Hoffa's Fat Pad Abnormality in the Development of Knee Osteoarthritis.

Over the past two decades, many hypotheses have been put forward to explain the cause of knee osteoarthritis. Scientific reports bring up the role of adipose tissue in the activation of the inflammatory mechanisms, which is a characteristic feature of osteoarthritis natural history. Adipose tissue produces and releases cytokines, interleukins, and growth factors by means of paracrine, endocrine, and autocrine mechanisms. Hoffa's fat pad (infrapatellar adipose tissue) plays a viable role in the initiation and progression of osteoarthritis due to its role in the activation and release of pro-inflammatory mediators. The degenerative joint disease is considered an inflammatory process. Therefore, in this article we overview the importance of Hoffa's fat pad in the development and progression of osteoarthritis.

[Current concepts in surgical treatment of chronic ankle joint instability]. / Aktualne poglAdy na temat leczenia operacyjnego przewlekLej niestabilnoSci stawu skokowego.

Ankle sprain is one of the most common musculoskeletal injuries. Initial treatment of choice in acute injury is conservative and is obtained by immobilization. The goal of such treatment is to heal ruptured capsular-ligamentous complex. However, despite the conservative treatment some patients develop chronic ankle instability as a result of injury. In those cases, surgical anatomical and non-anatomical ligamentous reconstruction is advised. Aim of the study was evaluation of the results obtained with various surgical techniques in view of published data. According to most authors, in patients who experienced chronic ankle instability, surgical technique of anatomical repair is preferred. In cases when anatomical repair might not be undertaken due to technical capabilities, anatomical reconstruction using autoor allografts is advised.

Periprosthetic Metastatic Lesion in Stem Region after THA. Case Study.

The paper describes a periprosthetic metastatic lesion in the stem region which developed 4 years after cementless total hip arthroplasty in a 64-year-old female patient. The patient underwent primary THA due to osteoarthritis in 2010. In June 2014, she presented with increasing hip pain. Diagnostic imaging revealed a periprosthetic osteolytic lesion in the stem region. The patient was referred to the Orthopaedic Department for further evaluation with a suspicion of pyogenic osteomyelitis. An open surgical biopsy was performed. Histopathological examination indicated metastatic cancer originating from the lungs or thyroid. A PET-CT scan showed a metabolically active tumour in the parahilar area of the left lung with metastases to mediastinal and hilar lymph nodes, left adrenal gland, spleen and right proximal femur. In October 2014, a revision total hip arthroplasty with the use of a modular femoral resection stem was performed. Patient subsequently received oncologic treatment (chemotherapy and radiation therapy).