RESUMO
Giant cell tumor is an aggressive destructive epiphyseal lesion characterized by abundant multinucleated giant cells, accounting for some 5% of Prim Bone Tumours. This study was conducted to see to functional outcome after intralesional excision, chemical adjuvant of phenol and augmentation with PMMA packing
Material and Methods: thirty patients of Companacci grade I and II were selected and operated with intralesional excision and PMMA packing. They were followed for 5 years. Final evaluation consisted of physical examination and radiographic evaluation
Results: majority of the patients [80%] were from 3rd and 4th decades of life. There was slight male preponderance 55% and chief presenting complaints were pain and swelling [79%]. The mean duration of symptoms was 8.4 months and 13 [65%] patients had lesions around knee either prox. Tibia and distal femur. Thirty percent patients were having grade I and 70% grade II lesions. Complications included recurrence in 10% limited range of motion 20% , superficial bone infection 10% and pain being most common 55% of patients. Otherwise overall fair to excellent results are seen
Conclusion: majority of patients with giant cell tumour of bone can be treated satisfactorily with intralesional excision technique coupled with adjuvant treatment. Bone cement carrying advantage over conventional bone grafting, as it acts as spacer, fills the gap, gives stability and acts as cytotoxic agent killing remaining tumor cells. Furthermore it does not carry morbidity of graft harvestin
RESUMO
Background: Unstable intertrochanteric fractures pose a challenging problem. Severe communication in elderly osteoporotic patients renders internal fixation difficult. Several methods, techniques and fixation devices have been advocated for treating these difficult fractures but each one has different rate of complications. The purpose of conduction of this study was to compare the results of Wayn country [valgus] reduction with anatomical reduction by using dynamic hip screw [OHS] in unstable intertrochanteric fractures
Material and methods: This was a prospective randomized study. Forty patients of unstable intertrochanteric fractures were treated with anatomical and Wayn county reduction, fixed with DHS. AO type A2 and A3 were included. Out of 40 cases 20 were treated by anatomical reduction, 20 cases included in Wayn county reduction group. All cases were followed up for 6 months and assessed with Larson's evaluation score for hip
Results: Out of 40 patients 23 [67.5%] were male and 17 [42.5%] were female. Average age was 64.25 years having higher incidence between 60 to 70 years [23 patients], 18 [ 45%] patients had associated diseases, 33 [82.5%] patients had A2 type fracture and 7 [ 17.5%] had A3 type fractures. 36 patients out of 40 were fully followed, there was no death during hospital stay, 4 patients died during follow up. All 4 patients were of Wayn county reduction group. Average delay in surgery was 10 days, average postoperative hospitalization was 11.6 days. Average operating time was 56 minutes in Wayn county reduction and 70 minutes in anatomical reduction. Average healing time was 14 weeks in Wayn county reduction and 13 weeks in anatomical reduction group. Implant placement in femoral head 27 were central - central and 13 were posterior-inferior. Overall results were excellent and good 87% in Wayn county reduction and 80% in anatomical reduction, mechanical failure was present in 0% in Wayn county and 20% in anatomical reduction group
Conclusion: Result showed that Wayn county reduction had better results than anatomical reduction with less chance of mechanical failure, p <0.05
RESUMO
Introduction: patients with severe degenerative knee joint disease often require knee arthroplasty to reduce pain, improve stability and restore function. Insall Burstein II prosthesis is posteriorly stabilized condylar prosthesis, which provide posterior cruciate ligament substitution. It was designed to improve range of motion, stair climbing ability and to prevent posterior subluxation
Objectives: evaluate the functional outcome of total knee arthroplasty with IB II prosthesis and evaluate the alignment of prosthetic components by radiological parameters and its correlation with functional outcome Study
Design: it was a case series descriptive study
Setting: department of Orthopaedic Surgery at Shaikh Zayed Hospital, Lahore
Duration of the Study: it was carried out in 3 years form 1st September 2003 to 31" August 2006
Subject and Methods: sixty knees of sixty patients were replaced by using Insall Burstein II prosthesis. Postoperative radiographs were evaluated for alignment of knee and prosthetic components by criteria selected from knee society roentogenographic evaluation system. Functional outcome was evaluated by rationale of knee society knee rating system
Results: prosthetic component was aligned in 93% and mal-alignment in 7% of the cases. There was significant improvement in function score from mean score 33.83 +/- 15.5 to 59.5 +/- i7.7 and knee score from 37 +/- 12.5 to 76.4 +/- 2.2. Postoperative functional score was found correlated with alignment significantly
Conclusion: total knee arthroplasty with I-B-II prosthesis is a safe durable and predictable procedure with proper surgical technique and expertise good alignment and satisfactory functional outcome can be achieved