Introduction: Soft tissue tumors around the knee joint still pose problems for the excision and subsequent reconstruction.
Methods: In the 6 included patients the soft tissue sarcoma has its base on the anterior surface of the extensor mechanism and expands towards the skin. The entire extensor apparatus (quadriceps tendon, patella, and patellar tendon) was resected and replaced by a fresh-frozen allograft.
Results: The mean follow-up was 6.7 years (range: 2-12.4 years). In two patients a local recurrence occurred, resulting in a 5-year local recurrence-free rate of 66.7% (95% CI: 19.5%-90.4%). Distant metastases were found in 4 patients resulting in a 5-year metastasis-free rate of 33.3% (95% CI: 4.6%-67.5%). Two patients underwent at least one revision surgery, including one patient in whom the allograft had to be removed. According to the ISOLS function score 24.7 points (range: 19-28 points) were achieved at the last follow-up. The mean active flexion of the knee joint was 82.5° (range: 25-120°) and a mean extension lag of 10° (range: 0-30°) was observed.
Conclusions: The replacement of the extensor mechanism by an allograft is a reasonable option, allowing wide margins and restoration of active extension in most patients.
Trial Registration: The presented study is listed on the ISRCTN registry with trial number ISRCTN63060594.
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http://dx.doi.org/10.1155/2018/6275861 | DOI Listing |
Revision total knee arthroplasty (rTKA) is an increasingly common challenge for arthroplasty surgeons. The survivorship of rTKA is significantly lower than that of primary total knee arthroplasty, resulting in an increasing incidence of repeat rTKA. These cases present multifactorial challenges including the skin and soft-tissue envelopes, bone loss, ligamentous compromise, and often a history of periprosthetic joint infection.
View Article and Find Full Text PDFSci Rep
December 2024
Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA.
As PI-LL mismatch is an effective index for spinal surgery and PI-LL less than 10 probably indicates better quality of life, this study aimed to assess spinopelvic parameters, lumbar instability, and lumbar muscle morphology in patients with chronic low back pain (CLBP) with different PI-LL mismatches. This cross-sectional study included 158 CLBP patients. The association between lumbar extensor muscle morphology (measured from magnetic resonance imaging) and spinopelvic parameters (measured from standing lateral radiographs) and lumbar instability (measured from lumbar flexion/extension radiographs) was compared between two groups of patients with different PI-LL mismatch.
View Article and Find Full Text PDFFront Surg
December 2024
Department of Orthopaedic Hand Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, United States.
Background: Tendon repairs often result in adhesion formation which can cause persisting functional deficits. Close proximity of healing tissues increases friction during tendon excursion, often leading to tendon tethering postoperatively. Despite continued improvements in techniques for tendon repairs, there is currently no consensus on the most effective modality to reduce adhesion formation.
View Article and Find Full Text PDFKnee Surg Sports Traumatol Arthrosc
December 2024
Mechanical Engineering Department, Biomechanics Group, Imperial College, London, UK.
Purpose: High-grade femoral trochlear dysplasia is associated with anterior knee pain, patellar maltracking, instability and the development of osteoarthritis. Scientific studies have signified the importance of trochlear resection on the knee extensor mechanism, and dysplasia can be addressed by a groove-deepening trochleoplasty. Alternatively, tibial tubercle anteriorisation has been proposed to reduce patellofemoral joint (PFJ) pressure and alleviate pain from osteoarthritis.
View Article and Find Full Text PDFInt J Gen Med
December 2024
School of Nursing, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, 215006, People's Republic of China.
Background: Blood flow restriction training (BFRT) can produce effects similar to high-intensity exercise at lower intensities, making it a potentially more suitable method for older adults with sarcopenia. This study aims to determine the efficacy of the intervention on improving physical fitness in older adults with sarcopenia when blood flow restriction (BFR) and aerobic exercise (AE) are combined (BFR-AE) and to explore the related metabolic and signaling mechanisms.
Methods: This is a three-arm, parallel, randomized controlled trial.
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