Management of proximal tibial stress fracture associated with advanced knee osteoarthritis: A systematic review.

Purpose: Tibial stress fracture associated with knee osteoarthritis is an unusual and difficult clinical scenario. There is no clear existing treatment guideline for this uncommon clinical disease. The aim of this study is to review the impact of various treatment options for patients with advanced knee osteoarthritis associated with proximal tibial stress fracture.

Medial tibial bone resorption following total knee arthroplasty comparing a traditional with a kinematic design.

Background: New total knee prostheses are being designed to improve clinical outcome, survivorship and patient satisfaction following total knee arthroplasty (TKA). A new knee system was developed with improvements in patellofemoral joint, trochlear geometry, polyethylene formulation and tibial baseplate. Aim of this study was to compare the newer kinematic knee system with its existing predecessor knee system in terms of clinical outcome, revision rates, radiographic outcomes specifically medial tibial bone resorption.

Clinical and Surgical Insights on Bilateral Total Knee Arthroplasty in Ochronotic Arthropathy: A Case-based Review.

Introduction: Ochronotic arthropathy (OcA) is a consequence of alkaptonuria, a rare systemic-inherited metabolic disorder leading to accumulation of homogentisic acid in articular cartilage and subsequent early degeneration of the joints. Only few cases of OcA managed with bilateral total knee arthroplasty (TKA) has been described in the literature so far. We aim to discuss surgical pearls, pitfalls, and clinical outcome of OcA of knees managed with simultaneous bilateral TKA.

Analysis of clinical and radiological outcomes of long tibial stemmed total knee arthroplasty in knee osteoarthritis complicated by tibial stress fracture.

Objective: Knee arthritis associated with tibial stress fractures represents an uncommon and difficult clinical scenario to treat. The use of long, fluted tibial extension rods has been vital in the management of such cases owing to immediate fracture stability and single-stage surgery without the need to open the fracture site. This study investigates clinical and radiological outcomes following total knee arthroplasty using a tibial extension stem in cases of knee osteoarthritis with tibial stress fracture.

The application of low-dose dexamethasone in total knee arthroplasty: finding out the best route and dosage schedule.

Background: The use of dexamethasone as additive to multimodal analgesic regimen in total knee arthroplasty has been well established, but the most suitable route, effectiveness, safety and dose schedule of low-dose dexamethasone is not known.

Methods: We conducted a prospective, randomized, double-blinded trial to investigate and compare the analgesic and antiemetic effects and safety of low-dose (8 mg) dexamethasone introduced as periarticular injection or intravenous (as a single dose or in two divided doses of 4 mg separated by 24 h) in unilateral total knee arthroplasty patients.

Results: The single dose intravenous administration as well as the periarticular administration of dexamethasone had similar mean visual analogue scores which were significantly lower than divided dose group at 24 and 48 h postoperatively.

Disassembly of Components of a Monoblock Bipolar Hip Prosthesis Following Dislocation: A Case Report and Review on "Bottle Opener Effect".

Introduction: Bipolar hemiarthroplasty has been reliable and successful treatment for geriatric patients following neck of femur fractures. Dissociation/disassembly of bipolar prosthesis is a rare complication in which separation of outer head from inner head leads to failure of prosthesis and needs revision surgery. The disassembly though commonly seen after years of primary surgery as a result of polyethylene wear leading to fixed varus position of outer head but it can happen in an acute setting anytime in immediate or late post-operative period following posterior dislocation with closed reduction attempt.

Stress Fracture of Isolated Middle Cuneiform Bone in a Trainee Physician: A Case Report and Review.

Stress fractures are chronic fatigue failure of bone from repetitive subthreshold loads. Insufficiency fractures occur in bones that are already osteopenic and fail to withstand normal loads over time. Stress fractures of cuneiform bones are extremely rare and usually reported to happen in athletes or recruits.