Aims. Knee osteoarthritis (OA) is characterized by a chronic inflammatory process involving multiple cytokine pathways, leading to articular cartilage degeneration. Intra-articular therapies using pharmaceutical or autologous anti-inflammatory factors offer potential non-surgical treatment options. Autologous protein solution (APS) is one such product that uses the patient’s blood to produce a concentrate of cells and anti-inflammatory cytokines. This study evaluated the effect of a specific
Aims. The primary aim of this study was to assess the feasibility of recruiting and retaining patients to a patient-blinded randomized controlled trial comparing corticosteroid injection (CSI) to autologous protein solution (APS) injection for the treatment of subacromial shoulder pain in a community care setting. The study focused on recruitment rates and retention of participants throughout, and collected data on the interventions’ safety and efficacy. Methods. Participants were recruited from two community musculoskeletal treatment centres in the UK. Patients were eligible if aged 18 years or older, and had a clinical diagnosis of subacromial impingement syndrome which the treating clinician thought was suitable for treatment with a subacromial injection. Consenting patients were randomly allocated 1:1 to a patient-blinded subacromial injection of CSI (standard care) or
Orthopaedic surgery uses many varied instruments with high-speed, high-impact, thermal energy and sometimes heavy instruments, all of which potentially result in aerosolization of contaminated blood, tissue, and bone, raising concerns for clinicians’ health. This study quantifies the aerosol exposure by measuring the number and size distribution of the particles reaching the lead surgeon during key orthopaedic operations. The aerosol yield from 17 orthopaedic open surgeries (on the knee, hip, and shoulder) was recorded at the position of the lead surgeon using an Aerodynamic Particle Sizer (APS; 0.5 to 20 μm diameter particles) sampling at 1 s time resolution. Through timestamping, detected aerosol was attributed to specific procedures.Aims
Methods
Aims. Astragalus polysaccharide (APS) participates in various processes, such as the enhancement of immunity and inhibition of tumours.
Introduction. Tibial components that match the resected proximal tibia may promote accurate rotational alignment and maximize coverage while minimizing overhang in total knee arthroplasty (TKA). Tibial component designs have traditionally been evaluated utilizing an overall anterior-posterior (AP)/medial-lateral (ML) ratio. However, since the tibial plateau is irregularly shaped, such a metric has drawbacks. Here, a detailed set of morphological metrics is used to evaluate six contemporary tibia designs against a multi-ethnic bone database. Methods. Tibial surfaces from 347 subjects, including 97 Indian (50m/47f), 99 Japanese (44m/55f), and 151 Caucasian (85m/66f), were virtually resected following a specific TKA procedure, as previous publications have shown surgical variability minimally impacts tibial resection morphology. Medial and lateral AP dimensions (MAP and LAP), ML width (ML), and medial and lateral anterior radii (MAR and LAR) were measured in a coordinate system constructed on the resected surface based on the neutral rotational axis (Fig. 1A). These metrics, along with anterior radius asymmetry (MAR/LAR), were regressed against ML for each ethnicity. The regressions were then compared with similar measurements obtained from tibial components in six contemporary TKA systems (one asymmetric: Design A; four symmetric: Designs B-E; and one anatomic: Design F). Results. The LAP of all six designs generally agrees well with the three ethnicities investigated. Designs A and F have MAP closer to tibial morphology (Fig. 2), while those of the symmetric designs are smaller than the morphological measurement, especially for tibiae with larger ML (Fig. 2). Across all three ethnicities, there is a positive correlation between anterior radii and ML (Fig. 3), which is reflected in each of the component designs. However, the symmetric designs tend to have bigger LAR and smaller MAR compared to the anatomic tibial morphology. Design F has the closest
We examined the one-year risk of symptomatic
venous thromboembolism (VTE) following primary total hip replacement
(THR) among Danish patients and a comparison cohort from the general
population. From the Danish Hip Arthroplasty Registry we identified
all primary THRs performed in Denmark between 1995 and 2010 (n =
85 965). In all, 97% of patients undergoing THR received low-molecular-weight
heparin products during hospitalisation. Through the Danish Civil
Registration System we sampled a comparison cohort who had not undergone
THR from the general population (n = 257 895). Among the patients
undergoing THR, the risk of symptomatic VTE was 0.79% between 0
and 90 days after surgery and 0.29% between 91 and 365 days after
surgery. In the comparison cohort the corresponding risks were 0.05%
and 0.12%, respectively. The adjusted relative risks of symptomatic
VTE among patients undergoing THR were 15.84 (95% confidence interval
(CI) 13.12 to 19.12) during the first 90 days after surgery and
2.41 (95% CI 2.04 to 2.85) during 91 to 365 days after surgery,
compared with the comparison cohort. The relative risk of VTE was
elevated irrespective of the gender, age and level of comorbidity
at the time of THR. We concluded that THR was associated with an increased risk of
symptomatic VTE up to one year after surgery compared with the general
population, although the absolute risk is small.
The accuracy and precision of two new methods of model-based
radiostereometric analysis (RSA) were hypothesised to be superior
to a plain radiograph method in the assessment of polyethylene (PE)
wear. A phantom device was constructed to simulate three-dimensional
(3D) PE wear. Images were obtained consecutively for each simulated
wear position for each modality. Three commercially available packages
were evaluated: model-based RSA using laser-scanned cup models (MB-RSA),
model-based RSA using computer-generated elementary geometrical
shape models (EGS-RSA), and PolyWare. Precision (95% repeatability
limits) and accuracy (Root Mean Square Errors) for two-dimensional
(2D) and 3D wear measurements were assessed.Objectives
Methods
Introduction. Angiosarcomas are rare aggressive sarcomas of vascular endothelial origin. These tumours have the potential to be multicentric and are associated with high rates of local recurrence, which makes treatment challenging. The gold-standard is that these patients are managed in specialist centres by a multidisciplinary team. We present our experience of managing patients with angiosarcoma in the North of England Bone and Soft Tissue Tumour Service and a review of the literature. Methods. A prospectively collated electronic database was used to identify patients with angiosarcoma treated between 2000 and 2008, and an analysis performed of demographics, anatomical site, surgical excision and reconstruction, local disease recurrence and metastatic disease. Results. Fifteen patients (ten female, ?ve male, mean age 71 years) were identi?ed. Eight patients developed tumours in a previously irradiated area, after a mean of 11 years. Six patients had metastatic disease at presentation. Fourteen patients underwent wide surgical excision of the tumour, of which nine required defect reconstruction(?ve free latissimus dorsi ?