Migratory Loose Bodies from the Ankle Joint into the Flexor Hallucis Longus Tendon Sheath

Objective: Loose bodies resulting from any form of osteochondral insult can migrate out of their intra-articular position to adjacent compartments. This retrospective study aims to illustrate the phenomenon of loose bodies migration from the ankle joint into the flexor hallucis longus (FHL) tendon sheath. Materials and Methods: Cases of loose bodies in the FHL tendon sheath were identified from the authors' radiological database by way of keyword interrogation, covering the modalities of CT, MRI, and ultrasound over a period of 11 years. The imaging features of the loose bodies were recorded, together with the presence of ankle instability and osteoarthritis. Patient demographics and relevant history, including trauma and surgery, were collected. Results: Thirty-four cases including 33 patients, with a total of 125 loose bodies in the FHL tendon sheath, were identified. There were 58 loose bodies (46.4%) in Zone 1 of the FHL tendon sheath, 65 loose bodies (52%) in Zone 2, and 2 loose bodies (1.6%) in Zone 3. All patients had features of ankle osteoarthritis on imaging, 14 of which had imaging features of ankle instability, and 19 patients had previous ankle trauma. Conclusion: Osteochondral loose bodies originating from the ankle joint can migrate into the FHL tendon sheath. It is important to recognise this phenomenon as a distinct entity, different from primary tenosynovial chondromatosis of the FHL tendon sheath, which may have a different surgical management and clinical outcome. Detection of FHL tendon sheath loose bodies should also prompt closer examination for articular disease in the ankle joint.

To Compare the Effects of UST and TENS with PNF Stretching To Increase the Mobility and Reduce Pain in OA - A Randomised Control Trial

Osteoarthritis is a chronic disorder which is degenerative in nature having a multifactorial etiology characterized by subchondral sclerosis, loss of the articular cartilage, hypertrophy of the marginal bone along with morphological and biochemical changes in the joint capsules and synovium. Knee osteoarthritis is the most common form of osteoarthritis. Knee OA is characterized by quadriceps muscle weakness, hamstring weakness, possible joint stiffness, effusion, loss of proprioception loss of range of motion and knee pain. Transcutaneous electrical nerve stimulation is the most widely used physical modalities for the management osteoarthritis knee. The benefits of TENS for relive chronic pain are well documented. The UST for the treatment of OA will lead to improvement of life by decreasing the swelling and reducing the pain at the knee joint. PNF relieves pain improves the ROM, restores proprioception as confirmed by clinical research. The aim of study to find out the effect of UST and TENS with PNF stretching to increase the mobility and reduce pain in OA Patients. Study duration is 6-week, source of data is Goldi masala factory, Kanpur. Sample size is 60 and method of data collection is random. Subjects were divided into two equal group, for group A we give PNF with ultrasound and for group B we give PNF with TENS for six consecutive weeks. After analysis of collected data result was null hypothesis is rejected and alternate hypothesis is accepted. In this way both technique is statistically significant. So, we concluded that both the technique i.e., PNF with UST and PNF with TENS is effective in treating the osteoarthritis patient with relieving pain and increasing range of motion. But statistically PNF with TENS is more significant over PNF with UST. Keywords: Osteoarthritis, proprioceptive neuromuscular facilitation, ultrasound therapy, transcutaneous electrical nerve stimulator, pain, range of motion, VAS scale, goniometer.

Comparsion of Mobile-bearing UKA and Posterior Cruciate Ligament Retaining TKA for Patients with Unicompartmental Knee Osteoarthritis:a Retrospective Cohort Study

Introduction: Many studies have compared unicompartmental knee arthroplasty (UKA) with total knee arthroplasty (TKA) for knee osteoarthritis suggesting that both procedures had good clinical outcomes. However, there have been fewer studies comparing the mobile-bearing UKA (MB-UKA) and posterior cruciate ligament retaining TKA (CR-TKA) for patients with unicompartmental knee osteoarthritis. Thus, we explored the differences in outcomes and complications between the two cohorts.Methods: In this retrospective study, 41 patients who underwent MB-UKA and 40 who underwent CR-TKA in our institution were included. All patients were suffered from unicompartmental knee osteoarthritis. Patient demographics, preoperative and latest postoperative range of movement (ROM), Knee Society (KS) scores, and Forgotten Joint Score (FJS) were compared between the two cohorts. Additionally, complications, revisions, and 5-years survivorship were also analyzed.Results: The results showed MB-UKA patients had similar preoperative ROM and Knee Society pain (KSP), functional (KSF), and clinical (KSC) scores with CR-TKA patients (p = 0.104, p = 0.755, p = 0.32, p = 0.928, respectively). The mean follow-up for MB-UKA and CR-TKA groups was 3.4 and 3.7 years, respectively. Two MB-UKA and one CR-TKA patient required revision surgery. The latest postoperative KSF scores, ROM, FJS, and change in KSC scores and ROM were higher (p < 0.05) after MB-UKA, but the latest postoperative KSP, KSC, and change in KSF scores were equivalent between the two cohorts. There were no differences in complication, revision rates, and 5-year survivorship estimates.Conclusions: MB-UKA patients showed better functional outcomes and FJS, and higher ROM with similar survivorship compared with CR-TKA patients. MB-UKA should be considered as a primary treatment option for patients with unicompartmental knee osteoarthritis.Trial registration: researchregistry5032. Registered 23 July 2019, retrospectively registered