The correlation between clinical outcomes and preoperative/postoperative measures of the lateral center-edge angle (LCEA) will help establish the cutoff values for this measurement and determine whether to obtain it from the lateral acetabular rim (LCEA_R) or the lateral end of the sourcil (LCEA_S). The hypothesis was that the LCEA_S would be more sensitive than the LCEA_R. An upper cutoff value of LCEA could predict better functional outcomes in FAI patients. 106 patients (103 unilateral, 3 bilateral) who underwent hip arthroscopy surgery due to FAI and had a minimum 2-year follow-up were included. Patient-reported outcomes included the mHHS and visual analogue scale for pain (Pain VAS). Radiological parameters (alpha angle, LCEA_S, LCEA_R) were evaluated at the pelvis, 45° Dunn X-rays. A receiver operating characteristic analysis was used to evaluate the correlation between significant variables and achievement of patient-acceptable symptomatic state (PASS) and calculate area under the curve (AUC) and critical values for LCEA. The mean age of the patients was 34 ±10 years with a mean follow-up of 5 years. There were 75 male and 31 female patients. The mHHS improved from 57 ± 11 before surgery to 93 ± 8 after surgery (P < .001). The Pain VAS decreased from 6 before surgery to 1 after surgery (P < .001). A higher frequency of reaching the PASS threshold for mHHS was associated with lower preoperative and postoperative _dunn LCEA_S and postoperative _dunn LCEA_R. Preoperative _dunn LCEA_S ≤ 24.8° had an AUC of 0.67, predicting PASS (+) with 0.38 sensitivity and 0.93 specificity. Combining LCEA_S with other parameters further improved predictability. LCEA_S seems more predictive of clinical significance than LCEA_R. However, predictivity exceeds the acceptable limit when they are measured together. The upper values for LCEA_S and LCEA_R seem to be 24° and 35°, respectively.

Joint-preserving prosthetic reconstruction for massive bone defects has the potential to be a new and revolutionary treatment option. In this paper, we discuss the case of a 30-year-old female patient who presented with pain and swelling around the knee for three months. The patient underwent this procedure. Postoperative patient satisfaction, pain scores, and range of motion results were found to be promising. We believe that this method has the potential to be the next stage in the quest for better treatment options for this condition.

Background: Labral reconstruction using various graft materials, including autografts and allografts, is gaining popularity to address labral deficiencies. However, the biomechanical effects of graft size, type, and fixation techniques remain underexplored. Purpose/Hypothesis: The purpose was to evaluate the effects of graft size, graft type, tubularization, and anchor number on suction seal force and distractive stability in an ovine hip model. It was hypothesized that larger graft sizes and the use of allografts would improve the suction seal force and distractive stability compared with smaller grafts and fewer anchor numbers, while tubularization would have no significant effect. Study Design: Controlled laboratory study. Methods: A total of 40 sheep hip joints were randomly assigned to 5 groups. Labral excision was performed, followed by reconstruction using autografts or allografts. Ovine extensor tendons were chosen as autografts, whereas labrums from a different ovine hip were used for allografts. For group 1, autografts matching the original labral width were used. For group 2, autografts twice the original labral width were used. For group 3, allografts matching the original labral width were harvested from a different ovine hip. For group 4, autografts matching the original width were fixed with only 2 anchors. For group 5, autografts matching the original width were tubularized before use. Suction seal force was measured before and after reconstruction using an electromechanical testing system. Statistical analyses included Mann-Whitney U and Wilcoxon signed-rank tests ( P < .05). Results: Group 2 showed the highest improvement in suction seal force, outperforming all other groups ( P < .01). Group 4 exhibited the lowest distractive stability among all groups. Tubularization (group 5) did not enhance biomechanical performance ( P = .752). Group 3, reconstructed with an allograft, exhibited suction seal performance most closely approximating that of group 2, with no significant difference between them. Conclusion: The data from the ovine cadaveric model indicate that increasing the graft size enhances the suction sealing force; however, it remains below the measurements observed in an intact labrum. Furthermore, increasing the number of anchors and optimal graft selection improve postoperative biomechanical stability. Clinical Relevance: Optimizing graft size and fixation techniques in labral reconstruction may improve joint stability and suction seal function and may support surgical strategies aimed at improving outcomes and delaying the progression of osteoarthritis in patients with labral defects.

Background/Aim: Prolonged wound complications and the possibility of reoperations are significant outcomes following minor amputations. As time progresses after the initial surgery, re-amputations become more prevalent. Contrary to prevailing beliefs, the incidence of early amputations remains consistent. Additionally, it is widely acknowledged that the first 6 months following the initial surgery pose the highest risk period for reoperation. This retrospective clinical study aims to investigate the risk factors contributing to ipsilateral re-amputation procedures within 6 months of the initial minor amputation. Methods: A retrospective cohort study was conducted involving amputee patients from 2008 to 2020. Patients with traumatic events, musculoskeletal tumors, prior major amputations, and those who underwent soft tissue procedures such as debridement, incision, drainage, or secondary closure were excluded. Patients who had undergone preoperative lower limb arterial Doppler ultrasound and whose initial preoperative laboratory records were accessible were included. The total cohort comprised 168 patients, comprising 57 women and 109 men. The mean follow-up duration was 1.5 years (range: 1.1–3.2 years). Patients who underwent ipsilateral re-amputation were categorized into two groups based on the timing of the subsequent surgery. The first group comprised 110 (65.5%) patients who underwent ipsilateral re-amputation 6 months after the initial amputation, while the second group encompassed 58 (34.5%) patients who underwent ipsilateral re-amputation within 6 months of the initial amputation. Results: Among the 168 patients, 58 (34.5%) experienced ipsilateral re-amputation within 6 months of their initial minor amputations, while 64.5% underwent re-amputation surgery after the initial 6 months. The absence of peripheral arterial disease was not linked to early re-amputations (P=0.001). Although the mean C-reactive protein values (80.30 mg/dL and 84.26 mg/dL for groups 1 and 2, respectively) did not display significance between the groups (P=0.40), the group undergoing amputation within 6 months demonstrated significance with elevated serum white blood cell mean levels (10.44 mcL and 11.96 mcL for groups 1 and 2, respectively; [P=0.004]). Moreover, lower hemoglobin levels (11.41 g/dL and 10.77 g/dL for groups 1 and 2, respectively) were associated with re-amputation within the initial 6 months following the initial surgery (P=0.024). Conclusion: The study underscores that the incidence of re-amputation after minor amputations in diabetic patients is comparably high, as has been reported in recent literature. While the selection of the initial amputation level remains pivotal, and not all patient-specific factors were examined in this study, the research brings attention to specific laboratory values and the vascular status of the diabetic limb as crucial considerations for surgeons prior to the initial surgery. '+st+' Malay DS, Margolis DJ, Hoffstad OJ, Bellamy S. The incidence and risks of failure to heal after lower extremity amputation for the treatment of diabetic neuropathic foot ulcer. J Foot Ankle Surg. 2006 Nov-Dec;45(6):366-74. DOI: https://doi.org/10.1053/j.jfas.2006.08.002 Thorud JC, Jupiter DC, Lorenzana J, Nguyen TT, Shibuya N. Reoperation and reamputation after transmetatarsal amputation: a systematic review and meta-analysis. J Foot Ankle Surg. 2016;55:1007–12 DOI: https://doi.org/10.1053/j.jfas.2016.05.011 Van Damme H, Limet R. Amputation in diabetic patients. Clin Podiatr Med Surg. 2007;24:569-82. 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The alpha angle is a radiological measurement that has been proposed for the detection of cam morphology in patients suspected of femoroacetabular impingement syndrome (FAIS). After analysing published articles on FAIS, it is apparent that different types of circles are used in the measurement of alpha angles. To determine the interobserver and intraobserver reliability of alpha angle values measured using different types of circles on a 45° Dunn lateral radiograph in patients with symptomatic FAIS. The 45° Dunn lateral radiographs of the operated hips of patients who underwent hip preservation surgery in Dokuz Eylül University Hospital between 2014 and 2017 were evaluated retrospectively. Alpha angles were measured manually with transparent goniometers using three different circle types: thin full circle, thin-dashed circle, and thick full circle, and eye estimation without circle insertion. Measurements were made separately by an orthopaedist and a radiologist. A second measurement was made by the radiologist 1 month later for intraobserver reliability. Interobserver reliability for the thin full circle, thin-dashed circle, thick circle, and eye estimation (ICC = 0.645, 0.525, 0.494, and 0.588, respectively). Intraobserver reliability for the thin, thin-dashed, thick line, and eye estimation (ICC= 0.626, 0.681, 0.681, and 0.462 respectively). Interobserver difference of mean values of alpha angles for thin full, thin-dashed, thick full, and eye estimation were 2.7°, 0.9°, 1.1°, and 2.3°, respectively. Intraobserver differences between measurements were 1.5°, 0.9°, 0°, and 1.6°, respectively. Our study demonstrated that interobserver reliability is highest when measurements are made using a thin full circle.