Unveiling Poncet Disease: A Rare Presentation with Multiple Tubercular Foci in the Hand and Spine of an Older Patient: A Case Report.

Poncet disease (PD) is a rare form of reactive polyarthritis associated with acute tuberculosis (TB). Multiple TB foci are rare in PD, particularly on the hands. Herein, we describe a case of PD with foci in the trapezium and spine of a 76-year-old man.

Referencing the Tibial Plateau With a Probe Improves the Accuracy of the Posterior Slope in Medial Unicompartmental Knee Arthroplasty.

Background: There is currently no consensus on intraoperative references for determining the posterior tibial slope (PTS) in medial unicompartmental knee arthroplasty (UKA). The medial tibial plateau could serve as a direct reference for determining the native PTS through the placement of a hook probe in the anteroposterior direction of the medial tibial plateau. This study aimed to examine the accuracy of this new referencing method.

Treatment of thigh abscess caused by retroperitoneal perforation of cecal cancer: A case report.

Introduction And Importance: Iliopsoas and iliacus abscesses are caused by hematogenous and lymphatic infections and the spread of inflammation in neighboring organs. A small number of cases have been reported in which inflammation spread not only within the iliopsoas muscle but also to the thigh. Here we report a case of retroperitoneal infiltration and perforation of cecal cancer that caused extensive abscess formation from the iliacus muscle to the thigh.

A direct referencing method of the tibial plateau for the posterior tibial slope in medial unicompartmental knee arthroplasty.

Purpose: There is no consensus on intraoperative references for the posterior tibial slope (PTS) in medial unicompartmental knee arthroplasty (UKA). An arthroscopic hook probe placed on the medial second quarter of the medial tibial plateau (MTP) in an anteroposterior direction may be used as a direct anatomical reference for the PTS. The purpose of this study is to investigate the availability and accuracy of this method.

The Medial Tibial Plateau Can Be Used as a Direct Anatomical Reference for the Posterior Tibial Slope in Medial Unicompartmental Knee Arthroplasty.

There has been no consensus about how to determine the individual posterior tibial slope (PTS) intraoperatively. The purpose of this study was to investigate whether the tibial plateau could be used as a reference for reproducing individual PTS during medial unicompartmental knee arthroplasty (UKA). Preoperative computed tomography (CT) data from 48 lower limbs for medial UKA were imported into a three-dimensional planning software.

Nontuberculous mycobacterial infection of the knee after arthrocentesis for idiopathic hemarthrosis: A case report.

Introduction: Nontuberculous mycobacterial (NTM) infections of the musculoskeletal system are uncommon. Such infections are typically acquired by direct inoculation after penetrating trauma, surgical procedures, or needle injections. There are no reported cases of NTM infection after arthrocentesis for idiopathic hemarthrosis of the knee.

Referencing the substitute anteroposterior line of the tibia improves rotational alignment of the tibial component in medial unicompartmental knee arthroplasty.

Background: There is no consensus regarding how best to determine the tibial rotational alignment in unicompartmental knee arthroplasty (UKA). The purpose of this study was to clarify whether using the substitute anteroposterior (sAP) line of the tibia, as has recently been proposed, can improve tibial rotation.

Methods: The study included 57 consecutive medial UKAs.

Winged scapula following axillary thoracotomy with long thoracic nerve preservation.

Winged scapula is a rare condition caused by injuries to the long thoracic nerve (LTN) and accessory nerves. A 69-year-old man underwent surgery for right lung cancer. Video-assisted thoracic surgery was converted to axillary thoracotomy at the fourth intercostal space.

Obliquity of tibial component after unicompartmental knee arthroplasty.

Background: The native knee joint line is varus relative to the tibia and remains parallel to the floor during gait even with varus lower-limb alignment. We investigated the desired degree of frontal obliquity for positioning the tibial component during unicompartmental knee arthroplasty (UKA).

Methods: We retrospectively analyzed full-leg, standing, hip to ankle digital radiographs from 107 osteoarthritic knees.

Anteroposterior Rotational References of the Tibia for Medial Unicompartmental Knee Arthroplasty in Japanese Patients.

Background: In unicompartmental knee arthroplasty (UKA), there is no consensus regarding how to determine the anteroposterior (AP) reference of the tibia. A number of surgeons in Japan perform the sagittal saw cut using the medial intercondylar ridge (MIR) of the tibia according to surgical manuals. However, there is no theoretical basis for this practice.

Location of the ankle center for total knee arthroplasty.

Background: The purpose of this study was to investigate the ankle center position as determined from the malleoli for total knee arthroplasty (TKA).

Methods: We retrospectively analyzed computed tomography data from 102 patients with osteoarthritic knees. The tibial anteroposterior (AP) axis and transmalleolar axis (TMA) were used as rotational reference axes of the knee and ankle joint, respectively.

The Valgus Inclination of the Tibial Component Increases the Risk of Medial Tibial Condylar Fractures in Unicompartmental Knee Arthroplasty.

Background: Medial tibial condylar fractures (MTCFs) are a rare but serious complication after unicompartmental knee arthroplasty. Although some surgical pitfalls have been reported for MTCFs, it is not clear whether the varus/valgus tibial inclination contributes to the risk of MTCFs.

Methods: We constructed a 3-dimensional finite elemental method model of the tibia with a medial component and assessed stress concentrations by changing the inclination from 6° varus to 6° valgus.

Comparison of MRI- and CT-based patient-specific guides for total knee arthroplasty.

Background: The patient-specific guide for total knee arthroplasty (TKA) is created from the data provided by magnetic resonance imaging (MRI) or computed tomography (CT) scans. It remains unknown which imaging technology is suitable for the patient-specific guide. The purpose of this study was to compare the accuracy of implant positioning and operative times between the two types of patient-specific guides for TKA.

Enhanced pre-operative thrombolytic status is associated with the incidence of deep venous thrombosis in patients undergoing total knee arthroplasty.

Background: Deep venous thrombosis (DVT), which is often associated with pulmonary embolism (PE), is a serious complication after total knee arthroplasty (TKA). In the present study, we examined the overall thrombotic and thrombolytic status using Global Thrombosis Test (GTT) in non-anticoagulated blood of patients undergoing TKA to develop the predictable marker for the incidence of DVT.

Methods: DVT was diagnosed using doppler ultrasonography a day after the surgery in 31 patients with osteoarthritis (n = 24), rheumatoid arthritis (n = 6) and ankylosing spondylitis (n = 1) by the well-trained operator.

Influence of the sagittal reference axis on the femoral component size.

The sagittal reference axes used for setting of the femoral component vary according to surgical methods. The purpose of the study was to clarify the relation of the sagittal reference axis with the anteroposterior (AP) length of the distal femur at the time of determining the femoral component size. Fifty consecutive varus osteoarthritic knees with primary total knee arthroplasty were divided into two groups according to surgical methods (intramedullary and extramedullary groups) and were examined based on CT data.

Tibia vara affects the aspect ratio of tibial resected surface in female Japanese patients undergoing TKA.

Background: Tibia vara seen in Japanese patients reportedly influences the tibial component alignment when performing TKA. However, it is unclear whether tibia vara affects the component position and size selection.

Questions/purposes: We therefore determined (1) the amount of medial tibial bow, (2) whether the tibia vara influences the aspect ratio of the tibial resected surface in aligning the tibial component with the tibial shaft axis, and (3) whether currently available tibial components fit the shapes of resected proximal tibias in terms of aspect ratio.

Estimation of frontal alignment error of the extramedullary tibial guide on the bi-malleolar technique: a simulation study with magnetic resonance imaging.

Purpose: The bi-malleolar technique for the extramedullary tibial guide is a representative method for determining the ankle center in total knee arthroplasty (TKA). The purpose of this study is to estimate three-dimensionally the lateral errors (difference between the real ankle center and the bi-malleolar center) and the varus angular errors of this technique under the condition that the malleolar prominences were correctly identified.

Methods: Magnetic resonance images of 51 lower limbs from 51 healthy volunteers were analyzed.

Increase in posterior tibial slope would result in correction loss in frontal plane after medial open-wedge high tibial osteotomy.

Purpose: The purpose of this study was to clarify the causes of the increase in the posterior tibial slope during open-wedge high tibial osteotomy (HTO) and to investigate whether its changes influenced the correction angle in frontal plane.

Methods: We retrospectively reviewed 20 patients (26 knees) treated with open-wedge HTO. They were divided into the following two groups.

Effects of cartilage remnants of the posterior femoral condyles on femoral component rotation in varus knee osteoarthritis.

Preoperative planning of total knee arthroplasty (TKA) based on computerized tomography (CT) data can produce a femoral rotational error due to lack of information on the femoral cartilage thickness. The research question of this study is how much femoral rotational error is expected due to the cartilage remnants when using the posterior condylar angles (PCA, angle between the posterior condylar line and the surgical epicondylar axis (SEA)) on CT data. CT arthrography was performed for 35 consecutive varus osteoarthritic knees in 31 patients who underwent TKA, on which the cartilage thicknesses of the posterior femoral condyles were measured.

Cyclic compression loaded on cartilage explants enhances the production of reactive oxygen species.

Objective: Although mechanical forces are an essential factor in the regulation of cartilage metabolism, the precise mechanisms involved have not yet been determined. We previously demonstrated that mechanical forces on chondrocytes inhibited proteoglycan (PG) synthesis. We also demonstrated the induction of reactive oxygen species (ROS) is loaded on the chondrocytes.

Axial shortening during distraction osteogenesis leads to enhanced bone formation in a rabbit model through the HIF-1alpha/vascular endothelial growth factor system.

Axial micromotion of bone fragments enhances callus formation during fracture repair or limb lengthening. To examine this, we used an axial-shortening model of the tibial callus in rabbits and performed histological analyses. After 10-mm lengthening of the left tibia with an external fixator, we shortened the callus by 2 mm.

Variability of extraarticular tibial rotation references for total knee arthroplasty.

Anatomic reference axes that determine rotational alignment of the tibial component have not been established. To assess variability of three anatomic reference axes (a new tibial anteroposterior axis that we proposed, the transmalleolar axis of the ankle, and the second metatarsus bone axis of the foot), we measured the angles between a defined anteroposterior axis of the tibia (a line perpendicular to the transepicondylar axis) and each of the three axes in 57 knees of healthy subjects using computed tomography scans. The angle between the defined anteroposterior axis and our proposed anteroposterior axis (a line connecting the middle of the posterior cruciate ligament and the medial edge of the patellar tendon attachment) averaged -0.

Late dissociation of an alumina-on-alumina bearing modular acetabular component.

Alumina-on-alumina bearings for total hip arthroplasty have been introduced as a promising alternative to reduce wear debris and to increase the life expectancy of the prosthesis. We report a case of a late dissociation of an alumina-on-alumina bearing modular acetabular component, which occurred 2 years, 8 months after surgery. Detailed analysis of the retrieved prosthesis suggested that the cause of the failure may be strong rotational torque developed by a roughening of the bearing's alumina surface caused by edge loading (microseparation).