Abstract. Introduction. Recent reports show that spinopelvic mobility influences outcome following total hip arthroplasty. This scoping review investigates the relationship between spinopelvic parameters (SPPs) and symptomatic femoroacetabular impingement (FAI). Methods. A systematic search of EMBASE, PubMed and Cochrane for literature related to SPPs and FAI was undertaken as per PRISMA guidelines. Clinical outcome studies and prospective/retrospective studies investigating the role of SPPs in symptomatic FAI were included. Review articles, case reports and book chapters were excluded. Information extracted pertained to symptomatic cam deformities, pelvic tilt, acetabular version, biomechanics of dynamic movements and radiological FAI signs. Results. The search identified 42 papers for final analysis out of 1168 articles investigating the link between SPPs and pathological processes characteristic of FAI. Only one (2.4%) study was of level 1 evidence, five (11.9%) studies) were level 2, 17 (40.5%) were level 3 and 19 (45.2%) were level 4. Three studies associated FAI pathology with a greater pelvic incidence (PI), while four associated it with a smaller PI. Anterior pelvic tilt was associated with radiographic overcoverage parameters of FAI. In dynamic movements, decreased posterior pelvic tilt was a common feature in symptomatic FAI patients at increased hip flexion angles. FAI patients additionally demonstrated reduced sagittal pelvic ROM during dynamic hip flexion. Six studies found kinematic links between sagittal spinopelvic movement and sagittal and transverse plane hip movements. Conclusions. Our study shows that spinopelvic parameters can influence radiological and clinical manifestations of FAI, with pelvic incidence, acetabular version and muscular imbalances being aetiologically implicated. These factors may be amenable to non-surgical therapy. Individual spinopelvic mechanics may predispose to the development of FAI. If FAI pathoanatomy already exists, sagittal pelvic parameters can influence whether FAI symptoms develop and is an area of further research interest

The paramount importance of synovial fluid in lubrication and protection of articular joints has long been recognized. Synovial fluid, a dialysate of plasma, forms an interface with both the synovium and cartilage and plays a crucial role in joint lubrication and bearing functions. In an osteoarthritic joint, damage to the articular cartilage causes modifications in the rheological properties of synovial fluid and, reducing the viscoelasticity and increasing the friction between articular surfaces. Viscosupplementation is a treatment for osteoarthritis that uses hyaluronic acid as a (visco)supplement to the diseased joint. The aim of this treatment is to restore the rheological properties of synovial fluid. Osteoarthritis is the most common disease affecting the joints in human population and among the most important causes of pain, disability and economic loss. Therefore, innovative methods are needed to more effectively treat osteoarthritis, directly addressing the disease process. Among various locomotor mechanisms that could serve to illustrate the integrated nature of functional morphology, perhaps none is more complex than the equine locomotor system. Confronting the need for evaluating the current methods to control joint disease, the horse provides an excellent animal model. As it suffers similar clinical manifestations to those seen in human, it may provide tentative biomedical extrapolations

Background. The different biodegradable local antibiotic delivery systems are widely used in recent years. The aim of this study was to evaluate the bactericidal activity antibiotic loaded PerOssal pellet in vitro and its effectiveness in the treatment of Staphylococcus aureus induced chronic osteomyelitis. Material and methods. MALDI-TOF have been applied to microbiological diagnosis in patient with osteomyelitis. In most cases, Staphylococcus aureus was isolated. In vitro Ceftriaxone-Loaded PerOssal pellet were placed in middle agar plate containing a stock strain of Staphylococcus aureus. Plates were incubated at 37ºC for 24 hours. The zones of bacterial inhibition were recorded after 24, 48 and 72 hours of incubation. In vivo evaluation was performed by prospectively studying of 21 patients with a clinically and bacteriologically diagnosed Staphylococcus aureus induced osteomyelitis. Mean age was 38±4,2(26 to 53)). After radical surgical debridement and ultrasound cavitation, the bone cavity was full filled with Perosal pellets loaded with different antibiotics depending from the antibiotic sensitivity test. Endpoints were the absence of clinical manifestation of infection or disease recurrence, no need for further surgery. Results. In vitro showed after 24 hrs inhibition zone was 4,2 х 4,9 cm, after 72 hrs the inhibition zone was increased till 7,6 х 8,4 cm. During the subsequent time, there were no changes. Results of the clinical study evidenced no signs of infection in 18 patients (86% (CI 69,8;100)) (p<0,05) at the follow up, while 3 (14%(CI 0;30,2)) (p<0,05) subjects showed infection recurrence at 6 months from operation and 2 of them needed further surgical procedures. Conclusion. PerOssal as an antibiotic carrier stabilizes the action of the antibiotic. This antibiotic carrier system allows to choose an antibiotic individually for each patient according to the antibiotic sensitivity test and can be successfully used in clinical cases of osteomyelitis

Late infection is the most frequent complications after hemiarthroplasty. Urinary tract infections are the only distant septic focus considered to be a risk factor in the literature. We retrospectively reviewed 460 patients with hip fracture treated by hemiarthroplasy over a period of one year. Preoperative positive urine dipsticks and urine analysis have been looked at as causes for delay of surgery in absence of clinical manifestations of urinary tract infection. 367 patients were operated within 24 hours. 78 patients were delayed more than 78 hours. Urinary tract infection had the least contribution as a cause of delay. 99 patients had preoperative urinary tract infection and 57 patients had postoperative wound infection. Of these with postoperative surgical site infection, 31 patients did not show any evidence of preoperative urinary tract infection, 23 patients had preoperative urinary tract infection, two had leg ulcer and one had chest infection. 13 patients had chronic urinary tract infection and five patients had the same causative organism in urine & wound. The most common organisms of urinary infection are E. Coli, mixed growth, Enteroccocus Faecalis, Pseudomonas and others. The most causative organism of the postoperative surgical site infection are Staph aureus including MRSA, mixed growth including Staph. Epidermidis, Enteroccocus Faecalis and others There is no direct significant correlation between preoperative urinary tract infection and surgical site infection. We recommend that preoperative urinary tract infection should be treated as a matter of urgency but it should not delay hip fracture surgery unless it is causing symptoms

Objectives

In this study, we compared the pain behaviour and osteoarthritis (OA) progression between anterior cruciate ligament transection (ACLT) and osteochondral injury in surgically-induced OA rat models.