Orthopedics

BACKGROUND: We hypothesized that undergoing surgery as soon as possible reduces early mortality in patients with a proximal femoral fracture. Our aim was to evaluate the association between surgical delay and early mortality in these patients. METHODS: We performed a retrospective analysis of prospectively collected data from the Danish Fracture Database and the Civil Registration System on patients who were fifty years of age or older and had undergone surgery for a proximal femoral fracture...

BACKGROUND: All prostheses with metallic components release metal debris that can potentially activate the immune system. However, implant-related metal hyper-reactivity has not been well characterized. In this study, we hypothesized that adaptive immunity reaction(s), particularly T-helper type 1 (Th1) responses, will be dominant in any metal-reactivity responses of patients with total joint replacements (TJAs). We tested this hypothesis by evaluating lymphocyte reactivity to metal "ions" in subjects with and without total hip replacements, using proliferation assays and cytokine analysis...

Ossification of the femoral attachment of the medial collateral ligament (MCL) of the knee with associated pain and restricted movements is rare and is characteristic of the Pellegrini-Stieda (PS) syndrome. Although in mild cases conservative treatment is often successful, patients with more significant bone formation and persistent symptoms require surgical excision. We describe a case of PS syndrome with a description of the surgical technique consisting of excision of the bony lesion and reconstruction of the MCL by using the adductor magnus tendon...

Athletes with persistent anterolateral ankle discomfort may have developed sinus tarsi syndrome (STS). Sinus tarsi syndrome develops from excessive motions of the subtalar joint that results in subtalar joint synovitis and infiltration of fibrotic tissue into the sinus tarsi space. Physical therapists treating athletes with ankle conditions should examine the talocrural and subtalar joints for signs of hypermobility as injuries can affect both of these important articulations of the lower extremity. Localized ankle discomfort to the sinus tarsi space and feelings of instability with pronation and supination movements of the subtalar joint will help identify STS...