Objective To evaluate the position of the acromioclavicular joint (ACJ) and relation to the critical shoulder angle (CSA) in shoulders with rotator cuff tears (RCT). Methods In a matched pair study including 75 shoulders with arthroscopically validated RCT and 75 controls (mean age 59.4 ± 7.9 years) the position of the ACJ in relation to the glenoid and the CSA were measured on true ap radiographs. Results The CSA is larger (p = 0.0018) and the position of the ACJ is more lateral (p = 0.0016) in shoulders with RCT in comparison to matched controls. Conclusion The more lateral position of the ACJ in shoulders with a large CSA might be an additional component in the multifactorial pathogenesis of RCT. © 2020 Published by Elsevier B.V. on behalf of Professor P K Surendran Memorial Education Foundation.Study design Retrospective cohort. Summary of background data Heterotopic ossification (HO) about the hip is a debilitating condition that can occur after fixation for acetabular fractures, total hip replacement, or polytrauma with closed head injuries. No classification exists that informs surgical treatment. Purpose To establish a classification system for HO about the hip by reviewing a consecutive series of HO at a single institution.  https://www.selleckchem.com/products/1-azakenpaullone.html  It was hypothesized that HO about the hip could be grouped into a novel classification scheme based upon the location and involved structures of the hip. Methods Retrospective chart review of single center's case log for HO excision from 2004 to 2018 was performed. Inclusion criteria included all patients undergoing excision of heterotopic bone excision about the hip. Demographic data, pre and post hip range of motion, surgical approach for each surgery, index surgery date and interval to excision are reported as well as presence and location of HO and Brooker classificationndran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.Objective No evidence exists about which biological approach is more reliable for creating non-union model. We investigated how to create a reproducible atrophic non-union model in a rat femur. Methods We compared three groups simple osteotomy (group A), partial periosteum cauterization (group B), and extensive periosteum and bone marrow resection (group C). Results All samples in group C demonstrated atrophic non-union in radiological, histological, and biomechanical analyses, however half of the samples in group B showed fracture healing at week 16. Conclusion Extensive resection of periosteum and bone marrow is important for a reproducible atrophic non-union model in a rat femur. © 2020 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.Introduction This investigation is a prospective cohort study examining the use of Clostridium histolyticum collagenase injection (CCH) for the treatment of Dupuytren's disease (DD) with a 7 years follow-up. Methods Forty-five monodigital DD patients were injected with CCH on a single joint. Assessment included measurement of residual passive extension deficit (PED), function (using QuickDASH) and patient satisfaction. Results 86.7% of PIPJ and 65.6% of MPJ had a worsening of PED. Nevertheless, thirty-nine patients (86.7%) concluded their treatment with only one injection, without any further treatment. Conclusion CCH provides a long-term effective solution. Recurrence occurs, especially in PIPJ, with acceptable rates. © 2020 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.Purpose The purpose of this study was to determine the in vivo kinematics of healthy knees and those with osteoarthritis (OA), during twisting using density-based image-matching techniques. Methods Five healthy subjects and 26 patients with medial knee OA performed twisting under periodic X-ray imaging. Results The tibiofemoral rotation at the ipsilateral/contralateral twist in healthy and OA knees were 11° ± 9.3° externally/9.5° ± 5.6° internally (p  less then  0.05) and 4.4° ± 7.2° externally/2.7° ± 8° internally (p  less then  0.05), respectively. Conclusions The kinematic analysis of OA knees during twisting revealed significantly smaller tibiofemoral rotation than those of healthy knees. © 2020 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.Objectives Management of missed Monteggia lesions presents a challenging clinical scenario for pediatric orthopaedic surgeons as the patient may be exposed to possible morbidities and increased complications. There are several evidenced surgical strategies described. We aimed to present 18 patients diagnosed within 4 months of injury who were treated using 4 of the identified many surgical strategies. Methods Eighteen consecutive cases of missed Monteggia lesions were treated in our institution between 2011 and 2014. The mean delay from injury to surgery was 8.3 weeks (range 4-16). Bilateral preoperative and postoperative radiographs, Oxford Elbow Score, the direction of radial head dislocation, Bado classification, ulnar pathology (plastic deformation or fracture), carrying angle, head-neck ratio, any abnormal bony architecture, and any related condition. Results There were no major complications to surgery. All patients had regained painless range of motion of the forearm and elbow, and reduced radiocapitellar joint. Ligament reconstruction or transcapitellar k-wire fixation did not influence the radiographic or clinical outcome. Conclusions Because conservative treatment of this injury may cause high morbidity, surgical management should be preferred in the foreground. The ulnar deformity is a key point in the reduction of the radiocapitellar joint. The preferred treatment strategy has no significant effect on the results as long as it provides radial head reduction. © 2020 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.Background This study evaluates the safety of foot and ankle outpatient surgeries at a freestanding ambulatory surgery centers. Methods A total of 1352 cases were evaluated for adverse events in a retrospective review of all foot and ankle cases performed over a 5-year period at a single center. Results The rate of adverse events was 2.3%, with 31 identified over the 5-year period (23 infections, 5 symptomatic thromboembolisms, 3 postoperative hospital transfers). Discussion The rate of postoperative adverse events in outpatient foot and ankle procedures is low. These surgeries can be performed safely in an outpatient setting at an ASC. Level of evidence Level IV, Case Series. © 2020 Published by Elsevier B.V. on behalf of Professor P K Surendran Memorial Education Foundation.