Patella Eversion Reduces Early Knee Range of Motion and Muscle Torque Recovery after Total Knee Arthroplasty: Comparison between Minimally Invasive Total Knee Arthroplasty and Conventional Total Knee Arthroplasty.

We hypothesized that patella eversion during total knee arthroplasty (TKA) reduces early return of active knee extension and flexion, quadriceps muscle strength, and postoperative pain. In 100 conventional TKA knees and 100 minimally invasive TKA (MIS TKA) knees, we compared knee range of motion (ROM), postoperative pain, and quadriceps muscle strength at 1 day, 4 days, 1 week, 2 weeks, 3 weeks, 4 weeks, 12 weeks, 1 year, and 5 years after surgery. The differences of surgical approach between MIS TKA and conventional TKA of this study are length of skin incision with subcutaneal flap and patella eversion. In MIS TKA, skin incision is shorter than conventional TKA. Furthermore, patella is not everted in MIS TKA procedure. There were no significant differences in preoperative factors. Postoperative improvement of ROM, postoperative muscle strength recovery, and postoperative improvement of visual analog scale were faster in patients with MIS TKA when compared to that in patients with conventional TKA. On the other hand, no significant difference was observed in complication, 5-year clinical results of subjective knee function score, and the postoperative component angle and lower leg alignment. These results indicate that patella eversion may affect muscle strength recovery and postoperative pain.

Synovial chondromatosis originating from the synovium of the anterior cruciate ligament: a case report.

A case of synovial chondromatosis originating from the synovium of the anterior cruciate ligament (ACL) resulting in a mechanical block to knee extension is reported. A 36-year-old man complained of a restricted range of left-knee motion and pain when walking. Plain roentgenograms showed normal appearance, however, magnetic resonance imaging showed intensity changes in the ACL. Arthroscopically, numerous small free bodies were observed. Proliferation of synovium and cartilaginous tissues were identified around the ACL. There were no significant findings in the synovium except around the ACL. The synovium around the ACL was resected and free bodies were washed out. This is the first report of synovial chondromatosis originating from the synovium of the ACL.