scholarly journals Fast Bowlers Knee - anterior impingement from the antero-medial tibia and femur

2017 ◽  
Vol 5 (5_suppl5) ◽  
pp. 2325967117S0019
Author(s):  
MJ Reid ◽  
SM Thompson ◽  
R Dawahn ◽  
M Jones ◽  
A Williams
Keyword(s):  
Knee Pain ◽  
Femoral Condyle ◽  
Arthroscopic Surgery ◽  
Clinical Findings ◽  
Left Knee ◽  
Injury Pattern ◽  
Medial Femoral Condyle ◽  
Duration Of Symptoms ◽  
Elite Level ◽  
The Mean

Objectives: Cricket is one of the world’s most popular team sports. In the past it was described as a sport of moderate risk for injury however at elite level, the international cricket timetable has massively expanded to encompass several new formats leaving very little time for recuperation. We report on a series of seven elite level fast bowlers that presented with a similar injury pattern to the antero-medial femoral condyle of the knee in the leading leg. We describe the presentation, investigation and treatment of this lesion and discuss the possible aetiology. This injury pattern has not previously been reported in the literature. Methods: 7 international level fast bowlers (two Indian and 5 English) presented to our clinic with knee pain in the lead leg (the right knee for left hand bowlers and the left knee for right handed). The mean age of the patients was 27 (20-32) and the mean duration of symptoms was 9 months (2 weeks to 2 years). In all patients a careful history and examination was undertaken followed by appropriate investigations. The main complaint was that of anterior knee pain which was restricting them from bowling. It was associated with a minor fixed flexion in three of the patients and all patients had an effusion at the time of presentation. There were no other symptoms. All patients underwent an MRI scan. A classical appearance of oedema within the medial femoral condyle (Figure 1) was noted. In 4 patients there was ascociated cartilage loss. The injury was also identified on SPECT scan (Figure 2) 3 patients were managed nonoperatively but due to more significant MRI and clinical findings Four went on to require arthroscopic surgery (Figure 3) in the form of microfracture of the lesion. Results: All patients returned to International cricket with a mean of 6 months in the non-operative group and 8 months in the operative group. Conclusion: Anterior impingement from the antero-medial tibia and femur can be a potentially career ending lesion in the fastbowler. A strong index of suspicion has to be exercised when a bowler attends with an effusion associated with episodic pain and localisation (which may be difficult to ascertain). This lesion may be present in the asymptomatic bowler, presenting with an associated injury in the same knee. This lesion is typical in this elite group and as such training schedules and medical staff need to be aware of it as a cause of significant injury.

Vascularized Medial Femoral Condyle Bone Graft for Resistant Nonunion of the Distal Radius

2017 ◽  
Vol 22 (01) ◽  
pp. 23-28 ◽  
Author(s):  
Mark Henry
Keyword(s):  
Distal Radius ◽  
Femoral Condyle ◽  
Difficult Problem ◽  
Medial Femoral Condyle ◽  
Dash Score ◽  
Structural Block ◽  
Surgical Interventions ◽  
Paired Student ◽  
Co Morbidity ◽  
The Mean

Background: Nonunion involving the metaphyseal region of the distal radius is exceedingly rare, usually involving co-morbidity. Patients that have failed multiple prior conventional surgical interventions represent an even more difficult subset to treat; this investigation examined the utility of a specially designed free vascularized medial femoral condyle flap consisting of a central structural block graft with an extended corticoperiosteal sleeve to wrap around the junctions. Methods: Six patients (5 males, 1 female) with a mean age of 52 years had failed to achieve union involving the distal radius metaphysis after a mean of 3.7 prior surgeries occurring over a mean period of 24 months. Comorbidities included smoking, alcoholism, chronic nutritional deficiency, and prior osteomyelitis. The unique descending genicular artery medial femoral condyle flap designed to address these patients consisted of a central structural block graft in continuity with an extended corticoperiosteal sleeve. The structural block filled the bone defect, and the corticoperiosteal sleeve wrapped around the bone junctions and the neighboring bone margins. The mean flap size was 5.3 (+/- 1.3) cm long by 4.5 (+/- 0.9) cm wide. Pre-operative to post-operative DASH scores were compared using the paired student’ s t-test, with p < 0.05. Results: All flaps achieved union at a mean of 6.8 (+/- 2.1) weeks following surgery, using the criteria of bridging trabeculae on all 3 radiographs: coronal, sagittal, and oblique. The mean pre-operative DASH score of 63 (+/- 10) was statistically significantly different compared to the mean post-operative DASH score of 18 (+/- 8). Conclusions: With few alternative solutions able to address this unique and difficult problem, the structural block of vascularized bone with the extended corticoperiosteal sleeve proved able to achieve a union that had failed multiple previous attempts and able to resist reactivation of infection, in a challenging group of patients with comorbidities.

ACCURACY OF SPECT IMAGING FOR ARTHROSCOPICALLY CONFIRMED MENISCAL TEARS IN PATIENTS WITH ACUTE KNEE PAIN AND NO RADIOGRAPHIC ARTHRITIS

2014 ◽  
Vol 17 (01) ◽  
pp. 1450006
Author(s):  
Barak Haviv ◽  
Shlomo Bronak ◽  
Rafael Thein
Keyword(s):  
Knee Pain ◽  
Tibial Plateau ◽  
Meniscal Tear ◽  
Arthroscopic Surgery ◽  
Emission Computed Tomography ◽  
Meniscal Tears ◽  
Plain Radiographs ◽  
The Mean ◽  
Spect Scan ◽  
Acute Knee

Purpose: To evaluate the accuracy of single photon emission computed tomography (SPECT) compared with arthroscopy in the diagnosis of acute knee pain due to meniscal tear. Methods: Patients with knee pain that persisted for less than six months with normal plain radiographs that had arthroscopic surgery following SPECT scan were included. The main scintigraphic criterion for diagnosing a tear of the meniscus was tibial plateau activity on the planar image with at least a half crescent of peripheral tibial plateau uptake. The accuracy of SPECT in detecting meniscal tears was calculated according to the arthroscopic findings as the gold standard. Results: There were 68 patients in the study (46 males and 22 females). The mean age was 45.3 (17–72) years and the mean time between SPECT scan and surgery was 3.5 (1–6) months. The overall sensitivity of SPECT was 90%, specificity 70%, NPV 54%, PPV 95% and accuracy 87%. Conclusion: SPECT was found to be an accurate imaging technique in the diagnosis of symptomatic meniscal tears in patients with acute knee pain and unremarkable plain radiographs. Thus, SPECT may be helpful in selecting candidates for arthroscopy.

scholarly journals Multiple Osteochondritis Dissecans in Multiple Joints

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Takuto Takeda ◽  
Ryuichiro Akagi ◽  
Yusuke Sato ◽  
Takahiro Enomoto ◽  
Ryosuke Nakagawa ◽  
...  
Keyword(s):  
Osteochondritis Dissecans ◽  
Femoral Condyle ◽  
Contralateral Side ◽  
Left Knee ◽  
Medial Femoral Condyle ◽  
The Body ◽  
Mri Scan ◽  
Femoral Trochlea ◽  
History Of ◽  
The Right

Background. Osteochondritis dissecans (OCD) rarely occurs in multiple joints. Furthermore, the existence of left-right asymmetric OCDs in different joints of the contralateral side of the body and lesions occurring with a temporal difference is rare. Here, we report a rare case with multiple OCDs sequentially detected in various joints. Case Presentation. The 15-year-old male patient was referred to our hospital for an OCD in the medial femoral condyle of the left knee. He had a history of an OCD in his right elbow, and his father had a history of surgically treated OCDs in both knees. One year and five months after, surgery was performed to the lesion in his left medial femoral condyle, a new OCD lesion occurred in the femoral trochlea of the same knee, which was again treated surgically. Five months after the second surgery, the patient returned with pain in the right knee, and an OCD on the right femoral trochlea was detected by an MRI scan. This lesion remained stable without any further restriction in physical activities for 17 months until detachment occurred and was again treated surgically. Conclusion. In cases with history and a family history of multiple OCDs, in particular, with a short stature, an MRI scan should be performed for the symptomatic joint to detect and treat the lesion before progression.

scholarly journals Intra-articular dislocation of the patella: a rare variant to an uncommon injury

2019 ◽  
Vol 12 (4) ◽  
pp. e228098
Author(s):  
Sushil Rangdal ◽  
Vikas Bachhal ◽  
Saurabh Vashisht ◽  
Mandeep Singh Dhillon
Keyword(s):  
Patellar Dislocation ◽  
Unusual Case ◽  
Articular Surface ◽  
Femoral Condyle ◽  
Quadriceps Tendon ◽  
Injury Pattern ◽  
Medial Femoral Condyle ◽  
Locked Knee ◽  
Superior Pole ◽  
Dislocation Of The Patella

Horizontal intra-articular dislocation of the patella is a very rare traumatic entity. We present an unusual case of horizontal intra-articular dislocation in which the patellar articular surface was facing upwards besides having an avulsion of the quadriceps tendon from the superior pole. There was associated posterolateral knee subluxation, which has not been described with intra-articular dislocation of the patella. A 20-year-old man presented with open patellar dislocation and locked knee after a roadside accident. The patient was managed successfully by open reduction and repair of the quadriceps tendon. There was buttonholing of the medial femoral condyle through the medial retinaculum leading to irreducible dislocation. A special reduction manoeuvre was employed to bring the knee to its normal alignment. Knowledge of this injury pattern is of utmost importance for proper recognition and appropriate allocation of the surgical technique.

scholarly journals Increasing posterior condyle cut for high-flex knee prosthesis may injure popliteus tendon origin: a cadaveric study

2020 ◽  
Vol 4 (1) ◽  
pp. 1-5
Author(s):  
Ong-art Phruetthiphat
Keyword(s):  
Standard Model ◽  
Knee Prosthesis ◽  
Femoral Condyle ◽  
Tendon Injury ◽  
Left Knee ◽  
Popliteus Tendon ◽  
Posterior Condyle ◽  
Total Knee ◽  
The Mean ◽  
The Right

Background: High-flex total knee prosthesis designs were proposed to improve flexion in total knee replacement (TKA). One of high-flex features is increasing posterior condyle cut which put popliteal tendon in higher risk of injury and may result in gap changes. Methods: Thirty-six popliteal origin sites from eighteen fresh cadavers were measured distances between the posterior rim of popliteal tendon origin and posterior border of the lateral femoral condyle (distance A) using digital “Vernier caliper”. The mean distances were compared to posterior condyle thickness of different prosthesis designs. Results: The mean of distance A on the right knee was 9.59 ±1.66 mm (6.03-12.70) while the mean of distance A on the left knee was 9.13 ± 1.78 mm (5.80-11.07). Posterior condyle thickness of the femoral prostheses varies upon their design and size from 7.4 to 10 mm for standard model and from 8.2 to 12.5 mm for high-flex design. Possibilities of popliteal tendon injury during posterior condyle bone cut were 16.7% to 66.7% for standard model and 27.8% to 97.2% for the high-flex design. Conclusion: High-flex TKA prosthesis with thicker posterior condyle relates to higher possibility of popliteal tendon origin injury compared to standard one.

scholarly journals Symptomatic Calcification within the Lateral Collateral Ligament of Knee: A Case Report on Rare Abnormality

2021 ◽  
Vol 9 (2) ◽  
Author(s):  
Sukesh A N ◽  
George Jacob ◽  
Jacob Varughese
Keyword(s):  
Knee Pain ◽  
Case Reports ◽  
Femoral Condyle ◽  
Lateral Collateral Ligament ◽  
Left Knee ◽  
Conservative Approach ◽  
Collateral Ligament ◽  
Lateral Aspect ◽  
Case Presentation ◽  
Anterior Posterior

Introduction: Lateral collateral ligament calcification is a rare cause of knee pain. There are only a handful of case reports, and the findings are usually incidental and asymptomatic. The exact mechanism for calcific deposit remains unclear. We present a case of symptomatic calcification within the lateral collateral ligament treated by surgical enucleation. Case presentation: A 52-year-old active woman presented with complaints of pain over the lateral aspect of the left knee of 6 months’ duration. Her pain was severe, aggravated on descending stairs but relieved on rest. Clinical examination revealed tenderness over the lateral aspect of the knee joint. Standard standing anterior-posterior radiograph of the left knee revealed a homogenous dense opacity adjacent to the lateral femoral condyle. Conclusion: Calcification within the lateral collateral ligament is rare and treatment is determined by whether the patient is symptomatic or not. If symptoms of the patient cannot be alleviated with a conservative approach, we recommend a surgical enucleation of the calcification, which in our case had good results. Keywords: Calcification, Knee pain, Lateral collateral ligament

scholarly journals MEDIAL FEMORAL CONDYLE CORTICOPERIOSTEAL FLAP: ANATOMIC STUDY

2018 ◽  
Vol 26 (3) ◽  
pp. 179-182 ◽  
Author(s):  
GUSTAVO BERSANI SILVA ◽  
MATHEUS TEOTONIO VELLOSA ◽  
ALVARO BAIK CHO ◽  
RAQUEL BERNARDELLI IAMAGUCHI DA COSTA ◽  
OLAVO PIRES DE CAMARGO ◽  
...  
Keyword(s):  
Knee Joint ◽  
Femoral Condyle ◽  
Case Series ◽  
Medial Femoral Condyle ◽  
Musculoskeletal Injuries ◽  
Anatomic Study ◽  
Level Of Evidence ◽  
Mean Diameter ◽  
Genicular Artery ◽  
The Mean

ABSTRACT Objective The medial femoral condyle corticoperiosteal flap is irrigated by the descending genicular artery, and when this is absent, by the superior medial genicular artery. The descending genicular artery divides into the muscular, saphenous, and osteoarticular branches. The objective of this study was to describe the variables involved in the dissection of the medial femoral condyle flap. Methods Thirty thighs from 20 cadavers were dissected and the following variables were recorded: age, height, weight, thigh length, presence of the descending genicular artery, whether the saphenous branch originated from the descending genicular artery, the length of the branches originating from the descending genicular artery, and the diameter of the descending genicular artery and the vena comitans. Results The descending genicular artery was present in 93.3% of the specimens (28/30). The saphenous branch originated from this artery in 76.7% of the dissections (23/70). The mean distance between the origin of the descending genicular artery and the knee joint was 13.4 cm (±١.4), the mean length of the descending genicular artery was 7.5 cm (±1.5), the mean diameter of the descending genicular artery was 1.9 mm (±٠.3), and the mean diameter of the vena comitans was 1.7 mm (±٠.3). Conclusion The vascularized medial femoral condyle is a versatile option for reconstruction of musculoskeletal injuries. It allows transference of bone associated with muscle and skin, which are each nourished by independent branches. Level of Evidence IV; Case series.

scholarly journals Diagnostic features of the presumed focal viral retinitis: A case series

2020 ◽  
Vol 12 (2) ◽  
pp. 339-346
Author(s):  
Anu Manandhar
Keyword(s):  
Visual Acuity ◽  
Case Series ◽  
Oral Prednisolone ◽  
Sudden Onset ◽  
Clinical Findings ◽  
Diagnostic Features ◽  
Duration Of Symptoms ◽  
Irregular Margin ◽  
Unilateral Involvement ◽  
The Mean

Introduction: Other than well-known herpetic retinopathies like acute retinal necrosis, progressive outer retinal necrosis and cytomegalovirus retinitis, there are few reports on atypical forms of viral retinitis caused by herpes virus from around the world. Cases: Presenting symptom was sudden onset of diminution of vision in all 6 cases. Mean duration of symptoms at presentation was 7.6 days. The mean age was 27.3 years (range 22-40 years). All were immunocompetent (4 females and 2 males), with unremarkable review of system. All had unilateral involvement. Presenting visual acuity ranged from CFCF to 6/60. Granulomatous anterior uveitis was present in 4 cases. All had focal retinitis with irregular margins, either juxtapapillary, macular or over one of the major vascular arcades. The diagnosis of focal viral retinitis was made solely based upon the clinical findings. All recovered after a course of oral acyclovir (one was given additional intravitreal acyclovir as well) and oral prednisolone, with final visual acuity of 6/6P to 6/9 in all except one. Conclusion: In case of focal retinitis with irregular margin, viral etiology should be borne in mind. Clinical features are typical enough to help in diagnosing without PCR test.

scholarly journals Knee pain caused by a fiducial marker in the medial femoral condyle: A clinical and anatomic study of 20 cases

2001 ◽  
Vol 72 (5) ◽  
pp. 477-480 ◽  
Author(s):  
Michael Nogler ◽  
Herbert Maurer ◽  
Cornelius Wimmer ◽  
Constantin Gegenhuber ◽  
Christian Bach ◽  
...  
Keyword(s):  
Knee Pain ◽  
Femoral Condyle ◽  
Fiducial Marker ◽  
Medial Femoral Condyle ◽  
Anatomic Study

scholarly journals An acquired plica-induced notch in the medial femoral condyle in a patient with medial patellar plica syndrome: a case report

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sung-Jae Kim ◽  
Yong Gon Koh ◽  
Yong Sang Kim
Keyword(s):  
Articular Surface ◽  
Femoral Condyle ◽  
Cartilage Damage ◽  
Arthroscopic Surgery ◽  
Medial Femoral Condyle ◽  
Resonance Imaging ◽  
Case Presentation ◽  
Articular Facet ◽  
Plica Syndrome ◽  
Preoperative Magnetic Resonance

Abstract Background An inflamed and thickened medial patellar plica (MPP) caused by repeated mechanical irritation from trauma or overuse leads to impingement between the anterior medial femoral condyle and the medial articular facet of the patella and produces pain or clicking, which is known as MPP syndrome. In patients with MPP syndrome, cartilage damage may occur depending on the shape of the MPP and the duration of the impingement. Case presentation Preoperative magnetic resonance imaging in a 17-year-old male patient with MPP syndrome showed a hypertrophic MPP along with an abnormal notch in the articular surface of the medial femoral condyle. We considered that the impinged hypertrophic plica between the anterior medial femoral condyle and the medial articular facet of the patella resulted in cartilage damage on the articular surface of the medial femoral condyle. However, during arthroscopic surgery, we found that the cartilage of the notch, which was located beneath the MPP, was completely intact. We concluded that this abnormal notch had developed gradually in the MPP without cartilage damage. Conclusions Surgeons should be mindful that acquired plica-induced notches in the articular surface of the medial femoral condyle can present in patients with MPP syndrome.

Sign in / Sign up

Export Citation Format

Share Document