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Context: Scapular strengthening is thought to be an important component of the rehabilitation of patients with internal impingement. Objective: To determine the effect of scapular-retractor-muscle fatigue on internal- and external-rotation-torque production in patients with internal impingement. Design: Case control study. Setting: Outpatient clinic. Participants: 15 patients and 18 healthy subjects. Intervention: A scapular-retractor-fatigue protocol. Main Outcome Measure: Shoulder-rotation-torque production. Results: After the scapular-retractor-fatigue protocol external-rotation strength was reduced in patients (involved 25%, noninvolved 19%; P < .001). Conclusion: Fatigue in the scapular retractors resulted in lower shoulder-rotation-torque production. These findings emphasize the importance of the scapular retractors for proper function of the shoulder rotators with the arm in an abducted position in patients with internal impingement. [ABSTRACT FROM AUTHOR]

Previous studies have suggested that femoral component positioning in resurfacing arthroplasty may affect strains in the femoral neck that could lead to decreased implant longevity, A strain gaged, Sawbones(®) model was used to determine the femoral neck strains for a variety of resurfacing head translations and angulations. We found that head positions affected strain distributions, most positions leading to increased neck strains, often over 100%, with the exception being a varus head position where the superior neck strains decreased over 50%. Although the clinical meaning of these findings is unclear, it could be of concern for stress-shielding or fatigue fracture of the femoral neck. [ABSTRACT FROM AUTHOR]

Treatment of the young patient with degenerative disease of the hip has historically been a difficult problem for the orthopaedist. Total hip arthroplasty in the young patient has generally produced inferior results as compared to older patients. Surface replacement arthroplasty (SRA) was initially developed over 50 years ago to treat degenerative disease of the hip. It has regained enthusiasm over the last 10 to 15 years as an alternative to total hip arthroplasty for the treatment of degenerative disease of the hip in younger patients. The modern metal-on-metal bearing provides improved wear characteristics over its metal-on-polyethylene predecessor. Multiple studies have demonstrated mid-term results of metal-on-metal SRA, which are comparable to total hip arthroplasty. The long-term survival data of SRA remains to be seen, as does the long-term effect of elevated serum ion levels. [ABSTRACT FROM AUTHOR]

El artículo explora las lesiones osteocondrales del astrálago. Estas lesiones son poco frecuentes y secundarias a traumatismos previos del tobillo. Se menciona que el correcto diagnóstico de estas lesiones es importante a causa de su limitada capacidad de reparación. Aunque la radiografía es utilizada como una herramienta diagnóstica, la resonancia magnética también es usada. El artículo discute los avances recientes en cuanto a los injertos osteocondrales.