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Case Reports
. 2014 Jul 12;49(4):414-9.
doi: 10.1016/j.rboe.2014.06.002. eCollection 2014 Jul-Aug.

Surgical features of Trevor's disease of the patella

Frederico Barra de Moraes  1 , Geraldo Dos Passos Barcelos Filho  1 , Guilherme Felipe Faria Lobo  1 , Cícero Almeida Santos  1 , Luiz Augusto Alves Reis  1 , Mauro Rodrigues Dos Santos  1
Affiliations
Case Reports

Surgical features of Trevor's disease of the patella

Frederico Barra de Moraes et al. Rev Bras Ortop. .

Abstract
in English, Portuguese

The aim of this study was to describe surgical features of resection of hemimelic epiphyseal dysplasia of the patella. We already described the clinical and imaging features in another article. The patient was a six-year-old boy with a tumor in his right knee measuring 12 cm longitudinally and 6 cm transversally, which was adhering to the patella and had been slowly growing for two years. Biopsy findings were suggestive of a benign osteochondromatous lesion, without a defined diagnosis. Imaging examinations such as radiography and tomography showed areas of bone formation and radiotransparent areas, while magnetic resonance imaging showed areas of hypo and hypersignal in T1 and T2, of estimated size 8.5 cm longitudinally and 6 cm transversally. The tumor growth was surgically resected and curettage was performed on the epiphyseal nucleus of ossification of the upper and medial centers of the patella, with good patellar remodeling and normal development. The patient did not present any recurrence of the lesion up to the time of reaching skeletal maturity.

Descrever aspectos cirúrgicos da ressecção de displasia epifisária hemimélica da patela. Os aspectos clínicos e de imagem já foram descritos em outro artigo. Paciente masculino, seis anos, com tumor de crescimento lento em joelho direito, por dois anos, com dimensões de 12 cm no eixo longitudinal e 6 cm no transversal, aderido à patela. Biópsia sugeriu lesão osteocondromatosa benigna, sem diagnóstico definido. Exames de imagem, como radiografias e tomografias, com áreas de formação óssea e áreas radiotransparentes e na ressonância magnética áreas de hipo e hiperssinal em T1 e T2, de tamanho estimado em 8,5 cm no eixo longitudinal e 6 cm no transversal. Foram feitas ressecção cirúrgica da tumoração e curetagem do núcleo de ossificação epifisário do polo superior e medial da patela, com boa remodelação patelar e desenvolvimento normal. Paciente não apresentou recidiva da lesão até o término da maturidade esquelética.

Keywords: Bone neoplasia; Knee; Osteochondrodysplasia.

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Figures

Fig. 1
Fig. 1
Preoperative appearance, with medial view (A) and lateral view (B) of the right knee with patellar tumor formation: hemimelic epiphyseal dysplasia.
Fig. 2
Fig. 2
Preoperative appearance on lateral radiographs of the right knee, with patellar tumor formation showing one month of evolution (A), one year (B) and immediately before the surgery (C): hemimelic epiphyseal dysplasia.
Fig. 3
Fig. 3
Preoperative appearance on axial computed tomography slice (A) and on T2-weighted sagittal magnetic resonance slice (B) of the right knee with voluminous patellar tumor formation, immediately before surgery: hemimelic epiphyseal dysplasia.
Fig. 4
Fig. 4
Intraoperative appearance of the resection of the patellar tumor formation (hemimelic epiphyseal dysplasia), showing lateral longitudinal parapatellar incision (A), dissection at muscle-tendon layer (B) and intracapsular layer (C).
Fig. 5
Fig. 5
Intraoperative appearance of the resection of the patellar tumor formation (hemimelic epiphyseal dysplasia), showing excision of the pedunculate voluminous mass with osteocartilaginous characteristics (A), surgical removal of the nucleus of ossification that originated the dysplasia (B), curettage and final cleaning of the upper center of the patella (C).
Fig. 6
Fig. 6
Appearance one year after the operation, with anterior view (A) and lateral view (B) of the right knee, with full extension and flexion: hemimelic epiphyseal dysplasia.
Fig. 7
Fig. 7
Appearance one year after the operation, on radiographs of the right knee in axial view (A) and lateral view (B), showing adequate growth of the patella.
See this image and copyright information in PMC

References

    1. Mouchet A., Belot J. La tarsomégalie. J Radiol Électrol. 1926;10:289–293.
    1. Trevor D. Tarso-epiphysialaclasis. A congenital error of epiphysial development. J Bone Joint Surg Br. 1950;32(2):204–213. - PubMed
    1. Fairbank T.J. Dysplasia epiphysealis hemimelica (tarso-epiphysial acalasis) J Bone Joint Surg Br. 1956;38(1):237–257. - PubMed
    1. Enriquez J., Quiles M., Torres C. A unique case of dysplasia epiphysealis hemimelica of the patella. Clin Orthop Relat Res. 1981;(160):168–171. - PubMed
    1. Araujo C.R., Jr., Montandon S., Montandon C., Teixeira K.I., Moraes F.B., Moreira M.A. Best cases from the AFIP: dysplasia epiphysealis hemimelica of the patella. Radiographics. 2006;26(2):581–586. - PubMed

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