Compelling evidence has mounted surrounding the relationship between the gut microbiome and many intestinal and extraintestinal cancers. Few studies exist investigating the relationship between the gut microbiome and sarcoma. We hypothesize that the presence of distant osteosarcoma induces change to the profile of flora within the mouse. Twelve mice were used for this experiment: six were sedated and received an injection of human osteosarcoma cells into the flank, while six served as controls. Baseline stool and weight were collected. Tumor size and mouse weight were recorded weekly, and stool samples were collected and stored. Fecal microbiomes of the mice were profiled by 16S rRNA gene sequencing and analyzed for alpha diversity, relative abundances of microbial taxa, and abundance of specific bacteria at different time points. Alpha diversity was increased in the osteosarcoma group compared with the control group. The family Lachnospiraceae had the second strongest negative net average change in relative abundance over time in the osteosarcoma group whereas it had a positive net average change in the control group. An increased Firmicutes/Bacteroidota (F/B) ratio was observed in the osteosarcoma group relative to the control mice. These differences suggest that there may be an interplay between the gut microbiome and osteosarcoma. Clinical significance: Due to the paucity of literature available, our work can support novel research on this relationship and the development of new, personalized treatments for osteosarcoma.

Isolated teres minor atrophy has a reported incidence in the literature of 3% to 6.2%. » There are 2 distinct muscular bundles of the teres minor that have varying degrees of atrophy. Fatty degeneration of the medial-dorsal component exceeds that of the lateral-ventral component in most cases.» A healthy and intact teres minor muscle is of functional importance in the setting of a complete infraspinatus tear because it becomes the only external rotator of the shoulder joint.» Clinical and functional outcomes after rotator cuff repair and reverse shoulder arthroplasty for patients with teres minor atrophy in the setting of a rotator cuff tear are still controversial.

Purpose To investigate if changes to hospital operational models during the COVID-19 pandemic negatively impacted overall time to surgery (TtS) as well as morbidity and mortality rates of hip fractures (HFx). Methods 416 patients treated for OTA 31 fractures at a single institution between January 2019 and November 2020 were reviewed. TtS as well as morbidity and mortality rates were obtained from pre-pandemic and pandemic groups. Results 263 patients were treated pre-pandemic and 153 were treated during the pandemic. There were no significant differences in median TtS, readmission rates ( p = 0.134), reoperation rates ( p = 0.052), 30-day ( p = 0.095) and 90-day ( p = 0.22) mortality rates. Conclusion Reallocation of hospital resources in response to the COVID-19 pandemic did not negatively impact surgical timing or complications. TtS for HFx remains a challenge and often requires multidisciplinary care, which is complicated by a pandemic. However, this study demonstrates HFx standard of care can be maintained despite COVID-19 obstacles to treatment efficiency and efficacy.

Introduction: Intraosseous lipomas are benign tumors composed of mature fat that reside within the intramedullary canal. Although many cases are asymptomatic, some patients report pain that interferes with daily living. For patients presenting with refractory pain, surgical excision may be performed. These tumors were once thought to be rare, but a recent increase in awareness and diagnostic capability may contradict this. Case Presentations: A 27-year-old female presented with a 3-month history of deep and aching pain in her left shoulder. The second patient was a 24-year-old female who presented with a 3-year history of pain in her right tibia. The third was a 50 year old female who presented with a 4-month history of deep pain in her right humerus. The fourth patient was a 34-year-old female who presented with a 6-month history of the left heel pain. All were found to have intraosseous lipomas and were treated with excisional curettage, achieving resolution of symptoms. Conclusion: These cases may help orthopedists better understand the presentation and treatment of intraosseous lipomas due to several shared characteristics. We also hope that this report may lead clinicians to include this pathology in their differential diagnosis when patients present with similar symptoms. As the prevalence of these tumors appears to be increasing, efficient diagnosis and treatment will become increasingly valuable to orthopedists and patients.

Treatment of Stenotrophonomas maltophilia infections is difficult due to its predilection to form biofilms and susceptibility to a limited number of antibiotics. We report a case of S. maltophilia-associated periprosthetic joint infection successfully treated with a combination of the novel therapeutic agent, cefiderocol, and trimethoprim-sulfamethoxazole after debridement and implant retention.