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

Adult ; Asymptomatic Diseases ; China ; Chondromatosis, Synovial ; diagnostic imaging ; pathology ; physiopathology ; surgery ; Hip Joint ; diagnostic imaging ; pathology ; physiopathology ; surgery ; Hospitals ; Humans ; Male ; Tomography, X-Ray Computed

Intra-articular haemangioma is a rare and uncommon condition that sometimes presents in infants. The lesion can be a diagnostic challenge, with misdiagnosis often leading to delayed diagnosis and treatment. It is essential to establish and treat the condition early, as intra-articular haemangioma can lead to destruction of the joint and secondary arthrosis. Herein, we report the case of a five-year-old boy who presented with intra-articular haemangioma and discuss the management of his condition.
Arthralgia ; physiopathology ; Biopsy, Needle ; Child, Preschool ; Follow-Up Studies ; Hemangioma ; diagnosis ; pathology ; surgery ; Humans ; Immunohistochemistry ; Joint Capsule ; pathology ; surgery ; Knee Joint ; pathology ; surgery ; Magnetic Resonance Imaging ; methods ; Male ; Orthopedic Procedures ; methods ; Rare Diseases ; Risk Assessment ; Synovectomy ; Synovial Membrane ; pathology ; Treatment Outcome

OBJECTIVETo investigate the clinicopathologic features of calcium pyrophosphate dihydrate crystal deposition disease (CPPD-CDD).

METHODSThe clinical and pathologic profiles were retrospectively analysed in 20 cases of CPPD-CDD.

RESULTSCPPD-CDD was far more common in women, most frequently involving joints, especially the knees and presenting with various arthrisis. Abnormally calcified and the articular damages were characteristic features by imageing. Histologically, multifocal indigo granular calcinosis was seen in synovium and sometimes appeared as needle-shaped or rhomboid crystals, which characterized the CPPD.

CONCLUSIONSThough clinical symptoms of CPPD are quite variable, the definite diagnosis can be made by the abnormal calcification and joint damage radiographically and the indigo CPPD crystals histopathologically.

Adult ; Aged ; Aged, 80 and over ; Chondrocalcinosis ; diagnostic imaging ; pathology ; surgery ; Female ; Follow-Up Studies ; Hip Joint ; diagnostic imaging ; pathology ; surgery ; Humans ; Intervertebral Disc ; diagnostic imaging ; pathology ; surgery ; Knee Joint ; diagnostic imaging ; pathology ; surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Spinal Diseases ; diagnostic imaging ; pathology ; surgery ; Synovial Membrane ; pathology ; Tomography, X-Ray Computed

BACKGROUND: We analyzed the clinical and radiologic results of patients with spontaneous osteonecrosis of the knee treated by minimally invasive medial unicompartmental arthroplasty using Oxford Uni. METHODS: We reviewed 22 knees in 21 patients which were treated for spontaneous osteonecrosis between 2002 and 2006. Patients included one male and 20 females. The mean age was 70.8 years (range, 53 to 82 years). The mean follow-up period was 70.3 months (range, 48 to 93 months). The clinical results were evaluated using the Hospital for Special Surgery (HSS) knee score and the range of motion of the knee preoperatively and at the final follow-up. Preoperative plain radiographs and magnetic resonance images were analyzed to determine the size and stage of osteonecrotic lesions. RESULTS: The mean HSS knee score was 64.3 (range, 54 to 75) preoperatively and 92.0 (range, 71 to 100) at the final follow-up. The mean preoperative flexion contracture was 8.9degrees (range, 0 to 15degrees) and 0.2degrees (range, 0 to 5degrees) at the final follow-up. The mean further flexion increased from 138.6degrees (range, 100 to 145degrees) preoperatively to 145.6degrees (range, 140 to 150degrees) at the final follow-up. Active full flexion was possible within 2 months of the operation. The squatting position was possible in 16 patients (84.2%) out of 19, except one case of bronchiectasis and one case of spine fracture. The cross-leg posture was possible in 19 patients (90.5%) out of 21. The mean tibiofemoral angle was improved from varus 0.98degrees to valgus 3.22degrees. Meniscal bearing dislocation occurred in 2 cases and femoral component loosening occurred in 1 case. CONCLUSIONS: Unicompartmental knee arthroplasty using Oxford Uni could be an alternative treatment option in spontaneous osteonecrosis of the knee.
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee/*methods ; Female ; Humans ; Joint Diseases/pathology/*surgery ; *Knee Joint/pathology ; Male ; Middle Aged ; Osteonecrosis/*surgery ; Retrospective Studies

OBJECTIVETo approach the short-term result and clinical application of metal on metal total hip arthroplasty with large diameter heads and evaluate its safety and efficacy clinically.

METHODSFrom January 2007 to March 2008, 39 hips in 37 patients (24 males and 13 females,ranging in age from 43 to 75 years, with an average of 58.5 years) were treated with metal on metal total hip arthroplasty with large diameter heads (ASRTM XL) included 14 cases of osteonecrosis (ON), 2 cases of osteoarthritis (OA), 18 cases of fresh femoral neck fracture, 3 cases of developmental dysplasia of the hip (DDH). All patients were evaluated by self assessment form, hip function examination, radiographs, preoperative and postoperative Harris hip score. Based on the short-term results, its design characteristic and clinical properties were analyzed.

RESULTSAll the incision healed well and there were not any complications such as femoral fracture, infection, dislocation and neurovascular injury. All patients obtained the follow-up and an average time was 16.5 months (12 to 19 months), all the joints had good or excellent clinical results. Radiographically, the positions of the prostheses were normal, the average limbs length and femoral eccentricity recovered as normal. The average range of motion of the hip improved remarkable, such as flexion improved from (20.1 +/- 8.2) degrees to (85.7 +/- 9.8) (t = 32.86, P < 0.01), abduction improved from (10.2 +/- 4.4) degrees to (41.5 +/- 9.1) degrees (t = 19.34, P < 0.01), adduction improved from (16.3 +/- 8.8) degrees to (40.3 +/- 10.4) (t = 11.00, P < 0.01),external rotation improved from (12.3 +/- 5.2)0 to (42.0 +/- 7.7) degrees (t = 19.96, P < 0.01), internal rotation improved from (3.4 +/- 1.1) degrees to (23.0 +/- 9.8) degrees (t = 12.41, P < 0.01). The Harris score rose from preoperative (39.3 +/- 5.6) to (91.4 +/- 10.3) at the latest follow up (t = 27.75, P < 0.01).

CONCLUSIONShort-term results show that metal on metal hip joint prosthesis with large diameter heads has advantages of small deformation of acetabular cup, lower wearing, large range of motion and few dislocation. It offers a newly valuable technology for treatment of osteonecrosis, osteoarthritis, femoral neck fracture and DDH with the higher requirement of movement after the operation.

Adult ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Female ; Humans ; Joint Diseases ; diagnostic imaging ; pathology ; physiopathology ; surgery ; Male ; Metals ; Middle Aged ; Tomography, X-Ray Computed ; Treatment Outcome

OBJECTIVETo explore effect and the application value of continuous douche and vacuum sealing drainage (VSD) in refractory tissue, and joint infections after complete debridement.

METHODSAs retrospective analysis of treatment time and restoration or recurrence, from Jan. 2006 to Dec. 2007, 61 cases of refractory tissue, bone and joint infections underwent continuous douche and VSD combined with the treatment of anti-inflammatory and rehabilitation training after debridement in our hospital. The 61 patients included 39 males and 22 females with age ranging from 10 to 58 years with an average of (35 +/- 12) years, among whom 61 identified to have ankle ulcers combined with infections,open fracture combined with infections, sacrococcygeal pressure ulcers combined with infections, infections after hip replacement, infections after open fracture, and infections after skin avulsion postoperation were 11, 15, 9, 3, 5 and 18 cases respectively. The course was from 2 weeks to 11 months with an average of 4 months.

RESULTSIn all 61 patients,the mean healing time was 17, 36, 42, 24, 32, 29 and 28 days in ankle ulcers and infections, tibia and fibula open fracture and infections, femoral shaft fracture and infections, sacrococcygeal pressure ulcers and infections, infections after hip replacement, infections after open fracture, and infections after skin avulsion postoperation respectively. The replacement of VSD was 1, 2-4, 3-5, 1-3, 2-4, 2-3 and 1-3 times in each group respectively. There was no wound recurrence except for 2 cases with recurrent in 61 cases with external fixation nail hole semi-pathological fracture in 1 case of femoral shaft fracture and infection and 1 case of tibia and fibula fracture and infection after follow-up at least one year.

CONCLUSIONApplication of continuous douche and VSD can effectively decrease incidence of complications and promote the refractory tissue, bone and joint infections wound growth, healing and considerably shorten the healing time.

Adolescent ; Adult ; Bone Diseases ; pathology ; physiopathology ; surgery ; Child ; Debridement ; adverse effects ; Female ; Follow-Up Studies ; Humans ; Joint Diseases ; pathology ; physiopathology ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Suction ; methods ; Therapeutic Irrigation ; methods ; Time Factors ; Wound Healing ; Young Adult

OBJECTIVETo explore the clinical outcomes of atlanto-axial screw-plate fixation and bone fusion for the treatment of atlanto-axial instability.

METHODSFrom June 2003 to June 2008,15 cases with atlanto-axial instability were treated with atlanto-axial lateral mass screw-plate fixation and self-cancellous bone graft fusion. There were 10 males and 5 females with the mean age of 41.7 years (range, from 19 to 72 years). Six cases were old odontoid fracture, 3 cases rheumatoid arthritis, 6 cases odontoid developmental deformity. All patients had symptoms and signs of upper cervical myelopathy and the imaging displayed atlanto-axial instability. JOA scores before operation were from 6 to 11 with an average of 7.4.

RESULTSAll patients were followed up with the mean of 28 months (range, from 9 to 40 months). The follow-up data indicated solid fusion in all patients, posterior reductions were satisfactory, no loosening or screw-plate broken was found. There were 10 cases which spinal cord function improved obviously, 4 cases improved slightly, 1 case no changed in the study. The postoperative JOA scores were from 13 to 17 with an average of 15.6.

CONCLUSIONAtlanto-axial screw-plate fixation and self-cancellous bone graft can stabilize atlas and axis, and promote fusion of atlanto-axial joint, which is an effective method for the treatment of atlanto-axial instability.

Adult ; Aged ; Atlanto-Axial Joint ; diagnostic imaging ; pathology ; physiopathology ; surgery ; Bone Screws ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Humans ; Joint Diseases ; diagnostic imaging ; physiopathology ; surgery ; therapy ; Male ; Middle Aged ; Recovery of Function ; Spinal Fusion ; methods ; Tomography, X-Ray Computed ; Treatment Outcome

Adult ; Arthritis, Rheumatoid ; epidemiology ; pathology ; surgery ; Female ; Humans ; Joint Diseases ; diagnosis ; pathology ; Male ; Middle Aged ; Shoulder Dislocation ; epidemiology ; pathology ; surgery ; Shoulder Fractures ; epidemiology ; pathology ; surgery ; Shoulder Joint ; pathology ; surgery ; Shoulder Pain ; epidemiology ; pathology ; surgery

Adipose Tissue ; pathology ; Adult ; Arthroscopy ; methods ; Female ; Humans ; Joint Diseases ; diagnosis ; pathology ; surgery ; Knee Joint ; pathology ; Male ; Middle Aged