Medical Education - Research Publications

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Start date: 2000 × End date: 2009 × Author: Choong, Peter ×

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    The relevance of ligament balancing in total knee arthroplasty: how important is it? A systematic review of the literature
    Babazadeh, S ; Stoney, JD ; Lim, K ; Choong, PFM (PAGEPRESS PUBL, 2009)
    Ligament balancing affects many of the postoperative criteria for a successful knee replacement. A balanced knee contributes to improved alignment and stability. Ligament balancing helps reduce wear and loosening of the joint. A patient with a balanced knee is more likely to have increased range of motion and proprioception, and decreased pain. All these factors help minimize the need for revision surgery. Complications associated with ligament balancing can include instability caused by over-balancing and the possibility of neurovascular damage during or as a result of ligament balancing. This article attempts to summarize the literature, to define a balanced knee, and outline the benefits and possible complications of ligament balancing. Different techniques, sequences, and tools used in ligament balancing, and their relevance in correcting various deformities are reviewed.
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    Intraosseous angiosarcoma with secondary aneurysmal bone cysts presenting as an elusive diagnostic challenge.
    Tse, LF ; Ek, ET ; Slavin, JL ; Schlicht, SM ; Choong, PF (Springer Science and Business Media LLC, 2008-05-20)
    Angiosarcoma of bone is an exceedingly rare primary bone malignancy that can present as an aggressive osteolytic lesion. Histological diagnosis can be extremely challenging, as the pathological features often resemble that of aneurysmal bone cysts. We report an interesting and peculiar case of an intraosseous angiosarcoma that presented as a diagnostic dilemma and discuss the relevant radiological and pathologic findings.
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    The role of thallium-201 and pentavalent dimercaptosuccinic acid for staging cartilaginous tumours.
    Choong, PF ; Kunisada, T ; Slavin, J ; Schlicht, S ; Hicks, R (Springer Science and Business Media LLC, 2004-11-08)
    INTRODUCTION: Heterogeneity of cartilage tumours may confound accurate diagnosis and grading resulting in under and over treatment. Improved preoperative assessment of malignancy and grade would be invaluable for developing a rational plan for treatment. We examined correlations between nuclear tracer avidity and malignancy grade in cartilage tumours. METHODS: Between 1996 and 2000, 92 consecutive patients with cartilaginous tumours (50 benign, 42 non-metastatic malignant) underwent nuclear scanning. Thallium-201 (TL-201) and pentavalent dimercaptosuccinic acid (DMSAV) were used as nuclear isotopes. Scanning with these agents was performed on separate days 48 hours apart. Static and SPECT images were obtained at 30 m and 4 h after injection of nuclear tracer. Pathology review was undertaken blinded to the results of the nuclear scans and correlations between histologic results and trace uptake at 4 hours examined. RESULTS: 25 patients with negative DMSAV had benign tumours. 15/17 tumours with positive TL-201 had malignant tumours. 11/13 patients with both positive DMSAV and TL-201 scans had intermediate or high grade tumours and 4 of these developed metastases. We have developed an algorithm for the management of patients with tumours that aims to avoid over treatment of low grade tumours and under treatment of high grade tumours. CONCLUSION: Functional nuclear scanning with TL-201 and DMSAV complements other imaging modalities in the management of cartilaginous tumours.