In patients with extra-articular deformities, TKA with asymmetric intra-articular resection and ligament balancing can relieve pain and realign the mechanical axis of the lower limb.

No abstract

El edema periférico es una manifestación clínica común, frecuentemente de etiología multifactorial. Puede presentarse de forma uni o bilateral, pudiendo ser la clave diagnóstica de patologías sistémicas o locales. Presentamos el caso clínico de una mujer de 79 años, que acude al servicio de urgencias por tumefacción asimétrica del miembro inferior derecho, con limitación funcional; sin otra sintomatología asociada. Tras excluir las causas más frecuentes, se constató la existencia de un quiste sinovial de la articulación coxofemoral, una causa atípica del edema.

<p><strong>Background:</strong> The objective of current study was to compare the short-term outcomes between a cohort of patients that undergone total hip replacement by a superpath technique at the beginning of the surgeon's learning curve, and a cohort of patients that undergone a total hip replacement by a conventional posterior approach.</p><p><strong>Methods:</strong> A cohort of 22 patients was prospectively and randomly selected for being part of a superpath approach group or a conventional posterior approach group. Clinical evaluation was performed in two primary end-points - the third post-operative day and the first month after surgery - using physical exams as the “20 meter walking test” and the “30 seconds sit to stand test”, the Harris hip score, the visual analogue scale for pain. Radiological evaluation was also performed.</p><p><strong>Results:</strong> 11 patients underwent the superpath approach and 11 patients underwent the conventional posterior approach. The surgery time was 78.2 min in the superpath group and 59.4 min in the posterior group. The average hospital stay was 3.4 days in the superpath group and 5.3 days in the posterior group. When assessing pain improvement through VAS, it was found that both on the third postoperative day and on the first postoperative month, patients in the superpath group showed greater improvement. There were no differences in functional results with statistical significance. No complications were seen in both groups.</p><p><strong>Conclusions:</strong> Despite the longer surgical time seen with the superpath approach, it managed to significantly decrease the length of hospital stay and obtained better results in improving pain in the short term.</p>

<p>A 73 years old female diagnosed with rheumatoid arthritis for over 30 years with an end-stage right elbow arthritis (stage V of Larsen’s classification) with a major instability. The patient presented gross deformity and severe pain with critical limitation of limb function. The patient was treated with a total elbow arthroplasty with an intraoperative olecranon fracture. At six months follow up, the patient presents with an excellent active range of motion and painless joint, without daily activities limitation.</p>