RESUMEN
Background: The treatment of isolated internal tibiofemoral knee osteoarthritis on young and active patients is controversial. This treatment can be a high tibial osteotomy or a joint replacement that can be a partial unicompartmental knee arthroplasty [UKA] or total knee replacement [TKR]. The aim of our study is the long-term evaluation of functional outcome of partial unicompartmental knee arthroplasty [UKA] in elderly patients under than 60 years
Methods: This is a retrospective study of 25 unicompartmental knee arthroplasties in 22 patients, collected between1993 and 2003 whose age was less than 60 years. The minimum follow-up was 10 years. At last follow, an analysis of IKS score [International Knee Score] with assessment of both articular and functional components have been established. The Radiological score of Knee Society [KS] was used
Results: At mean 14.2 years [min: 10, max: 20], the mean of knee flexion was 110 [degree sign]. The IKS function score going 47 points preoperatively to 77 points postoperatively and IKS score 40 points knee preoperatively to 94 points postoperative. The radiological assessment found a postoperative mean tibiofemoral mechanical axis of 174.8 [degree sign] [172 [degree sign] min, max 182 [degree sign]]. The survival of implants at 12 years postoperatively was 84%
The survival of the prostheses was de84 to 12%, with a revision for polyethylene wear, a second for conflict of the femoral component with tibia thorns responsible of chronic pain, a third revision for infection and two for osteoarthritis evolution
Conclusion: The long-term evaluation of patients with a unicompartmental does not objective an obvious deterioration of outcome with a normal rate of revision comparatively to other series without particular difficulties during revision
RESUMEN
Chondroblastoma is a rare and benign cartilaginous tumor of bone often localized in the epiphysis of long bones and affecting young persons between 10 and 20 years. To study the epidemiological, clinical and radiological aspects of bone chondroblastoma, to assess the outcome of chirurgical treatment and factors associated with recurrence. It's a retrospective study, concerning 13 patients with chondroblastoma of bone, attending the orthopedic department of Sahloul hospital between 1991 and 2007. The patients' age, sex, clinical features, radiological aspects, treatment and evolution were recorded. After initial clinical examination, all patients have had plane radiographs. Twelve patients were explored by Computed tomography. The treatment was surgical in every case: curettage of the lesion in 11 cases associated with bone grafting in 5 cases and cementation in one case, one in-bloc resection and one simple biopsy. Histology confirmed the diagnostic in all cases. The average age of patients was 18, 2 years and sex ratio was 2, 3. The long bones are the most commonly involved. The main presenting symptoms were pain in all cases and local swelling in 8 cases. Radiographs showed a lytic geographic well-defined lesion in 7 cases. Computed tomography showed better calcifications and soft tissue extension. The mean follow-up of our patients was 8 years [6 mois-18 ans]. Two recurrences were noted. Functional results were good in 11 cases. Chondroblastoma is a rare and benign cartilaginous tumor of bone which usually involves the epiphysis of long bones. Plane radiographs are sufficient for diagnostic in typical cases. MRI is interesting in unusual presentations and localizations. Curettage and grafting constitute the treatment of choice. Prognosis depends basically on a relatively high rate of recurrence. Aggressive feature of the lesion and incomplete curettage are the most important predictive factors of recurrence
RESUMEN
The marginal anterior fractures of the distal radius are considered unstable and involve more therapeutic than diagnosic problems. We propose, through a retrospective series of 60 distal radial anterior marginal fractures treated by anterior plate, to analyze the obtained results and to clarify the place and the limits of this technique with regard to the other therapeutic methods. Our series consists of 50 men and 10 women.The mean age was 38 years [17 to 82]. Road-traffic accidents were the common cause of these fractures. According to the Kapandji classification, our series was composed of 37 fractures type 7a and 23 fractures type 7b .The ulnar styloidfracture was the lesion most frequently associated [49%].The results have been analyzed according to the Castaing classification with a mean follow-up of 35 months [6 to 156]. The functional results are rated as good and exellent in 67 per cent and the anatomical results are rated as good and exellent in 91 per cent . The obtained results confirm the interest and the efficiency of the surgical treatment by anterior plating of these fractures, in the condition to restore perfectly thg articular surface and to insure an adequate ostesynthesis