Notes

Consumption of Phenolic-Rich Foodstuff and also Health supplements as a Crucial Tool throughout SARS-CoV-19 Infection.
The menisci and articular cartilage of the knee have a close embryological, anatomical and functional relationship, which explains why often a pathology of one also affects the other.Traumatic meniscus tears should be repaired, when possible, to protect the articular cartilage.Traumatic articular cartilage lesions can be treated with success using biological treatment options such as microfracture or microdrilling, autologous chondrocyte transplantation (ACT), or osteochondral transplantation (OCT) depending on the depth and area of the lesion.Degenerative cartilage and meniscus lesions often occur together, and osteoarthritis is already present or impending. Most degenerative meniscus lesions should be treated first conservatively and, after failed conservative treatment, should undergo arthroscopic partial meniscus resection. Degenerative cartilage lesions should also be treated conservatively initially and then surgically; thereby treating the cartilage defect itself and also maintaining the axis of the leg if necessary.Tears of the meniscus roots are devastating injuries to the knee and should be repaired e.g. by transtibial re-fixation.The clinical role of 'ramp' lesions of the meniscus is still under investigation. Cite this article EFORT Open Rev 2020;5652-662. DOI 10.1302/2058-5241.5.200016.The prognosis of sickle cell disease (SCD) has greatly improved in recent years, resulting in an increased number of patients reporting musculoskeletal complications such as osteonecrosis of the femoral head. Total hip arthroplasty (THA) can be utilized to alleviate the pain associated with this disease.Although it is well known that hip arthroplasty for avascular necrosis (AVN) in SCD may represent a challenge for the surgeon, complications are frequent, and no guidelines exist to prevent these complications. Because patients with SCD will frequently undergo THA, we thought it necessary to fulfil the need for guidance recommendations based on experience, evidence and agreement from the literature.For all these reasons this review proposes guidelines that provide clinicians with a document regarding management of patients with SCD in the period of time leading up to primary THA. The recommendations provide guidance that has been informed by the clinical expertise and experience of the authors and available literature.Although this is not a systematic review since some papers may have been published in languages other than English, our study population consisted of 5,868 patients, including 2,126 patients with SCD operated on for THA by the senior author in the same hospital during 40 years and 3,742 patients reported in the literature. Cite this article EFORT Open Rev 2020;5641-651. DOI 10.1302/2058-5241.5.190073.Classical indications for hip preserving surgery are femoro-acetabular impingement (FAI) (intra- and extra-articular), hip dysplasia, slipped capital femoral epiphysis, residual deformities after Perthes disease, avascular necrosis of the femoral head.Pre-operative evaluation of the pathomorphology is crucial for surgical planning including radiographs as the basic modality and magnetic resonance imaging (MRI) and/or computed tomography (CT) to evaluate further intra-articular lesions and osseous deformities.Two main mechanisms of intra-articular impingement have been described (1) Inclusion type FAI ('cam type').(2) Impaction type FAI ('pincer type').Either arthroscopic or open treatment can be performed depending on the severity of deformity.Slipped capital femoral epiphysis often results in a cam-like deformity of the hip. LOXO-305 nmr In acute cases a subcapital re-alignment (modified Dunn procedure) of the femoral epiphysis is an effective therapy.Perthes disease can lead to complex femoro-acetabular deformity which predisposes to impingement with/without joint incongruency and requires a comprehensive diagnostic workup for surgical planning.Developmental dysplasia of the hip results in a static overload of the acetabular rim and early osteoarthritis. Surgical correction by means of periacetabular osteotomy offers good long-term results. Cite this article EFORT Open Rev 2020;5630-640. DOI 10.1302/2058-5241.5.190074.The intramedullary headless compression screw (IMCS) technique represents a reliable alternative to percutaneous Kirschner-wire and plate fixation with minimal complications.Transverse fractures of the metacarpal shaft represent a good indication for this technique. Non-comminuted subcapital and short oblique fractures can also be treated with IMCS.This technique should not be used in the presence of an open epiphysis, infection and, most of all, in subchondral fractures, because of the lack of purchase for the head of the screw.A double screw construct is recommended for comminuted subcapital fractures of the metacarpal to avoid metacarpal shortening. IMCS can even be applied for peri-articular fractures of the proximal third of the phalanx and in some multi-fragmentary proximal and middle phalangeal fractures.Usually the intramedullary screws are not removed. The main indications for screw removal are joint protrusion, infection and screw breakage after new fracture. Cite this article EFORT Open Rev 2020;5624-629. DOI 10.1302/2058-5241.5.190068.Glenoid fractures of the shoulder are uncommon.Any scapular fracture involving the glenoid should be scrutinized carefully for a surgical treatment option.Classification is helpful in deciding the surgical tactic. Cite this article EFORT Open Rev 2020;5620-623. DOI 10.1302/2058-5241.5.190057.Fracture-related infection (FRI) is common and often diagnosed late.Accurate diagnosis is the beginning of effective treatment.Diagnosis can be difficult, particularly when there are no outward signs of infection.The new FRI definition, together with clear protocols for nuclear imaging, microbiological culture and histological analysis, should allow much better study design and a clearer understanding of infected fractures.In recent years, there has been a new focus on defining FRI and avoiding non-specific, poorly targeted treatment. Previous studies on FRI have often failed to define infection precisely and so are of limited value. This review highlights the essential principles of making the diagnosis and how clinical signs, serum tests, imaging, microbiology, molecular biology and histology all contribute to the diagnostic pathway. Cite this article EFORT Open Rev 2020;5614-619. DOI 10.1302/2058-5241.5.190072.
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