Unusual presentation of synovial sarcoma as meniscal cyst: A Case Report

Periarticular cyst and cystic soft tissue lesion around the knee are common. Synovial sarcoma is a rare and malignant soft tissue tumor accounting for approximately 5 of soft tissue sarcoma. A case is presented where a lesion adjacent to the joint line of the knee was diagnosed clinically and on imaging as a meniscal cyst. MRI signal was homogenous and no concomitant meniscal tears were seen. The tissue diagnosis was monophasic synovial sarcoma. © 2015 BY THE ARCHIVES OF BONE AND JOINT SURGERY

A numerical study on the cold sprayability of carbon fibre reinforced composites

One of the open questions in cold spraying on fibre reinforced composites is the optimal thickness of the top layer to provide a suitable base for successful deposition of the metallic particles and at the same time to hinder the probable damage of the fibres. In this study, a detailed finite element model is developed to study the deformation of a single Cu particle deposition on to polyether ether ketone (PEEK) substrate reinforced with carbon fibres. A PEEK layer with 30, 40 or 60 μm thickness was considered on the top surface of the composite. The particle impact velocity was varied in the range of 300-600 m/s to analyse its effects on the induced deformations as well as the structural integrity of the critical carbon fibres. It is believed that the proposed model can provide a helpful tool for predicting the optimal conditions in the metallization of polymers using the cold spray technique

Stage IE primary bone lymphoma: Limb salvage for local recurrence

Background: Primary bone lymphoma or non-Hodgkin lymphoma of bone is a rare disease. There are only a few case series of stage IE of this condition in medical literature. The aim of this study is to determine the rate of survival for stage IE after combined modality treatment, the rate of local recurrence, and the results of limb salvage in cases of local recurrence. Methods: We collected data from 61 patients with histologically confirmed PBL treated at the Musculoskeletal Oncology Department of our hospital from 2000 to 2010. Retrospective evaluation included demographics, symptoms, tumor locations, outcomes of surgical treatment for local recurrence and survival rates. Results: All patients received Combined Modality Therapy. Overall, five year survival was 89 and five year disease free survival rate was 78. Local recurrence occurred in 6 patients during follow up period, which was treated surgically by wide excision and reconstruction. The mean follow-up for the local recurrence group was 36(24-54) months and mortality rate in this group was 17. Conclusions: Combined Modality Therapy for stage IE primary bone lymphomaresults in good survival rate. In case of local recurrence, wide excision and reconstruction improves the outcomes. © 2015 BY THE ARCHIVES OF BONE AND JOINT SURGERY

Adapting Shot Peening for Surface Texturing Using Customized Additive Manufactured Shots

Surface textures in engineering materials not only affect the reflective properties and aesthetics but if properly designed can modulate surface-related properties such as wettability, fatigue, wear, corrosion, and scratch resistance. Herein, a new surface texturing method is introduced based on the conventional shot peening process. Custom shots are designed, and their surface texturing capability is investigated on acrylonitrile butadiene styrene (ABS) polymer substrates. A finite-element model is developed to bombard the substrate using AISI 316 stainless steel customized shots. The generated unique textures are compared qualitatively by visual examination and quantitatively using the standard surface roughness parameters. As a proof of concept, preliminary experiments are performed using a candidate custom shot and a spherical shot to treat the ABS sheets. The results highlight the high potential of the shot peening technique paired with additive manufacturing for customizing the peening media to be used for surface texturing polymeric materials

fracture and microstructural study of bovine bone under mixed mode i ii loading

Abstract Understanding the fracture behavior and associated crack growth mechanism in bone material is an important issue for biomechanics and biomaterial researches. Fracture of bone often takes place due to complex loading conditions which result in combined tensile-shear (i.e. mixed mode) fracture mechanism. Several parameters such as loading type, applied loading direction relative to the bone axis, loading rate, age and etc., may affect the mixed mode fracture resistance and damage mechanism in such materials. In this research, a number of mixed mode I/II fracture experiments are conducted on bovine femur bone using a sub-sized test configuration called "compact beam bend (CBB)" specimen to investigate the fracture toughness of bone under different mode mixities. The specimen is rectangular beam containing a mid-edge crack that is loaded by a conventional three-point bend fixture. The results showed the dependency of bone fracture toughness on the state of mode mixity. The fracture surfaces of broken CBB specimens under different loading conditions were studied via scanning electron microscopy (SEM) observations. Fracture surface of all investigated cases (i.e. pure mode I, pure mode II and mixed mode I/II) exhibited smooth patterns demonstrating brittle fracture of bovine femur. The higher density of vascular channels and micro-cracks initiated in the weakened area surrounded by secondary osteons were found to be the main cause of the decreased bone resistance against crack growth and brittle fracture

The results of biplanar distal femoral osteotomy; a case series study

Background: Distal femur wedge osteotomies for varus or valgus alignment of the lower extremity could be done in either uniplanar or biplanar fashion. Union time and stability of the osteotomy site has been considered important in this anatomic region. In this study, clinical and radiographic findings of biplane distal femur osteotomy were reported. Methods: Clinical, functional, and radiological findings of eight patients (10 knees) underwent biplane distal femur osteotomy were evaluated. Visual analogue score (VAS) and Lysholm-Tegner knee score were used for the assessment of pain and function before and three months after surgery. Results: In this study, eight patients were included. All patients were female. The mean age was 28±6.3. The mean pre-operative mechanical angle was 8.7±2.2° and the post-operative angle was 1.4±0.53° in patients with valgus alignment whileit was 7.0±1.0°preoperatively and 0.66±1.2° postoperatively in patients with varus alignment. The mean lateral distal femoral angle (LDFA) was 85±8.0° before surgery and was 88±1.3° after surgery. According to Lysholm-Tegner knee score, in the post-operative visit, six knees were good and four were excellent. The mean union time was 9.2±2.3 weeks. Conclusions: Biplane distal femur osteotomy is a reliable technique that creates larger surfaces and more stability at the osteotomy site with further rapid union. © 2015 BY THE ARCHIVES OF BONE AND JOINT SURGERY

National Joint Registry of Iran

Joint replacement is currently on the rise with a high community burden. A registry was designed to evaluate the costs, possible complications, and rate of revisions as well as finding the most effective techniques, risk factors associated with poor results, indications for revision surgeries, and also demographic evaluation of patients undergoing joint replacement surgery in Iran. © 2019 BY THE ARCHIVES OF BONE AND JOINT SURGERY

Distal radius radiographic indices and perilunate fracture dislocation

Background: Distal radius radiographic indices may play a role as risk factors in pathogenesis of Kienbock's disease, scaphoid fracture and nonunion. Perilunate fracture dislocations are devastating wrist injuries, and their relationship and distal radius indices have not been addressed in the literature. Objectives: The aim of this study was to evaluate the possible role of distal radius radiographic indices including radial height, radial inclination, ulnar variance and volar tilt as risk factors in the perilunate fracture dislocation injury of the wrist. Patients and Methods: We studied distal radius radiographic indices including radial height, radial inclination, ulnar variance and volar tilt in 43 patients with perilunate fracture dislocations and compared them with 44 wrists in the control group. Results: The mean values of the radial height, radial inclination, ulnar variance and volar tilt were 12.74 (5-18), 24.20 (7-35),-0.73 (-5-4) and 12.28 (2-20) in the patient group. These values were 12.68 (9-22), 23.22 (17-30),-0.11 (-4-3) and 11.05 (-3-20), respectively in the control group. There was no statistically significant difference between the two groups. Conclusions: This study did not show that distal radius anatomical indices including the radial height, radial inclination, ulnar variance and volar tilt influence perilunate fracture dislocation as risk factors. Copyright © 2016, Trauma Monthly

Surgical treatment of chronic patellar tendon rupture: A case series study

Background: Early detection and treatment of extensor mechanism rupture are essential for a long-term functional knee joint. In chronic cases, quadriceps muscle retraction and contracture make surgery di cult and results are less predictable. Objectives: The purpose of this study was to evaluate outcomes in the cases of late repaired patellar tendon rupture. Methods: This study included patients with chronic patellar tendon rupture who were operated at Shafa orthopedic hospital from 2006 to 2013. Results: A total of ten patients were evaluated, wirh 12 cases of chronic patellar tendon rupture. Patients had a mean age of 34.4 years (range 18 - 58). Seven cases were caused by a traffic accident and three by a fall. The mean length of time from injury to surgery was 23 months (range 3 - 132). The mean time of follow-up was 6.2 years (range 3 - 9). Cerclage wire reinforcements were applied in nine of the knees and three knees had fiber wire reinforcement. Tendon graft augmentation was applied in ten of the knees; six with semitendinosus and gracilis autograft, two with semitendinosus autograft, one with an Achilles tendon allograft, and one with a tibialis anterior allograft. Means for preoperative/postoperative active knee range of motion, extension lag, subjective international knee documentation committee score, and modified Cincinnati scores were 81/117, 32/2, 22.7/84.5 and 24/87, respectively. Wire breakage was seen on all nine knees but wires were removed in only two symptomatic cases. Conclusions: Good to excellent results were obtained in terms of functioning with operative treatment of chronic patellar tendon rupture. Direct repair with autogenous or allogenic graft augmentation and cerclage wire reinforcement and postoperative cast immobilization are recommended. Copyright © 2018, Trauma Monthly