Knee osteoarthritis associated with extra-articular deformity treated by total knee arthroplasty plus simultaneous corrective osteotomy.

Background And Objective: Correct mechanical limb alignment is crucial in Total Knee Arthroplasty (TKA) and is particularly difficult to achieve when the knee osteoarthritis (KOA) is associated with an Extra-Articular Deformity (EAD). Our objective is to present a surgical option in cases of severe knee arthritis associated with an EAD (indications, mechanical planning and surgical technique), pros and cons and discuss the results with this one-stage technique.

Material And Methods: We retrospectively reviewed all cases of severe KOA associated with EAD treated surgically in our institution from 2010-2016.

[Translated article] Bone lengthening with magnetic nails. Experience in patients younger than 18.

Background And Goal: Bone elongation with magnetic endomedullary nails (MEN) has been proposed as an advantageous alternative to other techniques, by eliminating the drawbacks of external fixation. The aim of this work is to analyse the results and assess the complications in a series of patients under the age of 18.

Material And Methods: From 2014 to 2019, 31 elongations (23 femurs, 8 tibias) using MEN (Precice2®) have been performed in 28 patients younger than 18 (15 males and 13 females).

Bone lengthening with magnetic nails. Experience in patients younger than 18.

Background And Goal: Bone elongation with magnetic endomedullary nails (MEN) has been proposed as an advantageous alternative to other techniques, by eliminating the drawbacks of external fixation. The aim of this work is to analyze the results and assess the complications in a series of patients under the age of 18.

Material And Methods: From 2014 to 2019, 31 elongations (23 femurs, 8 tibias) using MEN (Precice2™) have been performed in 28 patients younger than 18 (15 males and 13 females).

Salvage Procedures of the Shoulder: Glenohumeral Arthrodesis and Resection Arthroplasty.

Background: With the advances of modern medicine and technology there has been an increase of indications of shoulder reconstruction techniques and shoulder arthroplasty. Consequently, the number of complications and failures have increased in parallel. Not negligible number of cases are driven to an end-stage situation where salvage procedures, such as glenohumeral arthrodesis (GHA) and shoulder resection arthroplasty (SRA), are the only remaining solution.

Atraumatic Anterior Hip Dislocation as High Grade of Hip Instability: A Case Report.

Case: Fifty-year-old woman who presented an atraumatic anterior hip dislocation during a local traditional dance exhibition. The dislocation occurred during a dance step in which extreme hip position in extension and external rotation was held. After urgent closed reduction under general anesthesia, the patient underwent conservative management with a follow-up of 24 months.

Upper Limb Lengthening in Achondroplasia Using Unilateral External Fixation.

Purpose: The purpose of this study was to analyze the long-term results of humeral lengthening in achondroplastic patients and make suggestions on the most appropriate surgical technique to improve patient outcomes.

Methods: Fifty-four humeral lengthening procedures performed in 27 achondroplastic patients were reviewed. Elongations were performed by means of callotasis with unilateral external fixation.

Update on premature physeal closure. Diagnosis and treatment.

Purpose Of Review: Premature Physeal Closure (PPC) is the most common consequence of a mostly posttraumatic, physeal injury. They are of utmost importance because they can significantly alter physeal function and lead to disorders such as limb length discrepancies and angular deformities.

Recent Findings: The type of physeal fracture has not demonstrated a solid predictive value in the formation of PPC, especially in the knee where almost any type of fracture can produce it.

Prospective study of pediatric medial humeral epicondyle fractures nonoperatively treated. Clinical, radiologic, and functional evaluation at long term.

The objective of the study is to evaluate the natural history of the medial epicondyle avulsion in children with nonoperative treatment (NOPT) on different magnitude of displacement and long-term follow-up. A prospective study of 34 patients with medial epicondyle avulsion with (NOPT) was performed. Clinical test (stability, strength, atrophy, tenderness, Tinel test, and range of motion), subjective scores [Visual Analog Scale (VAS), Likert scale, side-to-side valgus test], and objective four scores were performed.

One-Stage Total Knee Arthroplasty Plus Corrective Osteotomy for Osteoarthritis Associated With Severe Extra-articular Deformity.

The mainstay for treatment of articular deformity caused by advanced tricompartmental osteoarthritis of the knee is total knee arthroplasty. When this is also associated with an extra-articular deformity, this also must be compensated or corrected. In this scenario, it is essential to achieve an optimal mechanical situation by restoring the anatomical and mechanical limb axes and an adequate soft-tissue balance.

Lateral circumflex femoral artery false aneurysm as a complication of intertrochanteric hip fracture with displaced lesser trochanter.

We present a patient who suffered an unstable intertrochanteric hip fracture and underwent osteosynthesis with a trochanteric nail. During the postoperative period, he presented a pseudoaneurysm of the lateral circumflex branch of the deep femoral artery secondary to a displaced fracture of the lesser trochanter. With the suspected diagnosis due to indirect clinical and radiological signs and confirmation by Doppler ultrasound and computed tomography angiography, a transverse arterial embolization with resolution of the symptoms was carried out.

Update on treatment of adolescent Blount disease.

Purpose Of Review: Treatments available to correct adolescent Blount disease deformities differ in terms of features, advantages, and disadvantages. Each is indicated, therefore, for different scenarios of severity, physeal condition, and maturity. The purpose of this review is to update basic concepts, surgical treatments, and controversies concerning this disorder.

Core Decompression Augmented With Autologous Bone Marrow Aspiration Concentrate for Early Avascular Necrosis of the Femoral Head.

Lack of necessary perfusion to the femoral head can lead to necrosis of the underlying bone (avascular necrosis) and result in femoral and acetabular surface changes in advanced stages. Numerous treatments have been reported in the literature, including nonoperative and surgical procedures. In addition to the standard core decompression, we describe the use of bone marrow aspirate to stimulate a healing response and bone grafting, allowing for immediate weight bearing postoperatively.

Proximal Rectus Femoris Avulsion Repair.

Proximal rectus femoris tendon avulsions are rare and occur mostly in male athletes. Currently, the standard of care for complete tendinous avulsions of the direct arm of the rectus femoris is nonoperative treatment. However, surgical repair may be considered in high-level athletes who have a high demand for repetitive hip flexion performed in an explosive manner or in patients in whom nonoperative treatment has failed.

Reactivation of coccidioidomycosis: a prosthetic joint infection in Spain.

A resident of Spain was found to have a prosthetic knee infection due to coccidioidomycosis. He had a history of having pneumonia which resolved while living in an area of California endemic for Coccidioides in 1957-1961. The patient left California in 1961 returned to Spain and never left Spain thereafter.