A new bone anchor for re-attachment of soft tissue and management of fractures and dislocations.

The attachment of soft tissue to bone is a problem in orthopedic surgery. Over the last one hundred years several methods have been used. The earliest method involved drilling a hole in the bone, pulling the tendon through the hole and sewing the tendon onto itself. While this worked on tendon transfers, it did not work particularly well around the knee, shoulder and the ankle where there are large areas of cancellous bone and the tissue to be reattached is ligamentous and is less well-defined than a tendon. The second method was to split the periosteum, prepare a trough in the bone, and sew the tendon or the soft tissue directly into the periosteum. This method requires long immobilization of the joint, and while it does work, the immobilization often leads to arthrofibrosis. Staples, nails, tacks, and other devices have been used to attach soft tissue with various degrees of success.

Varicella arthritis.

Varicella arthritis is an acute self-limited arthritis, occurring in close temporal association with clinical varicella, which is usually monarthric, involving the knee of a prepubertal girl. We have reported a case of varicella arthritis and summarized the clinical and laboratory findings of our case and the cases reported in the English literature. It is important to differentiate this condition from septic arthritis.

Simultaneous and staged bilateral total knee arthroplasty.

Bilateral total knee arthroplasties were performed in twenty-six patients with severe rheumatoid arthritis and osteoarthritis. Twelve had simultaneous operations bilaterally and fourteen had separate, staged procedures. The improvement in the two groups of patients was statistically comparable to the relief of pain and the over-all restoration of function. There were no intraoperative complications. The postoperative morbidity was minimum and was not predominant in either group. Costs were greatly increased with the staged procedure.