METHODS: CT scans of 50 lower limbs were analyzed. Key anatomical landmarks such as the medial epicondyle (ME), lateral epicondyle, and transepicondylar width (TEW) were determined on 3D models constructed from the CT images. Best-fit planes placed on the most distal and posterior loci of points on the femoral condyles were used to define the distal and posterior joint lines, respectively. Statistical analysis was performed to determine the relationships between the anatomical landmarks and the distal and posterior joint lines.
RESULTS: There was a strong correlation between the distance from the ME to the distal joint line of the medial condyle (MEDC) and the distance from the ME to the posterior joint line of the medial condyle (MEPC) (p
MATERIALS AND METHODS: A retrospective study of patients diagnosed as benign bone tumours according to the Enneking classification who underwent simple or extended curettage at Menoufia university-Orthopedic Oncology Division (with or without grafting or filling) during the surgical treatment (Jan 2015 to Feb 2020). A review of the medical records was done. Lesions' size (length, width and depth) was measured on plain radiographs using the image j program. When applicable, degrees of filling of the resultant cavity were classified into four categories, according to Modified Neer's classification. Functional evaluation using the musculoskeletal tumour society (MSTS) score was reviewed.
RESULTS: Overall, 88 patients diagnosed with a primary bone tumour and who received the surgical intervention were included in the study. The mean age of the patients was 22.61+13.497 (3-58) years. There were 48 males and 40 females (54 right and 34 left). The mean follow-up period was 28.09+16.13 months. The most common location was the distal femur in 15 patients, the proximal femur in 10 patients and the proximal tibia in 12 patients. The most common diagnosis was giant cell tumour in 20 patients, followed by UBC in 19 patients, ABC in 15 patients and enchondroma in 13 patients. Twenty-three patients had simple curettage, while 65 patients had extended curettage. Mean MSTS was 28.78±1.68. Fifty-five lesions were classified according to modified Neer's classification.Thirtty-two patients were classified as type 1 with complete healing,22 patient was classified as type 2 with partial healing, and only one was classified as a recurrent lesion. Seven patients (7.9%) developed local recurrences.
CONCLUSION: Filling the resulting cavity after the removal of the pathological tissues is usually necessary but not always required. This is determined by the type of lesion and the size of the resulting cavity following curettage. Individualised surgery is required; additional fixation should be considered.
CASE PRESENTATION: A 57-year-old man presented to our orthopedic outpatient department with 3-months history of an unusual painful swelling at the operated area following DFO. The leakage of joint fluid from the penetrated suprapatellar pouch was assumed to be the reason for this complication.
CONCLUSIONS: The overall aim of this case report is to provide a lesson to budding surgeons who might experience a similar situation that cannot be easily explained, like the unexpected complication in the present case.
METHODS: A total of 8 and 7 children who had gradual GGS and ACO correction, respectively, for angular deformities due to rickets from 2002 to 2022 were recalled for follow-up. Demographic data, types of rickets, data on pharmacological treatment, biochemical parameters, recurrence of angular deformity and postoperative complications were obtained from the medical records. A radiographic evaluation of the leg was performed to determine the tibiofemoral angle. For functional evaluation, the Active Scale for Kids (ASK) and Lower Extremity Functional Scale (LEFS) instruments were used for children below and above 15 years old, respectively.
RESULTS: In terms of the tibiofemoral angle, the GGS group documented greater angle changes compared to the ACO group, but the difference was not significant. In terms of functional outcomes, the overall score percentage of both groups was comparable with the GGS group showing a trend of higher score percentage compared to the ACO group. The GGS group presented no complication while 2 neurovascular injuries and 1 implant failure were recorded in the ACO group.
CONCLUSION: Both GGS and ACO procedures resulted in similar radiographic and functional outcomes for the treatment of rickets in children. GGS may be advantageous in terms of reducing complications of surgery. Nevertheless, the choice of surgical intervention should be made based on the patient's circumstances and the surgeon's preference.
METHODS: Three different cams (triangle, ellipse, and circle) and three different posts (straight, convex, concave) geometries were considered in this study and were analysed using kinematic analyses. Femoral rollback did not occur until reaching 50° of knee flexion. Beyond this angle, two of the nine combinations demonstrate poor knee flexion and were eliminated from the study.
RESULTS: The combination of circle cam with concave post, straight post and convex post showed 15.6, 15.9 and 16.1 mm posterior translation of the femur, respectively. The use of ellipse cam with convex post and straight post demonstrated a 15.3 and 14.9 mm femoral rollback, whilst the combination of triangle cam with convex post and straight post showed 16.1 and 15.8 mm femoral rollback, respectively.
CONCLUSION: The present study demonstrates that the use of circle cam and convex post created the best femoral rollback effect which in turn produces the highest amount of knee flexion. The findings of the study suggest that if the design is applied for knee implants, superior knee flexion may be possible for future patients.
LEVEL OF EVIDENCE: IV.