Controlled laboratory study.

Background: Lipoma arborescens is a rare, intra-articular benign lesion characterized by hyperplastic formation of villous projections that commonly presents as nonspecific mechanical knee pain. The treatment of choice for lipoma arborescens of the knee is open or arthroscopic synovectomy. However, data are lacking on the success of arthroscopic treatment, despite its increasingly widespread use. We aimed to systemically review the outcomes of arthroscopic treatment of lipoma arborescens.Methods: PubMed and Embase were searched by 2 reviewers independently on October 9, 2018, and all relevant articles in the English and French languages up to and including that date were considered. The search terms "lipoma arborescens," "knee," "arthroscopy," and "arthroscopic" were used. Articles were screened on the basis of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.Results: Among the 110 initial studies that were retrieved, 28 satisfied the inclusion criteria. A total of 71 knees in 65 patients ranging from 13 to 78 years of age underwent arthroscopic synovectomy for the treatment of lipoma arborescens. The duration of follow-up ranged from 3 weeks to 84 months. The recurrence rate was 2.8%, and 2 patients underwent conversion to open surgery. One patient had postoperative hematoma that required evacuation, and another patient reported persistent residual pain at the time of the latest follow-up.Conclusions: On the basis of this uncontrolled, systematic review, arthroscopic synovectomy is a safe and effective treatment for lipoma arborescens of the knee, with a success rate of .95%.

In this cross-sectional study, we surveyed all pediatric orthopedic surgeons in Saudi Arabia using an anonymous electronic questionnaire composed of 23 items to identify the rate of occupational injuries and obtain other relevant information. Thirty-nine participants completed the questionnaire (response rate: 83%). Participants who sustained occupational injuries throughout their careers represented 82.5%. The most injured areas were the hands, eyes, and back by 54.5%, 24.2%, and 15.2%, respectively. Approximately 11.1% were injured while operating on infected patients. Approximately 30.3% reported their injuries to their institution. We concluded that the rate of occupational injuries among pediatric orthopedic surgeons is very high and underreported.

IntroductionTraumatic hip dislocation is a severe injury with the potential for significant morbidity and mortality. Bilateral hip dislocation is rare representing 1.25% of all hip dislocations.Presentation of the caseA 19-year-old male had a high-speed motor vehicle accident. After stabilizing the patient, it was noticed that the position of the right lower limb was in adduction and internal rotation while the left was in external rotation and abduction. Pelvis x-ray showed right superior posterior and left anterior inferior hip dislocations. Closed reduction was performed within 3 hours from the trauma for both sides. The post reduction CT scan showed adequate reduction of both hips with no associated fractures. During his three-year follow-up, he never had any complaints and the clinical examination and radiographs did not reveal any abnormalities.DiscussionEarly reduction of hip dislocations minimizes the risk of osteonecrosis of the femoral head. The current recommendations state that a hip dislocation must be reduced within 6 hours.ConclusionThis is a rare case of bilateral asymmetric hip dislocations with no concomitant fractures. It is important to reduce hip dislocation within 6 hours from the time of injury to prevent osteonecrosis of the femoral head.