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Journal: European journal of orthopaedic surgery & traumatology : orthopedie traumatologie


We describe our experience with a new system of patient-specific template called Personal Fit(®), which is unique in shoulder surgery and used in combination with Duocentric(®) prosthesis. The reverse prosthesis’s concept is the invention of Paul Grammont, developed with Grammont’s team of Dijon University as from 1981, which led to the first reversed total shoulder prosthesis called Trumpet in 1985. The Duocentric(®) prosthesis developed in 2001 is the third-generation prosthesis, coming from the Trumpet and the second-generation prosthesis Delta(®) (DePuy). This prosthesis provides a novel solution to the notching problem with an inferior overhang integrated onto the glenoid baseplate. Personal Fit(®) system is based on reconstructing the shoulder joint bones in three dimensions using CT scan data, placing a landmark on the scapula and locating points on the glenoid and humerus. That will be used as a reference for the patient-specific templates. We study the glenoid position planned with Personal Fit(®) software relative to native glenoid position in 30 cases. On average, the difference between the planned retroversion (or anteversion in one case) and native retroversion was 8.6°.

Concepts: Humerus, Joint, Shoulder, Rotator cuff, Deltoid muscle, Scapula, Acromion, Glenoid cavity


PURPOSE: Osteoarthritis (OA) is characterized by chondrocyte apoptosis and necrosis which play a key role during the progression of OA. Intra-articular administration of bupivacaine is a practical and effective way of postoperative pain control following various joint surgeries. 0.25 % bupivacaine showed to be safe in terms of chondrocyte toxicity. Around 200 nM of bupivacaine was shown to be effective for peripheral nerve block. This study aims to observe the possible cytotoxic effects of bupivacaine and its enantiomer levobupivacaine on chondrocyte cell culture at 7.69, 76.9, and 384.5 μM or at 0.0125, 0.0025, and 0.00025 % concentrations, respectively. METHODS: Chondrocytes were isolated from rat articular cartilage after incubating with collagenase in RPMI-1640 medium. Cells were treated with bupivacaine and levobupivacaine at 7.69, 76.9, and 384.5 μM concentrations for 6, 24, and 48 h. Treated chondrocytes were stained with acridine orange and ethidium bromide and examined under a fluorescence microscope at a 490 nm excitation wavelength for apoptotic changes. RESULTS: Study results suggest that both bupivacaine and levobupivacaine have dose-dependent chondrocyte toxicity, and this is significantly lesser at 7.69 μM dose. There was no significant difference in terms of chondrocyte apoptosis, (p > 0.05). CONCLUSIONS: Clinicians should be skeptic for the serious long-term side effects of bupivacaine and its analogs, even at ultra-low doses.

Concepts: Fluorescence, Cell, Apoptosis, Cartilage, Osteoarthritis, Knee, Autologous chondrocyte implantation, Chondrocyte


Scaphocapitate fracture syndrome is rare, complex injury. We report an unusual presentation of scaphocapitate fracture syndrome, involving fracture of the scaphoid and capitate associated with volar dislocation of the lunate and scaphoid and the proximal fragment of the capitate in a 30-year-old male after a motor vehicle accident. Computed tomography was found to be helpful for achieving the correct diagnosis. Open reduction and internal fixation was performed. The scaphoid fracture was fixed using a headless compression screw, and the volar displaced proximal fragment of the capitate was reduced to its original position, but could not be fixed because of severe comminution. This case cautions that the capitate fragment should not be excised even when it cannot be fixed due to comminution.

Concepts: Tram accident, Lunate bone, Scaphoid bone


The present study involved an in vitro examination of spinal cord interstitial pressure (CIP) during distraction before and after durotomy in three spinal cord segments obtained from five pigs.

Concepts: Present



In the nineteenth century, the prevalent understanding of the hallux valgus was that it was purely an enlargement of the soft tissue, first metatarsal head, or both, most commonly caused by ill-fitting footwear. Thus, treatment had varying results, with controversy over whether to remove the overlying bursa alone or in combination with an exostectomy of the medial head. Since 1871, when the surgical technique was first described, many surgical treatments for the correction of hallux valgus have been proposed. A number of these techniques have come into fashion, and others have fallen into oblivion. Progress in biomechanical knowledge, and improvements in materials and supports have allowed new techniques to be developed over the years. We have developed techniques that sacrifice the metatarsophalangeal joint (arthrodesis, arthroplasties), as well as conservative procedures, and one can distinguish those which only involve the soft tissues from those that are linked with a first ray osteotomy.


Femoroacetabular impingement (FAI) is thought to play an important role in the development of hip osteoarthritis. However, there is no consensus about the optimal treatment options, since non-operative therapy such as physiotherapy and surgical treatment such as arthroscopic hip surgery can both improve symptoms. Therefore, the aim of the present meta-analysis was to compare the outcomes between two different treatment regimes; physiotherapy versus arthroscopic treatment for FAI.


Soccer is considered the most popular sport in the world concerning both audience and athlete participation, and the incidence of ACL injury in this sport is high. The understanding of injury situations and mechanisms could be useful as substratum for preventive actions.

Concepts: Knee, Anterior cruciate ligament, Injuries, Ligament, Anterior cruciate ligament injury, Anterior cruciate ligament reconstruction, Cruciate ligament, Ligaments


Emergence of the Covid-19 pandemic resulted in dramatic changes in global healthcare provision. Resources were redirected across all healthcare sectors to support the treatment of viral pneumonia with resultant effects on other essential services. We describe the impact of this on the provision of major trauma care in a major capital city.


Adductor canal block (ACB) is a peripheral nerve blockade technique that provides good pain control in patients undergoing total knee arthroplasty which however does not relieve posterior knee pain. The recent technique of an ultrasound-guided local anesthetic infiltration of the interspace between popliteal artery and the capsule of posterior knee (IPACK) has shown promising results in providing significant posterior knee analgesia without affecting the motor nerves.