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Paraneoplastic syndrome is defined as a systemic malignancy producing prostaglandins or other substances that lead to various manifestations, syndromes or diseases. In the following report we present a case of a young patient complaining of bilateral Baker's cysts who ultimately was diagnosed as suffering from gastric lymphoma. Following subtotal total gastrectomy the Baker's cysts disappeared with no specific treatment.

Mitteilung zweier Beobachtungen von Osteogenesis imperfecta tarda bei 6jährigem Mädchen und 7jährigem Jungen. Bei beiden im 1. Lebensjahr zahlreiche Spontanfrankturen mit entsprechenden Verbiegungen der Extremitätenknochen. Jetzt frische Spontanfrakturen: Im einen Fall glatte Heilung eines Oberschenkelbruchs im Laufe mehrerer Monate bei gleichzeitig vorhandenen multiplen Umbauzonen an den stark verbogenen Unterschenkelknochen, im anderen Fall langsame Konsolidierung eines älteren Oberschenkelbruchs und fehlende Heilungstendenz einer röntgenologisch als Umbauzone imponierenden pseudarthrotischen Tibiaspontanfraktur. Im einen Fall etwas erniedrigter Calcium blutspiegel. im anderen an der unteren Grenze der Norm befindlicher Calcium- und Phosphorsäureblutspiegel. Calcium- und Phosphorsäurestoffwechsel bleiben durch Calcium, Vitamin D und Höhensonnenbehandlung während mehrmonatiger Beobachtung unbeeinflußt. Nennenswerte Einwirkung dieser Faktoren auf Knochenumbau und Knochenregeneration nicht beobachtet. In einem Fall normale Knochenregeneration bei verzögertem Knochenumbau, im anderen verzögerte Callusbildung und Neigung zu Pseudarthrose.

Greater trochanteric pain syndrome (GTPS) is clinically defined as greater trochanter pain with mechanical characteristics. Most cases of GTPS are resolved with conservative treatment. Surgical techniques are reserved for those who had unsatisfactory results with conservative treatment. The aim of the present paper is to describe the outcomes observed within endoscopic treatment of peritrochanteric pathology. Twenty-three patients were included in the present study, undergoing surgery between January 2010 and December 2011, diagnosed with GTPS and surgically treated with endoscopy. All patients were evaluated with Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC) Modified Harris Hip Score (mHHS) and Hip Outcome Score (HOS). The Scales were assessed before surgery and at 3, 6 and 12 months postoperatively. All scores showed statistically significant differences (p < 0.001) within all periods. The endoscopic technique has proven to be safe and reproducible with good and excellent results, thus being an additional surgical procedure to consider within therapeutic management of greater trochanteric pain syndrome. IV. Case series

We describe a surgical technique of double-bundle ACL reconstruction with a single tibia tunnel and report the clinical outcome. The Achilles tendon portion was split longitudinally into two separate bundles, namely, an anteromedial (AM) bundle with 7–8 mm diameter and a posterolateral (PL) bundle with 4–6 mm diameter. The central portion of the calcaneal bone plug was prepared with a diameter of 10 mm and a length of 30 mm. For the femoral tunnel preparation, we preferred inside out target through an accessory anteromedial portal for an approach to native ACL footprint and outside in reaming through separate incision on the lateral aspect of distal thigh to prevent cartilage injury of medial femoral condyle. 10 mm diameter of single tibia tunnel was prepared at the central portion of ACL tibial footprint. After graft passage from tibia to femoral side, fixation of calcaneal bone plug within the tibia tunnel was performed using two bioabsorbable cross pins. Then, AM bundle was first fixed at 45° of flexion while the PL bundle was fixed at 10° of flexion using bioabsorbable interference screws and augmented staples. Clinical results of 22 patients (18 males and 4 females, average age 30.7 years) who underwent double-bundle anterior cruciate ligament (ACL) reconstruction with this technique were evaluated. At an average follow-up of 30 months, there was significant improvement of the Lysholm knee score, the 2,000 IKDC subjective knee score, the median Tegner activity score and the side-to-side difference. According to the 2,000 IKDC knee examination form, the grade rated as normal in seven patients, nearly normal in 14 patients and abnormal in one patient at the latest follow-up. There were no postoperative complications and revisional surgeries. Split Achilles allograft and single tibia tunnel technique for double-bundle ACL reconstruction can be an alternative option for patients with small tibial insertion sites. Level IV, therapeutic study.

The incidence of hip fracture in Finland was studied for the year 1988. During 1988, 6139 patients were treated for a fresh hip fracture. Three out of four hip fracture patients were women, and the occurrence of cervical fractures was 2.8 times and that of trochanteric fractures 2.5 times more common in women than in men. The incidence rates of hip fractures per 100000 were 174 in women, 70 in men and 123 in the whole population. The mean hospitalization time for fresh hip fractures was 33 days for cervical fractures and 38 days for trochanteric fractures. The costs of primary hospitalizations due to fresh hip fractures in 1988 were estimated at US $ 66 million.

To investigate fast-track rehabilitation concept in terms of a measurable effect on the early recovery after total knee arthroplasty (TKA). This was an open, randomized, prospective clinical study, comparing the fast-track rehabilitation—a pathway-controlled early recovery program (Joint Care®)—with standard postoperative rehabilitation care, after TKA. Overall, 147 patients had TKA (N = 74 fast-track rehabilitation, N = 73 standard rehabilitation). The fast-track rehabilitation patients received a group therapy, early mobilization (same day as surgery) and 1:1 physiotherapy (2 h/day). Patient monitoring occurred over 3 months (1 pre- and 4 post-operative visits). The standard rehabilitation group received individual postoperative care according to the existing protocol, with 1:1 physiotherapy (1 h/day). The cumulative American Knee Society Score (AKSS) was the primary evaluation variable, used to detect changes in joint function and perception of pain. The secondary evaluation variables were WOMAC index score, analgesic drug consumption, length of stay (LOS), and safety. After TKA, patients in the fast-track rehabilitation group showed enhanced recovery compared with the standard rehabilitation group, as based on the differences between the groups for the cumulative AKSS (p = 0.0003), WOMAC index score (<0.0001), reduced intake of concomitant analgesic drugs, reduced LOS (6.75 vs. 13.20 days, p < 0001), and lower number of adverse events. For TKA, implementation of pathway-controlled fast-track rehabilitation is achievable and beneficial as based on the AKSS and WOMAC score, reduced intake of analgesic drugs, and reduced LOS.