OBJECTIVE: To measure and analyze the relationships among the posterior tibial slope (PTS), meniscal slope (MS), and meniscus posterior horn thickness (MPHT) of the medial and lateral tibial plateau in healthy people and patients with anteromedial osteoarthritis (AMOA) in Heilongjiang province, so as to provide reference basis for appropriate tibial osteotomy and prosthesis placement angles in knee joint surgeries. METHODS: A retrospective collection of imaging data from knee joint MRI examinations conducted prior to AMOA for various reasons was performed. A total of 103 healthy individuals (healthy group) and 30 AMOA patients (AMOA group) were included. There was no significant difference in the gender composition ratio, side, and body mass index between the two groups ( P>0.05); however, the comparison of ages between the two groups showed a significant difference ( P<0.05). The collected DICOM format image data was imported into the RadiAnt DICOM Viewer software and measured the medial PTS (MPTS), lateral PTS (LPTS), medial MS (MMS), lateral MS (LMS), medial MPHT (MMPHT), and lateral MPHT (LMPHT) with standard methods. The differences of the above indexes between the two groups and between different genders and sides in the two groups were compared, and Pearson correlation analysis was carried out. At the same time, the measured data of healthy group were compared with the relevant literature reported in the past. RESULTS: Compared to the healthy group, the AMOA group exhibited significantly smaller MPTS and LPTS, as well as significantly greater MMPHT and LMPHT, with significant differences ( P<0.05). However, there was no significant difference in the MMS and LMS between the two groups ( P>0.05). The differences in various indicators between genders and sides within the two groups were not significant ( P>0.05). The correlation analysis and regression curves indicated that both MPTS and LPTS in the two groups were positively correlated with their respective ipsilateral MS and MPHT ( P<0.05); as PTS increased, the rate of increase in MS and MPHT tend to plateau. Compared to previous related studies, the MPTS and LPTS measured in healthy group were comparable to those of the Turkish population, exhibiting smaller values than those reported in other studies, while MMS and LMS were relatively larger, and MMPHT and LMPHT were smaller. CONCLUSION In healthy people and AMOA patients in Heilongjiang province, PTS has great individual differences, but there is no significant individual difference in MS. MPHT can play a certain role in retroversion compensation, and its thickness increase may be used as one of the indicators to predict the progression of AMOA. The above factors should be taken into account when UKA is performed, and the posterior tilt angle of tibial osteotomy should be set reasonably after preoperative examination and evaluation.
Humans ; Osteoarthritis, Knee/surgery* ; Retrospective Studies ; Tibia/pathology* ; Male ; Female ; Adult ; Menisci, Tibial/anatomy & histology* ; China ; Knee Joint/pathology* ; Magnetic Resonance Imaging ; Middle Aged ; Aged ; Osteotomy

An unusual grayish brown discoloration of the synovium was found during a knee arthroscopy of a 72-year-old man. He also had similar pigmentation affecting the skin on the legs, arms, hands, and face. It was found he had been taking 400 mg of amiodarone hydrochloride daily for last 7 years. Amiodarone is known to cause a slate grey pigmentation of skin and cornea, but we believe this is the first report of amiodarone-induced pigmentation of the synovium. The arthroscopist should be aware of the possibility of drug-related synovial pigmentation and include this in differential diagnosis.
Aged ; Amiodarone/*adverse effects/therapeutic use ; Anti-Arrhythmia Agents/*adverse effects/therapeutic use ; Arrhythmias, Cardiac/complications/drug therapy ; Arthroscopy ; Diagnosis, Differential ; Humans ; Knee Joint/surgery ; Male ; Pigmentation Disorders/*chemically induced/*diagnosis ; Skin/pathology ; Synovial Membrane/*pathology

OBJECTIVETo compare the long-term outcomes of arthroscopy and non-surgical therapy in patients with knee synovial plica syndrome (SPS).

METHODSThirty-one patients with knee SPS undergoing arthroscopic surgery and 27 SPS patients undergoing conservative treatment with articular cavity injection of sodium hyaluronate (control group) were compared for visual pain score (VAS) and the Lysholm score before and after the operation. The patients were followed-up for more than 5 years, and the long-term outcomes were compared using Kaplan-Meier survival analysis.

RESULTSs VAS and the Lysholm scores in both groups were significantly lowered after treatment (P<0.05). The postoperative VAS score was significantly lower while the Lysholm score significantly higher in arthroscopic surgery group than in the control group (P<0.05). Arithmetic mean and the median time of curative effect maintenance were 49 and 43 months in arthroscopic surgery group, as compared with 33 and 29 months in the control group, respectively; the cumulative effect maintenance rate in arthroscopic surgery group was significantly higher than that in the control group (Χ2=4.933, P=4.933).

CONCLUSIONArthroscopic treatment produces better therapeutic effect on knee joint SPS and ensures longer long-term therapeutic effect maintenance than conservative treatment.

Adult ; Arthroscopy ; Female ; Follow-Up Studies ; Humans ; Hyaluronic Acid ; administration & dosage ; Injections, Intra-Articular ; Joint Diseases ; surgery ; Knee Joint ; pathology ; surgery ; Male ; Pain, Postoperative ; Postoperative Period ; Synovectomy ; Synovial Membrane ; pathology ; Treatment Outcome

PURPOSE: The aim of the study was to investigate and analyze bilateral incidence and morphology of complete discoid lateral meniscus (DLM) with possible relation to tears and symptoms in knee joints. MATERIALS AND METHODS: Thirty-eight consecutive patients with symptomatic or already-torn complete DLM on magnetic resonance imaging in a unilateral knee underwent diagnostic arthroscopy on both knee joints upon agreement. The presence and shape of complete DLM as well as presence and pattern of tear were recorded accordingly. RESULTS: In total, 89.5% (34 of 38 patients) showed bilateral complete DLM, and 84.2% yielded bilateralism with identical shape. Cape-slab was the most frequent shape, comprising 68.8% of patients with identically-shaped bilateral DLM overall. Tear patterns were more frequent, in the order of longitudinal, simple horizontal, radial, and degenerative; however, the morphological shape of complete DLM was not significantly related to tear incidence or pattern. Meniscus tears and knee symptoms occurred in the contralateral knee with incidences of 32.4% and 26.5% in patients with bilateral complete DLM, respectively. CONCLUSION: Based on these findings, more aggressive warning on the presence of discoid pathology and the need for evaluation on the contralateral knee should be considered during consultation with patients with symptomatic complete DLM in a unilateral knee in the outpatient clinic.
Adolescent ; Adult ; Arthroscopy/*methods ; Female ; Humans ; Incidence ; Knee Joint/*pathology ; Magnetic Resonance Imaging/methods ; Male ; Menisci, Tibial/*injuries/surgery ; Middle Aged ; Musculoskeletal Abnormalities/complications/diagnosis/epidemiology/*surgery ; Retrospective Studies ; Young Adult

OBJECTIVETo investigate the clinical effect of lateral superior genicular composite tissue flap for tissue defect.

METHODSThe axis line of flap is the lateral thigh vertical midline. The cutaneous branch is inserted 4 cm near the femoral lateral epicondylus. The anterior border is the elongation line along patellar lateral border. The posterior margin is the hinder margin of femoral biceps. The lower border is the horizontal line along the upper line of patella. The composite flaps were used in 18 cases with soft tissue defects in extremities, 11 cases with clacaneus tenden defects and 16 cases with bony nonunion. Results From Mar. 2002 to Sept. 2013, 45 cases were treated with the composite tissue flaps. The flaps size ranged from 6 cm x 3 cm to 17cm x 9 cm. All the flaps survived completely. Blood supply crisis happened in 2 cases, which was released by reanastomosis. The patients were followed up for 1 - 2. 5 years with satisfactory aesthetic and functional results. All the bone defect and nonunion were healed. Good healing was also achieved in donor sites. 8 months after operation, knee joint function is evaluated as good by hospital special surgery knee score (HSS).

CONCLUSIONLateral superior genicular compostie tissue flap can be used to reconstruct soft tissue defect, bone defect and tenden calcaneus defect in one stage.

Anatomic Landmarks ; anatomy & histology ; Follow-Up Studies ; Graft Survival ; Humans ; Knee ; anatomy & histology ; Muscle, Skeletal ; anatomy & histology ; Soft Tissue Injuries ; pathology ; surgery ; Surgical Flaps ; transplantation ; Thigh ; Time Factors ; Wound Healing

Humans ; Osteoarthritis, Knee ; pathology ; surgery ; Risk Factors ; Synovectomy ; Synovial Membrane ; pathology

OBJECTIVETo explore selection and method of tissue flaps for the repair of severe defects of skin and soft tissue around the knee joints.

METHODSFifty-four patients with wounds around the knee joints, all accompanied by exposure or necrosis of tendon or bone and exposure of prosthesis, were hospitalized in our burn center from June 2008 to December 2014. Five of them were with knee joint injury. After thorough debridement or tumor resection, the wound area ranged from 5 cm × 5 cm to 46 cm × 22 cm. Three patients were repaired with free latissimus dorsi myocutaneous flaps, 7 were repaired with modified sartorius myocutaneous flaps, 8 were repaired with gastrocnemius myocutaneous flaps, one was repaired with gastrocnemius muscle flap, two were repaired with posterior leg flaps combined with gastrocnemius muscle flaps, one was repaired with femoral biceps muscle flap combined with gastrocnemius muscle flap, 13 were repaired with reverse anterolateral thigh island flaps, two were repaired with reverse anterolateral thigh island flap combined with gastrocnemius myocutaneous flaps, two were repaired with superior lateral genicular flaps, 4 were repaired with reverse posterior thigh island flaps, 11 were repaired with saphenous artery flaps. Patellar ligament was reconstructed in 4 patients. The tissue flap size ranged from 5 cm × 5 cm to 38 cm × 19 cm. Some donor sites were sutured directly, and the others were closed by split-thickness skin grafting obtained from ipsilateral or contralateral legs.

RESULTSAmong 59 tissue flaps of 54 patients, 55 tissue flaps of 50 patients survived, while necrosis of the distal part was observed in 4 tissue flaps, including one saphenous artery flap, two reverse anterolateral thigh island flaps, and one free latissimus dorsi myocutaneous flap. Among them, 3 flaps with necrosis at the distal part healed after debridement followed by skin grafting, one myocutaneous flap healed by transplanting gastrocnemius myocutaneous flap. During the follow-up period of 6 to 36 months, the tissue flaps were in good appearance and texture, and knee joint function was good in most cases. In 4 patients the knee joint function was satisfactory after patellar ligament reconstruction, while stiffness was observed in 4 out of 5 patients with knee joint injury.

CONCLUSIONSFree latissimus dorsi myocutaneous flaps are preferred to repair extensive defects around the knee joints. Reverse anterolateral thigh island flaps followed by saphenous artery flaps are preferred to repair wounds around the anterior knee. Wounds of the lateral knee are mainly repaired with reverse anterolateral thigh island flaps, and for small wounds the use of the superior lateral genicular flaps may be considered. Wounds of the medial knee can be repaired with modified sartorius myocutaneous flaps or saphenous artery flaps. Wounds of the posterior knee can be repaired with reverse posterior thigh island flaps or superior lateral genicular flaps. Wounds with severe infection or large space can be repaired with gastrocnemius myocutaneous flaps or muscle flaps or modified sartorius myocutaneous flaps. Anterolateral thigh flaps and gastrocnemius myocutaneous flaps are preferred in cases with indication of patellar ligament reconstruction.

Debridement ; Humans ; Knee Injuries ; surgery ; Knee Joint ; pathology ; Muscle, Skeletal ; Necrosis ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; Treatment Outcome ; Wound Healing

Acute Disease ; Arthroplasty, Replacement, Knee ; adverse effects ; Diagnosis, Differential ; Humans ; Knee Joint ; pathology ; surgery ; Male ; Middle Aged ; Pyoderma Gangrenosum ; diagnosis ; Skin ; pathology ; Surgical Wound Infection ; diagnosis

The localized type of tenosynovial giant cell tumor usually occurs on the palmar side of fingers and toes. Tenosynovial giant cell tumors of the tendon sheath are rarely intra-articular. We report a giant cell tumor of the tendon sheath arising from femoral attachment of the anterior cruciate ligament and its treatment with arthroscopy in a 28-year-old man.
Adult ; Anterior Cruciate Ligament/pathology/surgery ; Arthroscopy ; Femur ; Giant Cell Tumors/diagnosis/surgery ; Humans ; Knee ; Male ; Synovitis, Pigmented Villonodular/diagnosis/*surgery ; Tendons/*pathology

OBJECTIVETo study soft tissue changes observed through musculoskeletal ultrasound (MSUS) in the treatment of knee osteoarthritis with needle-knife, so as to provide MSUS basis for needle-knife in the treatment of knee osteoarthritis.

METHODSForty patients with knee osteoarthritis treated in the Third Affiliated Hospital of Beijing University of Chinese Medicine from December 2011 to December 2012 were selected according to inclusion and exclusion criteria. All the patients were treated with needle-knife release method. The VAS scores and knee joint circumference were recorded before treatment and 2 weeks after treatment. The changes of knee joint hydrops articuli and joint synovial thickness were measured through MSUS.

RESULTSThe knee pain index was 6.850 +/- 1.417 before treatment and 2.790 +/- 1.299 after treatment;the index after treatment was lower than that of before treatment. The knee joint circumference was 407.320 +/- 45.151 mm before treatment and 391.240 +/- 41.129 mm after treatment; the knee joint circumference decreased after treatment. The amount of hydrops articuli observed by musculoskeletal ultrasound showed that 47 knees were cured, 19 knees improved and 2 knees failed. The synovial membrane thickness: 43 knees cured, 17 knees improved and 8 knees failed.

CONCLUSIONThe hydrops articuli and synovial thickness of knee joint of patients with knee osteoarthritis observed under the MSUS is consistent with the main symptoms and signs, which suggests that MSUS observation on soft tissue changes before and after needle knife in the treatment of knee osteoarthritis with high reliability.

Adult ; Aged ; Female ; Humans ; Knee Joint ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Needles ; Osteoarthritis, Knee ; complications ; diagnostic imaging ; pathology ; surgery ; Pain ; complications ; Synovial Membrane ; pathology ; Treatment Outcome ; Ultrasonography