Fracture in an arthrodesed Charcot’s knee joint

2021 ◽  
Vol 14 (11) ◽  
pp. e246529
Author(s):  
Sai Sabharish Reddy ◽  
Abhishek Vaish ◽  
Raju Vaishya
Keyword(s):  
Spina Bifida ◽  
Knee Joint ◽  
Rare Case ◽  
Locking Plate ◽  
Dynamic Compression ◽  
Weight Bearing ◽  
Bony Union ◽  
Stable Fixation ◽  
Knee Arthrodesis ◽  
Postoperative Rehabilitation

Charcot’s joint is a type of neuro-arthropathy, where asymmetrical damage of the involved joint happens haphazardly, without following any described pattern. We present a rare case of Charcot’s joint involving the knee joint in an adult male following spina bifida. His knee joint was successfully fused after two surgeries. Later, he sustained a fracture through the arthrodesis after a fall, which we managed surgically. The fracture through the knee arthrodesis was managed surgically by an open reduction and internal fixation, using a 14-hole broad low contact dynamic compression locking plate with bone grafting. Union was achieved at the knee arthrodesis site in 6 months. Fracture through a fused knee requires surgical management. Re-arthrodesis was done using a stable fixation. Postoperative rehabilitation should include protected weight bearing with braces and splints until a sound bony union is achieved.

scholarly journals Study of outcome of knee joint in patients with fracture distal femur versus fracture ipsilateral femur and tibia

2021 ◽  
Vol 12 (2) ◽  
pp. 1174-1181
Author(s):  
Ravindra B Gunaki ◽  
Chitresh Mehta ◽  
Rahul Sharma ◽  
Swapnil Chitnavis
Keyword(s):  
Knee Joint ◽  
Distal Femur ◽  
Weight Bearing ◽  
Early Mobilization ◽  
Bony Union ◽  
Fracture Femur ◽  
Articular Fractures ◽  
Stay Time ◽  
A Prospective Study ◽  
Type Of Fracture

The posture on the two wheeler at the speed we travel, makes knee the vulnerable joint of all in any of the mishaps. We as orthopedic surgeons see the fractures around the knee joint as one of the most studied concept in the subject. This is a prospective study conducted, over 2 years, in Krishna Institute of Medical Sciences, Deemed to be University, Karad. In this study, 20 cases of fracture distal femur and 20 cases of ipsilateral fracture femur and tibia were studied to evaluate outcome of knee joint and post surgical stabilization of fractures. The fractured limb was stabilized with splinting the limb in Thomas splint or plaster slab. The type of fracture, type of fracture fixation, duration of hospital stay, time of union and time to start weight bearing are evaluated. According to Neer’s score, Good outcome was found in both Fracture Distal femur and Ipsilateral Fracture Femur and tibia. The functional outcome was found to be better in diaphyseal fractures femur and tibia treated with intramedullary interlock nailing which allowed early mobilization and weight bearing than in intra-articular fractures treated with plating. Bony union occurred early in closed, diaphyseal and simple transverse or oblique fractures and delayed in open, intraarticular and comminuted fractures. 

scholarly journals Knee joint stability following fixation of tibial plateau fracture by angular locking plate fixation

2021 ◽  
Author(s):  
Jahidul Bari ◽  
Wang . ◽  
Wu .
Keyword(s):  
Knee Joint ◽  
Tibial Plateau ◽  
Locking Plate ◽  
Tibial Plateau Fracture ◽  
Plate Fixation ◽  
Weight Bearing ◽  
Joint Stability ◽  
Locking Plate Fixation ◽  
Plateau Fracture ◽  
The Mean

<p class="abstract"><strong>Background:</strong> Injuries to the tibial plateau generally occur because of a force directed either medially or laterally an axial compressive force or both an axial force and force from the side. Tibial plateau fractures resulting frequently in functional impairment.</p><p class="abstract"><strong>Methods: </strong>The total of cases included in the study was 47 in number. More than 20 years old patients of both sexes with tibial plateau fractures attended in the study. Proper informed consent was taken from the patients under the study and purpose of the study was explained. Ethical approval was obtained from the Institutional Ethics Committee. All data were processed, analyzed, and disseminated by MS Office and Statistical package for social sciences (SPSS) version 26 as per need.</p><p class="abstract"><strong>Results: </strong>In this study, for majority (51%) patients &lt;12 weeks were in needed for union. Besides these, for 23.40% and 21.28% patients, time for union were 12-14 and &gt;14 weeks respectively. Unfortunately, in 4.26%% cases (n=2) incidence of non-union was occur. The mean period of radiological union was 12.75 weeks (12-16 weeks). Most of the patients were allowed complete weight bearing at 11 to 14 weeks. Average time gap for complete weight bearing was 13.5 weeks. In assessing the knee stability of the participants, we observed, the mean (±SD) angle of knee joints was 112.08 ±12.32 degree. The mean (±SD) Knee Society Score (KSS) was found 77.51 ± 8.16. As per the functional outcomes among all the participants, majority of them (57.45%) got ‘good’ results whereas 29.79% got ‘Excellent’ and 8.51% got ‘Poor’ results.</p><p class="abstract"><strong>Conclusions:</strong> Satisfactory knee joint stability for patients with tibial plateau fracture angular locking plate fixation technic may be considered as an effective treatment method for orthopedic surgeons.  </p>

scholarly journals OP0083 DORSAL ROOT GANGLIA INFILTRATING MACROPHAGES MAINTAIN OSTEOARTHRITIS PAIN

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 55.2-56
Author(s):  
R. Raoof ◽  
C. Martin ◽  
H. De Visser ◽  
J. Prado ◽  
S. Versteeg ◽  
...  
Keyword(s):  
Knee Joint ◽  
Dorsal Root Ganglia ◽  
Immune Cells ◽  
Dorsal Root ◽  
Weight Bearing ◽  
Joint Damage ◽  
Osteoarthritis Pain ◽  
Knee Pathology ◽  
Femoral Condyles ◽  
Over Time

Background:Pain is a major debilitating symptom of knee osteoarthritis (OA). However, the extent of joint damage in OA does not correlate well with the severity of pain. The mechanisms that govern OA pain are poorly understood. Immune cells infiltrating nervous tissue may contribute to pain maintenance.Objectives:Here we investigated the role of macrophages in the initiation and maintenance of OA pain.Methods:Knee joint damage was induced by an unilateral injection of mono-iodoacetate (MIA) or after application of a groove at the femoral condyles of rats fed on high fat diet. Pain-like behaviors were followed over time using von Frey test and dynamic weight bearing. Joint damage was assessed by histology. Dorsal root ganglia (DRG) infiltrating immune cells were assessed over time using flow cytometry. To deplete monocytes and macrophages, Lysmcrex Csfr1-Stop-DTR were injected intrathecal or systemically with diptheria toxin (DT).Results:Intraarticular monoiodoacetate injection induced OA and signs of persistent pain, such as mechanical hyperalgesia and deficits in weight bearing. The persisting pain-like behaviors were associated with accumulation of F4/80+macrophages with an M1-like phenotype in the lumbar DRG appearing from 1 week after MIA injection, and that persisted till at least 4 weeks after MIA injection. Macrophages infiltrated DRG were also observed in the rat groove model of OA, 12 weeks after application of a groove at the femoral condyles. Systemic or local depletion of DRG macrophages during established MIA-induced OA completely ablated signs of pain, without affecting MIA-induced knee pathology. Intriguingly when monocytes/macrophages were depleted prior to induction of osteoarthritis, pain-like behaviors still developed, however these pain-like behaviors did not persist over time.In vitro,sensory neurons innervating the affected OA joint programmed macrophages into a M1 phenotype. Local repolarization of M1-like DRG macrophages towards M2 by intrathecal injection of M2 macrophages or anti-inflammatory cytokines resolved persistent OA-induced pain.Conclusion:Overall we show that macrophages infiltrate the DRG after knee damage and acquire a M1-like phenotype and maintain pain independent of the lesions in the knee joint. DRG-infiltrating macrophages are not required for induction of OA pain. Reprogramming M1-like DRG-infiltrating macrophages may represent a potential strategy to treat OA pain.Acknowledgments:This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreements No 814244 and No 642720. Dutch Arthritis SocietyDisclosure of Interests:Ramin Raoof: None declared, Christian Martin: None declared, Huub de Visser: None declared, Judith Prado: None declared, Sabine Versteeg: None declared, Anne Heinemans: None declared, Simon Mastbergen: None declared, Floris Lafeber Shareholder of: Co-founder and shareholder of ArthroSave BV, Niels Eijkelkamp: None declared

scholarly journals Imaging in a rare case of intramuscular angioleiomyoma around the knee joint

2019 ◽  
Vol 29 (4) ◽  
pp. 438 ◽  
Author(s):  
Krishnendu Sarkar ◽  
Vinay Maurya ◽  
R Ravikumar ◽  
Richa Ranjan
Keyword(s):  
Knee Joint ◽  
Rare Case

scholarly journals Case Report of a Medial Femoral Condyle Fracture in a Unicompartmental Oxford Knee Replacement Surgery

2019 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Femoral Condyle ◽  
Intraoperative Complications ◽  
Weight Bearing ◽  
Full Range ◽  
Postoperative Rehabilitation ◽  
Medial Condyle ◽  
Case Presentation ◽  
Replacement Surgery ◽  
Stable Osteosynthesis ◽  
Condyle Fracture

Introduction: The unicompartmental Oxford prosthesis has been used as a goodalternative for medial unicompartmental osteoarthritis because it is associated with earlyrehabilitation and a low rate of intraoperative complications. This case describes a rarecomplication during the procedure. Case Presentation: We present an intraoperative fracture of the medial condyle in a 70-year-old woman that was treated with 6.5 mm cannulated screws with a compressiontechnique. The patient remained in a non-weight bearing protocol for 6 weeks andreached a full range of mobility at 3 months. Complete radiological consolidation and agood functional outcome were observed. Conclusion: Intraoperative fractures benefit from a stable osteosynthesis that allows freerange of mobility and does not delay postoperative rehabilitation.

scholarly journals Outcome of Ilizarov assisted ankle arthrodesis

2018 ◽  
Vol 5 (2) ◽  
pp. 433
Author(s):  
Priyajit Chattopadhyay ◽  
Paras Kumar Banka ◽  
Anindya Debnath ◽  
Sanjay Kumar
Keyword(s):  
Dynamic Compression ◽  
Weight Bearing ◽  
Major Complication ◽  
Ankle Arthrodesis ◽  
Time Interval ◽  
Early Weight Bearing ◽  
Ilizarov Fixator ◽  
American Orthopaedic ◽  
Second Procedure

Background: Among the various techniques used for ankle arthrodesis, Ilizarov technique has various advantages along with the potential for treating complex and failed cases.Methods: Eleven cases were undertaken for ankle arthrodesis using the Ilizarov fixator. Two rings were applied along the tibia and one at the talus/calcaneum. The articular cartilage was denuded, and dynamic compression applied. The clinical, functional and radiological outcome were evaluated. The goal was a stable fusion with a well aligned foot.Results: The mean follow-up period was 95 weeks. Fusion was achieved in all cases with no major complication. Only one case had a residual deformity. The average time interval for the ankle fusion was 140.8±25.7 days. The postoperative modified American Orthopaedic Foot and Ankle Society (AOFAS) Hindfoot score was 67.5±9.6 points.Conclusions: Ilizarov assisted ankle arthrodesis aids in early weight bearing, better alignment, and has good functional outcomes even in cases with previously failed procedures. It has the advantage of postoperative readjustment of the arthrodesis without the need of any second procedure with no major complications.

scholarly journals Successful utilization of triphasic silica containing ceramic coated hydroxyapatite (HASi) for the treatment of comminuted tibial fracture in a goat: a case report

2021 ◽  
Vol 52 (2) ◽  
Author(s):  
Rahul Rao ◽  
P. T. Dinesh ◽  
S. Sooryadas ◽  
George Chandy ◽  
Manju Mathew
Keyword(s):  
Hind Limb ◽  
Tibial Fracture ◽  
Dynamic Compression ◽  
Weight Bearing ◽  
Segmental Defect ◽  
Dynamic Compression Plate ◽  
Comminuted Fracture ◽  
Compression Plate ◽  
History Of ◽  
One Year

A one year old female Sirohi crossbred goat was presented with a history of non weight bearing lameness on right hind limb. Radiography revealed comminuted fracture of tibial mid diaphysis. The comminuted fracture fragments and bone devoid of any soft tissue were surgically removed and the resultant segmental defect was reinstated with triphasic silica containing ceramic coated hydroxyapatite (HASi) after stabilising the fracture fragments with 2.7mm dynamic compression plate and screws. The animal recovered with normal limb ambulation after the eighth post-operative week.

scholarly journals Comparative Analysis of Knee Joint Fusion with Long Locking Nail and Ilizarov Apparatus in Patients with Deep Infection after Arthroplasty

2020 ◽  
Vol 26 (3) ◽  
pp. 109-118
Author(s):  
L. N. Solomin ◽  
E. A. Shchepkina ◽  
K. L. Korchagin ◽  
F. K. Sabirov
Keyword(s):  
Quality Of Life ◽  
Comparative Analysis ◽  
Blood Loss ◽  
Knee Joint ◽  
Internal Fixation ◽  
Inpatient Treatment ◽  
Deep Infection ◽  
Knee Arthrodesis ◽  
Locking Nail

Relevance. Deep infection after knee arthroplasty requires radical surgical treatment of the infection site, removal of endoprosthesis components, and an antimicrobial spacer placement. If revision knee arthroplasty is impossible, the «gold standard» for this kind of patients is knee joint arthrodesis. The purpose of the study was the comparative analysis of knee joint fusion by external and internal fixation. Materials and Methods. The analysis of 60 cases of knee arthrodesis was carried out. The patients were divided into two groups with 30 patients in each. In the first group, knee arthrodesis was performed with long locking nail, in the second group — with external ring fixation. We compared the groups by intraoperative and drainage blood loss, the inpatient treatment duration, the terms of fusion and complications registered. The patients quality of life was evaluated using the SF-36 questionnaire before surgery, for the periods of 3, 6, and 12 months after the surgery. Results. The comparison of two methods of knee arthrodesis showed that blood loss in the internal fixation compared with external one, was 2.03 times more, the duration of inpatient treatment was 1.4 times less, and the total number of complications was 4.4 times less. However, the complications that affected the treatment outcome in long nail group were 1.5 times more. The differences in the average time of ankylosis formation were not statistically significant (p<0.05). The functional results of the treatment in 3 months after surgery in the group with internal fixation were much better. In 6 months after surgery the quality of life had no significant differences. In 12 months follow-up the indices in both groups were the same. Conclusion. The results of our study suggests us to think, knee joint arthrodesis by long fusion nail should be prefereble. If the nail insertion is technically impossible, and there is the high risk of deep infection recurrence, the external osteosynthesis should be used.

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