Osteoid osteoma is very rarely located in the patella, and can represent a significant diagnostic challenge, resulting in a delay of treatment. Patients with osteoid osteoma of the patella often present with knee pain that is also a typical symptom of trauma or of other diseases such as arthritis, which are much more common than osteoid osteoma. We present two young male patients diagnosed with osteoid osteoma of the patella. Each of these patients had a history of intense knee pain; however, accurate diagnosis of osteoid osteoma in the patella had been delayed for more than one year. Computed tomography (CT) scans or magnetic resonance imaging (MRI) showed a circumscribed lesion of the patella in both patients, whereas X-ray examination (posteroanterior projection) was not able to detect the tumor. Different surgical procedures were performed in these patients for resection of the tumors, and the pathology findings confirmed the diagnosis of osteoid osteoma. Both patients recovered completely from surgery.
Adolescent ; Adult ; Humans ; Male ; Osteoma, Osteoid ; diagnosis ; diagnostic imaging ; surgery ; Patella ; diagnostic imaging ; pathology ; surgery ; Radiography

Fracture Fixation, Internal ; methods ; standards ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Knee Injuries ; diagnostic imaging ; surgery ; Patella ; injuries ; surgery ; Radiography

BACKGROUND: Several tendon graft and fixation methods have been introduced in medial patellofemoral ligament (MPFL) reconstruction for recurrent patellar dislocation. The purpose of this study was to evaluate the results of MPFL reconstruction using a gracilis autograft fixation without bone tunnel in patients with recurrent patellar instability. METHODS: Nine patients (four males and five females) diagnosed with recurrent patellar instability from July 2009 to January 2013 and had MPFL reconstruction using a gracilis autograft were included. The average age of the patients was 24.6 years (range, 13 to 48 years), and the average follow-up period was 19.3 months (range, 12 to 30 months). For every patient, femoral attachment was fixed using suture anchors securing the patella by suturing the periosteum and surrounding soft tissue. Clinical evaluation included the Kujala, Lysholm, and Tegner scores; in addition, patients were examined for any complication including recurrent dislocation. The congruence angle and patella alta were assessed radiologically before and after surgery. RESULTS: The Kujala score improved from an average of 42.7 ± 8.4 before surgery to 79.6 ± 13.6 (p = 0.008) at final follow-up; the Lysholm score improved from 45.8 ± 5.7 to 82.0 ± 10.5 (p = 0.008); and the Tegner score improved from 2.8 ± 0.8 to 5.6 ± 1.5 (p = 0.007). The Insall-Salvati ratio changed from 1.16 ± 0.1 (range, 0.94 to 1.35) before surgery to 1.14 ± 0.1 (range, 0.96 to 1.29; p = 0.233) at the final follow-up without significance. The congruence angle significantly improved from 26.5°± 10.6° (range, 12° to 43°) before surgery to -4.0°± 4.3° (range, -12° to 5°; p = 0.008) at final follow-up. Subluxation was observed in one patient and hemarthrosis occurred in another patient 2 years after surgery, but these patients were asymptomatic. CONCLUSIONS: We achieved good results with a patellar fixation technique in MPFL reconstruction using a gracilis autograft employing soft tissue suturing in patients with recurrent patellar dislocation.
Adolescent ; Adult ; *Autografts ; Female ; Humans ; Knee Injuries/radiography/*surgery ; Ligaments, Articular/radiography/*surgery ; Male ; Middle Aged ; Muscle, Skeletal/surgery/transplantation ; Patella/radiography/*surgery ; Patellofemoral Joint/radiography/*surgery ; Reconstructive Surgical Procedures/adverse effects/instrumentation/*methods ; Retrospective Studies ; Thigh/surgery ; Young Adult

Adolescent ; Bone Plates ; Fracture Fixation, Internal ; instrumentation ; Fractures, Bone ; diagnostic imaging ; pathology ; physiopathology ; surgery ; Humans ; Male ; Patella ; injuries ; surgery ; Radiography

It has been reported that the common sites of brown tumors are the jaw, pelvis, ribs, femurs and clavicles. We report our experience in a case of brown tumor of the patella caused by primary hyperparathyroidism. An initial radiograph and CT showed an osteolytic lesion and MR images showed a mixed solid and multiloculated cystic tumor in the right patella. One month after the parathyroidectomy, rapid bone formation was observed on both radiographs and CT images.
Adult ; Bone Density ; Bone Neoplasms/*etiology/radiography/*surgery ; Female ; Humans ; Hyperparathyroidism, Primary/*complications/*surgery ; Parathyroidectomy ; Patella/*pathology/radiography ; Tomography, X-Ray Computed

Breakage of K-wires and stainless steel wires which are used for fracture fixation is not uncommon, but migration is rare. We report a case of migration of broken K-wire used for patella tension band wiring to the popliteal fossa. The broken hardware was removed surgically. We would like to suggest that K-wire and wire fixation used for treatment of patellar fractures can migrate into the posterior compartment of the knee and cause clinical symptoms. Close clinical and radiological follow-up after internal fixation to identify the presence of hardware breakage or movement and removal of wires once fracture has united can avert such complications.
Adult ; Bone Wires ; Equipment Failure ; Foreign-Body Migration ; etiology ; Fracture Fixation, Internal ; instrumentation ; methods ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Male ; Patella ; diagnostic imaging ; injuries ; Radiography ; Time Factors

OBJECTIVETo evaluate long-term result of Scorpio posterior-stabilized total knee arthroplasty.

METHODSThere were 160 patients (240 knees) underwent Scorpio posterior-stabilized total knee arthroplasty between December 1998 and December 2000, which were performed by the same surgeon. Patients were followed up from June 2013 to December 2013. Knee Society Scoring (KSS), Hospital for Special Surgery (HSS) patellofemoral scoring, standard weight-bearing anteroposterior and patellar tangential radiographs were assessed. Satisfaction of outcome was requested. Alignment of components and presence of radiolucent lines were assessed by the radiographic scoring system of knee society. Paired t-test was used compared to the data between preoperation and the time of last follow-up.

RESULTSNinety-five patients (141 knees) (59.4%) were followed up. Average follow-up duration was 13.3 years (range 12 to 15 years). Eight knees were revised due to periprosthetic infection (4 knees), aseptic loosening of tibial tray (3 knees) and wear-out of polyethylene insert (1 knee). Compared with preoperative ones, KSS knee score, KSS functional score and range of motion improved significantly (pre-operation: 26±16, 34±18, 87°±25°; follow-up time: 93±8, 78±27, 114°±22°) (t=45.55, 15.60, 13.03, all P<0.01). In terms of KSS knee score and HSS patellofemoral score, 106 knees were rated as excellence respectively. Ninety-five knees had satisfaction with outcome for maximum. The presences of radiolucent lines occurred around 5 femoral and 11 tibial components with range less than 2 mm. The survival rate at 10 years was 94.5% with revision for any reason as the end point.

CONCLUSIONThe long-term study indicates that Scorpio posterior-stabilized knee system shows favorable clinical and radiological results.

Arthroplasty, Replacement, Knee ; methods ; Femur ; diagnostic imaging ; Follow-Up Studies ; Humans ; Knee Joint ; surgery ; Knee Prosthesis ; Patella ; diagnostic imaging ; Polyethylene ; Radiography ; Range of Motion, Articular ; Reoperation ; Tibia ; diagnostic imaging ; Treatment Outcome