Background: Chondral and osteochondral injuries of the knee joint are undervalued in subjects undergoing orthopedic surgery. Chondral lesions are difficult to diagnose as they do not present specific clinical signs. The objective of the study was to establish the prevalence of cartilage injuries in patients undergoing arthroscopy of the knee for knee pain or instability. Materials and methods: A retrospective study was conducted on 355 consecutive knee arthroscopies. Chondral lesions were found in 247 (69.6%) cases. Regarding their location, chondral lesions were more likely to be located on the medial femoral condyle (53.8%), while lesions on the lateral femoral condyle alone (0.8%) were the least frequent ones. Chondral injuries were frequently found with associated articular findings such as meniscal lesions (56.68%) and anterior cruciate ligament tears (2.84%) or both menisci and anterior cruciate ligament tear (15.38%). The ICRS grade II cartilage lesions were most frequently diagnosed (56.3%) while grade IV was the least frequent type (6.9%). Conclusions: Chondral damage is frequently diagnosed during knee arthroscopy, present in more than 50% of the arthroscopies performed for various indications, and an important part of cartilage injuries were linked with other intraarticular findings, such as anterior cruciate ligament tear and medial meniscus tear.
Elbow arthroplasty is very successful in terms of pain relief, motion and function. Indications include posttraumatic osteoarthritis, acute distal humerus or proximal forearm fractures, and many others. With the present article, the authors would like to present the case of a patient who underwent total elbow arthroplasty following a car crash which resulted in the following conditions: IIIC type distal humerus open fracture, IIIC type proximal forearm open fracture, and multiple other lesions. Immediate surgical care consisted of primary wound correction and external fixation of the bones and secondary wound correction was practiced. A few months later the patient underwent total elbow arthroplasty. One year after the accident, following rigorous physical therapy, the patient has regained 45% of nerve function, 70% of muscle function and now can lead a relatively normal life. He can drive a car and use his elbow in daily activity. Although replacement arthroplasty was initially used mainly in patients with inflammatory arthritis, its indications were expanded to other conditions, which place higher demands on the implants and seem to lead to higher failure rates, but an elbow arthroplasty is a good option in complicated open fractures if we have a multidisciplinary team and the time of surgery is opportune despite the high failure risk.
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