scholarly journals Ten-Year Follow-Up of Desarthrodesis of the Knee Joint 41 Years after Original Arthrodesis for a Bone Tumor

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Ahmed Hamed Kassem Abdelaal ◽  
Norio Yamamoto ◽  
Katsuhiro Hayashi ◽  
Akihiko Takeuchi ◽  
Shinji Miwa ◽  
...  

Introduction. The main indication for knee arthrodesis in tumor surgery is a tumor that requires an extensive resection in which the joint surface cannot be preserved. We report a patient that had knee desarthrodesis 41 years after giant cell tumor resection followed by a knee arthrodesis. This is the longest reported follow-up after desarthrodesis and conversion to total knee arthroplasty (TKA), almost ten years.Case Report. A 71-year-old man with a distal femoral giant cell tumor had undergone a resection of the distal femur and knee arthrodesis using Kuntscher nail in 1962. In July 2003 he experienced gradually increasing pain of his left knee. We performed a desarthrodesis and conversion to TKA in 2005. The postoperative period passed uneventfully as his pain and gait improved, with gradually increasing range of motion (ROM) and no infection. He now walks independently, with no brace or contractures.Conclusion. Desarthrodesis of the knee joint and conversion to TKA are a difficult surgical choice with a high complication risk. However, our patient’s life style has improved, he has no pain, and he can ascend and descend stairs more easily. The surgeon has to be very meticulous in selecting a patient for knee arthrodesis and counseling them to realize that their expectations may not be achievable.

2019 ◽  
Vol 73 ◽  
pp. 581-587
Author(s):  
Szymon Ł. Dragan ◽  
Mirosław Kulej ◽  
Łukasz Mucha ◽  
Piotr Morasiewicz ◽  
Wiktor Urbański ◽  
...  

Introduction: Cancer of the patella is a rare condition. Giant cell tumor of the patella is an extremely rare and a difficult to solve therapeutic problem. Depending on the degree of bone destruction, it may cause significant knee joint dysfunction. It is assumed that surgery is the treatment of choice. Material/Methods: This study presents an innovative treatment of a giant cell tumor of the patella in a 40-year-old male with significant dysfunction of the knee extensor mechanism. Complex therapy included neoadjuvant treatment using a human monoclonal antibody IgG2 that binds to RANKL (Denosumab) and follow-up allogeneic grafting of knee extension mechanism. Results: Follow-up CTs showed correct positioning and healing of grafted knee extensor mechanism. Early functional outcome was perfect. Seven weeks after the surgery, reduction of pain, improvement of the contour of the joint, full active extension and flexion of 110° were noticed. Fifteen months after the surgery, the patient presented complete active extension and flexion of the knee joint, actively participated in professional life and CT tests did not reveal features of tumor recurrence. Conclusions: Treatment of isolated giant cell tumor of the patella with destruction of patella and joint dysfunction does not have a clear solution in the available literature. Such a condition may also exclude traditional procedures. In such cases, grafting of the whole extensor mechanism appears to be the appropriate treatment.


SICOT-J ◽  
2015 ◽  
Vol 1 ◽  
pp. 18 ◽  
Author(s):  
Serda Duman ◽  
Hakan Sofu ◽  
Yalkin Camurcu ◽  
Sarper Gursu ◽  
Ramadan Oke

1998 ◽  
Vol 28 (5) ◽  
pp. 323-328 ◽  
Author(s):  
Y. Oda ◽  
H. Miura ◽  
M. Tsuneyoshi ◽  
Y. Iwamoto

1991 ◽  
Vol 26 (2) ◽  
pp. 356
Author(s):  
Kwang Jin Rhee ◽  
Sang Rho Ahn ◽  
Young Ahn Jin ◽  
Cheon Hwan Ryou

2020 ◽  
Vol 4 (1) ◽  
pp. 64-67
Author(s):  
Sushil Adhikari ◽  
Arun Sigdel ◽  
Rajesh Kumar Sah ◽  
Luna Devkota

Giant cell tumour (GCT) is histopathologically benign tumor of long bone particularly in distal femur and the proximal tibia. It commonly occurs in adults of age 20-40 years but rare in children. GCT is considered to be locally aggressive tumor and tendency of recurrence is higher even after surgery. The clinical features are nonspecific, the principle symptoms are pain, swelling and limiting adjacent joint movements. Diagnosis is based on the radiographic appearance and histopathological findings .In our case X-ray showed ill defined lytic lesion on proximal fibula with cortical thinning and MRI finding revealed expansile lyticlesion in meta-epiphysis of right fibula 16×16×28mm adjacent to growth plate with fluid level. The sclerotic rim appears hypo intense on T1 & hyper intense on T2. Core needle biopsy showed giant cell tumor on proximal fibula. Considering the risk of recurrence wide local excision was done. Management of GCT of proximal fibula in young patient is critical for preventing recurrence and enhancing functional outcomes by saving adjacent anatomical structure. No evidence of local recurrence and metastasis was found in 24 months of follow up.


Hand Surgery ◽  
2012 ◽  
Vol 17 (01) ◽  
pp. 125-127
Author(s):  
J. Terrence Jose Jerome ◽  
Kumar Venkatesan ◽  
Amarnath G ◽  
Usha Rani ◽  
Rohini Sridhar

We report a 75-year-old man who presented with a painless friable mass in the index finger pulp mimicking pyogenic granuloma. Complete excision of the mass was done. The radiological and the histopathological findings suggested giant cell tumor of the tendon sheath. The patient had no recurrence at the end of a two-year follow-up. This unusual clinical presentation of the giant cell tumor of the tendon sheath was our study base and adds up to its variant presentation in the literature.


2019 ◽  
Vol 08 (03) ◽  
pp. 215-220 ◽  
Author(s):  
S. Ruatti ◽  
M. Boudissa ◽  
P. Grobost ◽  
G. Kerschbaumer ◽  
J. Tonetti

Purpose Giant cell tumor of the distal radius are frequent lesions, and different types of surgeries have been described. Functional results, after conservative treatment or arthrodesis, often find a decreased strength and range of motion. The sacrifice of the distal radioulnar joint could be one of the causes. We report the case of a 26-year-old patient who presented with a Campanacci Grade III giant cell tumor of the distal radius. We managed his case by the association of en bloc resection and allograft reconstruction with the preservation of distal radioulnar joint. Hypothesis This procedure could improve functional results, without increasing the risk of recurrence at 2 years follow-up. Case Report The originality of our technique was the possibility of distal radioulnar joint conservation. We preserved a long portion of cortex bone all through the ulnar side of the distal radius. We then used an allograft of distal radius, fixed by a reconstruction anatomical plate. Results At 2 years follow-up, the range of motion was 100° with 60° of palmar flexion, 40° of extension, 75° of pronation, and 70° of supination. Radial and ulnar inclination were 10 and 15°, respectively. MTS (Musculoskeletal Tumor Society Score) 1993 was 88% and DASH score was 6. Concerning grip strength, it was measured at 85% in comparison with the other side. Pronation and supination strengths were 80 and 73%, respectively, in comparison with the other side. At follow-up, standard X-rays showed no recurrence. The allograft was well integrated. Conclusion Conservative treatment of the distal radioulnar joint allowed an almost ad integrum recovery, concerning strengths and range of motion. It allows a better functional recovery, without increasing the risk of recurrence.


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