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Ewings sarcoma of patella:A rare entity treated with a novel technique of extensor mechanism reconstruction using tendoachilles auto graft

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World Journal of Orthopedics 2015年第9期6卷 744-749页

作者： rejith mannambeth valsalan Balaji Zacharia Department of Orthopaedics Govt. Medical College

We report a case of Ewings sarcoma(ES) involving the patella in a young female. ES of patella is a rare entity. The patient was presented with anterior knee pain and swelling arising from the patella. She was treated with neoadjuvant chemotherapy followed by wide excision of the patella and reconstruction of the extensor mechanism using split tendoachilles auto graft. The patella is an uncommon site for primary or metastatic tumors of the bone. ES, though rare, should be included in the differential diagnosis of swellings arising from the patella. Auto graft from the tendoachilles is a good alternative for reconstructing the extensor mechanism of the knee.

关键词： Patellar tumor Tendoachilles auto graft Extensor mechanism repair Ewing sarcoma CD99

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Computerised tomography vs magnetic resonance imaging for modeling of patient-specific instrumentation in total knee arthroplasty

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World Journal of Orthopedics 2015年第2期6卷 290-297页

作者： Paul Stirling rejith valsalan mannambeth Agustin Soler Vineet Batta Rajeev Kumar Malhotra Yegappan Kalairajah Department of Orthopaedic Surgery Luton and Dunstable University Hospital Catterall Unit Royal National Orthopaedi Hospital University College of Medical Sciences

AIM: To summarise and compare currently available evidence regarding accuracy of pre-operative imaging, which is one of the key choices for surgeons contemplating patient-specific instrumentation(PSI) ***: The MEDLINE and EMBASE medical literature databases were searched, from January 1990 to December 2013, to identify relevant studies. The data from several clinical studies was assimilated to allow appreciation and comparison of the accuracy of each modality. The overall accuracy of each modality was calculated as proportion of outliers > 3% in the coronal plane of both computerised tomography(CT) or magnetic resonance imaging(MRI). RESULTS: Seven clinical studies matched our inclusion criteria for comparison and were included in our study for statistical analysis. Three of these reported series using MRI and four with CT. Overall percentage of outliers > 3% in patients with CT-based PSI systems was 12.5% vs 16.9% for MRI-based systems. These results were not statistically significant. CONCLUSION: Although many studies have been undertaken to determine the ideal pre-operative imaging modality, conclusions remain speculative in the absence of long term data. Ultimately, information regarding accuracy of CT and MRI will be the main determining factor. Increased accuracy of pre-operative imaging could result in longer-term savings, and reduced accumulated dose of radiation by eliminating the need for post-operative imaging and revision surgery.

关键词： Patient-specific instrumentation Arthroplasty Alignment Accuracy Cost-effectiveness

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