Cleveland University-Kansas City

The infrapatellar branch of the saphenous nerve (IPBSN) is implicated in nerve injury from different knee surgeries because of its intimate course relative to the knee joint capsule. Pain physicians encounter patients in their practice for the management of neuralgia of this nerve or in the context of advanced management of knee osteoarthritis. This article aims to provide a comprehensive review of the anatomy, sonoanatomy, and the intervention of the IPBSN in pain management of infrapatellar neuralgia and chronic knee pain.

Ponte osteotomy (PO) is frequently used in corrective surgery, yet its specific effect on vertebral rotation correction remains unclear. This study systematically reviewed the literature to compare PO with alternative techniques in patients with idiopathic scoliosis. Following PRISMA methodology, MEDLINE, Embase, and Web of Science were searched for comparative studies assessing axial rotation outcomes in idiopathic scoliosis treated with or without PO. The primary outcome was vertebral rotation correction. Six studies were included, encompassing a total of 439 patients with mean ages ranging from 13.5 ± 2.8 to 17.5 ± 3.7 years. Most study populations were predominantly female in four studies, predominantly male in one, and evenly distributed in one. Two studies showed a meaningful improvement in postoperative thoracic rotation in the PO group compared to inferior facetectomy (IF). Other studies found PO to be superior to IF and posterior spinal fusion (PSF), although these differences were not statistically significant, except for one study that reported a statistically significant advantage of PO over PSF. No meaningful superiority was observed when comparing PO with skip pedicle screw fixation. Overall, intraoperative and postoperative complication rates were similar between PO and non-PO groups, although one study reported a higher rate of intraoperative neuromonitoring changes and reoperations in the PO group. Most studies to date have found that PO is associated with superior vertebral rotation outcomes compared to IF and PSF, with only half showing statistical significance. PO is also linked to longer operative time and greater blood loss, warranting further high-quality studies to clarify its risk–benefit profile.

Transfemoral transcatheter aortic valve replacement (TF-TAVR) is the preferred vascular access route for aortic valve implantation, but procedural success is highly dependable on iliofemoral vascular anatomy. This study aimed to directly assess anatomic risk factors for TF-TAVR using cadaveric dissection and highlight their relevance in the context of imaging-based literature. Thirty-two formalin-embalmed cadavers (64 limbs) were dissected to assess luminal diameters of the common femoral (CFA), external iliac (EIA), and common iliac arteries (CIA). Anatomical configurations of the femoral triangle, bifurcation patterns of the CFA, atherosclerotic burden, and sheath-to-artery ratios (SFAR, SEIAR, SCIAR) for 14–18 F sheath sizes were recorded. High CFA bifurcation and posteriorly originating deep arteries of the thigh (DAT) were present in 39.1

SummaryA man in his 70s presented with a 6-month history of moderate left foot and ankle pain without a clear mechanism of injury. Initial radiographs obtained during evaluation revealed an incidental lesion within the distal tibia. To further characterise this finding and assess for associated pathology, an MRI was subsequently performed. The MRI demonstrated no acute fracture, severe tendinosis of the peroneus longus tendon at the cuboid tunnel and mild tendinosis at the Achilles insertion. In addition, a multilobulated intramedullary lesion with high T2-weighted signal was identified in the distal tibia, consistent with enchondroma. There were no symptoms attributable to the tibial lesion. The patient underwent a trial of physiotherapy with limited improvement, largely due to poor adherence. Given the incidental nature of the enchondroma and absence of aggressive imaging features, the patient was advised to follow-up with his primary care physician for continued surveillance.

Chronic pelvic pain (CPP), affecting approximately 26