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The classic: On loose bodies in the joint. 1887.

ABSTRACT: This Classic Article is a translation of the original work by Franz König, "Ueber freie Körper in den Gelenken" [On loose bodies in the joint]. Dtsch Z Chir. 1887;27: 90-109. available at DOI 10.1007/s11999-013-2824-y (Translated by Drs. Richard A. Brand and Christian-Dominik Peterlein). An accompanying biographical sketch of F. König is available at DOI 10.1007/s11999-013-2823-z . A PDF of the original German is available as supplemental material. (ED Note: An attempt has been made to preserve some of the original wording while placing the material in a contemporary context. In some cases the author's original intent was obscure.).

SUBMITTER: Konig F

PROVIDER: S-EPMC3586001 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Arthroscopic removal of loose bodies in synovial chondromatosis of shoulder joint, unusual location of rare disease: A case report and literature review.

Project description:IntroductionSynovial chondromatosis is a benign mono-articular arthropathy affecting synovial joints. It mostly affects knee joint, followed by hip, elbow and wrist and is rarely reported for shoulder joint. The exact pathogenesis is not known. Usual symptoms are pain, difficulty in movement due to mechanical obstruction. The classic treatment is arthrotomy, removal of chondromatoid loose bodies and synovectomy. With recent advances arthroscopic removal of the chondromatoid loose bodies is a good option with relatively better post op rehabilitation and faster recovery.Case presentation20 years old gentleman presented to clinic with history of pain in right shoulder for 2 years and decreased range of motion. There was no history of trauma or fever. Work up done and diagnosed with synovial chondromatosis. Arthroscopic removal of chondromatoid loose bodies and synovectomy was done. More than 120 loose bodies were removed. On two (2) years follow-up patient is pain free and having full range of motion at right shoulder joint.DiscussionSynovial chondromatosis is rare in shoulder joint. The Primary synovial chondromatosis of unknown etiology, and secondary synovial chondromatosis due to degenerative joint disease. Classic treatment is arthrotomy and synovectomy. With recent advances, arthroscopic removal of loose bodies and synovectomy is also a good option for its treatment. In literature only few cases have been reported treated with arthroscopic removal of loose bodies and synovectomy.ConclusionArthroscopic treatment of synovial chondromatosis is a good option if expertise is available. It causes less surgical trauma, better visualization during surgery, early recovery.

| S-EPMC6297053 | biostudies-literature

Posterior Knee Loose Bodies: Treated by Posterior Knee Arthroscopy.

Project description:The posterior portion of the knee joint, which includes the tibial attachment of the posterior cruciate ligament and the posterior horn of the menisci, has been called a "blind spot" because it is difficult to observe this area under arthroscopy through standard anterior portals. Posteromedial, posterolateral, and posterior transseptal portals have been developed for visualization and instrumentation of the posteromedial and posterolateral compartments of the knee joint.A 57-year-old man presented of persistent left posterior knee pain for 1 year. Radiographs and magnetic resonance imaging showed posterior knee encapsulated loose bodies. The symptoms did not respond to physiotherapy and analgesics. The loose bodies were removed via posterior knee arthroscopy. The symptoms subsided afterward.Lateral portal of the knee allows establishment of the posterolateral portal under endoscopic visualization, and the loose bodies of the posterior compartment of the knee can be effectively removed via the posterior knee arthroscopy.

| S-EPMC5553838 | biostudies-other

The classic: Radiography of the trapeziometacarpal joint. Degenerative changes of this joint. 1936.

Project description:This classic article is a translation and reprint (Appendix 1. Supplemental material is available with the online version of CORR.) from the French of the original article by M. Robert, entitled La radiographie de l'articulation trapézo-métacarpienne. Les arthroses de cette jointure. The original article was published in Société de Radiologie Méd de France, Bulletins.1936;24:687-689. (Reproduced with kind permission of the SFR.).

| S-EPMC3940747 | biostudies-literature

Techniques and Tips to Arthroscopically Remove Prominent and Loose Shoulder Joint Hardware.

Project description:The number of arthroscopic shoulder operations has continued to steadily increase in recent years, with a projection of over 500,000 rotator cuff operations in 2023. Although the incidence of anchor pullout, hardware failure, and aberrant hardware placement is relatively low, this increased volume of shoulder operations has inevitably resulted in a consequent increase in the number of patients who experience such hardware complications. These hardware issues can cause significant pain, limit shoulder function, and cause permanent damage to the shoulder articular cartilage. The described arthroscopic techniques are presented to provide tools and strategies to safely and effectively remove prominent and loose shoulder joint hardware.

| S-EPMC10533940 | biostudies-literature

The use of a ureteric stone basket for removing loose bodies at hip arthroscopy.

Project description:We present the use of a ureteric stone basket for arthroscopic removal of loose bodies from the hip joint. The technique is easy to perform and reduces the time required for loose body retrieval while minimizing the risk of iatrogenic damage to the cartilage surfaces of the joint.

| S-EPMC3834842 | biostudies-other

Virtual non-contrast images calculated from dual-energy CT shoulder arthrography improve the detection of intraarticular loose bodies.

Project description:ObjectiveThis study aims to evaluate the image quality of virtual non-contrast (VNC) images calculated from dual-energy CT shoulder arthrography (DECT-A) and their ability to detect periosteal calcifications and intraarticular loose bodies.Materials and methodsIn 129 shoulders of 123 patients, DECT arthrography (80 kV/140 kV) was performed with diluted iodinated contrast material (80 mg/ml). VNC images were calculated with image postprocessing. VNC image quality (1 = worst, 5 = best), dose parameters, and CT numbers (intraarticular iodine, muscle, VNC joint fluid density) were assessed. Image contrast (iodine/muscle) and percentage of iodine removal were calculated. Two independent readers evaluated VNC and DECT-A images for periosteal calcifications and intraarticular loose bodies, and diagnostic confidence (1 = low, 4 = very high) was assessed.ResultsVNC images (129/129) were of good quality (median 4 (3-4)), and the mean effective dose of DECT-A scans was 2.21 mSv (± 1.0 mSv). CT numbers of iodine, muscle, and VNC joint fluid density were mean 1017.6 HU (± 251.6 HU), 64.6 HU (± 8.2 HU), and 85.3 HU (± 39.5 HU), respectively. Image contrast was mean 953.1 HU (± 251 HU) on DECT-A and 31.3 HU (± 32.3 HU) on VNC images. Iodine removal on VNC images was 91% on average. No difference was observed in the detection of periosteal calcifications between VNC (n = 25) and DECT-A images (n = 21) (p = 0.29), while the detection of intraarticular loose bodies was superior on VNC images (14 vs. 7; p = 0.02). Diagnostic confidence was higher on VNC images for both periosteal calcifications (median 3 (3-3) vs. 3 (3-3); p = 0.009) and intraarticular loose bodies (median 3 (3-4) vs. 3 (3-3); p < 0.001).ConclusionVNC images from DECT shoulder arthrography are superior to DECT-A images for the detection of intraarticular loose bodies and increase the confidence in detecting periosteal calcifications.

| S-EPMC9197803 | biostudies-literature

Endoscopic Removal of Loose Bodies of the Posterior Ankle Extra-articular Space Arising From Flexor Hallucis Longus Tenosynovial Osteochondromatosis.

Project description:Loose bodies of the posterior ankle can occur either at the posterior recess of the ankle or subtalar joint or at the posterior ankle extra-articular space. Loose bodies at the extra-articular space can be a result of tenosynovial chondromatosis of the tendons of the posterior ankle, especially the flexor hallucis longus tendon. Endoscopic removal of loose bodies of the posterior ankle extra-articular space is indicated for symptomatic cases that are not improved by conservative treatment. It is contraindicated if there is active infection at the planned portal sites or the surgeon is not familiar with the technique of posterior ankle endoscopy. Systematic assessment of the different parts of the posterior ankle will minimize the risk of loose body retention.

| S-EPMC5263117 | biostudies-literature

The Classic: A Dissertation Upon Dislocations and Fractures of the Clavicle and Shoulder-Joint. 1894.

Project description: Not available

| S-EPMC3210282 | biostudies-literature

Identification of a rare case of intra-articular osteochondroma manifesting as three loose bodies in a patient with hereditary multiple osteochondromas: A case report.

Project description:Hereditary multiple osteochondromas (HMO) is an autosomal dominant bone disorder characterised by the presence of multiple benign cartilage-capped tumours. Exostosin-1 (EXT1) and EXT2 are the major morbigenous genes associated with HMO, mutations in which are responsible for 90% of all HMO cases. In patients with HMO, osteochondromas arise adjacent to the metaphysis and typically remain in the metaphyseal region of the long bones. Therefore, it is rare for osteochondromas to be identified intra-articularly, although they may manifest as loose bodies. The present study describes a rare case of HMO manifesting as limited flexing range in the right knee joint of a 27-year-old male patient. Computed tomography and magnetic resonance imaging (MRI) revealed three intra-articular osteochondromas located in the intercondylar fossa of the patient's right knee. The intra-articular osteochondromas and protuberant extra-articular osteochondromas around the right knee were resected, resulting in improved right knee function and no postoperative recurrence. Pathological analysis revealed that the intra-articular osteochondromas had a thinner cartilage cap layer than the extra-articular osteochondromas. In addition, genetic analysis of the patient and the patient's mother was conducted. From this, it was determined that a nonsense mutation, c.115G>T (p.E39X) in exon 1 of the EXT1 gene, was the cause of HMO in this case. Thus, it is proposed that osteochondromas with a pedicle within the knee, may tear and become loose intra-articular bodies, resulting in limited joint function and thereby contributing to the progression of HMO.

| S-EPMC4509409 | biostudies-literature

Loose excitation-secretion coupling in astrocytes.

Project description:Astrocytes play an important housekeeping role in the central nervous system. Additionally, as secretory cells, they actively participate in cell-to-cell communication, which can be mediated by membrane-bound vesicles. The gliosignaling molecules stored in these vesicles are discharged into the extracellular space after the vesicle membrane fuses with the plasma membrane. This process is termed exocytosis, regulated by SNARE proteins, and triggered by elevations in cytosolic calcium levels, which are necessary and sufficient for exocytosis in astrocytes. For astrocytic exocytosis, calcium is sourced from the intracellular endoplasmic reticulum store, although its entry from the extracellular space contributes to cytosolic calcium dynamics in astrocytes. Here, we discuss calcium management in astrocytic exocytosis and the properties of the membrane-bound vesicles that store gliosignaling molecules, including the vesicle fusion machinery and kinetics of vesicle content discharge. In astrocytes, the delay between the increase in cytosolic calcium activity and the discharge of secretions from the vesicular lumen is orders of magnitude longer than that in neurons. This relatively loose excitation-secretion coupling is likely tailored to the participation of astrocytes in modulating neural network processing.

| S-EPMC4788586 | biostudies-literature

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