It is often technically demanding to find and remove loose bodies in several difficult locations like the popliteus hiatus and posterior compartment arthroscopically. We aim to present the technical aspects of establishing some special accessory portals to achieve arthroscopic removal of the loose bodies in these locations. From September 2010 to July 2017, 76 patients underwent removal of loose bodies in the popliteus hiatus and posterior compartment arthroscopically using some special accessory portal techniques. An auxiliary extreme lateral approach was established to remove loose bodies in the popliteus hiatus; a double-posteromedial portal was applied to handle loose body removal in the posteromedial compartment, and the posterior trans-septal portal was needed for loose body removal in the posterolateral compartment. Functional outcomes were evaluated using Lysholm score, Tegner score, and International Knee Documentation Committee (IKDC) score, respectively. Seventy-six patients (24 males and 52 females, average age 54.9 ± 11.4) finished the follow-up visit at 3 weeks after surgery. There was no statistically significant difference among the three groups in demographics. All the patients were performed following the special technique. According to a comparison of knee joint scores before and after surgery, all the patients obtained good prognosis using some special accessory portals in loose body removal. With the help of the above accessory portals under endoscopic visualization, loose bodies in the popliteus hiatus and posterior compartment of the knee can be safely and effectively removed.

To report the clinical and radiographic outcomes of isolated medial patellofemoral ligament (MPFL) reconstruction in patients with recurrent or first-time

To compare clinical outcomes and complications of medial patellofemoral ligament (MPFL) reconstruction using femoral fixation proximal versus distal to the

BACKGROUND Infectious arthritis is an infection of the joint and joint cavities, with Staphylococcus aureus being the most common causative agent. Most cases of infectious arthritis are caused by a single pathogen, with polymicrobial infections being comparatively rare. This article describes a patient with a knee infection caused by Treponema pallidum, Brucella spp., and possibly co-infected with Mycobacterium tuberculosis and Escherichia coli (E. coli). The aim of this paper is to discuss the characteristics of atypical joint diseases caused by multi-pathogenic infections and to provide a reference for the diagnosis and treatment of related diseases. CASE REPORT A 58-year-old male veterinarian from western China presented with pain, swelling, and restricted movement in his left knee after arthroscopic surgery. The imaging results showed extensive and severe damage to the knee joint structure, but the laboratory results showed that the neutrophil level was normal and he did not experience severe pain. His blood and cerebrospinal fluid were positive for Treponema pallidum antibodies and his blood was positive for IgG antibodies against Brucella abortus. Because the knee joint was severely damaged, knee arthrodesis surgery was performed, with a satisfactory outcome. CONCLUSIONS This case was a multi-pathogenic joint infection with a complex course. By comparing the patient's test results and clinical condition with the common features and symptoms of Charcot arthropathy, we concluded that syphilis had invaded the central nervous system, and that Charcot arthropathy, likely secondary to neurosyphilis, masked the severe pain typically associated with extensive joint destruction. This case highlights the diagnostic challenges associated with such conditions.