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With substantial interest devoted to improving knee flexion after TKA, it is important to document the relationship between high range of motion and patient-rated outcomes shown. We therefore asked whether single-design high-flexion mobile-bearing posterior-stabilized TKA resulted in: (1) improved knee function; (2) satisfying subjective results; (3) participation recreational and sporting activities; and (4) function correlated to the final range of motion. We prospectively followed 445 consecutive patients having 516 TKAs from September 2000 to January 2005. The same high-flexion posterior-stabilized mobilebearing implant was used in all patients. Mean patient age was 71 ± 8 years and mean body mass index was 28 ± 4 kg/m 2 . The minimum clinical followup was 2 years (mean, 3 years; range, 2-4 years). The postoperative range of knee flexion was 128°± 4°and the mean Knee Society function and knee scores were 91 ± 6 and 96 ± 3, respectively. Eighty-two percent of patients were involved in sporting activities and 86% returned to their previous level of activity. These data confirm that high postoperative range of knee flexion improve patient-rated outcomes.

We report a case of an 18-year-old female without a relevant medical history who presented with an 8-month history of a left foot mass. It started as a small nodule that progressively increased in size over time. The mass then became ulcerative with foul-smelling discharge. There was no palpable left inguinal or other lymph nodes upon physical examination. Histological examination of the biopsy confirmed a diagnosis of clear cell sarcoma. Clear cell sarcoma is a rare soft tissue neoplasm. However, early diagnosis is crucial to prevent metastasis and worsened prognosis. Clear cell sarcoma has an extremely poor prognosis once metastasis occurs, and to the best of our knowledge, only fewer than 100 cases have been reported in the literature.

The postoperative functional outcomes are similar in diabetic and nondiabetic patients. Therefore, the management of trigger finger should be the same in both groups.

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Background/Aim:Osteoporosis is a systemic disease characterized by decreased bone density and increased tendency to develop fractures. Osteoporosis in children and adolescents is a rare disease usually secondary to Medical conditions or medications given to children. The condition affects normal bone growth and development and carries with it multiple morbidities (physical and psychological) if not corrected promptly. This study aims to share our experience with Zoledronic Acid Therapy in Pediatric patients with secondary osteoporosis.Method:A retrospective study which included 46 patients aged 3 to 18 years. All patients received specific doses of Zoledronic acid and were followed up at King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia. Clinical and laboratory data were collected for each patient from their files. Adverse events were also recorded.Results:The use of Zoledronic Acid in children and adolescents appears to be statically significant reduce fracture rate (p=0.005), bone turnover markers (Osteocalcin p= 0.003, CTX p= 0.008) and pain frequency in symptomatic individuals (p=0.000). Careful selection of cases is required to provide maximum benefits compared to risks associated with therapy.Conclusion:This study demonstrates that Zoledronic acid has positive effects on clinical outcome and bone marker level as well as quality of life for Pediatric patients with Osteoporosis and their families, with no long-term side effects.

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Purpose Carpal tunnel syndrome (CTS), a neuropathological disorder, is the most common upper limb manifestation; it affects 6.7% of the general population and leads to medical costs of approximately half a billion dollars per year in the United States. The clinical symptoms of CTS include pain, numbness, tingling, autonomic disturbances, and weakness. There is controversy regarding diabetes as a risk factor for worse clinical outcomes in patients with CTS. This study aimed to compare the functional outcomes following carpal tunnel release between patients with and without diabetes using the QuickDASH scores. Methods In this case-control retrospective study, we reviewed patients who underwent open carpal tunnel release surgery at our Department of Orthopaedic Surgery between March 2012 and September 2022. The patients were interviewed using a questionnaire to collect demographic data and medical and surgical history; the Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire (Arabic version) was also administered. Results Overall, 85 patients were included, 43 patients (51.6%) without diabetes and 42 (49.4%) with diabetes. The most prevalent co-morbidity was Diabetes followed by Hypertension (51.6% and 42.4%, respectively). Overall, the mean QuickDASH score was 25.1 (standard deviation [SD], 20.7); it was 31.927 in patients with diabetes and 18.5 in those without diabetes (p = 0.002). Conclusion Patients with diabetes had worse functional outcomes than did those without diabetes. Understanding the intrinsic and extrinsic risk factors will aid in the better management of patients. Optimum management of these patients associated risk factors, will contribute to more desirable outcome.