Osteoid osteoma of elbow. Two case reports and review of literature

Although osteoid osteoma is a relatively common lesion, it rarely occurs at elbow. We report two cases of osteoid osteoma of elbow in trochlea. Diagnosis was delayed because of non-specific clinical and radiological features. The two patients suffered from flexion contracture of elbow due to synovitis, while at the same time, pronation and supination remained normal. Only one of the patients complained of specific nocturnal pain. Both patients had latencies between the onset of symptoms and the appearance of radiological signs. Open surgical excision of the nidus resulted in complete relief and motion recovery in both cases. Diagnostic difficulties and treatment options are discussed below

study on the results of reconstructing posterior cruciate ligament using graft from quadriceps muscle tendon

Background: many of the knees affected by rupture of the posterior cruciate ligament [PCL] lack their desirable function. Researchers are currently seeking surgical procedures for treating PCL rupture, which can offer a reliable degree of objective and subjective knee stability after surgery. This study assesses the results of anatomical reconstruction of PCL using graft from the tendon of the quadriceps muscle

Methods: this is a descriptive prospective study involving 14 patients with clinical diagnosis of PCL rupture. The patients complained of knee discomfort in spite of conservative treatment and many sessions of physiotherapy. Subjective symptoms of knee instability, i.e. giving way, pain after long walks and pain during climbing, as well as objective knee instability symptoms as assessed by posterior drawer test at 30degree and 90degree knee flexion, and neutral rotation were recorded and compared prior to and after surgery. The procedure entailed anatomical reconstruction of PCL using grafts taken from the tendon of quadriceps muscle and part of proximal patella

Results: two patients were excluded from the study due to their failure to refer for follow-up. The patients included 11 men and 1 woman with a mean age of 23 years. The patients displayed statistically significant improvement after surgery as regards subjective symptoms, i.e. giving way, pain after long walks and pain in climbing. Objective knee instability symptoms as evaluated by posterior drawer test at 30degree and 90degree knee flexion and neutral rotation also showed significant improvement compared to pre-operation findings

Conclusion: reconstruction of PCL is aimed at achieving normal knee kinematics and stability. The procedure used in this study entailed anatomical reconstruction of PCL. Given the objective and subjective results obtained, the use of this procedure is recommended by authors as the method of choice for reconstructing PCL