The American journal of orthopedics
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Review Case Reports
Associated lateral process and posteromedial tubercle talus fractures:a case report and literature review.
This article describes the case of a 39-year-old man who sustained both a lateral process and posteromedial tubercle talus fracture. Both fractures were treated with open reduction and internal fixation resulting in a satisfactory clinical outcome. Although this combination of injuries has been described in the literature, this is the first reported case to describe surgical fixation of both fractures.
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Case Reports
Modified technique for unipolar allograft ankle replacement: midterm follow-up. A case report.
The management of tibiotalar arthritis remains a clinical challenge. Conventional treatment relies primarily upon arthrodesis or prosthetic arthroplasty. Fresh osteochondral total ankle allograft transplantation has been reported in limited cases. ⋯ His Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index, total WOMAC score, and American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale score were 0, 94, and 98, respectively. The final radiograph showed complete integration of the allograft with mild joint space narrowing. Osteochondral allografting for ankle arthritis may be considered an option in select patients.
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Can interepicondylar distance predict joint line position in primary and revision knee arthroplasty?
Restoration of the position of the prosthetic joint line (JL) to the same level as the original JL is a challenging problem in primary adn revision knee arthroplasty, and there is no reliable method for achieving this objective. We hypothesized that there is a constant ratio between the interepicondylar distance (IED) and the perpendicular distance from this interepicondylar line to the JL and analyzed 100 computed tomography scans of the knee to study this relationship. The IED and the perpendicular distance from this interepicondylar line to the JL was measured using both the clinical epicondylar axis (CEA) and the surgical epicondylar axis (SEA). ⋯ The ratio was found to be constant, irrespective of the patient's sex or height. We suggest using the CEA because of the ease in localizing epicondyle peaks and conclude that the position of the JL from the interepicondylar line is one-third the IED using the CEA. This will prove to be a valuable aid in restoring the JL position during knee arthroplasty.
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Review Case Reports
Proximal humerus osteolysis after revision rotator cuff repair with bioabsorbable suture anchors.
Biodegradable anchors were designed to provide secure fixation while allowing for later resorption and replacement by host tissue. First-generation implants degraded relatively rapidly and caused foreign-body reactions, synovitis, fragmentation, and osteolysis. ⋯ Case reports have described glenoid osteolysis around biodegradable suture anchor placement for shoulder stabilization, but up until now, to our knowledge, only 1 case of proximal humerus osteolysis has been reported for these implants. Here we describe a semicrystalline, poly-L-lactic acid bioabsorbable suture anchor failure after revision rotator cuff repair with subsequent humeral tuberosity osteolysis.
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In this article, we describe a case series study involving a new radiologic evaluation of sagittal imbalance. We review the current radiologic assessment of sagittal imbalance and introduce a new radiologic evaluation that helps in ruling out hip flexion contracture as the primary cause of sagittal imbalance and the type and level of spinal osteotomy required to regain sagittal balance. Sagittal imbalance is important in spinal deformity assessment. ⋯ Interobserver reliability was lower but good (κ = 0.76). Inclusion of the proximal femur on the long upright lateral plain radiograph of the entire spine and identification of the relation between the femoral axis line and the center of C7 are important in evaluating sagittal imbalance. Excellent intraobserver reliability, coupled with good interobserver reliability, suggest that this new radiologic assessment method can be helpful in preoperative assessment of sagittal imbalance.