Feasibility of robot­assisted radical cystectomy in a patient with an ectopic kidney: A case report.

An ectopic kidney is a rare congenital defect in which the kidney does not migrate to its normal anatomical position. In the present study, a robot-assisted radical cystectomy and intracorporeal urinary diversion were performed for a patient with an ectopic kidney. The present study describes the case of a 72-year-old male patient who was diagnosed with a bladder tumor by magnetic resonance imaging and cystoscopy. A transurethral resection of the bladder tumor was performed. The pathological examination revealed an invasive urothelial carcinoma. Contrast-enhanced computed tomography revealed an ectopic left kidney in the upper pelvis. A robot-assisted radical cystectomy, extended lymph node dissection and intracorporeal urinary diversion were performed. On the whole, as demonstrated herein, a robot-assisted radical cystectomy with intracorporeal urinary diversion is a feasible approach for muscle-invasive bladder cancer complicated by an ectopic kidney.

Changes in patellar baja progress until 3 months after medial open-wedge high tibial osteotomy.

PURPOSE: The purpose of this study was to evaluate sequential patellar height changes as well as the factors leading to these changes after medial open-wedge high tibial osteotomy (MOWHTO). METHODS: The study cohort constituted 37 knees from 36 patients who underwent MOWHTO for varus knee. The Caton-Deschamps index (CDI) for patellar height was measured preoperatively and at 2 weeks and 3, 6, and 12 months postoperatively. The factors related to sequential changes in patellar height were evaluated. RESULTS: Significant differences were observed between preoperative CDI and postoperative CDI at all time points (p < .05). Two-week postoperative CDI and postoperative CDI at 3,6,12-months was also significantly different (p < .05). The only significant factor for the change in patellar height between preoperative CDI and postoperative CDI at 2-weeks and 12-months was the change in the Δ medial proximal tibial angle (ΔMPTA) (postoperative MPTA-preoperative MPTA). We could not identify the factor that affected the change in patellar height change from 2-weeks postoperatively. CONCLUSION: The change in patellar height continued sequentially until at least 3 months postoperatively. ΔMPTA was associated with the change in patellar height at 2 weeks postoperatively compared with preoperatively; however, no factors associated with the change in patellar height from 2 weeks postoperatively to 3, 6, and 12-months postoperatively were identified.

Acute Anterior Dislocation in a Total Knee Arthroplasty Patient With a History of Sarcoma Resection.

Dislocation after total knee arthroplasty (TKA) is a rare complication, and few cases of anterior dislocation have been reported. Furthermore, there are no reports of early postoperative dislocation. A 72-year-old woman who had previously undergone resection of the posterior thigh muscle group for liposarcoma of the thigh underwent TKA for knee osteoarthritis. However, anterior dislocation was observed at 1 week postoperatively. We considered that the cause of the early anterior dislocation was previous resection of the posterior soft tissues of the knee joint. This case is a rare report of early anterior postoperative dislocation after TKA.