1.Current advances on surgical treatment for knee articular cartilage injuries.
Long XIN ; Chun ZHANG ; Wei-Xing XU ; Fu-Hua ZHONG ; Shun-Wu FAN ; Zhen-Bin WANG
China Journal of Orthopaedics and Traumatology 2018;31(3):281-285
Chondral injuries are short of self-healing ability and need to surgical repair after articular cartilage injury. Conventional treatment includes debridement and drainage under arthroscope, micro-fracture, osteochondral autograft transplantation (OATS), mosaiplasty and osteochondral allografts (OCA), autologous chondrocyte implantation (ACI). Debridement and drainage could remove pain factor, and has advantages of simple operation, wide clinical application and early clinical effect. Micro-fracture and osteochondral autograft transplantation is suitable for small area of cartilage repair, while the further effect showed that fibrous cartilage permeated by drill could decrease postoperative clinical effect. Osteochondral autograft transplantation has better advantages for reconstruction complete of wear-bearing joint. Autologous chondrocyte implantation and allogeneic cartilage transplantation are suitable for large area of cartilage defect, postoperative survival of allogeneic cartilage transplantation is effected by local rejection reaction and decrease further clinical effect. Cartilage tissue engineering technology could improve repair quality of autologous chondrocyte implantation, and make repair tissue close to transparent cartilage, but has limit to combined subchondral bone plate, reactive bone edema, bone loss and bad axis of lower limb. New technology is applied to cartilage injury, and has advantages of less trauma, simple operation, rapid recover, good clinical effect and less cost;and could be main method for treat cartilage injury with surgical repair technology. How to improve repair quality with compression resistance and abrasive resistance are expected to be solved.
Cartilage, Articular
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injuries
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surgery
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Chondrocytes
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transplantation
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Humans
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Knee Injuries
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surgery
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Knee Joint
;
surgery
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Transplantation, Autologous
3.Loss of Distal Femur Combined with Popliteal Artery Occlusion: Reconstructive Arthroplasty Using Modular Segmental Endoprosthesis: A Case Report.
Shin Taeg KANG ; Chan Ha HWANG ; Bo Hyeon KIM ; Byung Yoon SUNG
Journal of Korean Medical Science 2009;24(2):350-353
Severe injury to the knee and the surrounding area is frequently associated with injury to ligaments of the knee joint and structures in the popliteal fossa. This case involved a popliteal artery occlusion, severe bone loss of distal femur, loss of collateral ligaments, and extensor mechanism destruction of the knee. Initially, prompt recognition and correction of associated popliteal artery injury are important for good results after treatment. After successful revascularization, treatment for severe bone loss of distal femur and injury of the knee joint must be followed. We treated this case by delayed reconstruction using modular segmental endoprosthesis after revascularization of the popliteal artery. This allowed early ambulation. At 36 months after surgery, the patient had good circulation of the lower limb and was ambulating independently.
*Arthroplasty, Replacement, Knee
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Femur/*injuries/radiography/*surgery
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Humans
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Internal Fixators
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Knee Injuries/*surgery
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Knee Joint/surgery
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Male
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Middle Aged
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Popliteal Artery/*injuries/radiography/*surgery
5.Treatment of floating knee injury in children.
Guohui, LIU ; Shuhua, YANG ; Jingyuan, DU ; Qixin, ZHENG ; Zengwu, SHAO
Journal of Huazhong University of Science and Technology (Medical Sciences) 2006;26(1):96-8
The necessity and superiority of the surgical operation on children with floating knee injury and the fracture union and complications were investigated. Twenty-eight children with floating knee injury were subjected to open reduction and internal fixation or external fixator. The patients were followed up for 18 months to 7 years. The curative effectiveness was scored by Karlstrom criteria. The results showed that no nonunion or deformity was found. The affected limb was 1.2 cm to 1.5 cm longer in 2 cases, 0.8 to 1.2 cm shorter in 3 cases than the contralateral. No severe dysfunction of knee joint occurred. The excellent-good rate was 92.8% and the curative rate 71.4% respectively. So for children whose age is older than 5 years, it's a good way to treat the fractures of femur and tibia with open reduction and internal fixation or external fixator. The method can be advantageous for the nursing care, early function recovery, shortening of the hospital stay and avoidance of severe complications.
Femoral Fractures/complications
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Femoral Fractures/*surgery
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Fracture Fixation
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Knee Injuries/classification
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Knee Injuries/etiology
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Knee Injuries/*surgery
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Tibial Fractures/complications
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Tibial Fractures/*surgery
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Treatment Outcome
6.Total knee arthroplasty with long tibial stem for tibial stress fractures with knee osteoarthritis: Two birds with one stone.
Satvik N PAI ; Mohan M KUMAR ; Pravin K VANCHI ; Raghav RAVI ; Pradeesh KISWANTH
Chinese Journal of Traumatology 2022;25(6):357-361
PURPOSE:
The treatment and outcome of tibial stress fractures concomitant with knee osteoarthritis (OA) are complicated. The aim of this study was to evaluate the functional and radiological outcome of total knee arthroplasty with long tibial stem as a treatment for patients having knee OA and tibial stress fracture.
METHODS:
Patients who were diagnosed to have proximal tibia stress fracture along with knee OA at our institution between June 2013 and November 2018 were included in our study. All patients underwent total knee arthroplasty with long tibial stem. Preoperative and postoperative functional assessments were done according to range of movement of the knee joint, knee society score and knee injury and OA outcome score. Descriptive analysis was carried out by mean and standard deviation for quantitative variables, frequency and proportion for categorical variables.
RESULTS:
Twelve patients were included in the study. All patients were found to have stress fractures in the proximal half of tibia and extra-arthrosis. Four patients had non-union/delayed union, and 8 patients had acute fractures. The average preoperative range of movement was 88.1°, which improved to 116.3° at 3 months following surgery. It was found that the fracture has healed in all cases. Mean knee society score improved from 32.9 preoperatively to 89.3 at 1 year follow-up. Knee injury and OA outcome score improved from a mean score of 28.3 preoperatively to 81.1 at 1 year follow-up.
CONCLUSION
Stress fractures can occur in the proximal tibia in patients with knee OA. Total knee arthroplasty with tibial stem provides a suitable solution for both conditions. Additional plating or bone graft is unlikely to be required.
Humans
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Arthroplasty, Replacement, Knee/adverse effects*
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Osteoarthritis, Knee/surgery*
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Tibia/surgery*
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Fractures, Stress/surgery*
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Tibial Fractures
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Knee Joint
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Knee Injuries/surgery*
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Treatment Outcome
7.Simultaneous bilateral patellar tendon rupture without predisposing systemic disease or steroid use: a case report.
Hua-Ding LU ; Dao-Zhang CAI ; Kun WANG ; Chun ZENG
Chinese Journal of Traumatology 2012;15(1):54-58
There is a dearth of case reports describing simultaneous bilateral patellar tendon ruptures in the medical literature. These ruptures are often associated with systemic disorders such as lupus erythematosus or chronic steroid use. The author describes a case of a 24-year-old man who sustained traumatic bilateral patellar tendon ruptures without any history of systemic disease or steroidal medication. We repaired and reattached the ruptured tendons to the patella and augmented our procedure with allogeneic tendon followed by wire loop reinforcement. One year after operation, the patient regained a satisfactory range of motion of both knees with good quadriceps strength and no extensor lag. The recurrent microtrauma from a history of intense sports activity and a high body mass index may have played an important role in this trauma event.
Humans
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Knee Injuries
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Patella
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injuries
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Patellar Ligament
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Rupture
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Tendon Injuries
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surgery
8.Vascular Injury Associated with Blunt Trauma without Dislocation of the Knee.
Jong Woo KIM ; Chang Meen SUNG ; Se Hyun CHO ; Sun Chul HWANG
Yonsei Medical Journal 2010;51(5):790-792
Failure to recognize popliteal artery injury and restore vessel continuity of flow after blunt trauma is a major cause of lower extremity amputation and morbidity. A high index of suspicion and early recognition of the injury are paramount for limb salvage. We experienced a rare case of poplitial artery occlusion with the presence of arterial pulses due to collateral circulation after blunt trauma. Expeditious revascularization was achieved by using posterior approach, allowing two surgical teams to work simultaneously. This case illustrates that, even in the absence of knee dislocation, surgeons must always consider the possibility of a popliteal artery damage whenever a blunt trauma near the knee.
Adult
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Female
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Humans
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Knee Dislocation
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*Knee Injuries/complications/surgery
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Magnetic Resonance Imaging
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Popliteal Artery/*injuries/surgery
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Treatment Outcome
9.Vascular Injury Associated with Blunt Trauma without Dislocation of the Knee.
Jong Woo KIM ; Chang Meen SUNG ; Se Hyun CHO ; Sun Chul HWANG
Yonsei Medical Journal 2010;51(5):790-792
Failure to recognize popliteal artery injury and restore vessel continuity of flow after blunt trauma is a major cause of lower extremity amputation and morbidity. A high index of suspicion and early recognition of the injury are paramount for limb salvage. We experienced a rare case of poplitial artery occlusion with the presence of arterial pulses due to collateral circulation after blunt trauma. Expeditious revascularization was achieved by using posterior approach, allowing two surgical teams to work simultaneously. This case illustrates that, even in the absence of knee dislocation, surgeons must always consider the possibility of a popliteal artery damage whenever a blunt trauma near the knee.
Adult
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Female
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Humans
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Knee Dislocation
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*Knee Injuries/complications/surgery
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Magnetic Resonance Imaging
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Popliteal Artery/*injuries/surgery
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Treatment Outcome
10.Treatment of medial collateral ligament tears at its attachment point with anchoring nail.
Li ZHU ; He-jie YANG ; Yong HAN ; Hui ZHOU
China Journal of Orthopaedics and Traumatology 2009;22(3):178-179
Adolescent
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Adult
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Bone Nails
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Female
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Humans
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Knee Injuries
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surgery
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Male
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Medial Collateral Ligament, Knee
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injuries
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surgery
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Middle Aged