Total knee arthroplasty in patients with prior ipsilateral hip arthrodesis.

Only a few articles based on the management of symptomatic knee osteoarthritis in patients with prior ipsilateral hip arthrodesis have been reported, and there are no clear criteria for the best treatment option [to carry out a total knee arthroplasty (TKA)-or to take down the hip fusion and conversion to a total hip arthroplasty-THA, and after that to carry out the TKA]. We report two cases, a 72-year-old male who underwent a left hip arthrodesis at 28 because of a trauma and a 51-year-old woman who underwent a left hip arthrodesis at 9 years because of a congenital dislocation. They presented severe ipsilateral symptomatic knee osteoarthritis. Once the cases were studied and the two therapeutic possibilities were evaluated, we decided to perform TKA. Currently, both patients have no pain, a stable knee with good range of motion and without aseptic loosening radiologic criteria.

Ácidos grasos esenciales de cadena larga en las células de la mucosa bucal de preescolares Venezolanos: Diferencias regionales y por estratos socioeconómicos / Long chain essential fatty acids of oral mucosa cells in pre-school Venezuelan children: Regional and socioeconomic strata differences

Los ácidos grasos poliinsaturados de cadena larga son importantes para el crecimiento y funcionamiento de numerosos órganos y sistemas bioquímicos del niño. Objetivo: Documentar el nivel de ácidos grasos (AG) en niños preescolares de Venezuela para obtener datos sobre su promedio, desviación estándar y su relación con el estrato socioeconómico y ubicación geográfica. Métodos: Estudio descriptivo y transversal que incluyó a 191 niños en edad preescolar de los Estados Miranda, Nueva Esparta, Bolívar y Orinoquia de diversos estratos socioeconómicos según la clasificación de Graffar-Méndez-Castellano. Se analizó el contenido de AG de los glicerofosfolípidos de las células de la mucosa bucal con el método de Klinger y colaboradores modificado. El análisis estadístico se realizó usando el paquete estadístico StatCrunch. Resultados: La distribución de Ácido Docosahexaenoico (DHA) es bimodal, mientras que la del Araquidónico es Gaussiana. El DHA es mayor en los grupos socio-económicos más aventajados (Estratos sociales I-III) que en los con menores ingresos (Estratos sociales IV-V) en Caracas, donde estos últimos llegan a tener valores inferiores al 0,2%. Esa situación se revierte (Estratos sociales IV-V) > Estratos sociales I-III) en Margarita. La población indígena de Orinoquia tiene valores de DHA comparables a valores reportados en países ricos. Los valores de AG trans isómeros son bajos (<0,5%). Conclusiones: Hay diferencias en los niveles de AG en niños preescolares venezolanos según las regiones geográficas y el estrato socioeconómico. Los valores bajos de DHA encontrados en algunos grupos urbanos de preescolares ameritarían futuros estudios de intervención con alimentos fortificados con este AG.

Long-chain polyunsaturated fatty acids are important for growth and function of several organs and biochemical systems in the child. Objective: Document the level of fatty acids (FA) in Venezuela preschool children to obtain data on their average, standard deviation and its relationship with socioeconomic status and geographic location. Methodology: A cross-sectional study included 191 preschool children from Miranda, Nueva Esparta, Bolívar States and Orinoquia coming from different socioeconomic strata according to the Graffar-Méndez-Castellano classification system. The FA content of glycerophospholipids fraction in oral mucosal cells was analyzed by the method of Klinger and colleagues with minor modification. Data analysis was performed using the statistical package StatCrunch. Results: The Docosahexaenoic acid (DHA) has a bimodal distribution pattern whilst the Arachidonic acid is Gaussian. DHA is higher in the better-off socioeconomic groups (Strata I-III) than in the worst-off groups (Strata V-V) in Caracas, whose values are lower than 0.2%. This situation is reversed (Strata V-V) > Strata (I-III)) in Margarita. The indigenous population from Orinoquia has high levels of DHA, similar to those reported in affluent countries. The Trans fatty acid isomer content of the majority of children was low (<0.5%). Conclusions: There are differences in the FA content of Venezuelan pre-school children with respect to their socioeconomic and geographical regions. Low levels of DHA found in some urban groups of pre-school children require future intervention studies with FA fortified food.

Achilles tendon recurrent rupture following surgical repair: report on two cases.

BACKGROUND: Rerupture is a main complication in Achilles tendon rupture surgery, with an incidence of 2-8%. Although wound break-down and rerupture are well known complications, spontaneous open rerupture has not been previously reported to the authors' knowledge. METHODS: We report on two cases of open rerupture of Achilles tendon following augmented repair, through a transverse wound perpendicular to the primary incision line. Reruptures occurred 80 and 54 days after primary repair. RESULTS AND CONCLUSIONS: After surgical repair long term follow-up results are good in both cases. This complication could be related to subtotal closure of the paratenon due to the bulk of the augmented repair and to an inadequate and a too extended period of postoperative ankle immobilization.