Intra - Osseous Venography in Patellofemoral Disorders
نویسنده
چکیده
Patients with severe degenerative osteoarthritis of the hip and knee have impaired venous drainage from the juxtachondral cancellous bone across the cortex (M#{233}riel et a!. 1955; Phillips 1966; Arlet, Ficat and Sebbag 1 968; Arnoldi, Linderholm and MUssbichler 1 972). Intra-osseous phlebography will demonstrate the absence of the normal drainage pattern, with delayed emptying of the contrast medium from the medullary cavity. Brookes and Helal (1968) found that in rats increased trabeculation of bone and calcification of the articular cartilage appeared as a consequence of chronic venous congestion, and suggested that this might be the precursor of osteoarthritis. Primary or secondary venous engorgement and intra-osseous hypertension play a significant role in the aetiology of pain in osteoarthritis. Arnoldi, Lemperg and Linderholm (1971) demonstrated a reduction in intra-osseous pressure following osteotomy of the femur, and Morscher (1978) noted that pain was produced when intra-osseous phlebography was performed under local anaesthesia. We have investigated the state of the venous drainage of the patella in patients with chondromalacia patellae and patellofemoral osteoarthritis. We agree with the view of Shoji, Sakai and Granda (1 974) and of Mankin (1 976) that chondromalacia patellae is an early stage in the development of patellofemoral arthritis.
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