UNASSIGNED: Ankylosing spondylitis (AS) is an inflammatory spondyloarthropathy, often involving the spine and sacroiliac joints. Total hip arthroplasty (THA) has been shown to be effective in improving pain and function in patients with AS with hip involvement. However, extraskeletal manifestations and altered mechanics in those with AS leads to increased complications. Thus, the aims of this study were to assess the effects that AS has on medical and implant complications, falls, length of stay, and readmissions following THA.
UNASSIGNED: A retrospective review of the Mariner private insurance claims database was conducted from 2010 to 2020. All cases of THA and those with AS were identified using Current Procedural Terminology, and International Classification of Disease 9th and 10th revision codes. Patients who underwent THA with a diagnosis of AS were matched to non-AS patients 1:5 based on demographic and comorbidity profiles. 90-day medical complications, falls, and readmission rates, as well as 2-year implant complications were compared between cohorts.
UNASSIGNED: A total of 6509 AS patients were matched to 32,489 control patients. The AS group had significantly higher rates of myocardial infarction, cerebrovascular accident, deep vein thrombosis, pulmonary embolism, urinary tract infection, wound complications, acute kidney injury, pneumonia, sepsis, transfusions, and falls when compared to the control group. The AS group had significantly higher rates of prosthetic joint infection, dislocation, mechanical loosening, and periprosthetic fracture (all p < 0.0001). Likewise, mean length of stay and readmissions were significantly greater in the AS group.
UNASSIGNED: Ankylosing spondylitis in patients undergoing THA is associated with significant risk of medical and implant complications, as well as fall risk, length of stay, and readmission rates. These findings may allow orthopaedic surgeons to be more attentive in identifying those patients at risk and allow for more educated patient counseling and perioperative planning.

BACKGROUND: Total talus dislocation without ankle (malleoli) fracture is a very rare injury with prevalence of only 0.06% of all dislocations and only 2% of talar injuries, and are usually associated with common complications such as infection, avascular necrosis, and posttraumatic arthritis. The treatment usually involves debridement, reduction, stabilization of the ankle joint, and primary or secondary closure of the wound.
METHODS: We present the case of a 40-year-old South Asian woman who was involved in an accident. She was rushed to our hospital, whereby subsequent examination revealed an open total talus dislocation with the talus being exposed in its entirety from a contaminated wound in the medial side. Furthermore, radiograph confirmed total talus dislocation without concomitant malleoli fracture. She was immediately taken to the operating theater whereby debridement and immediate reduction was performed under anesthesia, and the ankle was stabilized with external fixator for about 6 weeks. She is now able to bear weight on the affected ankle with minimal tolerable pain and has normal range of motion of the ankle.
CONCLUSIONS: Open total talus dislocation without concomitant malleoli fracture is a rare injury. Reduction of the talus in combination with complete wound debridement potentially successfully avoids infection, provides early revascularization preventing avascular necrosis, and preserves the normal ankle anatomy.

Elbow dislocations are among one of the most frequently dislocated joints, with an incidence of five to six cases annually per 100,000 persons in the United States. The vast majority of elbow dislocations occur posteriorly, secondary to a disruption in the anterior elbow- and posterior elbow-stabilizing structures. Anterior elbow dislocations are rare injuries in both children and adults, occurring as the proximal ulna is forced anterior to the distal humerus with or without the proximal radius. As of 2019, only 21 anterior elbow dislocations without fractures have been reported between 1922 and 2018. Here, we report the rare case of a patient that sustained a complex anterior elbow dislocation after being involved in a motor vehicle collision.

Background Dislocation is one of the most prominent and challenging complications following the revision of total hip arthroplasty (THA). Dual-mobility cups are an option to address this problem. There is, however, little data on the outcomes of modern modular dual-mobility (MDM) cups in the revision of THA. In this study, the clinical and radiological outcomes following the revision of THA with an MDM cup using the direct anterior approach (DAA) were evaluated. Methodology We retrospectively reviewed patients who underwent a revision of THA between March 2017 and July 2019. The inclusion criteria were a revision of THA using an MDM cup through the DAA. A uniform acetabular implant was used in each revision. Outcome measures were assessed radiographically and clinically. The clinical outcome measures consisted of dislocation, infection, and re-revision. Functional assessment was performed using the Harris Hip Score preoperatively and at the last clinical examination in our department. Results This study retrospectively identified a cohort of 26 patients who underwent a revision of THA. Two patients were excluded due to incomplete follow-up because they died. Finally, 24 patients were included. A total of 17 isolated acetabular revisions and seven complete revisions were performed with a mean follow-up of 39 months (range = 29-59). No dislocations or deep infections were observed in our population to date. Except for one case of early aseptic loosening of the acetabular component, we observed no other signs of loosening, osteolysis, migration, or intraprosthetic dislocation. Conclusions THA revision through the DAA using an MDM cup is a safe and effective procedure. We observed no dislocation in a high-risk population undergoing THA revision surgery during a minimal follow-up of two years.

UNASSIGNED: The outcomes of revision total hip arthroplasty (rTHA) have become increasingly important as their volume increases. Computer navigation, a reliable method to improve component positioning during primary total hip arthroplasty (THA), is not well studied in the rTHA setting. Given that dislocation rates following rTHA are significantly higher than those of primary THA, component positioning becomes paramount in these cases.
UNASSIGNED: Here, we present two case reports and surgical techniques, one of a 77-year-old man undergoing rTHA for recurrent hip instability following primary THA, and one of a 61-year-old woman undergoing rTHA for severe iliopsoas bursitis who was at increased risk for instability and dislocation given her history of large segment spinal fusion.
UNASSIGNED: Both patients achieved optimal acetabular component positioning after rTHA with imageless computer navigation.
UNASSIGNED: The use of imageless computer navigation in rTHA provides accurate and reproducible component positioning during acetabular rTHA.

Bilateral asymmetric hip fracture dislocation is an extremely rare entity. The injury is caused by a high velocity mechanism. We reported a case of bilateral hip fracture dislocation and its management. A 30-year-old man with no previous medical or surgical history was involved in a road accident involving a high-speed collision between two trucks. X-rays of the pelvis revealed asymmetrical bilateral fracture-luxation of the hips. The reduction of the hips was done under general anesthesia. Asymmetrical bilateral traumatic dislocation fracture of the hip is a rare serious injury. Reduction must be performed within 6 hours. Short- and long-term monitoring of the patient is essential.

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UNASSIGNED: Surgical treatment of bilateral traumatic sternoclavicular (SC) joint dislocations has never been reported in the literature. In the acute setting, posterior dislocation can present with a host of comorbidities due to structures that lie in close proximity posterior to the medial clavicle.
UNASSIGNED: This study presents a case of bilateral traumatic posterior SC joint dislocation with associated brachiocephalic injury that was treated with open reduction and surgical stabilization.
UNASSIGNED: This is a rare case of bilateral posterior sternoclavicular joint dislocation that underwent open surgical intervention. Treatment of this injury resulted in excellent radiographic and clinical outcomes at 2-year follow-up.

Isolated volar distal radioulnar joint (DRUJ) dislocation is a rare condition with only a few cases reported in the literature. Its diagnosis is often overlooked in the acute phase, and there is no consensus in its management. We present the case of a 20-year-old male patient with an isolated volar radioulnar dislocation, together with a review of the literature. The aim is to present and summarize the acute management of this condition and propose a therapeutic algorithm.

Medial swivel dislocation is a rare subtype of midtarsal bone dislocation, mostly associated with fracture rather than isolated dislocation. It is caused by medially or laterally direct forces to the midfoot. In case of failed closed reduction of the deformity, the patient should undergo open reduction and stabilization of the injury as soon as possible. We are presenting a 17-year-old, male, who sustained a left ankle injury and presented with a deformity, closed reduction of the deformity failed multiple times, and the patient was taken for open reduction and stabilization of the deformity in the operating theater. Intra-operatively, the dislocation was locked with the lateral process of the navicular being impacted into the taller head. Six months following the injury the patient was back to his pre-injury status and did not have any recurrent dislocation of the midfoot.