Purpose. There is controversial whether
Diffuse-type Tenosynovial Giant-Cell Tumour (d-TGCT) of large joints is a rare, locally aggressive, soft tissue tumour affecting predominantly the knee. Previously classified as Pigmented Villonodular Synovitis (PVNS), this monoarticular disease arises from the synovial lining and is more common in younger adults. Given the diffuse and aggressive nature of this tumour, local control is often difficult and recurrence rates are high. Current literature is comprised primarily of small, and a few larger but heterogeneous, observational studies. Both arthroscopic and open
Diffuse-type Tenosynovial Giant-Cell Tumour (d-TGCT) of large joints is a rare, locally aggressive, soft tissue tumour affecting predominantly the knee. Previously classified as Pigmented Villonodular Synovitis (PVNS), this monoarticular disease arises from the synovial lining and is more common in younger adults. Given the diffuse and aggressive nature of this tumour, local control is often difficult and recurrence rates are high. Current literature is comprised primarily of small, and a few larger but heterogeneous, observational studies. Both arthroscopic and open
Ultrasound screening has shown that the shoulder joint is almost always involved in rheumatoid arthritis. But only few of rheumatoid patients suffering from omarthritis are in considerable pain. Loss of strength and mobility is often compensated by the adjacent joints. Low patients demands, as pain and swelling can be treated often temporarely successfully by corticoid injections and the need of a wide exposure of the shoulder joint when performing an open
Aim: To test the hypothesis that open surgical
Synovitis of the smaller hand joints leads to soft-tissue and bony affections. Radiologically Larsen/Dale/Eek (LDE) distinguish 6 stages of increasing destruction. Tendon ruptures, swan-neck and buttonhole deformities may occur. In early stages, when the ligament- and capsule structures require no balancing therapy, arthroscopic
To determine the long term outcome and complications associated with arthroscopic
Purpose: In order to investigate if arthroscopic
Purpose: Synovium proliferation of rheumatoid arthritis (RA) is a key role in development of destruction in articular joints. Arthroscopic
Purpose: Rheumatoid arthritis (RA) frequently affects the finger joints. Persistent synovitis is believed to cause not only bone destruction but also various deformities of the hands. For this reason,
Aim of study: To determine the long term outcome and complications associated with arthroscopic
Introduction.
Purpose: The synovectomy-reaxation-stabilisation (SRS) procedure classically involves tenosynovectomy of the extensors, articulr
Introduction: Diffuse pigmented villo-nodular synovitis (DPVNS) of the knee remains a difficult tumor to eradicate. We report our experience with a combined posterior and open
Since 1976 we have performed 60 radioactive synoviorthesis in 53 haemophilic patients with age from 6 to 40 years with a mean of 10 years of age, 45 of these patients were under 12 years of age. The knees were injected in 38 cases, elbow in 16 cases, ankles in 5 and shoulders in 1 case. The procedure was performed in 6 sittings of 10 patients each. The synoviorthesis is done by an intrarticular injection of the radioactive material preceded by a local anesthetic. The clinical results of this procedure gives an 80 % of excellent results with no further bleeding. One of the criticisms against this method is the possible chromosomal damage induced by the radioactive material. In our center, two previous studied have been done in order to see whether these possible changes are everlasting and both have demonstrated that chromosomal changes are reversible. The radioactive material used in these synoviorthesis was 189 Au In 1978, 354 metaphases were studied with 61 ruptures, 17.23 %, (non premalign) and 6 structural changes -considered premalignant, 1.69 %. Any number below 2 % is considered non dangerous. A further study was done in 1982, in the same group of patients with a result of 21 ruptures, 3.34% and no structural changes. This demonstrated that the possible premalignant changes disappeared with time. A third study was performed in a series of 13 patients that unstained radioactive synoviorthesis with Re 186 in November 1991. We performed for comparison a chromosomal study just before and 6 months after the radioactive material injection. The results confirmed that changes that could be attributed to the radiation, appears equally in non irradiated patients and those due to the radiation disappear with time, never reaching the dangerous zone of 2 %. In these group treated with 186 Re we studied an additional number of 130 metaphases with identical results and NO structural changes. Conclusions: In view of these results, it seems that radioactive
Aim. The aim of this systematic review was to assess the existing published data on tuberculous arthritis involving native joints in adults aged 18 years and older. The specific research questions focused on the diagnosis and management of the disease. Method. This study was performed in accordance with the guidelines provided in the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR). A systematic literature search was undertaken of Pubmed, Web of Science, Scopus and the Cochrane library. Only studies published in English since 1970 were considered. Case series involving less than 10 patients, systematic and narrative reviews, and laboratory or animal studies were excluded. We also excluded reports of TB infections not involving a “native joint” and tuberculosis of the spine. The level of evidence and strength of recommendations was performed in accordance with the GRADE system. Results. The systematic review of the literature yielded 2023 potential sources. Following deduplication, screening and full-text review, 20 data sources involving 573 patients from nine countries, were included. There was considerable variation amongst the studies in terms of the approach to diagnosis and management. The most common method used to confirm the diagnosis was microbiological culture of tissue obtained by biopsy, with positive findings in 93% of cases. Medical management involved a median 12 months of antitubercular treatment (IQR 8–16; range 4–18 months). Duration of pre-operative treatment ranged from two to 12 weeks in duration. Surgery was performed in approximately 87% of patients and varied from arthroscopic debridement to complete
Pigmented villonodular synovitis is a monoarticular proliferative process most commonly involving the synovium of the knee joint. There is considerable debate with regards to diagnosis and effective treatment. We present our experience of managing PVNS of the knee joint over a 12 year period. Twenty-eight patients were reviewed. MRI was used to establish recurrence in symptomatic patients rather than routine screening and to identify posterior disease prior to surgery. Eight patients had localised disease and were all treated with open
Improvements in ceramic materials, component design, and surgical technique have made ceramic bearing complications increasingly rare. However, when it happens, a fractured ceramic component can cause significant pain and morbidity following total hip arthroplasty (THA). The hard and sharp particulate debris from fractured ceramic components can cause damage to the existing hip prosthesis and jeopardise subsequent revision THA results due to third body wear. Patients with ceramic fractures can present with sudden onset of pain and dysfunction. Often, the patient will report a noisy hip articulation. Radiographs can range from subtle densities surrounding the hip implant to complete disintegration and loss of sphericity of the femoral head or acetabular liner. Ceramic component fractures should be treated expeditiously. Revision options for failed ceramic components depend on existing component fixation, position, and locking mechanism and femoral trunnion integrity. In order to retain the implants, the components must be well-fixed, in good position, and have tapers and locking mechanisms that can accept new modular components. Additionally, an extensile exposure and complete
Objective: To study the incidence of joint replacement procedure, arthrodesis, and