1/9. Ultrastructure of the haemophilic synovial membrane and electron-probe X-ray analysis of haemosiderin.An ultrastructural study of the haemophilic synovial membrane revealed the presence of solitary siderosomes, compound siderosomes and a peppering of the cell cytoplasm with electron-dense particles. These changes were found in synovial intimal cells, subsynovial macrophages and fibroblasts. Electron-probe X-ray analysis of siderosomes revealed the presence of iron and traces of phosphorus. On the basis of previous and present studies it is postulated that haemosiderin is essentially a condensate of hydrated ferric oxide and that a variable amount of phospholipid material lies in company with it in the siderosome.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
2/9. Successful arthroscopic treatment of pigmented villonodular synovitis of the knee in a patient with congenital deficiency of plasminogen activator inhibitor-1 and recurrent haemarthrosis.We report the arthroscopic treatment of pigmented villonodular synovitis (PVNS) in a 13-year-old Japanese boy with congenital partial deficiency of plasminogen activator inhibitor-1 (PAI-1). He was admitted to our hospital with recurrent haemarthrosis of his right knee. Characteristic abnormalities of fibrinolysis included shortened euglobulin lysis time, low PAI-1 activity and low PAI-1 antigen levels. In addition, levels of "active PAI" in the plasma, which is a measure of total PAI bound to exogenous plasminogen activator, were very low. These parameters remained low after venous occlusion. The diagnosis of PVNS was established by synovial membrane biopsy, and arthroscopic synovectomy was performed with adjuvant administration of intravenous tranexamic acid. Subsequent bleeding episodes have been well controlled by oral administration of tranexamic acid on demand.- - - - - - - - - - ranking = 0.2keywords = membrane (Clic here for more details about this article) |
3/9. Successful use of ReFacto continuous infusion in two paediatric patients with severe haemophilia A undergoing orthopaedic surgery.In this report we describe the successful use of B-domain-deleted recombinant factor viii (ReFacto) administered by continuous infusion during orthopaedic procedures in two children with severe haemophilia A. Both patients underwent ankle synovectomy and in patient 2, a medial patello-femoral ligament repair was performed in the same operative session. Patient 2 developed septic arthritis A in his knee joint and arthroscopic joint irrigation and debridement was performed 2 weeks after the initial procedure. Surgical cover was initiated with a bolus dose of ReFacto 50 IU kg(-1) followed by continuous infusion at 3.3-4.8 IU kg(-1) h(-1) which was maintained for up to 9 days postoperatively. Patient 2 received an additional bolus dose of 15 IU kg(-1) during the infusion period. All procedures were performed without haemostatic complications and long-term orthopaedic outcomes were good in both patients.- - - - - - - - - - ranking = 68.717885007533keywords = ligament (Clic here for more details about this article) |
4/9. Delayed recurrent hemarthrosis after staple fixation of tibial avulsion fracture of the posterior cruciate ligament: a case report.This study reports a case of unusual vascular complication related to the staple fixation for the tibial avulsion fracture of the posterior cruciate ligament (PCL). The patient, who experienced recurrent hemarthrosis 12 months after staple fixation for the avulsion fracture of the PCL, was successfully managed by removing the staple and suturing the bleeding focus of the popliteal artery. Injury to the popliteal artery by the prominent staples could be the culprit causing the recurrent hemarthrosis. This type of delayed popliteal artery injury should be kept in mind in open reduction and internal fixation for the tibial avulsion fracture of the PCL.- - - - - - - - - - ranking = 343.58942503767keywords = ligament (Clic here for more details about this article) |
5/9. Segond fracture, hemarthrosis, and anterior cruciate ligament disruption.A case of anterior cruciate ligament disruption in a patient with an avulsion fracture of the lateral proximal tibia is presented. The "Segond" fracture is an unusual fracture that is important to recognize because it is often associated with anterior cruciate ligament disruption and anterolateral instability. These injuries are usually best treated by early surgical repair.- - - - - - - - - - ranking = 412.3073100452keywords = ligament (Clic here for more details about this article) |
6/9. hemarthrosis as the presenting manifestation of true myeloma joint disease.This is the first reported of a patient with hemarthrosis due to invasion of the synovial membrane by myeloma cells. With angiographic studies of the affected joint it was apparent that the tumor tissue extended from the destructive bone lesion of the femoral condyle into the synovial membrane. Intraarticular spontaneous bleeding was the first manifestation of a monoclonal IgG multiple myeloma; the hemarthrosis recurred after drainage but was controlled with local roentgen therapy.- - - - - - - - - - ranking = 0.4keywords = membrane (Clic here for more details about this article) |
7/9. Acute traumatic knee hemarthrosis.A rapidly developing hemarthrosis in an acutely injured knee is reported to be associated with "surgically significant" lesions, such as anterior cruciate ligament tears, meniscus tears, and osteochondral fractures, in < or = 90% of cases. We report two cases of adult men who showed signs of such acute hemarthroses in stable knees after significant trauma. Neither had significant intraarticular pathology, such as meniscal, articular, or ligamentous injury, at arthroscopy. Persistent postarthroscopic bleeding led to additional diagnostic testing that found mild factor viii deficiency. hemophilia a and other clotting disorders should be considered by arthroscopic surgeons as a possible cause of a posttraumatic hemarthrosis.- - - - - - - - - - ranking = 137.43577001507keywords = ligament (Clic here for more details about this article) |
8/9. Recurrent acute hemarthrosis after anterior cruciate ligament reconstruction. Report of an unusual complication and a review of the literature.Arthroscopic-assisted and endoscopic operative techniques have allowed for less and less restrictive postoperative rehabilitation programs after cruciate ligament reconstruction. Accelerated rehabilitation programs may, however, also provoke mechanical problems at the transplant-bone interface, as reports in the literature of loosened fixation devices and loosened or even fractured bone pegs with subsequent hemarthrosis and recurrent instability have shown. We describe the case of a patient who presented with recurrent acute hemarthrosis after anterior cruciate ligament reconstruction without additional trauma and without instability. However, the symptoms and signs were clearly related to the fixation method employed.- - - - - - - - - - ranking = 412.3073100452keywords = ligament (Clic here for more details about this article) |
9/9. Open synovectomy for the prevention of recurrent hemarthrosis of the ankle in patients with hemophilia. A report of five cases with magnetic resonance imaging documentation.Hemophilic arthropathy is an incapacitating complication of severe hemophilia resulting from recurrent bleeding in the same joint. Open synovectomy has been used since 1969 to prevent recurrent hemarthrosis of target joints. Between 1988 and 1993 we performed open synovectomy of the ankle in five hemophiliacs aged 6 to 9 years with early-stage hemophilic arthropathy. magnetic resonance imaging proved very useful for evaluating the severity of joint damage, usually underestimated on plain radiographs; for determining the degree of synovial membrane hypertrophy, which is a critical factor in the decision to perform synovectomy; for planning the surgical procedure and for explaining treatment failures. A decrease in the frequency of hemarthrosis episodes occurred in all five ankles. A repeat synovectomy was needed in one case and in another patient the frequency of hemarthrosis episodes increased somewhat after the fourth year. There was no loss of range of motion. Our data suggest that open synovectomy is effective and safe for reducing the frequency of hemarthrosis and that magnetic resonance imaging should be routinely performed before the procedure.- - - - - - - - - - ranking = 0.2keywords = membrane (Clic here for more details about this article) |