The purpose of the Initiative is to assist regulators in determining whether and how gas production from the Marcellus Shale and other shale formations in Maryland can be accomplished without unacceptable risks of adverse impacts to public health, safety, the environment, and natural resources.
The Patella fracture may consist of a single crack across the kneecap or the kneecap may be broken into several pieces, in what is known as a 'stellate' fracture. In some instances a forceful contraction of the Quadriceps muscles can be enough to cause a fracture of the patella. This causes a horizontal crack across the knee cap, which makes it impossible for the patient to straighten their knee.
Most surgeons agree, if the kneecap dislocates multiple times, then surgery should be considered. When the kneecap dislocates, it is possible to damage the cartilage in the knee, leading to an increased risk of knee arthritis. When multiple dislocations occur, patellar stabilization surgery should be considered.