Diffuse-Type Tenosynovial Giant Cell Tumor An Update of Current Management Strategies.

Diffuse-type giant cell tumor (Dt-GCT), formerly known as pigmented villonodular synovitis, is the more aggressive entity belonging to the spectrum of benign proliferative lesions of synovial origin that may affect the joints, bursae, and tendon sheaths. Diffuse-type giant cell tumor's importance stems from its local aggressiveness and sequelae if left untreated. This review briefly describes Dt-GCT's clinical features, its imaging and pathology findings, and provides an extensive discussion of its available treatments.

Outcomes of treatment for developmental dislocation of the hip when the Pavlik method has failed.

Objectives: Despite the success rate of the Pavlik method in the treatment of developmental dislocation of the hip, there is a subset of hips that do not reduce with harness use. The purpose of this study was to determine the outcomes after closed reduction (CR), open reduction (OR) and combined open reduction and pelvic osteotomy (OR+PO) in patients with infantile hip dislocations who initially failed the Pavlik method.

Methods: This was a retrospective cohort study of patients with infantile hip dislocations who failed the Pavlik method and subsequently underwent a secondary procedure for persistent hip dislocation.

Dedifferentiated Chondrosarcoma: Diagnostic Controversies and Emerging Therapeutic Targets.

Purpose Of Review: The pathogenesis of dedifferentiated chondrosarcoma is controversial, and no genetic abnormality has consistently been identified in the disease. Focusing on the diagnostic challenges encountered in dedifferentiated chondrosarcoma, the following review aims at summarizing the tumor's active neoplastic pathways while highlighting therapeutic modalities that could potentially be explored to enhance patient survivorship.

Recent Findings: Owing to the challenging examination of small needle biopsy sampling as well as the disease's overlapping morphological and immunohistochemical features with other bone and soft-tissue sarcomas, the diagnosis of dedifferentiated chondrosarcoma can be problematic.

A Comparison Between 3 Functional Hip Scores for Evaluation of the Pediatric Hip.

Background: This investigation aimed to determine the degree of correlation among 3 functional scales for evaluating the hip in pediatric patients and determine the correlation between measures of global function and outcome.

Methods: We performed a prospective study of 173 consecutive patients (M age = 13 ± 3 y) being followed for developmental dysplasia of the hip (n = 122, 71%), slipped capital femoral epiphysis (n = 31, 18%), or Legg-Calve-Perthes disease (n = 20, 12%). We evaluated patients clinically, and we compiled scores for the Iowa Hip Score (IHS), Harris Hip Score (HHS), and Children's Hospital Oakland Hip Evaluation Scale (CHOHES).

Massive pseudotumor of unknown etiology in a cemented metal-on-polyethylene total hip arthroplasty: a case report.

Background: The formation of destructive pseudotumors is a well-documented, albeit rare, complication of total hip arthroplasties. They tend to be progressive and, if left untreated, can result in extensive periprosthetic bony destruction. The current case presents a large benign mass consistent with a pseudotumor on both imaging and intraoperative findings but histologic findings demonstrating chronic hematoma.

Effect of a Protocol to Reduce Radiographic Imaging in Pediatric Patients With Suspected Fractures.

Background: Children with suspected fractures are typically evaluated with multiple x-rays. This approach can add time, discomfort, and radiation exposure without clinical benefit. The purpose of this study was to determine whether a focused radiographic protocol could reduce the number of x-rays performed without missing any fractures.

Acute Multifocal Nonhematogenous Methicillin-Sensitive Staphylococcus aureus Osteomyelitis in a Healthy Adolescent: An Atypical Presentation.

Osteomyelitis represents inflammation and infection of bone tissue by a pathogen. Acute osteomyelitis is more likely to be unifocal compared to a chronic process which tends to be multifocal and recurrent. Early diagnosis, aggressive appropriate antibiotic therapy and a multidisciplinary approach are essential for a satisfactory prognosis and improved outcome.

Narrative review of the management of a relapsed clubfoot.

The management of idiopathic clubfoot has transformed over the past several decades as the Ponseti method for the correction of this deformity became the standard of care, and surgical release has almost all but been abandoned. The Ponseti method has shown very high initial success rate and excellent long-term functional results. Relapse of the deformity, however, continues to be a major problem, occurring in up to 40% of patient, and there is no consensus on the definition and management of the relapsed clubfoot.

Long-term follow-up of children treated with the Repiphysis expandable prosthesis for lower extremity bone sarcoma.

Expandable endoprostheses provide a limb salvage option for skeletally immature patients with bone sarcoma of the lower extremities. Initial reports of the Repiphysis prosthesis were encouraging; however, medium-term follow-up revealed high complication rates. We report on the long-term follow-up of a cohort of patients treated with the Repiphysis prosthesis.

Impact of tranexamic acid on blood loss and transfusion rate in children with cerebral palsy undergoing hip reconstruction with two or more osteotomies.

Purpose: Tranexamic acid (TXA), a synthetic lysine analogue, has been used in orthopedic procedures to limit blood loss and prevent allogeneic blood transfusions. However, data are scarce on its use in hip reconstruction of patients with cerebral palsy (CP). This study examines the effect of TXA on patients with CP undergoing hip reconstruction with at least two osteotomies.

Extraskeletal Ewing sarcoma: Diagnosis, management and prognosis.

Extraskeletal Ewing sarcoma (EES) is a relatively uncommon primary tumor of the soft tissues, which accounts for 20-30% of all reported cases of ES. Being uncommon, all members of the ES family tumors are treated following the same general protocol of sarcoma tumors. The present review summarizes the diagnosis, management and prognosis of EES, focusing on the differences between the subtypes of ESS.

Extraskeletal Myxoid Chondrosarcoma: Long-Term Survival in the Setting of Metastatic Disease.

Three cases of extraskeletal myxoid chondrosarcoma (EMC) in patients who presented with pulmonary metastases and were managed with long-term close observation without systemic intervention are presented. Follow-up imaging showed slow progression of their disease over several years, and the patients remained asymptomatic from their pulmonary metastases. This clinical experience provides insight into the natural history of the disease and suggests that some patients may experience long-term survival and remain asymptomatic even without systemic intervention, thereby improving their quality of life by avoiding potentially debilitating treatments.

Ultrasound Evaluation of Pediatric Orthopaedic Patients.

Ultrasonography is a valuable tool that can be used in many capacities to evaluate and treat pediatric orthopaedic patient. It has the capability to depict bone, cartilaginous and soft-tissue structures, and provide dynamic information. This technique can be readily applied to a wide range of pediatric conditions, including developmental dysplasia of the hip, congenital limb deficiencies, fracture management, joint effusions, and many other musculoskeletal pathologies.

Union Following Biological and Rigid Fixations of Distal Tibia Extra-articular Fractures.

Background: Distal tibia fractures are among the most common bony injuries, with a significant rate of nonunion and delayed union. There are multiple methods for the management of distal tibia fractures. Among the plating methods, there are bridge plating and compression plating techniques.

Citation analysis of the highest-cited articles on developmental dysplasia of the hip.

The purpose of this study is to determine the highest-cited articles on developmental dysplasia of the hip (DDH) and analyze their bibliometric characteristics. We searched the Web of Science (WoS) for articles with the highest number of citations on DDH and recorded their number of citations in WoS, Scopus, and Google Scholar (GS). We ranked and selected the top 100 cited articles.

The association of anaemia and its severity with composite morbidity after total hip arthroplasty.

Background: Total hip arthroplasty (THA) is a common orthopaedic procedure and is expected to increase with an increasing elderly population. Many of these patients suffer from chronic diseases which might be associated with anaemia. Anaemia, by itself, increases the risk of morbidity.

Use of hamstring autograft to reconstruct the patellar tendon after endoprosthetic replacement of the proximal tibia for bone sarcomas.

The surgical treatment of bone sarcoma involves wide surgical resection and endoprosthetic replacement. Surgical resection for proximal tibia bone sarcoma includes the patellar tendon. The secondary extension lag is a common complication and, although many have been described, the options for reconstruction of the patellar tendon are suboptimal.

The Validity of Patient-reported Outcome Measurement Information System (PROMIS) Parent Proxy Instruments to Assess Function in Children With Talipes Equinovarus.

Background: Idiopathic talipes equinovarus (ITEV) is a prevalent structural deformity of the foot and ankle in children. The disease-specific instrument (DSI) has commonly been used as an outcomes metric in these patients. The Patient-Reported Outcomes Measurement Information System (PROMIS) was developed to examine the quality of life across various medical conditions.

Primary Total Hip Arthroplasty for Legg-Calvé-Perthes Syndrome: 20 Year Follow-Up Study.

Background: Patients with Legg-Calvé-Perthes Syndrome (LCPS) are at an increased risk for developing osteoarthritis of the hip and undergoing total hip arthroplasty (THA) at an early age. Importantly, this younger age may put them at a higher risk for failure and revision surgery. The purpose of the study was to assess the clinical and radiographic outcomes as well as implant failure rate and risk for revision surgery at an average 20 years follow up.

Comparing the 30-Day Risk of Venous Thromboembolism and Bleeding in Simultaneous Bilateral vs Unilateral Total Knee Arthroplasty.

Background: Simultaneous bilateral total knee arthroplasty (SBTKA) may offer certain benefits; however, its overall safety is still disputed. This study aimed at comparing the risk of thromboembolism and bleeding in patients who underwent SBTKA vs unilateral total knee arthroplasty (TKA).

Methods: The American College of Surgeons National Surgical Quality Improvement Program database from 2008 to 2015 was used to investigate the short-term postoperative complications and their risk factors following SBTKA as compared to unilateral TKA.

Effect of Gender on Postoperative Morbidity and Mortality Outcomes: A Retrospective Cohort Study.

Full extent of gender differences on postoperative outcomes has never been studied on large scale, specifically postoperative complications. This study aims to assess the effect of gender on 30-day morbidity and mortality after major surgery. A retrospective cohort study was carried out using data of patients undergoing major surgeries from the American College of Surgeons' National Surgical Quality Improvement Program database between 2008 and 2011.