Department of Orthopaedic Surgery, Saiseikai Hiroshima Hospital, 2-3-10 Kitashinchi, Sakacho, Aki-gun, Hiroshima, 731-4311, Japan.
Department of Orthopaedic Surgery, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima prefecture, Hiroshima, 734-8551, Japan.
BMC Musculoskelet Disord. 2024 Aug 31;25(1):690. doi: 10.1186/s12891-024-07817-z.
We report a rare case of posterior cruciate ligament (PCL) calcification, which has only been reported in two case studies on PubMed.
A 71-year-old man developed left popliteal pain in the morning without any history of trauma and the pain became severe that night. On the following day, he presented to our department. The patient could not flex his left knee at all due to pain and swelling. CT and MRI scans showed calcification behind the PCL with mild osteoarthritic changes and accumulation of synovial fluid in the joint. Synovial fluid analysis did not reveal any crystals. Blood tests at first admission showed inflammation, hyperglycemia, and low blood uric acid levels. Although the patient's knee joint was injected with steroids, his symptoms did not improve. Thus, we performed arthroscopic surgery two days after symptoms had appeared. Intraoperatively, we observed a white, soft tissue in the synovial membrane behind the PCL. Part of this tissue was collected for histological analysis, which revealed sparse fibers with calcium deposits. Immediately after surgery, the patient's symptoms were completely gone. Afterward, the patient remained asymptomatic one month after surgery.
This is the first reported case of debridement of PCL calcification and ossification that was performed soon after symptoms appeared. In addition, we demonstrated that early debridement led to complete recovery.
我们报告了一例罕见的后交叉韧带(PCL)钙化病例,该病例仅在 PubMed 上的两项病例研究中有所报道。
一名 71 岁男性清晨出现左膝后窝疼痛,无外伤史,当晚疼痛加剧。次日,他到我科就诊。由于疼痛和肿胀,患者的左膝完全无法弯曲。CT 和 MRI 扫描显示 PCL 后有钙化,伴有轻度骨关节炎改变和关节内滑液积聚。关节滑液分析未发现任何晶体。初次入院时的血液检查显示炎症、高血糖和低血尿酸水平。尽管患者的膝关节注射了类固醇,但症状并未改善。因此,在症状出现两天后我们进行了关节镜手术。术中观察到 PCL 后滑膜上有白色、柔软的组织。部分组织被收集进行组织学分析,结果显示有稀疏的纤维和钙沉积。手术后,患者的症状立即完全消失。此后,患者在手术后一个月仍无症状。
这是首例报道的在症状出现后立即进行 PCL 钙化和骨化清创术的病例。此外,我们证明了早期清创可实现完全康复。