Pub Date : 1900-01-01DOI: 10.13107/jkoa.2023.v11i01.060
Nirath S Hegde, E. Nazareth, S. Shetty, S. S.
Posterior interosseous nerve compressions are rare. The compression of the posterior interosseous nerve can happen either before, or through or after the course of the nerve in the supinator muscle. Tumors could rarely lead to secondary compression of the nerve by mass effect. We describe a case of a lady aged 73 years with a posterior interosseous nerve syndrome due to an intermuscular lipoma. The patient had appreciable recovery after surgery and physiotherapy. Keywords: Intermuscular lipoma, Posterior interosseous nerve, Compression.
{"title":"A Case Report of Posterior Interrosseous Nerve Syndrome Due to Intermuscular Lipoma","authors":"Nirath S Hegde, E. Nazareth, S. Shetty, S. S.","doi":"10.13107/jkoa.2023.v11i01.060","DOIUrl":"https://doi.org/10.13107/jkoa.2023.v11i01.060","url":null,"abstract":"Posterior interosseous nerve compressions are rare. The compression of the posterior interosseous nerve can happen either before, or through or after the course of the nerve in the supinator muscle. Tumors could rarely lead to secondary compression of the nerve by mass effect. We describe a case of a lady aged 73 years with a posterior interosseous nerve syndrome due to an intermuscular lipoma. The patient had appreciable recovery after surgery and physiotherapy. Keywords: Intermuscular lipoma, Posterior interosseous nerve, Compression.","PeriodicalId":167557,"journal":{"name":"Journal of Karnataka Orthopaedic Association","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130269169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.13107/jkoa.2022.v10i01.049
R. Krishnan, Aditi Pinto, T. Desai, R. Amaravathi
Lipoma arborescens is not so common condition of unknown etiology. The usual presentation is that of a long standing mono articular soft tissue swelling involving the knee joint. This diagnosis is not often made clinically but usually made with the help of Magnetic Resonance imaging and Biopsy. We are reporting a case of chronic massive knee joint swelling so as to raise awareness about the condition and its imaging features, so that misdiagnosis can be avoided and early appropriate treatment can be given. Keywords: Lipoma arborescens, Synovium, Magnetic Resonance Imaging
{"title":"Lipoma Arborescens: A Case of Massive Knee Swelling","authors":"R. Krishnan, Aditi Pinto, T. Desai, R. Amaravathi","doi":"10.13107/jkoa.2022.v10i01.049","DOIUrl":"https://doi.org/10.13107/jkoa.2022.v10i01.049","url":null,"abstract":"Lipoma arborescens is not so common condition of unknown etiology. The usual presentation is that of a long standing mono articular soft tissue swelling involving the knee joint. This diagnosis is not often made clinically but usually made with the help of Magnetic Resonance imaging and Biopsy. We are reporting a case of chronic massive knee joint swelling so as to raise awareness about the condition and its imaging features, so that misdiagnosis can be avoided and early appropriate treatment can be given. Keywords: Lipoma arborescens, Synovium, Magnetic Resonance Imaging","PeriodicalId":167557,"journal":{"name":"Journal of Karnataka Orthopaedic Association","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127324150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.13107/jkoa.2022.v10i01.045
Anoop Pilar, Madan Mohan M, Sunil L K, Surendra Babu S, P. Sekaran, R. Amaravathi
Background: Meniscal root tears cause biomechanical changes comparable to a total meniscectomy. The resultant compromise in hoop stress, leads to decreased tibiofemoral contact area and increased contact pressure. This will lead to early arthritis. The meniscus root tear causes more detrimental changes in people with varus alignment of the lower limb. This increases the chances of progression to arthritis, causing joint pain and functional limitation, eventually necessitating early replacement surgery. Surgical management with repair of the meniscus, with corrective osteotomy restoring the normal anatomy, has been reported to improve clinical and functional outcomes and delay the replacement surgery. This study aimed to evaluate the functional outcome following concurrent Medial meniscus posterior horn root (MMPHRTs) repair during open medial wedge high tibial osteotomy (HTO) with medial osteoarthritis. Methods: We performed posterior horn root repair with open medial wedge HTO in 9 patients, between 2016 and 2021. The mean follow-up of patients was 2 years. The mean Lysholm and IKDC scores showed significant improvement (7 had excellent and 2 had satisfactory scores). Patients returned to their expected activity of daily living. Conclusion: Concurrent MMPHRT repair along with medial open wedge HTO for medial compartmental osteoarthritis with varus alignment gives good results and has shown good clinical and radiological outcome on short term follow-up. Keywords: Meniscal root tear, Medial open wedge HTO, Preoperative planning, Outcome.
{"title":"Functional Outcome Following Concurrent Medial Meniscus Posterior Horn Root Repair during High Tibial Osteotomy in Early Medial Compartment Osteoarthritis","authors":"Anoop Pilar, Madan Mohan M, Sunil L K, Surendra Babu S, P. Sekaran, R. Amaravathi","doi":"10.13107/jkoa.2022.v10i01.045","DOIUrl":"https://doi.org/10.13107/jkoa.2022.v10i01.045","url":null,"abstract":"Background: Meniscal root tears cause biomechanical changes comparable to a total meniscectomy. The resultant compromise in hoop stress, leads to decreased tibiofemoral contact area and increased contact pressure. This will lead to early arthritis. The meniscus root tear causes more detrimental changes in people with varus alignment of the lower limb. This increases the chances of progression to arthritis, causing joint pain and functional limitation, eventually necessitating early replacement surgery. Surgical management with repair of the meniscus, with corrective osteotomy restoring the normal anatomy, has been reported to improve clinical and functional outcomes and delay the replacement surgery. This study aimed to evaluate the functional outcome following concurrent Medial meniscus posterior horn root (MMPHRTs) repair during open medial wedge high tibial osteotomy (HTO) with medial osteoarthritis. Methods: We performed posterior horn root repair with open medial wedge HTO in 9 patients, between 2016 and 2021. The mean follow-up of patients was 2 years. The mean Lysholm and IKDC scores showed significant improvement (7 had excellent and 2 had satisfactory scores). Patients returned to their expected activity of daily living. Conclusion: Concurrent MMPHRT repair along with medial open wedge HTO for medial compartmental osteoarthritis with varus alignment gives good results and has shown good clinical and radiological outcome on short term follow-up. Keywords: Meniscal root tear, Medial open wedge HTO, Preoperative planning, Outcome.","PeriodicalId":167557,"journal":{"name":"Journal of Karnataka Orthopaedic Association","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114783554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.13107/jkoa.2022.v10i01.048
Bharath Raju G, Ravish V N, Naveen Kumar, B. Gowda
Background: This case report is presented to increase awareness among clinicians about the existence of this rare cause of calcaneal pain. Intraosseous lipoma is a rare, benign primary tumour occurring in the bone We report a 40-year-old lady who presented with the history of one week old trauma with pain in the lateral aspect of right ankle which was clinically diagnosed to be right lateral collateral ligament sprain. The radiographs of the right ankle and heel incidentally revealed a lytic lesion. The patient had no symptoms persisting to foot and heel. MRI of right foot was suggestive of calcaneal stage 2 intra osseous lipoma. In view of the subchondral location of the lesion, prophylactically the lesion was treated with curettage and bone grafting to prevent the pathological fracture. The post-operative radiographs demonstrated continued remodelling and healing of the graft site. The patient was followed up on an OPD basis and made a full recovery with good patient compliance. Even though this tumour is rare, there is a need for physicians to recognize its radiological findings and offer the appropriate treatment options. It is also important for primary care physicians to be aware that there are other causes of heel pain than the common suspects. Keywords: Intraosseous lipoma, Heel pain, Lytic lesion, Benign primary tumour
{"title":"Calcaneal Intraosseous Lipoma: A Case Report","authors":"Bharath Raju G, Ravish V N, Naveen Kumar, B. Gowda","doi":"10.13107/jkoa.2022.v10i01.048","DOIUrl":"https://doi.org/10.13107/jkoa.2022.v10i01.048","url":null,"abstract":"Background: This case report is presented to increase awareness among clinicians about the existence of this rare cause of calcaneal pain. Intraosseous lipoma is a rare, benign primary tumour occurring in the bone We report a 40-year-old lady who presented with the history of one week old trauma with pain in the lateral aspect of right ankle which was clinically diagnosed to be right lateral collateral ligament sprain. The radiographs of the right ankle and heel incidentally revealed a lytic lesion. The patient had no symptoms persisting to foot and heel. MRI of right foot was suggestive of calcaneal stage 2 intra osseous lipoma. In view of the subchondral location of the lesion, prophylactically the lesion was treated with curettage and bone grafting to prevent the pathological fracture. The post-operative radiographs demonstrated continued remodelling and healing of the graft site. The patient was followed up on an OPD basis and made a full recovery with good patient compliance. Even though this tumour is rare, there is a need for physicians to recognize its radiological findings and offer the appropriate treatment options. It is also important for primary care physicians to be aware that there are other causes of heel pain than the common suspects. Keywords: Intraosseous lipoma, Heel pain, Lytic lesion, Benign primary tumour","PeriodicalId":167557,"journal":{"name":"Journal of Karnataka Orthopaedic Association","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116724742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chondromyxoid fibroma is a rare benign Primary tumour occurring in the calcaneum. We report a case of a 23-year-old woman with 3 months history of sudden onset right heel pain with no history of trauma. Which was exacerbated by movement such as walking and standing. A radiographic examination of the right foot and ankle revealed a lesion in the posterior part of the calcaneum. The calcaneum was further evaluated using an MRI scan which revealed a lytic lesion with clearly defined borders. The lesion was treated with curettage, iliac bone grafting, and cementing. Three months after surgery, the graft was consolidated with bone cement in place. There was no sign of recurrence at the one-year follow-up, and the patient had adequate ankle range of motion. Even though the tumour is rare, there is a need for physicians to recognize its radiological features and offer appropriate treatment options. Keywords: Chondromyxoid fibroma, Lytic lesion, Benign primary tumour
{"title":"A Rare Case of Chondromyxoid Fibroma of Calcaneum: A Case Report","authors":"Shekar Mudramaiah, Pavith Janardhan T, Ajay Krishna","doi":"10.13107/jkoa.2023.v11i01.062","DOIUrl":"https://doi.org/10.13107/jkoa.2023.v11i01.062","url":null,"abstract":"Chondromyxoid fibroma is a rare benign Primary tumour occurring in the calcaneum. We report a case of a 23-year-old woman with 3 months history of sudden onset right heel pain with no history of trauma. Which was exacerbated by movement such as walking and standing. A radiographic examination of the right foot and ankle revealed a lesion in the posterior part of the calcaneum. The calcaneum was further evaluated using an MRI scan which revealed a lytic lesion with clearly defined borders. The lesion was treated with curettage, iliac bone grafting, and cementing. Three months after surgery, the graft was consolidated with bone cement in place. There was no sign of recurrence at the one-year follow-up, and the patient had adequate ankle range of motion. Even though the tumour is rare, there is a need for physicians to recognize its radiological features and offer appropriate treatment options. Keywords: Chondromyxoid fibroma, Lytic lesion, Benign primary tumour","PeriodicalId":167557,"journal":{"name":"Journal of Karnataka Orthopaedic Association","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121916046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.13107/jkoa.2023.v11i01.058
Lakshith B R, Adarsh U Tuppad, S. Shetty, E. Nazareth, Kumar Mihir
The purpose of this study was to document the pattern of ligament and meniscal injuries that occur with proximal tibia fractures due to high energy trauma. Seventy patients with fractures of proximal tibia due to high-energy mechanisms were evaluated with magnetic resonance imaging (MRI) of the knee. All studies were reported by a single musculoskeletal radiologist who was blinded to surgical and physical findings. Of the 70 patients, there were 42 patients with AO/OTA type 41B2 (60%) fractures. On average, 70 % sustained a complete tear or avulsion of one or both cruciates.70% sustained collateral ligament injury.91% had lateral meniscal pathology.40% had medial meniscus tears. Of the 70 patients, 42 patients (60%) had Schatzker type II injuries, in which 90% had lateral meniscus tear, 80% MCL and ACL tear, 66% PCL and LCL tear. We adopted chi-square test to find the association. In our study, we found that there is a significant association between footprint avulsion of PCL and lateral meniscus (p value-0.038), between partial tear of LCL and lateral meniscus (p value-0.048), between partial tear of ACL and medial meniscus (p value-0.023). Also there is a significant association between complete tear of ACL and medial meniscus (p value- 0.019), between partial tear of PCL and medial meniscus (p value-0.007). But there is no significant association between ACL, PCL, MCL, LCL and Schatzker type (p value >0.05). We conclude MRI scanning should be considered for proximal tibia fractures due to high energy mechanism, which would help to identify and treat of associated soft tissue injuries. Keywords: Soft tissue injury, Proximal tibia fracture, Magnetic resonance imaging, ACL, PCL, LCL, MCL, Medial meniscus and lateral meniscus.
{"title":"Soft Tissue Injuries Associated with Proximal Tibia Fractures","authors":"Lakshith B R, Adarsh U Tuppad, S. Shetty, E. Nazareth, Kumar Mihir","doi":"10.13107/jkoa.2023.v11i01.058","DOIUrl":"https://doi.org/10.13107/jkoa.2023.v11i01.058","url":null,"abstract":"The purpose of this study was to document the pattern of ligament and meniscal injuries that occur with proximal tibia fractures due to high energy trauma. Seventy patients with fractures of proximal tibia due to high-energy mechanisms were evaluated with magnetic resonance imaging (MRI) of the knee. All studies were reported by a single musculoskeletal radiologist who was blinded to surgical and physical findings. Of the 70 patients, there were 42 patients with AO/OTA type 41B2 (60%) fractures. On average, 70 % sustained a complete tear or avulsion of one or both cruciates.70% sustained collateral ligament injury.91% had lateral meniscal pathology.40% had medial meniscus tears. Of the 70 patients, 42 patients (60%) had Schatzker type II injuries, in which 90% had lateral meniscus tear, 80% MCL and ACL tear, 66% PCL and LCL tear. We adopted chi-square test to find the association. In our study, we found that there is a significant association between footprint avulsion of PCL and lateral meniscus (p value-0.038), between partial tear of LCL and lateral meniscus (p value-0.048), between partial tear of ACL and medial meniscus (p value-0.023). Also there is a significant association between complete tear of ACL and medial meniscus (p value- 0.019), between partial tear of PCL and medial meniscus (p value-0.007). But there is no significant association between ACL, PCL, MCL, LCL and Schatzker type (p value >0.05). We conclude MRI scanning should be considered for proximal tibia fractures due to high energy mechanism, which would help to identify and treat of associated soft tissue injuries. Keywords: Soft tissue injury, Proximal tibia fracture, Magnetic resonance imaging, ACL, PCL, LCL, MCL, Medial meniscus and lateral meniscus.","PeriodicalId":167557,"journal":{"name":"Journal of Karnataka Orthopaedic Association","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133187737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.13107/jkoa.2022.v10i01.047
R. S, Supreeth D R, H. Kalyan
Background: Severe bilateral Fixed flexion deformity of the knees resulting from irreversible joint damage is a disabling complication of long-standing rheumatoid arthritis, associated with loss of ambulatory ability. While Total knee Arthroplasty is an effective treatment for such patients, it poses significant intra-operative technical demands and challenges with post-operative rehabilitation. Method: We report a case of Severe Fixed flexion deformity of both knees in a 46-year-old male with long-standing rheumatoid arthritis, non-ambulatory since 5 years, treated by sequential total knee arthroplasty. Results: Treating Severe bilateral Fixed flexion deformities in a non-ambulatory patient by sequential total knee Arthroplasty using standard implants yielded complete deformity correction and pain-free restoration of active range of motion in both knees with stable independent ambulation and complete restoration of lower limb function within 3 months of surgery. Conclusion: Our case is particularly remarkable for complete restoration of stable, pain-free restoration of ambulation within 3months in a patient with severe bilateral knee fixed flexion deformities who had been non-ambulatory for 5 years preceding his bilateral sequential total knee arthroplasty. Keywords: Fixed flexion deformity, Total knee arthroplasty, Common peroneal nerve, Rheumatoid arthritis.
{"title":"Total Knee Arthroplasty in Bilateral Severe Fixed Flexion Deformity: A Case Report","authors":"R. S, Supreeth D R, H. Kalyan","doi":"10.13107/jkoa.2022.v10i01.047","DOIUrl":"https://doi.org/10.13107/jkoa.2022.v10i01.047","url":null,"abstract":"Background: Severe bilateral Fixed flexion deformity of the knees resulting from irreversible joint damage is a disabling complication of long-standing rheumatoid arthritis, associated with loss of ambulatory ability. While Total knee Arthroplasty is an effective treatment for such patients, it poses significant intra-operative technical demands and challenges with post-operative rehabilitation. Method: We report a case of Severe Fixed flexion deformity of both knees in a 46-year-old male with long-standing rheumatoid arthritis, non-ambulatory since 5 years, treated by sequential total knee arthroplasty. Results: Treating Severe bilateral Fixed flexion deformities in a non-ambulatory patient by sequential total knee Arthroplasty using standard implants yielded complete deformity correction and pain-free restoration of active range of motion in both knees with stable independent ambulation and complete restoration of lower limb function within 3 months of surgery. Conclusion: Our case is particularly remarkable for complete restoration of stable, pain-free restoration of ambulation within 3months in a patient with severe bilateral knee fixed flexion deformities who had been non-ambulatory for 5 years preceding his bilateral sequential total knee arthroplasty. Keywords: Fixed flexion deformity, Total knee arthroplasty, Common peroneal nerve, Rheumatoid arthritis.","PeriodicalId":167557,"journal":{"name":"Journal of Karnataka Orthopaedic Association","volume":"365 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122314419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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