The aim of this study was to evaluate the reliability and validity of a patient-specific algorithm which we developed for predicting changes in sagittal pelvic tilt after total hip arthroplasty (THA). This retrospective study included 143 patients who underwent 171 THAs between April 2019 and October 2020 and had full-body lateral radiographs preoperatively and at one year postoperatively. We measured the pelvic incidence (PI), the sagittal vertical axis (SVA), pelvic tilt, sacral slope (SS), lumbar lordosis (LL), and thoracic kyphosis to classify patients into types A, B1, B2, B3, and C. The change of pelvic tilt was predicted according to the normal range of SVA (0 mm to 50 mm) for types A, B1, B2, and B3, and based on the absolute value of one-third of the PI-LL mismatch for type C patients. The reliability of the classification of the patients and the prediction of the change of pelvic tilt were assessed using kappa values and intraclass correlation coefficients (ICCs), respectively. Validity was assessed using the overall mean error and mean absolute error (MAE) for the prediction of the change of pelvic tilt.Aims
Methods
Scapular notching is thought to have an adverse effect on the outcome of reverse total shoulder arthroplasty (RTSA). However, the matter is still controversial. The aim of this study was to determine the clinical impact of scapular notching on outcomes after RTSA. Three electronic databases (PubMed, Cochrane Database, and EMBASE) were searched for studies which evaluated the influence of scapular notching on clinical outcome after RTSA. The quality of each study was assessed. Functional outcome scores (the Constant-Murley scores (CMS), and the American Shoulder and Elbow Surgeons (ASES) scores), and postoperative range of movement (forward flexion (FF), abduction, and external rotation (ER)) were extracted and subjected to meta-analysis. Effect sizes were expressed as weighted mean differences (WMD).Aims
Methods
In this review, we discuss the evidence for patients returning to sport after hip arthroplasty. This includes the choices regarding level of sporting activity and revision or complications, the type of implant, fixation and techniques of implantation, and how these choices relate to health economics. It is apparent that despite its success over six decades, hip arthroplasty has now evolved to accommodate and support ever-increasing patient demands and may therefore face new challenges. Cite this article:
This pilot study reports the clinical outcomes
of a combination of partial subscapularis tendon transfer and small-head
hemiarthroplasty in patients with rotatator cuff arthropathy. A
total of 30 patients (30 shoulders; eight men and 22 women) with
a mean age of 74 years (55 to 84) were assessed at a mean follow-up
of 31 months (24 to 60). The inclusion criteria were painful cuff
tear arthropathy with normal deltoid function and a non-degenerative subscapularis
muscle and tendon and a preserved teres minor. Outcome was assessed using the University of California Los Angeles
score, the Japanese Orthopaedic Association score, and the Oxford
Shoulder Score. Radiographic measurements included the centre of
rotation distance and the length of the deltoid. All clinical scores were significantly improved post-operatively.
The active flexion and external rotation improved significantly
at the most recent follow-up (p <
0.035). Although the mean centre
of rotation distance changed significantly (p <
0.001), the mean
length of the deltoid did not change significantly from the pre-operative
value (p = 0.29). The change in the length of the deltoid with <
100° flexion was significantly less than that with >
100° (p <
0.001). Progressive erosion of the glenoid was seen in four patients.
No patient required revision or further surgery. A combination of partial subscapularis tendon transfer and small-head
hemiarthroplasty effectively restored function and relieved pain
in patients with rotator cuff arthropathy. Cite this article: 2015;97-B:1090–5.
Primary total knee arthroplasty (TKA) is a reliable
procedure with reproducible long-term results. Nevertheless, there
are conditions related to the type of patient or local conditions
of the knee that can make it a difficult procedure. The most common
scenarios that make it difficult are discussed in this review. These
include patients with many previous operations and incisions, and
those with severe coronal deformities, genu recurvatum, a stiff knee,
extra-articular deformities and those who have previously undergone
osteotomy around the knee and those with chronic dislocation of
the patella. Each condition is analysed according to the characteristics of
the patient, the pre-operative planning and the reported outcomes. When approaching the difficult primary TKA surgeons should use
a systematic approach, which begins with the review of the existing
literature for each specific clinical situation. Cite this article:
