Osteophyte Excision Research Articles

Mucous Cysts of Fingers: Diagnostics and Treatment Mistakes

Background. Mucous cysts of hand represent tumor-like masses. This pathology is associated with a large number of diagnostic and treatment mistakes with inappropriate procedures and incomplete surgical interventions, which result in recurrences and complications.
 Aim of the study — to analyze diagnostics and treatment mistakes in patients with mucous cysts of fingers in order to improve the quality of medical care for patients with this pathology.
 Methods. The study enrolled 62 patients. Diagnostics included medical history analysis, clinical and X-ray examination, and ultrasonography. According to the patients’ history, they were divided into two groups: group 1 consisted of patients who had come to the clinic for the first time, group 2 — of patients who had referred to the clinic with recurrences of mucous cysts. All patients underwent surgical interventions with osteophyte excision of the phalanx and skin defect grafting after cyst excision. Treatment results were evaluated 2, 6, 12 months after the operation using X-ray data, VAS, QuickDash questionnaire, and measurements of the range of motion in the distal interphalangeal joint.
 Results. Initial referrals of group 2 patients (with disease recurrence) were analyzed in terms of the profile of specialists and the type of care provided. It was found that patients with recurrence had undergone procedures (cyst puncture, cauterization, removal of thin skin over the cyst) or surgeries without osteophyte excision of the phalanx and skin defect grafting after cyst excision. The use of a diagnostic algorithm at the referral stage made it possible to confirm the diagnosis and detect an osteophyte of the affected phalanx in all patients. Patients were followed up for a year.
 Conclusion. At the diagnostic stage, X-ray and ultrasonography are conclusive methods of examination. The only correct method of mucous cysts treatment is radical surgery including skin defect grafting with local tissues after cyst excision and osteophyte removal.

Osteophyte compression mimicking a pharyngeal pouch!

<p class="Standard">Dysphagia is a broad term encompassing various symptoms due to any condition affecting the normal mechanism of swallowing. The symptoms are often varied like inability to swallow solids and/or liquids, cough on taking liquids, recurrent episodes of aspiration pneumonia and so on. Zenker‘s diverticulum is a not so common condition in which the patient usually presents with hallitosis, delayed regurgitation of feeds in an unchanged manner and foreign body sensation in the throat. Another rare condition is an osteophyte indenting onto the esophagus and causing dysphagia. A 63 year old male presented to the laryngology out patient department with symptoms of food sticking in his throat and regurgitation of feeds in unchanged form which occurred hours after the initial meal. As clinical evaluation and flexible endoscopic evaluation of swallowing were unremarkable he was subjected to a fluoroscopy. Fluoroscopy showed prominent osteophytes at fourth cervical vertebra (C4) and seventh cervical vertebra (C7); the higher one obliterating the apex of right pyriform fossa thereby leading to occasional stagnation of barium in the right pyriform fossa which mimicked a pouch. A computed tomography confirmed the finding of an osteophyte compressing on the lower end of the hypopharynx and giving rise to symptoms similar to that of a pharyngeal pouch. He consequently underwent an osteophyte excision via anterior cervical approach following which he was relieved of his symptoms.</p>

Comparison of early outcomes of arthroscopic labral repair or debridement : a study using the UK Non-Arthroplasty Hip Registry dataset.

AimsThis study uses prospective registry data to compare early patient outcomes following arthroscopic repair or debridement of the acetabular labrum.MethodsData on adult patients who underwent arthroscopic labral debridement or repair between 1 January 2012 and 31 July 2019 were extracted from the UK Non-Arthroplasty Hip Registry. Patients who underwent microfracture, osteophyte excision, or a concurrent extra-articular procedure were excluded. The EuroQol five-dimension (EQ-5D) and International Hip Outcome Tool 12 (iHOT-12) questionnaires were collected preoperatively and at six and 12 months post-operatively. Due to concerns over differential questionnaire non-response between the two groups, a combination of random sampling, propensity score matching, and pooled multivariable linear regression models were employed to compare iHOT-12 improvement.ResultsA total of 2,025 labral debridements (55%) and 1,659 labral repairs (45%) were identified. Both groups saw significant (p < 0.001) EQ-5D and iHOT-12 gain compared to preoperative scores at 12 months (iHOT-12 improvement: labral repair = +28.7 (95% confidence interval (CI) 26.4 to 30.9), labral debridement = +24.7 (95% CI 22.5 to 27.0)), however there was no significant difference between procedures after multivariable modelling. Overall, 66% of cases achieved the minimum clinically important difference (MCID) and 48% achieved substantial clinical benefit at 12 months.ConclusionBoth labral procedures were successful in significantly improving early functional outcome following hip arthroscopy, regardless of age or sex. Labral repair was associated with superior outcomes in univariable analysis, however there was no significant superiority demonstrated in the multivariable model.Level of evidence: IIICite this article: Bone Jt Open 2022;3(4):291–301.

Treatment of Mucous Cyst of the Distal Interphalangeal Joint With Osteophyte Excision and Joint Debridement.

BackgroundMucous cyst of the distal interphalangeal joint (DMC) or interphalangeal connection of the thumb is common in middle-aged and elderly people, and it often occurs in the fingers of people with osteoarthritis (OA). Although there are many conservative treatments, DMC is usually treated by surgery. The common complications of surgical treatment are recurrence of DMC and skin necrosis. This article introduces the method and clinical effect of osteophyte excision and joint debridement in the treatment of DMC of the distal interphalangeal (DIP) joint.MethodsIn total, 19 cases of affected fingers made an 'S' incision in the DIP joint under local anesthesia to remove the osteophyte of the DIP joint, clean the dorsal joint capsule, wash the joint, and retain only the bilateral collateral ligament and extensor tendon device. It is suspected that the injured finger of the extensor tendon should be protected by external fixation.ResultsOut of 15 patients, 1 patient presented with partial skin necrosis that healed after dressing changes while the other patients recovered well. The visual analog scale (VAS) scores of all affected fingers after surgery were lower than those before the surgery (VAS score: 4.93 ± 0.88 vs. 4.07 ± 1.03, p < 0.05). The range of motion (ROM) of the affected finger decreased in one patient, and the post-operative activity of the other fingers increased in varying degrees (ROM: 67.60 ± 5.40 vs. 71.27 ± 7.06, p > 0.05).ConclusionsUsing osteophyte excision and joint debridement to treat DMC can avoid skin necrosis caused by cyst removal and can avoid the recurrence of DMC to the greatest extent, so it is a safe and effective way of treatment.

Thoracic osteophyte as a cause of symptomatic greater splanchnic nerve compression. Case report

Thoracic osteophytes are a common feature of degenerative spine disease. However, it is rare that osteophytes overgrowth on the anterior surface of thoracic spine results in the compression of vital structures and causes symptoms. A 39-year old man with a two-year history of thoracic and upper abdominal pain was admitted to the neurosurgery ward after having been seen by several specialists. Thoracic spine MRI and CT scans were analyzed. Osteophytes were identified on the anterolateral right side at level T8–T9 and were indicated as a possible cause of the symptoms. After obtaining patient consent, surgery was performed with transthoracic access to the anterolateral surface of the spine. Intraoperatively, the greater splanchnic nerve was released by osteophyte removal. The patient reported improvement of the preoperative symptoms at the six-month and two-year follow-up visit. Postoperative MRI indicated complete osteophyte excision. To the best of our knowledge, this is the first report of symptomatic sympathetic trunk branch compression by thoracic osteophytes.

Bipedicle Advancement Flap for Skin Coverage after Digital Mucous Cyst Excision: A Retrospective Study of 18 Cases.

ObjectivesTo assess the clinical outcomes of using a bipedicle advancement flap to cover the skin defects after digital mucous cyst (DMC) excision.MethodsData for 15 patients (18 fingers) with DMC, admitted to the Department of Orthopaedics and Surgery of the Affiliated Zhongshan Hospital of Dalian University from January 2016 to January 2018, were analyzed retrospectively. This study included 4 men and 11 women, with a mean age of 64 ± 7.8 years (range, 47–77 years). A total of 5 cases involved the thumb, 4 involved the index finger, 5 involved ithe middle finger, and 4 involved the ring finger. Among a total of 18 digital mucous cysts, 7 cases were in the left hand and 11 were in the right hand. Approximately 77.8% of cases had osteophytes. The cysts ranged in size from 0.5–1.0 cm to 0.7–1.2 cm. All patients underwent cyst and osteophyte excision and a bipedicle advancement flap to cover the resultant defect. The same surgical procedure was applied to all patients. Postoperative flap survival, healing, and infection were evaluated. The preoperative and postoperative ranges of motion (ROM) of the distal interphalangeal (DIP) and thumb interphalangeal joints (TIPJ) were recorded. Postoperative patient satisfaction was assessed by the visual analog scale (VAS, 0–10) during follow‐up visits. The Shapiro–Wilk test was used to determine whether the data for the difference between the preoperative and postoperative ROM of the DIP/TIPJ were normally distributed or not. The homogeneity of variance was expressed as mean ± standard deviation. A paired t‐test was used to compare the preoperative and postoperative ROM of the DIP/TIPJ.ResultsThe patients were followed up for 20 ± 6.0 months (range, 12–36 months). All the flaps survived after surgery, and the incisions healed well. The sutures were removed 2 weeks postoperatively. No infections occurred and there was no cyst recurrence at follow up. After systemic physical therapy and functional exercises, the ROM of all the fingers was restored to the preoperative ROM by 1 month after surgery. The scores for patient satisfaction with surgery by means of the VAS were 8.5 ± 1.0 points, 2.8 ± 1.4 points, 2.0 ± 1.6 points, 1.5 ± 1.2 points, and 1.1 ± 1.3 points preoperatively, and 1, 3, 6, and 12 months postoperatively, respectively. The data for the difference between preoperative and postoperative VAS scores were normally distributed. There were significant differences between the preoperative and postoperative VAS scores. The preoperative DIP/TIPJ ROM was 71.7° ± 14.0°, and the postoperative ROM at 1, 3, 6, and 12 months were 69.3° ± 15.3°, 70.4° ± 12.7°, 71.5° ± 15.6°, and 71.8° ± 15.6°, respectively. The data for the difference between preoperative and postoperative ROM of the DIP/TIPJ were normally distributed. No difference was found between the preoperative and postoperative ROM.ConclusionThe bipedicle advancement flap provides a simple and effective technique for covering skin defects following DMC excision.

Can isolated removal of osteophytes achieve correction of varus deformity and gap-balance in computer-assisted total knee arthroplasty?

The aims of this study were to determine the effect of osteophyte excision on deformity correction and soft tissue gap balance in varus knees undergoing computer-assisted total knee arthroplasty (TKA). A total of 492 consecutive, cemented, cruciate-substituting TKAs performed for varus osteoarthritis were studied. After exposure and excision of both cruciates and menisci, it was noted from operative records the corrective interventions performed in each case. Knees in which no releases after the initial exposure, those which had only osteophyte excision, and those in which further interventions were performed were identified. From recorded navigation data, coronal and sagittal limb alignment, knee flexion range, and medial and lateral gap distances in maximum knee extension and 90° knee flexion with maximal varus and valgus stresses, were established, initially after exposure and excision of both cruciate ligaments, and then also at trialling. Knees were defined as 'aligned' if the hip-knee-ankle axis was between 177° and 180°, (0° to 3° varus) and 'balanced' if medial and lateral gaps in extension and at 90° flexion were within 2 mm of each other. Of 50 knees (10%) with no soft tissue releases (other than cruciate ligaments), 90% were aligned, 81% were balanced, and 73% were aligned and balanced. In 288 knees (59%) only osteophyte excision was performed by subperiosteally releasing the deep medial collateral ligament. Of these, 98% were aligned, 80% were balanced, and 79% were aligned and balanced. In 154 knees (31%), additional procedures were performed (reduction osteotomy, posterior capsular release, and semimembranosus release). Of these, 89% were aligned, 68% were balanced, and 66% were aligned and balanced. The superficial medial collateral ligament was not released in any case. Two-thirds of all knees could be aligned and balanced with release of the cruciate ligaments alone and excision of osteophytes. Excision of osteophytes can be a useful step towards achieving deformity correction and gap balance without having to resort to soft tissue release in varus knees while maintaining classical coronal and sagittal alignment of components. Cite this article: Bone Joint J 2020;102-B(6 Supple A):49-58.

Does Circumferential Patellar Denervation Result in Decreased Knee Pain and Improved Patient-reported Outcomes in Patients Undergoing Nonresurfaced, Simultaneous Bilateral TKA?

Anterior knee pain, which has a prevalence of 4% to 49% after TKA, may be a cause of patient dissatisfaction after TKA. To limit the occurrence of anterior knee pain, patellar denervation with electrocautery has been proposed. However, studies have disagreed as to the efficacy of this procedure.Questions/purposes We evaluated patients undergoing bilateral, simultaneous TKA procedures without patellar resurfacing to ask: (1) Does circumferential patellar cauterization decrease anterior knee pain (Kujala score) postoperatively compared with non-cauterization of the patella? (2) Does circumferential patellar cauterization result in better functional outcomes based on patient report (VAS score, Oxford knee score, and Knee Injury and Osteoarthritis Outcome Score) than non-cauterization of the patella? (3) Is there any difference in the complication rate (infection, patellar maltracking, fracture, venous thromboembolism, or reoperation rate) between cauterized patellae and non-cauterized patellae? Seventy-eight patients (156 knees) were included in this prospective, quasi-randomized study, with each patient serving as his or her own control. Patellar cauterization was always performed on the right knee during simultaneous, bilateral TKA. Five patients (6%) were lost to follow-up before the 2-year minimum follow-up interval. A single surgeon performed all TKAs using the same type of implant, and osteophyte excision was performed in all patellae, which were left unresurfaced. Patellar cauterization was performed at 2 mm to 3 mm deep and approximately 5 mm circumferentially away from the patellar rim. The preoperative femorotibial angle and degree of osteoarthritis (according to the Kellgren-Lawrence grading system) were measured. Restoration of the patellofemoral joint was assessed using the anterior condylar ratio. Clinical outcomes, consisting of clinician-reported outcomes (ROM and Kujala score) and patient-reported outcomes (VAS pain score, Oxford knee score, and Knee Injury and Osteoarthritis Outcome Score), were evaluated preoperatively and at 1 month and 2 years postoperatively. Preoperatively, the radiologic severity of osteoarthritis, based on the Kellgren-Lawrence classification, was not different between the two groups, nor were the baseline pain and knee scores. The mean femorotibial angle of the two groups was also comparable: 189° ± 4.9° and 191° ± 6.3° preoperatively (p = 0.051) and 177° ± 2.9° and 178° ± 2.1° postoperatively (p = 0.751) for cauterized and non-cauterized knees, respectively. The preoperative (0.3 ± 0.06 versus 0.3 ± 0.07; p = 0.744) and postoperative (0.3 ± 0.06 versus 0.2 ± 0.07; p = 0.192) anterior condylar ratios were also not different between the cauterized and non-cauterized groups. At the 2-year follow-up interval, no difference was observed in the mean Kujala score (82 ± 2.9 and 83 ± 2.6 for cauterized and non-cauterized knees, respectively; mean difference 0.3; 95% confidence interval, -0.599 to 1.202; p = 0.509). The mean VAS pain score was 3 ± 0.9 in the cauterized knee and 3 ± 0.7 in the non-cauterized knee (p = 0.920). The mean ROM was 123° ± 10.8° in the cauterized knee and 123° ± 10.2° in the non-cauterized knee (p = 0.783). There was no difference between cauterized and non-cauterized patellae in the mean Knee Injury and Osteoarthritis Outcome Score for symptoms (86 ± 4.5 versus 86 ± 3.9; p = 0.884), pain (86 ± 3.8 versus 86 ± 3.6; p = 0.905), activities (83 ± 3.2 versus 83 ± 2.8; p = 0.967), sports (42 ± 11.3 versus 43 ± 11.4; p = 0.942), and quality of life (83 ± 4.9 versus 83 ± 4.7; p = 0.916), as well as in the Oxford knee score (40 ± 2.1 versus 41 ± 1.9; p = 0.771). Complications were uncommon and there were no differences between the groups (one deep venous thromboembolism in the cauterized group and two in the control group; odds ratio 0.49, 95% CI, 0.04-5.56; p = 0.57). Patellar cauterization results in no difference in anterior knee pain, functional outcomes, and complication rates compared with non-cauterization of the patella in patients who undergo non-resurfaced, simultaneous, bilateral, primary TKA with a minimum of 2 years of follow-up. We do not recommend circumferential patellar cauterization in non-resurfaced patellae in patients who undergo TKA. Level II, therapeutic study.

Anterior Surgical Techniques for Cervical Spondylotic Myelopathy: WFNS Spine Committee Recommendations.

ObjectiveThis study was performed to review the literature and to present the most up-to-date information and recommendations on the indications, complications, and success rate of anterior surgical techniques for cervical spondylotic myelopathy (CSM). The commonly performed anterior surgical procedures are multiple-level anterior cervical discectomy and fusion, anterior cervical corpectomy and fusion and its variants (skip corpectomy and hybrid surgery), and oblique corpectomy without fusion. MethodsA comprehensive literature search and analysis were performed using MEDLINE (PubMed), the Cochrane Register of Controlled Trials, and the Web of Science for peer-reviewed articles published in English during the last 10 years. ResultsCorpectomy is mandated for ventral compression of fewer than 3 vertebral segments where single-level disc and osteophyte excision is inadequate to decompress the cord. Endoscopic or oblique partial corpectomy improves the sagittal canal diameter by 67% and obviates the need for an additional bone graft procedure. ConclusionThe indications of anterior surgery in patients with CSM include a straightened or kyphotic spine with a compression level lower than 3. With an appropriate choice of implants and meticulous surgical technique, surgical complications can be seen only rarely. Improvements after anterior surgery for CSM have been reported in 70% to 80% of patients.

Arthroscopic Management of Glenohumeral Arthritis: A Joint Preservation Approach.

Treatment of young, active patients with primary glenohumeral osteoarthritis (GHOA) is challenging because shoulder arthroplasty may not be ideal in this population. In the past two decades, joint-preserving arthroscopic management options for GHOA, including débridement, have been used to treat different pathologies related to GHOA to reduce pain, to improve function, and to delay or even avoid arthroplasty. Key aspects of comprehensively addressing GHOA arthroscopically include chondroplasty, synovectomy, loose body removal, humeral osteoplasty with excision of the goat's beard osteophyte, capsular release, subacromial and subcoracoid decompression, axillary nerve decompression, and biceps tenodesis. Although data are still emerging, clinical studies report that an arthroscopic approach to glenohumeral arthritis using these various procedures reduces pain, improves function, and improves clinical outcome scores in the short- to mid-term follow-up period. Additional high-level studies are warranted to evaluate long-term outcomes and durability following this procedure.

Comparing two surgical treatment methods for mucous cysts of the distal interphalangeal joint in elderly patients

Objective To contrast and compare two surgical treatments for mucous cysts of the distal interphalangeal joint. Methods Clinical data from April 2004 to January 2016 were retrospectively analyzed.Patients who underwent tumor excision, osteophyte excision, and local flap coverage were assigned into a flap group(n=16), while patients who received osteophyte excision, cyst pedicle resection, and cystic fluid drainage were assigned into a simple osteophyte resection group(n=17). Procedure time, pain, satisfaction score, and hand function were compared between the two groups. Results Patients in the flap group were followed up for 14 to 28 months(mean=19.5 months); the simple osteophyte resection group for 15 to 26 months(mean=20.5 months). There was no recurrence in either group.The rate of excellent efficacy was 81.25%(13/16)for the skin flap group and 82.35%(14/17)for the simple osteophyte resection group, and the difference was not statistically significant(χ2=0.007, P>0.05). Pain relief was achieved in both groups after operation, and the postoperative satisfaction score was higher than the pre-operation score.There was no statistical difference in pre-operation pain and satisfaction scores(t=0.14 and 0.35, both P>0.05), no statistical difference in postoperative pain scores(t=-0.09, P>0.05), but a statistically significant difference in postoperative satisfaction scores(t=-4.15, P<0.05)between the two groups. Conclusions Two surgical treatments of mucous cysts can achieve satisfactory aesthetic and clinical outcomes.The simple osteophyte resection method is characterized by a short procedure time and a high level of postoperative satisfaction, but it requires training in microsurgery.Local flap coverage is simple and suitable for lower level hospitals where staff surgeons may lack microsurgical skills, but it may result in certain minor injuries. Key words: Mucocele; Osteophyte; Surgical flaps; Pedicle resection

Subungual mucous cyst disappeared by only excision of osteophyte

Subungual mucous cyst disappeared by only excision of osteophyte

The Comprehensive Arthroscopic Management Procedure for Treatment of Glenohumeral Osteoarthritis

Younger, high-demand patients who are less suitable for joint replacement procedures are often affected by advanced glenohumeral osteoarthritis. There are several alternatives to total joint arthroplasty for the treatment of these patients. However, the outcomes of these procedures are less predictable and have limited durability. The comprehensive arthroscopic management procedure, which includes a combination of arthroscopic glenohumeral debridement, chondroplasty, synovectomy, loose body removal, humeral osteoplasty with excision of the goat's beard osteophyte, capsular releases, subacromial and subcoracoid decompressions, axillary nerve decompression, and biceps tenodesis, has been shown to reduce pain, improve function, and provide a predictable short-term joint-preserving option for patients with advanced glenohumeral osteoarthritis. A unique feature of the comprehensive arthroscopic management procedure is the indirect and direct decompression of the axillary nerve, which may explain the difference in outcomes with this technique compared with other approaches. Furthermore, the technique is technically demanding and associated with several notable pitfalls that are preventable when using the meticulous surgical technique detailed in this article and accompanying video.

An Osteophyte in the Tibial Plateau Is a Risk Factor for Allograft Extrusion After Meniscus Allograft Transplantation

Background: Osteophytes can be observed on the tibial plateau during meniscus allograft transplantation (MAT). However, no studies to date have evaluated the effect of these osteophytes on meniscus allograft extrusion. Hypothesis: Osteophyte excision in the tibial plateau could reduce extrusion of the transplanted meniscus and improve short-term clinical outcomes with meniscus allograft transplantation. Study Design: Cohort study; Level of evidence, 3. Methods: Between October 2004 and July 2012, a total of 323 patients underwent MAT at a single institution. Of these, 88 patients had a peripheral osteophyte in their tibial plateau, and they were enrolled in the study retrospectively. The mean age of the patients was 35.3 years (range, 15-56 years); there were 57 male and 31 female patients. Forty-four patients underwent osteophyte excision concomitantly with MAT and 44 patients underwent MAT only. The 2 groups showed no difference in terms of age, body mass index, time after meniscectomy, and preoperative knee scores. A medial meniscus allograft was transplanted in 13 cases (15%) and a lateral meniscus in 75 (85%). The absolute extrusion and relative percentage of extrusion were measured to evaluate allograft extrusion 12 months after MAT. The modified Lysholm scoring system and the Hospital for Special Surgery score at 2 years after MAT were used to evaluate clinical outcomes. Results: The mean absolute extrusions at 1 year postoperatively in the excision and nonexcision groups were 3.5 ± 1.5 and 5.5 ± 1.6 mm, respectively. The mean relative percentages of extrusion were 34.1% ± 15.9% and 54.7% ± 20.7%, respectively. The rates of allograft extrusion (>3 mm) were 28 of 44 (63.6%) and 41 of 44 (93.2%) in the excision and nonexcision groups, respectively. The intergroup differences in absolute extrusion, relative percentage of extrusion, and rate of allograft extrusion were statistically significant (P < .001 for all 3 parameters). There were no significant differences in the clinical outcomes (modified Lysholm or Hospital of Special Surgery scores) at 2-year follow-up (P < .762 and < .298, respectively). Conclusion: The excision of a peripheral osteophyte larger than 2 mm in the proximal tibial plateau was associated with less allograft extrusion after MAT.

Commentary on Lee et al. Osteophyte excision without cyst excision for a mucous cyst of the finger

Commentary on Lee et al. Osteophyte excision without cyst excision for a mucous cyst of the finger

TREATMENT OF ANKLE IMPINGEMENT SYNDROMES IN ATHLETES

BackgroundPainful limitation of ankle movement in athletes is commonly caused by soft-tissue or osseous formations. The impingement syndromes of the ankle are attributed to initial injuries which, undertreated, in a...

Osteophyte excision without cyst excision for a mucous cyst of the finger

Osteophyte excision is a mainstay of treatment for mucous cyst combined with Heberden's node in a distal interphalangeal joint or in an interphalangeal joint of the thumb. The aim of this study was to evaluate the results of osteophyte excision without cyst excision for the treatment of a mucous cyst combined with Heberden's node. The medical records of 37 patients (42 cases) with a mucous cyst with Heberden's node were retrospectively reviewed. Thirty-eight of 40 cases with available pre-operative simple radiographs showed evidence of joint arthrosis. A T-shaped skin incision of the joint capsule between the extensor tendon and lateral collateral ligament was used. Osteophyte excision without cyst excision was performed. All cysts, except one, regressed without recurrence or a skin complication after osteophyte excision, but eight cases showed post-operative pain and loss of range of motion. Osteophyte excision without cyst excision may be a good treatment choice for mucous cyst of the finger.

Median Nerve Enterapment Secondary To Carpal Osteophyte: A Case Report

Carpal tunnel syndrome secondary to space occupying lesion is a relatively rare condition. Median nerve compression secondary to carpal osteophyte is extremely rare. We report a case of carpal tunnel syndrome due to osteophytic bony projection in the carpal tunnel in a 54-year-old man with antecedent traumatic wrist injury before 20 years. To our knowledge, this is the second reported case. Complete excision of osteophyte resulted in complete relief of sensory symptoms.

Median Nerve Enterapment Secondary To Carpal Osteophyte: A Case Report

Carpal tunnel syndrome secondary to space occupying lesion is a relatively rare condition. Median nerve compression secondary to carpal osteophyte is extremely rare. We report a case of carpal tunnel syndrome due to osteophytic bony projection in the carpal tunnel in a 54-year-old man with antecedent traumatic wrist injury before 20 years. To our knowledge, this is the second reported case. Complete excision of osteophyte resulted in complete relief of sensory symptoms.

Unique relationship between osteophyte and femoral-tibia component size mismatch in determining polyethylene wear in primary total knee arthroplasty: a case report

IntroductionKnee pain is a complex problem that can occur after total knee arthroplasty. One cause of knee pain may be due to a retained osteophyte, but it is not clear if the retained osteophyte is sufficient explanation of the pain, as not all patients with retained osteophytes are symptomatic. In fact, the literature shows that excised osteophytes can also recur over a period of time, without any symptoms. Therefore a retained osteophyte alone is probably not sufficient to cause symptoms.Case presentationWe present a case of intermittent medial knee pain occurring post-primary total knee arthroplasty, in a patient who underwent several investigations over a period of 5 years. Radiographs showed an osteophyte in the postero-medial femur along with slight tibial component overhang which was normal for that knee implant design. The symptoms eventually settled with excision of only the osteophyte, without altering the tibial component.ConclusionA retained osteophyte alone, or tibial component overhang alone, did not seem to cause significant symptoms in our patient whose symptoms completely settled with excision of the osteophyte alone, without changing the tibial component. Therefore, it seems that the combination of retained osteophyte and tibial component overhang (tibia-femoral component size mismatch) are detrimental and therefore best avoided. This report also emphasises the importance of meticulous osteophyte excision and avoiding tibial component overhang during knee arthroplasty.