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Total knee arthroplasty in a patient with ipsilateral calcific myonecrosis.

ABSTRACT: Calcific myonecrosis (CM) is a rare soft tissue condition associated with previous trauma that presents with a large lower extremity mass and can be misdiagnosed as a malignancy. Biopsy, accidental entry, or disturbance to the lesion can be accompanied by a high risk of complications. We present the case of a 72-year-old man with severe post-traumatic knee arthritis, as well as a large pretibial mass consistent with CM, who successfully underwent total knee arthroplasty. To our knowledge, this is the first report focusing on total knee arthroplasty in a patient with CM and we discuss considerations for evaluation, tourniquet usage, component positioning and placement, postoperative care, and range-of-motion expectations.

SUBMITTER: Barron SL

PROVIDER: S-EPMC6287287 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Total knee arthroplasty in a patient with ipsilateral calcific myonecrosis.

Barron Sivana Leigh SL McGrory Brian J BJ

Arthroplasty today 20181103 4

Calcific myonecrosis (CM) is a rare soft tissue condition associated with previous trauma that presents with a large lower extremity mass and can be misdiagnosed as a malignancy. Biopsy, accidental entry, or disturbance to the lesion can be accompanied by a high risk of complications. We present the case of a 72-year-old man with severe post-traumatic knee arthritis, as well as a large pretibial mass consistent with CM, who successfully underwent total knee arthroplasty. To our knowledge, this i ...[more]

PMID: 30560169

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Project description:BackgroundThere is an existing perception that obesity has a negative impact on complications following total knee arthroplasty (TKA). However, data on the impact of obesity levels on patient-reported outcomes (PROMs) is sparse. We investigated the association between different obesity classes with PROMs among patients who underwent TKA.MethodsWe performed retrospective secondary analyses on data extracted from the total joint replacement data repository (Alberta, Canada) managed by the Alberta Bone and Joint Health Institute (ABJHI). Patients had WOMAC and EQ5D scores measured at baseline in addition to 3 and/or 12 months following TKA. Patients were stratified according to the World Health Organization (WHO) classification, into five body mass index (BMI) groups of normal, overweight, BMI class I, BMI class II, and BMI class III. The association between BMI and mean changes in WOMAC subscales (pain, function, and stiffness) and EQ-5D-5L index over the time intervals of baseline to 3 months and 3 to 12 months following TKA was assessed. Linear mixed-effects models were used, and the models were adjusted for age, sex, length of surgery, comorbidities, year of surgery, and geographical zone where the surgery was performed.ResultsMean age was 65.5 years (SD = 8.7). Postoperatively, there was a significant improvement (p < 0.001) in WOMAC subscales of patient-reported pain, function, and stiffness, as well as EQ-5D-5L regardless of BMI group. Although, patients in BMI class II and class III reported significantly improved pain 3 months after TKA compared to those with normal BMI, all BMI groups attained similar level of pain reduction at 12 months after TKA. The greatest improvement in all WOMAC subscales, as well as EQ5D index, occurred between baseline and 3 months (adjusted p < 0.0001).ConclusionThe findings indicate that patients reported improved pain, function, and stiffness across all BMI groups following TKA. Patients with BMI classified as obese reported similar benefits to those with BMI classified as normal weight. These results may help health care providers to discuss expectations regarding the TKA recovery in terms of pain, function, and quality of life improvements with their TKA candidates.

Dataset Information

Total knee arthroplasty in a patient with ipsilateral calcific myonecrosis.

Publications

Total knee arthroplasty in a patient with ipsilateral calcific myonecrosis.

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