RESUMEN
Isolated patellofemoral osteoarthritis is now recognised to be more common than previously thought. The features and management are reviewed, including the various surgical options in symptomatic patients. The evidence base for managing patellofemoral osteoarthritis is behind that for the tibiofemoral joint. All treatments are based on uncontrolled observational case series, typically retrospectively reviewed. Fortunately the majority of patients with isolated patellofemoral degenerative changes do not need surgical treatment. Those who are symptomatic can usually be successfully treated with weight loss and quadriceps strengthening exercises.
Asunto(s)
Osteoartritis de la Rodilla/diagnóstico , Osteoartritis de la Rodilla/cirugía , Artroplastia de Reemplazo de Rodilla , Cartílago Articular/trasplante , Fémur/anatomía & histología , Fémur/cirugía , Humanos , Articulación de la Rodilla/anatomía & histología , Articulación de la Rodilla/cirugía , Osteotomía , Rótula/anatomía & histología , Rótula/cirugíaRESUMEN
The aim of this comparative study was to examine the potential advantage of the tunnel view radiograph over a series of weight bearing antero-posterior (AP), lateral and skyline radiographs. The study population consisted of 240 subjects with knee pain aged 19 to 93 years. A total of 309 knees had a weight bearing AP in extension, lateral, skyline and tunnel view radiographs. Each radiograph was reported with respect to features related to osteoarthritis, modified from the Ahlback system. Each feature was assessed using the tunnel radiograph alone and then the AP, lateral and skyline views in combination without, and blind to, the information from the tunnel view. On the basis of Bowker's test, the tunnel view was more likely to pick up abnormal intercondylar notch and tibial spine osteophytes but not loose bodies. We conclude that the tunnel view is a valuable addition in the routine assessment of the knee joint in osteoarthritis but not for the diagnosis of loose bodies alone.
Asunto(s)
Rodilla/diagnóstico por imagen , Osteoartritis de la Rodilla/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dolor , Estudios Prospectivos , Radiografía/métodosRESUMEN
The use of a pneumatic tourniquet in total knee arthroplasty has been linked to complications caused by local tissue hypoxia. Fat necrosis is a rare condition that presents as an ill-defined subcutaneous lesion. The clinical features resemble that of a lipoma but histological appearance is characteristic. Ultrasound imaging is helpful in establishing the diagnosis both by sonographic appearance as well as in directing a biopsy if necessary. We present a case of encapsulated fat necrosis caused by the use of a pneumatic tourniquet during total knee arthroplasty.
