A Randomized Trial of Autologous Chondrocyte Implantation Versus Alternative Forms of Surgical Cartilage Management in Patients With a Failed Primary Treatment for Chondral or Osteochondral Defects in the Knee.

Background: There are limited randomized controlled trials with long-term outcomes comparing autologous chondrocyte implantation (ACI) versus alternative forms of surgical cartilage management within the knee.

Purpose: To determine at 5 years after surgery whether ACI was superior to alternative forms of cartilage management in patients after a failed previous treatment for chondral or osteochondral defects in the knee.

Study Design: Randomized controlled trial; Level of evidence, 1.

Patient-specific instruments: advantages and pitfalls.

Patient-specific instruments (PSI) aim to improve the accuracy of total knee replacement (TKR) based on computer-assisted preoperative planning. In this work, the authors describe the advantages and pitfalls of PSI based on their clinical experience. The main conclusion of this work is that PSI has direct impact on the logistical and technical features of TKR with some advantages and pitfalls.

The 2-0 Ethilon test.

Tight closure, which is a sign of ischemia secondary to tension, can lead to tissue necrosis. This article describes a simple and reliable test to help avoid excessive tension during skin closure.

Acutrak fixation of comminuted distal radial fractures.

The authors describe a new technique of fixation of comminuted displaced distal radial fractures in young adults. A 40-year-old man fell from a ladder and injured his wrist. He sustained a comminuted fracture of the distal radius.

The Long Gamma Nail for stabilisation of existing and impending pathological fractures of the femur: an analysis of 48 cases.

The results in a series of 42 patients with 48 impending or complete pathological femur fractures stabilised with the Long Gamma nail (Howmedica-Osteonics, Rutherford, NJ,USA) are presented. Twenty two impending and 26 completed pathological femoral fractures treated between 1995 and 1999 were retrospectively analysed. The mean age of the patients was 65.

Phalangeal intraosseous epidermoid cyst.

The authors describe two cases of phalangeal intraosseous epidermoid cyst. Two theories try to explain their origin. One theory sees traumatic implantation of epidermal cells as causative.

The 30 ml cement test.

We describe a simple and reliable test which can be used while performing hip arthroplasty as an indicator of the size and volume of the femoral canal to roughly estimate the volume of cement required to fill the femoral canal for cementing the femoral prosthesis.

Implant removal on an outpatient basis. A patient satisfaction survey.

Unstable fractures of the distal radius can be stabilised with Kirschner wires. The K wires need to be removed after five to six weeks. The authors surveyed 100 consecutive patients with distal radial fractures treated with percutaneous Kirschner wires that were left buried under the skin.

A biomechanical analysis of four different methods of harvesting bone-patellar tendon-bone graft in porcine knees.

Background: Anterior cruciate ligament reconstruction with use of bone-patellar tendon-bone graft is commonly performed to treat functional instability of the knee after injury of the anterior cruciate ligament. Patellar fracture is an underreported complication of this procedure, yet it may be a career-ending injury for a professional athlete. The purpose of this study was to design a new technique to procure the patellar bone plug when reconstructing the cruciate ligament with use of patellar tendon.