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https://www.readbyqxmd.com/read/28526569/total-joint-replacement-for-neglected-posterior-knee-dislocation-following-septic-arthritis-after-arthroscopy
#1
Yusuf Öztürkmen, Yunus Emre Akman, Ethem Ayhan Ünkar, Erhan Şükür
This report presents the first case of a knee dislocation following septic arthritis after arthroscopy. A 65-year-old woman had an arthroscopy with irrigation and debridement (I&D) of the joint and microfracture for the chondral lesions. She had complaints of postarthroscopic infection but non-steroidal anti-inflammatory medication and local ice compression was recommended. She revisited her physician twice and at the last visit she had a large purulent effusion in her knee. The gram stain of the joint fluid aspirate demonstrated gram-positive cocci and the cultures grew methicilline-sensitive Staphylococcus aureus...
May 16, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28507957/arthroscopic-synovectomy-in-bilateral-lipoma-arborescens
#2
Paolo Fornaciari, Pascal A Schai, Michael O Kurrer, G Ulrich Exner
INTRODUCTION: Lipoma arborescens (LA) is an uncommon condition that consists of a villous lipomatous proliferation of the synovial membrane. Open synovectomy has been previously selected as a curative treatment option. In recent years, some authors have published good results with arthroscopic interventions. We describe a well-documented case of bilateral LA of the knees treated with staged arthroscopic synovectomy. CASE REPORT: A 48-year-old North American woman without a history of trauma presented with recurrent effusions and mild pain in both knee joints for many years...
November 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28499922/critical-analysis-of-the-lever-test-for-diagnosis-of-anterior-cruciate-ligament-insufficiency
#3
Patrick A Massey, Joshua D Harris, Leland A Winston, David M Lintner, Domenica A Delgado, Patrick C McCulloch
PURPOSE: To critically analyze the "lever test" in detecting anterior cruciate ligament (ACL) tears and to compare its accuracy with the Lachman, anterior drawer (AD), and pivot shift tests. METHODS: From June 2014 to June 2015, 91 subjects were analyzed. Inclusion criteria were subjects aged 16 to 60 years, presenting after a knee injury with subjective swelling, or an objective effusion and an uninjured normal contralateral knee for comparison. Exclusion criteria included previous knee ligamentous reconstruction, fracture of the distal femur or proximal tibia, bilateral knee injuries, or known cruciate ligament tear...
May 9, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28497416/internal-medicine-point-of-care-ultrasound-curriculum-consensus-recommendations-from-the-canadian-internal-medicine-ultrasound-cimus-group
#4
Irene W Y Ma, Shane Arishenkoff, Jeffrey Wiseman, Janeve Desy, Jonathan Ailon, Leslie Martin, Mirek Otremba, Samantha Halman, Patrick Willemot, Marcus Blouw
Bedside point-of-care ultrasound (POCUS) is increasingly used to assess medical patients. At present, no consensus exists for what POCUS curriculum is appropriate for internal medicine residency training programs. This document details the consensus-based recommendations by the Canadian Internal Medicine Ultrasound (CIMUS) group, comprising 39 members, representing 14 institutions across Canada. Guiding principles for selecting curricular content were determined a priori. Consensus was defined as agreement by at least 80% of the members on POCUS applications deemed appropriate for teaching and assessment of trainees in the core (internal medicine postgraduate years [PGY] 1-3) and expanded (general internal medicine PGY 4-5) training programs...
May 11, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28472071/associations-between-mri-features-versus-knee-pain-severity-and-progression-data-from-the-vancouver-longitudinal-study-of-early-knee-osteoarthritis
#5
Eric C Sayre, Ali Guermazi, John M Esdaile, Jacek A Kopec, Joel Singer, Anona Thorne, Savvas Nicolaou, Jolanda Cibere
OBJECTIVE: To determine associations between features of osteoarthritis (OA) on MRI and knee pain severity and knee pain progression. DESIGN: Baseline, 3.3- and 7.5-year assessments were performed for 122 subjects with baseline knee pain (age 40-79), sample-weighted for population (with knee pain) representativeness. MRIs were scored for: osteophytes (0:absent to 3:large); cartilage (0:normal to 4:full thickness defect; 0/1 collapsed); subchondral sclerosis (0:none to 3:>50% of site), subchondral cyst (0:absent to 3:severe), bone marrow lesions (0:none to 3:≥50% of site); and meniscus (0:normal to 3:maceration/resection), in 6-8 regions each...
2017: PloS One
https://www.readbyqxmd.com/read/28469926/primary-hypertrophic-osteoarthropathy-due-to-a-novel-slco2a1-mutation-masquerading-as-acromegaly
#6
Ruth Mangupli, Adrian F Daly, Elvia Cuauro, Paul Camperos, Jaime Krivoy, Albert Beckers
SUMMARY: A 20-year-old man with an 8-year history of progressive enlargement of his hands and feet, coarsening facial features, painful joints and thickened, oily skin was referred for investigation of acromegaly. On examination, the subject was of normal height and weight. He had markedly increased skin thickness around the forehead, eyelids and scalp with redundant skin folds. Bilateral painful knee swelling was accompanied by enlargement of the extremities, and his fingers were markedly clubbed...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28419533/a-new-approach-for-radiosynoviorthesis-a-dose-optimized-planning-method-based-on-monte-carlo-simulation-and-synovial-measurement-using-3d-slicer-and-mri
#7
Mirta Bárbara Torres Berdeguez, Sylvia Thomas, Patricia Rafful, Tiago Arruda Sanchez, Susie Medeiros Oliveira Ramos, Marta Souza Albernaz, Lidia Vasconcellos de Sá, Sergio Augusto Lopes de Souza, Felix Mas Milian, Ademir Xavier da Silva
PURPOSE: Recently, there has been a growing interest in a methodology for dose planning in radiosynoviorthesis to substitute fixed activity. Clinical practice based on fixed activity frequently does not embrace radiopharmaceutical dose optimization in patients. The aim of this paper is to propose and discuss a dose planning methodology considering the radiological findings of interest obtained by three-dimensional magnetic resonance imaging combined with Monte Carlo simulation in radiosynoviorthesis treatment applied to hemophilic arthropathy...
April 17, 2017: Medical Physics
https://www.readbyqxmd.com/read/28385936/unsatisfactory-outcomes-following-unicompartmental-knee-arthroplasty-in-patients-with-partial-thickness-cartilage-loss-a-medium-term-follow-up
#8
T W Hamilton, H G Pandit, A Inabathula, S J Ostlere, C Jenkins, S J Mellon, C A F Dodd, D W Murray
AIMS: While medial unicompartmental knee arthroplasty (UKA) is indicated for patients with full-thickness cartilage loss, it is occasionally used to treat those with partial-thickness loss. The aim of this study was to investigate the five-year outcomes in a consecutive series of UKAs used in patients with partial thickness cartilage loss in the medial compartment of the knee. PATIENTS AND METHODS: Between 2002 and 2014, 94 consecutive UKAs were undertaken in 90 patients with partial thickness cartilage loss and followed up independently for a mean of six years (1 to 13)...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28372703/editorial-commentary-thinking-inside-the-box-yields-the-possibility-of-harvesting-stem-cells-from-inside-the-injured-knee
#9
EDITORIAL
Michael J Rossi
Looking to the injured knee for potential stem cell harvesting has attractive benefits. Stem cells can be successfully harvested but the concentrations with the current technology are lower than bone marrow or lipoaspirate sites. The technique of utilizing the knee effusion and tissue by-products after cruciate ligament injury shows future promise.
April 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28326424/total-knee-arthroplasty-in-a-patient-with-hypofibrinogenemia
#10
Christopher R Nacca, Kalpit N Shah, Jeremy N Truntzer, Lee E Rubin
Patients with afibrinogenemia or hypofibrinogenemia present a unique challenge to the arthroplasty surgeon as fibrinogen is a key contributor to hemostasis. Patients with these disorders are known to have a higher risk for postsurgical bleeding complications. We present the case of a patient with hypofibrinogenemia who underwent an elective total knee arthroplasty. Our colleagues in hematology-oncology guided us initially to achieve and maintain appropriate fibrinogen levels in the early perioperative period...
December 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28291008/the-efficacy-of-yttrium-90-radiosynovectomy-in-patients-with-camptodactyly-arthropathy-coxa-vara-pericarditis-syndrome
#11
Sulaiman Mohammed Al-Mayouf, Nora Almutairi, Khalid Alismail
OBJECTIVE: Camptodactyly-arthropathy-coxa-vara-pericarditis (CACP) syndrome is an autosomal recessive disorder caused by mutations in PRG4 gene that encodes for proteoglycan 4, the main lubricant for joints and tendon surfaces. It is a non-inflammatory arthropathy, characterized by joint effusions and synovial hypertrophy. So far, there is no effective treatment for this disorder. To evaluate the effectiveness of yttrium-90 radiosynovectomy in arthropathy of patients with CACP syndrome...
February 5, 2017: Molecular Imaging and Radionuclide Therapy
https://www.readbyqxmd.com/read/28283723/intravoxel-incoherent-motion-magnetic-resonance-imaging-of-the-knee-joint-in-children-with-juvenile-idiopathic-arthritis
#12
Fabian Hilbert, Annette Holl-Wieden, Alexander Sauer, Herbert Köstler, Henning Neubauer
BACKGROUND: MRI of synovitis relies on use of a gadolinium-based contrast agent. Diffusion-weighted MRI (DWI) visualises thickened synovium but is of limited use in the presence of joint effusion. OBJECTIVE: To investigate the feasibility and diagnostic accuracy of diffusion-weighted MRI with intravoxel incoherent motion (IVIM) for diagnosing synovitis in the knee joint of children with juvenile idiopathic arthritis. MATERIALS AND METHODS: Twelve consecutive children with confirmed or suspected juvenile idiopathic arthritis (10 girls, median age 11 years) underwent MRI with contrast-enhanced T1-weighted imaging and DWI at 1...
March 10, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28274889/knee-effusion-synovitis-volume-measurement-and-effects-of-vitamin-d-supplementation-in-patients-with-knee-osteoarthritis
#13
X Wang, F Cicuttini, X Jin, A E Wluka, W Han, Z Zhu, L Blizzard, B Antony, T Winzenberg, G Jones, C Ding
OBJECTIVE: To develop a measure of knee joint effusion-synovitis volume and to examine the effect of vitamin D supplementation on effusion-synovitis in patients with knee osteoarthritis (OA) and low vitamin D levels over 24 months. METHOD: Symptomatic knee OA patients with a low 25-(OH)D level (12.5-60 nmol/l) were recruited for a multi-centre, randomised, placebo-controlled and double-blind trial. Participants (age 63 ± 7 years, 208 females) were allocated to either 50,000 IU monthly vitamin D3 (n = 209) or placebo (n = 204) for 24 months...
March 6, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28272066/unusual-presentation-of-chondroblastoma-mimicking-trevor-s-disease
#14
Y Karkhur, A Tiwari, T Verma, L Maini
Chondroblastoma is a benign bone tumor, represents 1%-2% of all primary bone tumors, typically seen in patients 10-25-year-old and more common in males. It occurs most frequently in the distal femur, proximal tibia, and proximal humerus. Soft tissue extension is extremely rare. Adjacent joints may develop effusions, but the tumor mass protruding into the joint has never been seen in case of chondroblastoma. We report a rare case of intra-articular chondroblastoma arising from proximal tibia in a 16-year-old boy and growing into the knee joint mimicking an intra-articular osteochondroma...
March 3, 2017: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/28224443/report-of-the-clinical-and-functional-primary-outcomes-in-men-of-the-acl-sports-trial-similar-outcomes-in-men-receiving-secondary-prevention-with-and-without-perturbation-training-1-and-2-years-after-acl-reconstruction
#15
Amelia J H Arundale, Kathleen Cummer, Jacob J Capin, Ryan Zarzycki, Lynn Snyder-Mackler
BACKGROUND: Athletes often are cleared to return to activities 6 months after anterior cruciate ligament (ACL) reconstruction; however, knee function measures continue to improve up to 2 years after surgery. Interventions beyond standard care may facilitate successful return to preinjury activities and improve functional outcomes. Perturbation training has been used in nonoperative ACL injury and preoperative ACL reconstruction rehabilitation, but has not been examined in postoperative ACL reconstruction rehabilitation, specifically return to sport rehabilitation...
February 21, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28224442/report-of-the-primary-outcomes-for-gait-mechanics-in-men-of-the-acl-sports-trial-secondary-prevention-with-and-without-perturbation-training-does-not-restore-gait-symmetry-in-men-1-or-2-years-after-acl-reconstruction
#16
Jacob John Capin, Ryan Zarzycki, Amelia Arundale, Kathleen Cummer, Lynn Snyder-Mackler
BACKGROUND: Movement asymmetries during walking are common after anterior cruciate ligament (ACL) injury and reconstruction and may influence the early development of posttraumatic osteoarthritis. Preoperative neuromuscular training (like perturbation training, which is neuromuscular training requiring selective muscle activation in response to surface perturbations) improves gait asymmetries and functional outcomes among people who are ACL-deficient, but the effect of postoperative perturbation training on gait mechanics after ACL reconstruction is unknown...
February 21, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28219656/ultrasound-abnormalities-in-septic-arthritis-are-associated-with-functional-outcomes
#17
Emeline Gaigneux, Grégoire Cormier, Stéphane Varin, Oriane Mérot, Yves Maugars, Benoit Le Goff
OBJECTIVES: To describe the ultrasound abnormalities seen in septic arthritis and to assess their associations with clinical, biological, and radiological outcomes. METHODS: We prospectively included 34 patients with septic arthritis of a native joint (knee, n=19; shoulder, n=6; hip, n=4; ankle, n=3; or wrist, n=2). Ultrasonography was performed to record synovial-membrane thickness and vascularity, joint effusion, and abnormalities of adjacent soft tissues, at baseline then 4days, 2weeks, and 3months later...
February 17, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/28217620/human-immunodeficiency-virus-polyarthropathy
#18
Priyanka Lakshmanan, Ira Shah
Articular manifestations are a frequent but often underdiagnosed manifestation in patients infected with the human immunodeficiency virus (HIV). We present a 7-year-old HIV-infected malnourished girl who presented with recurrent joint pain and effusion in the left knee joint. Her antistreptolysin O, dsDNA, antinuclear antibody and rheumatoid arthritis factor were negative. She responded to antiretroviral therapy.
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28199129/a-focal-defect-at-the-lateral-patellar-retinaculum-on-clinical-knee-mri-and-cadaveric-study-a-normal-variant-or-pathologic-lesion
#19
Ji Su Kim, Seong Jong Yun, Wook Jin, Gou Young Kim, So Young Park, Ji Seon Park, Kyung Nam Ryu
OBJECTIVE: The purpose of this study is to retrospectively investigate the frequency of a focal defect at the lateral patellar retinaculum on knee MRI and to determine the variables that are significantly associated with the defect. MATERIALS AND METHODS: Two radiologists independently reviewed 99 knee MR images for the presence of a focal defect at the lateral patellar retinaculum and categorized patients with concordant results into two groups: a group with the defect (≥ 3 mm; group 1) and a group without the defect (< 3 mm; group 2)...
May 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28163248/associations-between-endogenous-sex-hormones-and-mri-structural-changes-in-patients-with-symptomatic-knee-osteoarthritis
#20
X Jin, B H Wang, X Wang, B Antony, Z Zhu, W Han, F Cicuttini, A E Wluka, T Winzenberg, L Blizzard, G Jones, C Ding
OBJECTIVE: To investigate the longitudinal association between endogenous sex hormones and knee osteoarthritis (OA) structures and pain. METHOD: We examined 200 participants (mean age 63.0 ± 7.3 years) from a clinical trial of vitamin D supplement for symptomatic knee OA. Serum levels of estradiol, progesterone, testosterone and sex hormone binding globulin (SHBG) were analyzed at baseline and 24 months later. Magnetic resonance imaging (MRI) scans of selected knee were obtained at both baseline and follow-up for the measurement of cartilage volume, cartilage defects, bone marrow lesions (BMLs) and effusion-synovitis volume...
February 2, 2017: Osteoarthritis and Cartilage
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