Objective: To evaluate the functional outcomes after extended curettage and reconstruction using a combination of bone graft and bone cement (sandwich). Methodology: In this prospective case series 16 skeletally mature patients with primary giant cell tumor around the knee were included. Patients with previous surgically treated, malignant transformation, degenerative knee changes and those presenting with pathological fracture were excluded. The tumor was excised with bone graft filling space beneath the articular cartilage and a block of gel foam was placed over the cortical surface of picked bone graft. Remaining cavity was filled with polymethylmethacrylate cement (sandwich) with or without internal fixation. The func tional evaluation was done us ing Musculoskeletal Tumor Society (MSTS) Score six months postoperatively and after one year. Schatzker and Lambert Score was used in the last visit to assess the functional outcome Results: The mean MSTS Score was 27.13±3.030 (range, 20-30) and the mean functional arc of motion around the knee was 123.13±12.230 degrees (range, 90–135). According to Schatzker and Lambert Score 75% had excellent results, 12.5% had good results and 12.5% had fair results. Two patients (12.5%) had a recurrence of the tumor, and one (6.25%) developed postoperative fracture in the distal femur. Conclusion: Sandwich reconstruction for giant cell tumor is a good option for definite management and there is improvement in the quality of the patient's life. (Rawal Med J 202;45:637-640).
Background: Peripheral giant cell lesion (PGCL) and central giant cell lesion (CGCL) of the jaws have a distinct clinical behavior.Giant cell tumour (GCT) is a benign locally aggressive neoplasm affects the long bones. Both lesions are characterized histologically by multinucleated giant cells in a background of ovoid to spindle-shaped mesenchymal cells. The WW domain-containing oxidoreductase (WWOX) gene is located at 16q23.1–16q23.2, a region that spans the second most common human fragile site, FRA16D, at 16q23.2.The Ki-67 antigen is a nuclear protein that is associated with and may be necessary for cellular proliferation.Ki-67 protein is present during all active phases of the cell cycle (G1, S, G2, and mitosis), but is absent fr
... Show MoreLocking of the knee is a one of the commonest orthopedic outpatient presentation. This patient usually need magnetic resonance imaging (MRI) when there is suspected lesion in the soft tissue clinically. Meniscal tears is the first differential diagnosis when accompany with painful knee. (1, 2)Giant cell tumor (GCT) is benign a localized nodular tenosynovitis often occur in the tendon sheath , Mostly involve the hand tendons in middle age group between 30 and 50 years old , female affect more than male.(3,4) The WHO defines two well-known kinds of giant cell tumor: (1) pigmented villonodular synovitis ( generalized type), which mainly involve the joints of the lower limb and (2) giant cell tumor of the tendon sheath ( localized type)
... Show MoreLocking of the knee is a one of the commonest orthopedic outpatient presentation. This patient usually need magnetic resonance imaging (MRI) when there is suspected lesion in the soft tissue clinically. Meniscal tears is the first differential diagnosis when accompany with painful knee. (1, 2)
Giant cell tumor (GCT) is benign a localized nodular tenosynovitis often occur in the tendon sheath , Mostly involve the hand tendons in middle age group between 30 and 50 years old , female affect more than male.(3,4) The WHO defines two well-known kinds of giant cell tumor: (1) pigmented villonodular synovitis ( generalized type), which mainly involve the joints of the lower limb and (2) giant cell tumor of the tendon sheath ( localized type)
Abstract 20 patients with osteoarthritis of the knee joint were treated by electrical stimulation in the form of 6 sessions every other day each sessions of diphase fixe (DF) for 4 minutes followed by rest for 4 minutes then treated with a monophase fixe (MF) for 2 minutes. By clinical & statistical analysis ( P value < 0.05) we conclude that the electrical stimulation is effective as one method in the treatment of osteoarthritis.
Background : Knee flexors tightness has been documented in apparently healthy adults and in those with musculoskeletal problems, but the influence of age on the tightness has not been studied in Iraq. This study was therefore designed to determine the influence of age on knee flexors tightness in apparently healthy subjects.Methods: Knee flexors tightness was measured using the active knee extension test (AKET) in 200 apparently healthy male and female subjects, aged 13 to 59 years. The subjects were recruited into 5 age groups using the purposive sampling technique.Knee flexors tightness was compared across the age groups using one-way analysis ofvariance (ANOVA). The independent t-test was used to compare knee flexors tightness on both
... Show MoreGiant Cell Fibroma (GCF) is a relatively rare oral mucosal lesion, so named due to the characteristic giant cells present within the fibrous stroma of the lesion, limited number of clinicopathological studies were performed in previously published literature. This study was performed to evaluate the clinicopathological features of Giant cell fibroma in a sample of Iraqi patients. Formalin-fixed paraffin-embedded sections from 22 giant cell fibroma in period between 2010 and 2018 were retrieved from the laboratory of oral pathology of Baghdad University/College of Dentistry, Clinical data and microscopic features were reviewed and analyzed according to the available surgical reports. The mean age of patients at the time of diagnosis was 29.6
... Show MoreBackground: Knee osteoarthritis (KOA) is a common joint disorder leading to considerable pain and locomotor disability in lower limb function. Locomotor disability, which is difficulty in activities of daily living related to lower limb function, can be the consequence of KOA, so early diagnosis and management may improve quality of life.
Objective: To assess the contribution of radiological osteoarthritis of the knees to disability in the activities of daily living related to lower limb function.
Methods: One hundred twenty Iraqi KOA patients (104 females and 16 males) who were attending to Rheumatology Unit, Full history was taken and complete clinical exami
... Show MoreBackground: The prevalence of deep veins thrombosis, complicating total knee replacement in Asian countries, has not been fully appreciated in comparison to western countries as there are few studies on that. There is an important correlation between the evidence of deep veins thrombosis in the lower extremity and likelihood of pulmonary embolism later one . Because of its noninvasive nature, duplex ultrasound has become one of the initial dependable modality for the cheek out of deep veins thrombosis after total knee replacement . Therefore, this study was designed to evaluate the outcome of asymptomatic after total knee replacement by duplex ultrasound among Iraqi patients.
Methods: This
... Show MoreBackground. Aneurysms of the distal anterior cerebral artery (DACA) are uncommon; they often form near the pericallosal-callosomarginal junction and are typically small. To our knowledge, giant DACA aneurysms developing from the more distant parts of the anterior cerebral artery (ACA), A4-5, have been described only once in the literature. Case description. A 66-year-old gentleman reported with a brief loss of consciousness followed by weakness in his right lower leg. The patient was admitted with a Glasgow Coma Score (GCS) of 15. A computed tomography (CT) scan of the head revealed a left hyperdense mass in the frontal parasagittal supracallosal region. Contrast MRI revealed a heterogeneously enhancing mass measuring 35x30x25 mm. C
... Show MoreBackground: Giant middle cerebral artery (MCA) aneurysms are surgically challenging lesions. Because of the complexity and variability of these aneurysms, a customized surgical technique is often needed for each case. In this article, we present a modified clip reconstruction technique of a ruptured complex giant partially thrombosed middle cerebral artery aneurysm.
Case description: The aneurysm was exposed using the pterional approach. Following proximal control, the aneurysm sac was decompressed. Then, we applied permanent clips to reconstruct the aneurysm neck. The configuration of the aneurysm mandated a tailored clipping pattern to account for resi
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