Radiofrequency ablation (RF), in its pulsed and thermal modalities, is a minimally invasive technique for managing refractory chronic neuropathic pain. We present the case of a 60-year-old woman with persistent pain in her left ankle following avascular necrosis of the talus treated with total ankle arthroplasty. This surgical intervention can lead to complications such as postoperative neuropathic pain, with an incidence that can vary between 10% and 20%. Despite physiotherapy and electrotherapy, she maintained a VAS score of 8 and a DN4 score of 7. A diagnostic block of the superficial peroneal and sural nerves provided temporary relief, so pulsed RF (65V, 4min) was performed on the superficial peroneal nerve and thermal RF (80°C, 90s) on the sural nerve, both under ultrasound guidance. Subsequently, both nerves were infiltrated with 1cc of betamethasone, 2cc of mepivacaine, and 2cc of saline solution to prevent pain after the procedure. At two weeks, the patient presented with a resting VAS score of0, an active VAS score of3, and a DN4 score of2, with sustained improvement at one month and 6months, with increased functionality. This case suggests the value of RF as a safe and effective alternative for postoperative neuropathic pain resistant to conventional therapies. The objective is to present a representative case of the interventional management of neuropathic pain using radiofrequency, with emphasis on patient selection, technique, highlighting safety considerations and reviewing the available evidence.

Background Anterior cruciate ligament (ACL) reconstruction with hamstring tendon autografts is well-established, but peroneus longus autografts have emerged as a promising alternative. Optimal graft diameter is a prerequisite for knee stability and satisfactory postoperative outcomes. Attainable autograft diameter is shown to directly correlate with patient height. The relative efficacy of hamstring (HS-R) versus peroneus longus (PL-R) reconstruction for ACL tears among graft-commensurate, short-statured patients is unknown. Methodology In this prospective observational study, 44 patients with a height of 173 cm or less who underwent arthroscopic single-bundle anterior cruciate ligament reconstruction using quadrupled HS-R or tripled PL-R for isolated ACL tears were followed for a minimum of 12 months postoperatively. Patient groups were compared in terms of their demographic and anthropometric characteristics, mode and side of injury, preoperative clinical assessment findings, autograft dimensions attained, and postoperative clinical assessment findings. Donor site morbidity and postoperative complications, where present, were recorded. Results The study cohort comprised 22 men each, who underwent HS-R and PL-R. The patient groups were comparable in terms of age, height, weight, body mass index, mode and side of injury, and preoperative International Knee Documentation Committee (IKDC), Lysholm, and Modified Cincinnati Score (MCS). PL-R was associated with significantly longer grafts (median (interquartile range (IQR)): 90 (89.5-90) mm vs. 90 (80-90) mm; P = 0.024) with larger diameters (median (IQR): 9 (8-10) mm vs. 8 (8-9) mm; P = 0.011) and resulted in lower postoperative thigh hypotrophy (median (IQR): 1 (0-1) cm vs. 2 (1-3) cm; P = 0.004) when compared with HS-R. Significant improvements in IKDC, Lysholm, and MCS were observed in both groups following surgery, though their postoperative scores were comparable. All patients in the PL-R group had satisfactory ankle function. However, six patients (27.3%) in the HS-R group reported anterior knee pain and hypoesthesia around the proximal leg. Conclusions PL-R is a viable alternative to HS-R for ACL reconstruction, with comparable functional outcomes, but yields longer and thicker autografts. It may be a better graft option in patient subsets with low anticipated graft diameters, such as women and short-statured patients. Given its inevitable use in revision surgery and when hamstring autograft yield is insufficient, arthroscopic surgeons may consider adopting this technique more frequently, particularly in selected patients likely to benefit.

Chromobacterium violaceum is a rare but highly virulent Gram-negative organism found in tropical and subtropical environments, associated with rapidly progressive sepsis and high mortality. Musculoskeletal involvement, particularly septic arthritis, is exceedingly uncommon. We report a case of a previously healthy 23-year-old male who presented with progressive left ankle pain, swelling, and fever. Initial evaluation revealed thrombocytopenia, markedly elevated inflammatory markers, and positive serology for Dengue virus infection, suggestive of a possible concurrent infection. Blood cultures grew C. violaceum, confirming bacteremia. Despite initiation of intravenous antibiotics and supportive care, the patient experienced rapid clinical deterioration with septic shock, severe metabolic acidosis, hyperkalemia, and multi-organ failure. He required intubation and vasopressor support but suffered multiple cardiac arrests and died within three days of hospitalization. This case highlights the aggressive clinical course of C. violaceum infection, even in immunocompetent individuals, and underscores the diagnostic and therapeutic challenges associated with this rare pathogen. Concurrent dengue infection may have contributed to immune dysregulation and worsened disease severity. Early recognition, prompt diagnosis, and appropriate antimicrobial therapy are critical in managing C. violaceum infections. Clinicians should maintain a high index of suspicion in patients presenting with rapidly progressive sepsis, especially in endemic regions or in the presence of potential environmental exposure.