Cases reported "Osteoarthritis, Knee"

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1/42. Fracture of the femoral component associated with polyethylene wear and osteolysis after total knee arthroplasty.

    Fracture of the femoral component associated with polyethylene wear and osteolysis after total knee arthroplasty (TKA) has not been well reported before. A 63-year-old man with osteoarthritis of the right knee underwent TKA with a New Jersey LCS Knee, with cementing on the tibia and patella but not on the femoral component. After 42 months, in addition to wearing of polyethylene of the tibia and patella, severe osteonecrosis of the medial femoral condyle was noted. osteonecrosis caused loss of osseous support of the medial flange of the femoral component, and the bone ingrowth of the central and lateral flange to the distal femur was so good that it overcame the yield stress of the metal of the femoral component and caused fracture of the femoral component. The osteolytic area was filled with autogenous iliac bone, and a new femoral component was inserted and cemented. The patient's condition became satisfactory with relief of pain. Although uncommon, fracture of the femoral component does occur associated with polyethylene wear and osteolysis.
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ranking = 1
keywords = osteoarthritis, arthritis
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2/42. Nonunion of tibial stress fractures in patients with deformed arthritic knees. Treatment using modular total knee arthroplasty.

    In two years we treated four women with ununited stress fractures of their proximal tibial diaphyses. They all had arthritis and valgus deformity. The stress fractures had been treated elsewhere by non-operative means in three patients and by open reduction and internal fixation in one, but had failed to unite. After treatment with a modular total knee prosthesis with a long tibial stem extension, all the fractures united. A modular total knee prosthesis is suitable for the rare and difficult problem of ununited tibial stress fractures in patients with deformed arthritic knees since it corrects the deformity and the adverse biomechanics at the fracture site, stabilises the fracture and treats the arthritis.
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ranking = 0.00024525536089956
keywords = arthritis
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3/42. Allograft reconstruction of the extensor mechanism for progressive extensor lag after total knee arthroplasty and previous patellectomy: a 3-year follow-up.

    Major extensor lag after total knee arthroplasty may follow operative damage to the patellar tendon or its insertion. It may also occur in a late progressive form postoperatively. A successful allograft reconstruction of the extensor mechanism for progressive extensor lag after total knee arthroplasty is described. Patellectomy had been carried out earlier on the same knee for patellofemoral osteoarthritis.
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keywords = osteoarthritis, arthritis
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4/42. Saw tooth patello--femoral arthritis.

    Four patients with an unusual form of patello-femoral arthritis are described. The characteristic feature of the condition is an erosive 'saw tooth' pattern characteristically seen on both sides of the joint. Radiologically, this pattern is best seen on the skyline view. The other principal features are a lamellar-like pattern on slightly oblique lateral views, a smooth supra patellar erosion of the femur seen on the lateral view and cortical ridging of the lateral femoral condyle seen 'en face' on the AP projection. A possible mechanism to account for the radiological features is proposed. Anbarasu, A., Loughran, C. F. (2000). Clinical Radiology55, 767-769.
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ranking = 0.00061313840224889
keywords = arthritis
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5/42. Acute arthritis after intra-articular hyaluronate injection: onset of effusions without crystal.

    Side effects of intra-articular hyaluronate injection include aseptic acute arthritis, which develops within hours after injection. Based on standard crystal analysis, calcium crystal shedding has been postulated to explain this complication. However, it is not known whether apatite crystals or low amounts of calcium pyrophosphate dihydrate (CPPD) crystals are also involved as to determine this requires a complete synovial fluid (SF) analysis. Two cases of such an acute arthritis are reported in patients after receiving a second Hylan GF-20 intra-articular injection. The SF did not contain CPPD, monosodium urate, or calcium apatite microcrystals as examined by microscopic analysis (using a compensated polarised light microscope) after alizarin red staining. Further studies are required to investigate possible direct proinflammatory effects of hyaluronic acid degradation products.
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ranking = 0.00073576608269867
keywords = arthritis
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6/42. Osteoarticular tuberculosis: current diagnosis and treatment.

    Tuberculous synovitis frequently presents as a monoarthritis of weight-bearing joints such as the hip, knee, or ankle. Owing to its low incidence in developed countries, the diagnosis is often delayed for months to years. early diagnosis with a synovial biopsy permits prompt antituberculous therapy and substantially improves the prospect of preservation of joint structure and function. Initial treatment typically includes combination therapy with four drugs (isoniazid, rifampin, pyrazinamide, and streptomycin or ethambutol) because of the frequency of isoniazid resistance. Antimicrobial therapy should be of at least 9 months' duration, longer in immunocompromised hosts. Partial synovectomy and other surgical procedures should be restricted to joints with severe cartilage destruction, large abscesses, joint deformity, multiple drug resistance, or atypical mycobacteria.
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ranking = 0.00012262768044978
keywords = arthritis
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7/42. Primary total knee arthroplasty for supracondylar/condylar femoral fracture in osteoarthritic knees.

    Supracondylar or condylar femoral fractures require extended treatment and often result in loss of knee range of motion. We present 3 cases in which femoral fractures and preexisting painful knees secondary to osteoarthritis were treated using total knee arthroplasty with a stemmed femoral implant. The patients were all women aged 83, 84, and 87 years old. All fractures united within 3 months, and the patients could walk with 1 cane within 2 months. Primary total knee arthroplasty should be considered as a treatment for supracondylar/condylar femoral fractures in osteoarthritic knees.
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ranking = 1
keywords = osteoarthritis, arthritis
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8/42. Reversal of medial compartment osteoarthritic uptake pattern after high tibial osteotomy.

    Two cases of osteoarthritis of the knee are presented that illustrate the typical medial compartment pattern of scintigraphic uptake. In both cases the patients had significant medial joint pain. After high tibial osteotomy, the pattern of uptake was altered and paralleled the improvement in symptoms. These observations prompt several important issues regarding the cause of the uptake and may provide a way to monitor treatment response.
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ranking = 1
keywords = osteoarthritis, arthritis
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9/42. Staged bilateral total knee replacement--a safer approach in older patients.

    Simultaneous bilateral total knee replacement has been advocated for bilateral symptomatic arthritis of the knee. The alternative is staged bilateral total knee replacement. We retrospectively reviewed all the total knee replacements performed in our hospital between January 1996 and July 1999. A total of 455 patients had 533 total knee replacements: 54 patients had simultaneous bilateral total knee replacement, 34 patients had staged bilateral total knee replacement and 367 patients had unilateral total knee replacements. Four patients who had simultaneous bilateral total knee replacement died in the immediate post-operative period. During the same period, no deaths were observed in the other two groups. risk factors were assessed and in our series, age was the only factor found to be associated with mortality following simultaneous bilateral total knee replacement. A staged operation appears to be safer than simultaneous bilateral total knee replacement for patients who are 75 years or older.
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ranking = 0.00012262768044978
keywords = arthritis
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10/42. Extensive plasma cell infiltration with crystal IgG inclusions and mutated IgV(H) gene in an osteoarthritis patient with lymphoplasmacellular synovitis. A case report.

    The presence of immunoglobulin crystal inclusions in plasma cells from plasmacytomas and B-NHLs (linked to overstimulation and overproduction) has been frequently reported. Our case describes a lymphoplasmacellular synovitis in a patient with osteoarthritis (OA) showing an unusually high plasma cell infiltration and for the first time crystals in plasma cells. Using immunohistochemistry. these crystals were identified as being IgG with a balanced lambda/kappa ratio. IgV(H) gene analysis (n = 5 clones) showed that they were somatically mutated (R/S of CDR > 3): in one case, an insertion of 9 nucleotides on the CDR2 region was observed. High R/S values in the CDR indicated antigen selectivity and affinity (4/5). Since no germinal centers could be detected and the analyzed B cells showed antigen selectivity, it may be concluded that already antigenically activated B cells migrated into the synovium and locally differentiated into plasma cells, leading to the extensive infiltration observed. Rheumatoid fibroblasts were shown to support terminal B cell differentiation. Our data suggests that the ability of fibroblasts to activate B cells is not only restricted to RA, but also occurs in OA. The intense plasma cell infiltration contributed to further cartilage damage by altering the microenvironment of the nourishing synovial tissue or by the local production of pathogenic autoantibodies.
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ranking = 5
keywords = osteoarthritis, arthritis
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