1
|
Chhajed BB, Mehta MA, Prajapati A. A Novel and Effective Surgical Technique for Reconstruction of Extensor Mechanism with Iliotibial Band Tendon Graft After Patellectomy for Primary Patella Tumor. Indian J Orthop 2024; 58:1310-1315. [PMID: 39170664 PMCID: PMC11333392 DOI: 10.1007/s43465-024-01190-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/22/2024] [Indexed: 08/23/2024]
Abstract
Background Amongst primary patella tumor Campanacci grade 3 tumor of Giant cell tumor of bone (GCTB) and malignant tumors requires patellectomy. We had a patient with huge recurrent GCTB of patella with involvement of skin. We reconstructed extensor mechanism of Knee with long iliotibial band (ITB) tendon graft. Material and Methods After patellectomy, we harvested long ITB graft (length 22 cm; width proximally 6 cm, distally 1.5 cm) through patellectomy wound and small "L" shaped incision proximally. We passed ITB graft from patella tendon and quadriceps tendon in figure of 8 manner and sutured it back to itself and host tendon with fiber Wire and closed both the wounds primarily. We started ROM and quadriceps strengthening in graded manner. We measured functional outcome with Musculoskeletal Tumour Society (MSTS) scoring system. Results There were no post-operative complications. At 10 weeks follow up, patient had no extension lag and knee ROM was 90°. At final follow up of 7 months patient regained pre-operative functional status without knee instability. Her MSTS score was 30 and she was disease free. Conclusion Reconstruction of extensor mechanism of knee with ITB graft doesn't have donor site morbidity and gives excellent function with graded physiotherapy protocol.
Collapse
Affiliation(s)
| | - Milind A. Mehta
- Dr. Jivraj Mehta Smarak Health Foundation, Bakeri Medical Research Centre, Dr Jivraj Mehta Marg Paldi, Ahmedabad, Gujarat India
| | - Ashwin Prajapati
- Dr. Jivraj Mehta Smarak Health Foundation, Bakeri Medical Research Centre, Dr Jivraj Mehta Marg Paldi, Ahmedabad, Gujarat India
| |
Collapse
|
2
|
Zheng W, Li H, Hu K, Li L, Bei M. Chondromalacia patellae: current options and emerging cell therapies. Stem Cell Res Ther 2021; 12:412. [PMID: 34275494 PMCID: PMC8287755 DOI: 10.1186/s13287-021-02478-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/22/2021] [Indexed: 01/08/2023] Open
Abstract
Chondromalacia patellae (CMP), also known as runner’s knee, typically occurs in young patients, which is characterized by anterior knee pain (AKP) that is associated with visible changes in patellar cartilage. The initial pathological changes include cartilage softening, swelling, and edema. CMP is caused by several factors, including trauma, increased cartilage vulnerability, patellofemoral instability, bony anatomic variations, abnormal patellar kinematics, and occupation hazards. CMP may be reversible or may progress to develop patellofemoral osteoarthritis. Quadriceps wasting, patellofemoral crepitus, and effusion are obvious clinical indications. Additionally, radiological examinations are also necessary for diagnosis. Magnetic resonance imaging (MRI) is a non-invasive diagnostic method, which holds a promise in having the unique ability to potentially identify cartilage lesions. Modalities are conventionally proposed to treat cartilage lesions in the PF joint, but none have emerged as a gold standard, neither to alleviated symptoms and function nor to prevent OA degeneration. Recently, researchers have been focused on cartilage-targeted therapy. Various efforts including cell therapy and tissue emerge for cartilage regeneration exhibit as the promising regime, especially in the application of mesenchymal stem cells (MSCs). Intra-articular injections of variously sourced MSC are found safe and beneficial for treating CMP with improved clinical parameters, less invasiveness, symptomatic relief, and reduced inflammation. The mechanism of MSC injection remains further clinical investigation and is tremendously promising for CMP treatment. In this short review, etiology, MRI diagnosis, and treatment in CMP, especially the treatment of the cell-based therapies, are reviewed.
Collapse
Affiliation(s)
- Weitao Zheng
- Hubei Provincial Key Laboratory of Industrial Microbiology, Sino-German Biomedical Center, National "111" Center for Cellular Regulation and Molecular Pharmaceutics, Hubei University of Technology, Wuhan, 430068, Hubei Province, China.,Shanxi Yinmei Technology Co., Taiyuan Economic and Technological Development Zone, Room 301, No. 8, East Street, Taiyuan, China
| | - Hanluo Li
- Hubei Provincial Key Laboratory of Industrial Microbiology, Sino-German Biomedical Center, National "111" Center for Cellular Regulation and Molecular Pharmaceutics, Hubei University of Technology, Wuhan, 430068, Hubei Province, China
| | - Kanghong Hu
- Hubei Provincial Key Laboratory of Industrial Microbiology, Sino-German Biomedical Center, National "111" Center for Cellular Regulation and Molecular Pharmaceutics, Hubei University of Technology, Wuhan, 430068, Hubei Province, China
| | - Liming Li
- Shanxi Yinmei Technology Co., Taiyuan Economic and Technological Development Zone, Room 301, No. 8, East Street, Taiyuan, China
| | - Mingjian Bei
- Department of Orthopedic Surgery, Emergency General Hospital, Xibahenanli29, Chaoyang dis, Beijing, 100028, China.
| |
Collapse
|