Combined syringe cement pressurisation and intra-osseous suction: an effective technique in total knee arthroplasty.

Our study looked at the short and medium-term results of a cost-effective technique of bone surface preparation and cement introduction in total knee arthroplasty (TKA). Numerous factors determine the outcome following TKA. Early failure and component loosening have been attributed to inadequate bone-cement and prosthesis-cement interfaces, established at the time of surgery. Various operative techniques have been reported to achieve effective cement penetration and inter-digitation into cancellous bone, with techniques of cement pressurization and intra-osseous suction being employed. We have devised a technique of cement pressurization using a modified standard 20 ml syringe, combined with intra-osseous suction. Retrospective evaluation of a series of 50 post-operative radiographs has shown that effective and even penetration of cement to a depth of 8.0 to 10.6 mm can be achieved consistently with this technique, during TKA, without the use of tourniquet. In addition evaluation of post-operative plain radiographs with minimum follow-up of 5 years showed 16 knees with minor, non-progressive lucent lines around the tibial component with a maximum Knee Society TKA Roentgenographic score of 2. To conclude we propose that this simple technique of surface preparation and cement introduction produces good results in the short and medium-term.

Large pelvic giant cell tumor: a case report and a review of current treatment modalities.

Giant cell tumors (GCTs) of bone typically present in adults between the ages of 20 and 50 with the symptoms of progressive pain and local swelling. Females are slightly more often affected than males. GCTs tend to arise in epiphyses of long tubular bones. The typical radiographic appearances are of geographical radiolucency and cortical thinning, without internal mineralization. GCTs represent 5% of all primary bone tumours. Although benign, GCTs are locally aggressive entities producing expansive and lytic lesions. We present the case of a young man with a GCT of his pelvis who could not be treated by previously described methods because of the size of the lesion, its location, and the effects it had on surrounding bony structures.

Meralgia paraesthetica--an addition to 'seatbelt syndrome'.

A case of meralgia paraesthetica linked to 'seatbelt syndrome'.