Iontophoresis with a concentrated gentamicin-agar mixture may provide a rapid increase of gentamicin levels in the cornea.

Hip arthroscopy is an important diagnostic and therapeutic tool in the management of synovial chondromatosis. Removal of osteochondral fragments (OCFs) from the central and peripheral compartments is crucial for the relief of mechanical symptoms and subsequent joint destruction. Direct access to the central compartment is often limited because of the ball-and-socket morphology and limitation of traction. We present our surgical technique for removing OCFs and a new method for the removal of a large loose body using a nitinol stone retrieval basket. The technique facilitates removal of difficult-to-access fragments from the central compartment. Moreover, this technique allows removal of far-medial OCFs from the peripheral compartment.

Adequate traction to achieve hip joint distraction is essential for avoiding iatrogenic injury to the joint during hip arthroscopy. An inability to distract the joint is a relative contraindication for hip arthroscopy. This report describes a novel technique involving an extracapsular approach to gain safe access to a hip joint that fails a trial of traction during positioning for hip arthroscopy. The anterolateral portal is established under fluoroscopic guidance. The arthroscope is positioned on the lateral rim of the acetabulum. A shaver, introduced through a modified anterior portal, is used to facilitate capsular exposure. An arthroscopic capsular incision is made proximal to the lateral acetabular rim and extended anteriorly with a radiofrequency probe. Osteoplasty of the anterolateral acetabular rim is carried out with a burr while protecting the labrum. Distraction of the hip is then possible, allowing safe central-compartment access and subsequent chondrolabral procedures.

It is impossible to achieve a diagnosis without a comprehensive list of possible diagnostic explanations for a certain symptom or syndrome. Joint complaints are very frequent in general practice, paediatrics, emergency medicine and naturally rheumatology and orthopaedics. The differential diagnosis of joint and surrounding tissue pain and inflammation is impressively challenging. Orthopaedic surgeons and rheumatologists deal with different aspects of this subject, while primary care physicians need to have a wider perspective that includes both orthopaedic and rheumatic disorders. The purpose of this paper is to provide a unified, comprehensive, clear and concise guide to this subject that will include both orthopaedic and rheumatic disorders and may serve the practitioner as basic reference for differential diagnosis. Short dictionary-style definitions would be given for each disorder in order to provide a ‘bird’s-eye view’, rather than an in-depth description of many diseases. Medical students, residents and primary care physicians are the primary target audience, but we believe that even the experienced orthopaedic surgeon or rheumatologist may benefit from a systematic and well-organised method.

Background Human body tissues, including bones, have the ability to repair, remodel, and even regenerate after injury, illness, or wear and tear. Important participants in this process are the mesenchymal stem cells (MSCs) that can undergo proliferation and differentiation to different lineages including osteoblasts. The ability to influence this process can be used to control the rate and direct the bony healing process. Purpose In this study, we examine a natural powder made of quality elk velvet antlers (QEVA) for its bioactivity effect over MSCs. Methods Human bone marrow was taken and purified until MSCs were retrieved. These cells were grown in cultures and served as responders to examine the QEVA agent. QEVA extract in different concentrations was added along with defined cell culture medium (DCCM) and compared to fetal calf serum (FCS) or DCCM alone. An XTT Reagent kit served to evaluate cell viability, alkaline phosphatase (AP) staining to asses cell differentiation to osteoblasts and immunohistochemical staining for specific markers. ResultsAdding QEVA extract was shown to have an encouraging effect on cell growth rate compared to DCCM alone or DCCM together with 1% FCS. Combined with serum and DCCM, it also had a superior effect over serum and DCCM alone. AP staining showed QEVA extract addition to encourage differentiation to the osteogenic lineage; however, it was not superior to serum supplement. Immunohistochemical dyes were positive for osteopontin, signifying mature osteoblasts. Conclusions QEVA powder extract was shown to induce propagation and osteogenic differentiation in human MSC cultures. Further studies are needed to pinpoint the exact agent responsible for these bioactivities.