Ultrasonographic study of the femoro-patellar joint and its attachments in infants from birth to 24 months of age. Part II: children with Down syndrome

Abstract

An ultrasonographic study was carried out in 25 infants (50 knees) with Down syndrome, whose age ranged from zero to 24 months, average being 13.2 months; 13 were males and 12 were females. The ultrasonographic investigation was performed with the knee being in full extension for the transversal view and in 30 degrees flexion for the sagittal view. The Insall-Salvati index and femoral cartilaginous sulcus angle were measured. Insall-Salvati index values ranged from 1.06 to 1.15 (average 1.10), with standard deviation of 0.16. No significant differences were observed with regard to Insall-Salvati index values in normal children. The femoral cartilaginous sulcus angle in infants with Down syndrome ranged from 152.7 to 155.8 degrees (average 154.3) with standard deviation of 7.959. In Down syndrome we noticed significant difference as compared to the normal values. The authors suggest that ultrasonography is useful in Down syndrome for an early diagnosis of instability of the patella.

Surgical treatment of patellar dislocation in children with Down syndrome: a 3- to 11-year follow-up study

“…In the initial phases, with low degrees of patellofemoral instability (grade II), no pain, and scarce functional disability, an attempt at physical therapy or bracing is advisable [3], and it results effective in most cases. In most knees presenting with fair or poor ambulatory status, conservative treatment has shown to be ineffective [19], and surgery is indicated: a LRR can be performed [21], as we did in two patients. Nevertheless, the long‐term results reported in the literature for cases of unstable or hypermobile patellae treated by LRR are not satisfactory [6, 23].…”

“…In most knees presenting with fair or poor ambulatory status, conservative treatment has shown to be ineffective [19], and surgery is indicated: a LRR can be performed [21], as we did in two patients. Nevertheless, the long-term results reported in the literature for cases of unstable or hypermobile patellae treated by LRR are not satisfactory [6,23].…”

“…Nevertheless, the importance of early diagnosis [15,21] should be emphasized. In our opinion, clinical examination of knees of children with Down syndrome is primary and should be performed regularly (we suggest every 2 years), particularly evaluating articular excursion of knees and patella, gait, pain, occurrence and frequency of falls.…”

Controle postural em indivíduos portadores da síndrome de Down: revisão de literatura

“…O fenótipo é variável, afetando diferentes sistemas e tecidos. Dentre as alterações musculoesqueléticas destacam-se a irregularidade da densidade óssea, hipoplasia da cartilagem, baixa estatura e frouxidão ligamentar 2 . Em relação ao sistema nervoso central, observam-se menor volume total do cerebelo, alterações celulares na região do hipocampo e redução das sinapses no córtex temporal 3 .…”

Evaluation of muscle using electromyography in patients with Down syndrome undergoing hippotherapy

“…Essas alterações podem influenciar a capacidade de gerar torque articular e força em contrações isocinéticas. O déficit de força muscular também pode influenciar a habilidade de realizar tarefas diárias, como a manutenção do equilíbrio, marcha e postura 6 . As alterações posturais na SD também ocorrem pela dificuldade de percepção das respostas posturais, o que prejudica a sensação do movimento de maneira correta 5 .…”