We found ultrasound-guided injections to be useful for treatment of de Quervain's tenosynovitis. Our success with ultrasound-guided injections was slightly better than that reported in the literature and without adverse reactions.

Superior capsular reconstruction (SCR) is a novel technique for treating irreparable rotator cuff tears in younger patients in whom a reverse total shoulder arthroplasty is not the optimal treatment choice. This case study describes a middle-aged male with a recurrent, massive, irreparable rotator cuff tear treated with SCR that subsequently failed at the glenoid attachment. The patient underwent successful arthroscopic revision of the SCR. The case illustrates the MRI and arthroscopic correlations of the failed dermal allograft reconstruction, which to our knowledge has not been previously shown in the radiology literature.

The purpose of this study was to assess the outcomes of primary total hip arthroplasty (THA) in super-obese patients compared to a cohort who had a normal body mass index (BMI). Twenty patients (23 hips) who had a minimum BMI of 50 kg/m2 who underwent a primary THA between 2001 and 2010 were reviewed. They had a mean age of 50 years and follow-up of 36 months. These patients were compared (1:2 ratio) to a matched group of 40 patients (46 hips) who had a normal body mass index (less than 25 kg/m2) who underwent a THA during the same time period. Outcomes evaluated included implant survivorship, Harris hip scores, and complication rates. Overall, aseptic implant survivorship was lower in the super-obese patients compared to the matching group (96% versus 100%), but the difference was not significant. However, super-obese patients had significantly lower mean Harris hip scores (84 vs 91 points) and higher complication rate at final follow-up. Although the clinical outcomes of primary total hip arthroplasty were poorer in the super-obese patients, it is encouraging that even in these patients, total hip arthroplasty can have acceptable outcomes. However, these patients may benefit from a discussion with their orthopaedic surgeons to develop realistic expectations from the outcomes of their arthroplasty procedure.

This study evaluated inpatient cruciate ligament reconstruction in the United States during a 13-year period. The Nationwide Inpatient Sample database was used to identify inpatient cruciate ligament reconstructions performed from 1998 to 2010. National trends in incidence, patient demographics, perioperative complications, length of stay, and total admission costs were evaluated. The impact of various contributing factors on these outcomes was further evaluated using multivariable regression analyses. The rate of inpatient cruciate ligament reconstruction has decreased significantly in the United States during the past decade. The outcome data from this study can be used as a comparison cohort for future outpatient analyses of anterior cruciate ligament reconstruction in the United States.