Purpose The sensitivity of Gram staining is known to be suboptimal for the diagnosis of native joint septic arthritis. We lack information about the accuracy of Gram compared to other microscopic staining techniques for predicting infection in different patient populations. Methods This was a cohort study with cost evaluations at the
The replacement of a native hip joint by a metal‐on‐metal prosthesis may induce deleterious inflammatory side effects that are associated with the release of wear particles and metal ions. These events are referred to the adverse reaction to metal debris (ARMD) and the adverse local tissue reaction (ALTR). While wear particles seem involved in ARMD, the role of metal ions in ALTR and their impact on myoblasts, located in the prosthesis vicinity, has not been fully identified. To clarify this issue we investigated, using an in vitro culture system, the effect of cobalt and/or chromium ions (Co2+ and/or Cr3+) on human myoblast proliferation, cellular differentiation, and inflammatory marker expression. Freshly isolated human myoblasts were cultured in media supplemented with graded concentrations of Co2+ and/or Cr3+. Co2+ induced a concentration‐dependent decrease of both myoblast viability and myogenic differentiation while Cr3+ did not. Co2+ or Co2+/Cr3+ also induced the upregulation of ICAM‐1, whereas HLA‐DR expression was unaffected. Moreover, allogenic monocytes induced the synergistic increase of Co2+‐induced ICAM‐1 expression. We also found that Co2+ stabilized HIF‐1α and increased TLR4, tumor necrosis factor‐alpha (TNF‐α), and interleukin 1β (IL‐1β) expression in a dose and time‐dependent manner in human myoblasts. This study showed that Co2+, but not Cr3+, was toxic toward myoblasts and induced, in the surviving cells, expression of inflammatory markers such as ICAM‐1, TLR4, TNF‐α, and IL‐1β. This suggests that Co2+, most efficiently in the presence of monocytes, may be a key inducer of ALTR, which may, if severe and long‐lasting, eventually result in prosthesis loosening.
Case: A 14-year-old girl sustained a posterior elbow dislocation and presented with a proximal radioulnar translocation (PRUT) and a displaced fracture of the radial head. Reduction of the elbow dislocation and the proximal radioulnar translocation were achieved by external manipulation in the operating room. The radial head was not amenable to closed reduction and remained entrapped in the anteromedial compartment of the elbow. So open reduction and internal stabilization was carried out. Conclusions: In PRUT, closed reduction should be attempted. The radial head should be preserved even if it is fully dislocated from metaphysis. Retrograde intramedullary radial nailing provides enough stability of the fracture to promote early mobilization and facilitate union.
Arthrose de la cheville : pourquoi si jeune, et quelle option thérapeutique ?L'arthrose de la cheville survient souvent chez les patients avec des antécédents de traumatisme de cheville. Parce que ces patients sont jeunes avec une haute demande fonctionnelle, le traitement doit être adapté. Le traitement conservateur est basé sur des orthèses correctrices, des chaussures de soutien et des infiltrations d'acide hyaluronique. La chirurgie conservatrice de la cheville représente une alternative au traitement traditionnellement proposé, soit l'arthrodèse de cheville. Elle peut améliorer la biomécanique articulaire, ralentir la dégénérescence et soulager substantiellement les douleurs. Elle permet également de retarder le besoin de chirurgies secondaires, et préserve la possiblité de bénéficier d'une chirurgie conservant la mobilité de la cheville ou d'une arthroplastie totale de cheville. Management of ankle osteoarthritis in the young adultAnkle osteoarthritis often presents in patients with a history of lower leg trauma. Hence, they are young with sportive demands and in the active labor phase, treatment must be adapted. Non-surgical treatment is based on corrective orthotics, supportive shoes, and intraarticular hyaluronic acid injections. Joint preserving surgery (JPS) represents a valid alternative to the traditional ankle fusion. JPS may restore normal biomechanics of the ankle joint, resulting in substantial postoperative pain relief, functional improvement, and slowing of the degeneration process. Overall, JPS defers the need for secondary surgeries in most of these young patients, making these patients suitable candidates for joint motion-preserving surgery, as is the case of ankle arthroplasty. Évaluation radiographiqueLe premier outil diagnostique est la radiologie standard du pied et de la cheville en charge sur les incidences de face et de profil.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.