Vol 5-1 Review Article

Ganglion Cysts of the ACL and Meniscus: A Review of Literature

Phillip J Stokey1, Anderson Lee1*, Isabell Igo1, Kyle Behrens1, Hamzeh Jajeh2, Nabil Ebraheim1

1Department of Orthopaedic Surgery, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA

2Department of Specialty Medicine, Ohio University Heritage College of Osteopathic Medicine, Dublin, OH, USA

Introduction: Ganglion cysts of the anterior cruciate ligament (ACL) and meniscus may have generalized clinical symptoms that can make them difficult to diagnose, especially considering their rarity. The aim of this study is to provide a comprehensive review of cysts arising in and around the knee with a focus on differential diagnosis to emphasize the importance of proper evaluation.

Methods: A literature search using the database PubMed, Cochrane, and Google Scholar was performed to find the information that comprehensively covered information relevant to this review.

Conclusion: Intra-articular ganglion cysts of the knee are a rare occurrence that typically cause generalized symptoms. Each type of cyst is different with regards to its origin and location, but their similar clinical presentation makes differentiation based on a history and physical exam difficult. MR imaging is of utmost importance for the evaluation of pathologies in and around the knee joint. Once a proper diagnosis is achieved, direct arthroscopic excision of the cyst or treatment of the underlying cause in the case of a meniscus cyst can definitely treat symptoms with minimal concern for recurrence.

DOI: 10.29245/2767-5130/2024/1.1188 View / Download Pdf
Vol 5-1 Case Report

Multiple Diagnoses of Nutritional Rickets in An Inner-City Pediatric Population: A Case Series

Michelle Jeffery1, Judy-Mae Lima2, Aditi Khokhar3, O. Folorunsho Edobor-Osula2*

1Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA

2Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA

3Pediatric Endocrinology, Goryeb Children’s Hospital, Morristown, NJ, USA

This case series details seven pediatric cases of nutritional rickets in an inner-city population of New Jersey. Eighty six percent of these patients were exclusively breast fed, and all self-identified as black or African American. Patients ranged in age from 8 months to 3 years at the time of initial diagnosis. All seven patients were male. Five patients were presented in an office setting, while two were found to have nutritional rickets in an emergency setting. Patients demonstrated classic pathognomonic findings of rickets, including three patients with rachitic rosary. The aim of this case series is to emphasize the importance of surveillance and high clinical suspicion for nutritional rickets, particularly in children with darker skin complexions and who were exclusively breast-fed during infancy. Rapid diagnosis and intervention may delay or negate the need for orthopedic surgical intervention.

DOI: 10.29245/2767-5130/2024/1.1192 View / Download Pdf
Vol 5-1 Review Article

Lumbar Disc Arthroplasty: History and Analysis

Alexandra C. Echevarria1*, Robert E. Carrier1, Anas M. Abbas1, Bongseok Jung1, Tim Reed2, Rohit B. Verma2

1Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY, USA

2Department of Orthopaedic Surgery, Northwell Health - North Shore University Hospital, Manhasset, NY, USA

Degenerative disc disease describes a ubiquitous condition involving the natural deterioration of an intervertebral disc. Conservative methods such as physical therapy and anti-inflammatories are recommended as first-line therapies for noninvasive management. However, when these interventions fail to reduce pain, surgical intervention is indicated. While laminectomies, discectomies, and spinal fusion procedures have been considered the standard treatment throughout the 20th century, the development of artificial discs has introduced an alternative surgical intervention in the form of total disc replacement. Initially, the novel devices garnered significant attention, thus leading to a rise in the rates of disc replacement procedures performed. However, several years after FDA approval of the first device, the prevalence of procedures steadily decreased. Several factors may have contributed to the downward trend, including the growing financial burden of hospitalization, stringent inclusion criteria indicating the procedure, and lack of provider familiarity and comfort with the procedure. Although the expected prevalence of disc arthroplasty remains unrealized, there is significant potential for an expanded role in the contemporary treatment of degenerative disc disease. This review illustrates the timeline and course of lumbar disc arthroplasty by describing its development, followed by its introduction in Europe and eventual arrival in the United States. The initial growth in popularity due to promising results is explained along with the surgery’s swift decline primarily due to lack of sufficient evidence promoting replacement, poor insurance coverage, lack of clear indications and complications. This review encapsulates all components and describes future directions and clinical value of lumbar disc arthroplasty.

DOI: 10.29245/2767-5130/2023/1.1190 View / Download Pdf