Hemiarthroplasty for Hallux Rigidus: Mid-Term Results.

Hallux rigidus is a progressive osteoarthritic condition affecting the first metatarsophalangeal joint that causes pain and stiffness, with a marked reduction in dorsiflexion. Joint arthrodesis has previously been the standard treatment of hallux rigidus; however, new surgical techniques have evolved and first metatarsophalangeal joint hemiarthroplasty is now a viable option. The present retrospective study reviewed the data from the 11 patients (12 feet) who had undergone first metatarsophalangeal joint hemiarthroplasty with the HemiCAP(®) prosthesis. Postoperatively, all feet were clinically and radiologically assessed and scored using the hallux metatarsophalangeal-interphalangeal scale developed by the American Orthopaedic Foot and Ankle Society and the Foot and Ankle Disability Index score. Follow-up examinations were performed at a mean of 47 (range 36 to 48) months and showed a mean postoperative American Orthopaedic Foot and Ankle Society score of 66.5 (range 22 to 92) and mean Foot and Ankle Disability Index score of 63.7 (range 26.9 to 98.1). Of the 12 feet, 5 (41.7%) were reported to be pain free at the follow-up examination, 3 (25%) had mild pain, 2 (16.7%) had moderate, and 2 (16.7%) severe pain. Furthermore, 5 feet (42%) displayed no evidence of radiologic subsidence and 7 feet (58%) displayed a mean subsidence of 2.71 (range 1 to 6) mm. Hemiarthroplasty is designed to maintain the joint range of movement and allow easy conversion to arthrodesis, if required. In the present study, most patients continued to have a limited range of movement with only reasonable levels of satisfaction. Most patients continued to experience some level of pain postoperatively. The HemiCAP(®) prosthesis has recently been adapted to include a dorsal flange. This might improve the range of dorsiflexion not seen with the traditional model.

Living history in current orthopaedic hip surgery: intrapelvic teflon granuloma after total hip replacement.

The teflon hip arthroplasty design was used by Sir John Charnley in the early 60's but was taken off the market due to high complication rates. A case is reported of an intrapelvic granuloma after total hip arthroplasty following the use of a teflon socket. This appears to be the last surviving patient treated by Sir John Charnley using a Teflon hip socket design.

The Incidence of Traumatic Posterior and Combined Labral Tears in Patients Undergoing Arthroscopic Shoulder Stabilization.

BACKGROUND: Posterior and combined shoulder instabilities have been reported as accounting for only 2% to 5% of cases. More recently, an increased incidence of posterior capsulolabral tear has been reported. PURPOSE: To assess the incidence of posterior and combined labral tears in a large cohort of patients with surgically treated shoulder labral tears. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: This was a retrospective study that evaluated 442 patients who underwent an arthroscopic capsulolabral repair over a 3-year period. Patients were categorized according to the location of their labral tear and whether their injury was sustained during sporting or nonsporting activity. Proportions of labral tears between sporting and nonsporting populations were compared using the chi-square test. RESULTS: Patients had a mean age of 25.9 years and 89.6% were male. Isolated anterior labral tears occurred in 52.9%, with posterior and combined anteroposterior labral tears accounting for 16.3% and 30.8%, respectively. The frequency of posterior and combined lesions was greater in the sporting population compared with the nonsporting population (P = .013). CONCLUSION: Posterior and combined labral tears are more prevalent than previously reported, particularly in the sporting population.

Retained Surgical Drain After Total Knee Arthroplasty: An Eight-Year Follow-up: A Case Report.

CASE: This report describes a patient in whom the intra-articular portion of a suction drain broke during total knee arthroplasty. The broken portion of the drain could not be removed, but the patient experienced no major complications over an eight-year follow-up period. CONCLUSION: The presence of a retained surgical drain needs to be carefully assessed but is not an absolute indication for removal.

A Rare Case of Simultaneous Acute Bilateral Quadriceps Tendon Rupture and Unilateral Achilles Tendon Rupture.

INTRODUCTION: There have been multiple reported cases of bilateral quadriceps tendon ruptures (QTR) in the literature. These injuries frequently associated with delayed diagnosis, which results in delayed surgical treatment. In very unusual cases, bilateral QTRs can be associated with other simultaneous tendon ruptures. CASE REPORT: We present a rare case of bilateral QTR with a simultaneous Achilles Tendon Rupture involving a 31 years old Caucasian man who is a semi-professional body builder taking anabolic steroids. To date bilateral QTR with additional TA rupture has only been reported once in the literature and to our knowledge this is the first reported case of bilateral QTR and simultaneous TA rupture in a young, fit and healthy individual. CONCLUSION: The diagnosis of bilateral QTR alone can sometimes be challenging and the possibility of even further tendon injuries should be carefully assessed. A delay in diagnosis could result in delay in treatment and potentially worse outcome for the patient.

The linea aspera-pilaster complex as a possible cause of confusion with the 'flame sign': a case report.

The linea aspera is an important osteological feature onto which many muscles insert. Evolutionary as well as individual lifestyle changes can lead to the radiographic appearance of the linea aspera-pilaster complex as the track sign. This rare feature is known to radiologists and anthropologists as a normal roentgen and anatomical variant. However, its knowledge is less common even amongst experienced senior orthopedic surgeons. The track sign can be readily confused with the pathological 'flame sign' of Paget's disease leading to unnecessary investigations. This case report intends to increase awareness amongst experienced and trainee orthopedic surgeons alike, of the physiological existence of the track sign.