Arthroscopic Removal of a Displaced Cannulated Screw after Glenoid Rim Fracture - A Case Report.

INTRODUCTION: Internal fixation has been shown to successfully prevent recurrent dislocations after fractures of the glenoid rim. With regards to fixation either suture anchors or screws can be used, depending on the fragment size. Complications regarding suture anchors and their management have been described previously but not the arthroscopic management of screw impingement. CASE REPORT: We present a case of a 70 year old women who suffered from limited range of motion after fixation of a Ideberg III fracture using cannulated screws. X-rays showed one of the screws to be proud. The proud screw could be successfully removed arthroscopically resulting in an improved range of motion, function and decreased pain. CONCLUSION: Our report describes a possible technique for performing a procedure arthroscopically that used to be done as an open procedure before and highlights it's limitations.

Thermal damage and tracker-pin track infection in computer-navigated total knee arthroplasty.

Choice of pins, drills, and drilling technique can result in heat generation leading to thermal necrosis of bone. This has been reported frequently in internal as well as in external fixation. This publication is the first report of a patient having osteomyelitis of the proximal tibia due to thermal necrosis following tracker pin placement in computer-navigated total knee arthroplasty.

CCR1 blockade reduces interstitial inflammation and fibrosis in mice with glomerulosclerosis and nephrotic syndrome.

BACKGROUND: CC chemokines mediate leukocyte infiltration into inflamed tissue. We have recently shown that blockade of the CC chemokine receptor CCR1 reduces interstitial inflammation and fibrosis in murine obstructive nephropathy. However, it is not known whether CCR 1 blockade is protective in progressive renal injury associated with severe proteinuria. We therefore studied the effect of the small-molecule CCR1 antagonist BX471 in a murine model of adriamycin-induced focal segmental glomerulosclerosis (FSGS) with nephrotic syndrome and progressive interstitial inflammation and fibrosis. METHODS: Adriamycin nephropathy with persistent proteinuria was induced in male BALB/c mice by two intravenous injections of adriamycin (13 mg/kg) at day 0 and 14. BX471 treatment was started at day 14 when proteinuria and interstitial inflammation had developed. At 6 weeks, renal histology was studied by morphometry and immunohistochemistry. RESULTS: At week 6, adriamycin-treated mice showed FSGS, associated with tubulointerstitial injury consisting of tubular dilation and atrophy, interstitial leukocyte infiltration, and fibrosis. The mRNA expression of CCR1 and CC chemokines, including the CCR1 ligands CCL3 (MIP-1alpha) and CCL5 (RANTES), was up-regulated in diseased kidneys, with a prominent interstitial expression of CCL5. Compared to vehicle-treated controls BX471 significantly reduced the amount of macrophages and T lymphocytes in interstitial lesions by 51% and 22%, respectively. Markers of renal fibrosis such as interstitial fibroblasts (48%) and interstitial volume (23%) were significantly reduced by BX471 treatment. In contrast, the extent of proteinuria and glomerular sclerosis was not affected by BX471 treatment. CONCLUSION: Blockade of CCR1 substantially reduced interstitial leukocyte accumulation and the subsequent renal fibrosis in a murine model of nephrotic syndrome and FSGS. These findings support a role for CCR1 in interstitial leukocyte recruitment and suggest that CCR1 blockade might be a new therapeutic strategy in progressive nephropathies such as FSGS.