Using Imageless Optical Navigation to Identify the New Hip Center in Crowe IV Dysplasia.

In total hip arthroplasty for patients with acetabular dysplasia, cup placement in the native acetabulum is preferred to placement in the pseudoacetabulum. Identifying the true acetabulum may prove challenging. In a patient with Crowe IV dysplasia, 3-dimensional mini-optical navigation was used to match the new hip center to the preoperative radiographic plan, which was identified to be 34 mm inferior to the pseudoacetabulum.

A Stepwise Approach to Management of Open Radiocarpal Fracture-Dislocations: A Case Report.

Radiocarpal dislocations are uncommon and occur after significant trauma. We describe a unique case of open radiocarpal fracture-dislocation presenting with progressive neurovascular compromise. Staged management was necessary.

That Tendon is the Median Nerve: Perils of a Palmaris Longus Deficient Wrist.

Background: To document the course of the median nerve in the distal forearm in palmaris longus (PL) deficient forearms and elucidate features that help distinguish it from the PL.

Methods: In the cadaveric study, 56 cadaveric forearms were dissected and the location and course of the median nerve were documented. In the clinical study, 20 healthy subjects with absent PL were examined with provocative tests to elucidate the PL (Schaeffer's test and Thompson's test), and modified Durkan's and Phalen's tests.

Total Knee Arthroplasty in Obesity: In-Hospital Outcomes and National Trends.

Background: Both the prevalence of obesity and the utilization rate of total knee arthroplasty are increasing. The rate and proportion of total knee arthroplasty (TKA) performed in the setting of obesity/morbid obesity is increasing significantly over time.

Methods: Using International Classification of Diseases-Ninth Revision codes, we searched the National Hospitals Discharge Survey national database for patients admitted for primary TKA between 2001 and 2010.

Posterolateral dislocation of the knee: Recognizing an uncommon entity.

Posterolateral dislocations of the knee are rare injuries. Early recognition and emergent open reduction is crucial. A 48-year-old Caucasian male presented with right knee pain and limb swelling 3 d after sustaining a twisting injury in the bathroom.

Methicillin-resistant Staphylococcus aureus infected gluteal compartment syndrome with rhabdomyolysis in a bodybuilder.

Gluteal compartment syndrome (GCS) is a rare condition. We present a case of gluteal muscle strain with hematoma formation, methicillin-resistant Staphylococcus aureus (MRSA) superinfection, leading to acute GCS, rhabdomyolysis and acute kidney injury. This combination of diagnoses has not been reported in the literature.

Design and characterization of an injectable tendon hydrogel: a novel scaffold for guided tissue regeneration in the musculoskeletal system.

A biocompatible hydrogel consisting of extracellular matrix (ECM) from human tendons is described as a potential scaffold for guided tissue regeneration and tissue engineering purposes. Lyophilized decellularized tendons were milled and enzymatically digested to form an ECM solution. The ECM solution properties are assessed by proteome analysis with mass spectrometry, and the material's rheological properties are determined as a function of frequency, temperature, and time.

Reconstruction of the tendon-bone insertion with decellularized tendon-bone composite grafts: comparison with conventional repair.

Purpose: Injuries involving the tendon-bone interface (TBI) are difficult to address. Standard techniques typically lead to diminished strength of the healed insertion site. We hypothesized that these injuries would benefit from being reconstructed with decellularized composite grafts replacing both tendon and bone.

Human flexor tendon tissue engineering: in vivo effects of stem cell reseeding.

Background: Tissue-engineered human flexor tendons may be an option to aid in reconstruction of complex upper extremity injuries with significant tendon loss. The authors hypothesize that human adipose-derived stem cells remain viable following reseeding on human tendon scaffolds in vivo and aid in graft integration.

Methods: Decellularized human flexor tendons harvested from fresh-frozen cadavers and reseeded with green fluorescent protein-labeled pooled human adipose-derived stem cells were examined with bioluminescent imaging and immunohistochemistry.

Tissue-engineered collateral ligament composite allografts for scapholunate ligament reconstruction: an experimental study.

Purpose: In patients with chronic scapholunate (SL) dissociation or dynamic instability, ligament repair is often not possible, and surgical reconstruction is indicated. The ideal graft ligament would recreate both anatomical and biomechanical properties of the dorsal scapholunate ligament (dorsal SLIL). The finger proximal interphalangeal joint (PIP joint) collateral ligament could possibly be a substitute ligament.

The effect of suture coated with mesenchymal stem cells and bioactive substrate on tendon repair strength in a rat model.

Purpose: Exogenously administered mesenchymal stem cells and bioactive molecules are known to enhance tendon healing. Biomolecules have been successfully delivered using sutures that elute growth factors over time. We sought to evaluate the histologic and biomechanical effect of delivering both cells and bioactive substrates on a suture delivery vehicle in comparison with sutures coated with bioactive substrates alone.

Human flexor tendon tissue engineering: revitalization of biostatic allograft scaffolds.

Cadaveric tendon allografts form a readily available and underutilized source of graft material. Because of their material properties, allografts are biomechanically and biologically superior to synthetic scaffolds. However, before clinical use, allografts must undergo decellularization to reduce immunogenicity and oxidation to increase porosity, leaving a nonvital biostatic scaffold.

Overcoming the learning curve: a curriculum-based model for teaching zone II flexor tendon repairs.

Background: Repairs of zone II flexor tendons have benefited in recent years from modifications involving suture technique and configuration. These advances, however, present new obstacles in resident training. A focused tutorial incorporating a practical, hands-on exercise and standardization of technique may offer an effective low-risk, low-cost strategy for overcoming these challenges.

Human flexor tendon tissue engineering: decellularization of human flexor tendons reduces immunogenicity in vivo.

Background: In mutilating hand injuries, tissue engineered tendon grafts may provide a reconstructive solution. We have previously described a method to decellularize cadaveric human flexor tendons while preserving mechanical properties and biocompatibility. The purpose of this study is to evaluate the immunogenicity and strength of these grafts when implanted into an immunocompetent rat model.

Three-dimensional-construct bioreactor conditioning in human tendon tissue engineering.

Human tendon tissue engineering attempts to address the shortage of autologous tendon material arising from mutilating injuries and diseases of the hand and forearm. It is important to maximize the tissue-engineered construct's (TEC's) biomechanical properties to ensure that the construct is in its strongest possible state before reimplantation. In this study, we sought to determine the bioreactor treatment parameters that affect these properties.

Flexor tendon tissue engineering: acellularization of human flexor tendons with preservation of biomechanical properties and biocompatibility.

Objective: Acellular human tendons are a candidate scaffold for tissue engineering flexor tendons of the hand. This study compared acellularization methods and their compatibility with allogeneic human cells.

Method: Human flexor tendons were pretreated with 0.

Subtalar arthroscopy and flurosocopy in percutaneous fixation of intra-articular calcaneal fractures: the best of both worlds.

Background: Fixation of intra-articular calcaneal fractures has traditionally been guided by intraoperative fluoroscopy. Recent reports indicate that there is a role for subtalar arthroscopy in surgical fixation of these fractures. The earliest reports described the use of subtalar arthroscopy for joint assessment during late hardware removal.

Rice bodies, millet seeds, and melon seeds in tuberculous tenosynovitis of the hand and wrist.

Tuberculosis (TB) is still endemic in many developed countries. Involvement of the hand and wrist at presentation is extremely rare, and the diagnosis is often missed. Operative findings of "rice bodies, millet seeds, or melon seeds" are highly suggestive of tuberculous tenosynovitis.

Hazards of steroid injection: Suppurative extensor tendon rupture.

Local steroid injections are often administered in the office setting for treatment of trigger finger, carpal tunnel syndrome, de Quervain's tenosynovitis, and basal joint arthritis. If attention is paid to sterile technique, infectious complications are rare. We present a case of suppurative extensor tenosynovitis arising after local steroid injection for vague symptoms of dorsal hand and wrist pain.

CASE REPORT Journey of a Noma Face.

Objective: Noma, or cancrum oris, is rare in developed countries. Surgeons are likely to encounter this disease only in the context of a medical mission. While it is tempting to approach noma sequelae as an oncologic resection, an understanding of the disease process will reveal that the challenge is quite different.