Breaking Free from Knee Pain: A Surgical Triumph in Managing Pellegrini-Stieda Syndrome with Massive Lesion: A Case Report

J Orthop Case Rep. 2024 Apr;14(4):13-17. doi: 10.13107/jocr.2024.v14.i04.4342.

Abstract

Introduction: Introduction: Pellegrini-Stieda syndrome, characterized by medial collateral ligament (MCL) calcification or ossification, often follows a history of trauma. While rare, its distinct radiographic features pose diagnostic challenges. Conservative treatments are effective for many, but surgical intervention is necessary when they fail.

Case report: A 31-year-old male with knee pain and stiffness, an inability to extend his knee, and a fixed flexion deformity. Radiological examinations confirmed heterotopic ossification along the MCL, indicating post-traumatic Pellegrini-Stieda syndrome. Despite 3 months of conservative treatment, the patient's pain persisted, leading to surgical excision. The surgical approach involved diagnostic arthroscopy, revealing arthritic changes and adhesions. Arthroscopic adhesiolysis and open excision of the ossified mass significantly improved the patient's range of motion. Histopathological examination confirmed heterotopic bone formation. Follow-up appointments at 1, 3, and 6 months showed a pain-free and mobile knee joint, with the Pellegrini-Stieda lesion disappearing from radiographs.

Conclusion: This case underscores the effectiveness of surgical intervention for refractory Pellegrini-Stieda syndrome, offering hope for improved patient outcomes and highlighting the importance of early diagnosis and tailored treatment in managing this rare condition.

Keywords: Pellegrini–stieda syndrome; arthroscopic adhesiolysis; heterotopic ossification; massive lesion; medial collateral ligament.

Publication types

  • Case Reports