Background Computer-aided surgery aims to improve implant alignment in TKA but has only been adopted by a minority for routine use. A novel approach, navigated freehand bone cutting (NFC), is intended to achieve wider acceptance by eliminating the need for cumbersome, implant-specific mechanical jigs and avoiding the expense of navigation. Questions/Purposes We determined cutting time, surface quality, implant fit, and implant alignment after NFC of synthetic femoral specimens and the feasibility and alignment of a complete TKA performed with NFC technology in cadaveric specimens. Methods Seven surgeons prepared six synthetic femoral specimens each, using our custom NFC system. Cutting times, quality of bone cuts, and implant fit and alignment were assessed quantitatively by CT surface scanning and computational measurements. Additionally, a single surgeon performed a complete TKA on two cadaveric specimens using the NFC system, with cutting time and implant alignment analyzed through plain radiographs and CT. Results For the synthetic specimens, femoral coronal alignment was within ± 2°of neutral in 94% of the specimens. Sagittal alignment was within 0°to 5°of flexion in all specimens. Rotation was within ± 1°of the epicondylar axis in 97% of the specimens. The mean time to make cuts improved from 13 minutes for the first The institution of four authors (KLG, AB, CWH, HH) has received, during the study period, funding from DePuy Orthopaedics Inc (Warsaw, IN, USA) and contract research funding from Arthrex Inc (Naples, FL, USA), Biomet Inc (Warsaw, IN, USA), Naval Health Research Center (San Diego, CA, USA), Empirical Testing Corp (Colorado Springs, CO, USA), Exactech Inc (Gainesville, FL, USA), Exponent Inc (Philadelphia, PA, USA), ESKA (Lübeck, Germany), Gruppo Bioimpianti (Milan, Italy), Kyocera Medical Corp (Osaka, Japan), Implanet (Martillac, France), Ortho Development (Draper, UT, USA), Otis Glebe Medical Research Foundation (Omaha, NE, USA), Renovis Surgical Technologies (Redlands, CA, USA), Smith & Nephew Inc (Memphis, TN, USA), SoftJoint (Iowa City, IA, USA), Stryker Orthopaedics (Mahwah, NJ, USA), Spine Medica (Atlanta, GA, USA), and Tornier (Montbonnot, France). The institution of one of the authors (CRM) has received, during the study period, funding from Smith & Nephew. One of the authors (KLG) certifies that he, or a member of his immediate family, has received or may receive payments or benefits, during the study period, an amount of $100,001 to $1,000,000 from Biomet Inc. One of the authors (HH) certifies that he, or a member of his immediate family, has received or may receive payments or benefits, during the study period, an amount of $10,000 to $100,000 from AMTI (Watertown, MA, USA), an amount of less than $10,000 from Arthrex, an amount of $10,000 to $100,000 from Biomet Inc, an amount of less than $10,000 from Orthopedic Surgical Manufacturers Association (Rockville, MD, USA), an amount of less than $10,000 from SoftJoint, and an amount of less than $10,000 from SI-BONE (San Jose, C...

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La hiperglucemia inducida por glucocorticoides es un escenario frecuente al cual se enfrenta el clínico durante su práctica hospitalaria diaria, constituyendo un reto en el abordaje y control del estado metabólico de estos pacientes, con el fin de disminuir su morbimortalidad asociada. Presentamos el caso clínico de una paciente de género femenino de 69 años con antecedente de diabetes mellitus tipo 2 y linfoma no Hodgkin, hospitalizada para inicio de ciclo quimioterapéutico, durante el cual se documentan hiperglucemias sostenidas de difícil manejo. La paciente recibió tratamiento con esquema basalbolo y un bolo adicional de insulina NPH titulado según las dosis y tipo de glucocorticoide aplicado, alcanzando adecuado control metabólico. Se realiza una revisión de la literatura respecto a la hiperglucemia inducida por glucocorticoides, su abordaje y tratamiento, y las recomendaciones existentes en cuanto al uso de insulina NPH como esquema adicional correctivo.