scholarly journals A case of synovial chondromatosis of knee joint treated with total knee arthroplasty

2021 ◽  
pp. 221049172098381
Author(s):  
Sourav Kumar Pal ◽  
Konchada Srikant ◽  
Amlan Dash

Synovial Chondromatosis is a rare disease of the synovial membrane characterised by formation of multiple loose bodies in a joint. Knee is the most common joint to be affected by this disease. Though, this disease can be managed by synovectomy and removal of loose bodies with a favourable functional outcome but in some cases where there is damage of articular cartilage, simple synovectomy might not be sufficient. Here, we present a case of right knee pain in a 53 year old male since 4 years with a established diagnosis of synovial chondromatosis. No other joint was affected. Pain was associated with a fixed flexion deformity and restriction of knee range of motion and multiple slipping bodies. Radiography showed multiple loose bodies in the tibio-femoral as well as in patello femoral compartment. MRI of knee revealed several damaged areas in the knee articular surface. As a result, decision was taken to perform total knee arthroplasty. Intraoperatively all the loose bodies were removed along with the affected synovium and arthroplasty was done. Patient was discharged in fourth post operative day with proper instructions and was called for follow up at 1 month, 3 month, 6 month, 1 year. Functional outcome was assessed by Tegner Lysholm knee score, Knee Society score and Visual Assessment Scale.

2021 ◽  
pp. 42-44
Author(s):  
Amol K Salve ◽  
Vinod Kumar Yadav ◽  
Ajay M Wankhade ◽  
Tanay Nahatkar ◽  
Sangam Jain

Intro- For TKA, there are two types of bearing designs: xed-bearing and mobile-bearing. Round femoral components articulate with a relatively at tibial articular surface in a xed-bearing knee design. Because the insert does not hinder the natural movements of the femoral component, the mobile-bearing (MB) TKA design is thought to allow more exibility of motion than the xed-bearing (FB) variety. Aim and objective: To compare xed bearing and mobile bearing total knee arthroplasty. Material and methods:This study is a prospective type of study done at Seth GS medical college Mumbai, Department of Orthopaedics during August 2019 to June 2021 on patients undergoing total knee arthroplasty. Patients who were to undergo total knee arthroplasty were invited to take part in the study. This study, done on them was explained in detail to them. An informed consent was obtained. Patients fullling the inclusion criteria were listed. Result: Range of motion achieved after mobile arthroplasty was 123.62±2.94 and in xed arthroplasty it was 121.96±2.74. Pain after last follow up in mobile arthroplasty was 48.83±0.62 and for xed arthroplasty was 47.39±0.86. Flexion gap after last follow up in mobile arthroplasty was 24.13±0.45 and in xed was 24.02±0.45. Stability was almost similar in both mobile and xed arthroplasty. Conclusions: there is no signicant difference between xed arthroplasty and mobile arthroplasty as far as Range of motion, Pain ,Flexion gap. Stability was almost similar in both mobile and xed arthroplasty.


2021 ◽  
Vol 12 (1) ◽  
pp. 567-570
Author(s):  
Pradeep P ◽  
Thiyagarajan U ◽  
Senthil Loganathan ◽  
Raghavendar B

Total knee arthroplasty is becoming a more frequently performed orthopedics surgery these days aimed mainly to improve the functional outcome and correct deformity in patients suffering from arthritis of the knee joint. To evaluate the results, we conducted a prospective study from March 2017 to December 2019. The pain was evaluated every 4th hourly during the first 24 hours and thereon every 6th hourly till 5th POD. The 2MWT was administered during the 2nd POD and 6MWT was administered during the 6 weeks follow up to check for the muscle endurance when walking. In our study, we had 22 patients who were between 55-60 years, 21 patients between 61-70 years and 17 patients between 71-80 years. Based on analysis of our results, the mean VAS pain score was 4 on POD 0 and VAS pain score was 3 on Post-operative day 1 and 2. The 2 MWT administered on the 2nd POD showed that 35 patients (58.3%) were able to walk 30 meters. The rest of the 25 patients (42%) were not able to do the 2MWT due to various reasons like pain (15) and dizziness (10). The 6MWT administered at 6 weeks showed that all the patients were able to walk an average of 480 meters. Periarticular cocktail of analgesics used in Total knee arthroplasty was associated with a favorable improvement in walking capacity, pain management in the immediate post-operative period and improved knee function. Periarticular administration of a cocktail of analgesics helped to improve the patient's ambulatory status.


2018 ◽  
Vol 69 (8) ◽  
pp. 2222-2227
Author(s):  
George Viscopoleanu ◽  
Bogdan Sendrea ◽  
Emil Haritinian

The objectives of the current study were to identify the causes leading to revision knee arthroplasty, analyse implant choices and assess the short-term outcome. The current study is a retrospective on including a group of 33 patients operated between Jan 2013-Dec 2016 in a single institution. Data was collected from the Romanian National Arthroplasty Register. The cause for revision surgery was noted, as well as the type of implant used during the surgical procedure. The bony defect was classified according to the Anderson Orthopaedic Research Institute (AORI) Classification and the reconstruction method was analysed. Functional outcome was assessed using Oxford Knee Score preoperatively and at one year follow-up. Infection was the cause of failure in 18 cases, aseptic loosening in 11 cases, malposition of implants in 2 cases, instability in 1 case and periprosthetic fracture in 1 case. Revision implants were chosen based on joint stability and degree bone loss. The preferred implant was a condylar constrained knee type (20 cases), followed by a rotating hinge type (5 cases). An unconstrained implant was used in 2 cases. Six infected cases required an arthrodesis of the knee. Based on the AORI Classification, there were 10 type III defects, 14 type IIB, 8 type IIA and only one type I defect. Metal augments were preferred for reconstruction of bone defects. Bone graft was used in 8 cases. The mean Oxford Knee Score was 15 pre-op (12-20) and 38 post-op (32-45). Implant survival at final follow-up was 100%. The most common cause of failure of primary total knee arthroplasty is prosthetic joint infection. Bone defects can be addressed using metal augments or bone allograft. Postoperative functional outcome is improved irrespective of the type of implant used.


2018 ◽  
Vol 5 (1) ◽  
pp. 29-32
Author(s):  
Sameer Rathore ◽  
Nithin Vadlamudi ◽  
Yellati Lvsnr ◽  
A.H. Ashwin Kumar ◽  
Indukuri Viswanatha Reddy ◽  
...  

Author(s):  
Radhakrishna A. M. ◽  
Shivananda S. ◽  
Girish S.

<p class="abstract"><strong>Background:</strong> To <span lang="EN-IN">study the clinical and functional outcome in a consecutive series of Total Knee Arthroplasty using Posterior cruciate substituting (PS) design using the Knee Society Score(KSS). The objectives of the study was 1) To assess the improvement in pain relief post-operatively, stability, mobility of the joint and to assess the correction of deformities. 2) To compare the knee clinical score (KCS) pre-operatively and post-operatively. 3) To compare the knee functional score (KFS) pre-operatively and post-operatively. 4) To assess the radiological outcome of total knee arthroplasty. 5) To study the association between the KCS and the KFS.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">The study was conducted on patients who have undergone Primary total knee replacement, in Department of Orthopaedics, KIMS hospital from June 2014 to February 2017. The patient was assessed clinically, functionally using the Knee Society Score and a radiographic evaluation was done. These evaluations were performed at 6weeks, 12 weeks, 24 weeks and 1year follow up visits</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">At 1 year follow up of 60 knees, the average pre-op knee clinical score and functional score of 24.7 and 41.2 improved to an average post-op score of 89.9 and 87.8 respectively. Knee clinical and functional score grade of excellent to good was seen in 96.7% (58 knees of 60). Significant association was seen between KCS and KFS. 5 patients had delayed wound healing and one patient had deep infection. Alignment of prosthesis was found satisfactory in all patients. Flexion deformity, valgus and varus correction achieved in all the patients. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Total knee arthroplasty using posterior cruciate substituting designs resulted in excellent relief of pain, range of motion, restoration of function, low prevalence of patellofemoral complications and continues to function well during the follow-up period. Improvement in clinical score correlated significantly with improvement in functional score. Knee society scoring system effective in evaluating clinical, functional and radiological outcomes.</span></p><p> </p>


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