title: Histologic retinacular changes associated with ischemia in painful patellofemoral malalignment.
abstract: Ischemic changes in 31 samples of lateral retinacula excised at surgical realignment in patients with isolated symptomatic patellofemoral malalignment resistant to conservative treatment were evaluated with conventional histology, electron microscopy, immunohistochemistry, and molecular biology. Morphologic and ultrastructural changes associated with ischemia including hypervascularization and increased vascular endothelial growth factor release were identified in painful patellofemoral malalignment. It is hypothesized that periodic short episodes of ischemia could be implicated in the pathogenesis of anterior knee pain in most cases of isolated symptomatic patellofemoral malalignment in active young patients by triggering neural proliferation.
authors.affiliation: Department of Orthopedic Surgery, Hospital Arnau de Vilanova,Valencia, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Sanchis-Alfonso
authors.forename: Esther
authors.initials: E
authors.lastname: Roselló-Sastre
authors.forename: Fernando
authors.initials: F
authors.lastname: Revert
authors.forename: Almudena
authors.initials: A
authors.lastname: García
mesh_terms: D000293:Adolescent; D000328:Adult; D001808:Blood Vessels / Q000473:pathology; D005260:Female; D005347:Fibroblasts / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D007511:Ischemia / Q000378:metabolism / Q000473:pathology*; D008297:Male; D046788:Patellofemoral Pain Syndrome / Q000378:metabolism / Q000473:pathology*; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
chemical_list: D042461:Vascular Endothelial Growth Factor A