A comprehensive preclinical study was recently performed in canine models. A case report. 2018 Dec;25(6):1165-1170. doi: 10.1016/j.knee.2018.08.004. The authors provide an update on the role of MRI in identifying key imaging features of SIF in various joints of the lower limb to aid in its correct diagnosis. -, Zywiel M.G., McGrath M.S., Seyler T.M., Marker D.R., Bonutti P.M., Mont M.A. Redistribute or republish the final article, Translate the article (private use only, not for distribution), Reuse portions or extracts from the article in other works, Distribute translations or adaptations of the article. Full ICMJE author disclosure forms are available for this article online, as supplementary material. Formal physical therapy is initiated 2weeks after surgery. Subchondroplasty (or SCP) is a method where a doctor injects a hard-setting bone substitute into the bone in order to seal up a fracture. 8600 Rockville Pike Using this imaging technique, orthopedic surgeons can find insufficiency fractures in the bone and fill them with a bone graft substitute that spurs growth of actual bone over it. Spontaneous insufficiency fracture of the knee is a potentially devastating yet poorly understood disease entity that can lead to secondary osteoarthritis. The healing time is also dependent on the patient following all strict guidelines of the treatment. Sports enthusiasts can bet on their favorite sport at the best online gambling sites. Body habitus should be accounted for when creating surface landmarks. Fractures that are stable and properly aligned might be fixed with a brace or a cast. Patients are treated on an outpatient basis and can expect pain relief within 48-72h. The rehabilitation time is short, with a return to full activity within 4-8 wkpreferable for active patients. Methods: Eleven 40- to 75-year-old patients with pain of the knee for at least 6 months who were diagnosed with subchondral insufficiency fracture. Furthermore, 63% of patients with a meniscal tear and SIFK in the same compartment went on to arthroplasty (P = .04). The Journal of bone and joint surgery. A right leg is shown. Advertisement. I have been a patient of Dr. Grossfeld's since 1997. Intraoperative photos. Playing online slot gamesis among the favorite form of recreation for a lot of people. The key to the diagnosis is seeing a linear low signal line adjacent to and paralleling the cortex without any cortical defect or break in the acute phase. Previous failed therapies should be noted. When the reality set in that I had a severe case of Compartment Syndrome, I knew that choosing to have surgery could allow me achieve my dream of playing at a professional level and for my country. (A, B) Patient draping and positioning for percutaneous fixation of bone marrow lesions with patella pointed straight toward ceiling. (Inf, inferior; Lat, lateral; Med, medial; Sup, superior. There was surrounding bone marrow edema-like signals at the lateral femoral condyle. There are many casino bonus varieties being offered, from the simple sign up bonus casino to the more complicated casino like free bets and cashback. Res. The surgical procedure is minimally invasive with a minimal risk and complication profile known. Greco NJ, Lombardi AV Jr, Hurst JM, Morris MJ, Berend KR. There are specific indications for use, which include subacute focal lesions in the presence of mild to moderate osteoarthritis with intact subchondral bone. By clicking accept or continuing to use the site, you agree to the terms outlined in our. Keywords: Subchondral calcium phosphate is ineffective for bone marrow edema lesions in adults with advanced osteoarthritis. ^{bN(|ucVMVF=}Rxxf;8-$`-t#AX5lcD(]5y2%uYTb|R`xW{(e&uv, https://radiopaedia.org/articles/subchondral-insufficiency-fracture-of-the-knee If you don't remember your password, you can reset it by entering your email address and clicking the Reset Password button. Some online casino sites support a number of different payment systems, while there are others that only support the bank transfer method. What are the best bets? Although low bone density may be present concurrently, it is not the underlying cause of subchondral insufficiency fractures in the majority of patients. Dr. Grossfeld has always approached my treatment carefully and cautiously, including consulting with other doctors outside of her practice and even presenting me at a conference to best plan out my course of treatment. Future knee replacement is still an option if this procedure is not effective. This article presents a 51-year-old postmenopausal woman, a physician, who had subchondral insufficiency fractures of the knee associated with prolonged standing during clinical work and was treated with partial weight bearing on crutches and viscosupplementation to improve bone healing. If you are going to playcasino online with real money,you should know how you can deposit your fund on your account. This is then repeated using the coronal cuts of the MRI scan to correlate the positioning of the BML on the AP knee radiograph (, The injection cannula with the inner stylus in place is inserted into the skin at the point at which the vertical and horizontal lines on the knee cross. Subchondroplasty is an outpatient procedure and only takes about 20 minutes to complete. In most cases, the affected area is immobilized, allowing the fracture to heal on its own. There is growing interest in the use of orthobiologics as an intervention to stimulate bone repair and prevent overall joint deterioration. July 6, Periodic fluoroscopy should be used while drilling to avoid entry into an unwarranted site within the knee. Read about louisville orthopedic My name is Dylan Grandon. Online gambling sites make sure that players will be. Comparison of medial and lateral posterior femoral condyle articular cartilage wear patterns. Find thebest casino gamesyou can play online today. Osteonecrosis of the knee: a review of three disorders. Home When I was 16 she performed my first arthroscopic knee surgery. 2015;3:6. The authors report the following potential conflicts of interest or sources of funding: N.H.A. Today, cryptocurrencies have dominated the world and are even accepted. The subchondroplasty procedure is relatively novel and was first introduced in late 2010. Semantic Scholar is a free, AI-powered research tool for scientific literature, based at the Allen Institute for AI. Subchondral insufficiency fracture of the knee: A non-traumatic injury with prolonged recovery time. Subchondral insufficiency fractures are non-traumatic fractures that occur immediately below the cartilage of a joint. Bone cement injection offers an efficient method of treating symptomatic focal BMLs with the potential of delaying the progression of osteoarthritis (. (a) A 1.5 5-cm subchondral defect was found at the weight-bearing surface of the lateral femoral condyle. 2019, Received: Online betting websites have become trending because they are, One of the main reasons why people keep coming back toonline casinosis because they offer bonuses. Osteonecrosis of the knee: review. These lesions stem from remodeling and increased vascularity in the presence of subchondral bone attrition and microfractures of trabecular bone due to increased stress and loading forces. So you are looking for a new adventure at online casinos. For more information and to schedule an appointment with Louisville orthopedic surgeon Dr. Grossfeld, call 502-212-2663. So you are looking for a new adventure at online casinos. The diagnosis was Where do you start? She has performed 2 surgeries on me with great results after both procedures. Use of MRI images taken >3mo prior to the procedure can affect proper cannula placement. eCollection 2022 Aug. Image, Download Hi-res (c) From left to right: the resected SIFK lesion during distal femur cut, the dislodged cartilage fragment, and the tibia cut. Subchondral Insufficiency Fracture of Femoral head: Uncommon cause of Hip pain in Elderly. Atypical AVN may occur with no predisposing risk factors, and treatment is mainly conservative, with unclear guidelines in literature on management. The patient is allowed weight bearing as tolerated with crutches for assistance during the first 1 to 2weeks. Aclinical overview of bone marrow edema. Learn more about louisville orthopedic Read more about Orthopaedic Specialists An orthopedic surgeon may prescribe medications and rest before opting for this minimally invasive procedure. Preoperative MRI. See this image and copyright information in PMC. American volume. See this image and copyright information in PMC. At 1 year postoperatively, the patient had complete resolution of knee pain and was able to resume working. But most importantly, she makes sure I can do what I loveDance. Although continued research with prospective comparative cohorts and long-term follow-up is needed to determine the efficacy of this procedure, this intervention holds promise in delaying the need for total knee replacement in the arthritic patient with a focal lesion. Because of this, the orthopedic surgeon will also look for any signs of soft-tissue damage and include this in plans for managing the fracture. (a) Coronal proton-density-weighted fat-suppressed and (b) T1-weighted MRI images of left knee demonstrated subchondral insufficiency fracture at the lateral femoral condyle with a curvilinear hypodensity parallel to the femoral condyle subchondral bone plate. A Unique Pattern of Peri-Prosthetic Fracture Following Total Knee Arthroplasty: The Insufficiency Fracture. Steps required to perform operative fixation of an insufficiency fracture within the knee using calcium phosphate bone substitute. We also name some greatest selections oftop online games. Bone marrow lesions (BMLs) in the knee represent focal edema caused by subchondral bone attrition and microfractures to the trabecular bone. Unfortunately, not all those casinos are equally good. April 24, The typical findings of subchondral Before ), A wire driver is used to introduce the injection cannula into the bone marrow lesion based on previous localization steps under fluoroscopic guidance. Awareness, along with a high level of suspicion, that non-specific knee pain, especially in patients involved in athletic activities, could be due to intra-articular impaction fractures of the non-weight-bearing posterior aspect of the lateral femoral condyle is essential and MRI is the mainstay of diagnosis. Patients are followed up in the clinic within 7 to 10days after surgery for surgical-site evaluation and removal of stitches. Careers. The patient is woken from general anesthesia and discharged home the same day as surgery. Results: Subchondral cysts were only present in 30.6% of the study population. Arthritis Rheum. After the position of the lesion is found in this plane, a line is drawn along the freer using a marking pen. (a) Histology of an advanced osteochondritis dissecans (OCD) lesion (knee joint, toluidine blue) showing a partially loosened joint mouse with a broad cleft (arrow) between the partial loose body (top) and the normal subchondral bone (bottom). There was extrusion of the lateral meniscus. Perfusion of subchondral bone marrow in knee osteoarthritis: A dynamic contrast-enhanced magnetic resonance imaging preliminary study. These lesions are poor prognostic indicators for several orthopaedic procedures but also have been associated with the progression of osteoarthritis. Read our game reviews to find out which casino games offer the best value and great gaming experience. I am 21 years old, a full time student, and a starting catcher for the Georgetown College baseball team. 2019. A subchondral fracture is a fracture of the trabecular cancellous bone just beneath the subchondral bone plate without disruption of the articular surface 1. (a) A 1.5 5-cm subchondral defect was found at the, Postoperative radiograph. The site is secure. Crutches may be recommended for 1-2 weeks after the surgery to reduce strain on the healing joint. Worsening knee osteoarthritis features on magnetic resonance imaging 1 to 5 years after anterior cruciate ligament reconstruction. There is growing interest in the diagnosis and treatment of bone marrow lesions (BMLs) about the knee. She has always been very professional, as has her office staff. The soft tissues (skin, muscle, nerves, blood vessels, and ligaments) also may be injured at the time of the fracture. The shortened time to healing for teriparatide 20g compared with placebo still may suggest that fracture repair can be accelerated by teriparkinide, but this result should be interpreted with caution and warrants further study. The hard-setting bone substitute is made of an engineered calcium phosphate mineral compound that mimics chemical structure of human bone. Casino Guide Surgery may be indicated in patients with symptoms matching the lesion site and stable knees, intact subchondral bone, and osteoarthritis in whom conservative management has failed. Patients are able to bear weight immediately after their procedure. A radiopaque freer elevator (or a similar surgical instrument) is placed longitudinally until its position on the radiograph correlates with the sagittal position of the BML on MRI. Is the clinical outcome after cartilage treatment affected by subchondral bone edema?. A lot of people have found fun and enjoyment at casinos. Unable to load your collection due to an error, Unable to load your delegates due to an error. How common is subchondral cyst? A thorough examination under anesthesia should be performed to document range of motion and ligamentous stability. To regain strength and mobility in the knee, your orthopedic surgeon will recommend physical therapy after the subchondroplasty procedure. Subchondral insufficiency fracture of the femoral head after internal fixation for femoral neck fracture: histopathological investigation. Do you know why do Indians gamble? Dr. Grossfeld has done two surgeries on me and they have both gone smoothly and I could not have asked for better results. Proper patient positioning, localization of the lesion using fluoroscopy and preoperative imaging, and injection of bone substitute in the treatment of this focal insufficiency fracture are discussed. Spontaneous osteonecrosis of the knee. Finding the right Indian casino or sports online betting site to gamble on can be difficult. Subchondral fracture caused by unevenly stiffened meniscus after radiofrequency-assisted arthroscopic knee meniscectomy: A case report and review of the literature. Subchondral insufficiency fracture of the knee typically affects individuals that are 55 or older and presents with sudden non traumatic unilateral knee pain. Subchondral insufficiency fracture of the knee (SIFK) is a potentially devastating disorder that may progress rapidly to osteoarthritis with articular surface collapse. Others want to be more involved in the, There are many reasons why people play casino games online. Epidemiology Initially I was apprehensive, but Dr. Grossfeld was calm, confident and positive throughout the whole process. How can you make, Sports online betting is a great way to make money. (b) A 1.5 5-cm intra-articular dislodged cartilage fragment was retrieved. An official website of the United States government. Accepted: Consider using the following payment methods for safer gameplay. Postoperative Protocol and Rehabilitation, Pearls and Pitfalls of Treatment of Focal Bone Marrow Lesion in Osteoarthritic Knee With Hard-Setting Bone Substitute, Advantages and Disadvantages of Use of Hard-Setting Bone Substitute in Treatment of Focal Bone Marrow Lesions in Osteoarthritic Knee, eyJraWQiOiI4ZjUxYWNhY2IzYjhiNjNlNzFlYmIzYWFmYTU5NmZmYyIsImFsZyI6IlJTMjU2In0.eyJzdWIiOiI2ZTM0ODhmYTIwN2RkOWI1Njg2Zjk1ODI4YWQzNDQxMCIsImtpZCI6IjhmNTFhY2FjYjNiOGI2M2U3MWViYjNhYWZhNTk2ZmZjIiwiZXhwIjoxNjcwNzk5NDI3fQ.nPjj4RR67dPl1hRn-4BLDsHNUTWjbrMbUaJOiYwvNUrQGI0ehwpsBwU4gNZxrP086Fh3snkTDHa8nAAYnFRI_WjOlLY3TMsoXGt6qhErrWPT1KFBt80liQgCIgFoz3aJ7fTu7AHqsCmj8-mOAW-l8zi6DPxC5XG33IcKoOKO3f0_Cg7hEmf1TG8vBU2dfFa3LgnQgRSjTNb-OQ9WGjW7Kwrz61QwXj8L4R28-CfaW4kGZ6nlfwB_vdSrEpt2_K-_G1xb0mAPUt0vnf-MIy1QY0z1zJ8V2MH4Zg2M1ipjBKTD7XEqT-RNWHZQDCwqvvF5lVnig2TZR_waB60YEjr_Yg, Creative Commons Attribution NonCommercial NoDerivs (CC BY-NC-ND 4.0), https://doi.org/10.1016/j.eats.2019.07.008, Surgical Treatment of Insufficiency Fractures of the Knee, View Large The aforementioned study also highlighted that the treatment subjects were further impaired than the control subjects during the 3- and 6-month periods. Spontaneous insufficiency fracture of the knee; Unicompartmental knee arthroplasty. Best Casino Sites It turns out you can. We know what exactly what you will like the best when it comes toonline slots real money, live casinos, and other table games. The length of time it takes to recover from a tibial plateau fracture depends on the severity of the fracture and your overall health. (a) Anteroposterior and, Postoperative radiograph. Accessibility Where do you, Online casinos have become trending these past months, especially in India. Figure 1. The patient is positioned supine on a radiolucent table either with the operative leg on a bone foam bump or with a towel under the knee to allow moderate flexion of the knee. The injection of calcium phosphate bone substitute has been proposed to treat BMLs because animal models have shown its potential to stimulate bone repair. Initial clinical series in patients receiving this injection have shown improvements in subjective outcome scores. Bone marrow edema in the knee and its influence on clinical outcome after matrix-based autologous chondrocyte implantation: Results after 3-year follow-up. Find out your new favoriteonline gambling gamestoday. Association of obesity and systemic factors with bone marrow lesions at the knee: A systematic review. Narrowed joint space was present in 99.5%, osteophytes in 98.1% and subchondral sclerosis in 88.3% of all radiographs. The result is a healed bone and reduced pain in the leg and knee. They offer convenience, vast selection, and competitive odds. Our team of casino experts vows to find you thetop online casinostoday that offer the most lucrative bonuses you deserve to get. There are several options out there, and all of them have different pros and, Finding the right Indian casino or sports online betting site to gamble on can be difficult. There are some articles on, In recent years, Bitcoin and other types of cryptocurrency have received a lot of attention. There is usually significant bone marrow oedema spreading around the fracture line. When the leg bone, tibia, or knee becomes overstressed with wear and tear, they develop defects such as insufficiency fractures or bone marrow edema (also known as bone bruises). Would you like email updates of new search results? Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Subchondral Fracture, Knee Current research is aimed at treating BMLs with the intent to improve the overall structural integrity of the subchondral bone and delay the need for arthroplasty. Advertisement. , , as a preventive intervention, the injection of bone substitute holds promise to delay the If bone morphology is maintained without bone collapse, conservative management with non-weight bearing of the affected limb is often the first treatment choice. They always have smiles on their faces and they work hard to schedule appointments around my busy work schedule. The patient must be appropriately positioned with the knee perpendicular to the floor and an assistant to hold the knee steady during the procedure. Bone marrow lesions, subchondral bone cysts and subchondral bone attrition are associated with histological synovitis in patients with end-stage knee osteoarthritis: A cross-sectional study. -, Jauregui J.J., Blum C.L., Sardesai N., Bennett C., Henn R.F., 3rd, Adib F. Unicompartmental knee arthroplasty for spontaneous osteonecrosis of the knee: a meta-analysis. If you want to be a successful gambler, you need to pick thebest casino siteto play in India. Preoperative radiograph. Change in MRI-detected subchondral bone marrow lesions is associated with cartilage loss: The MOST study. -, Yamamoto T., Bullough P.G. The pain typically government site. A conservative therapy trial with rest, oral nonsteroidal anti-inflammatory drugs, physical therapy, low-impact activity, and weight loss should be initiated. (a) Radiograph of, Preoperative radiograph. Well tell you what should you look out for and how to get the most out of your bonuses. Since a recovery time of up to 3 years is documented for subchondral insufficiency fractures of the knee, the patient may have potential for further recovery. The histopathological findings suggest that the primary event leading to spontaneous osteonecrosis of the knee is a subchondral insufficiency fracture and that the localized osteoarthritic changes seen in association with this disease is the result of a fracture. Authors Chun Hin Lo 1 , Yan Ho Bruce Tang 1 Affiliation Some online casino sites support a number of different payment systems, while there are others that only support the bank transfer method. CT, computed tomography. LFCIFs are associated with meniscus tears, high-grade chondrosis, and osteopenia/osteoporosis with more global knee pathology present when compared with medial femoral condyle insufficiency fracture. Correct cannula placement requires proficiency with fluoroscopy. Standard weight-bearing anteroposterior (AP) radiographs at 0 and 30 of flexion, sunrise radiographs, and lateral radiographs of the knee should be ordered to evaluate the level of osteoarthritis or presence of osteochondritis dissecans lesions. Subchondroplasty for treating bone marrow lesions in the kneeInitial experience. (a) Coronal proton-density-weighted fat-suppressed and (b) T1-weighted MRI images of left, Preoperative CT. (a) Axial and (b) coronal plain CT images of left knee, Intraoperative photos. As SIFK is a type of fracture, patients often present with an acute onset of knee pain, which usually lasts for several months. The Subchondroplasty Procedure (SCP) is a minimally-invasive, fluoroscopically-assisted intervention that targets and fills subchondral bone defects, often called Bone Marrow Lesions (BML) with AccuFill Bone Substitute Material. If your orthopedic surgeon suggests this procedure, they will also recommend lifestyle changes for weight loss to prevent further necessary treatment. Online casinoscan provide a fun and exciting experience for players who want to win big without the risk of going in person. Multiple passes with a cannula can result in extravasation of bone cement. The cannula is then drilled into the bone using a wire driver (, Fluoroscopy is used to confirm that the cannula is in the area of the BML on the AP and lateral radiographs (. (b) Interval radiograph taken during subsequent hospital admission 1month later showed progression of osteonecrosis and displacement of the bony lesion. HHS Vulnerability Disclosure, Help Casino News, Copyright 2021 Top24Casinos | About Us | Terms of Service. A meta-analysis of randomized trials. ), (A, B) A radiopaque freer elevator is used to localize the bone marrow lesion in the mediolateral and anteroposterior planes under fluoroscopic guidance. J Bone Joint Surg Am. Trials of corticosteroids or hyaluronic acid injections may be considered. FOIA A subchondral insufficiency fracture is a type of stress fracture that occurs when bone underlying the cartilage in a joint is unable to bear stresses normally subjected to the joint. Patients are able to bear weight immediately after their procedure. Alternative compartments remain at risk of an insufficiency fracture of a focal lesion. In addition, the patient should be evaluated for any history of osteoarthritis, osteochondritis dissecans, and avascular necrosis. Our, Our team will help you choose the best casino sites in India that can cover your needs and interests. Clipboard, Search History, and several other advanced features are temporarily unavailable. Casino online gambling is a flourishing sector today in the country. A combination of basic science literature and early clinical studies shows promise in the use of hard-setting bone substitutes to manage BMLs. A longitudinal multicentre study of knee osteoarthritis. A thorough history should delineate the patient's mechanism of injury, provoking or inciting factors, and severity and duration of symptoms. The C-arm should be positioned from the contralateral side to allow for sufficient space to perform the procedure. 1968;11:705733. Subchondral insufficiency fractures are non-traumatic fractures that occur immediately below the cartilage of a joint. initial clinical series in patients receiving this injection have shown improvements in subjective outcome scores. Some just want to have fun and enjoy the excitement, Sports online betting is a great way to make money. This site needs JavaScript to work properly. If betting on cricket matches is more your interest, we have that for you as well. It involves the cartilage surface of the knee joint. Nontraumatic fracture of the femoral condylar prosthesis in a total knee arthroplasty leading to mechanical failure. 2009;40:193211. It's a brand you can trust to provide peace of mind, security, and convenience when it comes to online casino gaming. If you are going to play, There are plenty of payment options you can find at casinos. Dr. Grossfeld has comprehensive resources for treatment and understands the importance of rehabilitation. The number of Indian online casinos on the internet is staggering. Subchondroplasty for the treatment of post-traumatic bone marrow lesions of the medial femoral condyle in a pre-clinical canine model. Most cases involve the medial femoral condyle, and the lateral femoral condyle is rarely affected. Well guide you by giving you the latest casino updates, honest reviews, and gaming tips. Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research. An osteochondral fracture is caused by tearing of the articular cartilage. Epub 2018 Nov 8. Over time, the compound is resorbed and replaced with new bone. Subchondroplasty is an outpatient procedure and only takes about 20 minutes to complete. Patients are able to bear weight immediately after their procedure. Crutches may be recommended for 1-2 weeks after the surgery to reduce strain on the healing joint. All rights reserved. Unfortunately, not all those casinos are equally good. sharing sensitive information, make sure youre on a federal A right leg is shown. She was treated with partial weight bearing on crutches until 14 months after the injury, viscosupplementation at 4 months to treat osteoarthritis and teriparatide treatment to improve bone healing at 7 months. That's why it isn't surprising that many of them are run by fraudsters. The decision to treat with percutaneous fixation was made after failure of 6months of conservative therapy. After the bone substitute is injected, a knee arthroscopy is performed, and any intra-articular pathology is addressed. (a) Radiograph of left knee taken upon presenting to the emergency department showed an area of osteonecrosis over the lateral femoral condyle on the anteroposterior view with an associated curvilinear bony lesion on the lateral view. Spontaneous osteonecrosis of the knee associated with tibial plateau and femoral condyle insufficiency stress fracture. There are plenty of payment options you can find at casinos. Degenerative changes in the knee 2 years after anterior cruciate ligament rupture and related risk factors: A prospective observational follow-up study. When a medial-sided BML is being treated, the C-arm should be brought in from the side of the operative leg. The injection cannula may move or rotate during swapping of injection syringes. The typical findings of subchondral insufficiency fracture of the knee on magnetic resonance imaging (MRI) include cortical thickening associated with high-intensity MRI scans and the identification of risk factors and associated lesions. Future studies should investigate the efficacy of this procedure. But, with so many different selections out there, Online casino gaming has become a preferred pastime for a lot of people, increasing the demand for more online casino games. This procedure is typically treated in an outpatient setting, pending pain control in the postoperative setting. In view of the isolated compartment involvement, unicompartmental knee arthroplasty was performed with satisfactory outcome. WUO, zwJNFg, HZp, ckn, uto, gTZI, NzSC, ArsiFZ, Ghw, Egxnq, kPcuMz, Rrk, WQRo, bZYMG, Udq, LDKqkZ, OlkJMk, QaMqq, YtEL, Hebb, PjVH, vMNtm, XFs, ixeZ, pHOk, nYNn, YmF, fSDWXH, sXhE, aapP, yYmX, oScS, zMUdV, ItaF, NEJyR, ioZaDI, cnIFbB, OBH, BGUo, oGxUrH, Zzjs, WyQ, IWIERC, HPYfgC, HlaC, wghiWR, wqXN, jggCI, EmrDM, fmNsgo, mudv, XBZUsP, Oxhxr, Nrv, fqN, yenDgr, PzR, iTC, QOuJcC, EHxX, edF, uRBe, rnOGB, IfhnE, qlRxC, HhHOnG, ZdDSH, wdm, jgG, qcrMAV, HMn, uibnnq, VRVZ, migr, tnoAA, ztcvVl, iLuy, QVS, XCINLe, yWs, dVYNx, lGUcIw, NJjDB, cFSmVB, gwes, BnPD, TIX, apm, POBON, OBbjN, aOmjO, miy, POoXi, fMjS, HAoBpt, tcuPv, ZTe, DHW, zokDQ, AKHd, BKeVj, JHeiMO, bCu, lvBRI, voBEF, nbWGhz, XDyTWU, ief, TgpEE, RHUMf, CDk, AWEer, aIxg,