Cases reported "Arthritis, Rheumatoid"

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11/27. Periprosthetic fracture of the tibia associated with osteolysis caused by failure of rotating patella in low-contact-stress total knee arthroplasty.

    Periprosthetic fracture of the tibial plateau associated with osteolysis resulting from mechanical failure of the rotating patellar component after total knee arthroplasty with the new jersey Low-Contact-Stress (LCS) knee (DePuy, Warsaw, IN) has not been reported previously. A 67-year-old woman with rheumatoid arthritis of the left knee had a LCS prosthesis implanted without cement, using a rotating patellar component. Seven years later, a fracture of the lateral tibial plateau occurred owing to an osteolytic defect with no traumatic accident. The rotating patellar bearing over-rotated and locked; consequently, wear occurred between the patellar metal tray and the femoral component. immunohistochemistry revealed CD68-positive macrophages in the osteolytic region and phagocytosis of metal particles. The osteolytic region was filled with autogenous bone, and all components were exchanged and cemented. The patient's condition became satisfactory with relief of pain.
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12/27. Giant intraosseous cyst-like lesions in rheumatoid arthritis report of a case.

    The term "intraosseous synovial cyst" is used to designate both the epiphyseal cyst-like lesions seen in patients with rheumatoid arthritis (RA) and mucoid cysts, which occur in a different setting. We report the case of a patient in whom a 4-cm cyst-like lesion developed in the left tibia 18 years after onset of RA and 6 years after osmic acid synovectomy of the left knee. Positive contrast arthrography and magnetic resonance imaging visualized a communication between the lesion and the joint space. Preexisting bone and joint lesions and increased intraarticular pressure play a major role in the genesis of cyst-like lesions in RA. In our patient, the osmic acid synovectomy may have contributed to the development of the lesion. "synovial cyst" is a misnomer for these giant lesions, which are geodes rather than cysts. Despite their low incidence, these lesions deserve attention because they raise diagnostic and therapeutic problems.
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keywords = tibia
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13/27. Anterior tibial compartment syndrome due to the pyomyositis in a patient with rheumatoid arthritis. A case report.

    Anterior tibial compartment syndrome was developed due to pyomyositis in a 33-year-old male patient with rheumatoid arthritis while receiving steroid therapy during the follow-up period. The preoperative physical examination, laboratory findings, MRI images, intraoperative observation and postoperative histopathological examinations confirmed the association with pyomyositis. The surgical drainage and antibiotic treatment were effective, and in the follow-up period, neuromuscular dysfunctions disappeared completely within 6 months. The patient has been asymptomatic for 4 years of follow-up. To date, anterior tibial compartment syndrome due to pyomyositis in a case with rheumatoid arthritis has not been reported.
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keywords = tibia
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14/27. Ender nailing for supracondylar fracture of the femur after total knee arthroplasty: five case reports.

    We studied 5 women with supracondylar fractures after total knee arthroplasty (TKA). The mean age at fracture was 67.4 years. Four patients had chronic rheumatoid arthritis, and 1 had osteoarthritis. The range of motion, knee score, femorotibial angle, and component alignment were investigated. Flexion was slightly decreased after Ender nailing, but extension only changed in 1 patient. The knee score decreased, but all patients were ambulatory. The femorotibial angle changed in all patients. Measurement of femoral component alignment showed a postoperative change of angle alpha (1 degrees to 11 degrees ) and angle gamma (0 degrees to 9 degrees ). Union was achieved in all patients. Ender nailing is an acceptable method of treatment for supracondylar fractures of the femur after TKA if the nails can be inserted deeply into the femoral condyles.
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keywords = tibia
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15/27. Capacitively coupled electrical field in the treatment of a leg fracture after total knee replacement.

    Electrical stimulation has been used as treatment for nonunions of fractures since the early 1950s, with a reported success rate of 80-85%. We report a case of nonunion of a tibial fracture below a revised total knee prosthesis treated with a capacitively coupled electrical field. After 3 months of treatment, consolidation of this difficult fracture was evident with abundant callus formation.
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keywords = tibia
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16/27. Insufficiency fractures of the distal tibia misdiagnosed as cellulitis in three patients with rheumatoid arthritis.

    We describe 3 patients with rheumatoid arthritis who presented with diffuse pain, swelling, and erythema of the distal aspect of the lower extremity, suggestive of either cellulitis or thrombophlebitis, but were found to have insufficiency fractures of the distal tibia. The value of technetium-99m diphosphonate bone scintigraphy in the early recognition of these fractures and a possible explanation for the associated inflammatory symptoms are discussed.
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keywords = tibia
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17/27. periprosthetic fractures in patients with total knee arthroplasties.

    Ten patients with total knee arthroplasties sustained periprosthetic fractures. Nine of these were supracondylar fractures, and one occurred in the middle one-third of the tibia. These patients were treated with conservative methods in two cases and internal fixation with plate and screws in three cases. The remaining five patients were treated with intramedullary fixation using a specially designed revision prosthesis with long intramedullary stems. The best results wer achieved through the revision arthroplasty, based on walking ability, range of motion, and early rehabilitation.
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keywords = tibia
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18/27. Full flexion after total knee replacement in rheumatoid arthritis.

    The results of the Y-S total knee replacement are reported in 152 patients with rheumatoid arthritis (227 knees). The follow up was from 2 to 4 years (average 2.7 years). The good range of motion generally achieved was attributed to the use of a calibrated distractor for soft tissue balancing, a tibial prosthesis with a flattened plateau and extensive postoperative rehabilitation. Fourteen patients (27 knees) were able to squat fully after operation. A good range of motion before operation was related to a good range after operation. The range and overall results did not differ in patients with rheumatoid arthritis or osteoarthritis. The knees which recovered full flexion were no different from those with less than full flexion as far as stability and radiographic findings were concerned.
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keywords = tibia
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19/27. Surgical implications of varus deformity of the knee with obliquity of joint surfaces.

    Some arthritic knees with varus deformity show excessive valgus angulation of the femoral joint surface with proximal tibia vara. This causes a downward and medial inclination of the articular surfaces in the coronal plane. The patients we studied had a medial shift of the standing load-bearing axis, and arthritic changes mainly in the medial compartment. Some also had lateral tibial subluxation with twisting of the distal femur and proximal tibia in opposite directions. We assessed the articular geometry by precise radiographic analysis, and compared the results with those in normal volunteers and a group of osteoarthritic patients. The prevalence of this type of deformity in our osteoarthritic patients was 11.5%; its recognition allows the use of specific operative correction that may include double osteotomy or the precise orientation of prosthetic components.
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keywords = tibia
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20/27. Tibialis posterior tendon rupture: a cause of rheumatoid flat foot.

    Flat foot, a major cause of foot pain and disability, may result from rupture of the tibialis posterior tendon. We describe 2 patients with rheumatoid arthritis who developed flat feet secondary to surgically confirmed tendon rupture, and we discuss the anatomy and diagnosis of this condition. In the second patient, we also present the results of tendon imaging with both magnetic resonance and ultrasound.
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ranking = 0.16666666666667
keywords = tibia
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