OBJECTIVESTo investigate whether tibial intercondylar hyperplasia can cause anterior cruciate ligament (ACL) injuries.

METHODSFrom February 2009 to October 2012, 58 cases (including 70 knees) with knee osteoarthritis (KOA) without trauma history were selected from the out-patient department of orthopaedics in Guang'anmen Hospital attached to China Academy of Chinese Medical Science. All cases were tested by MRI scanning, then vertical height of the medial and lateral intercondylar spine in coronal position and the area of abnormal signal of ACL in sagittal position were tested from patients. Correlation between the height of intercondylar spine and the area of abnormal signal of ACL were analyzed.

RESULTSFives cases of 58 cases( 70 knees) were excluded from episome in knee joint, and other 65 knees were in accordance with the inclusion criteria. Among them, there were 10 males and 48 females aged from 39 to 79 years old with an average of 61 years old. The vertical height of the medial intercondylar spine was (10.02 +/- 1.46) mm and lateral was (8.92 +/- 1.69) mm. The area of abnormal signal ACL was (318.42 +/- 130.10) mm2. There was positive correlation between the height of medial intercondylar spine and the area of abnormal signal of ACL (r=0.06, P=0.00). But there was no correlation between lateral intercondylar spine and the area of abnormal signal of ACL (P=0.10).

CONCLUSIONThe height of medial intercondylar spine and the area of abnormal signal of ACL is positively correlated. The clinical significance is in study, while the clinical meaning still need further study.

Adult ; Aged ; Anterior Cruciate Ligament ; abnormalities ; diagnostic imaging ; surgery ; Female ; Humans ; Hyperplasia ; diagnostic imaging ; surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Osteoarthritis, Knee ; diagnostic imaging ; surgery ; Radiography ; Tibia ; diagnostic imaging ; pathology ; surgery

BACKGROUND: Percutaneous lateral hemiepiphysiodesis of the lower extremity is a simple and excellent method to correct the angular and length problems cosmetically. However, the efficacy of percutaneous lateral hemiepiphysiodesis is not well established in the literature. The purpose of this study was to evaluate the efficacy of percutaneous lateral hemiepiphysiodesis for angular corrections in adolescent idiopathic genu varum patients with proximal tibia vara and identify the factors affecting the amount of deformity correction of the lower limb in the coronal plane. METHODS: We retrospectively reviewed 20 patients (40 lower limbs) who had percutaneous lateral hemiepiphysiodesis on the proximal lateral tibia between 1997 and 2010. Radiographic evaluations were made using (1) the hip-knee-ankle angle and (2) the length of the tibia. Furthermore, the intercondylar distance was evaluated at the level of the knee joint. Preoperative factors (gender, age, body mass index, intercondylar distance, preoperative hip-knee-ankle angle, remaining growth of tibia, and calculated correctable angle) were analyzed, as well as their correlation with the degree of the actual correction angle. RESULTS: The amount of coronal deformity of the lower limb was improved from its preoperative state. The median average of hip-knee-ankle angle improved from 8.0degrees (interquartile range [IQR], 7.0degrees to 10.0degrees) preoperatively to 3.0degrees (IQR, 2.5degrees to 4.0degrees) at the final follow-up (p < 0.001). The median percent ratio of the angular correction was 60% (IQR, 50% to 71.3%). The correlation coefficients were -0.537, 0.832, 0.791, and 0.685 for the bone age, preoperative hip-knee-ankle angle, the remaining growth of tibia, and calculated correctable angle, respectively. CONCLUSIONS: Despite the excellent cosmetic outcome of percutaneous lateral hemiepiphysiodesis on the proximal lateral tibia in adolescent idiopathic genu varum, the effect was limited in most cases. For optimum results, surgery a few months earlier is recommended, rather than at the calculated operation time.
Adolescent ; Child ; Female ; Genu Varum/diagnostic imaging/pathology/*surgery ; Humans ; Leg Bones/diagnostic imaging/pathology/surgery ; Male ; Orthopedic Procedures/*methods ; Retrospective Studies ; Tibia/diagnostic imaging/pathology/*surgery ; Treatment Outcome

To investigate the clinical characteristics of chondroblastoma with an emphasis on lesions located in the long bone diaphysis, we reviewed the clinical data of 7 patients with histologically proven chondroblastoma treated in Tianjin Medical University Cancer Hospital and Fudan University Cancer Hospital between January 1995 and May 2009. There were two rare cases of chondroblastoma in the long bone diaphysis. One patient with a lesion in the tibial diaphysis underwent intralesional curettage and bone grafting, and the postoperative bone function was measured as excellent according to the Enneking scoring system. The patient was still alive upon follow-up at 60 months. The other patient with a lesion in the humeral diaphysis underwent resection, and the postoperative bone function was excellent at 48 months, at which there was no evidence of recurrence or metastasis. Thus, except for the distinctive site of the long bone diaphysis, which made diagnosis difficult, the patients' ages, symptoms, X-ray and CT images, treatment, and prognosis were in accordance with typical lesions in the epiphysis and metaphysis. The diagnosis of chondroblastoma in the long bone diaphysis significantly depends on histopathologic characteristics.
Adolescent ; Adult ; Bone Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; surgery ; Bone Transplantation ; methods ; Chondroblastoma ; diagnosis ; diagnostic imaging ; pathology ; surgery ; Curettage ; methods ; Diaphyses ; diagnostic imaging ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Humerus ; diagnostic imaging ; pathology ; surgery ; Magnetic Resonance Imaging ; Male ; Tibia ; diagnostic imaging ; pathology ; surgery ; Tomography, X-Ray Computed ; Young Adult

Child ; Growth Plate ; blood supply ; physiopathology ; surgery ; Humans ; Male ; Popliteal Artery ; pathology ; Salter-Harris Fractures ; Tibia ; blood supply ; diagnostic imaging ; injuries ; surgery ; Tomography, X-Ray Computed

Actins ; metabolism ; Adult ; Amputation ; Arthroplasty, Replacement, Knee ; Bone Neoplasms ; diagnosis ; metabolism ; pathology ; surgery ; Calmodulin-Binding Proteins ; metabolism ; Humans ; Leiomyosarcoma ; diagnosis ; metabolism ; pathology ; surgery ; Magnetic Resonance Imaging ; Male ; Radiography ; Tibia ; diagnostic imaging ; surgery

BACKGROUNDIt has been demonstrated that bone tunnel widening could appear after knee anterior cruciate ligament (ACL) reconstruction, especially for those patients whose ruptured ACL were reconstructed with semitendinosus and gracilis tendons. Many factors can influence the extent of tunnel widening. Few studies have investigated the relationship between bone tunnel widening and rehabilitation procedures. This research was carried out to find the rehabilitation procedures' influence on the tibial bone tunnel widening after ACL reconstruction.

METHODSSixty-five cases, whose ACL reconstructions were done using quadrupled semitendinosus and gracilis tendons, were divided into two groups. Group A had 33 cases, 19 men, 14 women, averaged (31.2 +/- 12.4) years old, only ACL reconstruction was done using Paessler's technique, and aggressive rehabilitation procedure was used for function recovery post operation. Group B had 32 cases, 20 men, 12 women, averaged (30.3 +/- 10.3) years old. Except for ACL reconstruction, every patient in group B accepted meniscus repair using re-fixation methods or cartilage repair using microfracture technique, conservative rehabilitation procedure was used post operation. Six months post operation, standard posterior-anterior radiographic plates were taken for each case, CorelDRAW 8.0 software was used to digitize all X-ray plates and measure the upper, middle and lower parts of the tibial tunnel. Magnification effect of X-ray plates was taken out after measurement.

RESULTSSix months after ACL reconstruction the tibial tunnel widening of the upper, middle and lower parts on both the posterior-anterior and lateral X-ray plates in Group A with aggressive rehabilitation procedure was much more serious than in Group B with conservative rehabilitation. KT-1000 knee stability measurement and clinical manifestation showed no difference between the two groups.

CONCLUSIONSRehabilitation procedure after ACL reconstruction is one of the reasons for tunnel widening. It not only can directly influence the function recovery of ACL reconstructed knee, but also perhaps indirectly influence the function recovery and long-term clinical result of the operated knee by influencing the tunnel widening.

Adult ; Anterior Cruciate Ligament ; diagnostic imaging ; surgery ; Female ; Humans ; Joint Instability ; Knee Injuries ; rehabilitation ; surgery ; Male ; Middle Aged ; Orthopedic Procedures ; Radiography ; Reconstructive Surgical Procedures ; Retrospective Studies ; Tendons ; transplantation ; Tibia ; diagnostic imaging ; pathology

Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Male ; Reconstructive Surgical Procedures ; Recovery of Function ; Tibia ; diagnostic imaging ; pathology ; physiopathology ; surgery ; Tomography, X-Ray Computed

Adult ; External Fixators ; Female ; Humans ; Male ; Middle Aged ; Recovery of Function ; Tibia ; anatomy & histology ; pathology ; physiopathology ; Tibial Fractures ; diagnosis ; diagnostic imaging ; physiopathology ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome

Adamantinoma ; diagnostic imaging ; metabolism ; pathology ; surgery ; Adult ; Diagnosis, Differential ; Female ; Femur ; Follow-Up Studies ; Humans ; Humerus ; Ilium ; Keratins ; metabolism ; Male ; Middle Aged ; Mucin-1 ; metabolism ; Retrospective Studies ; Sarcoma, Ewing ; pathology ; Sarcoma, Synovial ; pathology ; Tibia ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVEto study the clinicopathological features, imaging characteristics, immunophenotypes and differential diagnosis of giant cell angioblastoma (GCAB).

METHODSa case of GCAB in the left middle-upper tibia and fibula was studied by light microscopy, X-ray and CT imaging, immunohistochemistry.

RESULTSX-ray and CT imaging showed a clearer lesion in the left middle-upper tibia than in the ipsilateral fibula with enlarged ostealleosis and increased inhomogeneously medullary cavity density, irregular thickening of cortical bone, local cortical default at the inner edge, soft tissue swelling around the abnormal bone. Histologically, tumor tissue was located between the bone trabeculae by nodular, linear and plexiform aggregates of oval-to-spindle cells, large mononucleate cells and multinucleate giant cells with prominent nucleoli and abundant granular eosinophilic cytoplasm. Some aggregates had uncentain amount of discernible lumens, either empty or containing few erythrocytes. A concentric arrangement of oval-to-spindle Cells around small-caliber vascular structures together with collagen fiber contributed to a so-called 'onion-skin' arrangement. The background showed a loose mesenchymal stroma formed of some inconspicuous spindle-fibroblast-like cells, stellate-shape mesenchymal cells, a moderate mononuclear inflammatory cell infiltrate and scattered mast cells. Immunophenotype showed the tumor cells and giant cells strongly positive for vimentin. A good many oval-to-spindle cells stained markedly for CD31 and CD34, but weakly for FVIII, while the giant cells are highlighted instead by CD68, occasionally, very few giant cells showed positive focally for FVIII, a-SMA decorated notedly the cells surrounding the endothelium-like cells but weakly positive in some other tumor cells.

CONCLUSIONGCAB is a rare, locally infiltrative but slow growing neoplastic angiogenesis with unique morphological characteristics during infancy, which may occur not only in the skin, mucosa, subcutis and deep soft tissue but also in the bone.

Actins ; metabolism ; Antigens, CD ; metabolism ; Antigens, CD34 ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Bone Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Dermatofibrosarcoma ; metabolism ; pathology ; Diagnosis, Differential ; Fibula ; Giant Cell Tumor of Bone ; diagnostic imaging ; metabolism ; pathology ; surgery ; Hemangioblastoma ; diagnostic imaging ; metabolism ; pathology ; surgery ; Hemangioendothelioma ; metabolism ; pathology ; Hemangioendothelioma, Epithelioid ; metabolism ; pathology ; Hemangioma, Cavernous ; metabolism ; pathology ; Humans ; Infant ; Kasabach-Merritt Syndrome ; Male ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Sarcoma, Kaposi ; metabolism ; pathology ; Skin Neoplasms ; metabolism ; pathology ; Thrombocytopenia ; metabolism ; pathology ; Tibia ; Tomography, X-Ray Computed ; Vascular Neoplasms ; metabolism ; pathology ; Vimentin ; metabolism