At 5 years, young athletes with LROM of the hip showed increased progressive degenerative changes on MRI and radiographs compared with matched controls. Although the majority of these participants remained asymptomatic, those with features of FAI had radiographic findings consistent with early osteoarthritis. These outcomes suggest that more aggressive screening and counseling of young active patients may be helpful to prevent hip osteoarthritis in those with FAI.

Background Periprosthetic infections are devastating for patients and more efficacious preventive strategies are needed. Surface-modified implants using antibacterial coatings represent an option to cope with this problem; however, manufacturing limitations and cytotoxicity have curbed clinical translation. Among metals with antibacterial properties, copper has shown superior in vitro antibacterial performance while maintaining an acceptable cytotoxicity profile. A thin film containing copper could prevent early biofilm formation to limit periprosthetic infections. This pilot study presents the in vitro antibacterial effect, cytotoxicity, and copper ion elution pattern of a thin film of titanium-copper oxide (TiCuO). Questions/purposes (1) Do titanium alloy (Ti6Al4V) discs coated with a thin film of TiCuO reduce Staphylococcus epidermidis biofilm and planktonic cell density compared with uncoated discs? (2) Do Ti6Al4V discs coated with a thin film of TiCuO affect normal human osteoblast viability compared with untreated cells? (3) Is copper ion concentration generated by coated discs lower than previously published copper ion concentrations that cause 50% toxicity in similar human cell lines in vitro (TC50)? Methods Ninety Ti6Al4V discs (12.5 mm diameter; 1.25 mm thick) were used in this study. Seventy-two Ti6Al4V discs were coated with a thin film of either titanium oxide (TiO) or TiCuO containing 20%, 40%, or 80% copper using high-power impulse magnetron sputtering (HiPIMS). Eighteen Ti6Al4V discs remained uncoated for control purposes. We tested antibacterial properties of S epidermidis grown on The institution of one or more of the authors (GAN, RP, MK, CCW, PJJ, KEB, ADH, RJS) has received funding in excess of USD 100,000 from Codelco (Codelco Lab, Santiago, Chile; FP00076314-01-S01) and in excess of USD 10,000 from the Mayo Clinic. With the exception of one of the authors (RJS), the investigators have not personally received any money related to this study. One of the authors certifies that he (RJS), or a member of his immediate family, has received or may receive payments or benefits, during the study period, in an amount of USD 10,000 to USD 100,000 from Biomet Inc (Warsaw, IN, USA Clinical Orthopaedics and Related Research ®A Publication of The Association of Bone and Joint Surgeons® discs in wells containing growth medium. After 24 hours, planktonic bacteria as well as biofilms removed by sonication were quantitatively cultured. Annexin/Pi staining was used to quantify in vitro normal human osteoblast cell viability at 24 hours and Day 7, respectively. Copper elution was measured at Days 1, 2, 3, 7, 14, and 28 using an inductively coupled plasma mass spectrometer to analyze aliquots of culture medium. Copper ion concentration achieved at 24 hours was compared with previously published TC50 for gingival fibroblast, a phenotypically similar cell line with available data regarding copper ion exposure. Results Discs coated with TiCuO 80% copper showed greater biofilm and planktonic cell density re...

Background Bone marrow-derived mesenchymal stem cells (bmMSCs) have been used as a cellular therapeutic option for treatment of osteonecrosis of the femoral head. However, use of bmMSCs as a treatment adjuvant for orthopaedic disorders in general has achieved limited success. Adipose-derived MSCs (aMSCs) may be a moreefficient regenerative cell source given their greater quantity and protection from physiologic stress.

Review MSCs in osteoarticular pediatric diseasesoption is to use MSCs as a modulator of autoimmune chronic diseases with joints and bone clinical symptoms. The systemic interaction between MSCs and lymphocytes could result in a systemic modulation of the immune reaction. In this case, the indication of MSCs is not expected to cure but reduce the symptoms and complications.

Introduction: There is little data regarding timing of index dislocation in patients who undergo primary total hip arthroplasty (THA) and subsequent risk of redislocation and revision. Methods: Between 1992 and 2013, 21,490 primary THAs were performed at a single institution. 189 patients (190 hips) had a first episode of dislocation within one year of index surgery (0.9 %). 32 patients (32 hips) were excluded for the following reasons: complex THA secondary to fracture malunion, Crowe III/IV developmental hip dysplasia, periprosthetic fracture, prior hip surgery, incomplete information, and hip abductor avulsion. The final cohort consisted of 157 patients (158 hips) who experienced dislocation within 1 year of primary non-complex THA. 88 patients were female (56%), mean age was 61 years (SD = 14), and mean follow-up was 76 months (range 0–229). Multivariable Cox proportional-hazards regression models with fractional polynomial models were used to estimate the association between timing of index dislocation and subsequent redislocation and revision surgery. Results: 69 patients (44%) redislocated at final follow-up. Revision for any cause occurred in 26 out of 157 hips (17%). Time lapse from index THA to first dislocation was significantly associated with the risk of redislocation ( p = 0.004) and with the risk of revision ( p = 0.04). For every additional 7 days from surgery, risk of redislocation increased by a factor of 1.1 and risk of revision was increased by a factor of 1.13. Conclusion: This study demonstrates there is a lower risk of redislocation and revision in patients who have a first episode of dislocation closer to primary THA.

Primary extraskeletal osteosarcoma is an exceedingly rare malignant neoplasm that accounts for approximately 1% of soft tissue sarcomas and most often occurs in the deep soft tissues of adults. Extraskeletal osteosarcoma is characterized by the production of osteoid, bone, and/or chondroid matrix. The diagnosis of extraskeletal osteosarcoma requires careful radiologic and clinical correlation to ensure that the patient does not have an underlying bone primary. This is a case report of primary subcutaneous extraskeletal osteosarcoma arising in the thigh of a 15-year-old girl with a complex karyotype, and the morphologic differential diagnosis is reviewed.

SI joint abnormalities are more prevalent in patients with FAI associated with labral ossification (LO) than in a matched control group without LO; suggesting there may be an autoimmune link to LO.

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