Tumors of the Patella: The Experience of Institute of Orthopedics and Traumatology at University of São Paulo, Brazil

Abstract

Objective: To obtain epidemiological data from the tumors of the patella diagnosed and treated at the Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Universidade de São Paulo (IOT-HC-FMUSP) between 1998 and 2015.Methods: Series of cases with retrospective evaluation of patients diagnosed with tumors located in the patella. The data was obtained from the records and patients' charts at the Department of Pathology of IOT-HC-FMUSP.Results: A total of 2220 medical records from patients with anatomopathological reports were included in the study. Only eight (0.3%) patients had patellar tumors. We found that six (75%) of these were benign, one (12.5%) was a pseudotumoral lesions and one (12.5%) was reported as malignant. Among benign tumors, the giant cell tumor (GCT) was the most frequently reported corresponding to 50% of the cases. Hemagioendothelioma was the only case of malignant tumor in this series. As for the pseudotumoral lesions, we found a brown tumor.Conclusion: From the data obtained retrospectively in a 17 year time frame, in a service that treats benign, malignant and pseudotumoral bone lesions, we conclude that our casuistry in patellar tumors is similar to that reported in scientific literature, where benign tumors are predominant in a 7:1 ratio over malignant tumors, being a rare location of appearance, with the GCT as the most common diagnosis . Level of Evidence IV, Case Series.

Reconstruction of the extensor mechanism using polypropylene mesh in a displaced pathological fracture of the patella affected by giant cell tumour

“…To further enhance extensor strength, a rotational gastrocnemius flap or a reverse iliotibial band flap may be employed. In the other levels, the reconstruction of the extensor mechanism can be achieved through various methods such as allografts, rotation flaps, free fascial grafts or synthetic mesh 7–10 14–16. Regarding the allograft types, fresh frozen allografts possess greater strength and exhibit a higher likelihood of immune response compared with freeze-dried allografts.…”

“…This task is critical due to the extensive soft tissue damage, the risk of tumour recurrence and the goal of restoring function 4 5. Various methods, including autograft, allograft, rotational flaps and more recently, polypropylene mesh, have been employed with success 3–8. However, autografts may be insufficient, allografts carry risks of disease transmission and are often scarce, and local flaps require considerable surgical skill and come with the issue of donor site morbidity.…”