Arthroscopic Treatment of Gonarthrosis in a Low-Income Setting

Background: Knee osteoarthritis is a frequent, debilitating, and degenerative condition. It is the most common operative indication for surgical arthroscopy. Hypothesis: Arthroscopy allows painless treatment of knee osteoarthritis and functional recovery. Patients and Methods: Our study was conducted in a private medical center in the city of Brazzaville in Congo, during the period from September 2020 to February 2023. It was prospective and based on patients with mechanical knee pain caused by osteoarthritis. A mobile arthroscopy device was used. The IKDC and KOOS scores allowed the evaluation of the treatment. Results: Our work involved 15 men and 7 women, with an average age of 39.9 years. Knee osteoarthritis was classified as type 2 according to Ahlbäck in 26 cases (70.27%) and type 3 in 11 cases (29.73%). In 7 patients, arthroscopy revealed lesions not visualized on MRI. Joint lavage was performed in all cases, synovial debridement in 17 cases (45.94%), and extraction of cartilaginous foreign bodies in 10 cases (27.03%). 20 patients were very satisfied with the surgery and 2 moderately satisfied. The EVA, subjective IKDC and KOOS scores were acceptable on a long-term follow-up. Discussion: Arthroscopy is a modern surgical technique for the management of intra-articular lesions of the knee. It relieves pain and stabilizes the degenerative process. A mobile arthroscopy device used here was preferred because of the low cost of installation and production.

C1-C2 Pott’s Disease, a Rare Location of Spine Tuberculosis

The authors report a new case of spine tuberculosis of C1-C2 occurred in a 58-year-old negative HIV patient that was responsible of inflammatory cervical pain with multidirectional stiffness and complicated by spastic quadriplegia. The diagnosis was made on the basis of presumptive elements, including cervical spinal CT scan, which showed atlan-to-axial subluxation (C1-C2) with destruction of the odontoid apophysis and lateral mass of the atlas and favorable evolution under specific antibiotic treatment with ethambutol, isoniazid, rifampicin, pyrazinamide and immobilization with brace cast, despite the absence of bacteriological and anatomo-pathological evidence of certainty. The evolution has been favorable, with the disappearance of cervical pain, progressive motor recovery and resumption of autonomy of walking.

Profile of Secondary Bone Cancer in Brazzaville

Objectives: To report an epidemiology study and prognosis for metastatic bone tumor. Methodology: It was a descriptive, transversal study on records of patients hospitalized in Rheumatology and Oncology-Radiotherapy departments of the University Teaching Hospital of Brazzaville, Congo from 1 January 2005 to 31 July 2011 (7 years and 6 months). The diagnosis of bone metastasis was made because of the existence of bone pain, or pathological fracture, or bone swelling and a bone-condensing or mixed or osteolytic radiological image. The anatomo-pathological evidence was made after biopsy of the bone lesion or primary cancer. 3687 patients were hospitalized for active cancer, among them 81 had documented bone metastasis. Results: There were 60 men (74.1%) and 21 women (25.9%) with a sex ratio of 2.85. The average age was 53 years, ranging from 3 to 80 years. 75% of patients were more or equal to 50 years old at the discovery of the bone metastasis. Bone pain was the main mode of discovery (67.9% of cases). However, in 6.2% of cases, it was discovered incidentally. The metastasis was bone condensing in 50.7% of cases, osteolytic in 40.7% and mixed in 8.6%. They were unifocal in 25.9% and multifocal in 74.1% of cases. The Primary cancer most frequently found was that of the prostate in 55.6% of cases, breast in 20.7% and rhabdomyosarcoma in 4.9%. In 6.2% of cases, the primary site of cancer was unknown. The average survival was 25 months. Conclusion: The clinical and radiological presentation remains classic. Cancer of the prostate and breast are the main neoplasia responsible for bone metastasis in our series. The discovery of metastasis remains a major evolutionary step of cancer.