Knee arthroscopy may be called the most commonly and increasingly performed orthopaedic procedure. Posterior medial compartment visualization may be quite challenging. The aim of the present study is to detect objective measurement of medial joint space widening with percutaneous “pie crust” release of medial collateral ligament (MCL) during knee arthroscopy. We used this technique for all knees that require any intervention in the posteromedial compartment and for tight knees in which adequate visualization of the posteromedial compartment cannot be obtained. Eighteen patients (18 knees) were included in this study. Patients were evaluated clinically with the Lysholm and Tegner scores at the final office visit. Joint balance, valgus instability, pain or tenderness on MCL region, and numbness over the medial side of the joint were also noted. Measurements of medial joint space (mm) were obtained at three different times with perioperative C-arm images: normal, controlled valgus force, and after pie crusting. The median follow-up time was 9 (6–12) months. Final follow-up Lysholm (p < 0.05) and Tegner scores (p < 0.05) increased significantly compared with preoperative scores. At the final follow-up, there was no pain or tenderness over MCL and there were no signs of saphenous nerve or vein injury. Medial joint space values in after pie crusting increased significantly (p < 0.05) compared with neutral position measurements and controlled valgus force application (p < 0.05). Controlled release of the MCL in knees provided ∼2.45 times wider visualization place. Furthermore, pie crusting of MCL is a safe and effective technique that provides enough space for visualization and instrumentation in knees. This is a Level IV study.
Our results indicate that the Ilizarov method allows effective restoration of bone defects in the treatment of bone tumors despite various disadvantages.
When children present for evaluation of bone tumor, great anxiety often occurs among the family. Usually the diagnosis of a benign bone tumor can be made easily with plain radiographs without biopsy. Most have a good outcome. However, occasionally, serious complications can develop. Moreover, the physician must be aware of the possibility of the malignant tumors. To avoid errors in the evaluation and treatment of this heterogeneous group of tumors, the clinician should have a good knowledge base of common bone neoplasms and correlate the clinical, radiographic, and pathologic findings. In this article, history, diagnosis, evaluation, treatment, and management of common types of benign tumors of bone commonly seen in children and adolescents are reviewed in the light of current literature.
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