1/6. Massive intraosseous ganglion of the talus: reconstruction of the articular surface of the ankle joint.We report on the outcome after autologous chondrocyte and spongiosal bone transplantation in a case of a massive intraosseous ganglion of the talus in a young patient. A 24-year-old man suffered from decreased ankle joint motion, recurrent swelling, and pain. Diagnostic evaluation by plain radiographs, computed tomography, and magnetic resonance imaging revealed cystic lesions in the head and the body of the talus with additional involvement of the cartilage surface. Operative treatment consisted primarily of an initial diagnostic arthroscopy, which established grade VI articular damage according to the arthroscopic classification of Bauer and Jackson. Pathological examination of intralesional biopsy tissue revealed the existence of an intraosseous ganglion. Additionally, healthy cartilage biopsy specimens were obtained and sent for chondrocyte extraction and cultivation with 60 mL of autologous serum. To retain the function of the ankle joint and to minimize the number of necessary operative interventions, 3 weeks after the initial arthroscopic operation, we performed a simultaneous curettage of the cystic lesion followed by autologous spongiosal bone and cultivated chondrocytes transplantation of the talus. Continuous passive motion was applied postoperatively and full weight bearing was allowed after 8 weeks. There were no complications. The clinical result after 18 months was excellent, with a fully functional, pain-free, and weight-bearing ankle joint. The postoperative evaluation score of Finsen (modified Weber score) of 2/6 = 0.3 showed an improvement comparison with the preoperative value of of 21/6 = 3.5 (0 = normal, 4 = pathologic).We encountered no complications postoperatively. Clinical success was achieved by this method of treatment on a patient too young to be treated through arthrodesis.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/6. Intraosseous ganglia of glenoid.A rare case of intraosseous ganglia of the glenoid in a 35-year-old woman is presented. The patient had painful right shoulder and no limit of motion. Radiographs and computed tomographic scans showed a large lytic lesion involving the entire glenoid bone. The patient was treated by curettage and autocorticocancellous bone graft. Six months after the operation, the patient has an excellent clinical outcome and radiologic sign of integration of the bone graft. Few cases of intraosseous ganglia of the glenoid have been reported, but none with the entire glenoid involvement.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
3/6. Vascular pedicle fibular transplantation as treatment for bone tumor.In 4 cases of bone tumor in which extensive bone defects resulted from removal of the tumorous focus, vascular pedicle free fibular transplantation was performed using microsurgical techniques together with filling the defects with iliac bone. Early bone union was achieved. atrophy and fracture were avoided. Early postoperative physical therapy was possible. The vessels selected in the recipient site are dependent upon the location of the graft bed, but the anastomosed site of the vessels should be kept outside of the graft bed. It is important to plan the operation so as to avoid motion at the site of callus formation and tension at the anastomosis site.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
4/6. Intraosseous ganglion cyst of the scaphoid.Intraosseous ganglion cysts are rare causes of hand and wrist pain. Differential diagnosis of painful cystic radiolucent carpal lesions includes osteoid osteoma and osteoblastoma. Isolated cases of ganglion cysts occurring in the lunate, scaphoid, pisiform, hamate, triquetrum, capitate, metacarpal, and phalanx have been reported. A case of intra-articular intraosseous ganglion cyst of the scaphoid is presented. A 49-year-old right-handed woman presented with a 3- to 4-month history of progressive left-wrist pain. No history of trauma was reported. Conservative treatment with anti-inflammatory medications before referral was unsuccessful. Examination revealed marked tenderness in the region of the volar scaphoid proximal pole as well as tenderness overlying the dorsal radial styloid. No palpable masses were present. wrist motion was not limited. Grip strength was symmetric. Radiographic studies revealed a cystic lesion eroding the radial-volar surface of the scaphoid waist. magnetic resonance imaging studies demonstrated the cystic lesion to be of the penetrating type, originating from the radiocarpal joint and eroding into the scaphoid. The patient underwent radial styloidectomy, excision of the ganglion cyst, curettage of the scaphoid lesion, and bone grafting with radial styloid bone. Intraosseous carpal ganglion cysts, although rare, present with chronic wrist pain and should be included in the differential diagnosis.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
5/6. En-bloc resection of the distal fibula for aneurysmal bone cyst.A 21-year-old woman who presented with a voluminous aneurysmal bone cyst in the distal left fibula was treated with en-bloc resection. After 30 months of follow-up, the stability and range of motion of the left ankle were similar to that of the contralateral ankle.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
6/6. Local arthroscopic bone grafting of a juxta-articular glenoid bone cyst.This report describes a rare, juxta-articular bone cyst of the posterior glenoid that developed after a fracture of the glenoid in a 38-year-old male. The patient had persistent pain, popping and stiffness of his right shoulder for 3 years, and failed to improve after a nonoperative rehabilitation program. At arthroscopy, the senior author transported an autogenous bone graft from the bare area of the humeral head to fill the glenoid cyst arthroscopically. At second-look arthroscopy approximately 1 year after the index procedure, the bone graft had consolidated within the original cystic defect and the surface was covered with fibrocartilage. The graft harvest site posteriorly on the humeral head had healed with a small amount of scar tissue at the articular margin. Comfortable motion and function were restored.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |