Sinovitis villonodular pigmentada de rodilla: resultado en el tratamiento artroscópico en 10 pacientes / Pigmented villonodular synovitis of the knee: arthroscopic treatment in 10 patients

Objective: To report our experience in the diagnosis, treatment and follow up of patients with clinical and histopathological diagnosis of knee pigmented villonodular synovitis (PVNS). We performed a descriptive retrospective study of a consecutive series of 10 patients treated by knee PVNS in a ten years period. The mean follow-up was 39 months. Clinical records and surgery protocols were reviewed; functional clinical results were documented using the Lysholm score. Results: Nine patients consulted by pain and one case corresponded a incidental finding. All patients were initially treated with an arthroscopic synovectomy. Two patients presented relapse and as a final treatment they underwent total knee arthroplasty. The mean post-operative Lysholm score at follow up was 95 (90-100) points. Conclusion: We documented low incidence of knee PVNS. The total recurrence in our series was of 20 percent.

Objetivo: Reportar nuestra experiencia en el diagnóstico, tratamiento y evolución de pacientes con diagnóstico clínico-histopatológico de sinovitis villonodular pigmentada (SVNP) de rodilla tratados en nuestro centro. Métodos: Estudio retrospectivo, descriptivo, de una serie consecutiva de diez pacientes tratados por SNVP de rodilla en un período 10 años con un seguimiento promedio de 39 meses. Se revisaron fichas clínicas, protocolos quirúrgicos y documentamos los resultados funcionales subjetivos mediante el puntaje de Lysholm. Resultados: Nueve pacientes consultaron por dolor y en un caso correspondió a un hallazgo. A todos los pacientes se les realizó inicialmente una sinovectomía artroscópica. Dos pacientes presentaron recidiva y como tratamiento final se les realizó una artrosplastía total de rodilla. El promedio del puntaje Lysholm postoperatorio consignado durante el seguimiento fue 95 (90-100). Conclusión: La SVNP de rodilla corresponde a una patología de baja frecuencia, que presenta una recidiva de un 20 por ciento tras un tratamiento artroscópico.

Sinovectomia artroscopica para el tratamiento de la artritis reumatoidea en la rodilla / Arthroscopic sinovectomy for the treatment of rheumatoid arthritis of the knee

El objetivo de este trabajo es presentar nuestra experiencia en 30 rodillas de 27 pacientes sometidos a sinovectomía artroscópica de rodilla por padecer sinovitis de rodilla de más de 6 meses de evolución con el propósito de describir la técnica quirúrgica, evaluar resultados y determinar el lugar de esta técnica dentro del arsenal terapéutico actual de la artritis indiferenciada y reumatoidea. Material y métodos: Se incluyen en el estudio 30 rodillas en 27 pacientes intervenidos entre agosto de 1999 y agosto de 2006, pudiendo ser evaluadas 20 rodillas con un seguimiento mínimo de 12 meses. Resultados: El follow up promedio fue de 44,48 meses. Para la evaluación se utilizó el Score de Lysholm modificado por Klein y Jensen, con un máximo de 100 puntos. El valor promedio preoperatorio de 42,63 puntos se incrementó a 90 puntos en el postoperatorio. El 80 de las rodillas evaluadas fueron catalogadas como resultados buenos y excelentes. Conclusiones: La sinovectomía artroscópica es un procedimiento seguro. Atribuimos los buenos resultados obtenidos a una derivación precoz del paciente y a la completa resección de tejido sinovial.

Sinovectomia artroscopica para el tratamiento de la artritis reumatoidea en la rodilla / Arthroscopic knee synovectomy in knee rheumatoid arthritis

El objetivo de este trabajo es presentar nuestra experiencia en 30 rodillas de 27 pacientes sometidos a sinovectomÍa artroscópica de rodilla por padecer sinovitis de rodilla de más de 6 meses de evolución con el propósito de describir la técnica quirúrgica, evaluar resultados y determinar el lugar de esta técnica dentro del arsenal terapéutico actual de la artritis indiferenciada y reumatoidea. Material y Métodos: Se incluyen en el estudio 30 rodillas en 27 pacientes intervenidos entre Agosto de 1999 y Agosto de 2006, pudiendo ser evaluadas 20 rodillas con un seguimiento mínimo de 12 meses. Resultados: El follow up promedio fue de 44.48 meses. Para la evaluación se utilizó el Score de Lysholm modificado por Klein y Jensen, con un máximo de 100 puntos. El valor promedio preoperatorio de 42.63 puntos se incrementó a 90 puntos en el postoperatorio. El 80% de las rodillas evaluadas fueron catalogadas como resultados buenos y excelentes. Conclusiones: La sinovectomÍa artroscópica es un procedimiento seguro. Atribuimos los buenos resultados obtenidos a una derivación precoz del paciente y a la completa resección de tejido sinovial.

Elbow arthroscopy for management of loose bodies and synovial chondromatosis

Elbow arthroscopy has dramatically altered the approach to the diagnosis and treatment of a variety of elbow joint problems. Thirteen elbows Arthroscopy had been done removing different sizes of loose bodies from both anterior and posterior elbow compartments. In addition to loose bodies removal partial synovectomy of three cases with synovial chondromatosis had been done with excellent outcome. Pain relief and improvement of elbow range of motion were recorded in this procedure where eleven patients had scored as excellent and good. Average follow up were 6months. Elbow arthroscopy is valuable technique that must be encouraged to be used more and more in different elbow pathologies

Discoid medical meniscus varied presentation of 3 knees

Discoid medial meniscus is a rarity. We present 2 cases, one with bilateral discoid medial menisci, and the other with both medial and lateral discoid menisci in the same knee. The radiological, MRI and arthroscopic findings in these knees and their association with various synovial plicae have been described. Both patients had good results after arthroscopic subtotal meniscectomy

Hip arthroscopy a report of the early work of Assiut University Hospital

Hip arthroscopy is relatively a new advancement in the field of arthroscopy in Egypt. The purpose of this work is to report our early work on diagnostic and therapeutic hip arthroscopy. Hip arthroscopy was performed in six patients. Four were males, and two females. The age ranged from 15 - 56 years. Four cases had chronic unexplained hip pain after exhausting the non-invasive investigations, one had chronic pain with a previous history ofpyogenic arthritis, and one case had a loose body. The procedure was performed on traction table under the control of fluoroscopy, using the regular 4 mm. scope, and instruments that are used in Knee arthroscopy. in the case with a loose body it was extracted, and the case with previous history of pyogenie arthritis intra-articular adhesions was found and excised. In the other four cases arthroscopic partial synovectomy was done and the histological examination of the synovial membrane biopsy revealed early tuberculous arthritis in two cases, mono-articular rheumatoid arthritis in one case, and chronic non-specific arthritis in the last case. The adverse events were a pudendal nerve injury in one case, and entrapment of the suction tube in another case. Hip arthroscopy proved to be a useful procedure for diagnosis of hip problems, and for therapeutic procedures as loose body removal, and partial synovectomy

Hemangioma sinovial do joelho: relato de caso / Synovial hemangioma of the knee: case report

Hemangioma sinovial é uma neoplasia vascular benigna, rara, que afeta crianças e adultos jovens, comprometendo freqüentemente o joelho. Clinicamente, o paciente apresenta queixa de dor, limitaçao de movimento e hemartrose de repetiçao na articulaçao afetada. O diagnóstico será feito somente por médicos que estiverem cientes das características da patologia. Os autores discutem as características da neoplasia, apresentam as condutas tomadas e preconizam, como tratamento definitivo, a ressecçao do tumor e da sinovial envolvida.

Synovectomy of the rheumatoid knee joint results of short term follow-up

To study the role of synovectomy in the treatment of rheumatoid knee joint and to compare the results of the study with those in the literature. The study involved 22 synovectomy of rheumatoid knees in 17 patients. The disease was staged according to Stein Brocker criteria. Patients in the stage 1, II and III were selected for surgery when there was no response to standard medical treatment. The average follow up was 13. 7 months. The final results were assessed using Ishikawa modification of Laurin et al criteria. The results were excellent in nine knees [40.9%], satisfactory in 10 [45.4%], unsatisfactory in one [4.5%] and poor in two [9.09%]. Pain and effusion were significantly reduced, while range of motion showed slight improvement. No significant complications, were reported. Synovectomy for rheumatoid knees proved to be effective in patients who failed medical treatment. The best results were in stage I and II disease. Poor results were encountered in patients with flexion deformity or unstable joint. Cooperation of patients to take early post operative exercise so as to prevent joint stiffness and to ensure good results is essential. Although few joints may show deterioration over the passage of time, the technique is without any major complications

Emprego experimental do pericárdio eqüino na substituiçäo parcial da cápsula articular em joelho de coelhos: aspectos histológicos / Experimental use of equine pericardium in the partial replacement of the articular capsule in knee of rabbits: histological aspects

Os autores realizaram estudo experimental em 12 coelhos, substituindo fragmento da cápsula articular e respectiva membrana sinovial dos joelhos por pericárdio eqüino conservado em glicerina, com o objetivo de avaliar histologicamente a viabilidade do pericárdio como enxerto heterólogo de estruturas articulares. Os animais foram sacrificados aos 15, 45, 60, 90 e 120 dias de pós-operatório, sendo realizado, nessa oportunidade, estudo histológico. Os resultados mostraram que a reabsorçäo do pericárdio é lenta e de características centrípetas, näo sendo ele invadido pelo infiltrado inflamatório e sim englobado pelo mesmo, demonstrando baixa antigenicidade e servindo como estroma para total restrituiçäo da membrana sinovial enquanto substitui a cápsula retirada. O contato do líquido sinovial com o enxerto näo mostrou alteraçöes histológicas, sugerindo compatibilidade do mesmo no plano intra-articular

Arthroscopic synovectomy of the knee joint

Arthroscopic synovectomy has been done for 20 knees in 15 patients using the electric shaver. The etiology was chronic non specific synovitis in 13 and rheumatoid arthritis in 7 cases. Postoperatively pain and swelling decreased, the range of movements improved in most cases. The rehabilitation was easy and comfortable overcoming the disadvantages of open synovectomy

Villonodual synovitis of knee and hip. About 3 cases

The authors report three observations of the patients with a vilonodular synovitis treated by synovectomy. The result is good for all symptoms. They discuss about nosology, pathology, etiology, diagnostic and therapeutical problems