Adhesive capsulitis of the shoulder is a common debilitating condition with prevalence in the order of 2 to 5%. Whilst it is usually a self-limiting condition, patients are typically not willing, nor are they able, to wait to the end of the recovery phase. A number of treatment strategies have been described. Manipulation under anaesthesia can significantly increase motion in all planes, but carries a significant risk of fracture. Capsular release also significantly improves motion with fewer potential side effects.

We hypothesise that performing an arthroscopic excision of the abnormal capsulitis tissue will give better results with least risk of recurrence. Data was collected both retrospectively and prospectively for patients undergoing this procedure. Range of motion and Oxford shoulder scores was documented pre-operatively and post-operatively, at 6 weeks, 3 months and 6 months. 41 patients were included. At 3 months mean flexion had increased from 101 to 152 degrees, abduction from 91 to 151 degrees, and external rotation from 18 to 44 degrees. Mean Oxford shoulder score had increased from 20.6 to 35.8 at 3 months.

The results support the use of this technique for treating adhesive capsulitis. Larger patient numbers and longer term follow up will help compare it against the other well established techniques.

This study looks at the use of rotating hinge Total Knee Replacement (TKR) as a treatment option when dealing with fractures involving the knee.

The treatment of complex intra-articular fractures involving the knee has always proved challenging. Studies have investigated the outcome of various forms of treatment for such injuries, including internal fixation and primary knee arthroplasty. Recent advances in technology have brought about more sophisticated implants for both internal fixation and arthroplasty, including rotating hinge TKR.

The initial non-rotating hinged prostheses for total knee arthroplasty did not enjoy a good reputation. The cumulative survival rate has been quoted as 65% at 6 years, significantly lower than that of conventional prostheses. Therefore the use of such implants was restricted to complex primary or revision arthroplasty, and tumour surgery. Studies have been published advocating the use of hinged prostheses for distal femoral fractures in elderly patients. The average age in the most recent study was 82, of whom 42% had died within the first post-operative year.

This study is a case series of 16 patients with fractures who were treated with rotating hinge TKR. The age range is 36 to 92, with a mean of 69, lower than that of earlier studies. Outcome data as measured by the Oxford knee scoring system has been retrospectively collected. At follow up the range of Oxford knee scores was 14 to 52, with a mean of 36. We discuss the indications, experiences and outcomes in the management of these patients, and conclude that this is a valid treatment option in certain circumstances.