Imaging Modalities in the Preoperative Assessment of Femoroacetabular Impingement and Hip Dysplasia: Determining Best Practices.

¼ In the last decade, significant progress has been made in understanding hip pain, especially related to femoroacetabular impingement (FAI) and hip dysplasia (HD), which collectively affect over 20% of the population.¼ Preoperative imaging, including plain radiographs, computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound (US), plays a pivotal role in diagnosing FAI and HD. Imaging precision, standardized techniques, and accurate interpretation are crucial for effective treatment planning.¼ The continual advancements in imaging techniques, especially seen in MRI (arthrograms, application of leg traction, and delayed gadolinium-enhanced MRI of cartilage), represent important strides in the precise assessment of pathology associated with FAI and HD.¼ By incorporating these advancements into routine imaging protocols, healthcare providers can ensure a comprehensive understanding of hip joint dynamics, enabling more accurate diagnosis and effective management strategies for patients with FAI and HD, ultimately leading to improved clinical outcomes.

All-Soft-Tissue Meniscus Allograft Transplantation With Circumferential Suture Tape Augmentation to Mitigate Hoop Stress and Promote Centralization.

Meniscus allograft transplantation (MAT) is a technically challenging procedure. Bone plugs, slot techniques, and all-soft-tissue fixation techniques have been described in the past. Each technique comes with advantages and disadvantages. Native menisci have circumferential collagen fibers to help resist hoop stress during loading cycles. Although hoop stress resistance is a known function of the menisci, its recreation in MAT has only been targeted indirectly through anatomic root placement. The authors describe the use of a high-tensile suture tape (i.e. InternalBrace) to promote centralization by directly mitigating hoop stresses through recreation of peripheral meniscus tensioning in MAT.

Using Spinal Anesthesia and a Fracture Table for Closed Reduction of an Obturator Foramen Hip Dislocation: A Case Report.

CASE: A 37-year-old man with a right obturator foramen hip dislocation underwent closed reduction under spinal anesthesia with the use of a fracture traction table. CONCLUSION: This novel technique provides surgeons and anesthesiologists an alternative method of treating obturator foramen hip dislocations that provides a more controlled reduction and less need for assistants.

Well-Leg Compartment Syndrome Due to Hemilithotomy Positioning after Arthroscopic Reconstruction of the PCL.

Introduction: Acute compartment syndrome (ACS) occurs due to decreased perfusion of an osseofascial space due to increased compartmental pressure. Due to its potentially devastating sequelae, emphasis is placed on its prompt diagnosis. While fractures continue to be the most common cause of ACS, mechanisms such as crush injuries and even surgical positioning are described etiologies of compartment syndrome. ACS of the well-leg from hemilithotomy positioning has been previously depicted in medical literature; however, there have been no illustrations of this complication after elective arthroscopic-assisted posterior cruciate ligament (PCL) reconstruction. Case Report: This report discusses a patient undergoing PCL reconstruction who developed an ACS in the non-operative extremity that was positioned in hemilithotomy in a leg positioner. Conclusion: ACS is an uncommon but serious complication that can occur from hemilithotomy positioning. Surgeons should be mindful of risk factors that can place a patient at higher risk, including length of the case, body habitus, height of elevation of the leg, and method of leg support. The prompt recognition and surgical management of ACS can prevent the devastating long-term complications.

Comparison of Clinical & Laboratory Standards Institute standards in antimicrobial susceptibility among the carbapenemase producing Enterobacteriaceae.

AIM: Carbapenems are antibiotics reserved for treatment of severe infections. Carbapenem antimicrobial susceptibility testing profiles were determined in a population of Klebsiella pneumoniae, and their resistance assessed based on previous and current Clinical and Laboratory Standards Institute criteria. MATERIALS & METHODS: Isolates were examined using an automated antimicrobial susceptibility testing method, and real time polymerase chain reaction to detect the resistance (blaKPC) gene. RESULTS: The prevalence of blaKPC gene was 45/54 (83.3%). Five isolates that were susceptible under the previous criteria changed to nonsusceptible with the current standards. The overall difference in susceptibility between the standards was 8%. CONCLUSION: This study shows that the current Clinical and Laboratory Standards Institute criteria may not offer additional benefits in the fight against carbapenem-resistant Enterobacteriaceae.

Terapia de infecçöes bacilares Gram-negativas graves com aztreonam / Aztreonam therapy for serious Gram-negative bacillary infections

Cinquenta episódios de infecçäo bacilar Gram-negativa inclusive episódios de bacteremia, pneumonia, infecçöes da pele e do tecido conjuntivo, infecçöes do trato urinário e infecçöes abdominais - foram tratados com aztreonam. As infecçöes foram curadas em 88 por cento dos pacientes, inclusive todos os nove pacientes com bacteremia e 15 dos 17 pacientes com pneumonia. Trinta por cento das infecçöes foram causadas por Pseudomonas e todas responderam ao tratamento com aztreonam. A baixa incidência de toxicidade e o alto nível de eficácia tornam viável a adoçäo do aztreonam como agente terapêutico único. Quando foram encontrados organismos Gram-positivos ou anaeróbios ou havia suspeitas de sua presença nas infecçöes, a administraçäo adicional de agentes eficazes contra esses organismos foi necessária para a cura