The construction of one-bone forearm with side-to-side distal radioulnar bifurcation synostosis operation for congenital pseudarthrosis of the radius

The congenital radius pseudarthrosis is a rare condition which’s treatment is difficult. There were many reported surgical options for this situation. One of them is construction of one-bone in forearm. Here, we presented a seven years-old boy who has instability and defective congenital radius pseudarthrosis in forearm that treated with side-to-side distal radioulnar bifurcation synostosis technique preserving the distal radioulnar joint, and obtained good functional results

Outcomes of the chondral lesions of knee treated by microfracture technique and effective factors on the results

Objectives: The aim of this study was to evaluate the results of the microfracture technique in the treatment of chondral lesions.Materials and methods: A retrospective study was performed in 26 patients who had treated by arthroscopic microfracture technique for chondral lesions in the femoral condils between January 2003 and 2007september in our department. There were 11 females and 15 males with mean age of 37.2 years (range from 23 to 56 years). The average time between beginning of complaints and operation were 9.7 months (range from 3 to 35 months). The average of chondral lesions size were 1,6 cm2 (range from 0.7 to 2.4 mm2). The average follow-up period was 24.3 months (ranged from 10 to 44 months). Patients assessed according to subjective patient satisfaction and Lisholm scale at preoperative and postoperative time.Results: The mean Lysholm score increased from a preoperative 56.9 (range from 43 to 72) to a postoperative 77.9 (range from 62 to 100) (p<0.05). The rating was excellent in 9 patients (34.6%), good in 7 (27%) and fair in 10 (38.4%) according to Lysholm scale. All patients were satisfied with their knee function. The results of MRI taken at postoperative sixth month were proportional with patient’s satisfaction and Lysholm scores.Conclusion: Patients with excellent or good results had short symptom period, small chondral lesion and young age. Applied early microfracture technique in treatment of chondral lesions was a low cost, effective and successful treatment modalit

A neglected case of giant synovial chondromatosis in knee joint

Synovial chondromatosis is a rare benign condition arising from the synovial membrane of the joints, synovial sheaths or bursae around the joints. Primary synovial chondromatosis typically affects the large joints in the third to fifth decade of life. The purpose of this case report is to document this rare synovial pathology, which required open synovectomy and debridement to eradicate it. In our case, the biggest sized SOC was 20x19x6 cm, although there were many joint mice. Our case had the biggest SOC ever extracted, which to the best of my knowledge has not been reported earlier.Key words: Synovial chondromatosis, giant, loose body, knee Joint, surger

Periprosthetic proximal medial femoral cortical destruction caused by a femoral arterial pseudoaneurysm

WOS: 000366562000001PubMed: 26719683A femoral artery aneurysm is a very rare complication of hip surgery treatment. In this presentation, we report a rare case of bone destruction caused by the femoral artery aneurysm after a hip hemiarthroplasty operation as a late stage complication. A 77-year-old male patient presented with swelling and pain in the hip without any signs of ischemia. X-ray showed a 7 cm bone destruction in the medial cortex of the proximal femur. After ultrasound imaging, a femoral artery aneurysm was diagnosed. The patient was operated on by vascular surgeons, and a large amount of organized hematoma with artery aneurysm was removed. The diagnosis of femoral aneurysm after hip surgery treatment can be difficult. Femoral aneurysm is rare and usually secondary to trauma, infection, or iatrogenic injury. We assumed that this case occurred during the hemiarthroplasty operation, caused by a compressing effect to the bone causing destruction. The patient was followed for 2 years, during which time the preoperative symptoms reduced dramatically and Harris Hip Score improved. After a hip arthroplasty operation, it must be kept in mind that a femoral arterial aneurysm can cause persistent symptoms. This case illustrates the importance of considering a pseudoaneurysm as a possible cause of periprosthetic osteolysis, particularly if rapid progressive growth has occurred. If this vascular injury had not been correctly diagnosed, the method of treatment could have been much different, probably with catastrophic consequences

Does the location of placement of meniscal sutures have a clinical effect in the all-inside repair of meniscocapsular tears?

Abstract Background Meniscocapsular separation (MCS) is a lesion of the area which is attached from the peripheral section of the meniscus to the capsule and is seen less often than other meniscus injuries. The aim of this study was to investigate which of the different side applications of all-inside MCS repair of the meniscus was better in respect of clinical and functional results. Methods In this retrospective study, 53 patients with MCS pattern in their knee joints were treated with arthroscopic meniscus repair made with the all-inside method. The patients were separated into three groups according to the surface from which the fixation was applied: group 1, from the femoral joint surface of the meniscus (n = 17), group 2, from the tibial joint surface of the meniscus (n = 21) and group 3, from the femoral and tibial joint surfaces of the meniscus (n = 15). The participants were assessed using the subjective International Knee Documentation Committee Scoring (IKDC), Lysholm Knee Scale, Tegner Activity Level Scale, Barrett criteria and Kellgren–Lawrence classification after a 45 ± 12.1 months (range, 24–70 months) follow-up. Results Postoperatively, all the groups exhibited significantly increased subjective IKDC score, Lysholm score and Tegner activity score compared with their preoperative results (p < 0.001). At 6 months postoperatively, a statistically significant difference was determined between the groups in respect of the subjective IKDC score, Tegner activity score and Lysholm score with group 2 showing better results than the other groups (p < 0.001). At the final follow-up examination, no statistically significant difference was determined between the groups in respect of the subjective IKDC score, Tegner activity score or Lysholm score. A statistically significantly lower level of pulling and stress sensation was determined in group 2 (p < 0.001). Conclusions MCS repair made with the all-inside method is successful clinically and functionally and in respect of MRI findings. In addition, it was seen that the fixation method applied from the tibial surface of the meniscus does not disturb the anatomic position of the meniscus in MCS repair. The tibial joint surface is the most appropriate area for suturation in all-inside repair of MCS. Level of evidence Level IV

Repair of isolated horizontal meniscal tears with all-inside suture materials using the overlock method: outcome study with a minimum 2-year follow-up

WOS: 000386308300001PubMed: 27793159Background: This study aimed to consider the use of a meniscal repair in patients in order to close the horizontal cleavage extending up to the avascular zone. The hypothesis was to examine the clinical and arthroscopic outcomes following meniscal repair of degenerative horizontal cleavage tears with new-generation all-inside suture materials using the overlock method. Methods: We retrospectively reviewed a consecutive series of 55 patients which had a horizontal pattern, and finally, 27 patients with a horizontal tear only which required no additional intra-articular surgical intervention were included in the study. Arthroscopic meniscal repair was performed using the overlock method. Functional outcomes were evaluated using Lysholm knee scoring scale, Cincinnati scores, subjective International Knee Documentation Committee (IKDC) criteria and Tegner activity scale. Assessment of meniscal healing was evaluated clinically by the presence of meniscal signs. The preoperative and postoperative MRIs were examined. Results: The mean follow-up period was 29 months (range, 24-38). The mean Lysholm score improved significantly from 59.5 +/- 12.4 points preoperatively to 90.0 +/- 4.7 points postoperatively (P < 0.0001). The Cincinnati score increased from 14.8 +/- 5.3 to 26.9 +/- 1.6 (P < 0.0001). The Tegner activity score increased from 3.7 +/- 1.4 to 6.4 +/- 1. 6 (P < 0.0001). The mean IKDC subjective score also improved significantly from 48.5 +/- 9.8 preoperatively to 90.4 +/- 5.0 postoperatively (P < 0.0001). Conclusion: Meniscal repair of degenerative horizontal tears using the overlock method resulted in improved Lysholm and IKDC subjective scores. With careful selection of the patients and the horizontal meniscus tears, the success of the meniscus repairs increases. Repair can be recommended for all horizontal meniscus tears which can be repaired arthroscopically