1/10. Fasciocutaneous flaps based on fascial feeder and perforator vessels for defects in the patellar and peripatellar regions.BACKGROUND: Soft-tissue reconstruction in the patellar and peripatellar regions is a challenging problem. Restoring the original thin, pliable, and tough skin properties is a necessary demand, if appearance and knee function are not to be compromised. Local tissue provides the closest match to the original, but limited availability can restrict the reach of conventional local flaps and, more often than not, produce donor sites that need coverage of their own. methods: A retrospective study was performed over a 7-year period (from 1995 to September of 2002) using local fasciocutaneous flaps, based on fascial feeder and perforator vessels, to reconstruct a variety of patellar and peripatellar defects. Fifteen patients with a mean age of 62 years (range, 18 to 86 years) were reviewed. RESULTS: Early complications were minimal, with only one patient (wound dehiscence) requiring a further procedure. All patients achieved a good final outcome. CONCLUSIONS: The authors found the fascial feeder- and perforator-based local fasciocutaneous flap in the patellar and peripatellar regions to be a simple and reproducible technique to perform. By islanding local flaps on perforator/fascial feeder vessels, greater mobility is achievable, when compared with conventional flaps. Combining local fascial feeder- and perforator-based flaps with V-Y advancement minimizes donor-site complications. On this basis, well-matched local tissue can be used for reconstruction in the patellar and peripatellar areas, with minimal compromise to either appearance or function or both.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/10. Traumatic avulsion of knee joint.The report describes complete avulsion of knee joint en bloc, from the confines of the soft tissues of the leg but the patient was able to show full range of motion at his ankle and foot with palpable dorsalis paedis and posterior tibial vessels. Arthrodaesis was the best available management option.- - - - - - - - - - ranking = 0.16666666666667keywords = vessel (Clic here for more details about this article) |
3/10. Lateral compartment osteoarthritis of the knee after meniscectomy treated by the transplantation of tissue-engineered cartilage and osteochondral plug.Management of osteoarthritis of the knee after meniscectomy has been challenging, especially for young patients, because articular cartilage has very poor healing capacity because of its lack of vessels, nerve supply, and isolation from systemic regulation. Osteoarthritic lesions often involve both femoral and tibial cartilage, requiring treatments for both lesions. We report the case of a 14-year-old girl with lateral compartment osteoarthritis of the knee after a total meniscectomy of the discoid meniscus, who was successfully treated by the transplantation of both tissue-engineered cartilage made ex vivo for a femoral lesion and an autologous osteochondral plug for a tibial lesion. We treated both femoral and tibial cartilage defects simultaneously with this procedure. We confirmed cartilaginous regeneration in both femoral and tibial lesions at second-look arthroscopy. This procedure is one option to prevent further development of osteoarthritis in young patients.- - - - - - - - - - ranking = 0.16666666666667keywords = vessel (Clic here for more details about this article) |
4/10. Indications for the application of Wagner's method of external fixation across the knee joint.External fixation with Wagner's apparatus can, because of its mechanical properties, be employed for temporary immobilization of the knee joint. This method is especially suitable for patients for whom immobilization in plaster is problematic or disadvantageous. It can be applied to the following categories of patients: patients with injuries to the bones or ligaments of the knee which are associated with wounds or injuries of the blood vessels or nerves; patients with multiple injuries of the leg (e.g., fractures of the tibia and femur) and concomitant intra-articular knee injuries; patients with a septic arthritis of the knee joint.- - - - - - - - - - ranking = 0.16666666666667keywords = vessel (Clic here for more details about this article) |
5/10. Vascular injury complicating meniscectomy. Report of a case.Severe haemorrhage occurred from the posterior wall of the capsule during meniscectomy in a 17-year-old girl. Arteriography showed an aneurysm originating from a larger branch of the popliteal artery, and the aneurysm was extirpated. Exploration of the blood vessels (or arteriography) is advisable, should severe bleeding occur during meniscectomy or postoperatively.- - - - - - - - - - ranking = 0.16666666666667keywords = vessel (Clic here for more details about this article) |
6/10. Microcirculatory changes in posttraumatic pigmented villonodular synovitis.The synovium from a case of pigmented villonodular synovitis was examined by light and electron microscopy. The hyperplastic villous processes were found to contain, besides many blood vessels, a dense population of phagocytic cells actively engulfing and digesting the erythrocytes; some of their phagosomes ("siderosome") contained iron-laden micelles sometimes arranged in a crystalline lattice. The synovial vessels were remarkable in two respects: first, there was evidence of endothelial breakdown; second, the basement membranes were strikingly multilayered.- - - - - - - - - - ranking = 0.33333333333333keywords = vessel (Clic here for more details about this article) |
7/10. knee dislocation. An illusive cause of critical arterial occlusion.popliteal artery injury is a hazardous and often subtle complication of traumatic knee dislocation. review of the literature in which series of knee dislocations were reported has revealed a 28% incidence of thrombosis or rupture of this critical vessel. Fifty-seven percent of these patients required leg amputation. The most frequent cause of limb loss has been absence or delay of direct surgical repair of the associated popliteal artery injury. This report describes a management plan that is intended to minimize the likleihood of future disabling leg amputations following knee dislocation.- - - - - - - - - - ranking = 0.16666666666667keywords = vessel (Clic here for more details about this article) |
8/10. popliteal artery injury following fracture or dislocation at the knee. diagnosis and management.Fracture dislocations or dislocations of the knee can produce an arterial injury that may be difficult to evaluate clinically. Aggressive diagnosis and treatment can produce satisfactory results in both vascular and orthopedic situations if performed early after the injury. Five cases of popliteal arterial injury were seen from April 1974 to August 1976. Three cases were following posterior knee dislocation, one was a femoral fracture displacement, and one was a rotary tibiofibular displacement. Four of the patients had complete popliteal artery transection and one had intramural hematoma and spasm. Initial diagnosis of severe arterial injury, although suspicious on clinical grounds, was not conclusive. Use of a Doppler flowmeter and arteriography was essential for the diagnosis of arterial injury. peroneal nerve injury was present in two of five patients. Vascular surgery was successful in all cases. Skeletal instability was corrected at the time of vascular exploration, usually through same incision. leg compartment edema or hematoma was common, but responded to fasciotomy in all cases. Vein graft reconstruction was preferred to direct repair because of wall contusion and the need for additional vessel length over edematous and contused tissue. Acceptable knee stability was obtained from initial repair in all cases.- - - - - - - - - - ranking = 0.16666666666667keywords = vessel (Clic here for more details about this article) |
9/10. Open knee dislocation associated with vascular injury successfully salvaged by primary arthrodesis in an elderly patient: a case report.Treatment by primary arthrodesis of the knee joint after temporary intraluminal shunt placement in a 70-year-old man with open knee dislocation involving the popliteal vessels is reported. After temporary shunting, the definitive vascular reconstruction of both the popliteal artery and vein was established by end-to-end anastomoses because of the shortening effect of the arthrodesis. Two skin coverage procedures were performed on day 0 and day 18. The patient recovered activity to a level near his pretrauma status. Primary arthrodesis for open knee dislocation associated with vascular injury in an elderly patient may be an efficacious procedure, depending on the patient's age, occupation, and level of activity.- - - - - - - - - - ranking = 0.16666666666667keywords = vessel (Clic here for more details about this article) |
10/10. Blunt popliteal artery injury: is physical examination alone enough for evaluation?Failure to recognize popliteal artery injury and restore vessel continuity of flow after blunt trauma is a major cause of lower-extremity amputation and morbidity. A high index of suspicion and early recognition of the injury are paramount for limb salvage, especially with posterior knee dislocation. Traditionally, arteriography has been the test most widely used to ensure an expedient diagnosis and institution of appropriate treatment. More recently, some authors have tried to move away from routine arteriography and rely on physical examination alone without arterial evaluation to guide them on their course of treatment. Based on our experience, the presence of arterial pulses after blunt trauma and dislocation of the knee is not an absolutely reliable indicator to exclude an arterial injury. The high morbidity of a missed popliteal artery injury mandates arterial evaluation of the popliteal artery either by arteriography or ultrasonography. A patient is presented with multiple injuries including a posterior knee dislocation. He had completely normal lower-extremity pulses on initial examination and at the time of discharge, but was required to have emergency reoperation with a ruptured popliteal artery pseudoaneurysm 5 weeks later.- - - - - - - - - - ranking = 0.16666666666667keywords = vessel (Clic here for more details about this article) |
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