Introduction: Discussion about parenthood, pregnancy and family planning in orthopaedics is still a taboo in many countries. It is also known that this is a subject that affects more women, specially those in the workforce. The number of female orthopaedic surgeons is proportionally one of the smallest in medical specialties worldwide. Since 2020, AMOB (Brazilian Association of Women in Orthopaedics) is supporting women from the beginning of the orthopaedic path , promoting diversity and inclusion. Objective: Summarize how family planning, pregnancy and parenthood affect the lives of Brazilian orthopaedic women. Methods: Statistical analysis of AMOB surveys database from 2020 to 2023. Results: Most women never got pregnant (59,2%), no respondents adopted a child. Miscarriage was reported by 30,2%. Pregnancies were planned by 76,1% women and 23,5% of first pregnancy was after 35 years old. Parental leave was granted to 54,6% of respondents. Most women reported a decrease in workload, income and number of surgeries. Gender discrimination was reported by 42,5%, influencing in childbearing delay. Master's and PhD degrees were achieved by 7,8 % and 2,8%, respectively, after motherhood. Discussion: Miscarriage rate among Brazilian orthopedists was substantially higher than found in literature. Even thought parental leave is a labor law in Brazil, only 54,6% of women had this right assured. Conclusion: Women's societies such as AMOB are in important tool to understand women's obstacles in the professional path, contributing to increase discussion and awareness in supporting family planning, pursuing to diminish gender bias in the orthopaedic practice.

Background: Antibiotic loaded bone cement is a proven way to deliver high concentration of the drug locally, even to avascular areas that are inaccessible by systemic antibiotics. The process of making antibiotic beads in the operating room sometimes results in wastage of cement as all the beads prepared may not be used due to the size of the defect or dead space. This encouraged us to conduct a study to see if antibiotic impregnated rods could be prepared beforehand and stored for use at a later date to avoid wastage of time and resources. The objective of this study is to determine the effect of sterilization and storage on efficacy of self-fabricated antibiotic impregnated bone cement rods. Methods: In the present study twenty batches of self-fabricated antibiotic impregnated bone cement rods were prepared. The samples in each batch were tested for sterility and efficacy against staphylococcus aureus at different time intervals over a period of three months. Results:None of the samples in our study showed any growth on culture medium. All the test samples showed a zone of inhibition greater than control sample. Conclusions: Self-fabricated antibiotic impregnated bone cement rods maintain their sterility
and efficacy after ETO sterilisation and storage at room temperature.

Purpose: To compare safety and efficacy of vesselplasty and vertebroplasty in chronic, non-healing, symptomatic osteoporotic vertebral compression fractures (VCFs) not responding to conservative management. Methods: Forty-eight consecutive patients with chronic VCFs (>8 weeks) causing severe pain (visual analogue scale; VAS ≥ 7) and disability underwent either vertebroplasty or vesselplasty. The two groups were compared for difference in physical functionality and post-procedure VAS scores at one week and three months follow-up, reduction in analgesic requirement, volume of cement injected, change in the vertebral body height and complication rates. Results: Forty-eight patients with a median age of 68 years (range: 51–83 years) underwent 52 VAPs. Twenty-nine patients underwent vertebroplasty involving 33 vertebrae (Group A) and 19 patients underwent vesselplasty in 19 vertebrae (Group B). The mean VAS score at one week and 3 months post-procedure was comparable between the two groups. Patients in Group B (vesselplasty) had a significantly better post-procedure SF-36 physical functionality score. The quantity of cement injected (Group A: 3.84 ml v/s Group B: 4.68 ml), mean increase in anterior vertebral height (Group A: 0.635 mm v/s Group B: 2.472 mm) and mean increase in central vertebral height (Group A: 0.63mm v/s Group B: 1.96mm) differed significantly between the two groups. Cement leakage was seen in 14 patients (50%) in Group A; no patient in Group B had a cement leak. Conclusion: Vesselplasty significantly reduces the incidence of cement leakage in osteoporotic VCF with similar or better relief of pain, improvement in disability scores and vertebral body height.

Secukinumab, an anti–interleukin-17A monoclonal antibody, significantly improved the quality
of life in symptomatic patients of ankylosing spondylitis (AS). The present study aimed to
evaluate the efficacy of Secukinumb 150 mg in term of Bath Ankylosing Spondylitis Disease
Activity Index (BASDAI) and Assessment of SpondyloArthritis international Society (ASAS) in AS
patients of Punjab, Pakistan. Total 152 patients with active AS received subcutaneous
secukinumab (150 mg) loading dose at weeks 1, 2, 3 and 4, and maintenance dose every 4 weeks
thereafter. The primary endpoint was the ASAS criteria for 20% improvement (ASAS20)
response rate at week 16 and ASAS40, BASDAI at week 52. At week 16, 69.74% of AS patients
treated with secukinumab 150 mg achieved ASAS20. The results of Secukinumab 150 mg in
symptomatic patients (92.10%) of AS depicted clinically significant difference and improvement
through 52 weeks of therapy.

Introduction: During the early stages of the COVID-19 pandemic the advice from the government of Ireland was that anyone over the age of seventy should remain in their homes and “cocoon. The aim of this study was to investigate the effect of a period of being “Housebound” had on the skeletal muscle mass of this cohort of patients.
Method: CT scans of the abdomen and pelvis performed on patients over the age of seventy were analysed. January 2020 was used as the pre-cocooning cohort and June 2020 was used as the post-cocooning cohort. The cross-sectional area of the psoas muscles at the level of the L3 vertebra was measured.
Results: There were 83 CTs eligible in January and 106 in June. The mean total psoas area of the January cohort was 1388mm2 & 1309mm2 in June. This difference in mean value has a p-value of 0.19 and is not considered statistically significant. Sub-group analysis by gender revealed no significant difference in the male group, but a decrease of 232mm2 from January to June in the female cohort. This difference had a p-value of .0003 and was considered significant.
Discussion: The results of this study seem to suggest that the female population is more susceptible to sarcopenia if their activity levels decrease. The results reinforce the importance of early mobilisation and return to activity in the, primarily female, hip fracture cohort and may be a consideration when triaging elective surgery lists to help arthritic patients maintain their mobility.

Introduction: There is a paucity of information in the literature on infection rates in low-and-middle-income countries (LMICs). This study aims to review the PJI rate and management based on the Egyptian Community Arthroplasty Registry (ECAR) and six arthroplasty surgeons.
Methods: Using data from the ECAR, for over ten years, and surveying six high-volume arthroplasty surgeons, we reviewed the infection rate, common organisms, antibiotics used, and how the revision surgeries were done. The total number of patients included in this study was 210 infection cases out of 5216 THA and TKA.
Results: Out of the 5216 joint replacement surgeries, the rate of all infections in THA and TKA was 4.03% (4.73% and 2.94%, respectively). The rate of infections requiring staged revision surgeries was 2.24% and 1.71% (2.03% in total) in the THA and TKA groups, respectively. The most encountered organism was staphylococcus aureus. The common antibiotics used were vancomycin and a combination of cefoperazone and sulbactam.
Conclusion: From this study, we conclude that THA was associated with a higher rate of PJI, surgeons' use of antibiotics for a relatively long period, and the rate of PJI in our setting is relatively higher than what is reported in developed countries but lower in other low-income settings. We believe that with improved operating theater design and infection control education, infection rates will decrease significantly. Finally, we acknowledge the need for a national arthroplasty registry that can help in documentation and improving patient outcomes.