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1.
Rev. venez. cir. ortop. traumatol ; 53(1): 20-26, jun. 2021. ilus
Article in Spanish | LILACS, LIVECS | ID: biblio-1252895

ABSTRACT

Cuando fracasa el tratamiento conservador en el Estadio I de Disfunción del Tendón Tibial posterior (DTTP), se debe indicar sinovectomía y debridamiento del tendón. En este estudio evaluamos la evolución con 8 años mínimo de seguimiento, de los pacientes con esta patología tratados vía tenoscópica. Este es un estudio retrospectivo de pacientes operados entre el año 2008 y el año 2011. En ese período de tiempo se intervinieron 11 pacientes con esta patología. Sólo 9 de los 11 pacientes operados pudieron ser evaluados. 7 pacientes mejoraron su sintomatología según el VAS y no progresaron a estadio II. En 3 pacientes se evidenció lesión tendinosa durante la tendoscopía y ameritaron reparación a cielo abierto. La sinovectomía tendoscópica del TTP es un procedimiento quirúrgico efectivo para tratar a los pacientes con DTTP Estadio I, rebeldes a tratamiento conservador(AU)


When conservative treatment fails for Stage I Posterior Tibial tendon dysfunction (PTTD), synovectomy and tendon debridement is indicated. In this study we evaluate tendoscopic treatment results for this pathology with a minimum of 8 years follow up. This is a retrospective study of patients after tendoscopic surgery performed between 2008 and 2011. 9 of the 11 patients were available for evaluation. 7 improved their symptoms according to VAS scale, and did not progress to stage II. In 3 patients tendon tear was visualized during tendoscopy and needed open repair. PTT tendoscopy is an effective surgical treatment to treat Stage I PTTD, failing to conservative treatment(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Flatfoot , Magnetic Resonance Spectroscopy , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Posterior Tibial Tendon Dysfunction/pathology , Tendinopathy , Synovectomy , Ultrasonics , Cryotherapy , Diagnostic Techniques and Procedures , Debridement
2.
Hematol., Transfus. Cell Ther. (Impr.) ; 43(1): 15-20, Jan.-Mar. 2021. tab, ilus
Article in English | LILACS | ID: biblio-1154301

ABSTRACT

ABSTRACT Introduction: The radiosynovectomy (RS) is one treatment option for recurrent hemarthrosis in patients with hemophilia (PWH). A prospective cohort study was designed to evaluate the effects of the RS on the synovial membrane volume in the ankles and knees of PWH and patient characteristics related to the RS outcome. Methods: In a one-year follow-up, 25 joints of 22 PWH who presented 3 bleeds or more in the same joint over the last 6 months (target joints) were subjected to the RS. Two groups were compared: those who retained target joints following the RS and those who did not (less than 3 bleeds/6 months after the RS). The groups were analyzed according to age, hemophilia type/severity, joint, body mass index (BMI), inhibitor and Hemophilia Joint Health Score 2.1 (HJHS). The magnetic resonance images (MRI) of six ankles and six knees were acquired prior to, and 6 months after, the RS. The synovial membrane volume and arthropathy MRI scale were accessed and volumes were compared and correlated with the Yttrium-90 dose injected. Results: Patients with a mean age of 12 years and a mean HJHS of 6.7 (p < 0.05) retained target joints after the RS. The inhibitor, joint, type/severity of disease and BMI showed no significant differences between groups. The synovial membrane volume had a significant reduction after the RS (p = 0.03), but no correlation with the Yttrium-90 dose. In proportion to the synovial membrane volume, doses injected to the ankles were larger than those injected to the knees. Conclusion: The synovial membrane volume is reduced after the RS, regardless of the effective 90Y dose.


Subject(s)
Humans , Child , Adolescent , Adult , Synovitis , Magnetic Resonance Imaging , Synovectomy , Hemarthrosis , Hemophilia A , Joint Diseases
3.
Rev. méd. Minas Gerais ; 31: 31409, 2021.
Article in Portuguese | LILACS | ID: biblio-1291386

ABSTRACT

O lipoma arborescente é uma causa incomum de lesão intra-articular que se apresenta como aumento de volume articular indolor, lentamente progressivo, que persiste por muitos anos e é acompanhado por derrames articulares intermitentes. O envolvimento de sítios extra-articulares é incomum, mas pode ocorrer em bainhas tendíneas e bursas. A ressonância magnética é o melhor exame para o diagnóstico, embora a biópsia sinovial possa ser necessária em alguns casos. Relatamos três casos com o objetivo de destacar o espectro clínico da doença, as características da imagem e a resposta ao tratamento imunossupressor.


Lipoma arborescens is an uncommon cause of intra-articular masses that presents as slowly progressive painless swelling of the joint, which persists for many years and is accompanied by intermittent effusions. Extra-articular site(s) involvement is unusual, but can occur in tendon sheaths and bursas. Magnetic resonance imaging is the best diagnostic exam, although synovial biopsy may be necessary. We report three cases in order to highlight the clinical spectrum and imaging features of the disease, so that early diagnosis and appropriate treatment can be given.


Subject(s)
Humans , Male , Female , Adult , Synovitis , Knee Injuries , Lipoma , Arthritis , Synovial Membrane , Magnetic Resonance Imaging , Adipocytes , Synovectomy , Joints
4.
Article in Chinese | WPRIM | ID: wpr-921898

ABSTRACT

Surgical treatment is the main treatment for hemophilia arthritis, including synoviectomy, joint replacement and joint fusion. Synoviectomy is suitable for early hemophilia synovitis, and is divided into radiation, chemical, arthroscopy, and open operation. Radionuclides were recommended as the first choice due to its positive efficacy and less side effects, but exsit some problems such as scarcity of nuclides. Chemical synoviectomy is cheap and easy to operate, which is suitable for developing countriesm, while mutiple doses and pain after injection are main fault. Synoviectomy under arthroscope has a significant effect on the advanced lesion, but has a higher surgical risk. Open surgery with severe trauma and postoperative joint stiffness, is rarely performed. Joint replacement could effectively improve range of motion in advanced patients and is suitable for joints with high range of motion. Arthrodesis are effective in improving symptoms but lead to loss of range of motion and are suitable for joints with low range of motion. Operation for hemophilia arthritis has some problems, such as single operation, untimely diagnosis and treatment in early stage, and unsatisfactory curative effect in late stage. In addition, the treatment of hemophilia arthritis should focus on the early treatment, the formation of the whole process, the system of individual treatment concept.


Subject(s)
Arthrodesis , Hemophilia A/complications , Humans , Joint Diseases , Synovectomy , Synovitis , Treatment Outcome
5.
Rev. chil. ortop. traumatol ; 61(2): 69-74, oct. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1342414

ABSTRACT

Las lesiones osteocondrales de la articulación subtalar es una patología infrecuente y de incidencia variable, dado su reporte principalmente como hallazgo en el estudio de dolor crónico de tobillo y ya con cambios degenerativos articulares. La sospecha clínica y el estudio imagenológico dirigido, permiten investigar esas lesiones en estadios iniciales, evitando así el uso de técnicas que no preservan la articulación para su manejo. La artroscopía subtalar es una excelente herramienta tanto diagnóstica como terapéutica para la resolución de dichas lesiones. Dadas las características anatómicas y biomecánicas de la articulación, en estadios iniciales, el manejo mediante sinovectomía y microfracturas es una alternativa con excelentes resultados funcionales. Este trabajo incluye dos casos de lesiones osteocondrales de la faceta posterior de la articulación subtalar manejadas vía artroscópica mediante sinovectomía y microfracturas y su posterior evolución.


Osteochondral lesions in the subtalar joint are an uncommon pathology with a variable incidence, being mainly reported as a finding in chronic ankle pain studies and with already visible degenerative joint changes at time of diagnosis. Clinical suspicion and directed imaging study, allows to investigate these lesions during early stages, thus avoiding the use of invasive techniques with scarce joint preservation. Subtalar arthroscopy is an excellent diagnostic and therapeutic tool for the resolution of these lesions. Given the anatomical and biomechanical characteristics of the joint, in the early stages the management by synovectomy and microfractures is an alternative with excellent functional results. This study includes two cases of osteochondral lesions of the posterior facet of the subtalar joint managed through arthroscopically synovectomy and microfractures and their subsequent evolution.


Subject(s)
Humans , Male , Adult , Middle Aged , Arthroscopy/methods , Subtalar Joint/surgery , Talus/surgery , Talus/injuries , Subtalar Joint/diagnostic imaging , Talus/diagnostic imaging , Fractures, Stress , Treatment Outcome , Synovectomy
6.
Medwave ; 19(4): e7641, 2019.
Article in English, Spanish | LILACS | ID: biblio-998354

ABSTRACT

La sinovitis villonodular pigmentada es un tumor benigno del tejido sinovial de muy baja incidencia. El compromiso de tobillo es aún menos frecuente. Se requiere diagnóstico y manejo precoz para evitar secuelas funcionales y mecánicas irreversibles. Se manifiesta inicialmente con aumento de volumen de partes blandas, edema o derrame articular y puede evolucionar con dolor progresivo y daño articular avanzado. Existe una forma focal y una difusa, siendo esta última la de peor pronóstico. El examen diagnóstico de elección es la resonancia magnética, confirmándose por biopsia en la que se observa tejido sinovial inflamatorio con depósitos de hemosiderina. El tratamiento es quirúrgico y consiste en sinovectomía abierta o artroscópica. La recurrencia es de hasta un 40%, por lo que están descritas terapias coadyuvantes biológicas y radioterapia. Este artículo expone el caso de un hombre de 30 años que consulta por dolor y claudicación del tobillo izquierdo, encontrándose en el estudio imagenológico (resonancia magnética) hallazgos compatibles con sinovitis villonodular pigmentada difusa del tobillo, con extensión a la articulación subtalar, por lo que se realiza artroscopía para tratamiento y biopsia. En este reporte de caso se ilustran los resultados con este paciente y una revisión bibliográfica del tema.


Pigmented villonodular synovitis is a benign tumor of synovial tissue with a very low incidence. Ankle location is even less frequent. Early diagnosis and management are required to avoid irreversible functional and mechanical sequelae. The clinical presentation starts with edema or joint effusion and may progress with pain and advanced joint degenerative changes. Pigmented villonodular synovitis can be focal or diffuse, the latter being the type with the worst prognosis. When suspected, magnetic resonance imaging is performed, and the diagnosis confirmed with a biopsy in which synovial inflammatory tissue with hemosiderin deposits is observed. An open or arthroscopic synovectomy is preferred over surgical management. Recurrence is up to 40%, which is why biological coadjutant therapies and radiotherapy are described. This article presents the case of a 30-year-old man who presented with pain and claudication of the left ankle; the imaging study findings were compatible with diffuse pigmented villonodular synovitis of the ankle with extension to the subtalar joint, leading to arthroscopy for treatment and biopsy. This case report illustrates the results with this patient and a literature review of the subject.


Subject(s)
Humans , Male , Adult , Arthroscopy/methods , Synovitis, Pigmented Villonodular/surgery , Ankle Joint/surgery , Pain/etiology , Synovitis, Pigmented Villonodular/diagnosis , Biopsy , Magnetic Resonance Imaging , Synovectomy/methods , Ankle Joint/pathology
7.
Acta ortop. mex ; 31(1): 53-56, ene.-feb. 2017. graf
Article in Spanish | LILACS | ID: biblio-886535

ABSTRACT

Resumen: La sinovitis vellonodular pigmentada (SVP) es una neoplasia benigna con proliferación sinovial y depósito de hemosiderina, se caracteriza por comprometer grandes articulaciones, en especial la rodilla. En la actualidad se describen dos variantes clínicas, la forma difusa (SVPD) y la localizada (SVPL). La sinovectomía artroscópica y sinovectomía por radiación conforman el tratamiento que ha demostrado mejores resultados funcionales. La resonancia magnética nuclear es un método adecuado para establecer el diagnóstico de la SVPL.


Abstract: The pigmented vellonodular sinovitis (PVNS) is benign neoplasm with synovial proliferation and hemosiderin deposit, characterized by large compromising joints, especially the knee. At present, two variants of clinics, the diffuse form (PVNSD) and the localized (PVNSL) are described. Arthroscopic synovectomy and radiosynoviorthesis (RSO) is the treatment that has shown the best functional results. Nuclear magnetic resonance is an appropriate method for conducting the diagnosis of PVNSL.


Subject(s)
Humans , Synovitis, Pigmented Villonodular/diagnostic imaging , Hemarthrosis/diagnostic imaging , Arthroscopy , Magnetic Resonance Imaging , Retrospective Studies , Synovectomy , Knee Joint
8.
Article in Chinese | WPRIM | ID: wpr-286828

ABSTRACT

<p><b>OBJECTIVE</b>To compare the long-term outcomes of arthroscopy and non-surgical therapy in patients with knee synovial plica syndrome (SPS).</p><p><b>METHODS</b>Thirty-one patients with knee SPS undergoing arthroscopic surgery and 27 SPS patients undergoing conservative treatment with articular cavity injection of sodium hyaluronate (control group) were compared for visual pain score (VAS) and the Lysholm score before and after the operation. The patients were followed-up for more than 5 years, and the long-term outcomes were compared using Kaplan-Meier survival analysis.</p><p><b>RESULTS</b>s VAS and the Lysholm scores in both groups were significantly lowered after treatment (P<0.05). The postoperative VAS score was significantly lower while the Lysholm score significantly higher in arthroscopic surgery group than in the control group (P<0.05). Arithmetic mean and the median time of curative effect maintenance were 49 and 43 months in arthroscopic surgery group, as compared with 33 and 29 months in the control group, respectively; the cumulative effect maintenance rate in arthroscopic surgery group was significantly higher than that in the control group (Χ2=4.933, P=4.933).</p><p><b>CONCLUSION</b>Arthroscopic treatment produces better therapeutic effect on knee joint SPS and ensures longer long-term therapeutic effect maintenance than conservative treatment.</p>


Subject(s)
Adult , Arthroscopy , Female , Follow-Up Studies , Humans , Hyaluronic Acid , Injections, Intra-Articular , Joint Diseases , General Surgery , Knee Joint , Pathology , General Surgery , Male , Pain, Postoperative , Postoperative Period , Synovectomy , Synovial Membrane , Pathology , Treatment Outcome
9.
Rev. Nac. (Itauguá) ; 7(2): 54-55, dic 2015.
Article in Spanish | LILACS, BDNPAR | ID: biblio-884788

ABSTRACT

RESUMEN Se presenta caso de varón joven con monoartritis aguda debido a sinovitis vellonodular pigmentada.


ABSTRACT If Young male is presented with acute monoarthritis because villonodular pigmented sinovitis.


Subject(s)
Humans , Male , Adult , Synovitis, Pigmented Villonodular/surgery , Synovitis, Pigmented Villonodular/diagnostic imaging , Synovectomy , Hemosiderin , Knee Joint
10.
Singapore medical journal ; : 547-549, 2014.
Article in English | WPRIM | ID: wpr-244752

ABSTRACT

<p><b>INTRODUCTION</b>Arthroscopic excision of the hypertrophic dorsal synovium is performed on patients with dorsal wrist pain in hyperextension. Although dorsal wrist impingement has been described in cadaveric studies, to our knowledge, there is no published clinical data on its treatment with arthroscopic synovial excision. Herein, we present the results of arthroscopic management of this condition in our hospital.</p><p><b>METHOD</b>A total of 13 patients underwent arthroscopic excision of the hypertrophic dorsal impinging synovium. All patients presented with the cardinal symptom of dorsal-radial wrist pain in extreme extension. The diagnoses were made after excluding other causes and confirmed on wrist arthroscopy. Arthroscopy was offered after nonoperative measures failed. The mean postoperative follow-up period was 14 (range 6-31) months.</p><p><b>RESULTS</b>Mean pre- and postoperative quick Disabilities of the Arm, Shoulder and Hand scores were 49 (range 34-82) and 17 (range 0-48), respectively; paired t-test revealed a significant difference between the two (p < 0.001). Mean postoperative flexion-extension arc and radial-ulnar deviation arc were 120º and 46º, respectively. Postoperatively, one patient developed complex regional pain syndrome, with tethering of the dorsal branch of the ulnar nerve, which required surgical release, while another patient required revision arthroscopic excision of the impinging tissue. Both patients had good postoperative outcomes.</p><p><b>CONCLUSION</b>When treating patients with dorsal wrist pain, dorsal wrist impingement caused by synovial hypertrophy should be included in the differential diagnosis. Arthroscopic excision of the impinging synovium can achieve reliable pain relief with significant functional improvement in the short term, although further research on its long-term benefits is required.</p>


Subject(s)
Adult , Arthralgia , Diagnosis , General Surgery , Arthroscopy , Methods , Female , Humans , Hypertrophy , Male , Middle Aged , Pain Management , Synovectomy , Synovial Membrane , Pathology , Wrist Injuries , Diagnosis , General Surgery , Wrist Joint , General Surgery
11.
Singapore medical journal ; : e228-9, 2013.
Article in English | WPRIM | ID: wpr-337834

ABSTRACT

Intra-articular haemangioma is a rare and uncommon condition that sometimes presents in infants. The lesion can be a diagnostic challenge, with misdiagnosis often leading to delayed diagnosis and treatment. It is essential to establish and treat the condition early, as intra-articular haemangioma can lead to destruction of the joint and secondary arthrosis. Herein, we report the case of a five-year-old boy who presented with intra-articular haemangioma and discuss the management of his condition.


Subject(s)
Arthralgia , Biopsy, Needle , Child, Preschool , Follow-Up Studies , Hemangioma , Diagnosis , Pathology , General Surgery , Humans , Immunohistochemistry , Joint Capsule , Pathology , General Surgery , Knee Joint , Pathology , General Surgery , Magnetic Resonance Imaging , Methods , Male , Orthopedic Procedures , Methods , Rare Diseases , Risk Assessment , Synovectomy , Synovial Membrane , Pathology , Treatment Outcome
12.
Article in English | WPRIM | ID: wpr-243221

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the efficacy of arthroscopic surgery in inflammatory hip arthritis.</p><p><b>METHODS</b>A retrospective clinical study was conducted inspecting 40 hips in 36 patients of inflammatory arthritis. There were 17 cases of ankylosing spondylitis, 11 cases of rheumatoid arthritis, and 8 cases of psoriatic arthritis. The joints were irrigated and the inflamed tissues were debrided with anthroscopy. The patients were followed up with Harris hip score, Oxford hip score, Visual Analog Scale (VAS), and magnetic resonance imaging (MRI). Statistical analysis was performed using Student t test.</p><p><b>RESULTS</b>All of the 36 cases were followed up for 46-103 months, averaging 67.2±8.4 months. Harris and Oxford scores increased from 66.9±12.1 and 69.4±16.4 before operation to 78.4±19.3 and 80.2±18.8 after operation, respectively (P<0.05). VAS score decreased from pre-operative 8.5±2.5 to post-operative 7.2±2.5 (P<0.05). All the patients showed improved joint range of motion. MRI revealed alleviation of hip synovitis. The results were classified as excellent in 8 patients, good in 17 patients, fair in 8 patient, and poor in 3 according to Harris hip score. Twenty-seven patients were satisfied with the operative outcomes as they regained normal daily activities.</p><p><b>CONCLUSIONS</b>Arthroscopy-assisted joint debridement and synovium resection is an effective procedure for hip lesion in inflammatory arthritis. The inflammatory lesion might be thereby controlled and the symptoms be relieved.</p>


Subject(s)
Adult , Arthritis , Pathology , General Surgery , Arthroscopy , Methods , Debridement , Methods , Female , Hip Joint , General Surgery , Humans , Magnetic Resonance Imaging , Male , Retrospective Studies , Synovectomy
13.
Article in Chinese | WPRIM | ID: wpr-282893

ABSTRACT

<p><b>OBJECTIVE</b>To continuously observe the long-term effects of synovectomy for improving joint damage and quality-of-life in patients with the rheumatoid knee.</p><p><b>METHODS</b>Twenty-one consecutive patients with rheumatoid arthritis (RA) involving 24 knees underwent open synovectomy from November 1988 to January 1997 between November 1988 and January 1997. The changes in radiographic damage were assessed with Larsen score on plain films before and 6 months after surgery with subsequent annual assessment for 8 years, and the functional recovery of the patients was also evaluated with Health Assessment Questionnaire (HAQ) at the same time.</p><p><b>RESULTS</b>The radiographic joint damage and juxta-articular osteoporosis or bone erosion was ameliorated after surgery in all the patients. Larsen score began to decrease 6 months after the operation, and the best effects were achieved at one year and maintained for at least 5 years after the operation, but then followed by recurrence of joint lesions. HAQ scores were improved after the surgery with the best effects observed 6 months after the operation lasting for over 2 years. HAQ score gradually decreased 4 years after the operation till reaching the preoperative scores.</p><p><b>CONCLUSION</b>Synovectomy in the patients with rheumatoid knee not only reverses progressive joint damage, but also improves juxta-articular bone erosions and the patients' quality of life. However, radiographic joint damage and functional deterioration may recur due to hyperplasia of the inflammatory synovium in the long term after operation, suggesting that the inflammatory synovium participates in local joint damage with bone erosions and systemic pathologic process of RA.</p>


Subject(s)
Adult , Arthritis, Rheumatoid , Diagnostic Imaging , General Surgery , Female , Follow-Up Studies , Humans , Knee Joint , Diagnostic Imaging , General Surgery , Male , Middle Aged , Radiography , Synovectomy , Time Factors
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