Background: Loose bodies (LBs) within the knee joint are commonly encountered during clinical practice and are frequently observed during knee arthroscopy. The primary treatment involves the removal of loose bodies; however, their complete eradication is often challenging and may not address underlying diseases, leading to persistent symptoms and the risk of new loose body formation. Aim: This case report aims to present the findings and surgical management of a 52-year-old male with an unusually large osseous loose body in the knee joint and associated pathologies. Case Presentation: The patient, a 52-year-old male, experienced recurrent episodes of severe, sudden, and painful locking of the knee joint, leading to difficulties moving. A plain MRI study was conducted to evaluate the condition of the knee joint, which revealed various degenerative changes and the presence of a loose body. Subsequently, an arthroscopic examination was performed under general anesthesia, uncovering the presence of an abnormally large loose body, as well as other pathologies including chondropathy, meniscal degeneration, and Baker’s cyst. Conclusion: Loose bodies (LBs) in the knee joint pose significant challenges and may lead to debilitating symptoms. Timely diagnosis and appropriate surgical intervention are crucial for symptom relief and the prevention of further joint damage as arthroscopic excision. Comprehensive imaging has a vital role in guiding treatment decisions and optimizing patient outcomes. In this case, the removal of the loose body improved patient outcomes and helped prevent potential joint complications.
References
[1]
Zmerly, H., Moscato, M. and Akkawi, I. (2022) Assessment and Management of Loose Bodies in the Knee Joint and Related Disease: A Narrative Review. Current Rheumatology Reviews, 18, 12-19. https://doi.org/10.2174/1573397117666211021165807
[2]
Pandey, P.K., Pawar, I., Gupta, J. and Verma, R.R. (2015) Giant Loose Body of Knee Joint Presenting as Accessory Patella—A Case Report. Open Journal of Orthopedics, 5, 235-239. https://doi.org/10.4236/ojo.2015.58031
[3]
Chai, H.L. and Lui, T.H. (2017) Posterior Knee Loose Bodies: Treated by Posterior Knee Arthroscopy. Journal of Orthopaedic Case Reports, 7, 57-61.
[4]
Zhao, B., Yu, Y., Liu, W. and Du, J. (2017) Efficacy of Arthroscopic Loose Body Removal for Knee Osteoarthritis. Experimental and Therapeutic Medicine, 15, 1666-1671. https://doi.org/10.3892/etm.2017.5564
[5]
Gursoy, M., Mete, B.D., Dag, F. and Bulut, T. (2019) The Distribution of Loose Bodies Determined on Knee Magnetic Resonance Imaging: Joint Compartments, Recesses and Bursae Including Arthroscopic Blind Spots. Acta Radiologica, 60, 1286-1293. https://doi.org/10.1177/0284185119856262
[6]
Krych, A.J., Saris, D.B.F., Stuart, M.J. and Hacken, B. (2020) Cartilage Injury in the Knee: Assessment and Treatment Options. Journal of the American Academy of Orthopaedic Surgeons, 28, 914-922. https://doi.org/10.5435/jaaos-d-20-00266
[7]
Yang, Y.P., Wang, J.J. and Li, H.Y. (2018) Atypical Synovial Chondromatosis of the Right Knee: A Case Report. Experimental and Therapeutic Medicine, 15, 4503-4507. https://doi.org/10.3892/etm.2018.5955
[8]
Sourlas, I., Brilakis, E.V., Mavrogenis, A.F., Stavropoulos, N.A. and Korres, D.S. (2013) Giant Intra-Articular Synovial Osteochondromata of the Knee. Hippokratia, 17, 281-283. https://pubmed.ncbi.nlm.nih.gov/24470744
[9]
Bruns, J., Werner, M. and Habermann, C. (2017) Osteochondritis Dissecans: Etiology, Pathology, and Imaging with a Special Focus on the Knee Joint. CARTILAGE, 9, 346-362. https://doi.org/10.1177/1947603517715736
