Loose Body in the Knee Joint: A Case Report

Background: Loose bodies (LBs) within the knee joint are commonly encountered during clinical practice and are frequently observed during knee arthroscopy. The primary treatment involves the removal of loose bodies;however, their complete eradication is often challenging and may not address underlying diseases, leading to persistent symptoms and the risk of new loose body formation. Aim: This case report aims to present the findings and surgical management of a 52-year-old male with an unusually large osseous loose body in the knee joint and associated pathologies. Case Presentation: The patient, a 52-year-old male, experienced recurrent episodes of severe, sudden, and painful locking of the knee joint, leading to difficulties moving. A plain MRI study was conducted to evaluate the condition of the knee joint, which revealed various degenerative changes and the presence of a loose body. Subsequently, an arthroscopic examination was performed under general anesthesia, uncovering the presence of an abnormally large loose body, as well as other pathologies including chondropathy, meniscal degeneration, and Baker’s cyst. Conclusion: Loose bodies (LBs) in the knee joint pose significant challenges and may lead to debilitating symptoms. Timely diagnosis and appropriate surgical intervention are crucial for symptom relief and the prevention of further joint damage as arthroscopic excision. Comprehensive imaging has a vital role in guiding treatment decisions and optimizing patient outcomes. In this case, the removal of the loose body improved patient outcomes and helped prevent potential joint complications.

Knowledge and attitudes of orthopedic surgeons regarding prosthesis joint infection

BACKGROUND Periprosthetic joint infection(PJI)is a critical complication after joint arthroplasty and is accompanied by increasing rates of morbidity and mortality.Several studies have aimed at preventing PJI.AIM To research the knowledge level and attitudes of orthopedic surgeons,who play a key role in both preventing and managing PJI.METHODS We conducted a web-based survey to evaluate orthopedic surgeons'knowledge level and attitudes regarding PJI.The Likert scale survey utilized consisted of 30 questions which were prepared based on the"Proceedings of the International Consensus on Periprosthetic Joint Infection".RESULTS A total of 264 surgeons participated in the survey.Their average age was 44.8,and 173 participants(65.5%)had more than 10 years of experience.No statistically significant relationship was found between the PJI knowledge of the surgeons and their years of experience.However,participants who worked in training and research hospitals demonstrated higher levels of knowledge than the ones in the state hospitals.It was also noticed that surgeons'knowledge concerning the duration of antibiotic therapy and urinary infections was not consistent with their attitudes.CONCLUSION Even though orthopedic surgeons have adequate knowledge about preventing and managing PJI,their attitudes might contradict their knowledge.Future studies are required to examine the causes and solutions of the contradictions between orthopedic surgeons'knowledge and attitudes.

Weld Joint Efficiency of the Kazakhstani Constructional Steel

In the Republic of Kazakhstan, the regulatory framework in construction based on Eurocodes has been in force since 2015. However, Kazakhstani produced steel has not been studied for compliance with the requirements of Eurocode 1993. This has resulted in limited use of Kazakhstani structural steel in construction. The feasibility of using structural steel in welded joints has been experimentally investigated. To verify the application of such joints in construction, including earthquake engineering, experimental studies of welded joints made of structural steel produced by Arcelor-Mittal in Temirtau have been carried out. In total, 7 types of structural steel of various thicknesses were selected. Five specimens have been used in each series of tests. The Brinell hardness values of the weld joint, yield strength of steel and tensile strength, relative rupture strain were determined. It was found that for all types of structural steel, the quality of weld joints complied with the requirements of Eurocode 1993—a sample rupture appeared along the plates (main body of the metal), not along the weld joints. It has been established that structural steel produced in the Republic of Kazakhstan fully complies with the requirements of Eurocode 1993. The studies on the dependence of Brinell hardness values of weld joint steel on the yield strength, tensile strength and relative rupture strain have been carried out. The correlation dependences between the values of yield strength of steel and tensile strength, relative rupture strain and BH Brinell hardness were studied. The results of work will allow for significantly increasing the use of Kazakhstani structural steel in seismic and conventional areas of the Republic of Kazakhstan.

Geometrical characteristic investigation of the Baihetan irregular columnar jointed basalt and corresponding numerical reconstruction method

Columnar jointed rock mass with unique geometric and geological properties is one spectacular example of geometrical order in nature.Columnar joints are generally accepted to be formed by spatially uniform volume contraction during cooling.In this paper,substantial field work was performed to study the geological characteristics of irregular columnar jointed basalt on the left bank dam foundation in the Baihetan Hydropower Station,where the columnar jointed rock mass is extensively exposed due to excavation.The quantitative measurements of the sizing of polygonal crack pattern of columnar joints and assessment of their degree of irregularity were summarized.Considering the irregularity of polygonal crack pattern,a modified Voronoi polygon(MVP)method was developed to model the special polygonal crack pattern of columnar joints.The new polygonal pattern obtained by the MVP method consists of a large number of irregular polygons,of which the degree of irregularity is consistent with the field measurement results.This method can reproduce the rapid evolution from an initial ideal regular hexagonal pattern to a final actual irregular polygonal pattern as the degree of irregularity increases.The compression tests of columnar jointed rock mass with different irregularity show that the geometric irregularity has a great influence on its mechanical properties.This numerical construction method provides a reliable way to reconstruct columnar joint structure with specific polygonal crack pattern,which is consistent with onsite columnar jointed basalt.

Non-albicans Candida prosthetic joint infections: A systematic review of treatment

BACKGROUND Non-albicans Candida prosthetic joint infections (PJIs) are rare. Optimal treatment involves a two-stage revision surgery in combination with an antifungal agent. However, no clear guidelines have been developed regarding the agent or treatment duration. Hence, a broad range of antifungal and surgical treatments have been reported so far. AIM To clarify treatment of non-albicans Candida PJIs. METHODS A literature review of all existing non-albicans Candida PJIs cases through April 2018 was conducted. Information was extracted about demographics, comorbidities, responsible species, duration and type of antifungal treatment, type of surgical treatment, time between initial arthroplasty and symptom onset, time between symptom onset and definite diagnosis, outcome of the infection and follow-up. RESULTS A total of 83 cases, with a mean age of 66.3 years, were located. The causative yeast isolated in most cases was C. parapsilosis (45 cases;54.2%), followed by C. glabrata (18 cases;21.7%). The mean Charlson comorbidity index was 4.4 ± 1.5. The mean time from arthropalsty to symptom onset was 27.2 ± 43 mo, while the mean time from symptom onset to culture-confirmed diagnosis was 7.5 ± 12.5 mo. A two stage revision arthroplasty (TSRA), when compared to one stage revision arthroplasty, had a higher success rate (96% vs 73%, P = 0.023). Fluconazole was the preferred antifungal agent (59;71%), followed by amphotericin B (41;49.4%). CONCLUSION The combination of TSRA and administration of prolonged antifungal therapy after initial resection arthroplasty is suggested on the basis of limited data.

Treatment of condylar osteophyte in temporomandibular joint osteoarthritis with muscle balance occlusal splint and long-term follow-up:A case report

BACKGROUND Condylar osteophytes,a remodeling form of temporomandibular joint osteoarthritis(TMJ OA),mainly manifest as marginal angular outgrowths of the condyle.Previous researchers have advocated surgical removal of condylar osteophytes.Reports on the effect of occlusal splint on TMJ OA patients’joints have mostly focused on treatment with this splint,which can reduce the absorption of the affected condyle and promote repair and regeneration.However,the effect of the splint on the dissolution of condylar osteophytes has not yet been reported.CASE SUMMARY A 68-year-old female patient suffered from occlusal discomfort with left facial pain for 2 years.Cone beam computed tomography showed a rare osteophyte on top of her left condyle.She was finally diagnosed with TMJ OA.The patient refused surgical treatment and received conservative treatment with a muscle balance occlusal splint.The pain experienced by the patient on the left side of her face was relieved,and her chewing ability recovered after treatment.The osteophyte dissolved,and the condylar cortex remained stable during long-term follow-up observations.CONCLUSION The muscle balance occlusal splint could be a noninvasive means of treating condylar osteophytes in TMJ OA patients.

Dental Treatment for Dizziness and Joint Mobility Disorder Caused by Harmful Electromagnetic Waves

With the development of an IT (Information Technology) society, the opportunity to use electronic devices, such as cell phones and personal computers, has increased. These electronic devices pro-vide many benefits to society. However, there have been a number of reports of electromagnetic hypersensitivity (EHS) related to the use of electronic devices. The symptoms of EHS may include headaches, fatigue, tinnitus, dizziness, memory loss, irregular heartbeat, and skin trouble. Since the pathogenic mechanism of such conditions is not yet clear, further research is required. This report shows how a subject’s dizziness and joint mobility disorder, caused by electromagnetic waves emitted by electronic devices, were cured by removing an onlay from the patient’s mouth and replacing it with a gold alloy onlay. The result indicates that the subject’s symptoms were caused by EHS. Although the symptoms were improved after the dental treatment, the underlying mechanism of the symptoms and the reason why this treatment is successful remain unclear. Further research is required to clarify these issues.

Effect of Post-weld Heat Treatment on Microstructure and Fracture Toughness of 30CrMnSiNi2A Steel Welded Joints

The electron beam local post-weld heat treatment (EBLPWHT) is a rather new method that provides the advantages of high precision, flexibility and efficiency, energy saving and higher productivity. This paper studies the effect of two post-weld heat treatment processes on the microstructure, mechanical properties and fracture toughness of an electron beam welded joints in 30CrMnSiNi2A steel. EBLPWHT, in a vacuum chamber, immediately after welding and a traditional furnace whole post-weld heat treatment (FWPWHT) were compared. The experimental results show that, after EBLPWHT treatment, the main microstructure of weld was changed from coarse acicular martensite into lath martensite, HAZ was changed from lath martensite, bainite into lower bainite, and base metal was changed from ferrite and pearlite into upper bainite and residual austenite. The microstructures of different zones of joints in FWPWHT condition were tempered sorbite. The properties of welded joints can be improved by the EBLPWHT in some extent, and especially largely for the fracture toughness of welded joints. However the value of fracture toughness of base metal is comparatively low, so appropriate heat treatment parameters should be explored in the future.

Regional Coordinated Development and Joint Prevention and Control for Environmental Protection in China in the New Era

The three important historical development stages of China from"standing up","getting rich"to"becoming strong"were analyzed deeply.Regional coordinated development policies and strategies have also gone through the"enlightenment stage","development stage"and"mature stage".On this basis,the problems of the coordination of China s regional coordinated development and joint prevention and control for environmental protection in the new era,as well as suggestions for the next step were further analyzed.

Early diagnosis and treatment of pulmonary embolism after total joint replacement: report of five cases

Objective To study the early diagnosis and treatment of pulmonary embolism (PE) after total joint replacement (TJR). Methods From April 1987 to December 2001, we performed 1 336 total knee replacements (TKR) in 926 patients and 1 745 total hip replacements (RHRs) in 1 566 patients. In this group there were 5 PE patients after operation. Two patients died (all after TKR), and 3 patients salvaged successfully (2 after TKR, 1 after THR). Results The total incidence of PE after TJR was 0. 2% (5/2 492), the incidence of PE after TKR was 0. 4% (4/926), and the incidence of PE after THR was 0.06% (1/1 556). In the patients who suffered PE, 2 died. The incidence of PE before 2000 was 0%. Conclusion Death after total joint replacement is due to pulmonary embolism ( PE), especially massive PE. The incidence of PE after TKR is higher than that after THR. Pulmonary angiography is the gold standard for the diagnosis of PE. With more understanding on PE and more popularity of joint replacement, the diagnosis of PE

Decompression via posterior-anterior approach and anterior fixation in treatment of fracturedislocation of the lower cervical spine with bilateral facet joints dislocation

Objective To evaluate surgical strategy of decompression via posterior-anterior approach and anterior fixation in treatment fracture-dislocation of lower cervical spine with bilateral facet joints dislocation. Methods This

Evaluation of the Effectiveness and Efficiency of Extracorporeal Shock Wave Combined with Rehabilitation Training in the Treatment of Muscle Articulation Chronic Pain

Objective: To analyze the effect of combined extracorporeal shock wave and rehabilitation training treatment in patients with muscle articulation chronic pain (MACP). Methods: Ninety-seven MACP patients admitted to our hospital from September 2021 to September 2023 were randomly selected and were divided into Group A (control group, 46 cases, rehabilitation training treatment) and Group B (observation group, 51 cases, extracorporeal shock wave with rehabilitation training treatment), and outcomes of the two groups were compared. Results: The treatment efficiency, post-treatment clinical indexes (upper and lower limb function scores, activities of daily living (ADL) scores, visual analog scale (VAS) scores), and short-form 36 (SF-36) scores of Group B were better than those of Group A (P < 0.05). Conclusion: Combined extracorporeal shock wave and rehabilitation training treatment for MACP patients improved their limb function, daily activities, quality of life, and reduced pain.

Improving the fatigue property of welded joints for AZ31 magnesium alloy by ultrasonic peening treatment

The fatigue property of AZ31 magnesium alloy and its TIG welded joints were investigated. The ultrasonic peening treatment （UPT） was used to improve the fatigue property of the TIG welded joints, which was treated at the weld toe by the UPT process. The test results show that the fatigue strength of the base metal of AZ31 magnesium alloys is 57.8 MPa, and those of the fillet joint and the transverse cross joint are respectively 20. 0 MPa and 17.2 MPa at 2 × 10^6 cycles. The fatigue strengths of two kinds of welded joints treated by the UPT are respectively 30. 3 MPa and 24. 7 MPa, which have been improved by 51.5% and 43.6%, respectively. The fatigue life of the fillet joint specimens is prolonged by about 2. 74 times and the fatigue life of the transverse cross joint specimens is prolonged by about 1.05 times when the stress range is at 40. 0 MPa.

Identification and preoperative optimization of risk factors to prevent periprosthetic joint infection

Despite significant improvements over the past several decades in diagnosis,treatment and prevention of periprosthetic joint infection(PJI),it still remains a major challenge following total joint arthroplasty.Given the devastating nature and accelerated incidence of PJI,prevention is the most important strategy to deal with this challenging problem and should start from identifying risk factors.Understanding and well-organized optimization of these risk factors in individuals before elective arthroplasty are essential to the ultimate success in reducing the incidence of PJI.Even though some risk factors such as demographic characteristics are seldom changeable,they allow more accurate expectation regarding individual risks of PJI and thus,make proper counseling for shared preoperative decision-making possible.Others that increase the risk of PJI,but are potentially modifiable should be optimized prior to elective arthroplasty.Although remarkable advances have been achieved in past decades,many questions regarding standardized practice to prevent this catastrophic complication remain unanswered.The current study provide a comprehensive knowledge regarding risk factors based on general principles to control surgical siteinfection by the review of current literature and also share own practice at our institution to provide practical and better understandings.

Surface grain refinement mechanism of SMA490BW steel cross joints by ultrasonic impact treatment

Ultrasonic impact treatment (UIT) is a postweld technique for improving the fatigue strength of welded joints. This technique makes use of ultrasonic vibration to impact and plastically deform a weld toe and can achieve surface grain refinement of the weld toe, which is considered as the main reason for the improvement of fatigue strength. In this paper, the microstructure of the surface of a treated weld toe was observed by metallographic microscopy and transmission electron microscopy (TEM). The results show that UIT could produce severe plastic deformation on the surface layer of the weld toe and the maximum depth of plastic deformation extended to approximately 260 μm beneath the treated surface. Repeated processing could exacerbate the plastic deformation on the surface layer, resulting in finer grains. We can conclude that the surface grain refinement mechanism of SMA490BW welded joints is related to the high density of dislocation tangles and dislocation walls. © 2017, University of Science and Technology Beijing and Springer-Verlag Berlin Heidelberg.

Effects of laser heat treatment on salt spray corrosion of 1Cr5Mo heat resistant steel welding joints

The surface of 1Cr5 Mo heat-resistant steel welding joint was processed with CO2 laser, and the corrosion behaviors before and after laser heat treatment(LHT) were investigated in the salt spray corrosion environments. The microstructures, phases, residual stresses and retained austenite content of 1Cr5 Mo steel welding joint before and after LHT were analyzed with optical microscope and X-ray diffraction, respectively. The cracking morphologies and chemical compositions of corrosion products after salt spray corrosion were analyzed with field emission scanning electron microscopy(FESEM) and energy disperse spectroscopy(EDS), respectively, the polarization curves were measured on a PS-268 A type electrochemical workstation, and the mechanism of corrosion resistance by LHT was investigated as well. The results show that the passive film of original sample is destroyed owing to the corrosive media penetrating into the subsurface, resulting in the redox reaction. The content of residual austenite in the surface and the self-corrosion potential are increased by LHT, which is contributed to improving the capability of salt spray corrosion resistance.

Improved Fatigue Behavior of Pipeline Steel Welded Joint by Surface Mechanical Attrition Treatment(SMAT)

A pipeline steel X80 with welded joint was subjected to surface mechanical attrition treatment （SMAT）. After SMAT, a nanostructure surface layer with an average grain size of about 10 nm was formed in the treated sample, and the fatigue limit of the welded joint was elevated by about 13% relative to the untreated joints. In the low and the high amplitude stress regimes, both fatigue strength and fatigue life were enhanced. Formation of the nanostructured surface layer played more important role in the enhanced fatigue behavior than that of residual stress induced by the SMAT.

Effect of heat treatment temperature on dissimilar welded joint

The dissimilar metals 1Crl8Ni9 and 16MnR are welded by shielded metal arc welding process using electrode A312. The corrosion experiments are carried out on welded joint samples, which is as-welded and post-weld heat treatment at 650 ℃, 750 ℃ and 850 ℃, for 2 h in 70% sodium hydroxide solution. EDS and X-ray diffraction analysis are carried out on the samples after corrosion. Average corrosion rate calculation and microhardness measurement are conducted on both as- welded and post-weld heat treatment samples. The results indicate that average corrosion rate of as-welded joint metal is smaller than that of post-weld heat treatment joint metal. Compared with that of post-weld heat treatment at 750 ℃ and 850 ℃ for 2 h, the average corrosion rate of welded joint after post-weld heat treatment at 650 ℃ for 2 h increases greatly.

Hip Joint Osteoarthritis Pain Sources and Control

Hip joint osteoarthritis, a widespread disabling disease with no known cause, produces considerable bouts of intractable pain as a result of multiple disease associated problems. This paper examines some sources of osteoarthritic hip joint pain, a poorly understood topic at best. Presented in three parts are data retrieved from several sources, including animal models. It is concluded that to improve the effectiveness of treatments designed to minimize hip osteoarthritis pain, a better understanding of the diverse origins of hip joint pain, and hip joint neurology, may permit the development of more precise as well as targeted pain strategies.