RESUMO
INTRODUCTION: The aim of the present study is to analyze the clinical-radiological outcomes of patients undergoing knee prosthesis revision surgery using constrained condylar prosthesis (LCCK; Zimmer-Biomet). MATERIAL AND METHODS: Retrospective study of 89 patients operated on between the years 2008 and 2020 with a minimum of 2 years of follow-up. Clinical outcomes were evaluated using the WOMAC Index score and KOOS scales. Radiological results (radiolucent lines, osteolysis, and cortical hypertrophy) were evaluated by two independent observers. Implant survival was analyzed using the Kaplan-Meier method. RESULTS: At the end of follow-up, a mean WOMAC Index score of 78.67 and KOOS score of 68.8 were obtained. Radiolucent lines (both non-progressive and progressive) were detected in 83.3% of the patients in the sample. Areas of osteolysis > 5 mm around the components were present in 6.75%. Cortical hypertrophy was seen around the femoral stem in 20.3% of cases, around the tibial stem in 20.3% and around both components in 6.76%. No statistically significant relationship was found between the presence of radiolucent lines, osteolysis or cortical hypertrophy with functional results. Implant survival was 88.1% at 13 years. CONCLUSION: The present study shows high survival of LCCK prosthesis in revision surgery. The progressive radiolucencies, were associated with worst clinical outcome.
Assuntos
Artroplastia do Joelho , Prótese do Joelho , Desenho de Prótese , Falha de Prótese , Reoperação , Humanos , Prótese do Joelho/efeitos adversos , Artroplastia do Joelho/métodos , Artroplastia do Joelho/efeitos adversos , Artroplastia do Joelho/instrumentação , Reoperação/estatística & dados numéricos , Feminino , Masculino , Estudos Retrospectivos , Idoso , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Radiografia , Osteólise/etiologia , Osteólise/diagnóstico por imagem , Articulação do Joelho/cirurgia , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/fisiopatologia , AdultoRESUMO
Endobronchial lipoma is a very rare benign tumor. The most frequent clinical presentation is caused by airway obstruction. A computed tomography finding of a homogeneous mass with fat density not enhanced by intravenous contrast material is considered diagnostic of this kind of tumor. The definitive diagnosis is given by bronchoscopy and biopsy. The treatment of choice is endoscopic resection, although open resection is sometimes required. We present a case of endobronchial lipoma that involved the left main bronchus and extended through the bronchial carina. Endoscopic treatment was initially attempted. However, open resection through superior lobectomy with carinal resection and a bronchoplastic procedure were required to avoid left pneumonectomy.