No abstract

A previously well 30 year old man presented with a short history of intra-articular mechanical locking, swelling, and anteromedial joint line pain. There was localised tenderness, and McMurray’s test was positive. Arthroscopy revealed a 3.6 × 2.6 × 1.5 cm firm pedicular localised pigmented villonodular synovitis originating from the insertion of the anterior horn of the medial meniscus. Owing to its size and consistency, mini-arthrotomy was required. This allowed a return to sporting activities. Localised pigmented villonodular synovitis can mimic symptoms of a meniscal tear.

We present a case of piriformis syndrome in a woman in her 30’s following low energy trauma, presenting with unilateral lower limb weakness, altered sensation and urinary retention. CT imaging revealed a bulky piriformis muscle which was further clarified on MRI as an intramuscular haematoma within the left piriformis causing compression of the left lumbosacral plexus. Haematoma formation was exacerbated due to use of an antiplatelet medication the patient was taking for Moyamoya disease, which carries an increased risk of cerebrovascular accident. Surgical exploration of the piriformis and sciatic nerve was undertaken and confirmed a haematoma within the piriformis. A full release of the piriformis tendon was undertaken, and the sciatic nerve was inspected, no further abnormality was found. After review in clinic post-discharge, the patient reported normal sensation and normal muscle power in her feet.

Adolescents are susceptible to patellar sleeve fractures. We present an interesting case of a patellar sleeve fracture in an 11-year-old child with lateral slip of the retinacular sleeve. Clinical assessment was difficult; however, an MRI scan confirmed the diagnosis. Surgical repair was undertaken, and the retinacular sleeve was repaired along with repair of the patellar tendon. The patient recovered well after surgery and underwent physiotherapy. A patellar sleeve fracture should always be suspected in patients less than 16 years of age, particularly in those with indirect acute trauma to the knee. Prompt surgical repair is important to achieve full functional recovery.

Background: Fifty thousand knee replacements are performed annually in the UK at an estimated cost of £150 million. Post-operative improvement depends on a number of factors including implant design and patient associated factors. To our knowledge there are no published study's comparing the results of AP glide and rotating platform designs of LCS knee arthroplasty. Therefore we feel that a study is required to investigate and compare the effects of two types of LCS total knee arthroplasty on joint proprioception and range of motion.