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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_IV | Pages 32 - 32
1 Mar 2012
Varghese B Patel N Hopton B Shutt D Groves C Bollen S
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Hamstring tendons are commonly used for Anterior Cruciate Ligament (ACL) reconstruction. In our series of 100 consecutive Hamstring ACL reconstructions, a four-strand graft was less than 7.0 mm in 5 patients. The aim of this study was to develop a screening test to assess the size of the hamstring tendon and so aid in the pre operative planning and patient counselling especially if hamstring size was deemed to be inadequate. A retrospective study of 100 consecutive hamstring ACL reconstructions analysed the correlation of the tendon size to height, weight and body mass index. A prospective double blind study was also set up involving independent observations by a musculoskeletal radiologist and the lead Orthopaedic surgeon.

Result

There was no correlation between the anthropometric measures and hamstring size in the retrospective study. A total of 27 limbs were assessed sonographically, in 26 patients. Spearman's rank correlation coefficient was found to Pearson's r = 0.0786; p = 0.715.

Conclusion

Pre-operative anthropometric measures and Ultrasound could not be used as a screening test to detect inadequate hamstrings in the clinical setting.


Orthopaedic Proceedings
Vol. 90-B, Issue SUPP_III | Pages 537 - 537
1 Aug 2008
Veysi V Metcalf R Shutt D Gillespie P Stone M
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Introduction: We present our results of the first 413 Charnley arthroplasties performed by and under the supervision of the senior surgeon, using the posterior approach.

Methods: This is a prospective study of clinical and radiographic outcomes. Four hundred and thirteen hip replacements were performed in 380 patients (215 female and 165 male) between 1992 and 1996. The mean age at the time of primary surgery was 67 years (28 – 91 years).

Results: The primary aetiology in 297 of the hips was osteoarthritis. Eighty-two had rheumatoid arthritis.

Eleven patients (3%) had one or more episodes of dislocation.

There were 22 revisions. Three of the revisions were carried out for infection, and a further 2 for recurrent dislocation. Aseptic loosening was the cause of failure in the remaining 17.

Thirty three patients (36 hips, 9%) could not be traced at the time of the final follow-up. There was significant and maintained improvement in pain and function scores.

One hundred and thirty eight patients (146 hips) had died at the time of the final follow-up.

The best and worst case survivorship figures at 10 years were 93 +/− 2% and 83 +/− 2%, and those at 14 years were 88 +/− 4% and 78 +/− 4%, respectively, with revision for any reason as the end-point.

Discussion: Excellent results for the Charnley hip are possible using the posterior approach and surgeons of varying experience. The results presented compare favourably with the published data and confirm that the Charnley remains the gold-standard for longevity in hip arthroplasty. The newer and more costly implants not only need to reproduce these results but also match the cost effectiveness of this prosthesis.