / radiotherapy / combination]. The origin of primary tumor was epithelial in 17 [60.71%; cases, sarcoma in 4[14.29%], germ cell carcinoma in 3[10.71%] melanoma in 1[3.57%], and 3[10.71%] were of unknown histology. Actuarial surival amongst the patients who had resection with curative intent and for incomplete resection, inoperable or unfit patients were 61.9% and 21.5% at Ist year, 23.8% and 8% at 5 year, 14.2% and 3% at 10 years. Overall median survival was 36 months after a mean follow-up of 48 months with the range being 1-98 months and 14 month for lateral group. 4[19%] patients of same group died during follow up with mean survival of 30.7 months. Among formal group, the 5 year survival was 17.8% with disease free interval of > 6 months, and in 3.5% < 6 months respectively. Median survival of 37 months for solitary unilateral lesions, 25 months for multiple / bilateral lesions, 108 months for germ cell tumor, 24 months for other histologies, 36 months with adjuvant therapy and 25 months without such measures. Univariate analysis confirmed that metastasectomy is a safe, potentially curative procedure for better prognosis of solitary metastases disease-free interval [DFI] of > 6 months, germ cell tumor and adjuvant therapy in selected cases