Liposome bupivacaine added to standard bupivacaine may lower pain and enhance patient's satisfaction in the first postoperative week even in the setting of multimodal analgesia for major shoulder surgery.This study was registered with clinicaltrials.gov (NCT02554357) on July 11, 2015, by Principal Investigator Catherine Vandepitte, MD.

Arthroscopically assisted reconstructions of the anterolateral bundle of the PCL in patients with symptomatic isolated grade II to IV PCL-deficient knees lead to significantly improved functional results at long term if there is no cartilage damage at time of surgery. Nonoperative treatment should not be extended more than 1 year from injury. Graft choice did not significantly influence the functional outcome at long term.

The use of plate-and-cable constructs to treat periprosthetic fractures around a well-fixed femoral component in total hip replacements has been reported to have high rates of failure. Our aim was to evaluate the results of a surgical treatment algorithm to use these lateral constructs reliably in Vancouver type-B1 and type-C fractures. The joint was dislocated and the stability of the femoral component was meticulously evaluated in 45 type-B1 fractures. This led to the identification of nine (20%) unstable components. The fracture was considered to be suitable for single plate-and-cable fixation by a direct reduction technique if the integrity of the medial cortex could be restored. Union was achieved in 29 of 30 fractures (97%) at a mean of 6.4 months (3 to 30) in 29 type-B1 and five type-C fractures. Three patients developed an infection and one construct failed. Using this algorithm plate-and-cable constructs can be used safely, but indirect reduction with minimal soft-tissue damage could lead to shorter times to union and lower rates of complications.

The burden of hip muscles weakness and its relation to other impairments has been well documented. It is therefore a pre-requisite to have a reliable method for clinical assessment of hip muscles function allowing the design and implementation of a proper strengthening program. Motor-driven dynamometry has been widely accepted as the gold-standard for lower limb muscle strength assessment but is mainly related to the knee joint. Studies focusing on the hip joint are less exhaustive and somewhat discrepant with regard to optimal participants position, consequently influencing outcome measures. Thus, we aimed to develop a standardized test setup for the assessment of hip muscles strength, i.e. flexors/extensors and abductors/adductors, with improved participant stability and to define its psychometric characteristics. Eighteen participants performed unilateral isokinetic and isometric contractions of the hip muscles in the sagittal and coronal plane at two separate occasions. Peak torque and normalized peak torque were measured for each contraction. Relative and absolute measures of reliability were calculated using the intraclass correlation coefficient and standard error of measurement, respectively. Results from this study revealed higher levels of between-day reliability of isokinetic/isometric hip abduction/flexion peak torque compared to existing literature. The least reliable measures were found for hip extension and adduction, which could be explained by a less efficient stabilization technique. Our study additionally provided a first set of reference normalized data which can be used in future research.

Patients with hip pathology present alterations in gait which have an effect on joint moments and loading. In knee osteoarthritic patients, the relation between medial knee contact forces and the knee adduction moment are currently being exploited to define gait retraining strategies to effectively reduce pain and disease progression. However, the relation between hip contact forces and joint moments has not been clearly established. Therefore, this study aims to investigate the effect of changes in hip and pelvis kinematics during gait on internal hip moments and contact forces which is calculated using muscle driven simulations. The results showed that frontal plane kinetics have the largest effect on hip contact forces. Given the high correlation between the change in hip adduction moment and contact force at initial stance (R 2 ¼ 0.87), this parameter can be used to alter kinematics and predict changes in contact force. At terminal stance the hip adduction and flexion moment can be used to predict changes in contact force (R 2 ¼ 0.76). Therefore, gait training that focuses on decreasing hip adduction moments, a wide base gait pattern, has the largest potential to reduce hip contact forces. ß