We report herein a rare case of lateral parapatellar synovial plica that developed simultaneously in both knees. A 15-year-old competitive soccer player visited our institution with a six-month history of anterolatera...We report herein a rare case of lateral parapatellar synovial plica that developed simultaneously in both knees. A 15-year-old competitive soccer player visited our institution with a six-month history of anterolateral pain and catching sensation in both knee joints. On physical examination, he complained of tenderness along the joint line of bilateral patellofemoral joint (PFJ). Visible and palpable popping was observed at the lateral margin of each patella during active knee motion. Magnetic resonance imaging showed obvious synovial soft nodules in the lateral side of the PFJ. On arthroscopy, a yellowish, thick, tongue-shaped tissue extending transversely from the lateral parapatellar synovium was identified in both knees, and parts of this tissue showed avascular hypertrophy. Arthroscopic findings of both knees are almost symmetrical in anatomical location, but no similar in size. After arthroscopic excision, the patient became asymptomatic. At 24-month follow up, he demonstrated full knee function, without evidence of local recurrence.展开更多
Background Controversy still exists regarding whether medial parapatellar approach （MP） or midvastus approach （MV） is preferable in total knee arthroplasty （TKA） up to now.The aim of this meta-analysis was to co...Background Controversy still exists regarding whether medial parapatellar approach （MP） or midvastus approach （MV） is preferable in total knee arthroplasty （TKA） up to now.The aim of this meta-analysis was to compare the clinical and radiological outcomes following the MV or MP for TKA.Methods A comprehensive search of unrestricted-language literature of all studies comparing MP with MV was conducted through the electronic literature databases of PubMed,EMBASE,Cochrane Library,CNKI,VIP,and WANFANG.Retrieval time was from the time when databases were built to October 2013.Manual search of relevant trials,reviews,and related articles was also performed.Outcomes of interest included postoperative knee extensor and flexor function,postoperative pain,patella tilt,and complications.Relative risk （RR） and weighted mean differences （WMD） from each trial were pooled using random-effects or fixed-effects model depending on the heterogeneity of the included studies.A subgroup analysis or a sensitivity analysis was conducted to explore the potential source of heterogeneity when necessary.Results Twenty-one randomized controlled trials （RCTs） comprising 1 188 patients （1 450 knees） were eligible.Our results showed that MV was associated with better early postoperative extension （WMD=-1.26,95% CI-2.36 to-0.16,P=0.02） and flexion （WMD=10.13,95% CI 5.36 to 14.90,P 〈0.01）,less postoperative pain （WMD=-0.21,95% CI-0.34 to-0.07,P=0.002）,and no greater risk for complications than MP.The patella tilt did not differ significantly between the two groups （WMD=-0.70,95% CI-1.94 to 0.54,P=0.27）.Conclusions MV may be a better approach than MP,as it improves postoperative early joint function and decreases oain.Future multi-center randomized controlled studies with large sample sizes are required to verify the current findings.展开更多
文摘We report herein a rare case of lateral parapatellar synovial plica that developed simultaneously in both knees. A 15-year-old competitive soccer player visited our institution with a six-month history of anterolateral pain and catching sensation in both knee joints. On physical examination, he complained of tenderness along the joint line of bilateral patellofemoral joint (PFJ). Visible and palpable popping was observed at the lateral margin of each patella during active knee motion. Magnetic resonance imaging showed obvious synovial soft nodules in the lateral side of the PFJ. On arthroscopy, a yellowish, thick, tongue-shaped tissue extending transversely from the lateral parapatellar synovium was identified in both knees, and parts of this tissue showed avascular hypertrophy. Arthroscopic findings of both knees are almost symmetrical in anatomical location, but no similar in size. After arthroscopic excision, the patient became asymptomatic. At 24-month follow up, he demonstrated full knee function, without evidence of local recurrence.
文摘Background Controversy still exists regarding whether medial parapatellar approach （MP） or midvastus approach （MV） is preferable in total knee arthroplasty （TKA） up to now.The aim of this meta-analysis was to compare the clinical and radiological outcomes following the MV or MP for TKA.Methods A comprehensive search of unrestricted-language literature of all studies comparing MP with MV was conducted through the electronic literature databases of PubMed,EMBASE,Cochrane Library,CNKI,VIP,and WANFANG.Retrieval time was from the time when databases were built to October 2013.Manual search of relevant trials,reviews,and related articles was also performed.Outcomes of interest included postoperative knee extensor and flexor function,postoperative pain,patella tilt,and complications.Relative risk （RR） and weighted mean differences （WMD） from each trial were pooled using random-effects or fixed-effects model depending on the heterogeneity of the included studies.A subgroup analysis or a sensitivity analysis was conducted to explore the potential source of heterogeneity when necessary.Results Twenty-one randomized controlled trials （RCTs） comprising 1 188 patients （1 450 knees） were eligible.Our results showed that MV was associated with better early postoperative extension （WMD=-1.26,95% CI-2.36 to-0.16,P=0.02） and flexion （WMD=10.13,95% CI 5.36 to 14.90,P 〈0.01）,less postoperative pain （WMD=-0.21,95% CI-0.34 to-0.07,P=0.002）,and no greater risk for complications than MP.The patella tilt did not differ significantly between the two groups （WMD=-0.70,95% CI-1.94 to 0.54,P=0.27）.Conclusions MV may be a better approach than MP,as it improves postoperative early joint function and decreases oain.Future multi-center randomized controlled studies with large sample sizes are required to verify the current findings.
文摘目的比较经股内侧肌入路与内侧髌旁入路行全膝关节置换术的临床疗效。方法 25例行同期双侧全膝关节置换术,每例患者随机一侧采用经股内侧肌入路,另一侧采用内侧髌旁入路,观察两组手术时间、术后引流量、术后6周关节活动度、直腿抬高恢复时间,术后第1、2、3、6天对每例患者双侧膝关节进行视觉模拟疼痛评分(visual analog scale,VAS)。结果经股内侧肌入路组在直腿抬高恢复时间[(2.2±0.8)d vs(4.4±1.4)d]、VAS评分方面明显优于内侧髌旁入路组(P<0.05),两组在术后引流量、手术时间、术后6周膝关节活动度方面差异无统计学意义(P>0.05)。结论经股内侧肌入路行全膝关节置换术与髌旁入路相比,可以减轻术后的疼痛,减少直腿抬高恢复时间,较早恢复膝关节功能,值得临床推广和应用。
