RESUMO
PURPOSE: The objective of this study was to report the clinical results for a patient with a post-traumatic osteoarticular defect of the lateral femoral condyle treated with unicondylar osteoarticular allograft reconstruction. METHOD: We describe the case with a massive osteoarticular loss of the lateral femoral condyle combined with a grade IIIA open distal femoral diaphyesal fracture. The patient underwent unicondylar osteoarticular reconstruction with an allogenic fresh-frozen condyle. RESULTS: There were no complications after the reconstructive procedure. At the five year follow-up, the patient showed a favorable clinical outcome with a full range of motion of the knee joint. Degenerative changes were seen in the graft compartment, but they did not cause serious functional limitations. CONCLUSION: Unicondylar allograft reconstruction appears to be a surgical option for patients who suffer from a post-traumatic distal femoral osteoarticular defect in which only one condyle is absent or severely damaged.
Assuntos
Transplante Ósseo/métodos , Epífises/cirurgia , Fraturas do Fêmur/cirurgia , Fixação Interna de Fraturas/efeitos adversos , Traumatismos do Joelho/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Acidentes de Trânsito , Pinos Ortopédicos , Epífises/lesões , Fixadores Externos , Fraturas do Fêmur/diagnóstico por imagem , Seguimentos , Fixação Interna de Fraturas/métodos , Consolidação da Fratura/fisiologia , Humanos , Escala de Gravidade do Ferimento , Traumatismos do Joelho/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Medição da Dor , Radiografia , Amplitude de Movimento Articular/fisiologia , Recuperação de Função Fisiológica , Reoperação , Medição de Risco , Transplante HomólogoRESUMO
We report a rare case of radial tears in the roots of the posterior horns of both the medial and lateral menisci associated with a chronic anterior cruciate ligament tear. Treatment included an arthroscopic pullout suture combined with anterior cruciate ligament reconstruction. At the 3-year postoperative follow-up, a second-look arthroscopic examination showed the posterior horns of both menisci to be well healed on the tibia. Manual knee laxity tests were negative and no side-to-side difference was detected by a KT-1000 arthrometer. The patient was able to perform outdoor activities without residual symptoms.
Assuntos
Lesões do Ligamento Cruzado Anterior , Ligamento Cruzado Anterior/cirurgia , Traumatismos do Joelho/cirurgia , Meniscos Tibiais/cirurgia , Lesões do Menisco Tibial , Artroscopia , Feminino , Humanos , Traumatismos do Joelho/diagnóstico , Imageamento por Ressonância Magnética , Pessoa de Meia-IdadeRESUMO
Hypoxia/reoxygenation has been incriminated as a major factor in the pathogenesis of ischemia/reperfusion injury in various ischemic diseases such as rheumatoid arthritis (RA). In this study, we have investigated the effect of hypoxia/reoxygenation on the expression of intercellular adhesion molecule-1 (ICAM-1) in synovial fibroblasts and adherence of lymphocytes to synovial fibroblasts. Hypoxia/reoxygenation strongly activated nuclear factor-kappaB (NF-kappaB) in synovial fibroblasts to the levels produced by phorbol 12-myristate 13-acetate and caused lymphocyte hyperadhesiveness to synovial fibroblasts as well as up-regulation of ICAM-1, both of which were completely blocked by a NF-kappaB antagonist (pyrrolidine dithiocarbamate). These results indicate that hypoxia/reoxygenation has a major role in sequestration of inflammatory cells to synovium mediated by the activation of NF-kappaB. Our data suggest that hypoxia/reoxygenation could be an important target for the development of new, therapeutic strategies in RA.