Foreign body reaction associated with polyethylene mesh interposition used for treatment of trapeziometacarpal osteoarthritis: Report of 8 cases

Purpose To report the incidence of foreign body reactions associated with placement of a polyethylenemesh implant in patients treated with trapiezectomy for trapeziometacarpal osteoarthritis. Methods Between November 2008 and September 2012, 70 hands in 66 adults with stage IV trapeziometacarpal osteoarthritis had a trapiezectomy with interposition of a spacer made of polyethylene terephthalate mesh (Anchois Ligastic, Orthomed SA, St Jeannet, France). Out of these 70 implants, 8 implants (11%) in 8 patients (mean age, 60 y; range, 49e75 y) were removed because of persistent swelling, synovitis, and pain. Results The mean interval between primary and revision surgery was 14 (range, 5e27) months. Histological analysis in all cases showed a foreign body giant cell reaction. Two hands showed bone resorption or carpal bone cysts similar to silicone particle synovitis. The cysts resolved after implant removal and bone grafting. Conclusions In the light of these results and the available literature, we recommend not using this material for interposition in the treatment of osteoarthritis of the trapeziometacarpal joint

Length of stopover, fuel storage and a sex-bias in the occurrence of red knots Calidris c. canutus and C. c. islandica in the Wadden Sea during southward migration

During southward migration the Wadden Sea is the meeting place of Red Knots Calidris canutus of two subspecies that breed in either western Siberia (C. c. canutus) or north Greenland and north-east Canada (C. c. islandica), but the details of their co-occurrence have not been described. In 1995-98 numbers of Red Knots in our study area in the western Dutch Wadden Sea usually built up in late July towards maxima of 10 000-20 000 individuals in August and early September. In each of these four years we attached tiny (1.3-1.8 g) radiotransmitters to a total of 95 molecularly sexed adults to determine the length of stay of different categories of birds. The 65 females (68%) predominated the samples, and among the females the majority (48 birds) was captured without traces of wing moult. In females, but not in males, birds caught in wing moult stayed significantly longer than non-moulting birds. Non-moulting females weighed up to 200 g and disappeared within three weeks after being marked. The timing of their disappearance corresponded with observed departures of flocks towards the southwest, and published departure times of canutus. The relationship between length of stay and mass at capture of these early departing non-moulting females suggests a daily mass gain of about 2.84 g d(-1). These birds had a mean bill length that was 1 mm (yet significantly) longer than those of the other female categories; a relatively long bill is a well known attribute of canutus. The much smaller sample of males with similar mass, moult and staging time characteristics did not show longer bill lengths and we are thus unable to unambiguously confirm the presence of canutus males in late July and early August; this bias remains to be functionally explained. Sex ratios were even in birds assignable to islandica

A systematic review of the optimal drainage technique for septic hip arthritis in children

Introduction: The hip is one of the most commonly affected joints in paediatric septic arthritis. Drainage can be performed using arthrocentesis (articular needle aspiration), arthroscopy or arthrotomy. The objective of this systematic review was to identify the most effective drainage technique for septic hip arthritis in the paediatric population. Materials and methods: The electronic MEDLINE, EMBASE and Cochrane databases were systematically searched for original articles that reported outcomes of arthrocentesis, arthroscopy or arthrotomy for septic arthritis of the paediatric hip. Outcome parameters were additional drainage procedures, clinical outcomes and radiological sequelae. The quality of each of the included studies was assessed with the Methodological Index for Non-randomized Studies (MINORS) score. Results: Out of 2428 articles, 19 studies with a total of 406 hip joints were included in the systematic review. Additional arthroscopy or arthrotomy was performed in 15% of the hips treated with arthrocentesis, in 14% after arthroscopy and in 3% after arthrotomy. Inferior clinical outcomes and more radiological sequelae were seen in patients treated with an arthrotomy. A meta-analysis could not be performed due to the diversity and low quality of the studies (MINORS median 4 [range 2–15]). Conclusions: This systematic review gives a comprehensive overview of the available literature on treatment for septic hip arthritis in children. Arthrocentesis and arthroscopic procedures may have a higher risk of additional drainage procedures in comparison with arthrotomy. However, arthrotomy might be associated with inferior outcomes in the longer term. The included studies are diverse and the scientific quality is generally low

Partial trapeziectomy and interposition of fascia lata allograft in the operative treatment of thumb base osteoarthritis

Aim: The purpose of this retrospective cohort study was to evaluate the results of fascia lata allograft interposition after partial trapeziectomy in patients with symptomatic first carpometacarpal joint osteoarthritis. Methods and results: Twenty-one patients (22 thumbs) with Eaton-Glickel stage II or III first carpometacarpal joint osteoarthritis were included. After a mean follow-up duration of 70.2 months, most patients experienced minimal pain. The operation was graded excellent or good by 15 patients (15 hands). Active range of motion and strength measurements were comparable to the contralateral hand, except for extension, which was slightly better in the contralateral hand. The mean radiologically measured difference pre- and postoperatively in distance between distal part of the trapezium and base of the metacarpal was 2.7 mm. Two patients had reoperations in the first year after the initial operation because of ongoing pain. Conclusion: Partial trapeziectomy with interposition of fascia lata allograft in patients with symptomatic first carpometacarpal joint osteoarthritis can achieve reasonable results. It may be considered a reliable operative treatment option in patients with first carpometacarpal joint osteoarthritis

In reply : Letter Regarding “Conservative Treatment of Thumb Base Osteoarthritis: A Systematic Review”.

Refers To: Jorge Hugo Villafañe, Kristin Valdes. Letter Regarding “Conservative Treatment of Thumb Base Osteoarthritis: A Systematic Review”. The Journal of Hand Surgery, Volume 40, Issue 5, May 2015, Pages 1058-105

Partial trapeziectomy and interposition of fascia lata allograft in the operative treatment of thumb base osteoarthritis

Aim: The purpose of this retrospective cohort study was to evaluate the results of fascia lata allograft interposition after partial trapeziectomy in patients with symptomatic first carpometacarpal joint osteoarthritis. Methods and results: Twenty-one patients (22 thumbs) with Eaton-Glickel stage II or III first carpometacarpal joint osteoarthritis were included. After a mean follow-up duration of 70.2 months, most patients experienced minimal pain. The operation was graded excellent or good by 15 patients (15 hands). Active range of motion and strength measurements were comparable to the contralateral hand, except for extension, which was slightly better in the contralateral hand. The mean radiologically measured difference pre- and postoperatively in distance between distal part of the trapezium and base of the metacarpal was 2.7 mm. Two patients had reoperations in the first year after the initial operation because of ongoing pain. Conclusion: Partial trapeziectomy with interposition of fascia lata allograft in patients with symptomatic first carpometacarpal joint osteoarthritis can achieve reasonable results. It may be considered a reliable operative treatment option in patients with first carpometacarpal joint osteoarthritis