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The consequences associated with state-level costs with regard to home- as well as community-based services around the chance of transforming into a long-stay elderly care homeowner after cool fracture.
Nowadays combined high tibial osteotomy and ACL reconstruction is accepted as a safe and effective surgery for patients with symptomatic varus osteoarthritis and anterior knee instability; however, the source of varus deformity is sometimes the femoral bone. No studies have reported concomitant ACL reconstruction and distal femoral osteotomy in ACL-deficient knees with femoral varus deformity and medial osteoarthritis till now. This prospective study presents the technique and clinical outcome of a consecutive series of simultaneous lateral closed-wedge distal femoral osteotomy and ACL reconstruction.

Nineteen patients with confirmed ACL rupture and femoral varus deformity (mechanical lateral distal femoral angle ≥ 93°) associated with medial osteoarthritis (± lateral thrust) were included the study. The patients underwent simultaneous lateral closed-wedge distal femoral osteotomy and ACL reconstruction. At the end of one year follow up, the final range of motion and stability of the knees and the last alreconstruction is a valuable procedure in femoral varus knees with medial osteoarthritis and anterior knee instability. After one year follow up all aspects of knee function were improved without serious complications.
Trunk muscles play an important role in providing both mobility and stability during dynamic tasks in athletes. Enzastaurin The purpose of this study was to evaluate the within-day and between-day reliability of ultrasound (US) in measuring abdominal and lumbar multifidus muscle (MF) thickness in athletes with and without hamstring strain injury (HSI).

Fifteen male soccer players (18-30 years old) with and without HSI were evaluated using two US probes (50 mm linear 7.5 MHZ and 70 mm curvilinear 5 MHz). The abdominal muscle thickness as well as the cross sectional area (CSA) of the MF was measured. To determine within and between days reliabilities, the second and third measurements were repeated with two hours and one week intervals, respectively.

Intraclass correlation coefficients for athletes with and without HSI demonstrated good to high reliability for the abdominal muscle thickness (0.82 and 0.93) and CSA of the MF muscle (0.84 and 0.89, respectively).

Our results indicated that US seemed to be a reliable instrument to measure abdominal and lumbar multifidus muscle thickness in soccer players with and without HSI. However, further studies are recommended to support the present study findings in other athletes.
Our results indicated that US seemed to be a reliable instrument to measure abdominal and lumbar multifidus muscle thickness in soccer players with and without HSI. However, further studies are recommended to support the present study findings in other athletes.
The ultimate goal of the treatment of infectious knee arthritis is to protect the articular cartilage from adverse effects of infection. Treatment, however, is not always hundred percent successful and has a 12% failure rate. Persistent infection is more likely to happen in elderly patients and those with underlying joint diseases, particularly osteoarthritis. Eradication of infection and restoration of function in the involved joint usually are not possible by conventional treatment strategies. There are few case series reporting two-stage primary knee arthroplasty as the salvage treatment of the septic degenerative knee joint; however, the treatment protocol remains to be elucidated.

Based on a proposed approach, patients with failure of common interventions for treatment of septic knee arthritis and underlying joint degeneration were treated by two-stage TKA and intervening antibiotic loaded static cement spacer. Suppressive antibiotic therapy was not prescribed after the second stage.

Complete infection eradication was achieved with mean follow up of 26 months. All cases were balanced with primary total knee prosthesis. The knee scores and final range of motions were comparable to other studies.

The two-stage total knee replacement technique is a good option for management of failure of previous surgical treatment in patients with septic arthritis and concomitant joint degeneration. Our proposed approach enabled us to use primary prosthesis in all of our patients with no need for suppressive antibiotic therapy.
The two-stage total knee replacement technique is a good option for management of failure of previous surgical treatment in patients with septic arthritis and concomitant joint degeneration. Our proposed approach enabled us to use primary prosthesis in all of our patients with no need for suppressive antibiotic therapy.
The purpose of this prospective study was to determine the accuracy of pedicular screw insertion without the use of fluoroscopy.

This study was conducted on patients with spinal diseases in need of pedicular screw fixation and fusion. The included patients suffered from such conditions as vertebral fracture, spinal stenosis, kyphosis, tumor, and pelvic fractures and were managed with triangular osteosynthesis fixation. However, those with scoliosis deformity were excluded from the study. A total of 760 pedicular screws were inserted in C7 to S1 vertebrae without using fluoroscopy. The locations of the screws were assessed by means of computed tomography scan after the surgery. The data were analyzed in SPSS software (version 22) using the Chi-square test.

Out of 387 thoracic screws and 373 lumbar screws, 65 (16.8%) and 34 (9.1%) screws perforated the pedicle wall or vertebral body, respectively. The most frequent locations of perforation in the thoracic and lumbar spine were the anterior cortex of the vertebral body and medial wall of the pedicle, respectively. Except for the perforation of the anterior vertebral body (
), there was no difference between the left and right sides or between thoracic and lumbar sites in terms of the preformation of the screw. No complication was observed due to screw perforation.

Our findings revealed the unnecessity of using fluoroscopy in spine surgeries for the insertion of pediculate screws. In this regard, the use of fluoroscopy for the placement of pedicular screw resulted in similar accuracy and complications, as compared to the free hand procedure.
Our findings revealed the unnecessity of using fluoroscopy in spine surgeries for the insertion of pediculate screws. In this regard, the use of fluoroscopy for the placement of pedicular screw resulted in similar accuracy and complications, as compared to the free hand procedure.
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