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Pincer impingement is often treated by surgical labral separation from the acetabular rim and rim reduction. A more recent technique the so-called ‘over the top’ involves reduction of the bony acetabular rim without separation of the labrum. Our purpose is to report mid-term results of the ‘over the top’ technique. Between January 2006 and January 2013 a consecutive series of patients with femoroacetabular impingement (FAI) diagnosis, treated with the ‘over the top’ technique were included, using the lateral approach. The Western Ontario and MacMaster (WOMAC) scores were evaluated. Fifty patients (20 males and 30 females) from the Hip and Knee Joint Reconstructive and hip arthroscopy division were included. The average age was 30.5 years old and the average follow-up was 48 months (range 70–90). Preoperative WOMAC average was 42. Post-operative WOMAC was 81.3 (P = 0.01). One patient required an arthroscopic revision due to adherences, but had a full recovery after the revision surgery. The ‘over the top’ technique is an excellent choice for the treatment of the pincer deformity in the FAI avoiding the injury of the chondrolabral union.

This study aimed to estimate the environmental cancer disease burden in adults attributable to fine particulate matter (PM 2.5) exposure using Ostro's function methodology, and health risk indexes for particle-bound toxic chemicals through hazard quotients (HQ, HI) and carcinogenic risk (CR, CRI) indexes from EPA guidelines, of two urban Chilean Municipalities: Coyhaique and Independencia. Quantification of chemical species (OC, EC, metals, and PAHs) was done at the Lamont-Doherty Earth Observatory of Columbia University, USA. Modern carbon in OC and EC analysis showed that the principal source of PM2.5 emission in Coyhaique was firewood burning compared with Independencia. The total PAHs and B[a]P concentrations were 6.3 and 8.9 times higher in Coyhaique than in Independencia. In contrast, As and Pb levels were significantly greater in Independencia. The HI was 14.5 and 2.37 times the limit considered acceptable (HI > 1) in Coyhaique and Independencia, explained 92.45% by B[a]P and 66.99% by As, respectively. CRI exceeded the threshold (1 x 10 -6 ) in Coyhaique and Independencia, explained by As (75.38%) plus B[a]P (20.30%) and As (97.01%). The attributable fraction (AF) of deaths due to lung cancer from long-term exposure to PM2.5 reached 54% (95% CI: 25-72) in Coyhaique vs. 43% (95% CI: 19 -46) in Independencia. The AF for cardiopulmonary cancer were 40% (95% CI: 17 -57) and 32% (95% CI: 12 -46), respectively. A relevant fraction of the cancer cases and potential expected adverse effects would be attributable to long-term exposure to PM2.5 and the presence of chemical compounds bound to the particles. These results deserve further study to help guide policy in different environments, mainly carcinogenic PM2.5-bound toxic species from other emission sources, particularly firewood burning.

The purpose of this article is to provide an overview and perspective of the available options for clinical outcomes evaluation of articular cartilage repair in the knee. A nonsystematic literature review of reported clinical measures for functional, qualitative, and quantitative structural outcomes evaluation after knee articular cartilage repair was performed. Several outcome scores have been validated for articular cartilage repair in the knee with the International Knee Documentation Committee score, Lysholm score, and Knee injury Osteoarthritis Outcome Score being reported most frequently. Activity measures including Tegner and Marx activity scales and the rate of return to sports have direct practical relevance for athletically active patients. Macroscopic and histological assessment provides important structural information about repair cartilage quality and quantity. In addition, magnetic resonance imaging (MRI) outcome scoring and functional MRI are gaining increasing popularity and promise less invasive systematic assessment. In summary, clinical outcome evaluation after cartilage repair can be performed by various established and validated functional outcome instruments as well as several evolving outcome parameters that provide clinically relevant outcome information for researchers, clinicians, and patients.