Thirty-two active duty soldiers (36 total joint replacements) were followed from 9 months and 18 years (average 4.1 years) to evaluate the outcome of total joint replacement in active duty soldiers. Follow-up consisted of clinical assessment and radiographic evaluation at 6 weeks, 3 months, 6 months, 1 year, and yearly thereafter. A Harris hip rating (HHR) was also completed at each clinic visit. There were 30 total hip arthroplasties in 27 patients with an average age at surgery of 40.8 years (range 31-58) and an average follow-up of 4.1 years. The HHR averaged 93 on latest evaluation. There were three revisions (average 7.2 years). Of the 27 patients, 18 were retained on active duty and 9 were separated from service. Of the senior enlisted (E7 or above) and officers (O4 or above), 16 of 17 (94%) were retained on active duty, whereas only 2 of 10 (20%) of the junior enlisted (E6 or below) were retained on active duty. There were 6 total knee arthroplasties in 5 patients with an average age at surgery of 49.8 years (range 33-58) and an average follow-up of 3.0 years (9 months to 4 years). There were no revisions, and all 5 soldiers were retained on active duty. Preliminary results from this study reveal that a high percentage of soldiers undergoing total joint replacement are retained on active duty (72%) and are able to continue active lives. Rank or seniority also appears to be a significant factor for retention on active duty. The revision rate (10%) and the rate of osteolysis (19%) are comparable with reported rates.

Soft tissue sarcomas are uncommon and frequently missed on examination, resulting in delays in diagnosis and, occasionally, inappropriate treatment. Sarcoma staging, the process of defining the local extent of tumor and potential distant spread, involves a thorough history and physical examination, directed imaging, and biopsy. Biopsy is a complicated procedure in approximately 20% of cases and should be performed only by experienced personnel and at a center with a multidisciplinary team familiar with the treatment of patients with soft tissue sarcomas. The goal of surgery is to obtain tumor-free margins. In conjunction with radiation therapy, surgery can then provide local disease control in more than 90% of patients. The role of chemotherapy in nonmetastatic disease is unclear and is of marginal efficacy in patients with metastases. Although most tumors recur within 2 to 5 years, long-term clinical and radiographic surveillance is necessary.

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The following case report highlights basic aspects of Multiple Hereditary Osteochondral Exostoses (MHOCE) and discusses the successful treatment of an adult with ankle pain secondary to growth arrest and foreshortening of the fibula. Two salient features include the age of the patient at presentation and the success of the procedure. Symptomatic valgus deformities of the ankle secondary to MHOCE are normally corrected during adolescence, prior to physeal closure. Reducing the ankle mortise by distally displacing the fibula and correcting rotational and angular ankle deformities with Ilizarov external fixation improved this patient's ankle function and relieved his pain.

Transplantation of bone allografts is an accepted procedure in dentistry as it is in many surgical specialties. Despite wide acceptance and ready access to a number of bone allografts, there is often insufficient knowledge of the origin of these allografts and the processing methods. This brief review paper summarizes contemporary knowledge of the biologic properties of bone transplants used in dentistry and discusses their safety. It is intended to aid dental practitioners in selecting suitable bone allograft materials for their patients. It does not deal with bone autografts nor does it compare autografts and allografts. Long-term clinical results with allografts processed by different methods are also outside of the scope of this review.