The information is taken from normal hips and may not be directly applicable to the deformed hip. Nevertheless, it is a prerequisite for a surgeon to understand the normal anatomy and use those boundaries to prevent mistakes during intra-articular joint-preserving hip surgical procedures.

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Background: Spondylodiscitis is an uncommon disease, and due to its indolent nature, it is often a late diagnosis. Great stress is put on the etiologic diagnosis, but blood cultures do not always yield positive results. Magnetic resonance imaging (MRI), despite being the diagnostic method of choice, is not always available. Our aim was to characterize the clinical presentation and to identify and check the efficacy of the etiologic and radiological methods of diagnosis of spondylodiscitis used at our hospital.Methods: A retrospective study was conducted in which spontaneous spondylodiscitis cases were identified. The clinical presentation and the results of etiologic and radiological methods of diagnosis were analyzed.Results: Over a period of 5 years, 34 patients fulfilled the inclusion criteria of the study. Regarding days of complaints, we identified a median of 9.5 days (1-547 days), with back pain being the predominant symptom. Fever was present in half the patients. Blood cultures were positive in 16 patients (48.5%). Nineteen patients underwent a computed tomography (CT)-guided biopsy (positive in 7 patients [36.8%]), and 10 patients underwent a surgical biopsy (positive in half of them). Overall, 27 patients (79.4%) had an etiologic diagnosis. The diagnostic work-up consisted mostly of an initial CT scan followed by a confirmatory MRI. Of note, in 5 patients the CT scan did not reveal changes that were later confirmed by MRI. A total of 29 patients (85.3%) underwent an MRI, with 28 being diagnostic.Conclusions: Spondylodiscitis remain a difficult diagnosis. Blood cultures should always be obtained before antibiotic administration and a CT-guided or surgical biopsy should be done if needed. Our results confirm the importance of MRI as the imaging modality of choice and highlight the possibility of false-negative CT scans and the inability of CT to allow for a definitive diagnosis.

Objective: Trapeziometacarpal osteoarthritis has a high prevalence. In the failure of conservative treatment, there are several surgical procedures, not having been proved to date the superiority of any of them. The PyroDisk interposition implant was introduced in 2005, and the few existing studies have short follow-ups. The objective of this study is to evaluate the clinical and radiological results of interposition arthroplasty with PyroDisk, after a minimum follow-up of 5 years. Materials and Methods: We conducted a retrospective, cross-sectional analytical study with a sample of patients undergoing arthroplasty with interposition PyroDisk between January 2008 and April 2010, with a minimum follow-up of 5 years. They were evaluated in individual interviews and through the clinical process: degree of satisfaction with the surgery, pain (through visual analogue scale), degree of capacity for the tasks of daily living (Disabilities of the Arm, Shoulder and Hand [DASH] score), palmar pinch and digital forces (through dynamometers), mobility (Kapandji score), and complications. We proceeded to assess the progression of

osteolysis by analyzing postoperative radiographs and using Herren scale peri-implant radiolucency adapted to the trapeziometacarpal joint. The statistical data analysis was done through SPSS v20. We evaluated 26 patients corresponding to 29 arthroplasties (3 bilateral), 24 females and 2 males, average age 68.1 years. The dominant etiology was primary osteoarthritis (89.1%). The average follow-up was 84.2 months (range, 69-98 months). Results: We found a high degree of satisfaction (92.3%) and 84.6% repeat surgery and had a low degree of disability in daily living activities (average DASH 22.1), with an average pain score of 1.18. The average Kapandji score at follow-up was 8.56 (91% contralateral mobility). The mean grip strength was 13.0 kg/cm 2 (91% of the contralateral force) and key pinch strength was 4.5 kg/cm 2 (4.6 kg on the antero-lateral side). Radiological assessment (modified Herren scale) revealed the progression of osteolysis at revision for grade I (< 1 mm) in 18.5% of patients, for grade II (> 1 mm) in 59.3%, and for grade III (macroscopic deviation implant > 25% of the base of the first metacarpal) in 22.2%. There was no statistically significant relationship between the degree of osteolysis and the clinical results at revision (P > 0.05). We registered three complications (10.3%): 2 dislocations and 1 superficial sensory branch neuroma. The implant survival at 5 years was 93.1%. Conclusions: Although the presence of peri-implant osteolysis has been universal in our study, we have not seen any relationship between the degree of osteolysis and implant failure, patient satisfaction, or clinical outcome. Our study confirms the good 5-year clinical results of interposition arthroplasty with PyroDisk. The observed lysis did not compromise the results. More research and greater follow-up are needed to study the effects of this long-term implant.