Arthroscopic resection of multiple ossifying tumors in the infrapatellar fat pad.

Tsutomu Oshigiri, Kota Watanabe, Hidenori Otsubo, Shintaro Takeda, Tomoyuki Suzuki, Takuma Kobayashi, Toshihiko Yamashita
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引用次数: 2

Abstract

A 49 year-old male visited a nearby clinic five years back with a complaint of pain in the right knee during exercise. Plain radiographs revealed absence of any anomalies. He began to feel a lumpy mass in his right knee two years back. The pain worsened, on imaging, an anomaly was identified in the infrapatellar fat pad of his right knee, and he was subsequently referred to our department where he was hospitalized. On examination, a mass extending on either side of the patellar tendon was identified along with rigid tenderness in that area. The knee's range of motion was 0degrees-130degrees, and knee flexion was accompanied by pain. The results of blood tests were normal. A plain radiograph of the knee revealed multiple ossifying tumors at a site consistent with the infrapatellar fat pad. T1-weighted MRI exhibited low-signal intensity, while T2-weighted MRI exhibited a mosaic-shaped tumor. We performed arthroscopic surgery to excise the tumor. The patient resumed work shortly after surgery and did not experience any pain during the two year postoperative observation period. The joint's range of motion improved to the extent that it was comparable with that of the left knee. No recurrence was observed on radiographic examination. In past studies, resection of similar tumors has been performed with an arthrotomy; however, we performed arthroscopic resection on our patient, who demonstrated a quick improvement in symptoms and range of motion after surgery. We believe that arthroscopic surgery is a feasible option to consider while treating such cases.

Abstract Image

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Abstract Image

关节镜下髌下脂肪垫多发骨化瘤切除术。
一名49岁的男性五年前到附近的一家诊所就诊,主诉运动时右膝疼痛。x线平片未见异常。两年前,他开始感到右膝有肿块。疼痛加重,影像学检查发现右膝髌下脂肪垫异常,随后转到我科住院。检查发现髌腱两侧有肿块延伸,该区域有僵硬压痛。膝关节活动范围0度-130度,膝关节屈曲伴有疼痛。血液检查结果正常。膝关节平片显示与髌下脂肪垫一致的部位有多发骨化肿瘤。t1加权MRI表现为低信号强度,而t2加权MRI表现为马赛克状肿瘤。我们进行了关节镜手术切除肿瘤。患者术后很快恢复工作,术后两年观察期间无任何疼痛。关节的活动范围改善到与左膝相当的程度。影像学检查未见复发。在过去的研究中,切除类似肿瘤采用关节切开术;然而,我们对患者进行了关节镜切除,术后症状和活动范围迅速改善。我们认为关节镜手术是治疗此类病例的可行选择。
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