case_images: PMC9826562_01
case_images: Pre-operative clinical photograph showing localized redness and soft-tissue swelling on the proximal medial tibial metaphyseal region. Full knee ROM could be seen.
case_images: JOCR-12-96-g001.jpg
case_images: PMC9826562_01_JOCR-12-96-g001.jpg
case_images: F1
case_images: On inspection, the left medial proximal tibial region showed redness and swelling (Fig. 1).
case_images: Radiographic evaluation of the left knee in AP and lateral views.
case_images: JOCR-12-96-g002.jpg
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case_images: F2
case_images: Clinical findings were confirmed by radiographs in anterior posterior (AP) and lateral views (Fig. 2).
case_images: Magnetic resonance imaging films suggestive of a well localized, non-articular lesion of proximal medial, and posteromedial tibial metaphysis of the left side in (a) T1-weighted sagittal image, (b) T2-weighted sagittal image, (c) T2 weighted coronal image, and (d) PD-FAT-SAT coronal image.
case_images: JOCR-12-96-g003.jpg
case_images: PMC9826562_01_JOCR-12-96-g003.jpg
case_images: F3
case_images: It was concluded that the lesion was suggestive of either an osteoblastoma or a hemangioma (Fig. 3).
case_images: Exposed involved bone through a medial incision. Sclerotic bone with formation of pores over the cortical surface.
case_images: JOCR-12-96-g004.jpg
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case_images: F4
case_images: Further, deeper portions were removed using a cross-action nibbler and a scoop (Figs. 4 and 5).
case_images: Sequential creation of a rectangular window and excision of the diseased bone using a scoop and cross-action nibbler.
case_images: JOCR-12-96-g005.jpg
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case_images: F5
case_images: Further, deeper portions were removed using a cross-action nibbler and a scoop (Figs. 4 and 5).
case_images: Sequential fluoroscopic intraoperative AP and lateral views showing complete excision of the lesion.
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case_images: F6
case_images: Resection was confirmed sequentially on fluoroscopy (Fig. 6).
case_images: Sequential fluoroscopic intraoperative views showing filling of the void with an allograft. Post impaction of allograft, an HA block was applied on the cortex and a three-hole Polyethyl Ether Ketone plate was applied. Last fluoroscopic picture is suggestive of final fixation of the proximal tibia.
case_images: JOCR-12-96-g007.jpg
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case_images: F7
case_images: After impaction of the allograft, breach in the cortical outline was supplemented using hydroxyapatite block and a three-hole medial support plate made of polyethyl ether ketone (PEEK) (Fig. 7).
case_images: Immediate post-operative radiograph.
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case_images: F8
case_images: Construct integrity was acceptable under fluoroscopy in AP and lateral views (Fig. 8).
case_images: (a) Four weeks post-operative radiograph and (b) 6 months post-operative radiographs suggestive of good incorporation of bone allograft and regained continuity of the cortical outline.
case_images: JOCR-12-96-g009.jpg
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case_images: F9
case_images: Radiographic union with incorporation of the bone allograft was observed (Fig. 9). The patient had been followed up for the next 6 months with no complaints and no recurrence of the lesion and the radiograph showing complete consolidation of the allograft with no obvious cortical defect (Fig. 9).
case_images: Clinical photographs at 6 months postoperatively showing (a) good scar healing (b) sitting cross-legged, and (c) complete flexion.
case_images: JOCR-12-96-g010.jpg
case_images: PMC9826562_01_JOCR-12-96-g010.jpg
case_images: F10
case_images: At 8 weeks, the patient started walking with full weight-bearing and had regained almost full ranges of motion at the knee joint and was able to sit cross-legged too (Fig. 10).