Clinical and surgical factors influencing screw breakage during hardware removal following periacetabular osteotomy.

Periacetabular osteotomy (PAO) is a procedure used to treat patients with hip dysplasia. Current literature reports symptomatic hardware removal (HWR) rates of 13.6% following PAO.

Favorable Early Outcomes and High Clinical Benefit Achievement Rate With Concomitant Hip Arthroscopy and Periacetabular Osteotomy for the Treatment of Developmental Dysplasia of the Hip.

Purpose: To report minimum 2-year follow-up patient-reported outcomes (PROs), clinical benefit, and survivorship in patients who underwent concomitant hip arthroscopy and periacetabular osteotomy (PAO) for the surgical treatment of the developmental dysplasia of the hip (DDH).

Methods: Prospectively collected data were retrospectively reviewed for patients who underwent hip arthroscopy with concomitant PAO between December 2015 and September 2022. Patients with baseline and minimum 2-year PROs were included.

Variability Between Full-Length Lateral Radiographs and Standard Short Knee Radiographs When Evaluating Posterior Tibial Slope in Revision ACL Patients.

Background: Increased posterior tibial slope (PTS) has been identified as a risk factor for failure after anterior cruciate ligament (ACL) reconstruction. Correction of PTS may improve outcomes after revision ACL reconstruction. There are conflicting reports demonstrating the measurement of the PTS on standard short knee (SSK) radiographs versus full-length lateral (FLL) radiographs including the entire tibia.

Survivorship, complications, and outcomes following distal femoral replacement for neoplastic indications.

Background: Distal femoral replacements (DFRs) are excellent treatment options for limb salvage procedures in patients who have bone loss secondary to neoplasm. Multiple studies report adequate survivorship and complication rates following DFR implantation, primarily for non-neoplastic indications. However, current literature regarding neoplasm-specific reports is often limited by sample size, survivorship, and patient reported outcome measurements.

Use of a Cannulated, Percutaneous Expandable Reamer for Physeal Sparing Excision of a Femoral Head Chondroblastoma.

The treatment of chondroblastoma in the epiphysis of the femoral head in skeletally immature individuals is challenging and often requires surgical hip dislocation. We present a unique method of percutaneous use of an expandable reamer (X-REAM, Wright Medical) to treat a chondroblastoma of the femoral head in a 9-year-old boy without requiring surgical hip dislocation. The described technique provides access to the tumor in the proximal femoral epiphysis and local tumor control.

National evaluation of patterns and predictors of underuse of multimodal therapy for high-risk extremity soft tissue sarcoma.

Background: Treatment of high-risk extremity soft tissue sarcomas remains widely varied. Despite growing support for a multimodal approach for treatment of these rare and aggressive neoplasms, its dissemination remains underused. This national study aimed to evaluate variations in treatment patterns and uncover factors predictive of underuse of multimodal therapy in high-risk extremity soft tissue sarcomas.

The Effect of Modern Antiretroviral Therapy on Complication Rates After Total Hip Arthroplasty.

Background: Antiretroviral therapy (ART) remains the cornerstone of decreasing morbidity and mortality in patients with human immunodeficiency virus (HIV), but additional information on its impact on total hip arthroplasty (THA) complication rates is needed to mitigate risks postoperatively. Therefore, we sought to examine patients with HIV who were and were not taking ART compared with a cohort without HIV in the setting of primary THA with respect to the following outcomes: length of stay, readmissions, and postoperative infection.

Methods: A retrospective database review was performed with PearlDiver for patients who underwent THA from 2010 to 2019 (n = 729,101).

Early Experience in Pathologic Humerus Fracture Treated With the Photodynamic Bone Stabilization System Shows Limitations Related to Patient Selection.

Impending and complete pathologic fractures often necessitate surgical fixation. Traditional orthopedic implants are commonly used, achieving clinically acceptable outcomes, but their metallic composition can impair radiographic evaluation and affect radiation treatments. Recognition of these concerns led to the development of radiolucent implants such as the minimally invasive Photodynamic Bone Stabilization System (PBSS; IlluminOss Medical Inc), featuring a light cured polymer contained within an inflatable balloon catheter.

Current Biopsy Methods for Primary Musculoskeletal Lymphoma: A Retrospective Multicenter Review.

Primary musculoskeletal lymphoma often requires multiple biopsies for tissue confirmation. This challenge is understood by specialists but has not been specifically quantified. One-hundred-eighteen biopsies performed in 100 cases of primary musculoskeletal lymphoma was performed.

Imaging of spindle cell lipoma.

Aim: To review the evaluation, diagnosis, and treatment of spindle cell lipoma (SCL) with emphasis on the location of these tumours and the spectrum of magnetic resonance imaging (MRI) and computed tomography (CT) appearances.

Materials And Methods: The MRI and CT findings of 27 histopathologically proven SCLs were evaluated retrospectively. Imaging features evaluated included margins, percentage visible fat, MRI signal characteristics, oedema, and contrast enhancement patterns.

Ground-Breaking Innovations in General Psychology.

The article addresses two recently published books in General Psychology by Niels Engelsted and Jens Mammen. The two approaches offer in their own way solutions to the so-called 'crisis of psychology'. Mammen's new logical foundation for psychology is based on two different properties of the objects we relate to: those characterizing the objects appearances, and those characterizing the objects as unique substances or singulars distributed in time and space - the existence of the objects as opposed to the appearance of the objects.

Gouty involvement of the patella and extensor mechanism of the knee mimicking aggressive neoplasm. A case series.

Gout is a common inflammatory crystal deposition disease that occurs in many joints throughout the body. Active gout is most often associated with painful synovitis causing searing joint pains, but gout can also produce large masses of space-occupying deposits called tophi. Tophi are most frequently seen in juxta-articular locations with or without bony erosion and are often misdiagnosed as degenerative joint disease.

Erosive Breast Cancer Metastasis to the Ankle: A Case Report.

Intra-articular tumors in the ankle are a rare presentation for metastatic disease. Metastatic breast disease presenting distal to the knee or within any joint is especially rare. We present a case of a painful intra-articular breast metastasis in a 56-year-old female with known breast carcinoma.

Hypercalcemia and diffuse osteolytic lesions in a 45-year-old patient with myeloid sarcoma with megakaryocytic differentiation.

Acute megakaryocytic leukemia is a rare form of acute myeloid leukemia that carries a poor prognosis. As most cases of osteolytic lesions are due to plasma cell and myeloid malignancies, maintaining a broad differential directly influences clinical course. We document a 45-year-old patient with progressive constitutional symptoms, osteolytic bone lesions in the setting of hypercalcemia, who developed acutely worsening pancytopenia.

PPP6R3-USP6 amplification: Novel oncogenic mechanism in malignant nodular fasciitis.

Nodular fasciitis (NF) is a clonal self-limited neoplastic proliferation characterized by rearrangements of the USP6 locus in most examples. To our knowledge well-documented malignant behavior has never been previously observed in NF. In this report we present an unusual case of NF with classical histologic features that showed a protracted clinical course characterized by multiple recurrences and eventual metastatic behavior over a period of 10 years.

CT-based Structural Rigidity Analysis Is More Accurate Than Mirels Scoring for Fracture Prediction in Metastatic Femoral Lesions.

Background: Controversy continues regarding the appropriate assessment of fracture risk in long bone lesions affected by disseminated malignancy.

Questions/purposes: The purpose of this ongoing Musculoskeletal Tumor Society-sponsored, multi-institutional prospective cross-sectional clinical study is to compare CT-based structural rigidity analysis (CTRA) with physician-derived Mirels scoring for predicting pathologic fracture in femoral bone lesions. We hypothesized CTRA would be superior to Mirels in predicting fracture risk within the first year based on (1) sensitivity, specificity, positive predictive value, and negative predictive value; (2) receiver operator characteristic (ROC) analysis; and (3) fracture prediction after controlling for potential confounding variables such as age and lesion size.

Treatment Planning and Fracture Prediction in Patients with Skeletal Metastasis with CT-Based Rigidity Analysis.

Purpose: Pathologic fractures could be prevented if reliable methods of fracture risk assessment were available. A multicenter prospective study was conducted to identify significant predictors of physicians' treatment plan for skeletal metastasis based on clinical fracture risk assessments and the proposed CT-based Rigidity Analysis (CTRA).

Experimental Design: Orthopedic oncologists selected a treatment plan for 124 patients with 149 metastatic lesions based on the Mirels method.

Angiosarcoma arising in a patient with a 10-year-old hemangioma.

The transformation of a benign hemangioma into a malignant angiosarcoma has been rarely reported, with only 11 cases reported in the literature. There have been no reports of malignant transformation of hemangioma into angiosarcoma in association with epithelioid hemangioendothelioma, to our knowledge. The existence of precursor malignancies in the tumorigenesis of sarcomas is still not clearly defined.