The radiographic findings of an osteolytic lesion in the knee may indicate numerous possible impressions. Furthermore, osteolysis is a possible cause if there is a surgical history of total knee arthroplasty (TKA). The authors diagnosed osteolysis of the fibular head after aseptic loosening of the tibial component of a cemented TKA in an 83-year-old female patient who visited with right knee pain and report their treatment with revision TKA along with a literature review.

Background: The purpose of this study was to evaluate the clinical usefulness of open-door laminoplasty using lateral mass anchoring screws and nonabsorbable sutures (ODLLM) for multilevel cervical myelopathy. Methods: We retrospectively studied 30 patients who underwent ODLLM. Clinical evaluations were performed using a visual analog scale (VAS), Japanese Orthopaedic Association (JOA) score, and Neck Disability Index (NDI) preoperatively, at 1 year postoperatively, and at the last follow-up. Radiographic evaluation was done using cervical spine radiographs to measure changes in the lordotic angle and range of motion (ROM) preoperatively, at 1 year postoperatively, and at the last follow-up and computed tomography at 1 year postoperatively to measure the opening angle and anteroposterior diameter of the spinal canal. Results: Significant improvement in VAS, JOA, and NDI was seen overall at 1 year after operation. However, there was no significant difference between 1 year after operation and the last follow-up. There were no significant changes in the lordotic angle and neck ROM. The mean opening angle of the opened lamina was measured as 39.04°. The mean anteroposterior diameter was significantly increased from 7.51 ± 1.79 mm before surgery to 13.98 ± 1.80 mm at 1 year of operation. Complications such as laminar reclosure and screw loosening were not observed in all cases. Conclusions The ODLLM was technically easy to perform and showed good results comparable to those of conventional techniques. It can be suggested that ODLLM is an appropriate treatment option for multilevel cervical myelopathy.

The purpose of this study is to develop the optimization method for adjusting the film isocenter shift and to suggest the quantitative acceptable criteria for film dosimetry after optimization in the dynamic conformal arc radiation therapy (DCAR). The DCAR planning was performed in 7 patients with brain metastasis. Both absolute dosimetry with ion chamber and relative film dosimetry were performed throughout the DCAR using BrainLab's micro-multileaf collimator. An optimization method for obtaining the global minimum was used to adjust for the error in the film isocenter shift, which is the largest part of systemic errors. The mean of point dose difference between measured value using ion chamber and calculated value acquired from planning system was 0.51+/-0.43% and maximum was 1.14% with absolute dosimetry. These results were within the AAPM criteria of below 5%. The translation values of film isocenter shift with optimization were within +/-1 mm in all patients. The mean of average dose difference before and after optimization was 1.70+/-0.36% and 1.34+/-0.20%, respectively, and the mean ratios over 5% dose difference was 4.54+/-3.94% and 0.11+/-0.12%, respectively. After optimization, the dose differences decreased dramatically and a ratio over 5% dose difference and average dose difference was less than 2%. This optimization method is effective in adjusting the error of the film isocenter shift, which is the largest part of systemic errors, and the results of this research suggested the quantitative acceptable criteria could be accurate and useful in clinical application of dosimetric verification using film dosimetry as follows; film isocenter shift with optimization should be within +/-1 mm, and a ratio over 5% dose difference and average dose difference were less than 2%.
Brain ; Film Dosimetry ; Humans ; Neoplasm Metastasis ; Radiotherapy*