Giant Cell Tumor as a Rare Cause of Loose Bodies in the Knee Joint - A Case Report.

Introduction: Loose bodies in the knee joint are relatively common and the common causes are transchondral fractures, synovial chondromatosis, osteochondritis dissecans, meniscal injury, and osteoarthritis. Neoplastic growths from synovium have been reported to have presentations mimicking loose bodies or meniscus tears. Case Report: We report the case of an unusual cause of loose body in the knee joint of a 35-year-old male who reported for follow-up 3 years after the surgical management of giant cell tumor (GCT) of the distal femur. He had symptoms of loose bodies in the joint without any complaint specific to the operative site. Imaging revealed loose bodies within the joint which were removed arthroscopically. Histopathology showed the loose bodies as GCT. The patient had relief of symptoms after removal and the patient has no evidence of recurrence at the primary site or in the knee joint. Conclusion: GCTs should be considered a cause of loose bodies in the joint when there is a neighboring bone affected by GCT and all such loose bodies removed should undergo histopathological examination.

Posterior Cruciate Ligament Avulsion with Posterior Tibial Rim Fracture: A Case Report.

Introduction: Posterior cruciate ligament (PCL) avulsion fractures are the most common type of isolated PCL injuries. Avulsion from the tibia is more common than femoral attachment. They can present as isolated tibial avulsion or as a component of posterior tibial rim fractures. The size, geometry of the fragment, and associated ligamentous injury dictate the method of fixation. Case Report: A 32-year-old patient presented with posterior rim tibial plateau fracture with PCL avulsion after a motor vehicle accident. We used Burke and Schaffer approach and fixed the ligamentous avulsion and rim fracture using high tensile sutures and knotless swivel lock anchors. Conclusion: PCL avulsions can present either as an isolated injury or as a part of a complex injury involving the anterior or posterior tibial rim. These complex injuries occur due to the hyperextension mechanism which results in either anterior tibial plateau compression fracture or posterior rim avulsion injuries. The treatment of such injuries requires addressing both ligamentous and bony components. The size, geometry of the fragment, and associated ligamentous injury dictate the method of fixation. We described the fixation of both ligamentous and rim avulsion using sutures and knotless anchors.

Bone Grafting of the Bone Defects after Harvesting the Bone Patellar Tendon Bone Graft - A Novel Surgical Technique.

Introduction: The anterior knee pain is the most common post-operative complaint associated with anterior cruciate ligament reconstruction (ACLR) using bone patellar tendon bone graft. It has been attributed to various factors such as loss of terminal extension, infrapatellar branch neuroma, and also due to the bone harvest site defect itself. Bone grafting of the defects in the patella and tibia has been shown to decrease anterior knee pain. At the same time, it also prevents post-operative stress fractures. Surgical Technique: Numerous bone pieces were produced in the knee joint as a result of the drilling during ACL reconstruction. Using a wash cannula and tissue grasper, all the bone fragments were gathered into a kidney tray. The bony fragments with the saline which were collected in the metal container were allowed to sediment at the bottom. The bone that was sedimented in the metal container was collected by decantation and placed into the bony defects of the patellar and tibial sides. Conclusion: Bone grafting of the defects in the patella and tibia has been shown to decrease anterior knee pain. Our technique is cost-effective as there is no requirement for special instrumentation like coring reamers, and no requirement for allograft or bone substitutes. Second, there is no morbidity associated with autografts harvested from elsewhere, we used the bone generated during the ACLR itself.