Snapping ankles: peroneal tendon subluxation and dislocation.

Peroneal tendon dislocation or subluxation is an orthopaedic condition that usually occurs as a result of injury to the superior peroneal retinaculum. The peroneal muscles are located in the lateral compartment of the leg, and their tendons run in the retromalleolar groove anchored by the superior peroneal retinaculum. Peroneal instability is usually classified using the Eckert and Davies classification, which was modified by Oden into a four-point grading system.

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.

Early radiographic osseointegration of a novel highly porous 3D-printed titanium collar for megaprostheses compared to a previous generation smooth HA-coated collar.

Purpose: Extracortical osseointegration at the collar-bone interface of megaprostheses is associated with improved implant stability, lower rates of stem fracture and loosening. The use of hydroxy-apatite (HA-) coated collars showed mixed results in previously published reports. A novel collar system has recently become available utilizing additive manufacturing technology to create a highly porous titanium collar with a calcium-phosphate coated surface.

Anatomic placement of the acetabular implant in cementless total hip arthroplasty does not adversely affect the implant survival and patient satisfaction.

Objective: This study aimed to evaluate if the acetabulum's conservative reaming with preservation of the medial acetabular bone and anatomic placement of the acetabular implant in cementless total hip arthroplasty (THA) has any adverse effect on the radiological outcome, long term implant survival and patient satisfaction.

Methods: 106 consecutive patients were identified from a single surgeon practice who underwent cementless THA from 2005 to 2010. Twenty-one were lost to follow up, and five patients died unrelated to THA.

Can Non-Contrast 3T MRI scans predict the type of labral procedure in hip arthroscopy?

Purpose: The study proposed a simple classification system that aimed at predicting the labral procedure during hip arthroscopy using images from unenhanced 3T MRI scans.

Patents And Methods: Forty patients undergoing hip arthroscopy had their MRI scans reviewed pre-operatively by one of two senior radiologists and classified into: type 1: stable labrum with intra-substance degeneration (no labral repair required), type 2: unstable labrum, no intra-substance degeneration (labral repair required), or type 3: unstable labrum with intra-substance degeneration (Labral repair not feasible). Hip arthroscopy is carried out by one of two surgeons and classified accordingly while blinded to the radiologists' assessment.

Thirty-Day Mortality for Proximal Femoral Fractures Treated at a U.K. Elective Center with a Site-Streaming Policy During the COVID-19 Pandemic.

Unlabelled: COVID-19 led to the reconfiguration of U.K. orthopaedic trauma services because surgical capacity was threatened in acute centers.

Case series of intradural disc in recurrence of lumbar disc prolapse.

Intradural disc herniation is a rare entity reported at 0.04-1.1% that occurs most commonly in the lumbar spine particularly at L4-L5 region.

Outcome measures evaluating physical functioning and their measurement properties in adolescent idiopathic scoliosis: a protocol for a systematic review.

Introduction: Physical functioning (PF) is the ability to carry out the physical activity of daily living. It is an important outcome that provides a meaningful evaluation of individuals' life. PF can be assessed using patient-reported outcome measures, performance-based outcome measures or body structure and function measure.

Bi-planar intra-articular deformity following malunion of a Schatzker V tibial plateau fracture: Correction with intra-articular osteotomy using patient-specific guides and arthroscopic resection of the tibial spine bone block.

Malunited tibial plateau fractures are a surgical challenge. We report a case of a malunion following a Schatzker V tibial plateau fracture with a biplanar deformity of the medial hemi-plateau. This was treated with an intra-articular osteotomy and biplanar restoration of the medial hemi-plateau using patient-specific guides and 3-dimensional planning based on computed tomography (CT) images.

Voriconazole-induced Severe Periostitis Deformans.

Periostitis deformans is an uncommon condition of the skeletal system, mainly manifested as bone pain with or without bony swellings. Voriconazole-induced periostitis is widely reported in the literature, mainly in the organ transplant patients on immunosuppressant therapy. The patient in this case report, was not on any immunosuppressant therapy, but developed widespread periostitis deformans secondary to voriconazole, who was being treated for the base of skull aspergillus osteomyelitis.

Physician associates working in secondary care teams in England: Interprofessional implications from a national survey.

Physician associates (PAs) are a new type of healthcare professional to the United Kingdom; however, they are well established in the United States (where they are known as physician assistants). PAs are viewed as one potential solution to the current medical workforce doctor shortage. This study investigated the deployment of PAs within secondary care teams in England, through the use of a cross-sectional electronic, self-report survey.

Best practices for the management of local-regional recurrent chordoma: a position paper by the Chordoma Global Consensus Group.

Chordomas are rare, malignant bone tumors of the skull-base and axial skeleton. Until recently, there was no consensus among experts regarding appropriate clinical management of chordoma, resulting in inconsistent care and suboptimal outcomes for many patients. To address this shortcoming, the European Society of Medical Oncology (ESMO) and the Chordoma Foundation, the global chordoma patient advocacy group, convened a multi-disciplinary group of chordoma specialists to define by consensus evidence-based best practices for the optimal approach to chordoma.

Angiomatoid fibrous histiocytoma: A case of local recurrence and metastases to loco-regional lymph nodes that responded to chemotherapy.

Angiomatoid fibrous histiocytoma (AFH) is a rare soft tissue tumour with intermediate malignant potential. We report the case of a patient with local recurrence of AFH in two locations and lymph node metastases 18 months after primary surgical excision. The patient was treated with six cycles of ifosfamide and doxorubicin chemotherapy and a further three courses of ifosfamide monotherapy.

Non-rinse skin cleansers: the way forward in preventing incontinence related moisture lesions?

Objective: The use of non-rinse skin cleansers in the care of patients who are at risk of tissue breakdown is not new within the National Health Service (NHS). Back to the Floor Continence Care Rounds (introduced in 2012 to facilitate bedside continence care education) at University Hospitals Birmingham had identified that in the current climate of austerity and efficiency savings, the use of non-rinse cleanser was being randomly rationed. Our objective was to determine whether the introduction of a smaller tube of non-rinse cleanser with targeted education would improve usage and ultimately improve the skin of incontinent patients.

Anatomical study of preganglionic spinal nerve and disc relation at different lumbar levels: Special aspect for microscopic spine surgery.

Background: Lumbar microdiscectomy is a widespread popular method of treatment. One major challenge is the spine level dependent different anatomy and the limited sight on the nerve root during the surgical procedure.

Objective: The aim was to analyze the specific anatomic relation of nerve root, intervertebral disc and intervertebral ganglion under determination of the specific nerve distances.

Association of circulating miR-223 and miR-16 with disease activity in patients with early rheumatoid arthritis.

Background: Identification of parameters for early diagnosis and treatment response would be beneficial for patients with early rheumatoid arthritis (ERA) to prevent ongoing joint damage. miRNAs have features of potential biomarkers, and an altered expression of miRNAs was shown in established rheumatoid arthritis (RA).

Objective: To analyse RA associated miRNAs in the sera of patients with ERA to find markers of early disease, clinical activity or predictors of disease outcome.

The two-stage ipsilateral fibular transfer for tibial defect following tumour excision.

Method. We performed a two-stage vascularized ipsilateral fibular graft transfer for segmental tibial defect following excision of malignant bone tumours.Results.

Clear cell chondrosarcoma in association with niemann-pick disease.

Purpose: The purpose of this case report is to bring to light this unusual combination of two rare diseases, namely Neimann-Pick disease Type B and clear cell chondrosarcoma occurring in the same patient. This has not previously been reported in the world literature.

Subject: Niemann-Pick disease (NPD) is a rare autosomal recessive inborn error of metabolism.

Wound complications following resection of adductor compartment tumours.

Purpose Limb salvage surgery of soft tissue sarcomas is associated with both a risk of local recurrence and wound complications. Although the lower limb appears to be at greater risk of wound-related morbidity, few studies separate anatomical compartments. We believe that the adductor compartment of the thigh has a particularly high rate of complications and so performed a retrospective analysis of all soft tissue sarcomas arising in this region undergoing limb salvage.

Malignant chondroblastoma of the os calcis.

Patient. We describe a case of chondroblastoma of the os calcis which metastasized to the tibia, soft tissues and lung. A complete response of the lung lesions was noted with chemotherapy.

Audit of conservative management of chronic low back pain in a secondary care setting--part I: facet joint and sacroiliac joint interventions.

The work of a chronic back pain service in secondary care in the West Midlands is reported. The service offers acupuncture, spinal injection procedures, osteopathy and a range of other interventions for patients whose back pain has not responded to conservative management. This section of the report focuses on injection procedures for lumbar facet joint and sacroiliac joint pain, which have been shown to be the cause of chronic low back pain in 16-40% and 13-19% of patients respectively.