The aim of this study was to assess the role of hip arthroscopy in the management of hip pain in elite athletes. It is a retrospective study of prospectively collected data. 31 hip arthroscopies were performed on 27 elite athletes. All the patients were assessed pre-operatively with a thorough clinical examination, radiographs and MRI scans. The modified HHS was also recorded for all the patients' pre and post-operatively. All operations were performed by the senior author, and the patients were assessed at 6 weeks, 3 months, 6 months and a year following the operation.Aim
Patients and methods
The aim of this study was to study the course of the infra-patellar branch of the saphenous nerve (IPBSN) and describe its anatomical variations and relations. Twenty-eight formalin-fixed cadaver lower extremity specimens were methodically dissected in the University Department of Anatomy. Dissection included identifying the saphenous nerve and tracing it distally till it pierced the deep fascia between the tendons of gracilis and sartorius. At this point, the saphenous nerve gave a branch that pierced the sartorius and became subcutaneous, known as the infrapatellar branch. The association of the nerve trunk with the sartorius muscle in terms of whether it originated above it, below it or pierced through it was studied. Following this the nerve was dissected along its course distally to the point of its termination where it gave one to three branches. The relationship of the point of termination of the IPBSN with bony surface landmarks like the medial border of the patella, the apex of the patella and the tibial tuberosity were also studied. The distance of the trunk from medial margin of patella was measured.Aim
Materials and Methods
The aim of this study was to assess the results of combined arthroscopically assisted posterior cruciate ligament reconstruction and open reconstruction of the posterolateral corner in patients with chronic (3 months or more) symptomatic instability and pain. A retrospective analysis of all the patients who had a combined reconstruction of the posterior cruciate ligament and the posterolateral corner between 1996 and 2003 was carried out. Nineteen patients who had the combined reconstruction were identified from the database. All the patients were assessed pre- and post-operatively by physical examination and three different ligament rating scores. All the patients also had weight bearing radiographs, MRI scans and an examination under anaesthesia and arthroscopy pre-operatively. The PCL reconstruction was performed using an arthroscopically assisted single anterolateral bundle technique and the posterolateral corner structures were reconstructed using an open Larson type of tenodesis.Objective
Patients & methods
Radiological measurements are an essential component of the assessment of outcome following knee arthroplasty. However, plain radiographic techniques can be associated with significant projectional errors because they are a two-dimensional (2D) representation of a three-dimensional (3D) structure. Angles that are considered within the target zone on one film may be outside that zone on other films. Moreover, these parameters can be subject to significant inter-observer differences when measured. The aim of our study therefore was to quantify the variability between observers evaluating plain radiographs following Unicompartmental knee arthroplasty. Twenty-three observers, made up of Orthopaedic Consultants and trainees, were asked to measure the coronal and sagittal alignment of the tibial and femoral components from the post-operative long-leg plain radiograph of a Unicompartmental knee arthroplasty. A post-operative CT scan using the low dose Imperial knee protocol was obtained as well and analysed with 3D reconstruction software to measure the true values of these parameters. The accuracy and spread of the pain radiographic measurements were then compared with the values obtained on the CT. On the femoral side, the mean angle in coronal alignment was 1.5° varus (Range 3.8, SD 1, min 0.1, max 3.9), whereas the mean angle in sagittal alignment was 8.6° of flexion (Range 7.5, SD 1.5, Min 3.7, Max 11.2). The true values measured with CT were 2.4° and 11.0° respectively. As for the tibial component, the mean coronal alignment angle was 89.7° (Range 11.6, SD 3.3, Min 83.8, Max 95.4), and the mean posterior slope was 2.4° (Range 8.7, SD 1.6, Min -2, Max 6.7). The CT values for these were 87.6° and 2.7° respectively. We conclude that the plain radiographic measurements had a large scatter evidenced by the wide ranges in the values obtained by the different observers. If only the means are compared, the plain radiographic values were comparable with the true values obtained with CT (that is; accuracy was good) with differences ranging from 0.3° to 2.4°. The lack of precision can be avoided with the use of CT, particularly with the advent of low-dose scanning protocols.
This study investigates the efficacy of the AO Pi-plate in the treatment of complex, unstable, intra-articular fractures of the distal radius. A retrospective study of 17 patients was carried out who underwent open reduction and internal fixation for dorsally displaced, intra-articular fractures of the distal radius using the AO Pi-plate. All patients were assessed clinically and radiologically post-operatively. The final functional outcome was assessed using the Gartland &
Werley scoring system. The average follow-up period was 34.3 months. 94% (16 patients) of the fractures were classified as AO type C fractures. The wrist movement was restored to a near normal range in all cases. The mean grip strength was 67% of the uninjured hand. The functional outcome as measured by the Gartland &
Werley scoring system showed excellent and good results in 88% of the patients. Radiographic assessment revealed an average articular step-off of 0mm post-operatively. The implant removal rate was 29% (5 patients) and the main reason for that was extensor tenosynovitis.