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  • ISSN: 2373-9290
    Volume 1, Issue 1
    October-December 2013
    Editorial
    Hanan Tanuos1* and Anthony Wassef2
    Many orthopedics complaints come to the attention of the primary care doctor. While there are common conditions that are seen and managed by the primary care doctor, an astute physician will discover the rare conditions. With a good history and physical exam, the physician can diagnose the patient and refer appropriately. In this article, our focus will be on the rare disorder of Hereditary Multiple Exostosis (multiple osteochondromatosis).
    Clement E. Tagoe*
    Chronic lymphocytic thyroiditis (CLT), a variant of autoimmune thyroiditis (AIT) is the commonest autoimmune disease with a prevalence of about 10% worldwide, rising to about 20% after age 50 years with a female to male preponderance of about 9:1 [1,2]. Although it is generally asymptomatic, severe disease can lead to failure of the thyroid gland and hypothyroidism in about 20% of cases [2]. Less commonly known is the fact that CLT and its goitrous form, Hashimoto thyroiditis, are associated with a multitude of other clinical syndromes including nervous system, psychological, dermatologic, metabolic, endocrine and musculoskeletal conditions [3]. A variety of causative mechanisms are probably involved including metabolic, endocrine, autoimmune and perhaps inflammatory processes. The association of CLT with other autoimmune conditions including connective tissue diseases is also likely responsible for the tremendous diversity of clinical presentations [4].
    Mohamed E. Abdel-Wanis*
    Vertebral compression fractures due to osteoporotic disease represent an increasingly significant public health problem [1]. There is no sharp line demarcation between stages of the fracture; acute, subacute and chronic. Lines of treatment include conservative treatment (e.g. brace and pain killers), cement augmentation (vertebroplasty, kyphoplasty and stentoplasty) and surgical treatment. Treatment remains an area of controversy with respect to best line of treatment, and indications, timing and type of surgical management [2].
    Fawzy A. Saad1, Daniel J. Leong1,2, Tony S. Wanich1, Konrad I. Gruson1 and Hui B. Sun1,2*
    Tendon injuries due to misuse or overuse as well as age-related degeneration are common clinical problems facing orthopedic surgeons and sports medicine clinicians. Following injury, tendons exhibit an ineffective repair response that is often characterized by scar formation. Severe tendon injuries often require surgical intervention, but the structure and function of repaired tendons remain inferior when compared to non-injured tendons [1]. The repair of injured tendons remains a great challenge, and becomes even more challenging in older patients. Currently, there are no therapies to restore the normal function and structure of injured tendons.
    Review Article
    Phuc (Phil) Dang and Ran Schwarzkopf*
    Abstract:
    Total knee arthroplasty (TKA) is one of the most commonly performed elective orthopaedic procedures in the United States. TKA provides significant pain relief and improvement in quality of life. However, TKA surgery has been shown to have significant blood loss that sometimes requires blood transfusions. Transfusion of blood products is not a benign procedure and is associated with many risks such as; periprosthetic joint infection, lengthen hospital stay, and increased cost for the patient and payers. Tranexamic acid (TXA), an inhibitor of fibrinolysis, has been used in TKA to control blood loss. Because of the TXA’s mode of action, there have been longstanding concerns about the possibilities of adverse effects, such as thrombosis, pulmonary embolism, and renal failure. Multiple studies and review articles have shown that tranexamic acid is efficacious and does not significantly increase the risk of stroke, myocardial infarction, deep vein thrombosis, pulmonary embolism, and renal failure. Intravenous and intra-articular (topical) TXA injection has been shown to be efficacious in controlling blood loss and transfusion requirement, with increasing concentration being more efficacious. Common dosage of IV TXA is 10mg/kg prior to tourniquet inflation and during closure. Common dosage for intra-articular TXA is 1.5g/100ml of normal saline during closure or through a drain. This article presents a review of literature on intravenous and intra-articular (topical) use of TXA in TKA.
    Case Report
    Ryosuke Sato*, Mitsuhiko Takahashi, Toshihiko Nishisho, Kenji Endo, and Koichi Sairyo
    Abstract: We here report a case of undifferentiated pleomorphic sarcoma (formerly malignant fibrous histiocytoma) arising in the femoral triangle where the tumor expanded by intratumoral hemorrhage and mimicked an intramuscular hematoma. T1- and T2-weighted magnetic resonance images showed a cystic mass containing septa and multiple nodules of heterogeneous intensity in the adductor muscle of the right thigh. Excisional biopsy indicated the tumor was an undifferentiated pleomorphic sarcoma. Following en-bloc resection, the patient has been free from recurrence or metastasis for 7 years. We discuss the salient features of this case and recent reports on cystic soft tissue tumors.
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