Introduction: Synovial chondromatosis is a rare benign entity with the presence of cartilaginous or osseous loose bodies in the synovium. It commonly involves the larger joints such as the knee, hip, ankle and rarely the shoulder joint manifesting with pain, swelling, and restriction of movements. The treatment of choice is surgical intervention in symptomatic patients using either the open or the arthroscopic approach.
Case Report: Here, we report a rare case of synovial chondromatosis affecting the right shoulder joint in a 23-year-old male with a 5-year disease duration who presented with progressive pain and restriction in movements which were impacting his routine activities. The loose bodies were removed using the arthroscopic approach combined with a partial synovectomy, and intra-articular methylprednisolone post procedure. The patient showed an excellent recovery in joint mobility within 4 weeks post-operatively, and there were no clinical signs of recurrence during a 6-month follow-up period.
Conclusion: We believe that arthroscopic surgery is effective in the treatment of patients with synovial chondromatosis with advantages such as good visualization, lesser morbidity, and early return of functional activities.
Keywords: Synovial chondromatosis, loose bodies, arthroscopy.
Introduction: Infected non-union of the tibia is difficult to manage due to problems like osteomyelitis, soft tissue distortion, draining sinuses, demineralization of bone, joint stiffness, and multidrug-resistant polybacterial infection. Material and Methods: We report the outcome of 18 patients (16 males and 2 females) of infected nonunion tibia treated with the Limb reconstruction system. The causes were open fracture in 15 cases and infection following internal fixation in 3 cases. We assessed the limb reconstruction system in the management of infected non-union of the tibia in terms of, union rate, control of infection, and associated complications. The assessment parameters were based on the Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria. Result: 88% were male and 11% were female, mean age was 32 ±9. The mean bone gap was 3.1±1.0. Draining sinus was present in 10 (55.6%) of the patients. Corticotomy and fibula osteotomy was performed in 14 (77.8%) of the patients. Bony union was seen in 17 (94.4%) of the patients. The mean time of union was found to be 9.7±1.7 months. The mean limb length discrepancy was 1.1±0.6 cm. Deformity angle of less than 7 degrees was present in 16 (88.9%).15 (83.3%) patients had excellent ASAMI bone scores and the remaining 02 (11.1%) had a good score. One patient in which the union was not observed had a poor score. For the functional component, 12 (66.7%) had an excellent score, 05 (27.8%) had a good score and 01 (5.6%) with non-union of the tibia bone was found to have a poor score. Conclusion: Limb reconstruction system is easy to perform, has predictable healing for infected nonunion, has a short learning curve, ensures compliance in patients, and provides reliable results with lesser complications.
The shoulder joint is the most common joint to undergo dislocation, with the anterior subtype being the most common. The most accepted definition of chronic dislocation is a shoulder joint that has remained dislocated for a minimum of three weeks. Due to rare presentation, there is a lack of consensus among surgeons regarding the optimal management option of chronic shoulder dislocation. The goal of this prospective study was to assess the efficacy of open reduction with Latarjet procedure in the management of chronic unreduced shoulder dislocation. A total of seven patients were included in this study. Five patients were males and two were females. The study was conducted in a single tertiary care centre between July 2015 and May 2018. All patients were managed by open reduction with the Latarjet procedure. The capsulolabral structures were repaired in all the cases. The post-operative functional outcome was assessed by shoulder range, Rowe score, and the University of California, Los Angeles (UCLA) score at regular intervals for a period of one year. There was a significant improvement in terms of pain relief and functional status of the patients. The patients were satisfied as they could do their daily routine activities without pain at a one-year follow-up. Early post-operative rehabilitation and physiotherapy are key to improving the functional range.
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