Chondrosarcoma is the second most common surgically treated primary bone sarcoma. Despite a large number of scientific papers in the literature, there is still significant controversy about diagnostics, treatment of the primary tumour, subtypes, and complications. Therefore, consensus on its day-to-day treatment decisions is needed. In January 2024, the Birmingham Orthopaedic Oncology Meeting (BOOM) attempted to gain global consensus from 300 delegates from over 50 countries. The meeting focused on these critical areas and aimed to generate consensus statements based on evidence amalgamation and expert opinion from diverse geographical regions. In parallel, periprosthetic joint infection (PJI) in oncological reconstructions poses unique challenges due to factors such as adjuvant treatments, large exposures, and the complexity of surgery. The meeting debated two-stage revisions, antibiotic prophylaxis, managing acute PJI in patients undergoing chemotherapy, and defining the best strategies for wound management and allograft reconstruction. The objectives of the meeting extended beyond resolving immediate controversies. It sought to foster global collaboration among specialists attending the meeting, and to encourage future research projects to address unsolved dilemmas. By highlighting areas of disagreement and promoting collaborative research endeavours, this initiative aims to enhance treatment standards and potentially improve outcomes for patients globally. This paper sets out some of the controversies and questions that were debated in the meeting.
Introduction: Periprosthetic fractures are a devastating complication following total knee arthroplasty. Little is known about the effect of mechanical factors on the incidence of periprosthetic fractures. The aim of this study was to examine the correlation between pre-operative mechanical factors, like side of surgery, coronal alignment and pre-operative range of motion and intra-operative factors, and the incidence of a periprosthetic fracture, following primary total knee arthroplasty (TKA). Materials and Methods: Forty-two patients with periprosthetic fractures (PPF) after primary TKA were identified from our hospital arthroplasty registry. These patients were matched two-to-one for gender and age at primary knee arthroplasty to 84 patients without PPF. The incidence of periprosthetic fracture with regards to laterality, coronal alignment and pre-operative range of motion was analysed. Intra-operative factors like implant type, patellar resurfacing and notching were also analysed using logistic regression. Results: Coronal alignment, pre-operative range of motion and patella resurfacing were not significant predictors of periprosthetic fractures. Anterior femoral notching was found to be significantly higher in the fracture group with an odds ratio of 17. Left sided surgery was also significantly higher in the periprosthetic fracture group. Conclusion: Periprosthetic fractures are 17 times more likely to occur in a knee with anterior femoral notching. Preoperative factors like coronal alignment and poor preoperative range of motion do not seem to increase the risk of periprosthetic fractures after TKA.
Texture-modified food has become an important strategy in managing dysphagia. Pureed food is proven to be the safest texture due to its high viscosity which can slow down the rate of the food bolus during swallowing. In this study, texture-modified chicken rendang was developed according to Texture C (smooth puree) as described by the Australian standard for texture-modified food. Samples were added with five different thickeners (sago starch, tapioca starch, modified corn starch, xanthan gum and carboxymethyl cellulose gum) at three different concentrations (10, 20 and 30% w/w). Their rheological effects were analyzed through dynamic and steady shear test. Results obtained reveals that samples contained xanthan gum have higher structure rigidity and shear thinning behaviour, while carboxymethyl cellulose gum provides the highest viscosity as well as yield stress than other samples. In terms of concentration, a strong dependence of structural rigidity and viscosity of all prepared samples with amount of thickeners added was observed. Overall, based on its rheological properties, the addition of carboxymethyl cellulose gum at 30% concentration was found to be the most suitable thickener, to be incorporated in the texture-modified chicken rendang. Selecting a suitable food thickener in developing food for individual with dysphagia plays an important role to ensure the right texture and consistency for their safe consumption.