To determine the effect that preoperative use of 3D printed models has on the outcomes for femoroacetabular impingement (FAI) surgery.

Ninety patients that underwent FAI surgeries by the same surgeon were retrospectively analyzed. Patients were age- and sex-matched for two groups - those who had pre-operative 3D printed hip models (n=45) and those with conventional planning using X-rays and/or CT scan (n=45) were identified. Radiographic parameters on pre- and post-operative radiographs that include the alpha angle (45 Dunn view), center edge angle (CEA) (weight bearing AP pelvis), and head-neck offset ratio (cross-table lateral) were obtained. Clinical outcomes were assessed by analyzing iHOT and HOS scores pre- and post-operatively.

Ninety patients (3D printed group 45, Conventional group 45) with a mean age of 36 years were evaluated. Mean follow-up time was 28 months. For all of the radiological variables (CEA and alpha angle), there was a significant improvement seen for both groups (p=0.001). However, the 3D printed group showed significantly better resection of bone to a normal alpha angle (< 5 5) than did the Conventional group. Additionally, head-neck offset was significantly better in the 3D printed group (p=0.001). Statistically significant improvements were seen in both groups on the HOS and iHOT-33 (p=0.001).

Planning FAI surgery using 3D hip models helps in achieving better resection, especially in CAM-type FAI.

The primary objective of this study was to establish a safety profile for an all-arthroscopic anatomic glenoid reconstruction via iliac crest autograft augmentation for the treatment of shoulder instability with glenoid bone loss. Short-term clinical and radiological outcomes were also evaluated.

This study involved a retrospective analysis of prospectively collected data for 14 patients (male 8, female 6) who were treated for shoulder instability with bone loss using autologous iliac crest bone graft between 2014 and 2018. Of 14 patients, 11 were available for follow-up. The safety profile was established by examining intra-operative and post-operative complications such as neurovascular injuries, infections, major bleeding, and subluxations. Assessment of pre-operative and post-operative Western Ontario Shoulder Instability (WOSI) index, radiographs, and CT scans comprised the evaluation of clinical and radiological outcomes.

A good safety profile was observed. There was no occurrence of intraoperative complications, neurovascular injuries, adverse events, or major bleeding. One patient did develop an infection in the neurovascular injuries, adverse events, or major bleeding. One patient did develop an infection in the treated shoulder post-surgery. There were no subluxations or positive apprehension tests on clinical examination post-operatively. Short-term clinical outcomes were seen to be favorable WOSI scores at the most recent follow-up were significantly higher than pre-operative scores, with a mean increase of 39.6 ± 10.60 (p = 0.00055). The average follow-up for CT scan was 4.66 (SD± 2.33) months, where all patients showed bone graft union.

Arthroscopic treatment of shoulder instability with bone loss via autologous iliac crest bone graft is shown to be a safe operative procedure that results in favorable short-term clinical and radiological outcomes. Further investigations must be done to evaluate the longevity of these positive health outcomes.

To evaluate the short-term clinical outcomes of patients treated arthroscopically with chitin-based scaffolding for acetabular chondral defects in conjunction with microfracture compared to microfracture alone.

This study is a retrospective analysis of prospectively collected data. A review of charts was performed (2014–2016) on all patients who underwent hip arthroscopy and had microfracture +/− scaffolding for acetabular chondral defects, intraoperative details (lesion size, grade, labral repair/reconstruction) and postoperative complications were recorded with a minimum follow-up of 2 years. Clinical outcomes were assessed by analysing iHOT and HOS scores which were obtained pre-operatively, at six months, one year and two years post-surgery. Plain radiographs were assessed for hip osteoarthritis by Kellgren & Lawrence grading.

A total of 60 patients (microfracture=25, scaffolding=35) were included. Patients had a mean age of 36.2 years at the time of the index operation. There were no major adverse events of deep vein 36.2 years at the time of the index operation. There were no major adverse events of deep vein thrombosis, blood vessel or nerve damage, hemarthrosis or device related adverse events in both groups. Two patients were readmitted due to pain as a result of an inflammatory reaction in the scaffolding group. Both treatments of microfracture and scaffolding showed significant improvement in outcome score (iHOT) (p < 0 .001) when compared postoperative to preoperative.

Both the arthroscopic treatment of chondral acetabular defects with chitin based scaffolding and microfracture demonstrated significant improvement from their pre-operative outcomes.

Background: The results of arthroscopic anterior labral (Bankart) repair have been shown to have high failure rate in patients with significant glenoid bone loss. Several reconstruction procedures using bone graft have been described to overcome the bone loss, including autogenous coracoid transfer to the anterior glenoid (Latarjet procedure) as well as iliac crest autograft and tibial allografts. In recent years, trends toward minimally invasive shoulder surgery along with improvements in technology and technique have led surgeons to expand the application of arthroscopic treatment. Purpose: This study aims to perform a retrospective analysis of prospectively collected data to evaluate the clinical and radiological follow up of patient who underwent anatomic glenoid reconstruction using distal tibia allograft for the treatment of shoulder instability with glenoid bone loss at 1-year post operation time point.

Between December 2011 and January 2015, 55 patients underwent arthroscopic stabilisation of the shoulder by means of capsule-labral reattachment to glenoid ream and bony augmentation of glenoid bone loss with distal tibial allograft for recurrent instability of the shoulder. Preoperative and postoperative evaluation included general assessment by the western Ontario shoulder instability index (WOSI) questionnaire, preoperative and postoperative radiographs and CT scans.

Fifty-five patients have been evaluated with mean age of 29.73 years at time of the index operation. There were 40 males (mean age of 29.66) and 15 female (mean age of 29.93). Minimum follow up time was 12 months. The following adverse effects were recorded: none suffered from recurrent dislocation, 2 patients suffered from bone resorption but without overt instability, 1 patient had malunion due to screw fracture, None of the patients had nonunion. The mean pre-operative WOSI score was 36.54 and the mean postoperative WOSI score was 61.0.

Arthroscopic stabilisation of the shoulder with distal tibia allograft augmentation demonstrates promising result at 1year follow up.

Aims

We performed a systematic review of the literature to determine whether earlier surgical repair of acute rotator cuff tear (ARCT) leads to superior post-operative clinical outcomes.

Purpose: To determine predictive factors for alloge-neic blood transfusion to aid in development of blood conservation strategies for the Hamilton arthroplasty population

Methods: A prospectively collected, retrospective study of 828 patients, who did not donate blood, treated with either primary total knee or total hip arthroplasty from 1998 to 2002 at Hamilton Henderson Hospital was carried out. A univariate analysis was performed to establish the relationship between all independent variables and the need for postoperative transfusion. Variables that were determined to have a significant relationship were included in a multivariate analysis

Results: The univariate analysis revealed a significant relationship between the need for postoperative blood transfusion and preoperative hemoglobin levels (p=0.000), age (P=0.000), and gender (P=0.005). However, the multivariate analysis only revealed significant relationship between the need for transfusion and pre-operative hemoglobin (P=0.000) and age (P=0.014). Patients with preoperative hemoglobin of > 150 g/L had a 10% risk of transfusion. Patients with preoperative hemoglobin of 141–150 g/L has 2.5 times greater risk, 131–140 g/L 4 times greater risk, 121–130 g/L 6 times greater risk, and < 120 25 times greater risk than patients with preoperative hemoglobin > 150 g/L.

Conclusions: The preoperative hemoglobin level and age were shown to predict the need for blood transfusion after total joint arthroplasty. These results of this will help to create guidelines for the Blood Conservation Program in HHSC.