1664 A rare case of Stenotrophomas maltophilia affecting an ACL Endobutton: A Case Report and Review of the literature

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M Adewusi ◽  
K Roy ◽  
Y Joshi
Keyword(s):  
Case Report ◽  
Cruciate Ligament ◽  
White Cell Count ◽  
Meniscal Repair ◽  
Bone Destruction ◽  
Joint Effusion ◽  
Orthopaedic Implants ◽  
Knee Effusion ◽  
Large Joint ◽  
History Of

Abstract Background Stenotrophomas maltophilia (SM) is a ubiquitous opportunistic gram-negative bacillus known to cause hospital acquired infections, commonly in immunosuppressed individuals. However, occurrence of this microorganism is rarely reported in the musculoskeletal system. We report a case of a young healthy man with recurrent knee swelling caused by SM. This organism has been reported to form biofilms over orthopaedic implants, with increased resistance to antibiotic therapy, making it difficult to eradicate once established. Case Report A 34-year-old man with psoriasis and asthma presented with right knee swelling and pain, and no history of preceding trauma or fever. He has a past surgical history of anterior cruciate ligament tear and underwent reconstruction with an endobutton two years prior, and a lateral meniscal repair treated in the previous year. At presentation, he was apyrexial and was noted to have a moderate right knee effusion. Initial radiographic imaging identified a large joint effusion with no obvious evidence of bone destruction, laboratory studies also showed a raised white cell count of 11.4 *10^9/L, C-reactive protein of 54mg/L and aspiration cultures were negative. He subsequently underwent numerous washouts, and removal of endobutton with open synovial biopsy which showed SM. The organism was sensitive to cotrimoxazole. The patient had appropriate antibiotics with resolution of symptoms, however he still presented with recurrence. Conclusions The persistence of SM despite intervention makes it difficult to treat. Although a rare organism, surgeons should consider it as a differential in recurring knee effusion with orthopaedic implants, and institute early and appropriate management for best outcomes.

scholarly journals PCL Reconstruction Using Adjustable Buttons with Outside-In Tunnel for Tibial Fixation: A case report

2019 ◽  
Vol 7 (11_suppl6) ◽  
pp. 2325967119S0048
Author(s):  
Prettysia Suvarly ◽  
Nyoman Aditya Sindunata ◽  
Lasa Dhakka Siahaan ◽  
Tommy Mandagi ◽  
John Butarbutar
Keyword(s):  
Case Report ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Pcl Reconstruction ◽  
Case Presentation ◽  
Tibial Fixation ◽  
Knee Effusion ◽  
Tunneling Method ◽  
Adjustable Button ◽  
Inside Out

Introduction: Posterior cruciate ligament (PCL) reconstruction needs a large and long graft. An allograft is a preferable option for thicker graft but its availability is limited in Indonesia. Alternatively, autograft needs to be folded several times for sufficient thickness but it will be shorter and only applicable for the inside-out method. We present a case of PCL reconstruction using a double adjustable button fixation with the outside-in tibia tunneling method. Case Presentation: A fifty-five-year-old male came to our office with an unstable right knee after he fell 1 month ago. Physical examination showed positive posterior drawer and mild right knee effusion, other findings were normal. MRI revealed a total PCL rupture. Two weeks later, the PCL reconstruction was done using autograft from gracillis and semitendinous. A large adjustable button was placed on the tibia tunnel, using the outside-in technique. Knee was stable postoperatively. Discussion: PCL reconstruction using double adjustable buttons was chosen to accommodate larger but shorter autografts. The outside-in tibial tunnel has less risk of graft laxity less expensive and more simple technically compared to inside-out adjustable button tunnel. Conclusion: Tibial fixation using an adjustable large button should be considered in PCL reconstruction with short autograft.

scholarly journals Tenosynovial Giant Cell Tumor in the Tibial Attachment of the Anterior Cruciate Ligament: A Case Report

2020 ◽  
pp. 1-4
Author(s):  
Loiy Alkhatibm ◽  
Loiy Alkhatibm ◽  
Ralf Kraus ◽  
Scott A. Sigman ◽  
Ulrich Stahl
Keyword(s):  
Anterior Cruciate Ligament ◽  
Case Report ◽  
Giant Cell ◽  
Cruciate Ligament ◽  
Arthroscopic Surgery ◽  
Tendon Sheath ◽  
Benign Tumors ◽  
Giant Cell Tumors ◽  
History Of ◽  
Anterior Cruciate

Tenosynovial giant cell tumors (TGCTs) are a group of rare, benign tumors that involve the synovium, bursae and tendon sheath and arise from the synovial tissue of the tendon sheath. Here, we reported a 21- year-old male patient with a 4-year history of mild pain in his right knee. Magnetic resonance (MR) study revealed a well-defined solid mass which was successfully excised by arthroscopic surgery. No recurrence was observed after 6 months of follow up. This is a first of its kind case report of a (TGCT) arising from the tibial attachment of the anterior cruciate ligament (ACL).

scholarly journals Additional Use of Synovial Mesenchymal Stem Cell Transplantation Following Surgical Repair of a Complex Degenerative Tear of the Medial Meniscus of the Knee: A Case Report

2019 ◽  
Vol 28 (11) ◽  
pp. 1445-1454 ◽  
Author(s):  
Ichiro Sekiya ◽  
Hideyuki Koga ◽  
Koji Otabe ◽  
Yusuke Nakagawa ◽  
Hisako Katano ◽  
...  
Keyword(s):  
Case Report ◽  
Adverse Events ◽  
Medial Meniscus ◽  
Rating Scale ◽  
Surgical Repair ◽  
Clinical Symptoms ◽  
Human Study ◽  
Meniscal Repair ◽  
Joint Effusion ◽  
Mesenchymal Stem Cell Transplantation

Complex degenerative tears of the medial meniscus in the knee are usually treated using meniscectomy. However, this procedure increases the risk of osteoarthritis, while other treatments aimed at meniscal repair remain challenging due to the high possibility of failure. The use of synovial mesenchymal stem cells (MSCs) is an attractive additional approach for meniscal repair, as these cells have high proliferative and chondrogenic potential. In this case report, we surgically repaired a complex degenerative tear of the medial meniscus and then transplanted autologous synovial MSCs. We evaluated clinical outcomes at 2 years and assessed adverse events. We enrolled patients with clinical symptoms that included a feeling of instability in addition to pain caused by their complex degenerative tears of the medial meniscus. Two weeks after surgical repair of the torn meniscus, autologous synovial MSCs were transplanted onto the menisci of five patients. The total Lysholm knee score, the Knee Injury and Osteoarthritis Outcome Scale scores for “pain,” “daily living,” “sports activities,” and the Numerical Rating Scale were significantly increased after 2 years. Three adverse events, an increase in c-reactive protein, joint effusion, and localized warmth of the knee were recorded, although these could have been due to the meniscal repair surgery. This first-in-human study confirmed that the combination of surgical repair and synovial MSC transplantation improved the clinical symptoms in patients with a complex degenerative tear of the medial meniscus. No adverse events occurred that necessitated treatment discontinuation. These findings will serve as pilot data for a future prospective study.

scholarly journals EP03 Parechovirus in a pathologist

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Claire Masih ◽  
Michael Dologhan ◽  
Andrew Cairns
Keyword(s):  
Case Report ◽  
White Cell Count ◽  
Respiratory Illness ◽  
Full Blood Count ◽  
Past Medical History ◽  
Mri Findings ◽  
Foreign Travel ◽  
History Of ◽  
Learning Points ◽  
Fluid Signal

Abstract Case report - Introduction A 42-year-old pathologist presented with a 1-week history of muscle pain and subjective weakness. CK level on 2 occasions was >3000. The patient was systemically well with no past medical history, medication, or foreign travel. He had 1-day history of shivering with no recorded pyrexia. He reported pain in his proximal muscles and neck and subjective muscle weakness and lack of finger dexterity with no objective findings. Case report - Case description Autoantibody panel and inflammatory markers were performed which were normal. Full blood count with differential white cell count including eosinophils was normal. There was a modest rise in transaminases. Myositis panel was negative. Full viral screen was positive for parechovirus with titre of 30 on several samples. MRI proximal musculature showed increased fluid signal in the perifascial region of both thighs primarily involving the hamstrings, not definitive for myositis but suggestive of fasciitis. Case report - Discussion Parechovirus is a picornavirus, often causing mild gastrointestinal or respiratory illness but has been associated with epidemic myalgia and myositis during outbreaks of parechovirus in a Japanese population. The patient improved spontaneously with CK reduced to 187 and improved symptoms after 1 week. We expect a good outcome and will review on patient's request if necessary. Case report - Key learning points Parechovirus can cause myofasciitis which is usually mild and self-limiting. It can be associated with elevated CK, transaminases and MRI findings and can be confirmed on respiratory viral swab.

Bilateral, Chronic Cranial Cruciate Ligament Avulsion in a Six-Year-Old Dog

1996 ◽  
Vol 09 (02) ◽  
pp. 84-7 ◽  
Author(s):  
S. J. Butterworth ◽  
A. R. S. Barr ◽  
P. A. Dieppe ◽  
J. F. Innes
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Cruciate Ligament ◽  
Cranial Cruciate Ligament ◽  
Tibial Insertion ◽  
History Of ◽  
Bone Fragments ◽  
The Right ◽  
Hindlimb Lameness

SummaryA 6-year-old Samoyed was admitted with bilateral hindlimb stiffness and left hindlimb lameness. Results of clinical, radiographic and scintigraphic examinations were consistent with bilateral cruciate ligament deficiency. There was complete avulsion of the tibial insertion of the cranial cruciate ligament of the left stifle and partial avulsion of the right cranial cruciate ligament. Surgical treatment consisted of removal of avulsed bone fragments and placement of an intra-articular fascial graft.Avulsion of the cranial cruciate ligament is reported rarely in the dog. All cases in the literature have involved dogs less than three years of age and there is often a history of trauma. This Case Report describes bilateral atraumatic cranial cruciate ligament avulsion in a six-year-old dog. The factors involved in patterns of cruciate injury are discussed.

Popliteal artery thrombosis secondary to a tibial osteochondroma

VASA ◽  
2011 ◽  
Vol 40 (3) ◽  
pp. 251-255 ◽  
Author(s):  
Gruber-Szydlo ◽  
Poreba ◽  
Belowska-Bien ◽  
Derkacz ◽  
Badowski ◽  
...  
Keyword(s):  
Case Report ◽  
Magnetic Resonance Angiography ◽  
Popliteal Artery ◽  
Doppler Ultrasonography ◽  
Histopathological Examination ◽  
Previous History ◽  
Plain Radiography ◽  
Artery Thrombosis ◽  
History Of ◽  
The Right

Popliteal artery thrombosis may present as a complication of an osteochondroma located in the vicinity of the knee joint. This is a case report of a 26-year-old man with symptoms of the right lower extremity ischaemia without a previous history of vascular disease or trauma. Plain radiography, magnetic resonance angiography and Doppler ultrasonography documented the presence of an osteochondrous structure of the proximal tibial metaphysis, which displaced and compressed the popliteal artery, causing its occlusion due to intraluminal thrombosis..The patient was operated and histopathological examination confirmed the diagnosis of osteochondroma.

Evaluation of Positive Contrast Arthrography in Canine Cranial Cruciate Ligament Disease

1996 ◽  
Vol 09 (01) ◽  
pp. 10-3 ◽  
Author(s):  
D.N. Aron ◽  
R. Roberts ◽  
J. Stallings ◽  
J. Brown ◽  
C.W. Hay
Keyword(s):  
Articular Surface ◽  
Cruciate Ligament ◽  
Positive Contrast ◽  
Joint Effusion ◽  
Radiographic Evaluation ◽  
Cranial Cruciate Ligament ◽  
Joint Pathology ◽  
Meniscal Pathology ◽  
Cranial Cruciate Ligament Disease ◽  
Better Than

SummaryArthrographic and intraoperative evaluations of stifles affected with cranial cruciate disease were compared. Arthrography did not appear to be helpful in predicting cranial cruciate ligament pathology. The caudal cruciate ligament was consistently not visualized in the arthrograms and was normal at surgery. The menisci were visualized consistently in the arthrograms, but conclusions could not be made as to the benefit of arthrography in predicting meniscal pathology. Arthrography was not helpful in predicting joint capsule and femoral articular surface pathology. Survey radiographic evaluation was better than arthrography in evaluating joint pathology. When cruciate injury is suspected, after history and physical examination, survey radiographs are better than positive contrast arthrograms at supporting the diagnosis.Positive contrast arthrography was evaluated as a diagnostic aid in canine cranial cruciate ligament disease. It did not appear to be useful in predicting joint pathology. With arthrography, both menisci could be visualized and evaluated for abnormalities. Joint effusion and presence of osteophytes evaluated on survey radiographs was better than arthrography in evaluating joint pathology.

Anterior Cruciate Ligament Rupture Associated with Cardiomyopathy in Three Cats

1991 ◽  
Vol 4 (01) ◽  
pp. 35-37 ◽  
Author(s):  
G. O. Janssens ◽  
D. L. Janssens ◽  
L. A. A. Janssens
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Anterior Cruciate Ligament Rupture ◽  
Acl Rupture ◽  
Thoracic Radiography ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Previous Trauma ◽  
History Of ◽  
Anterior Cruciate

SummaryOver a period of 14 years, three cats with anterior cruciate ligament (ACL) rupture were seen in our practice. In all, the rupture had occurred without a history of previous trauma. All were treated surgically. All died within a period of 14 days. The reason of death was in all cases cardiomyopathy. We now suggest that cats with rupture of the anterior cruciate ligament undergo an electrocardiographic recording and eventually an thoracic radiography before surgery is considered. We also suggest that cats with ACL rupture should preferably be treated conservatively.

An unusual presentation of epigastric pain due to thrombophlebitis of a recanalised umbilical vein – case report

2019 ◽  
Vol 98 (8) ◽  
pp. 326-327 ◽  
Keyword(s):  
Liver Cirrhosis ◽  
Abdominal Pain ◽  
Case Report ◽  
Portal Hypertension ◽  
Liver Disease ◽  
Epigastric Pain ◽  
Umbilical Vein ◽  
History Of ◽  
Clinically Significant ◽  
Inflammatory Changes

Introduction: The umbilical vein can become recanalised due to portal hypertension in patients with liver cirrhosis but the condition is rarely clinically significant. Although bleeding from this enlarged vein is a known complication, the finding of thrombophlebitis has not been previously described. Case report: We report the case of a 62-year-old male with a history of liver cirrhosis due to alcoholic liver disease presenting to hospital with epigastric pain. A CT scan of the patient’s abdomen revealed a thrombus with surrounding inflammatory changes in a recanalised umbilical vein. The patient was managed conservatively and was discharged home the following day. Conclusion: Thrombophlebitis of a recanalised umbilical vein is a rare cause of abdominal pain in patients with liver cirrhosis.

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