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Lateral epicondylitis (LE), also often called tennis elbow, is a frequent cause of elbow pain. The most characteristic symptom of LE is pain and burning around the lateral epicondyle of the humerus that may radiate to the forearm or to the upper arm. Ultrasonography is a quick and noninvasive tool used to confirm (or exclude) the diagnosis of LE. Management of LE symptoms should be directed to the management of pain, protection of movement, and improvement of arm performance. Treatment of LE includes nonoperative techniques and surgery. [ Orthopedics . 202x;4x(x):xx–xx.]

Introduction: Cystic lesions protruding into surrounding anatomical structures may decrease quality of life. Case presentation: In our case, the cyst was located periarticularly which indicated a potential need for open surgery. We used ultrasound-based minimally invasive arthroscopy technique. A 39-year-oldwoman’s ultrasonographic examination revealed delamination of the acetabular labrum and periarticular cyst located extra-articularly, compressing the iliopsoas muscle. The ultrasound-guided complete removal of the cyst was performed using a shaver blade placed into its lumen through the skin incision. The acetabular labral tear was treated with a classic arthroscopy procedure. 5 weeks after the surgery, the patient reported no pain and no functional impairment was detected. Conclusion: A well-known ultrasound diagnostic technique can save patients from more invasive procedures and can be beneficial for the surgeons.

Lateral epicondylitis (LE) is a common orthopedic problem. It is a not life-threatening condition and does not cause severe disability, but it is a burden in everyday life. This paper focuses on this area and provides guidance on how to effectively perform US examination of the lateral part of the elbow. We will provide recent evidence on LE with particular emphasis on the role of the ultrasound in diagnosis, treatment, and disease management and we will exemplify the pathology with representative cases.

(1) Background: Avascular necrosis (AVN) may affect every part of the bone. Epiphyseal infarcts are likely to be treated early because most are symptomatic. However, meta- and diaphyseal infarcts are silent and are diagnosed incidentally. Sarcomas developing in the necrotic bone are extremely rare, but they have been reported in the literature. (2) Methods: We conducted a mapping review of recent evidence regarding these malignancies. Methods: A mapping review using a systematic search strategy was conducted to answer research questions. We limited our research to the last ten years (2012–2022). (3) Results: A total of 11 papers were identified, including 9 case reports and 3 case series. The pathomechanism of carcinogenesis in AVN was not investigated to date. Histologically, most tumors were malignant fibrous histiocytoma. The prognosis is relatively poor, especially for patients with metastases, but adjuvant chemotherapy may increase short- and long-term survival. (4) Conclusions: Since AVN-related malignancies are sporadic, no prospective studies have been conducted. The majority of evidence comes from small case series. More research is needed to identify the risk factors that would justify follow-up of patients after bone infarcts at higher risk of developing a malignancy.

Avascular necrosis (AVN) of the femoral head is caused by disruption of the blood supply to the proximal femur. The alterations in the blood supply may occur following a traumatic event or result from a non-traumatic cause. Femoral neck fracture and hip dislocation and associated surgical procedures, corticosteroid therapy, and alcohol abuse frequently lead to AVN development. Type of fracture (displaced or undisplaced) and time between injury and surgery are the most critical factors in assessing the risk of developing AVN. Diagnosis of AVN can be established based on patients’ complaints, medical history, and radiographic findings. There is no consensus on the treatment of patients with AVN to date. Non-surgical methods are dedicated to patients in the early pre-collapse stages of the disease and consist of pharmacotherapy and physiotherapy. Surgery is recommended for patients with advanced disease.

Background: Avascular necrosis (AVN) of the femoral head often requires surgical treatment and is often associated with femoral neck fractures. We conducted a systematic review and meta-analysis of recent research on the risk of AVN following the stabilization of fractured femoral neck with implants in PubMed. We assessed the effect of age on AVN incidence among patients aged > 50 and younger, depending on fracture type, Garden stage, Pouwels degree, Delbet stage, and age category. We followed PRISMA guidelines. Relevant studies were defined as research articles describing real-world studies reporting on the risk of AVN following primary surgical fracture stabilization with implants, published between 1 January 2011 and 22 April 2021. Fifty-two papers met the inclusion criteria, with a total of N = 5930 with surgically managed fractures. The pooled mean AVN incidence was significantly higher among patients with displaced fractures (20.7%; 95% CI: 12.8–28.5%) vs. those with undisplaced fractures (4.7%; 95% CI: 3.4–6.0%). No significant correlation was observed between AVN incidence weighted by sample size and time interval from injury to surgery (p = 0.843, R2 = 0.01). In conclusion, the risk of AVN following femoral neck fractures was generally high, especially in patients with displaced fractures. The time from injury to surgery did not correlate with AVN incidence.

Background Numerous strategies are used to decrease the risk of the need for [allogeneic blood transfusion (ABT)], including [tranexamic acid (TXA)]. Objective In a single-center retrospective observational study, we have assessed the impact of TXA on the need and average volume of blood used during transfusion. Methods We have reviewed medical records of a total of 491 patients undergoing arthroplasty in our hospital from Dec 2016 to Dec 2019. Results 226 patients were administered TXA IV, and 265 did not receive an additional intervention. In the TXA group, 7/226 patients required ABT vs. 41/265 in the non-TXA group (p Conclusion We conclude that two doses of 1g TXA administered [intravenously (IV)] before incision and during skin suturing reduce the need for blood transfusion in patients undergoing JRS.

Frozen Shoulder (FS) by many specialists is still considered a benign, self-limiting condition, which usually resolves without intervention. This concept originated in the 70’, stating that FS will proceed from “the freezing” phase, with the predominance of inflammation and pain to “the frozen” phase with marked stiffness in the joint and “the thawing” phase, with a progressive return to the normal Range Of Motion (ROM) and function. Nevertheless, numerous authors have recently challenged this concept, arguing that most patients with FS will never fully recover, and suffer from residual pain and loss of function. Lack of early intervention, when a patient does not improve with conservative treatment, might lead to disability. We have discussed the recent concepts in the natural course of the disease and discussed both noninvasive and surgical methods in the treatment of FS.

There is no uniform standard of treatment for patients with hip fusion and accompanying symptomatic osteoarthritis of the ipsilateral knee. Fusion takedown is associated with an increased risk of complications, and often the results are not satisfactory for patients. Therefore, each case should be considered individually. We present a case report regarding a 70-year-old patient with hip fusion as a result of tuberculosis at a young age who underwent hip fusion takedown with total hip arthroplasty followed by total knee arthroplasty as a second step. The 70-year-old patient with end-stage renal failure and hip fusion as a complication of tuberculosis in adolescence complained of increasing pain in the left knee. After taking into account his comorbidities and discussing with the patient possible treatment options and their limitations, he was qualified for 2-step surgery involving hip replacement and total knee replacement spaced 5 months apart. At the last follow-up visit the patient did not report any pain, with a hip joint mobility of 110° flexion and -10° extension and internal and external rotation of 35° each. The range of knee flexion was 110°. On a VAS scale, the patient’s quality of life was rated 85/100 vs. 30/100 preoperatively. In patients with hip fusion, satisfactory results can be achieved with 2-stage hip and knee replacement, even despite significant co-morbidities. However, this requires careful intraoperative planning and management of patient expectations.

Sprains are the most common injury of the ankle joint and the most common traumatic injury of the musculoskeletal system. Ultrasound (US) examination of the posterior ankle joint is a challenge for the examiner. This paper focuses on this difficult area and provides guidance on how to effectively perform US examination of the posterior ankle.