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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_IV | Pages 16 - 16
1 Mar 2012
DIRECT STABILISATION OF LUMBAR SPONDYLOLYSIS WITH A HOOK SCREW
Sharma D Agarwal A Hammer A
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The hook screw method is a direct repair technique that permits ‘restitutio ad integrum’ for a functional segment. The surgical method of treating spondylolysis and grade 1 spondylolisthesis by spondylytic hook screw reduction and bone grafting in 34 patients is reported. Of these patients, 32 showed good to excellent results.

Surgical technique

The bone on either side of the defect is roughened. Then the screws are inserted after pre-drilling into the base of the articular process inclined at 400 to the vertebral endplate and diverging 15 to 20 degrees from each side. Then the special hooks, hooked under the lamina, are fixed to the screws by nuts over a spring so as to obtain compression over the defect. Autologous cancellous bone graft is placed in the defect.

Materials and methods

A total of 34 patients were included in this study from 1998 to 2006, 32 male and 2 female patients. Pre-operative and post-operative Oswestry Lumbar Disability Index score (OLDI) and SF 36 scores recorded.

Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_I | Pages 57 - 57
1 Mar 2006
RESURFACING HIP ARTHROPLASTY AND TOTAL HIP ARTHROPLASTY. ANALYSIS OF EARLY RESULTS, DISCHARGE PATTERN AND COST IMPLICATIONS
Sharma D Saeed Z Ramos J Hughes S
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Aims: To compare the results of resurfacing hip arthroplasty with conventional total hip replacement and to find out any differences in complication rates, discharge patterns and the resulting financial implications.

Trial Design: Retrospective analysis comparing resurfacing hip arthroplasties to conventional total hip replacements in patients who were 65 years old or younger at the time of operation. Criteria for comparison were blood loss, post operative complications (including the need for blood transfusion), revision of arthroplasty and the length of hospital stay.

Materials and Methods: All patients who had resurfacing arthroplasty in our hospital were included in the study (77 patients), and a similar group who had total hip replacements in the same time period were randomly selected for comparison. Case notes, computer records as well as X-rays were used to identify postoperative complications, especially DVT’s ,PE’s, neuro-vascular injuries, infection, fractured neck of femur and the need for revision of an arthroplasty. A detailed analysis of all revision arthroplasties including the causes, failure pattern of implant and the type of revision hip arthroplasty used and its cost implication was made. We also compared the pre and post-operative haemoglobin and units of blood transfused, if any. A comparison was also made of discharge pattern of these two groups of patients. A student t-test was performed to observe any difference in these two group.

Results:

Resurface hip arthroplasty Group: Average age 52.1 years; pre-operative Hb 14.22gm/dl; postoperative Hb.10.95gm/dl; average blood loss 3.28 gm/dl; Total hips revised 12; Average length of stay 8.53 days.

Total hip arthroplasty Group: Average age 58.8 years; pre-operative Hb 13.97gm/dl; post-operative Hb 10.65m/dl; average blood loss 3.5 gm/dl; Total hips revised 0; Average length of stay 8.9 days.

Conclusions: 1.There were no appreciable differences between these two group as far as the usual complications, blood loss and length of stay are concerned. 2. There was appreciable difference in revision rate, which has significant cost implication for health authority and patients

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