Percutaneous catheter drainage of tuberculous and nontuberculous psoas abscesses.

OBJECTIVE: To assess the utility of percutaneous catheter drainage in the management of tuberculous and nontuberculous psoas abscesses associated without any bony involvement or with minimal bony lesions that could not cause vertebral instability. MATERIALS AND METHOD: Eleven patients with psoas, iliopsoas and pelvic abscesses were drained under computed tomography and ultrasonography guidance. RESULTS: There were 15 (10 tuberculous, 5 pyogenic) abscesses in 11 patients. Six of the tuberculous abscesses and one of the pyogenic abscess were associated with vertebral involvement. Vertebral lesions were located in one or two vertebrae without causing any serious disturbance in the vertebral stabilization. In one case, the abscess was bilateral. Nine cases were drained under computed tomography guidance, while two cases were drained under both computed tomography and ultrasonography guidance. One session drainage was sufficient for abscess resolution in uniloculated cases. In the two of four multiloculated cases, catheter drainage was performed twice. Relapse of the abscess was found in only one patient. The mean abscess volume was 520 ml and mean drainage duration was 12 days. None of the cases required surgery. CONCLUSION: Percutaneous drainage, chemotherapy and additional external brace application with the cases associated with bony lesion may be used for treatment of tuberculous and nontuberculous unilocule and multiloculated abscesses.

Bilateral hip arthroplasty for ochronotic arthropathy.

Ochronosis is a musculoskeletal manifestation of alkaptonuria, a rare hereditary metabolic disorder characterised by the absence of the enzyme homogentisic acid oxidase and associated with various systemic abnormalities related to the deposition of homogentisic acid pigment (ochronotic pigment). In this report, we describe a 53-year-old, HLA-B27(+) woman with ochronotic arthropathy. In addition to the typical clinical features of the disorder, she had bilateral hip involvement, which was improved by cementless total hip prosthesis.

Initial fixation strength of interference nail fixation for anterior cruciate ligament reconstruction with patellar tendon graft (experimental study).

The objective of this study was to evaluate initial fixation strength of a new interference nail fixation in anterior cruciate ligament reconstruction using bone-patellar tendon-bone graft. Human cadaver knees were used. Fixation strengths ranged from 500 N to 600 N (mean 550 N). This corresponds to loads in the graft during aggressive rehabilitation. No slippage occurred at fixation site of specimens. Most of the failures appeared from the femoral side with tendon ruptures. With respect to primary fixation strength, interference nail fixation is a reasonable alternative for anterior cruciate ligament reconstruction with bone-patellar tendon-bone graft.

Synovial hemangioma in Hoffa's fat pad (case report).

A 15-year-old girl presented with anterolateral knee pain for 6 months. There were tenderness and pain at the anterolateral triangulation of the knee joint. Magnetic resonance imaging revealed a tumor in the anterolateral corner of the knee joint. Arthroscopy did not show the tumor because it was located in fat pad. The tumor was found during fat pad shaving and was resected arthroscopically. Synovial hemangioma was demonstrated histologically. The patient is asymptomatic postoperatively.

A new interference nail fixation for anterior cruciate ligament soft tissue grafts.

We present a new device for femoral and tibial fixation in anterior cruciate ligament reconstruction using soft tissue. We evaluated the method biomechanically in pullout tests using human cadaver knee joints. Fixation strengths ranged from 300 +/- 60 to 600 +/- 50 N (mean 400 +/- 50 N). This corresponds to loads in the graft during aggressive rehabilitation although cadaveric specimens were used. With respect to primary fixation strength this implant is a reasonable alternative for anterior cruciate ligament graft fixation.

An accessory ossification centre in the calcaneus with talonavicular and second metatarsocuneiform coalitions.

We present the case of an 11-year-old girl with an accessory ossification centre of the calcaneus with talonavicular and second metatarsocuneiform coalitions, and bilateral os tibiale externum.

Treatment of osteochondral defects with tendon autografts in a dog knee model.

Tendon autograft was used for the treatment of osteochondral defects induced experimentally in dogs' knees. Osteochondral defects were created on the femoral condyles in both knees of five dogs. The tendon was harvested from the anterior cruris, and a knot was tied in the middle. Then two tunnels were bored in the medial condyle. The free ends of the tendon were individually inserted into the tunnels and pulled from the openings on the medial recessus side so that the knot itself sat within the osteochondral defect. The lateral condyle was left untreated for comparison. At 24 weeks postoperatively, the dogs were killed and macroscopical and histological examinations were performed. A congruous articular surface had formed, and the grafted tendon was bonded into the defect. The tendon was not degraded, and was covered with reparative tissue as seen microscopically. Despite weight-bearing being allowed in the early stages after the operation, no sign of degradation was noted in the tendon.