Intra-articular therapies, such as steroid injection, viscosupplement injection and acupuncture, are common non-surgical options for patients with osteoarthritis of the knee. With any intra-articular injection or acupuncture procedure, there is a potential for inoculation with bacteria leading to possible knee infection. The authors report a patient who incurred an acute infection found after a total knee arthroplasty attributed to prior acupuncture procedure done as part of conservative treatment.
Arthroplasty, Replacement, Knee

Aim: Pelvic and acetabular fractures are associated with high energy trauma. The aim of this study was to identify factors that are associated with specific clinical outcomes following treatment for these fractures. Methods: A consecutive series of 30 patients who had surgical intervention for either pelvic or acetabular fractures formed the sample for this study. Clinical variables reviewed were: age, associated injuries, number of surgical procedures, time to surgery and post operative complications. Cli
Orthopaedic

We present the case of a 56-year old gentleman who presented with recalcitrant iliotibial band (ITB) friction syndrome which did not improve with various modalities of conservative treatment. Magnetic Resonance Imaging (MRI) of the affected knee did not show pathology typical of ITB friction syndrome. However, open exploration revealed a synovial cyst deep to the iliotibial band, abutting against the anterolateral capsule. The presence of distinctive clinical signs on physical examination should alert clinicians to consider knee synovial cyst as a differential diagnosis when dealing with recalcitrant ITB syndrome.
Iliotibial Band Syndrome

Bilateral anterior fracture-dislocations of humeral neck in a patient with seizure are extremely rare. We describe a rare case of a 33 -year-old Chinese gentleman who presented post seizure secondary to subdural gliosis, sequelae from a previous subdural haematoma. Following physical examination and radiographic assessment, including a Computed Tomography scan (CT scan), Rarely fracturedislocation of bilateral proximal humeri were diagnosed; similar fracture patterns were noted. Open reduction and internal fixation with PHILOS proximal humeral locking plate allowed early shoulder rehabilitation.

Human adipose-derived stem cells (HADSC) have demonstrated the capacity of differentiating into bone depending on the specific induction stimuli and growth factors. However, investigation on stem cell characteristic after osteogenic differentiation is still lacking. The goal of this study was to investigate the differential expression of sternness and osteogenic genes in non-induced HADSC compared with HADSC after osteogenic induction using quantitative Real Time RT-PCR. Our results showed that OCT-4, REX-1, FZD9, OSC, RUNX, and ALP were up regulated after osteogenic induction. This may indicated that HADSCs after osteogenic induction still possessed some stemness properties.

We report the case of a patient with a painful subcutaneous nodule, measuring 13 mm × 17 mm, at the pretibial graft aperture site, which presented two years after a successful anterior cruciate ligament reconstruction with an autologous hamstring graft. A bioabsorbable poly-L-lactide interference screw was used for graft fixation at the tibial aperture. The patient underwent surgical excision of the lesion and curettage at the tunnel aperture. Grossly, extruded fragments of the screw and a thick pseudocapsule of surrounding tissue were excised. There was no communication between the tunnel aperture and the knee joint. The graft was also intact. Histological analysis revealed fragments of the bioabsorbable material in association with fibrous and granulomatous chronic inflammatory cells. This was consistent with a foreign body reaction. The patient subsequently recovered and resumed preinjury level of activity. To the best of our knowledge, this is the first report describing a nodular granulomatous type reaction to foreign bioabsorbable poly-L-lactide screw material subsequent to an anterior cruciate reconstruction surgery.
Absorbable Implants ; adverse effects ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Anterior Cruciate Ligament Reconstruction ; adverse effects ; methods ; Arthralgia ; diagnosis ; etiology ; Bone Cysts ; complications ; diagnosis ; surgery ; Bone Screws ; adverse effects ; Follow-Up Studies ; Humans ; Knee Joint ; Magnetic Resonance Imaging ; Male ; Postoperative Complications ; Reoperation ; Tibia ; Young Adult

INTRODUCTIONThe purpose of this study was to compare the clinical outcomes of elderly hip fracture patients who received surgical treatment with those who received non-surgical treatment.

METHODSThis retrospective study involved 2,756 elderly patients with hip fractures who were admitted over a six-year period. The patients' biodata, complications, ambulatory status at discharge and length of hospital stay were obtained from the institution's hip fracture registry.

RESULTSAmong the 2,756 hip fracture patients, 2,029 (73.6%) underwent surgical intervention, while 727 (26.4%) opted for non-surgical intervention. The complication rate among the patients who underwent surgical intervention was 6.6%, while that among the patients who underwent non-surgical intervention was 12.5% (p < 0.01). The mean length of hospital stay for the surgical and non-surgical hip fracture patients was 15.7 days and 22.4 days, respectively (p < 0.01).

CONCLUSIONSurgical management of hip fractures among the elderly is associated with a lower complication rate, as well as a reduced length of hospital stay.