1/15. Femoral interference screw divergence after anterior cruciate ligament reconstruction provoking severe anterior knee pain.An unusual case of anterior knee pain after anterior cruciate ligament reconstruction secondary to femoral screw divergence is described. We hypothesize that a contracture of the lateral head of the gastrocnemius, caused by irritation from the femoral screw, could increase the patellofemoral joint reaction. This would contribute to increasing the overload of the subchondral bone, which could explain the anterior knee pain. Conversely, tight gastrocnemius may lead to an increase in foot pronation of the subtalar joint, resulting in an increased valgus vector force at the knee, which can cause anterior knee pain. Finally, dorsiflexion of the talocrural joint will also decrease if the gastrocnemius is tight, provoking biomechanical limitations and possible knee problems during walking and running.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
2/15. Intracarpal synovitis related to Dacron interposition after trapeziectomy: a report of three cases.To prevent the mechanical consequences of trapeziectomy, interposition devices are promoted, such a Dacron spacer. We report three cases of osteolysis and synovitis related to the use of such a device. This phenomenon occurred 4 months after insertion and required revision surgery after 9 months of follow-up because of pain and extensive osteolysis of the carpal bones. Revision consisted of an extended synovectomy, removal of the broken Dacron followed by a ligamentoplasty using the Flexor Carpi Radialis. Two years after revision surgery the result was satisfactory, with no recurrence of pain or osteolysis. The Dacron device did not demonstrate improvement in clinical results after short-term follow-up when compared to conventional ligamentoplasty. We recommend cautious use of the Dacron device at trapeziectomy and attention must be paid to follow up of the patient.- - - - - - - - - - ranking = 0.4keywords = ligament (Clic here for more details about this article) |
3/15. The clinical and diagnostic imaging findings of osteosarcoma of the jaw.OBJECTIVE: To clarify the valuable clinical features and diagnostic imaging findings regarding the diagnosis of osteosarcoma of the jaw (OSJ). MATERIALS AND methods: The initial symptoms and diagnostic imaging findings of 10 patients with OSJ were analysed. The points analysed on the diagnostic images were as follows: any widening of the periodontal ligament space of the teeth on the periphery of the OSJ; the presence of radial spicules and Codman's triangle; any signs of bone destruction; and the patterns of osteogenesis. RESULTS: All patients had pain and/or swelling of the affected site, and all OSJs, except for one edentulous case, showed a widening of the periodontal ligament space of the teeth on the periphery of the OSJ. Radial spicules or Codman's triangle were observed in only three cases (30%). Four out of five mandibular OSJs were osteolytic or osteolytic dominant with bone destruction, while, in contrast, four out of five maxillary OSJs were osteogenic or osteogenic dominant, and three out of the four maxillary OSJs did not show bone destruction. The osteogenic OSJ without bone destruction was similar to some benign cemento-osseous lesions of the jaw and thus was difficult to diagnose as OSJ based on the diagnostic imaging findings alone. CONCLUSION: Even though some OSJ showed features similar to the benign tumours of the jaw bone based on the diagnostic imaging findings, the pain and swelling of the affected site, and the widening of the periodontal ligament space of the teeth on the periphery of OSJ were considered to be common findings, which may help in making an accurate diagnosis of OSJ in this limited series.- - - - - - - - - - ranking = 0.6keywords = ligament (Clic here for more details about this article) |
4/15. Early aseptic loosening of a total knee arthroplasty due to Gore-Tex particle-induced osteolysis.anterior cruciate ligament reconstruction with the use of synthetic graft material has been used as an alternative to biologic grafts. The use of these grafts has largely been abandoned in reconstruction of the anterior cruciate ligament because of mechanical failure of the graft and production of wear debris leading to synovitis and recurrent effusions. This article presents a case of early, extensive periprosthetic osteolysis around a total knee arthroplasty associated with wear debris from retained fragments of a Gore-Tex (WL Gore and associates, Inc, Flagstaff, Ariz) (polytetrafluoroethylene) anterior cruciate ligament graft.- - - - - - - - - - ranking = 0.6keywords = ligament (Clic here for more details about this article) |
5/15. Rapidly destructive coxarthrosis--a report of a patient with "strip-mining" and "interior crumbling" of bone architecture.The pathomechanism of rapidly destructive coxarthrosis has not been clarified. Interesting findings were obtained in specimen from a 64-year-old male patient, i.e., the break-down (crumbling) of the internal structure of osteonal bone and superficial strip-mining of the femoral head. The detritic fragments and hydroxyapatite crystals were mainly deposited in the pocket of the joint capsule and some of them were embedded beneath the synovial membrane. We conjecture that apatite-associated destructive arthritis and/or detritic synovitis might accelerate the progression of rapidly destructive coxarthrosis.- - - - - - - - - - ranking = 0.0012462351136383keywords = membrane (Clic here for more details about this article) |
6/15. Endosteal erosion in association with stable uncemented femoral components.Sixteen cases of patients who had focal femoral osteolysis after total hip replacement without cement were identified. Fourteen of them were included in a retrospective review of 474 consecutive total hip replacements without cement in 441 patients who had been followed for at least two years. The criteria for inclusion in the study were focal osteolysis with a femoral component that appeared stable radiographically, and no subsidence or change of position of the implant. All but two patients were men and were quite active. The average age was forty-seven years (range, twenty to sixty-five years). Fourteen of the sixteen patients had an excellent clinical result (a Harris hip score of 90 points or more). In two patients, the hip replacement was revised and, in a third, a biopsy was done. In all three patients, the implant was found to be firmly fixed to the femur. In the two hips that were revised, extensive ingrowth of bone was demonstrated histologically, there was no evidence of infection, and a well defined fibrous membrane was found around the smooth portion of the stem. The histological specimens from these two hips contained focal aggregates of macrophages with particulate polyethylene and metallic debris. In the biopsy material from the hip that was not revised, a fine fibrous membrane lined a cystic cavity. Although the membrane contained an occasional macrophage, no foreign material was identified. Trabecular microfracture and osteoclastic resorption of bone were seen next to the fibrous lining. With one exception, osteolysis was not identified less than two years postoperatively. In most patients, osteolysis appeared after three years. This study showed that femoral osteolysis can occur around uncemented components.- - - - - - - - - - ranking = 0.003738705340915keywords = membrane (Clic here for more details about this article) |
7/15. Atraumatic osteolysis of the distal clavicle: histologic evidence of synovial pathogenesis. A case report.osteolysis of the distal clavicle was diagnosed in a young male athlete following many years as a baseball pitcher with a supplementary weightlifting program. There was no history of ligamentous injuries, contusions, fractures or separation of the acromioclavicular joint. As such, this case was categorized as "atraumatic" osteolysis. Non-decalcified histologic sections from the resected clavicle suggest that the pathogenesis of this atraumatic osteolysis arose from the synovium.- - - - - - - - - - ranking = 0.2keywords = ligament (Clic here for more details about this article) |
8/15. Spontaneous CSF communication to the middle ear and external auditory canal. A case report.A 27-year-old female with no history of trauma, surgery, infection, or neoplastic process was evaluated for the spontaneous onset of vomiting, headache, and loss of balance. Initial studies demonstrated extensive pneumocephalus. CT revealed a lytic, expansile defect of the right petrous bone, while intrathecal contrast images demonstrated flow of CSF that implied coincidental perforation of the tympanic membrane. MR imaging demonstrated a continuity of CSF signal. The patient underwent surgery to repair the CSF leak and a dural patch was applied. No symptoms of pneumocephalus were seen after surgery and the patient's condition improved.- - - - - - - - - - ranking = 0.0012462351136383keywords = membrane (Clic here for more details about this article) |
9/15. Extensive osteolysis around an aseptic, stable, uncemented total knee replacement.Extensive osteolysis occurred around an aseptic, well-fixed, stable, uncemented total knee prosthesis. At the time of revision, tibial polyethylene wear and minimal metal-on-metal contact were present. A hypertrophic synovium-like membrane abutted bone in regions of osteolysis. Examination of this membrane revealed polyethylene-wear debris and significant levels of chromium, cobalt, and titanium. Wear debris--polyethylene, metal, or a combination of both--may be responsible for the osteolytic process in this case.- - - - - - - - - - ranking = 0.0024924702272767keywords = membrane (Clic here for more details about this article) |
10/15. Radial neck osteolysis after annular ligament reconstruction. A case report.The treatment of the dislocated radial head in a late Monteggia lesion remains a matter of controversy. Annular ligament reconstruction using a strip of triceps tendon is a commonly used technique. Although most published series report good and excellent results, the overall complication rate of this procedure is not known. This study reports a 9-year-old boy who had avascular necrosis and bone resorption of the radial neck after a late annular ligament reconstruction using a sling of triceps tendon for a radial head dislocation that was not detected previously.- - - - - - - - - - ranking = 1.2keywords = ligament (Clic here for more details about this article) |
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