Osteoarthritic disease is the result of mechanical and biological events that destabilize the normal processes of degradation and synthesis of articular cartilage chondrocytes, extracellular matrix, and subchondral bone. Osteoarthritis of the knee can cause symptoms ranging from mild to disabling. Initial management of most patients should be nonoperative, but because of the progressive nature of the disease, many patients with osteoarthritis of the knee eventually benefit from operative treatment. Various procedures have been described for treatment of the osteoarthritic knee, ranging from arthroscopic lavage and debridement to total knee arthroplasty. The aim of this study was to evaluate the clinical results of distraction arthroplasty combined with arthroscopic lavage and drilling of cartilage defects for treatment of osteoarthritis of the knee. Nineteen patients (15 women and 4 men; age range, 39-65 years) were operated on. Pre- and postoperative findings were compared. A control group comprising 42 patients treated with only arthroscopic procedures was evaluated for comparison. Follow-up ranged from 3 to 5 years. Results were evaluated both clinically and radiologically postoperatively and throughout the follow-up period. Clinically, pain and walking capacity improved in most patients. Radiologically, joint space widening and improvement of the tibiofemoral angle was noted in nearly all patients.

Information regarding the precise dimensions of the lumbar vertebrae is essential for spinal surgery and instrumentation. When stenosis of the vertebral canal or the intervertebral foramen exists, the neural structures in them can be affected and cause symptoms such as low back or radicular pain. Accurate and comprehensive spinal canal measurements in the lumbar vertebrae are incomplete. The purpose of this study was to collect data on the dimensions of the lumbar spinal canal from computed tomography scans. Three hundred patients (162 men and 138 women) were studied. Computed tomography scans were obtained to determine the normal values of the midsagittal diameter, interpedicular distance, and lateral recess depth in the normal Egyptian population. The narrowest level was L3. The range of the midsagittal diameter was 11.07 to 26.07 mm at all levels. The range of the interpedicular distance was 17.00 to 43.41 mm at all levels. In all patients at all levels, mean lateral recess depth was 6.7 mm (range, 4-14 mm). The narrowest lateral recess depth was at L5. Few patients (3.3%) had a statistically stenotic midsagittal diameter measurement. The canal shape was not uniform along the 5 lumbar vertebrae; it ranged from being circular or rounded in the upper lumbar vertebrae to triangular in the midlumbar vertebrae to trefoil in the lower lumbar vertebrae, especially at L5. Trefoil canals existed mainly in the lower lumbar vertebrae at L5, followed by L4. Data from computed tomography scans combined with accurate measurements are the basis for anatomical studies, clinical research, and the development of implants suitable for a group of patients with measurements different from the population standard.

It is hypothesized that the interruption of the blood supply is an important factor causing femoral head osteonecrosis in the early stages of Legg-Calvé-Perthes disease. Currently, treatment by containment is recommended to direct and guide remodeling of the softened femoral head as it evolves from fragmentation through ossification. The goal of this study was to show the results of arthrodiatasis to induce height recovery of the femoral head and to achieve true ambulatory nonweight-bearing containment. Forty-two patients younger than 8 years with a diagnosis of Perthes' disease were studied. Twenty-three patients (9 class B and 14 class C according to Herring's classification) were treated with an articulated distraction technique and 19 patients (11 class B and 8 class C) were treated conservatively as a control group. Arthrodiatasis or articulated distraction of the hip combines off-loading of muscles and body forces with distraction of the joint space by means of an external fixator that crosses the hip joint. Radiologically, 21 patients (91%) had satisfactory results and 2 (9%) had unsatisfactory results. Clinically, the results were good in 21 patients (92%), fair in 1 (4%), and poor in 1 (4%). In patients treated conservatively, 14 patients (72%) had satisfactory results and 5 (28%) had unsatisfactory results. Clinically, 71% had good results, 17% had fair, and 12% had poor. We conclude that hip joint containment by articulated arthrodiatasis (plus adductors and psoas minimal tenotomy surgery) is an effective method in the management of Perthes' disease in patients younger than 8 years, classified B and C, and associated with a highly reduced range of abduction. Restoration of clinical abnormalities and satisfactory radiological parameters are achieved in high percentages.

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Aims: To examine the clinical outcomes of the minimally invasive plate osteosynthesis technique for comminuted diaphyseal humeral fractures based on clinical and radiologic records. Study Design:  Prospective study. Place and Duration of Study: This study was carried on twenty-one adult patients with comminuted humeral shaft fracture treated with MIPO between February 2020 to February 2021 were included in this study. Methods: Patients with pathological fracture, Gustilo and Anderson type 2 or 3, intra-articular fracture and preoperative radial nerve palsy were excluded. The surgery time, blood loss and time of union were noted. Clinical outcome was assessed by Q-DASH score. Results: We had thirteen cases of 12-B type and eight cases of 12-C type of fracture. According to Q-DASH score, eighteen cases had satisfactory results. The mean radiological fracture union time was 13.85 weeks. Mean elbow flexion was 1250, mean extension range was -2.140. out of all cases, two cases had superficial wound infection. One patient had iatrogenic radial nerve palsy. One patient had non-union. Conclusion: Although technically demanding, MIPO technically should be considered one of the management options in the treatment of complex humeral diaphyseal fractures as it adheres to biological fixation principles with minimal soft tissue dissection, preserving fracture hematoma and periosteal blood supply.