Synovial sarcoma (SS) is a malignant soft tissue sarcoma with a poor prognosis because of late local recurrence and distant metastases. To our knowledge, no studies have minimum follow-up of 10 years that evaluate long-term outcomes for survivors. Data on 62 patients who had been treated for SS from 1968 to 1999 were studied retrospectively in a multicenter study. The following parameters were examined for their potential prognostic value: age at diagnosis, sex, tumour site and size, histology, histological grade, fusion type (SYT-SSX1 vs. SYT-SSX2), and surgical margin status. Mean follow-up of living patients was 17.2 years, and of dead patients 7.7 years.Aim
Method
We have reviewed 183 patients (215 knees) assessing results and indications of High Tibial Osteotomies in medial gonarthrosis.
Healing delay was 55 days for closing and 70 for opening. R.O.M. was 125°. 25 knees are painful. 1/After opening, scoring is 77 and valgus angle is 3°. 2/After closing, scoring is 80 and valgus angle is 5°. 3/Global results: very good: 26%, good: 33%, medium: 28% and poor: 13%.
Clinical results are satisfying in early surgery. Reaxation is good for delaying or managing arthritis. The average of 5° mechanical valgus at osteotomy seems to be effective.
-Closing wedge for medium varus in younger patients. H.T.O. allows quite pain-free knees, restores axes and avoids or delays T.K.R. H.T.O. gives satisfactory results and should be then considered the best choice for early prevention and treatment of varus knee arthritis.
Purpose of the study: Congenital dislocation of the patella is a very rare condition. The pathology is inconsistent and treatment modalities are unclear. The aim of the study was to show the results of operative treatment of congenital dislocation of the patella. Material and methods: 9 knee joints in 7 patients with congenital dislocation of the patella have been treated between 1989 and 1999. Additional diagnoses were Rubinstein-Taybe syndrome, Larsen syndrome, pteryg-ium syndrome and cerebral palsy in 1 patient each. The age at the time of surgery was 8.9 years on average (between 4.3 and 14.8 years). In 6 knees primary treatment was a medial shifting of the quadriceps muscle according to Stanisavljevic, in the other 3 a combination of lateral release according to Green, proximal quadriceps realignment according to Insall and either medial displacement of the tibial tuberosity according to Elmslie or a duplication of the patellar tendon according to Goldthwait had been done. Results: The follow-up time was 6.4 years on average (between 2 and 12.5 years). 4 of 9 patellae remained stable after 1 operation, 3 remained stable after 2 operations and 2 remained unstable. 4 of the 9 knees were symptomatic at the time of follow-up. All patients were able to walk and to run and all had full extension. Apart from recurrence there were no major complications. Conclusions: Permanent dislocation of the patella reduces the extension force of the quadriceps muscle significantly. Medial shifting of the quadriceps muscle according to Stanisavljevic gives the best chance to reduce the patella permanently. Postoperative taping, splinting and muscle-exercises are often necessary to get a stable situation.
