Periprosthetic Fracture Following Tibial Echinococcosis
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|ClinicalTrials.gov Identifier: NCT03622346|
Recruitment Status : Completed
First Posted : August 9, 2018
Last Update Posted : August 9, 2018
|Condition or disease||Intervention/treatment||Phase|
|Cystic Echinococcus||Procedure: Semi-constrained total knee arthroplasty||Not Applicable|
Hydatid disease in humans caused by the parasitic tapeworm Echinococcus granulosus has an osseous involvement of about 0.5% to 2.5% of all cases in humans. The location of hydatid cysts in the tibia is seldom described in the medical literature, and its diagnosis and treatment is challenging.
This paper presents a patient, with a long term, well tolerated, bilateral total knee arthroplasty (TKA), treated at our clinic, with a recent history of pain and oedema in her left upper leg. After achieving a, radiologically and histopathologically, well documented, diagnosis of Echinococcosis lesion in her left proximal tibia, a surgical intervention was planed, a wide resection of the cyst performed, and a specific anti-helmintic therapy was instituted. Four years later the patient returns to the investigators observation complaining of pain and unable to bear weight on her left knee, from which a pathologic fracture, adjacent to the tibial component was diagnosed.
After surgical debridement of the newly advanced hydatid cyst growth, the TKA was revised, and due to the tibial component failure and the femoral implant loosening, a semi-constrained total knee revision arthroplasty was executed. Functional outcome was excellent.
Although challenges in treatment of musculoskeletal hydatid cysts (HC) lesions have been documented, data regarding the musculoskeletal HC lesions resembling tumor is scarce, and those resulting in a prosthetic failure haven't been published. The authors intend to add data concerning the therapeutic approach to this entity.
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||1 participants|
|Intervention Model:||Single Group Assignment|
|Intervention Model Description:||Just one patient, subject to two surgeries: curettage and external fixation; subsequently the patient underwent total knee arthroplasty|
|Masking:||None (Open Label)|
|Official Title:||Periprosthetic Pathologic Fracture Following Tibial Echinococcosis: A Case Report|
|Actual Study Start Date :||January 5, 2010|
|Actual Primary Completion Date :||July 1, 2016|
|Actual Study Completion Date :||July 1, 2017|
- Procedure: Semi-constrained total knee arthroplasty
Semi-constrained total knee arthroplasty
- Pain assessed by numerical rating scale (NRS) [ Time Frame: 6 years ]measured with numerical rating scale (NRS), ranging from 0 to 10 (minimum to maximum pain)
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Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03622346
|Principal Investigator:||Germano P Nascimento, MD||Centro Hospitalar do Médio Tejo, EPE|