Minor change in the sulcus angle during the first six years of life: a prospective study of the femoral trochlea development in dysplastic and normal knees.

PURPOSE: The aetiology of femoral trochlear dysplasia is unknown. The aim of this prospective cohort study was to describe trochlear development in a newborn population during the first six years of life. METHODS: In an earlier study, the femoral trochlea was examined by ultrasound in 174 newborns. A dysplastic trochlea was defined with a sulcus angle (SA) above 159°. Two groups were defined, one group of 15 knees with SA > 159° (dysplastic group), and one group of 101 knees with SA < 159° (non-dysplastic group). In the present follow-up study, the children were further examined at six, 18 and 72 months. RESULTS: There was a statistically significant difference in the SA between the dysplastic and the non-dysplastic group at all follow-ups (p < 0.001). A small but statistically significant change in the SA between 0 to 72 months was detected for the dysplastic knees (p = 0.032) and for the controls (p < 0.001). CONCLUSION: Only minor changes in the anatomy of the femoral trochlea from newborn to age six years were found. A dysplastic trochlea at birth remains shallow and the anatomy does not change from normal to dysplastic during the same time span. LEVEL OF EVIDENCE: II.

Characterization of the virulence potential of Staphylococcus condimenti isolated from a patient with severe soft tissue infection.

The coagulase-negative bacterium Staphylococcus condimenti and closely related species are commonly isolated from or found in starter cultures of fermented sausage as well as fish and soy sauces, and have traditionally been considered nonpathogenic. Recently, however, a case of catheter-related bacteraemia caused by S. condimenti was reported. In the present study we identified and characterized a strain of S. condimenti isolated from a patient with a severe soft tissue infection, comparing it to S. condimenti and S. carnosus type strains in order to elucidate the virulence potential of the clinical strain. Genome comparison showed high degree of conservation between the clinical strain and the type strain used in food industry, as well as with S. carnosus. The genome of the clinical S. condimenti strain contains few horizontally transferred regions and 37 putative virulence genes, including genes with similarity to leucocidin and genes involved in immune evasion, proinflammatory and cytolytic activity. However, it remains to be tested whether these putative virulence genes are expressed and functional. Although uncommon, S. condimenti may cause severe infection in previously healthy persons.

[Mitchell's osteotomy of hallux valgus]. / Mitchells osteotomi for hallux valgus.

45 patients were included in a prospective study to evaluate the results of Mitchell's osteotomy of hallux valgus. 43 patients complained of pain preoperatively. 44 patients were reviewed after one year, and excellent results were achieved in alleviating pain for 35 of these patients. Four patients developed metatarsalgia after surgery. There was a mean improvement in the hallux valgus angle of eight degrees. The mean shortening of the first metatarsal was 6 mm (1-12 mm). This shortening showed no correlation with postoperative pain. Signs of osteoarthrotic changes in the metatarsophalangeal joint were found in one patient and early signs of osteonecrosis of the first metatarsal head in two. We conclude that in spite of some serious complications this method produces satisfactory results and can be recommended when pain over the medial prominence is the main indication.