Unicompartmental knee arthroplasty provides a good alternative to total knee arthroplasty in patients with isolated medial compartment osteoarthritis. Reported ten-year survival for the Oxford medial unicompartmental knee arthroplasty is variable, ranging from 80.2% to 97.7% in the originator series. The aim of this study was to determine the survival and reasons for revision of the Oxford medial unicompartmental knee arthroplasty when performed at a specialist orthopaedic centre. Details of consecutive patients undergoing Oxford unicompartmental knee arthroplasty at our centre between January 2000 and December 2009 were collected prospectively. Failure of the implant was defined as conversion to total knee arthroplasty. Survival was determined using the Kaplan-Meier method.Background
Methods
Despite aggressive debridement, thorough irrigation, administration of systemic antibiotics and staged treatment, many open fractures still become infected. A graft that can promote bone regeneration and prevent infection could decrease complications. Polyurethane (PUR) scaffolds have been previously shown in separate studies to be non-toxic, osteoconductive, can promote bone growth through BMP delivery and prevent infection by having sustained release of an antibiotic. This scaffold can deliver both BMP and vancomycin simultaneously; the purpose of this study is to determine if the co-delivery of the antibiotic inhibits bone formation. Using an established critical size defect rat femur model, the amount of bone formation created by PUR scaffolds containing low and high doses of rhBMP-2 (2.4 μg and 22.4 μg respectively) and 0.8 mg vancomycin (8% of graft by weight) were compared to scaffolds that contained rhBMP-2 without antibiotics. After 4 weeks, the femurs were harvested and bone growth was assessed using microCT.Background
Methods
To determine, in skeletally immature children with acceptably angulated (< = 15 degrees deformity at presentation) distal radius fractures, if a pre-fabricated wrist splint is at least as effective as a cast. A randomised controlled, non-inferiority, single blinded, single-centre trial was performed. The primary outcome was physical function at six weeks. Secondary outcomes included angulation, wrist range of motion, strength, pain, and patient preferences.Purpose
Methods
The purpose of this study was to evaluate the independent contributions of surgeon procedure volume, hospital procedure volume, and standardisation of care on short-term post-operative outcomes and resource utilisation in lower-extremity total joint arthroplasty. An analysis of 182,146 consecutive patients who underwent primary total joint arthroplasty was performed with use of data entered into the Perspective database by 3421 physicians from 312 hospitals over a two-year period. Adherence to evidence-based processes of care was defined by administration of appropriate perioperative antibiotic prophylaxis, beta blockade, and venous thromboembolism prophylaxis. Patient outcomes included mortality, length of hospital stay, discharge disposition, surgical complications, readmissions, and reoperations within the first 30 days after discharge. Hierarchical models were used to estimate effects of hospital and surgeon procedure volume and standardisation on individual and combined surgical outcomes and length of stay.Background
Methods
