Moxifloxacin Concentrations in the Knee Joint, Tibial Bone, and Soft Tissue When Combined with Rifampicin

Synovial sarcoma unlike its name is not originating from synovial cells. It accounts for approximately 10% of all soft tissue sarcomas with main predilection for extremities.We present here a case of synovial sarcoma of subcutaneous origin of knee joint which is rarest of presentations and early diagnosis is associated with lower risk of metastasis and hence better prognosis.

Download Full-text

The Impact of Intraoperative Gap Difference Between Extension and Flexion on Perception of Joint Function After Total Knee Arthroplasty: a Comparative Retrospective Study

10.21203/rs.3.rs-569511/v1 ◽

2021 ◽

Author(s):

Tomohiro Okayoshi ◽

Yoshinori Okamoto ◽

Hitoshi Wakama ◽

Shuhei Otsuki ◽

Masashi Neo

Keyword(s):

Total Knee Arthroplasty ◽

Retrospective Study ◽

Soft Tissue ◽

Knee Joint ◽

Predictive Factors ◽

Knee Arthroplasty ◽

Difference Threshold ◽

Joint Function ◽

Flexion Gap ◽

Total Knee

Abstract Background: The argument presupposes that intra-operative soft tissue balance is associated with patient-reported outcome measures after total knee arthroplasty (TKA). Our aim was to assess the association between the extension-to-flexion gap and patients’ reported perception of knee joint function.Methods: This was a retrospective study of 60 cases of primary cruciate-retaining TKAs performed for the treatment of medial-compartment knee osteoarthritis, at a mean follow-up of 2.6 (range, 2.0–5.2) years. Knee perception was evaluated by asking patients whether they considered their knee joint as “natural” (grade I) or “artificial”, with or without restrictions (grades II–V). The following factors were compared between the two groups: age, sex, and the extension-to-flexion gap difference. A multiple logistic regression analysis was used to identify predictive factors of an artificial knee joint perception. A receiver operating characteristic curve analysis was used to identify cut-off values of predictive factors. Result: Compared to a natural knee joint perception (26 knees, 43%), an artificial perception (34 knees, 57%) was associated with a smaller gap difference at the distraction force of 20 lbf (p < .001), 30 lbf (p = .022), and 40 lbf (p = .038), a lower EuroQol 5-Dimension score (p = .029), and self-reported joint health (Knee injury and Osteoarthritis Outcome Score-Joint Replacement [KOOS-JR], p = .032). A gap difference <1.0 mm was a predictive of an artificial perception (odds ratio, 1.63; 95% confidence interval, 1.33–4.54; p < .001). A cut-off gap difference of 0.99 mm at 20 lbf predicted an artificial perception with a sensitivity of 81.5% and a specificity of 87.9%. Post-operative satisfaction (p < .001), KOOS-JR (p < .001), patient’s joint perception (p = .006), pain (p = .015), and EuroQol 5-Dimension (p = .032) differed between the two groups when the gap difference threshold was set to 1.0 mm.Conclusion: Careful balancing of soft tissue during TKA to achieve an extension-to-flexion gap ≥ 1.0 mm can improve patients’ perception of knee joint function and quality of life.

Download Full-text

Case 53: Cable Technique with a Medial Monorail for Bone Transport and Extended Soft Tissue Access for Reconstruction of More Than 16 cm of Tibial Bone

Limb Lengthening and Reconstruction Surgery Case Atlas ◽

10.1007/978-3-319-18020-5_294 ◽

2015 ◽

pp. 353-358 ◽

Cited By ~ 1

Author(s):

Peter Helmut Thaller ◽

Julian Fuermetz

Keyword(s):

Soft Tissue ◽

Bone Transport ◽

Tibial Bone

Download Full-text

Using MR Imaging and X-Ray Fluoroscopy to Quantify the Effects of Soft-Tissue Artifact on Measurement of Knee-Joint Kinematics

ASME 2009 Summer Bioengineering Conference, Parts A and B ◽

10.1115/sbc2009-206551 ◽

2009 ◽

Author(s):

Massoud Akbarshahi ◽

Justin W. Fernandez ◽

Anthony Schache ◽

Richard Baker ◽

Marcus G. Pandy

Keyword(s):

Soft Tissue ◽

Knee Joint ◽

Soft Tissues ◽

Surgical Techniques ◽

Joint Kinematics ◽

Segmental Motion ◽

Coordinate Systems ◽

Knee Joint Kinematics ◽

Soft Tissue Artifact

The ability to accurately measure joint kinematics in vivo is of critical importance to researchers in the field of biomechanics [1]. Applications range from the quantitative evaluation of different surgical techniques, treatment methods and/or implant designs, to the development of computer-based models capable of simulating normal and pathological musculoskeletal conditions [1,2]. Currently, non-invasive marker-based three dimensional (3D) motion analysis is the most commonly used method for quantitative assessment of normal and pathological locomotion. The accuracy of this technique is influenced by movement of the soft tissues relative to the underlying bones, which causes inaccuracies in the determination of segmental anatomical coordinate systems and tracking of segmental motion. The purpose of this study was to quantify the errors in the measurement of knee-joint kinematics due solely to soft-tissue artifact (STA) in healthy subjects. To facilitate valid inter-subject comparisons of the kinematic data, relevant anatomical coordinate systems were defined using 3D bone models generated from magnetic resonance imaging (MRI).

Download Full-text

Bone Transport for Treatment of Traumatic Composite Tibial Bone and Soft Tissue Defects: Any Specific Needs besides the Ilizarov Technique?

BioMed Research International ◽

10.1155/2020/2716547 ◽

2020 ◽

Vol 2020 ◽

pp. 1-13 ◽

Cited By ~ 1

Author(s):

Runguang Li ◽

Guozheng Zhu ◽

Chaojie Chen ◽

Yirong Chen ◽

Gaohong Ren

Keyword(s):

Soft Tissue ◽

Deep Infection ◽

Bone Transport ◽

Fixation Time ◽

Ilizarov Technique ◽

Soft Tissue Defects ◽

Flap Surgery ◽

Tibial Bone ◽

Tissue Defects

Objective. To evaluate the surgical efficacy of bone transport (Ilizarov technique) plus “shortening-lengthening,” “flap surgery,” and “open bone transport” as individualized treatments for traumatic composite tibial bone and soft tissue defects. Methods. We retrospectively analyzed sixty-eight cases (mean age: 35.69 years, (range, 16–65)) treated from July 2014 to June 2017, including 29 middle, 18 distal, and 21 proximal tibial bone defects (4–18 cm, mean: 7.97 cm) with soft tissue defects (2.5 cm × 4.0 cm to 30.0 cm × 35.0 cm after debridement). We adopted the bone transport external fixator to fix the fracture after debriding the defect parts. In the meantime, we adopted the “shortening-lengthening technique,” “flap surgery,” and “open bone transport” as individualized treatment based on the location, range, and severity of the composite tibial bone and soft tissue defects. Postoperative follow-up was carried out. Surgical efficacy was assessed based on (1) wound healing; (2) bone defect healing rate; (3) external fixation time and index; (4) incidence/recurrence of deep infection; (5) postoperative complications; and (6) Association for the Study and Application of the Methods of Ilizarov (ASAMI) score. Results. The mean duration from injury to reconstruction was 22 days (4–80 d), and the mean postoperative follow-up period was 30.8 months (18–54 m). After the repair and reconstruction, 2 open bone transport patients required infected bone removal first before continuing the bone transport treatment. No deep infection (osteomyelitis) occurred or recurred in the remaining patients, and no secondary debridement was required. Some patients had complications after surgery. All the postoperative complications, including flap venous crisis, nail channel reaction, bone nonunion, mechanical axis deviation, and refracture, were improved or alleviated. External fixation time was 12.5 ± 3.41 months, and the index was 1.63 ± 0.44. According to the ASAMI score, 76.47% of the outcomes were good/excellent. Conclusion. The Ilizarov technique yields satisfactory efficacy for composite tibial bone and soft tissue defects when combined with “shortening-lengthening technique,” “flap surgery,” and “open bone transport” with appropriate individualized treatment strategies.

Download Full-text

Surface marker cluster translation, rotation, scaling and deformation: Their contribution to soft tissue artefact and impact on knee joint kinematics

Journal of Biomechanics ◽

10.1016/j.jbiomech.2015.02.050 ◽

2015 ◽

Vol 48 (10) ◽

pp. 2124-2129 ◽

Cited By ~ 40

Author(s):

D.L. Benoit ◽

M. Damsgaard ◽

M.S. Andersen

Keyword(s):

Soft Tissue ◽

Knee Joint ◽

Joint Kinematics ◽

Surface Marker ◽

Knee Joint Kinematics ◽

Marker Cluster

Download Full-text

Childhood Anaplastic Large Cell Lymphoma with Unusual Localization-A Case Report

Blood ◽

10.1182/blood.v116.21.4903.4903 ◽

2010 ◽

Vol 116 (21) ◽

pp. 4903-4903

Author(s):

Aysegul Unuvar ◽

Tugce Uzunhan ◽

Zeynep Karakas ◽

Gulyuz Ozturk ◽

Sema Anak ◽

...

Keyword(s):

Lymph Node ◽

Soft Tissue ◽

Knee Joint ◽

Anaplastic Large Cell Lymphoma ◽

Cell Lymphoma ◽

Large Cell ◽

Lymph Node Involvement ◽

Left Knee ◽

Node Involvement ◽

Large Cell Lymphoma

Abstract Abstract 4903 Anaplastic large cell lymphoma (ALCL) accounts for approximately 10% of the childhood lymphomas. ALCL is characterized by peripheral, mediastinal or intra-abdominal lymph node involvement or extranodal involvement. We report a child with ALCL with unusual localization. An eleven-year-old boy had been admitted to the another university hospital with left knee pain and swelling for 15 days. The left knee joint punction had been done, and osteomyelitis had been diagnosed, and treated with antibiotics. However, there had been no recovery from his complaints, and left knee synoviectomy had been done. This operation had revealed anaplastic large cell lymphoma in the intraarticular soft tissue of the left knee. Then, he was referred to our hematology and oncology clinic for advanced therapy. There was nothing significant in the background and family history. Physical examination showed a 3 cm mass arising from the left knee joint with lobulated contours. PET-CT showed the left inguinal lymph node involvement, only. Chemotherapy according to ALCL 99 protocol was started because of the tumor was not resectable. After the first course of therapy, tumor mass was reduced apparently. By the end of his second chemotherapy course, tumor was not detectable. Now, he completed his therapy, and he is on follow-up without any complaint or recurrence for 18 months. In conclusion, to the best of our knowledge, this is the first reported case with ALCL originating from the intraarticular soft tissue which was treated successfully. Disclosures: No relevant conflicts of interest to declare.

Download Full-text