Pseudoaneurysm as a complication of ankle arthroscopy

We present a case of a pseudoaneurysm of the anterior tibial artery following ankle arthroscopy with synovectomy, an extremely rare complication when standard anteromedial and anterolateral portals are used. The patient was diagnosed and treated with appropriate interventions which led to an uneventful recovery. Nevertheless, the potential sequelae of delayed diagnosis or misdiagnosis of the complication are dangerous; therefore, a high index of suspicion for a pseudoaneurysm must be maintained in the postoperative period

Treatment of postaxial polydactyly with plantar plate and medial collateral ligament reconstruction after supernumerary excision: a case report

Introduction: Polydactyly is the most common congenital foot anomaly and consists of partial or complete duplication of a toe. Traditionally, surgical treatment has been amputation. There is little evidence when surgical treatment requires repairing the stabilizing structures of the metatarsophalangeal joint Objective: Assess the functional and radiologic outcomes of a case of postaxial polydactyly requiring plantar plate plate and medial collateral ligament reconstruction. Methods: A 59-year-old female presented at clinic complaining from bilateral fifth toe polydactyly and metatarsalgia. A rudimentary extra toe with bony structures poorly developed was observed in the left foot. An excision was performed on the left foot. In the right foot, a fully developed extra digit was observed with medial and downwards deviation underneath the fourth metatarsal. Results: Medial fifth-toe excision, plantar plate repair and medial collateral ligament reconstruction were performed due to malformation and widening of the distal surface of the plantar plate. Patient satisfaction and adequate functional status were observed at one-year follow-up. Conclusion: The plantar plate is the principal stabilizer of the MTP joint; therefore its reconstruction is of paramount importance for forefoot biomechanics

Extraskeletal myxoid chondrosarcoma of the knee

Extraskeletal myxoid chondrosarcoma is an uncommon neoplasm, accounting for less than 2% of all soft tissue sarcomas. It affects adult males with a median age in the fifth decade at the time of diagnosis. The tumor usually arises in the deep soft tissues, especially in the lower extremities. Patients present with a gradually enlarging mass that may or may not be associated with pain. This report describes a 25-year-old man who initially presented with a 4- to 5-year history of right knee pain and an enlarging mass in the right knee. Evaluation revealed a cartilaginous neoplasm with no evidence of metastatic disease. The tumor was widely excised and an allograft reconstruction was performed. The patient was closely followed with an eventual above the knee amputation for recurrent myxoid chondrosarcoma. At 34 months, retroperitoneal metastases were noted on abdominal CT. The patient underwent a left radical nephrectomy, renal vein thrombectomy and enucleation of the mass in the right kidney, distal pancreatectomy, and splenectomy. The patient received postoperative chemotherapy. Forty-eight months after initial diagnosis, the patient was found to have recurrent abdominal and retroperitoneal lesions. At 64 months, the patient died from complications of extraskeletal myxoid chondrosarcoma

Reduced Bacterial Growth on Titanium Screws With Nanophase TiO2 Surface Treatment

Category: Other Introduction/Purpose: An important strategy in the reduction of orthopedic infections is to develop implant materials that prevent initial bacteria adhesion and growth onto implant surfaces. Bacterial localization and biofilm formation may lead to acute and chronic infections[1]. Biofilm formation on implant surfaces protects bacteria from the immune system and antibiotic therapy, thus, requiring an aggressive treatment of antibiotics that frequently do not work post biofilm formation[2]. Thus, to prevent implant infections, various strategies have been developed aside from conventional systemic and local antibiotic treatment. Recently, there has been increasing interest for coating implants with other materials to improve osseointegration and prevent infection, chronic inflammation, and unwanted foreign body responses[3]. The current study focuses on modifying the surface of titanium implants by treating them with nanophase titanium dioxide using electrophoretic deposition. Methods: Nanophase titanium dioxide was synthesized using a wet chemical synthesis and was deposited on Ti-6Al-4 V titanium screws using a cathodic arc deposition plasma system. Bacterial assays were conducted using Staphylococcus aureus (ATCC® 29740™), Pseudomonas aeruginosa (ATCC® 39324™) and an ampicillin resistant strain of E. coli (BIO-RAD Strain HB101 K-12 #166-0408 and pGLO Plasmid #166-0405). 0.03% tryptic soy broth (TSB) (Sigma Aldrich, Cat # 22092) and agar (Sigma-Aldrich, Cat # A1296) were used as the media and colony forming assays were performed to determine bacterial adhesion. Results: Nanophase titanium dioxide was successfully synthesized and applied onto the desired surface. A statistically significant decrease in bacterial adhesion was observed across all 3 strains of bacteria; an example of confocal images for S. Aureus is given in figure 1. In addition, decreased macrophage functions and increase osteoblast functions were also observed in the nano TiO2 treated Ti6Al4 V screws. Importantly, this was all achieved without the use of drugs and/or antibiotics decreasing the chance for the spread of antibiotic resistant bacteria and drug side effects. Conclusion: The screws were successfully coated using EPD and reduced bacterial adhesion on the coated surface was observed