Left-sided and duplicate inferior vena cava (IVC) are two major anatomical variants within the spectrum of IVC malformations, both of which are developmental abnormalities of the supracardinal veins. Four clinical cases are described to highlight the computed tomographic appearances of these vascular malformations and provide novel data on venous dimensions. A systematic review of the recent literature (2000-2011) was conducted focusing on the anatomy, demographics, and associated pathology (congenital and acquired) of isolated left-sided and duplicate IVC. A total of 73 relevant articles were retrieved, consisting of case reports and small case series. The prevalence of left-sided IVC is about 0.1-0.4% and that for duplicate IVC about 0.3-0.4%; both anomalies show a slight male preponderance. In each condition, there are documented variations in the course and tributaries of the IVC. The clinical importance of these anomalies lies in three principal areas: the potential for misdiagnosis on imaging; technical difficulties during retroperitoneal surgery (particularly abdominal aortic aneurysm repair and live donor nephrectomy); and their significance in relation to the etiology and management of venous thromboembolism.

The Duracon total knee replacement and its forerunner the Porous-Coated Anatomic (PCA) knee system have been associated with good results. This study reviews a series of 181 knee replacements performed with these systems by seven general orthopedic surgeons with follow-up to a mean of 6.7 years. The mean Knee Society knee and function scores were 72 and 68. The mean Western Ontario and MacMaster Universities Osteoarthritis Index score was 76, and the mean 12-Item Short-Form Health Survey result was 55. A mean flexion of 104 degrees was recorded, and 93.8% of patients rated their satisfaction as good to excellent. Fifty-five percent of patients had minor radiographic lucencies-these were of questionable clinical significance. Seven patients required revision. These knee systems used in a relatively low-volume general unit provide consistent results comparable with those from larger arthroplasty units.

No abstract

No abstract

No abstract