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cells, and an extracellular matrix (ECM) composed of collagen, noncollagenous proteins, proteoglycans, and water. Hyaline cartilage ECM contains low densities of type II collagen fibers and an abundance of the proteoglycan, aggrecan, composing the ground substance. Water molecules embedded in the collagen matrix give

lining and underlying scar.13 In cases where this approach remains difficult, a lateral retinacular release may be considered, which allows for easier patellar eversion or lateral subluxation.14 Page 178At times, a more extensile exposure may be required. A quadriceps snip can be performed where

line, CT with contrast can assess the proximity of the acetabular component to intrapelvic structures (Fig. 30.1). • Fig. 30.1A–D show subsequent axial cuts of a CT scan demonstrating proximity of the acetabular component to intrapelvic structures.34 The acetabular component is designated

line therapy. Finally, duloxetine may be considered to treat severe pain that is refractory to other nonoperative treatments or in patients with depression; Page 19however, this is likely best managed by a primary care physician or psychiatrist. Narcotic pain medications should not be used

lining cells, ligaments, and lining

cells that synthesize the bone matrix, and cause apoptosis. Importantly, tobacco can also induce changes in the RANK/RANKL/OPG pathway that regulates differentiation and activity of osteoclasts.22 Smokers were found to have significantly lower levels of OPG, which is a protein secreted by osteoblasts

cells, LE, leukocyte esterase.aNew criteria from the previous iteration.bRemoval of criteria from the previous iteration (data from Refs. 13-18.) • Fig. 14.1 Bony landmarks and insertions for ligaments and tendons for the anterior (A), medial (B), lateral (C), and posterior (D) knee

line bundles (see section “Care of Vascular Access Devices”) can lower the risk of PN-associated bloodstream infections.5,21 In addition, knowledge of bloodstream infection pathogenesis has advanced, and a greater emphasis has been placed on standardizing the approach to CRBSI prevention and treatment.10

cell derived), as well as age and response to treatment.15 Non-Hodgkin lymphoma typically arises in older patients and presents with bone involvement and pain. Conversely, Hodgkin lymphoma has a bimodal distribution with early onset in the mid- to late 20s and after

cell disease, hemophilia, chronic obstructive lung disease (COPD), and obstructive sleep apnea.34-41 Glycemic control It is well established that uncontrolled diabetes is a risk factor for PJI and must be addressed preoperatively.42,43 However, there is controversy regarding the best metric to focus