To achieve expert clinical consensus in the delivery of hydrodilatation for the treatment of primary frozen shoulder to inform clinical practice and the design of an intervention for evaluation. We conducted a two-stage, electronic questionnaire-based, modified Delphi survey of shoulder experts in the UK NHS. Round one required positive, negative, or neutral ratings about hydrodilatation. In round two, each participant was reminded of their round one responses and the modal (or ‘group’) response from all participants. This allowed participants to modify their responses in round two. We proposed respectively mandating or encouraging elements of hydrodilatation with 100% and 90% positive consensus, and respectively disallowing or discouraging with 90% and 80% negative consensus. Other elements would be optional.Aims
Methods
A high precision of three-dimensional (3D) computerised planning of THA was recently reported. However, there is no comparative study analysing the value of 3D planning comparatively to the planning made on X-rays using 2D templates A prospective comparative randomised study was carried out from 2008 to 2009, and included 2 groups of 32 patients who underwent THA for primary osteoarthritis. One surgeon performed all the procedures using a direct anterior approach. In one group, the planning was made on calibrated X-Rays using 2D templates. In the other group, a 3D planning was performed based on CT-scan using the Hip-Plan software. Post operatively, the final hip anatomy was analysed on X-Rays for the 2D group and on CT-scan for the 3D group.Background
Material and method
High cup abduction angles generate increased contact stresses, higher wear rates and increased revision rates. However, there is no reported study about the influence of cup abduction on stresses under head lateralisation conditions for ceramic-on-Ceramic THA. A finite elements model of a ceramic-on-ceramic THA was developed in order to predict the contact area and the contact pressure, first under an ideal regime and then under lateralised conditions. A 32 mm head diameter with a 30 microns radial clearance was used. The cup was positioned with a 0°anteversion angle and the abduction angle was varied from 45° to 90°. The medial-lateral lateralisation was varied from 0 to 500 microns. A load of 2500 N was applied through the head center.Background
Material and method
Squeaking after total hip replacement has been reported in up to 10% of patients. Some authors proposed that sound emissions from squeaking hips result from resonance of one or other or both of the metal parts and not the bearing surfaces. There is no reported in vitro study about the squeaking frequencies under lubricated regime. The goal of the study was to reproduce the squeaking in vitro under lubricated conditions, and to compare the in vitro frequencies to in vivo frequencies determined in a group of squeaking patients. The frequencies may help determining the responsible part of the noise. Four patients, who underwent THR with a Ceramic-on-Ceramic THR (Trident(r), Stryker(r)) presented a squeaking noise. The noise was recorded and analysed with acoustic software (FMaster(r)). In-vitro 3 alumina ceramic (Biolox Forte Ceramtec(r)) 32 mm diameter (Ceramconcept(r)) components were tested using a PROSIM(r) hip friction simulator. The cup was positioned with a 75° abduction angle in order to achieve edge loading conditions. The backing and the cup liner were cut with a diamond saw, in order to avoid neck-head impingement and dislocation in case of high cup abduction angles (Figure1). The head was articulated ± 10° at 1 Hz with a load of 2.5kN for a duration of 300 cycles. The motion was along the edge. Tests were conducted under lubricated conditions with 25% bovine serum without and with the addition of a 3rd body alumina ceramic particle (200 μm thickness and 2 mm length). Before hand, engineering blue was used in order to analyze the contact area and to determine whether edge loading was achieved.INTRODUCTION
METHODS
