Intra-articular calcaneal osteoid osteoma is a very rare condition and the diagnosis as well as the treatment is extremely challenging. We report a case of a 19-year-old male with intra-articular ...osteoid osteoma of the calcaneus, initially treated for peroneal tenosynovitis with unsatisfactory results. Thorough diagnostic procedure revealed the superolateral location of a calcaneal osteoid osteoma, near the sinus tarsi. A cherry-red elevated lesion typical of an osteoid osteoma nidus was completely removed arthroscopically using the anterolateral portal and the middle portal for subtalar arthroscopy. Histopathology confirmed the suspected diagnosis. The postoperative clinical course was uneventful with immediate pain relief and full weightbearing and movement allowed soon. The patient had no recurrent pain and normal joint mobility 8 months postoperatively. Considering the accessibility of the lesion, intra-articular osteoid osteoma of the calcaneus can be successfully treated arthroscopically using lateral approach for subtalar arthroscopy.
Levels of Evidence: Therapeutic, Level IV: Retrospective, Case report
Sažetak. Artroskopija prvoga metatarzofalangealnog zgloba (1. MTF zglob) danas je neizostavna metoda kirurškog zbrinjavanja ozljeda i njihovih posljedica te oštećenja koja zahvaćaju taj zglob. ...Prednosti artroskopske kirurgije 1. MTF zgloba u odnosu prema klasičnoj otvorenoj metodi operacijskog liječenja višestruke su. U prvome redu artroskopija nam omogućuje izvanredan prikaz unutarzglobnih struktura i time detaljan pregled čitavog zgloba te potpuno izvođenje zahvata bez otvaranja zgloba. Nadalje, morbiditet je znatno niži, rehabilitacija brža, a brži je i povratak svakodnevnim aktivnostima. Osnovni preduvjeti za uspješnu primjenu artroskopije 1. MTF zgloba jesu pažljivo prijeoperacijsko planiranje, izvanredno dobro poznavanje regionalne anatomije, striktno praćenje pravila izvođenja zahvata, dobra tehnika te iskusan operater. Osnovnim indikacijama za artroskopiju 1. MTF zgloba danas se smatraju početni stadiji haluksa rigidusa, osteohondritis disekans glave 1. metatarzalne kosti, sinovitisi različite etiologije te patološki procesi sezamskih kostiju palca stopala. U ovom članku opisujemo indikacije, tehniku, komplikacije, kao i perspektivu artroskopije 1. MTF zgloba, uz detaljan pregled suvremenih literaturnih podataka.
Abstract The case of a 30-year-old male with a history of pain in his left ankle is presented. The pain was described as predominantly nocturnal and frequently relieved by the use of nonsteroidal ...anti-inflammatory drugs. Computed tomography indicated a diagnosis of an osteoid osteoma in the posteromedial portion of the tibia. The patient underwent excision of the tumor using 2-portal posterior ankle arthroscopy. A clearly visualized nidus was removed using a combination of a cochlea and shaver. Histopathologic analysis of the resected tissue confirmed the diagnosis of an osteoid osteoma. The patient reported immediate relief of the pain and was rapidly allowed to bear weight on the foot. During regular follow-up, he had no pain recurrence and his joint mobility was normal. To our knowledge, this is the first report of the removal of an osteoid osteoma of the ankle using 2-portal posterior ankle arthroscopy.
Overuse injuries in female athletes Ivkovic, Alan; Franic, Miljenko; Pecina, Marko ...
Croatian medical journal
48, Številka:
6
Journal Article
Recenzirano
Odprti dostop
The last three decades have witnessed a tremendous increase in female sports participation at all levels. However, increased sports participation of female athletes has also increased the incidence ...of sport-related injuries, which can be either acute trauma or overuse injuries. Overuse injuries may be defined as an imbalance caused by overly intensive training and inadequate recovery, which subsequently leads to a breakdown in tissue reparative mechanisms. This article will review the most frequent overuse injuries in female athletes in the context of anatomical, physiological, and psychological differences between genders.
Adaptive rowing is rowing or sculling for rowers with a physical disability. It debuted at the Paralympic Games in 2008. In order to ensure an equitable playing field, rowers with similar levels of ...physical function and disability are classified into different sport classes for competition. Rowers with an inability to use a sliding seat and impaired trunk function resulting in an inability to perform trunk forward and backward lean via hip flexion/extension are assigned to the Arms and Shoulders (AS) class. AS rowers have to use a chest strap set immediately below the chest in order to localize any trunk movement in AS class. Conditions created by adaptations of rowing equipment and technique within the AS class create unique stresses on the upper thoracic region. The following case report demonstrates how etiology and management of a rib stress fracture in an AS rower differs in comparison to able-body rowers. Of significant importance were the limitations imposed on the rower's ability to maintain rowing-specific fitness, due to the nature of the rib stress fracture and requirement to decrease force transmission through the ribs for several weeks. The rower's gradual return to full training was further impacted by obligatory use of the chest strap, which directly applied pressure over the injured area. Protective orthosis for the chest was designed and applied in order to dissipate pressure of the chest strap over the thorax during rowing (most importantly at the catch position) both on the ergometer and in the boat.
Osteoid osteoma (OO) is the most common benign osteogenic bone tumor that
predominantly affects young adults. OO is commonly localized in long bones, and therefore, it is
rarely considered in ...differential diagnosis of chronic shoulder pain. We report a case of a 22-year-old
male athlete, without history of previous trauma, who presented to our Department with chronic
shoulder pain, which escalated during the night and responded to nonsteroidal anti-inflammatory
drug treatment. Considering these typical symptoms, diagnostic pathway was immediately directed
towards OO, with magnetic resonance and computed tomography confirming the diagnosis of OO of
the coracoid process (CP). Since neurovascular structures are in the proximity of CP, and this very
delicate area does not support radiofrequency ablation, we decided to perform an open procedure with
drilling of the lesion and excochleation. The pain withdrew immediately after the procedure, and on
six-month follow up the patient remained pain free. In the treatment of OO of the CP, we recommend
open surgical procedure with tumor ablation by drilling instead of CP resection, presenting a safe,
simple and low-cost method that simultaneously completely destroys the lesion and preserves the
anatomical and functional role of CP.
Synovial chondromatosis of the elbow Dimnjaković, Damjan; Bojanić, Ivan; Mahnik, Alan ...
Collegium antropologicum
37, Številka:
2
Journal Article
Recenzirano
Synovial chondromatosis (SC) is a rare, mostly benign proliferation of the synovium of the joint, tendon or bursa which results in the formation of loose bodies. It can appear in one of 33 described ...localisations, but it is most common in the knee. In our study we gathered a group of 7 patients (6 male and 1 female) with SC of the elbow, which underwent arthroscopic surgery of the elbow, performing both removal of the loose bodies and complete synovectomy. Mayo Elbow Performance Score (MEPS) was used to evaluate and compare the patients' condition before the operation and at the final follow-up, 31 months, on average, after the operation (range 18-56 months). All patients had poor MEPS before the operation, with an average of 40.7 (range 15-50 points). At the final follow-up, 6 patients had a good or excellent MEPS, while a poor MEPS was present in a single patient. The average MEPS was 85 (range 45-100 points). The one patient who's MEPS remained poor developed heterotopic ossification in the same elbow shortly after arthroscopic surgery. This patient was reoperated 8 months later using an open technique. No other complications occurred in the rest of the operated patients and no recurrence of SC occurred in any of the operated patients. Our results confirm that arthroscopic removal of loose bodies and complete synovectomy should be the treatment of choice for SC of the elbow.
In this review article articular cartilage structure and organization is
explained, followed by brief discussion on articular cartilage focal lesion
development and subsequent endogenous ...regeneration, which mainly relies on presence of intrinsic healing capacity. In case of full thickness focal chondral defects intrinsic healing ability is insufficient and full spontaneous repair is almost never achieved. In those cases, cartilage repair techniques are indicated.
Currently, the most commonly used articular cartilage repair techniques
include three groups of techniques such as: bone marrow stimulation, osteochondral allografting/autografting and autologous chondrocyte implantation. These groups are further divided to specific cartilage repair techniques, discussed in detail and compared to other approaches. The information provided is intended to allow proper critical judgment and to answer the question “Which articular cartilage repair technique is the best for the particular patient?”.
Pigmented villonodular synovitis (PVNS) is a rare proliferative synovial disorder of uncertain etiology. Two forms of this disorder, a localized (LPVNS) and diffuse (DPVNS) form, are well ...differentiated. The therapy of choice for LPVNS is arthroscopic partial synovectomy with excision of the lesion. Total synovectomy, whether done arthroscopically or through an open arthrotomy, is the recommended treatment for DPVNS. During an eight-year period 13 patients, six male and seven female, average age 28 years (range, 16 to 60 years) were treated for PVNS of the knee with arthroscopic synovectomy. Average follow-up was 84 months (range, 28 to 127 months). Four patients were affected by localized PVNS and were subjected to partial arthroscopic synovectomy (two to three portals) with a complete lesion excision. The remaining nine patients presented with the diffuse form of PVNS and all of them underwent total arthroscopic synovectomy (five portals). The diagnosis was confirmed by synovial biopsy. Each patient was evaluated before treatment and at final follow-up. Results were assessed clinically, radiographically and subjectively and were rated as excellent, good, fair, or poor. No complications or recurrences were noted in the LPVNS group, and all four patients were rated as excellent. In the DPVNS group, eight patients were rated as excellent and one patient was rated as fair and it was the patient who suffered the only recurrence in our case series. No relevant complications were encountered. No cases of infection, joint stiffness or neurovascular lesions were seen. Arthroscopy has become the golden standard in treatment of LPVNS, and can undoubtedly give results that are as good as with open synovectomy when treating DPVNS, if performed by an experienced arthroscopic surgeon.
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