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Background: A primary challenge in the treatment of capitellar osteochondritis dissecans (OCD) is accurate imaging assessment. Radiographic classification consensus is not available in the current literature, and correlation of radiographs with lesion stability and resultant best treatment is lacking. Purpose: To determine the inter- and intrarater reliability of the presence or absence and common radiographic characteristics of capitellar OCD lesions. Study Design: Cohort study (Diagnosis); Level of evidence, 3. Methods: Anteroposterior, lateral, and oblique radiographs for 29 cases were reviewed by 7 orthopaedic surgeons. Images were assessed for elbow anthropometry and morphology, OCD presence, lesion characteristics, the presence of progeny bone and progeny features, and radial head abnormalities. Intra- and interrater reliability was assessed using Fleiss and Cohen kappa for nominal variables and intraclass correlation coefficients (ICCs) for continuous variables. Results: Surgeons demonstrated substantial to excellent inter- and intrarater reliability when assessing elbow characteristics: anthropometric (interrater ICC, 0.94-0.99; intrarater ICC, 0.82-0.96) and morphologic (Fleiss, 0.61-0.76; Cohen, 0.68). When the OCD lesion was assessed, fair to moderate interrater agreement was found for classifying the absence or presence of a lesion (Fleiss, 0.28-0.46) and the location of the OCD (Fleiss, 0.24-0.52), poor agreement for assessing the contour of the lesion (Fleiss, 0.00-0.09), and excellent agreement for measuring the size of the lesion (ICC, 0.82-0.94). Poor to fair interrater agreement was found for radial head abnormalities (Fleiss, 0.00-0.27). Progeny bone visualization and fragmentation demonstrated moderate interrater agreement (Fleiss, 0.43-0.47) where displacement of the bone demonstrated poor interrater agreement (Fleiss, 0.11-0.16). Intrarater agreement for OCD lesion characteristics, progeny bone visualization, and progeny bone features was moderate to excellent. Conclusion: Given only the fair to moderate agreement among raters for identifying OCD on radiographs, this imaging modality may not serve as a dependable screening tool in isolation. Additional imaging should be obtained if the clinical presentation suggests capitellar OCD and a definitive diagnosis is not possible with radiographs. However, clinicians can reliability measure the size of radiographically apparent OCD, suggesting that radiographs may serve as an appropriate imaging modality for follow-up care. [ABSTRACT FROM AUTHOR]

The glenohumeral joint is innately complex and comprised of both static and dynamic stabilizers. Anterior glenohumeral instability has been estimated to have an incidence of 11.2 cases per 100,000 persons and typically follows a traumatic injury. Although there are specific instances when conservative management is advocated, a majority of these patients are treated with operative stabilization. Recent advancements in arthroscopy have created a shift from the traditional open stabilization procedures towards more minimally invasive arthroscopic stabilization procedures. This comprehensive review will summarize current concepts involved in evaluating patients with anterior glenohumeral instability and specifically focus on those patients who suffer from recurrent instability. [ABSTRACT FROM AUTHOR]

We describe a minimally invasive procedure for removal of a distal femur locking plate using arthroscopic assistance. Using lateral accessory portals, we performed arthroscopically-assisted removal of distal locking screws. Under fluoroscopic image, proximal screws were removed from the diaphysis. The accessory lateral portal sites used to remove the distal screws were connected. Through this arthrotomy, the plate was elevated from the distal femur and removed without difficulty. With this method we were able to concomitantly visualize the intra-articular regions while accomplishing the hardware removal. [ABSTRACT FROM AUTHOR]

The NKX3.1 gene located at 8p21.2 encodes a homeodomain-containing transcription factor that acts as a haploinsufficient tumor suppressor in prostate cancer. Diminished protein expression of NKX3.1 has been observed in prostate cancer precursors and carcinomas. TOPORS is a ubiquitously expressed E3 ubiquitin ligase that can ubiquitinate tumor suppressor p53. Here we report interaction between NKX3.1 and TOPORS. NKX3.1 can be ubiquitinated by TOPORS in vitro and in vivo, and overexpression of TOPORS leads to NKX3.1 proteasomal degradation in prostate cancer cells. Conversely, small interfering RNA-mediated knockdown of TOPORS leads to an increased steady-state level and prolonged half-life of NKX3.1. These data establish TOPORS as a negative regulator of NKX3.1 and implicate TOPORS in prostate cancer progression. [ABSTRACT FROM AUTHOR]

Total hip arthroplasty (THA) can be challenging in the setting of internal fixation devices previously placed in the proximal femur. When these devices are used in adolescent patients, endosteal hypertrophy can lead to significant bony overgrowth. Removal of these implants can result in significant cortical defects that may compromise the results of THA. This article describes a technique that can be used when a plate applied to the lateral femoral cortex has become "intracortical" as a result of extensive bony overgrowth. In using this technique to avoid plate removal, the surgeon eliminates the need for more extensive procedures aimed at compensating for deficiency of the femoral cortex in the area of plate removal.