Giant Loose Body of Knee Joint Presenting as Accessory Patella<br/>—A Case Report

Abstract

Loose bodies are freely floating fragments of cartilage or bone inside the knee joint space. This is commonly seen in association with degenerative joint disease (DJD), direct or indirect trauma, synovial chondromatosis, osteochondritis dissecans (OCD) and size of the loose body may vary from few millimeters to few centimeters. Patients with loose bodies in knee joint presented to orthopaedists with knee pain, swelling and restricted movement, with intermittent locking or catching of the joint. This is managed surgically most of the times when it becomes symptomatic. The surgical technique most commonly utilized is arthroscopy. Open arthrotomy should be done when the loose bodies are very large/numerous/located in posterior joint space. In review of literature, we found very few cases of giant loose body in knee joint due to DJD reported in last 70 years. We are hereby reporting our case of 60-year-old male with a giant loose body of same size as of patella in the supra-patellar pouch of left knee joint and managed by arthrotomy to remove the giant loose body. Post-operatively patient recovered significantly over the period of 6-week follow-up. In conclusion, giant loose body should be removed through arthrotomy and all such cases should be thoroughly evaluated to diagnose the cause of giant loose body.

Giant loose body of knee joint in a case of osteoarthritis knee: A case report and review of literature

“…Unstable ones are free floating and therefore, present with symptoms. Small loose bodies are not clinically evident whereas the larger ones are usually difficult for the patient [6] . On the basis of pathology, they can be cartilaginous (articular cartilage trauma), fibrinous (bleeding in the joint or a tissue trauma) or osteo cartilaginous (e.g.…”

“…For loose bodies associated with osteoarthritis, maximum articles have reported small sized loose bodies which are easily removed by arthroscopic techniques. Only one article has reported a giant loose body presenting as an accessory patella which was removed by arthrotomy [6] .…”