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 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.

scholarly journals Synovial chondromatosis combine with synovial tuberculosis of knee joint: a case report

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Nan Zhou ◽  
Ke Fang ◽  
Djandan Tadum Arthur V ◽  
Runbin Yi ◽  
Feng Xiang ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Knee Joint ◽  
Knee Pain ◽  
Synovial Chondromatosis ◽  
Left Knee ◽  
Loose Bodies ◽  
Case Presentation ◽  
Joint Cavity ◽  
Careful Investigation

Abstract Backgroud Synovial chondromatosis is a rare synovial-derived metaplasia disease that comes from the formation of cartilage nodules within the synovial connective tissue of the joint. Knee tuberculosis is a disease caused mostly by the pulmonary tuberculosis and a few by tuberculosis of the digestive tract and lymphatic. tube. Case presentation Herein we report a 3-year-old child admitted by intermittent swelling of left knee joint with lameness for half a year, the patient received surgical treatment. The loose bodies filled in the joint cavity was taken out and the degenerative synovium was excised. Biopsy confirmed as synovial chondromatosis combined with synovial tuberculosis of knee joint. After 6 months follow-ups, knee swelling and claudication get totally recovered and the gait of patient recover back to normal. Conclusion Careful investigation of children with knee pain is recommended to avoid misdiagnosis, Synovial chondromatosis combine with tuberculosis should be considered a differential diagnosis in a child with knee pain.

Graft Site Morbidity in Elbow Ligament Reconstruction Procedures: A Systematic Review

2017 ◽  
Vol 45 (14) ◽  
pp. 3382-3387 ◽  
Author(s):  
Noortje C. Hagemeijer ◽  
Femke M.A.P. Claessen ◽  
Roel de Haan ◽  
Roeland Riedijk ◽  
Denise E. Eygendaal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ligament Reconstruction ◽  
Case Reports ◽  
Meta Analysis ◽  
Lateral Collateral Ligament ◽  
Extensor Tendon ◽  
Morbidity Rate ◽  
Collateral Ligament ◽  
Reconstruction Procedure ◽  
Longus Tendon

Background: It is unclear which tendon harvest for ulnar or lateral collateral ligament reconstruction has the lowest graft site morbidity rate. Purposes: To obtain graft site morbidity rates after tendon harvest for ulnar and lateral collateral ligament reconstruction procedures. Study Design: Systematic review/Meta-analysis. Methods: Studies were eligible if (1) patients had undergone elbow ligament reconstruction procedures; (2) original data for at least 5 patients were available; (3) the article was written in English, German, or Dutch; (4) a full-text article was available; and (5) information about graft site morbidity was available. The review excluded studies about complicated elbow ligament reconstruction procedures due to initial fractures, revision procedures, or circumferential graft techniques; animal studies; (systematic) reviews; and expert opinions. Because the majority of studies were case reports, no selection form or overall scoring system to evaluate methodological quality was used. Results: The review included 619 patients with an ulnar or lateral collateral ligament reconstruction procedure. The autograft types used included palmaris longus tendon (58%), gracilis tendon (24%), semitendinosus tendon (8%), triceps tendon (7%), toe extensor tendon (<2%), plantaris tendon (<2%), extensor carpi radialis longus tendon (<1%), and Achilles tendon (<1%). Conclusion: Graft site morbidity occurred in 1% of the patients after an ulnar or lateral collateral ligament reconstruction procedure. This study did not have enough samples of all the autograft types to conclude that autograft type and graft site morbidity are unrelated.

scholarly journals The evaluation of the distance between the popliteus tendon and the lateral collateral ligament footprint and the implant in Total Knee Arthroplasty using a 3-dimensional template.

2020 ◽  
Author(s):  
Akihito Takubo ◽  
Keinosuke Ryu ◽  
Takanori Iriuchishima ◽  
Masahiro Nagaoka ◽  
Yasuaki Tokuhashi ◽  
...  
Keyword(s):  
Femoral Condyle ◽  
Lateral Collateral Ligament ◽  
Lower Limbs ◽  
Lateral Femoral Condyle ◽  
Popliteus Tendon ◽  
Femoral Bone ◽  
Collateral Ligament ◽  
Bone Resection ◽  
Total Knee ◽  
Resection Area

Abstract Background The popliteus tendon (PT) or lateral collateral ligament (LCL) stabilizes the postero-lateral aspects of the knees. When surgeons perform total knee arthroplasty (TKA), PT and LCL iatrogenic injuries are a risk because the femoral attachments are relatively close to the femoral bone resection area. The purpose of this study was to evaluate the distance between the PT or LCL footprint and the TKA implant using a 3D template system and to evaluate any significant differences according to the implant model.Methods Eighteen non-paired formalin fixed cadaveric lower limbs were used (average age: 80.3). Whole length lower limbs were resected from the pelvis. All the surrounding soft tissue except the PT, knee ligaments and meniscus were removed from the limb. Careful dissection of the PT and LCL was performed, and the femoral footprints were detected. Each footprint periphery was marked with a 1.5 mm K-wire. Computed tomography (CT) scanning of the whole lower limb was then performed. The CT data was analyzed with a 3D template system. This simulation models for TKA were the Journey II BCS and the Persona PS. The area of each footprint, and the length between the most distal and posterior point of the lateral femoral condyle and the edge of each footprint were measured. Matching the implant model to the CT image of the femur, the shortest length between each footprint and the bone resection area were calculated.Results PT and LCL footprint were detected in all knees. The area of the PT and LCL footprints was 38.7±17.7mm2 and 58.0±24.6mm2, respectively. The length between the most distal and posterior point of the lateral femoral condyle and the edge of the PT footprint was 10.3±2.4mm and 14.2±2.8mm, respectively. The length between most distal and most posterior point of the lateral femoral condyle and the edge of the LCL footprint was 16.3±2.3mm and 15.5±3.3mm, respectively. Under TKA simulation, the shortest length between the PT footprint and the femoral bone resection area for the Journey II BCS and the Persona PS was 4.3±2.5mm and 3.2±2.9mm, respectively. The shortest length between the LCL footprint and the femoral bone resection area for the Journey II BCS and the Persona PS was 7.2±2.3mm and 5.6±2.1mm, respectively. The PT attachment was damaged by the bone resection of the Journey II BCS and the Persona PS TKA in 3 and 9 knees, respectively.Conclusion The PT and LCL femoral attachments existed close to the femoral bone resection area of the TKA. To prevent postero-lateral instability in TKA, careful attention is needed to avoid damage to the PT and LCL during surgical procedures.

scholarly journals Stress And Strain At The Lateral Collateral Ligament Complex Of The Elbow Joint

2007 ◽  
Author(s):  
G O Mbaka ◽  
A B Ejiwunmi ◽  
V U Chukwuma ◽  
O O Odusote
Keyword(s):  
Elbow Joint ◽  
Lateral Collateral Ligament ◽  
Qualitative Assessment ◽  
Annular Ligament ◽  
Stress And Strain ◽  
Collateral Ligament ◽  
Lateral Aspect ◽  
Full Extension ◽  
Radial Collateral Ligament ◽  
The Impact

Background: The radial collateral ligament was previously believed to be the only ligament existing at the lateral aspect of the elbow joint until Morrey and An (1976) classified the ligaments to include radial collateral (RCL) and lateral ulnar collateral ligaments (LUCL). There is therefore the need to assess the impact these ligaments in elbow joint stability. Objective: To investigate how the RCL and LUCL are affected by stress and strain in both routine and forceful movements of the limb. Materials and Methods: Eight (8) embalmed upper extremities were used for this investigation. The elbow joint was dissected with care taken to preserve the lateral ulnar collateral ligament seen in seven of the limbs. Qualitative assessment of ligament tension was made under valgus and varus stresses. The angles at which stress was applied were 450, 700, 750, 900, 1100, 1200 and full extension. These angles were chosen partly because most movements during racket sporting activities take place at higher angles (Regan et al 1991). The angles were determined by hand held goniometer while the arm was firmly held in a retort stand. Results: The RCL is more able to absorb stress and strain because of its greater flexibility enhanced by its attachment at the annular ligament. However, LUCL a thickened mass, in both valgus and varus stresses was taut throughout most of the entire arc of flexion. It is a much stronger ligament that effectively stabilizes elbow joint in both routine and forceful movement. Conclusion: This study has been able to establish that LUCL is more prone to stress and strain. Being attached from bone to bone, it equally provides greater stability at the lateral aspect of elbow joint. KEY WORDS: Elbow joint; Ulna and Radial Collateral Ligament; stress and strain.

scholarly journals The evaluation of the distance between the popliteus tendon and the lateral collateral ligament footprint and the implant in Total Knee Arthroplasty using a 3-dimensional template.

2020 ◽  
Author(s):  
Akihito Takubo ◽  
Keinosuke Ryu ◽  
Takanori Iriuchishima ◽  
Masahiro Nagaoka ◽  
Yasuaki Tokuhashi ◽  
...  
Keyword(s):  
Femoral Condyle ◽  
Lateral Collateral Ligament ◽  
Simulation Models ◽  
Ct Scanning ◽  
Lower Limbs ◽  
Lateral Femoral Condyle ◽  
Popliteus Tendon ◽  
Collateral Ligament ◽  
Bone Resection ◽  
Resection Area

Abstract Background When surgeons perform TKA, popliteus tendon (PT) and lateral collateral ligament (LCL) iatrogenic injuries are a risk because the femoral attachments are relatively close to the bone resection area. The purpose of this study was to evaluate the distance between the PT or LCL footprint and the TKA implant using a 3D template system and to evaluate any significant differences according to the implant model. Methods Eighteen non-paired formalin fixed cadaveric lower limbs were used. All the surrounding soft tissue except the PT, ligaments and meniscus were removed from the knee. Careful dissection of the PT and LCL was performed, and the femoral footprints were detected. Each footprint periphery was marked with a K-wire. CT scanning was then performed. The data was analyzed with a 3D template system. This simulation models for TKA were the Journey II BCS and the Persona PS. The area of each footprint, and the length between the most distal and posterior point of the lateral femoral condyle and the edge of each footprint were measured. Matching the implant model to the CT image, the shortest length between each footprint and the osteotomy area were calculated. Results The area of the PT and LCL footprints was 38.7±17.7mm 2 and 58.0±24.6mm 2 . The length between the most distal and posterior point of the lateral femoral condyle and the edge of the PT footprint was 10.3±2.4mm and 14.2±2.8mm. The length between these same points and the edge of the LCL footprint was 16.3±2.3mm and 15.5±3.3mm. Under TKA simulation, for the Journey II BCS and the Persona PS, the shortest length between the PT footprint and the osteotomy area was 4.3±2.5mm and 3.2±2.9mm, and the shortest length between the LCL footprint and the osteotomy area was 7.2±2.3mm and 5.6±2.1mm. The PT attachment was damaged by the bone resection of the Journey II BCS and the Persona PS TKA in 3 and 9 knee. Conclusion The PT and LCL femoral attachments existed close to the femoral bone resection area of the TKA. Careful attention is needed to avoid damage to the PT and LCL during surgical procedures.

scholarly journals PCL rupture tibial avulsion in a contact athlete teen with open physis. One case presentation and literature review

2017 ◽  
Vol 5 (1_suppl) ◽  
pp. 2325967117S0001
Author(s):  
Mario Larrain ◽  
Eduardo Di Rocco ◽  
Patricio Riatti ◽  
Facundo Ferreyra ◽  
Juan Sebastián Cianciosi
Keyword(s):  
Knee Pain ◽  
Left Knee ◽  
Joint Fluid ◽  
Case Presentation ◽  
Posterior Drawer ◽  
Open Physis ◽  
Posterior Translation ◽  
History Of ◽  
Pcl Injury ◽  
Sports Activities

Introduction: Given the infrequency and lack of consensus in the treatment of children and adolescents with these injuries, we decided to write this report with the aim of present a case of PCL tibial avulsion in a contact athlete teen with open physis and a review of the literature published. Materials and Methods: RF.male, 13 years, rugby, suffers French tackle and fall on knees flexed. 3 months post-trauma consultation with left knee pain, joint fluid and sport limitation. Whidout instability but "not feeling well". The posterior drawer test + + / ++++, gravitational test +. Rx posterior drawer: 8mm difference between the two nenes. MRI: tibial avulsion PCL. We interpreted as symptomatic PCL injury in athletes, surgery (arthroscopy + posterior approach) is decided reintegration of chondral fragment in 1 time P.OP: no load 4 Weeks . plaster wedge extension 6 weeks, then 3 months and passive immobilizer progressive mobility. Results: 0-90 mobility achieving in 8th week. The 3rd month drawer rx 4mm. MRI posterior translation of the 4th month reintegration of LCP with anchor . 6ª month later minimally elongated drawer with stop net. 11th month continuous strengthening recrearional and sports activities. Discussion and Conclusion: Most avulsion of PCL in patients with open physis probably be for greater strength and endurance ligament compared with the phisis and bone at this age. We suspected in patients with vague knee pain, with or without instability, history of trauma and normal Rx a correct examination and MRI to be essential for diagnosis. We beleave that athletes with open physis, because of the risk of joint degeneration, surgery is justified to restore kinematics, prevent osteoarthritis and resume activity prior to the injury.

scholarly journals Isolated avulsion fracture of the fibular head

2020 ◽  
Vol 77 (5) ◽  
pp. 545-548 ◽  
Author(s):  
Vladimir Harhaji ◽  
Ivica Lalic ◽  
Miodrag Vranjes ◽  
Milena Mikic ◽  
Vladimir Djan
Keyword(s):  
Avulsion Fracture ◽  
Treatment Options ◽  
Lateral Collateral Ligament ◽  
Football Player ◽  
Left Knee ◽  
American Football ◽  
Fibular Head ◽  
Collateral Ligament ◽  
Proximal Fibula ◽  
Clinical Instability

Introduction. Rupture of lateral collateral ligament of the knee is most often joined with other ligament ruptures. Isolated rupture of this ligament is rare and there are few papers about treatment options and results. Here we reported a case of isolated lateral collateral ligament rupture and the treatment outcome. Case report. A patient, 22 years old male, injured his left knee while playing American football. While landing on the outstretched left leg, he felt a sudden pain in his knee. The patient could not continue the competition. Initial orthopedic examination revealed lateral opening and further diagnostic procedure (magnetic resonance imaging) revealed isolated grade III rupture of lateral collateral ligament with avulsion fracture of the fibular head, and distension of anterior and posterior cruciate ligaments. Patient was surgically treated with metal sutures passed through conjoined tendon and proximal fibula. Postoperatively patient worn above knee cast for 6 weeks and after that he was included in rehabilitation. Three and six years after this injury, the patient has still been professional football player with no symptoms and no clinical instability of the knee despite radiological and computed tomography verified pseudoarthrosis of the fractured fibular head fragment. Conclusion. Early diagnostic and absence of additional injuries of the knee leads to a faster and full functional recovery of patients with isolated avulsion fracture of the fibular head, while surgical treatment provides knee stability with no residual ligament instability during sports activities.

scholarly journals Arthroscopic Excision of Calcification in Lateral Collateral Ligament of Knee with Direct Lateral (Bengaluru Chandrashekar) Portal

2019 ◽  
pp. 5-14
Author(s):  
Chandrashekar Puttaswamy ◽  
Nataraj Honnavalli Mallappa ◽  
Nagaraja Handenahally ◽  
Srinivasula Reddy Avula
Keyword(s):  
Case Reports ◽  
Lateral Collateral Ligament ◽  
Connective Tissues ◽  
Collateral Ligament ◽  
Calcific Deposit ◽  
Apatite Crystals ◽  
Arthroscopic Excision ◽  
Rare Location ◽  
Apatite Deposition ◽  
Calcific Deposits

Calcium apatite deposition disease (CADD) is a common entity characterized by deposition of calcium apatite crystals within and around connective tissues, usually in a periarticular location 1. Many different locations of CADD have been described amongst which, lateral collateral ligament (LCL) of the knee is a rare location 2. The first ever case of calcific deposits in the lateral collateral ligament of the knee was reported by Anderson et al 3 in 2003. A few isolated case reports of LCL calcification are published in the literature 4,5 but arthroscopic excision of calcific deposit in LCL has not been described yet in the literature. Here we are describing 2 cases of arthroscopic excision of calcific deposits in LCL of the knee by a new portal called ‘Direct lateral portal' for the knee.

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