Kinematic alignment in total knee arthroplasty: a five-year prospective, multicentre, survivorship study.

Aims: The mid-term results of kinematic alignment (KA) for total knee arthroplasty (TKA) using image derived instrumentation (IDI) have not been reported in detail, and questions remain regarding ligamentous stability and revisions. This paper aims to address the following: 1) what is the distribution of alignment of KA TKAs using IDI; 2) is a TKA alignment category associated with increased risk of failure or poor patient outcomes; 3) does extending limb alignment lead to changes in soft-tissue laxity; and 4) what is the five-year survivorship and outcomes of KA TKA using IDI?

Methods: A prospective, multicentre, trial enrolled 100 patients undergoing KA TKA using IDI, with follow-up to five years. Alignment measures were conducted pre- and postoperatively to assess constitutional alignment and final implant position.

Metastatic Merkel cell carcinoma and malignant melanoma in a single sentinel lymph node.

Merkel cell carcinoma (MCC) and malignant melanoma are aggressive skin cancers that usually arise in sun-exposed parts of the body. This report describes an 85-year-old man who underwent a wide local excision and sentinel lymph node biopsy for primary MCC and was subsequently found to have metastatic MCC and malignant melanoma within the left inguinal sentinel lymph node. Dual diagnoses of aggressive cutaneous carcinomas, although rare, may become more common in regions of high ultraviolet exposure and an ageing population.

Emergency Gastrectomy for Oesophageal and Gastric Polyps With Massive Bleeding Induced by Anticoagulation.

We report the management dilemma of a patient with known gastric polyposis requiring anticoagulation for a submassive pulmonary embolism and haemodynamic compromise. This occurred in a comorbid patient with iron deficiency anaemia and previous venous thromboembolism. The patient had repeated episodes of gastrointestinal bleeding post-thrombolysis for which the cause was not seen on gastroscopy and required an emergency gastrectomy to control the bleeding.

Pott's puffy tumour in an immunosuppressed adult: case report and systematic review of literature.

This case is of a 34-year-old immunocompromised male with Pott's puffy tumour, which was treated with antibiotics and endoscopic sinus surgery. Pott's puffy tumour is typically a complication of frontal sinusitis in children and immunocompromise can be a precipitating factor. A search was conducted of Embase, Medline, CINAHL, Cochrane, Google Scholar, Informit and Scopus of 'Pott's Puffy' and variations of this phrase.

Surgical approach to a left-sided gallbladder.

Biliary colic is a pain in the right upper quadrant or epigastrium thought to be caused by functional gallbladder spasm from a temporary obstructing stone in the gallbladder neck, cystic duct or common bile duct. A 56-year-old man presented with frequent episodes of typical biliary colic. At initial laparoscopy, the gallbladder was absent from its anatomic location.

Synchronous primary anorectal melanoma and sigmoid adenocarcinoma: a case report.

Synchronous primary anorectal melanoma and colorectal adenocarcinoma is extremely rare, with only 5 cases reported in the literature. Here, a case is reported and the currently available literature is summarized. A 72-year-old white male presented with changes in his bowel habits and unintentional weight loss.