scholarly journals A TRIATHLETE WITH MEDIAL MENISCUS TEAR AND SUBCHONDRAL INSUFFICIENCY FRACTURE

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Azlan M. Naing ◽  
Mariam G.M.
Keyword(s):  
Knee Pain ◽  
Medial Meniscus ◽  
Weight Bearing ◽  
Insufficiency Fracture ◽  
Meniscus Tear ◽  
Unusual Site ◽  
Subchondral Insufficiency Fracture ◽  
Tibial Condyle ◽  
One Year ◽  
Work Up

Subchondral insufficiency fracture of the knee (SIFK) is an important differential diagnosis for knee pain. If diagnosed early, SIFK can be treated conservatively with non-weight bearing ambulation. If left untreated, this disease may lead to catastrophic complications such as subchondral fragment detachment and fragmentation or subchondral collapse which will warrant the need for surgical intervention. The author reports a 44-year-old triathlete that presented with complaint of a trivial left anteromedial knee pain for one-year duration. This disease presented at an unusual site of the medial tibial condyle. Moreover, the patient is a healthy triathlete that does not have any predisposing factors for SIFK. Magnetic resonance imaging showed subchondral insufficiency fracture of the medial tibial condyle with a complex multi-directional medial meniscus tear in the same knee. Could the undiagnosed medial meniscus injury be the causation leading to the development of SIFK? Here, the author will summarize the literature on various clinical features, work-up and management of SIFK.

scholarly journals Elderly patients with medial meniscus tear should be aware of the occurrence of osteonecrosis: A case report and literature review

2020 ◽  
Author(s):  
Weiming Yang ◽  
Caiqiong Zhao ◽  
Xuewei Cao
Keyword(s):  
Elderly Patients ◽  
Knee Pain ◽  
Subchondral Bone ◽  
Medial Meniscus ◽  
Early Stage ◽  
Weight Bearing ◽  
Left Knee ◽  
Meniscus Tear ◽  
Walking Ability ◽  
Meniscal Root Tear

Abstract Background: Spontaneous osteonecrosis of the knee (SONK) was defined as a distinct clinical entity with characteristical findings that subchondral lesions in the weight-bearing region of a single condyle. In the early stage of SONK, we usually think that injury of meniscus was to blame for the knee pain. Elderly patients with medial meniscus tear should be aware of the occurrence of osteonecrosis. Case presentation：A 67-year-old male complained of pain in the left knee for 3 months in 2013. Magnetic resonance imaging (MRI) revealed a medial meniscal root tear (level III), so that he patient underwent arthroscopic meniscectomy. However, no obvious pain relief achieved at the follow-up. The pain was associated with weight bearing, of which was initially intermittent, gradually progressed in intensity and became frequent even at rest. At 18 months after the first visit, we re-examined the knee MRI and results clearly revealed subchondral bone osteonecrosis of the condyle. Finally, we performed unicompartmental arthroplasty which significantly relieved the pain and restored the walking ability of the patient. Conclusions: Meniscus injury often coexist with SONK. In the early stages of SONK, the area of necrosis is small which is very easy to be ignored causing a misdiagnosis. The case reminds us should pay much attention to the possibility of subchondral bone necrosis in patients with knee pain and meniscal injury.

Medial meniscus posterior root repair prevents the progression of subchondral insufficiency fracture of the knee

2020 ◽  
Author(s):  
Yuki Okazaki ◽  
Takayuki Furumatsu ◽  
Takaaki Hiranaka ◽  
Keisuke Kintaka ◽  
Shota Takihira ◽  
...  
Keyword(s):  
Medial Meniscus ◽  
Insufficiency Fracture ◽  
Posterior Root ◽  
Subchondral Insufficiency Fracture ◽  
Root Repair

scholarly journals Arthroscopic partial meniscectomy versus placebo surgery for a degenerative meniscus tear: a 2-year follow-up of the randomised controlled trial

2017 ◽  
Vol 77 (2) ◽  
pp. 188-195 ◽  
Author(s):  
Raine Sihvonen ◽  
Mika Paavola ◽  
Antti Malmivaara ◽  
Ari Itälä ◽  
Antti Joukainen ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Medial Meniscus ◽  
Controlled Trial ◽  
Partial Meniscectomy ◽  
Meniscus Tear ◽  
Arthroscopic Partial Meniscectomy ◽  
Serious Adverse Events ◽  
Secondary Outcomes

ObjectiveTo assess if arthroscopic partial meniscectomy (APM) is superior to placebo surgery in the treatment of patients with degenerative tear of the medial meniscus.MethodsIn this multicentre, randomised, participant-blinded and outcome assessor-blinded, placebo-surgery controlled trial, 146 adults, aged 35–65 years, with knee symptoms consistent with degenerative medial meniscus tear and no knee osteoarthritis were randomised to APM or placebo surgery. The primary outcome was the between-group difference in the change from baseline in the Western Ontario Meniscal Evaluation Tool (WOMET) and Lysholm knee scores and knee pain after exercise at 24 months after surgery. Secondary outcomes included the frequency of unblinding of the treatment-group allocation, participants' satisfaction, impression of change, return to normal activities, the incidence of serious adverse events and the presence of meniscal symptoms in clinical examination. Two subgroup analyses, assessing the outcome on those with mechanical symptoms and those with unstable meniscus tears, were also carried out.ResultsIn the intention-to-treat analysis, there were no significant between-group differences in the mean changes from baseline to 24 months in WOMET score: 27.3 in the APM group as compared with 31.6 in the placebo-surgery group (between-group difference, −4.3; 95% CI, −11.3 to 2.6); Lysholm knee score: 23.1 and 26.3, respectively (−3.2; −8.9 to 2.4) or knee pain after exercise, 3.5 and 3.9, respectively (−0.4; −1.3 to 0.5). There were no statistically significant differences between the two groups in any of the secondary outcomes or within the analysed subgroups.ConclusionsIn this 2-year follow-up of patients without knee osteoarthritis but with symptoms of a degenerative medial meniscus tear, the outcomes after APM were no better than those after placebo surgery. No evidence could be found to support the prevailing ideas that patients with presence of mechanical symptoms or certain meniscus tear characteristics or those who have failed initial conservative treatment are more likely to benefit from APM.

CRYSTALLINE RETINOPATHY WITH PERIFOVEAL TELANGIECTASIA – A CASE REPORT

2021 ◽  
pp. 23-24
Author(s):  
Vishal Agrawal ◽  
Anushree Sharma
Keyword(s):  
Crystalline Retinopathy ◽  
Macular Telangiectasia ◽  
Macular Holes ◽  
Capillary Plexus ◽  
Macular Telangiectasia Type 2 ◽  
One Year ◽  
Systemic Examination ◽  
Work Up ◽  
Foveal Cavitation

We report a case of Macular Telangiectasia type 2 with crystalline retinopathy in a 42 year old female complaining of gradual decrease of vision in both eyes for the past one year. Both eye fundus showed perifoveal refractile crystals with lamellar macular holes. A diagnosis of crystalline retinopathy was made. Other causes of crystals were ruled out based on history, systemic examination, multimodal imaging & laboratory work-up. Presence of dilated perifoveal deep capillary plexus, foveal cavitation & temporal leakage on FFA conrmed association with Macular Telangiectasia. To our knowledge, there is no thorough documentation of crystalline reti-nopathy reported in Indian population.

scholarly journals Electromyographic preactivation pattern of the gluteus medius during weight-bearing functional tasks in women with and without anterior knee pain

2011 ◽  
Vol 15 (1) ◽  
pp. 59-65 ◽  
Author(s):  
Theresa H. Nakagawa ◽  
Thiago B. Muniz ◽  
Rodrigo M. Baldon ◽  
Carlos D. Maciel ◽  
César F. Amorim ◽  
...  
Keyword(s):  
Knee Pain ◽  
Anterior Knee Pain ◽  
Weight Bearing ◽  
Gluteus Medius ◽  
Anterior Knee

scholarly journals An Unsual Site about Small Cells Osteosarcoma Parietal Region and Classique Osteosarcoma Occipital Region Mimicking Meningioma with Literature Review Management and Outcome

2019 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Correct Diagnosis ◽  
Small Cell ◽  
Small Cells ◽  
Long Bones ◽  
Unusual Site ◽  
First Case ◽  
Review Management ◽  
Similar Materials ◽  
One Year ◽  
Age Range

Introduction: Primary osteosarcoma (OS) is the second most common primary bone malignancy, the first being multiple myeloma. OS occurs in the second decade, with a predilection for ends of long bones. Head and neck involvement is seen in 2-9% with extragnathic craniofacial bones in 1–2% of cases. Small Cell OS (SCO) constitutes 1.3-4% of all OS, skeletal distribution and age range being similar. Materials and Methods: We report two rare osteosarcoma and we done the review of the literature about the management and the outcome about intracranial osteosarcoma in our department of neurosurgery. Results: It is two osteosarcoma cases about a 72-year-old man and one 49-year-old man who both mimiking first meningioma. The first case is an unusual site parietal and the second case is occipital. The both benefited surgery with excision and exam of histology confirm diagnosis. But the first case died 15 days after surgery in intensive unit care and the second cases died after one year, he benefited surgery and chemotherapy. Conclusion: Small cell osteosarcoma (SCO) is an extremely uncommon entity that mainly involves the metaphysics of long bones and, rarely, the skull. Histopathology is the key to establishing the correct diagnosis, including sub typing for appropriate management and prognostication, as radiological features are not specific.

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 The Effect of a Lower Body Positive Pressure Supported Treadmill Exercise Regime on Systemic Biomarkers of Inflammation and Cartilage Degradation in Individuals with Knee Osteoarthritis: A Pilot Study

2021 ◽  
Vol 9 (3) ◽  
pp. 18
Author(s):  
Stephen Cornish ◽  
Jason Peeler
Keyword(s):  
Articular Cartilage ◽  
Knee Pain ◽  
Weight Bearing ◽  
Cartilage Degradation ◽  
Treadmill Walking ◽  
Positive Pressure ◽  
Control Group ◽  
Knee Oa ◽  
And Cartilage

Background: Knee osteoarthritis (OA) has been linked to a chronic low-grade inflammatory response and altered metabolic activity of articular cartilage. Objective: The purpose of this investigation was to evaluate the effectiveness of a 12-week (3 times/week) lower body positive pressure (LBPP) treadmill walking regime on knee pain and systemic biomarkers of inflammation and cartilage degradation. Methods: Sixteen overweight (BMI > 25 kg/m2) knee OA patients were randomized to a LBPP treadmill walking exercise group (N = 7) or non-exercise control group (N = 9). Baseline and 12-week follow-up assessments evaluated the following dependent variables: acute knee pain during full weight bearing treadmill walking; inflammatory biomarkers (C-reactive protein, interleukin-1β, interleukin-6, s100A8/A9, and tumor necrosis factor-α), and catabolic metabolism of articular cartilage (sCOMP). Results: Knee pain at baseline and follow-up remained unchanged for the non-exercise control group (P > 0.05). However, knee pain for the LBPP exercise group was significantly decreased at follow-up (P ≤ 0.05). No differences in the biomarkers of inflammation and cartilage degradation were observed for between and within group comparisons (all P > 0.05). Conclusions: Data suggested that the LBPP supported walking regime could be effectively used to promote regular weight bearing exercise without exacerbation of knee joint pain and did not increase levels of systemic inflammation or catabolic activity of articular cartilage in overweight knee OA patients. This pilot investigation offers important insight regarding the potential role that the LBPP technology could play in facilitating investigations examining the disease modifying effect of exercise on knee OA pathogenesis.

scholarly journals Focal Periphyseal Oedema: A Physiologic Finding in Paediatric Knee Pain

2021 ◽  
Author(s):  
Susana Rosa ◽  
Margarida Freitas ◽  
Sara Antunes ◽  
Rute Pereira
Keyword(s):  
Knee Pain ◽  
Case Reports ◽  
Weight Bearing ◽  
Rehabilitation Program ◽  
Joint Line ◽  
Primary Care Clinician ◽  
Male Adolescent ◽  
Resonance Imaging ◽  
Inflammatory Drugs ◽  
Magnetic Resonance Imaging Mri

Knee pain is a common reason for adolescent calls or visits to a primary care clinician. The authors present a case of an 14-year-old male adolescent with progressive bilateral nociceptive somatic knee pain. The pain was worse with weight bearing, and relieved at rest. It was located over the medial joint line. The patient was treated conservatively with nonsteroidal anti-inflammatory drugs and a rehabilitation program. Magnetic Resonance Imaging (MRI) showed bone marrow oedema, and Focal Periphyseal Oedema (FOPE) diagnosis was made. After a total of 6 months of treatment, the patient was asymptomatic. The literature is limited to a few case reports and radiologic studies describing this symptomatic physeal pathology, not reporting physical examination or treatment. The goals of this case report were to elucidate physicians of this condition, a newly reported cause of knee pain in adolescent, and to elicit the importance of a patient-tailored rehabilitation program in the treatment of this finding. FOPE is a clinical entity that should not be ignored and must be treated for the patient’s comfort. It is a self-limited condition and has an excellent prognosis.

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