Pigmented villonodular synovitis

We cannot recommend PSI-TKR for a better outcome. It is an alternative to conventional and computer-assisted TKR, but further studies are needed to evaluate weather surgical or economic benefits may be achieved by choosing customised instruments.

No abstract

The results are encouraging for the further use of this pre-operative view with the premises of increasing the accuracy of prosthetic positioning and reducing the mechanical complications.

The present study describes a 29 years old patient diagnosed with aseptic osteonecrosis with multiple localization occurred after a corticoid treatment for chronic toxic hepatitis. The clinical and para-clinical examinations determined the diagnosis of Wilson disease and avascular necrosis with multiple localizations. The evolution of the disease was favourable following the surgical treatment consisting of bilateral total hip arthroplasty with cementless prosthesis, hemi-arthroplasty of the left shoulder with cementless prosthesis, orthotopic hepatic transplantation with an entire liver from donor in cerebral death and immunosuppressive, anticoagulant, antiretroviral and gastro-protective treatment. There is an increase of the number of patients undergoing a glucocorticoids treatment for several months, years or lifelong periods. This type of treatment increases the risk of osteonecrosis depending on the dosage and the duration of the treatment.

King should go no small share of the credit for the case, for he has taken great interest in it and the greater part of the work and worry have been his. We also thank Mr. Vincent Patrick for his interest and for removing the primary tumour, and Dr. J. H. Sheldon for the general examination of the patient. REFERENCE

Bicondylar tibial plateau fractures pose many challenges in surgical treatment. The aim of the present study was to analyze three methods of reduction, single medial, single lateral, and dual plating, for the treatment of a bicondylar tibial plateau fracture, through finite element analysis (FEA). A simple metaphyseal fracture, type C1.1 (AO-41) was modeled on a CT-derived 3D model of the knee. Lateral and medial proximal tibial polyaxial plates with screws were modeled and placed accordingly for the three methods of reduction. Simulation of physiological type loading corresponding to the maximal weight acceptance phase during a slow walking gait cycle was performed using FEA. Values of stress and strain were recorded near the fracture lines. Dual plating provided a decrease of stress and strain in the tibial plateau area. However, the differences in the values among the three cases were small. The stress concentration areas were located in the vicinity of the fracture, predominantly in the area of the tibial plateau. Considering the limitations of the present study, the results revealed that dual plating leads to smaller stress and strain values near the fracture lines in the tibial plateau area. However, values obtained for single lateral plating are close in range. Considering the complexity of the surgical approach for dual plating, single lateral plating may be a solution for good reduction with fewer surgical risks and complications. Further studies on the C1.1 fracture (AO-41) are needed to analyze the complex issue of reducing and stabilizing such a fracture and to characterize the postoperative state while providing predictable parameters for an optimal result.

This study included 56 patients who presented hip pain occurring spontaneously without any trauma history. A new radiological protocol was initiated for all the patients suspected of NACF. A pelvis, Dunlop profile and modified Budin at both hips scan was performed. In order to emphasize the effectiveness of the new radiological protocol, the following indicators were analyzed: the mobility of the affected hip, the radiological changes typical to the aseptic necrosis of the femoral head, the extension angle of the necrosis area on every incidence after Kerboul [1,2], the surface area covering the necrosis zone on every incidence and the coverage on every patient. The modified Budin profile has a greater diagnostic value for the early stages of NACF than the Dunlop profile and the radiography. The Budin incidence is important in order to differentiate stage III of NACF from stage IV by highlighting the degenerative changes in the acetabular cavity.