Journal of Orthopaedic Case Reports

INTRODUCTION: Posterior-stabilized (PS) total knee arthroplasty (TKA) prostheses are characterized by an articulation between the polyethylene tibial post and the cam of the femoral component. Tibial post-fractures, traumatic and non-traumatic, are uncommon but catastrophic complications. We report a rare and unusual case of complete atraumatic erosion of the tibial post after PS-TKA. CASE REPORT: We present a case of atraumatic tibial post-failure (complete erosion) in a 73-year-old female after primary TKA...

INTRODUCTION: Subarticular cystic lesions, also known as geodes, present a challenge in the management of patients undergoing primary total knee arthroplasty (TKA). Although multiple treatment options are available for addressing these lesions, uncertainty persists regarding the optimal approach. CASE REPORT: A 58-year-old man with a history of rheumatoid arthritis presented with several years of left knee pain. Evaluation showed severe left knee degenerative osteoarthritis complicated by the presence of a large lateral femoral condyle cyst...

INTRODUCTION: Customized, patient-specific interbody cages have been used in the treatment of spinal neoplasia, degenerative disease, infection, congenital anomalies, and trauma. However, to date, their use has been limited to a single spinal level, and the utility of customized spinal implants in multiple spinal levels remains unclear. In addition, limited studies exist that compare outcomes following fusion and decompression surgery using customized implants to traditional, standard implants...

INTRODUCTION: The concept of sacral epiduroscopic laser decompression (SELD) is based on the introduction of a steerable catheter in the sacral hiatus followed by the insertion of a fiberoptic laser system into the ventral side of the epidural disc space with an epiduroscope. This procedure enables the direct decompression of the ruptured annulus as the laser vaporizes the bulging disc in the herniated part, cauterization of the sinuvertebral nerve, adhesiolysis of structures nearby the nerve root, and irrigation of inflammation with saline and steroids...

INTRODUCTION: We present a case report concerning calcified chondroid mesenchymal neoplasms (CCMN), a novel category of tumors that exhibit chondroid formation and contain fibronectin 1-receptor tyrosine kinase fusions. CASE REPORT: Our report focuses on a 73-year-old female patient who presented with pain in her right hip and gluteal region. Initially, the condition was misdiagnosed as calcific tendinitis based on X-ray imaging. However, a subsequent magnetic resonance imaging (MRI) revealed a solid lobulated mass originating from the right hamstring tendon origin, exhibiting heterogeneously hypointense T1-weighted signal, heterogeneously isointense proton density fat-suppressed signal, and heterogeneous contrast-enhancement compared to skeletal muscle...

INTRODUCTION: Tibial tubercle osteotomy (TTO) is a surgical procedure commonly used. Several local postoperative complications have been identified in the literature, such as early proximal tibial fractures. In exceptional cases, these fractures can occur later in the postoperative period, i.e., after 6 months. The current paper described a case study of this rare delayed complication. CASE REPORT: An athletic 24-year-old military man was admitted to the emergency department following a spontaneous proximal tibial fracture below and arising from the TTO site realized 7 months earlier...

INTRODUCTION: Cervical Pott's constitutes about 10% of all Pott's spine cases. In tuberculous spondylitis, initially there occurs destruction of vertebral bodies and further progression may result in adjacent abscesses, leading to cord compression. Objective is to excise the diseased focus and to provide spinal stability. CASE REPORT: We are presenting 3 rare cases of cervical Pott's spine with epidural collection at multiple levels in the cervical region without significant vertebral body destruction that were followed up for a period of 1 year postoperatively...

INTRODUCTION: The common peroneal nerve (CPN) palsy in military personnel due to chronic exertional compartment syndrome (CECS) is uncommon. There are no previous reports of treatment of this condition with simultaneous CPN and superficial peroneal nerve (SPN) neurolysis and compartment release. CASE REPORT: An 18-year-old military recruit presented with complete CPN palsy after sitting cross-legged for 2 h in training. After 3 months of failed non-operative treatment, a clinical diagnosis of CECS with CPN palsy was made and the patient was treated with simultaneous CPN and SPN neurolysis and release of the anterior and lateral leg compartments...

INTRODUCTION: Calcaneal osteosarcoma is extremely uncommon, accounting for <1% of all osteosarcomas. They typically exhibit swelling and chronic heel pain and are frequently clinically misdiagnosed as traumatic or inflammatory process. CASE REPORT: We report a case of a 19-year-old girl with calcaneal osteosarcoma who initially complained of heel pain that was refractory to analgesic medications over a period of 4 months. CONCLUSION: The case highlights the importance of early diagnosis and management of osteosarcoma in patients with chronic heel pain and also highlights the importance of considering osteosarcoma as a differential diagnosis in adolescents who present with chronic heel pain, despite the rarity of the condition...

INTRODUCTION: COVID-19 pandemic created extreme pressure situation on health care services across the globe with shortage of medical staff and beds. The management of fragility fracture also affected significantly. The distal radius fractures (DRFs) are one of the common frailty fractures. There was a significant shift in the treatment of such injuries with new guidelines leaning toward more of non-operative management. CASE REPORT: A retrospective cross-sectional study of DRFs (DRF) treated during COVID pandemic for a period of 1 year in the United Kingdom...

INTRODUCTION: Isolated hamate dislocation is a rare case with potentially devastating complications, given the resultant instability of the carpus following the injury. This has been reported in the literature before with varying constructs and varying results but never with an internal bracing construct and early rehabilitation. CASE REPORT: A 26-year-old male injured his left hand in an all-terrain vehicle accident. After initial misdiagnosis and subsequent persistent pain, he was diagnosed with a chronic dorsal hamate dislocation...

INTRODUCTION: Permanent resection or excision arthroplasty of the knee involves the removal of any infected prosthetic material and thorough debridement, with no further reimplantation. The more common alternatives to permanent resection arthroplasty include knee arthrodesis or above-knee amputation (AKA). CASE REPORT: We describe two cases of complex periprosthetic infections of the knee associated with subsequent osteomyelitis, which were unsuitable for re-revision arthroplasty...

INTRODUCTION: Aggressive fibromatosis (AF) is a fibroblastic locally aggressive neoplasm arising from the musculoaponeurotic stroma and has no metastatic potential. The high tendency of recurrence despite complete surgical resections makes the management of the condition onerous. It can result in significant morbidity with major functional loss due to the destruction of adjacent vital structures and organs. AF with hip flexion contracture is a very rare occurrence. CASE REPORT: A 20-year-old male presented with recurrent abdominal AF with severe hip flexion contracture and an unresectable tumor...

INTRODUCTION: The evolution of prosthesis design has increased the frequency of RTSA procedures across various indications. This rise in surgeries has also led to a growing number of associated complications. This case report highlights an unusual occurrence: a mechanical failure of a RTSA at the humeral stem tray. CASE REPORT: A 55-year-old male patient was admitted to our hospital with a sharp pain after 2 years of his initial reverse total shoulder arthroplasty (RTSA) surgery...

INTRODUCTION: Fungal infection of the musculoskeletal system is very rare. We present a rare case of fungal infection in the ankle joint. Skeletal phaeohyphomycosis (PHM) has been reported only once before in the literature. CASE REPORT: A 56-year-old man presented with pain and swelling in his right ankle for 2 years. There was a diffuse swelling over the medial and lateral aspect of the ankle with restricted movements. Arthroscopic biopsy was done from the ankle and histopathological examination showed pigmented fungi with few phagocytosed fungal hyphae within multinucleated giant cells indicating PHM...

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...

INTRODUCTION: There is interest in partial exchange for infected total hip arthroplasty, as an alternative to complete removal of components in a traditional two-stage revision. Partial exchange avoids the difficulty of removing a well-fixed component and its associated bone loss. CASE REPORT: We report a case of a 61-year-old male patient with an infected total hip arthroplasty, who underwent a two-stage partial exchange, with retention of the well-fixed femoral stem, and an interim cemented liner...

INTRODUCTION: Humerus shaft fractures account for 3% of all adult fractures. Union rate after surgical management is around 84-97% with no difference between compression plating and intramedullary (IM) nailing. Non-union of humeral shaft fracture is not unusual complication of both conservative and operative treatment. IM nailing has been known to have several benefits from its relative stability with minimal soft-tissue dissection but with drawbacks such as less perfect reduction with higher risk of distraction, inability to take down interpositional tissue, risk of radial nerve injury and technical difficulty to pass guide wire and locking of nail...

INTRODUCTION: Hemangiomas are common benign vascular tumors. Intramuscular hemangioma is a very rare type of hemangioma occurring in the skeletal muscle. The lower limb muscles are more likely to be affected. The location within the muscles of the forearm is extremely rare. CASE REPORT: We present three cases of intramuscular hemangioma of the upper limb. Magnetic resonance imaging (MRI) revealed a vascular tumor within the pronator teres muscle in two cases and the extensor pollicis brevis muscle in the other...

INTRODUCTION: Spinal tuberculosis (STB) accounts for 1% of all tuberculosis (TB) cases and 50% of skeletal TB. The classic presentation is a paradiscal involvement leading to the destruction of bodies, progressive kyphosis that can end with neurological weakness. The advent of magnetic resonance imaging (MRI) has made detection early but at the same time, we find multilevel involvement which can be continuous/noncontinuous. CASE REPORT: A 26-year-old male, non-alcoholic, non-smoker presented with complete paraplegia involving the bladder and bowel...