Small-incision surgical exposure for select fractures of the acetabulum: the gluteus maximus-splitting approach.

This technique article presents a small-incision, gluteal-splitting approach for the treatment of select fractures involving the posterior acetabulum. The approach essentially involves the proximal portion of the Kocher-Langenbeck incision, and it can be extended to a larger exposure if needed. It is ideally suited for posterior-wall fractures, along with select transverse and posterior column fractures.

Presentation of gamma-irradiated-in-air polyethylene wear in the form of a synovial cyst.

The increased wear of polyethylene sterilized with gamma irradiation in air has well been documented in the total knee arthroplasty literature. Our case report describes a patient with a well-functioning total knee replacement presenting with wear debris synovitis in the form of a large synovial cyst. We discuss this patient's preoperative evaluation, intraoperative findings, and postoperative outcome after synovectomy and polyethylene exchange. We also review the current literature on appropriate polyethylene sterilization methods.