scholarly journals Limb salvage procedures in osteosarcomas around the knee joint

1994 ◽  
Vol 112 (4) ◽  
pp. 661-667
Author(s):  
Emérito Carlos Rodriguez Merchán ◽  
Salvador Sánchez Herrera ◽  
Jose Manuel Gonzalez Lopez
Keyword(s):  
Knee Joint ◽  
Limb Salvage ◽  
Knee Arthroplasty ◽  
Young Patients ◽  
Surgical Techniques ◽  
Current Status ◽  
Knee Arthrodesis ◽  
Osteoarticular Allograft ◽  
Rotation Plasty ◽  
Active Patients

Surgical techniques developed for restoring skeletal continuity after a local resection of a bone tumor (limb salvage procedures) revolutionized the management of the patient suffering from osteosarcomas around the knee. In this article the authors review the current status of various reconstruction procedures; they include osteoarticular allograft arthrodesis, rotation plasty, expandable prosthesis and knee arthroplasty. In summary they suggest that the knee arthrodesis is the preferred procedure for young and active patients, the rotation plasty should be recommended as the alternative to amputation for very young patients, and the customized prostheses are preferred for patients with limited longevity.

scholarly journals Design and Cadaveric Validation of a Novel Device to Quantify Knee Stability During Total Knee Arthroplasty

2012 ◽  
Vol 134 (11) ◽  
Author(s):  
Robert A. Siston ◽  
Thomas L. Maack ◽  
Erin E. Hutter ◽  
Matthew D. Beal ◽  
Ajit M. W. Chaudhari
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Joint ◽  
Knee Arthroplasty ◽  
Surgical Techniques ◽  
Load Cell ◽  
Knee Stability ◽  
Joint Stability ◽  
Postoperative Function ◽  
New Device ◽  
Total Knee

The success of total knee arthroplasty depends, in part, on the ability of the surgeon to properly manage the soft tissues surrounding the joint, but an objective definition as to what constitutes acceptable postoperative joint stability does not exist. Such a definition may not exist due to lack of suitable instrumentation, as joint stability is currently assessed by visual inspection while the surgeon manipulates the joint. Having the ability to accurately and precisely measure knee stability at the time of surgery represents a key requirement in the process of objectively defining acceptable joint stability. Therefore, we created a novel sterilizable device to allow surgeons to measure varus-valgus, internal-external, or anterior-posterior stability of the knee during a total knee arthroplasty. The device can be quickly adjusted between 0 deg and 90 deg of knee flexion. The device interfaces with a custom surgical navigation system, which records the resultant rotations or translations of the knee while the surgeon applies known loads to a patient’s limb with a handle instrumented with a load cell. We validated the performance of the device by having volunteers use it to apply loads to a mechanical linkage that simulated a knee joint; we then compared the joint moments calculated by our stability device against those recorded by a load cell in the simulated knee joint. Validation of the device showed low mean errors (less than 0.21 ± 1.38 Nm and 0.98 ± 3.93 N) and low RMS errors (less than 1.5 Nm and 5 N). Preliminary studies from total knee arthroplasties performed on ten cadaveric specimens also demonstrate the utility of our new device. Eventually, the use of this device may help determine how intra-operative knee stability relates to postoperative function and could lead to an objective definition of knee stability and more efficacious surgical techniques.

Knee Arthrodesis as Limb Salvage for Complex Failures of Total Knee Arthroplasty

2014 ◽  
Vol 29 (11) ◽  
pp. 2150-2155 ◽  
Author(s):  
Raul Kuchinad ◽  
Mitchell S. Fourman ◽  
Austin T. Fragomen ◽  
S. Robert Rozbruch
Keyword(s):  
Total Knee Arthroplasty ◽  
Limb Salvage ◽  
Knee Arthroplasty ◽  
Knee Arthrodesis ◽  
Total Knee

scholarly journals Patellofemoral Joint Arthroplasty: Our Experience in Isolated Patellofemoral and Bicompartmental Arthritic Knees

2016 ◽  
Vol 9 ◽  
pp. CMAMD.S40498 ◽  
Author(s):  
L. Sabatini ◽  
M. Schirò ◽  
F. Atzori ◽  
G. Ferrero ◽  
A. Massè
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Young Patients ◽  
Surgical Techniques ◽  
Complete Agreement ◽  
Unicompartmental Knee ◽  
Bone Preservation ◽  
Total Knee ◽  
Tibiofemoral Osteoarthritis ◽  
Patellofemoral Replacement

Introduction Isolated patellofemoral (PF) arthritis is rare, and there is no complete agreement about the best surgical treatment. The operative treatments are total knee arthroplasty and patellofemoral replacement (PFR). The incidence of many early complications of PF arthroplasty has decreased with the introduction of newer designs. Nowadays, the main cause of revision surgery is the progression of tibiofemoral osteoarthritis. In the past, PF arthroplasty was contraindicated in patients with evidence of osteoarthritis or pain in medial or lateral tibiofemoral compartments. The improvement in implant designs and surgical techniques has allowed the addition of a monocompartmental arthroplasty for the medial or lateral tibiofemoral compartment. In this work, we evaluate our first experience with PF arthroplasty and its combination with unicompartmental knee arthroplasty. Materials and Methods From May 2014 to March 2016, we treated 14 patients. An isolated PF arthroplasty was performed in six knees (five patients), and a combined PF and unicompartmental knee arthroplasty was performed in nine cases. We observed a significant improvement in the clinical and functional Knee Society Scores (KSSs) after surgery in our patients. Results We obtained good results in our cases both for clinical and functional KSSs. Patellar clunk was recorded in one case. Discussion and Conclusion We are going toward a new attitude in which partial osteoarthritic changes could be treated with partial resurfacing prosthetic solutions such as unicompartmental, bi–unicompartmental or PFR alone, or unicompartmental combined, which respects the cruciates and achieves maximal bone preservation, which is vital, particularly, for young patients.

Treatment of Early-Onset Hip Osteoarthritis in Young Patients

2018 ◽  
Vol 02 (03) ◽  
pp. 117-125
Author(s):  
Timothy Brown ◽  
Anthony Miniaci ◽  
Robert Westermann ◽  
Molly Day
Keyword(s):  
Early Onset ◽  
Treatment Options ◽  
Young Patients ◽  
Surgical Techniques ◽  
Treatment Strategies ◽  
Hip Osteoarthritis ◽  
Nonoperative Treatment ◽  
Active Patients ◽  
Review Current

AbstractPain and debilitating symptoms due to hip osteoarthritis (OA) can significantly compromise quality of life in young, active patients. The management of the young adult with hip OA presents a unique set of challenges, with symptoms that originate from a variety of underlying hip pathologies, and patient age spanning from youth through middle age. Early options for hip OA include nonoperative treatment with anti-inflammatory medications, physical therapy, and injections. For patients with structural hip abnormalities (femoroacetabular impingement or dysplasia), arthroscopy or reconstructive osteotomy are acceptable treatment options. In advanced disease, joint-preserving techniques are often ineffective, and patients may require joint resurfacing or replacement. The treatment strategies for early hip OA continues to evolve with the development of new and refined surgical techniques, especially in the setting of underlying hip pathology, and a growing popularity of utilizing biologic agents. The purpose of this manuscript is to review current conservative and surgical management and to describe an algorithm for treatment of early-onset hip OA.

scholarly journals Medial abrasion syndrome: a neglected cause of persistent pain after knee arthroplasty

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Shaw-Ruey Lyu ◽  
Chia-Chen Hsu ◽  
Jung-Pin Hung
Keyword(s):  
Knee Arthroplasty ◽  
Surgical Techniques ◽  
Varus Deformity ◽  
Outcome Study ◽  
Primary Arthroplasty ◽  
Post Operative Pain ◽  
Plateau Fracture ◽  
Advanced Stages ◽  
Total Knee ◽  
Medial Release

Abstract Introduction Persistent post-operative pain (PPOP) has detracted from some otherwise successful knee arthroplasties. This study investigated medial abrasion syndrome (MAS) as a cause of PPOP after knee arthroplasty. The surgical techniques and outcomes of incorporating this concept into the management of both primary arthroplasty cases and patients suffering from unknown causes of PPOP after arthroplasties were presented. Materials and methods In a 1-year period, the author performed unicompartmental or total knee arthroplasty (the UKA or TKA group) that also eliminated medial abrasion phenomenon (MAP) on 196 knees of 150 patients at advanced stages of knee osteoarthritis (OA). During the same year, 16 knees of 16 patients with unknown causes of PPOP after knee arthroplasties were referred to the author for the arthroscopic medial release procedure (the AMR group) after being diagnosed as MAS. Subjective satisfaction, Knee Society Score (KSS), and Knee injury and Osteoarthritis Outcome Score (KOOS) evaluations were used for outcome study. Results All 166 patients were followed for more than 3 years (mean 3.7 years, 3.1–4.2) for the outcome study. All knees receiving arthroplasty showed medial plicae with MAP at the time of surgery. Only 2 of them suffered from PPOP: one was a neglected tibial plateau fracture with residual varus deformity after UKA, and the other was a late infection after TKA and received revision. The satisfactory rate was 98.8% in the UKA group, 99.1% in the TKA group, and 100% in the AMR group. The Knee Society Scores and all subscales of KOOS were statistically improved in all groups. Conclusions MAS is a cause of pain in patients who have received knee arthroplasties, and MAP should be eliminated to ensure a successful knee arthroplasty. PPOP after knee arthroplasty can be caused by MAS, which can be managed by AMR.

Corrigendum to “Translational and rotational knee joint stability in anterior and posterior cruciate-retaining knee arthroplasty” [The Knee 18 (2011) 491–495]

The Knee ◽  
2012 ◽  
Vol 19 (3) ◽  
pp. 226
Author(s):  
JiaHsuan Lo ◽  
Otto Müller ◽  
Torsten Dilger ◽  
Nikolaus Wülker ◽  
Markus Wünschel
Keyword(s):  
Knee Joint ◽  
Knee Arthroplasty ◽  
Joint Stability ◽  
Cruciate Retaining

scholarly journals Radiofrequency Ablation of Hepatocellular Carcinoma: A Literature Review

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Yasunori Minami ◽  
Masatoshi Kudo
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Safety Margin ◽  
Surgical Techniques ◽  
Evidence Base ◽  
Current Status ◽  
Probe Design ◽  
Curative Therapy ◽  
Management Of Complications ◽  
Liver Cancers

Radiofrequency ablation (RFA) of liver cancers can be performed safely using percutaneous, laparoscopic, or open surgical techniques, and much of the impetus for the use of RFA has come from cohort series that have provided an evidence base for this technique. Here, we give an overview of the current status of radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC), including its physical properties, to assess the characteristics that make this technique applicable in clinical practice. We review the technical development of probe design and summarize current indications and outcomes of reported clinical use. An accurate evaluation of treatment response is very important to secure successful RFA therapy since a sufficient safety margin (at least 0.5 cm) can prevent local tumor recurrences. We also provide a profile of side effects and information on the integration of this technique into the general management of patients with HCC. To minimize complications of RFA, physicians should be familiar with each feature of complication. Appropriate management of complications is essential for successful RFA treatment. Moreover, adjuvant therapy, such as molecular targeted therapies following curative therapy, is expected to further improve survival after RFA.

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