We reviewed 231 patients who had undergone total knee replacement with an AGC (Biomet) implant over a period of 2.5 years. After applying exclusion criteria and with some loss to follow-up, there were 144 patients available for study. These were divided into two groups; those who had received intra-articular steroid in the 11 months before surgery and those who had not. There were three deep infections, all of which occurred in patients who had received a steroid injection. The incidence of superficial infection was not significantly different in the two groups. Five patients had undergone investigation for suspected deep infection because of persistent swelling or pain and all of these had received an intra-articular injection pre-operatively. We conclude that the decision to administer intra-articular steroids to a patient who may be a candidate for total knee replacement should not be taken lightly because of a risk of post-operative deep infection.

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We present, along with a literature review, the case report of a 6-year-old boy, involved in a high-speed motor vehicle accident, who sustained a seat belt injury of the lumbar spine. We discuss the clinical presentation of thoracolumbar fractures in children, the sensitivity of clinical examination and radiographic evaluation and the associated abdominal injuries that are commonly present with seat belt spinal injuries. Computerized tomography is limited in the detection of soft tissue spinal fractures because these fractures occur in the plain of the section. Plain lateral x-rays of the lumbar spine and computerized tomographic three-dimensional reconstruction images can be helpful but they cannot evaluate the extent of the soft tissue injury. The magnetic resonance imaging scan is the best diagnostic tool to provide the diagnosis.

The action of psoas major muscle as a primary flexor of the hip joint is undisputed. However it is also variably reported as being a medial and a lateral rotator of the femur at the hip joint. The psoas and iliacus muscles, along with their common insertion, were isolated by dissection in six adult cadaveric specimens. The action of psoas muscle was assessed by pulling the muscle along its long axis and then observing the effects on rotation of the femur, with a visual estimation of the rotation in degrees. The experiment was repeated with the hip joint capsule removed. In the anatomical position, applied traction along the long axis of the muscle produced hip flexion with no rotational component. With the hip in the abducted position, traction produced flexion, adduction, and lateral rotation of the femur at the hip joint. In adduction of the hip, traction on psoas produced only flexion at the hip joint, with no rotation. In maximal flexion, traction also produced adduction. The results were unaffected by the removal of the joint capsule. Clin. Anat. 12:264–265, 1999. © 1999 Wiley‐Liss, Inc.