A case report of simultaneous tears of the medial and lateral posterior meniscal roots with an intact ACL graft.

INTRODUCTION AND IMPORTANCE: Meniscal root tears are defined as soft-tissue and/or osseous injuries that rip or avulse within one centimeter of the meniscal insertion to the tibial plateau. These injuries impact around 100,000 patients a year and make up 10 % to 21 % of all meniscal tears. Meniscal extrusion frequently happens when there are root rips, and the transmission of circumferential hoop loads is hampered. CASE PRESENTATION: We present one case of a 28-year-old male who complained of pain and stiffness in his left knee since 2 years after undergoing ACL reconstruction using a hamstring autograft. His examination revealed joint line tenderness on both the medial and lateral sides of the left knee. Further investigations involving X-ray and MRI established the diagnosis of both medial and lateral meniscal root tears, which were surgically managed using the transtibial pullout technique. DISCUSSION: The biomechanical implications of meniscal root tears, such as loss of hoop forces and increased tibiofemoral contact pressures, underscore the importance of timely diagnosis and management. The literature advocates surgical treatment for managing root tears, as leaving them without surgical intervention can lead to functional outcomes similar to those of total meniscectomy. CONCLUSION: This case report presents both menisci posterior root tears with an intact ACL graft which is unique in that they commonly tear in conjuction with ACL. These kind of injuries necessitates prompt diagnosis and surgical intervention to protect the knee from early arthritic changes.

Congenital absence of the lateral meniscus: A case report.

BACKGROUND: Congenital absence of the menisci is a rare anatomical variation characterized by the absence or underdevelopment of one or both menisci in the knee joint. The menisci are crucial in load distribution, joint stability, and shock absorption. Understanding the clinical presentation, diagnosis, and management of this condition is important for optimal patient care. CASE SUMMARY: A 27-year-old male with a long-standing history of knee pain underwent diagnostic arthroscopy, revealing a congenital absence of the meniscus. The patient's clinical findings, imaging results, surgical procedures, and pertinent images are detailed. This case presents a unique aspect with the congenital absence of the meniscus, contributing valuable insights to the literature on rare anatomical anomalies. CONCLUSION: This case of congenital absence of the menisci highlights the diagnostic challenges posed by rare anomalies. The diagnostic arthroscopy played a crucial role in identifying the absence of the meniscus and providing an explanation for the patient's persistent knee pain. The case underscores the importance of individualized treatment approaches, including physical therapy, for optimal management of rare meniscal anomalies. Further research is warranted to explore effective management strategies for the aforementioned cases and to expand our knowledge of these rare conditions.

The incidence of adhesive capsulitis and COVID-19 pandemic effect.

Background: There are multiple pieces of evidence in the literature that coronavirus disease 2019 (COVID-19) has a pronounced effect on physiological health. There is little existing literature that has studied the pandemic's impact on adhesive capsulitis (AC) incidence. This study aimed to compare the incidence of primary AC before and during the pandemic. Methods: A retrospective cohort study was done to establish the incidence of primary AC during the COVID-19 pandemic, from March 2020 to March 2021, the pandemic period, and from March 2019 to March 2020, the control period. During these periods, all patients diagnosed with primary AC were included. Patients were also categorized into three different treatment groups according to corticosteroid injection status (none, 1 injection, and 2 injections). The waiting time for the appointment was calculated as a possible confounding factor. Statistical analysis used the chi-square for categorical variables and the Student t test for continuous variables. Results: There were 69 patients diagnosed with primary AC out of 704 new referrals during the pandemic. One year earlier, a total of 73 patients were diagnosed with primary AC out of 1148 new referrals. Representing a relative increase of 3.5% (P = .086) in the incidence of primary AC. No significant differences were found between the control and the pandemic groups in regard to the distribution of patients per treatment group (P = .13), age (P = .49), sex (P = .21), laterality (P = .54), diabetic disease (P = .45), and thyroid disease (P = .62). Conclusion: There was a nonstatistically significant increase in the incidence of primary AC during the COVID-19 pandemic. No other significant differences were found. Further research is still needed to evaluate the relationship between the COVID-19 pandemic and AC.

Aneurysmal bone cyst of the clavicle: A case report.

INTRODUCTION: An aneurysmal bone cyst (ABC) is a locally aggressive primary bone neoplasm. ABC of the clavicle is rare with only a few reported cases in the literature. PRESENTATION OF CASE: We report the case of a 10-year-old boy who presented with an ABC at the right acromial end of the clavicle. The patient underwent intralesional curettage and allogenic bone grafting. Moreover, the patient's arm was placed in a sling for 2 weeks postoperatively. The patient had a satisfactory outcome after 11 years, with excellent Toronto Extremity Salvage, Quick-Dash, and Musculoskeletal Tumor Society scores. DISCUSSION: Clavicular ABCs are uncommon. Early diagnosis helps to prevent pathological fractures. Adjuvant therapies might help decrease recurrence. CONCLUSION: ABC should be considered an important differential diagnosis for clavicular swelling and masses. The best results can be achieved using curettage and void-filled bone grafts.

Conservative treatment of processus vaginalis hernia in two peritoneal dialysis patients.

Dialysate leakage represents one of the major noninfectious complications of peritoneal dialysis (PD). In some instances, dialysate leakage may lead to discontinuation of the technique. Despite its importance, the incidence, risk factors, management, and outcome of dialysate leakage are poorly characterized in the literature. Here, we report two PD patients who presented with painless scrotal swelling. Computerized peritoneography confirmed the diagnosis of processus vaginalis hernia that was treated conservatively.