Delayed Bilateral Tibialis Anterior Tendon Repair in an Older Man: A Case Report.

Case: We report a 67-year-old healthy man who sustained bilateral hyper-plantarflexion injuries falling off a ladder that resulted in bilateral tibialis anterior tendon tears one month prior to presentation. His injuries were effectively managed with bilateral delayed operative treatment. After non-weightbearing for three months, the patient was subsequently permitted to full weight bear in CAM boots for three months.

Risk prediction models for diabetic foot ulcer development or amputation: a review of reviews.

Background: In adults with diabetes, diabetic foot ulcer (DFU) and amputation are common and associated with significant morbidity and mortality.

Purpose: Identify tools predicting risk of DFU or amputation that are prognostically accurate and clinically feasible.

Methods: We searched for systematic reviews (SRs) of tools predicting DFU or amputation published in multiple databases from initiation to January, 2023.

The Perioperative Pain Self-Management (PePS) randomized controlled trial protocol: Preventing chronic post-surgical pain and prolonged opioid use.

Background: Total joint arthroplasties are common orthopedic surgeries that carry risk for developing chronic post-surgical pain. In addition to pre- and post-operative pain severity, psychological distress (e.g.

Orthobiologics in Foot and Ankle Arthrodesis: A Systematic Review.

Orthobiologics are biologically-derived materials intended to promote bone formation and union. We review evidence on effectiveness and harms of orthobiologics compared to no orthobiologics for foot and ankle arthrodesis. We searched multiple databases (1995-2019) and included clinical trials and other studies with concurrent controls, English language, and reporting patient-centered outcomes, union/time to union, costs/resource utilization, or harms.

Gait analysis comparison of cruciate retaining and substituting TKA following PCL sacrifice.

The role of the posterior cruciate ligament (PCL) remains controversial in total knee arthroplasty (TKA), with some surgeons who believe in PCL sacrifice and substitution and others who believe in PCL preservation for stability. Manufacturers have developed both cruciate-substituting/posterior stabilized (PS) implants typically used when the ligament is sacrificed and cruciate retaining (CR) implants designed for ligament preservation. However, studies demonstrate excellent clinical results with CR implants despite PCL sacrifice.

Limb salvage in an unstable ankle fracture of a diabetic patient with Charcot arthropathy.

The treatment of ankle fractures in the presence of diabetes mellitus can be difficult because of a higher complication rate with this subset of the population. When peripheral neuropathy is present at the time of trauma, there is an increased risk of developing Charcot arthropathy, a limb-threatening complication that often creates breakdown, instability, and chronic ulceration of the limb. The authors present a case report of a diabetic patient who sustained an unstable ankle fracture with subsequent neuroarthropathic event that required multiple surgical procedures for salvage of the limb.

Suppression of interferon (IFN)-inducible genes and IFN-mediated functional responses in BCR-ABL-expressing cells.

The interferons (IFNs) are cytokines that play key roles in host defense against viral infections and immune surveillance against cancer. We report that BCR-ABL transformation of hematopoietic cells results in suppression of IFN-dependent responses, including transcription of IFN-inducible genes and generation of IFN-mediated antiviral effects. BCR-ABL transformation suppresses expression of several IFN-regulated genes containing IFN-sensitive response element (ISRE) or GAS elements in their promoters, including Isg15, Irf1, Irf9, and Ifit2 (interferon-induced protein with tetratricopeptide repeats 2).

Regulatory effects of mammalian target of rapamycin-mediated signals in the generation of arsenic trioxide responses.

Arsenic trioxide (As(2)O(3)) is a potent inducer of apoptosis of leukemic cells in vitro and in vivo, but the mechanisms that mediate such effects are not well understood. We provide evidence that the Akt kinase is phosphorylated/activated during treatment of leukemia cells with As(2)O(3), to regulate downstream engagement of mammalian target of rapamycin (mTOR) and its effectors. Using cells with targeted disruption of both the Akt1 and Akt2 genes, we found that induction of arsenic trioxide-dependent apoptosis is strongly enhanced in the absence of these kinases, suggesting that Akt1/Akt2 are activated in a negative feedback regulatory manner, to control generation of As(2)O(3) responses.

Activation of mammalian target of rapamycin and the p70 S6 kinase by arsenic trioxide in BCR-ABL-expressing cells.

Arsenic trioxide (As(2)O(3)) exhibits important antitumor activities in vitro and in vivo, but the precise mechanisms by which it induces its effects are not known. We provide evidence that during treatment of BCR-ABL-expressing cells with As(2)O(3), there is activation of a cellular pathway involving the p70 S6 kinase (p70S6K). Our data show that p70S6K is rapidly phosphorylated on Thr(421) and Ser(424) and is activated in an As(2)O(3)-inducible manner.

Role of the p38 mitogen-activated protein kinase pathway in cytokine-mediated hematopoietic suppression in myelodysplastic syndromes.

The p38 mitogen-activated protein kinase (MAPK) pathway is activated by IFNs and other cytokines to mediate signals for important cellular functions, including transcriptional regulation and apoptosis. We examined the role of the p38 pathway in the generation of the effects of myelosuppressive cytokines on human hematopoiesis. Pharmacologic inhibition of p38 using BIX-01208 resulted in reversal of IFN-, tumor necrosis factor-alpha (TNF-alpha)-, and transforming growth factor-beta (TGF-beta)-mediated suppression of human erythroid (blast-forming unit-erythroid) and myeloid (granulocyte-macrophage colony-forming unit) colony formation, consistent with a key role for p38 in the generation of myelosuppressive signals by different cytokines.

Total knee arthroplasty in patients on workers' compensation: a matched cohort study with an average follow-up of 4.5 years.

Little information in the literature exists regarding the outcome of total knee arthroplasty (TKA) in patients who are on workers' compensation (WC). Twenty-one WC patients who underwent 23 TKA procedures (cases) were compared with 16 randomly selected, age-matched control patients (controls) undergoing 21 TKA procedures. The mean follow-up was 56 months (34-112 months) for both groups.

Component removal in revision total hip arthroplasty.

Component removal is a time-consuming yet necessary step during revision hip surgeries. Because of the diversity of the components and the methods used to secure them, an equal diversity of approaches and tools are necessary for component removal. Careful and detailed preoperative planning is mandatory, the mode of failure must be understood, and detailed imaging should be available to the surgeon.

The cementless femoral stem revisited.

Despite the success of Sir John Charnley's cemented total hip arthroplasty (THA), large numbers of patients demonstrated mechanical failure due to loosening. The two main initial concerns were infection and wear. With the recent advances in antibiotics and aseptic techniques and with improvement in surgical technique, the incidence of infection has decreased tremendously.

Complications of total hip arthroplasty.

Complications following hip arthroplasty have a wide variation and range in incidence from 1.1% for pulmonary embolism to over 70% for infrapopliteal deep vein thrombosis. Recognition of the risk factors and all of the possible types of complications places the surgeon in a better position to detect such complications and formulate a plan to treat them.