The aim of this study was to examine the recent trend in delivery of arthroscopic subacromial decompression (ASD) in Scotland and to determine if this varies by geographical location. Scottish Morbidity Records were reviewed retrospectively between March 2014 and April 2018 to identify records for every admission to each NHS hospital. The Office of Population Censuses and Surveys (OPCS-4) surgical codes were used to identify patients undergoing primary ASD. Patients who underwent acromioclavicular joint excision (ACJE) and rotator cuff repair (RCR) were identified and grouped separately. Procedure rates were age and sex standardized against the European standard population.Aims
Methods
A simple technique for screw fixation of the carpal scaphoid in cases of delayed union and non-union is described. The results obtained in 32 patients treated by this method are reported. The average follow-up was three years ranging from 10 months to 12 years. Union was obtained in 28 patients. The causes of failure to unite are discussed and the advantages of the reported method over other techniques such as bone grafting are stressed.
Fifty patients who underwent a MacIntosh repair for anterolateral instability of the knee have been reviewed after a mean follow-up of two and a quarter years. The repair abolished a positive anterolateral jerk test in 42 out of 50 knees and at the time of review 37 patients (74 per cent) were involved in some form of active sport, having regained functional and clinical stability. The MacIntosh repair is described in detail and the importance of excluding meniscal lesions as the main cause of instability is emphasised.
A series of 135 knee arthroscopies has been reviewed to determine the accuracy of detection of meniscal lesions. Arthroscopy and double-contrast arthrography achieved similar accuracy (84 per cent and 86 per cent) in the diagnostically more difficult knees of the series. The combined accuracy of both examinations was 98 per cent. Arthroscopic difficulty in seeing the posterior third of the medial meniscus, and consequently tears in this region, is emphasised and discussed. Arthroscopy and arthrography are complementary in the diagnosis of difficult meniscal problems.
Intertrochanteric osteotomy gives compensatory correction for the severely slipped upper femoral epiphysis without endangering its blood supply. The results of thirty-five such osteotomies carried out over an eighteen-year period are reviewed. The indication for operation was a chronic slip of a third or more of the growth plate in the lateral radiograph. The mean age at operation was fourteen years and the mean follow-up period seven and a half years. The results showed that even a moderate correction of deformity as shown by the radiograph could produce a hip with a functionally satisfactory range of movement. Chondrolysis was the most serious complication and occurred in four hips. The radiological results are discussed in relation to details of operative technique and also to long-term prognosis.
