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Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_II | Pages 262 - 262
1 May 2006
Blom AW Rogers M Taylor AH Pattison G Whitehouse S Bannister GC
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The aim of this study was to determine the outcome of total hip arthroplasty, with regard to dislocation, at our unit.

1727 primary total joint arthroplasties and 305 revision total hip arthroplasties were performed between 1993 and 1996 at our unit. We followed up 1567 of the primary hip arthroplasties and 284 of the revision hip arthroplasties at 8 to 11 years post surgery. Patients were traced by postal questionnaire, telephone interview or examination of case notes of the deceased.

The dislocation rates by approach were: 23 out of 555 (4.1%) for the posterior approach, 0 out of 120 (0%) for the Omega approach and 30 out of 892 (3.4%) for the modified Hardinge approach.

58.5% of dislocations after primary total hip arthroplasty were recurrent. The mean number of dislocations per patient was 2.81.

8.1% of revision total hip arthroplasties suffered dislocation. 70% of these became recurrent. The mean number of dislocations per patient was 2.87. The vast majority of dislocations occur within 3 months of surgery.

To our knowledge this is the largest multisurgeon audit of dislocation after total hip arthroplasty published in the United Kingdom. The follow-up of 8 to 11 years is longer than most comparable studies.


Orthopaedic Proceedings
Vol. 84-B, Issue SUPP_II | Pages 161 - 161
1 Jul 2002
Taylor AH Stibbs M Miles AW Webb J
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Purpose: The study looked at different suturing configurations for hamstring reconstruction of the ACL to ensure that all four limbs of the graft were evenly tensioned at the time of insertion.

Method: Calf hoof flexor tendons were used as an animal model for the four strands of a “hamstring” ACL graft. They were sutured together at one end, which was clamped rigidly in a test rig. The free ends were then sutured altogether, in doubles or singly using 2 Ethibond. Miniature Variable Resistance Reluctance Transducers (DVRT) were then inserted into the tendons. The tendon construct was then loaded to 100N in 5N increments (with an initial I5N preload).

One hundred Newtons was decided on as the maximum force following measurements in theatre showing a force of approximately 75N were applied to a hamstring ACL graft at the time of fixation in the tibial tunnel. The DVRT’s allowed accurate assessment of the Load/Displacement of each tendon in the construct to be assessed. Repeatability experiments on the DVRT’s were performed. Ten specimens were prepared which were all tested in the different suturing configurations. Each test was repeated three times on each construct.

Results: The results showed that those tendons sutured all together did not load evenly with only one or two of the tendons in the construct showing any displacement throughout the loading cycle. When sutured as pairs, one of the tendons in each pair showed immediate displacement with the other tendon also showing displacement early in the loading cycle. When sutured individually the tendons all showed evidence of displacement early in the loading cycle, therefore showing more even tensioning and load sharing.

Conclusion: We recommend the use of singly sutured hamstring tendons in ACL reconstruction to allow more even tensioning and load sharing therefore reducing the risk of construct rupturing.