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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXI | Pages 46 - 46
1 May 2012
C. B M. DB A. B C. T
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Hypothesis

Reverse shoulder arthroplasty has good mid-term results for rotator cuff deficient arthritic conditions.

Methods and Analysis

103 reverse shoulder arthroplasties were performed in 91 patients from January 2003 to September 2009. Twelve patients had bilateral reverse shoulder arthroplasties.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXI | Pages 65 - 65
1 May 2012
J. A C. T T. H K. W
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Few studies have examined the socio-economic impact of complications requiring surgery following initial surgical management of proximal femoral fractures. Our hypothesis was that there would be a significant difference in the cost, mortality rate and ultimate discharge location in patients requiring further surgery after their index procedure for a proximal femoral fracture compared to a matched control group.

This was a retrospective matched cohort study of all proximal femoral fractures presenting to the John Radcliffe Hospital over a five year period. Data had been collected prospectively in a standard manner. The total cost of treatment for each patient was calculated by separating the treatment costs into its components. Mortality data was retrieved from the Office of National Statistics and data were analysed using SPSS statistics software, with a p value of less than 0.05 considered significant.

There were 2360 proximal femoral fractures in 2257 patients. Of this group, 144 (6.1%) required further surgical intervention due to a complication of the primary procedure. Mean age at time of fracture was 82.59 years; 81.6% women. Mean cost of treatment in those cases with complications was £18,731 compared to £8,575 for uncomplicated cases (p=0.00) with a mean length of stay of 62.8 days and 32.7 days respectively (p=0.00). Mortality probability of cases was significantly higher than the control group with a mean survival of 209 days versus 496 days for controls (p= 0.035) and patients with complications were statistically less likely to return to their own home (p< 0.01).

The socio-economic impact of complications following treatment of proximal femoral fractures is important in this current economic climate. Greater awareness and understanding are warranted. Recognition of potential risk factors for complications may allow earlier detection of potential cases and thereby reduce their number and in turn the socioeconomic cost.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXI | Pages 145 - 145
1 May 2012
G. H M. M T. B L. PS S. JL J-C T
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Hypothesis

Lumbar spinal stenosis (LSS) is diagnosed by a history of claudication, clinical investigation, cross-sectional area (CSA) of the dural sac on MRI or CT, and walking distance on the treadmill test. As radiological findings do not always correlate with clinical symptoms, additional diagnostic signs are needed. In patients without LSS, we observe the sedimentation of lumbar nerve roots to the dorsal part of the dural sac on supine MRI scans. In patients with LSS, this sedimentation is rarely seen. We named this phenomenon ‘sedimentation sign’ and defined the absence of sedimenting nerve roots as positive sedimentation sign for the diagnosis of LSS. We hypothesised that the new sedimentation sign discriminates between non-specific low back pain (LBP) and LSS.

Methods and analysis

This prospective case-control study included 200 patients in an orthopaedic in- and outpatient clinic. Patients in the LBP group (n=100) had low back pain, a cross-sectional area (CSA) of the dural sac >120mm2, and a walking distance >1000m; patients in the LSS group (n=100) showed claudication, a CSA < 80mm2, and a walking distance < 200m.