Patellar tendon rupture is an uncommon but serious complication that results in loss of knee extension during and after total knee arthroplasty (TKA), significantly impacting the patient’s quality of life. Various surgical treatments, ranging from initial repair to reconstruction, are available and accessible. In recent years, the peroneus longus tendon autograft has been utilised to restore the knee extensor system. The purpose of this case report was to present the case of a patient who had a traumatic patellar tendon rupture following TKA and requiring surgery along with peroneus tendon augmentation. A 71-year-old woman underwent bilateral robotic-assisted cruciate retaining TKA for a Grade IV arthritic knee. Post surgery, on day five patient had a history of a fall at home, following which she was unable to extend her knees. On evaluation through ultrasonography and radiographs, she was found to have a ruptured patellar tendon and sprain of the medial collateral ligament. Primary repair of the tendon along with augmentation with the peroneus tendon was performed, and the patient was followed for 12 months, at the end of which, the patient was able to achieve a good functional outcome. In conclusion, early results from patellar tendon reconstruction using an ipsilateral peroneus longus tendon autograft following TKA suggest that this technique is effective for managing acute post-traumatic patellar tendon rupture. It facilitates early recovery, yields favourable outcomes, and may reduce the risk of infection.

PURPOSE: There is sparse literature on treatment outcomes research on resectable oral tongue squamous cell carcinoma (OTSCC). The aim of this study was to measure the treatment outcomes, explore the failure patterns, and identify the potential clinicopathological prognostic factors affecting treatment outcomes for resectable OTSCC. MATERIALS AND METHODS: It is a retrospective analysis of 202 patients with resectable OTSCC who underwent upfront primary surgical resection followed by adjuvant radiotherapy with or without concurrent chemotherapy if indicated. RESULTS: The median follow-up was 35.2 months (range, 1.2 to 99.9 months). The median duration of locoregional control (LRC) was 84.9 months (95% confidence interval, 67.3–102.4). The 3- and 5-year LRC rate was 68.5% and 58.3%, respectively. Multivariate analysis showed that increasing pT stage, increasing pN stage, and the presence of extracapsular extension (ECE) were significantly associated with poorer LRC. The median duration of overall survival (OS) was not reached at the time of analysis. The 3- and 5-year OS rate was 70.5% and 66.6%, respectively. Multivariate analysis showed that increasing pT stage and the presence of ECE were significantly associated with a poorer OS. CONCLUSION: Locoregional failure remains the main cause of treatment failure in resectable OTSCC. There is scope to further improve prognosis considering modest LRC and OS. Pathological T-stage, N-stage, and ECE are strong prognostic factors. Further research is required to confirm whether adjuvant therapy adds to treatment outcomes in cases with lymphovascular invasion, perineural invasion, and depth of invasion, and help clinicians tailoring adjuvant therapy.
Carcinoma, Squamous Cell ; Drug Therapy ; Epithelial Cells ; Follow-Up Studies ; Humans ; Mouth Neoplasms ; Multivariate Analysis ; Outcome Assessment (Health Care) ; Prognosis ; Radiotherapy ; Radiotherapy, Adjuvant ; Retrospective Studies ; Survival Analysis ; Tongue ; Treatment Failure ; Treatment Outcome

Surgical excision along with use of postoperative radiotherapy forms an integral management of sinonasal teratocarcinosarcoma (SNTCS). However, given the rarity of the tumor, no standardised guidelines, dose, technique and target delineation exist especially in the era of modern radiation delivery techniques. This is a case of 55-year-old male diagnosed as SNTCS treated with radical ethmoidectomy followed by volumetric modulated radiotherapy, showing good local control and acceptable toxicity profile.
Head and Neck Neoplasms ; Humans ; Male ; Middle Aged ; Radiotherapy ; Radiotherapy, Intensity-Modulated

BACKGROUND/AIMS: Leptin is associated with metabolic disorders, which predispose one to non-alcoholic fatty liver disease (NAFLD). The role of leptin in NAFLD pathogenesis is not fully understood. We aim to investigate the association between serum leptin level and severity of NAFLD using U.S. nationally representative data. METHODS: Data were obtained from the United States Third National Health and Nutrition Examination Survey. NAFLD was defined by ultrasound detection and severity of hepatic steatosis in the absence of other liver diseases. The severity of hepatic fibrosis was determined by NAFLD fibrosis score (NFS). We used multivariate survey-weighted generalized logistic regression to evaluate the association between leptin level and the degree of NAFLD. We also performed subgroup analyses by body mass index (lean vs. classic NAFLD). RESULTS: Among 4,571 people, 1,610 (35%) had NAFLD. By ultrasound findings, there were 621 people with mild, 664 with moderate, and 325 with severe steatosis. There were 885 people with low NFS ( <−1.455, no significant fibrosis), 596 with intermediate NFS, and 129 with high NFS (>0.676, advanced fibrosis). Leptin levels for normal, mild, moderate and severe steatosis were 10.7±0.3 ng/mL, 12.1±0.7 ng/mL, 15.6±0.8 ng/mL, 16±1.0 ng/mL, respectively (trend P-value < 0.001). Leptin levels for low, intermediate, and high NFS were 11.8±0.5 ng/mL, 15.6±0.8 ng/mL, 28.5±3.5ng/mL, respectively (trend P-value < 0.001). This association remained significant even after adjusting for known demographic and metabolic risk factors. In the subgroup analysis, this association was only prominent in classic NAFLD, but not in lean NAFLD. CONCLUSIONS: Serum leptin level is associated with the severity of NAFLD, especially in classic NAFLD patients.
Body Mass Index ; Fibrosis ; Humans ; Leptin* ; Liver Diseases ; Logistic Models ; Non-alcoholic Fatty Liver Disease* ; Nutrition Surveys ; Risk Factors ; Ultrasonography ; United States