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Bone & Joint Open
Vol. 4, Issue 8 | Pages 628 - 635
22 Aug 2023
Hedlundh U Karlsson J Sernert N Haag L Movin T Papadogiannakis N Kartus J

Aims

A revision for periprosthetic joint infection (PJI) in total hip arthroplasty (THA) has a major effect on the patient’s quality of life, including walking capacity. The objective of this case control study was to investigate the histological and ultrastructural changes to the gluteus medius tendon (GMED) in patients revised due to a PJI, and to compare it with revision THAs without infection performed using the same lateral approach.

Methods

A group of eight patients revised due to a PJI with a previous lateral approach was compared with a group of 21 revised THAs without infection, performed using the same approach. The primary variables of the study were the fibril diameter, as seen in transmission electron microscopy (TEM), and the total degeneration score (TDS), as seen under the light microscope. An analysis of bacteriology, classification of infection, and antibiotic treatment was also performed.


Bone & Joint Research
Vol. 12, Issue 4 | Pages 294 - 305
20 Apr 2023
Aquilina AL Claireaux H Aquilina CO Tutton E Fitzpatrick R Costa ML Griffin XL

Aims

Open lower limb fracture is life-changing, resulting in substantial morbidity and resource demand, while inconsistent outcome-reporting hampers systematic review and meta-analysis. A core outcome set establishes consensus among key stakeholders for the recommendation of a minimum set of outcomes. This study aims to define a core outcome set for adult open lower limb fracture.

Methods

Candidate outcomes were identified from a previously published systematic review and a secondary thematic analysis of 25 patient interviews exploring the lived experience of recovery from open lower limb fracture. Outcomes were categorized and sequentially refined using healthcare professional and patient structured discussion groups. Consensus methods included a multi-stakeholder two-round online Delphi survey and a consensus meeting attended by a purposive sample of stakeholders, facilitated discussion, and voting using a nominal group technique.


Bone & Joint Open
Vol. 4, Issue 3 | Pages 188 - 197
15 Mar 2023
Pearson NA Tutton E Gwilym SE Joeris A Grant R Keene DJ Haywood KL

Aims

To systematically review qualitative studies of patients with distal tibia or ankle fracture, and explore their experience of injury and recovery.

Methods

We undertook a systematic review of qualitative studies. Five databases were searched from inception to 1 February 2022. All titles and abstracts were screened, and a subset were independently assessed. Methodological quality was appraised using the Critical Appraisal Skills Programme (CASP) checklist. The GRADE-CERQual checklist was used to assign confidence ratings. Thematic synthesis was used to analyze data with the identification of codes which were drawn together to form subthemes and then themes.


The Bone & Joint Journal
Vol. 104-B, Issue 8 | Pages 972 - 979
1 Aug 2022
Richardson C Bretherton CP Raza M Zargaran A Eardley WGP Trompeter AJ

Aims

The purpose of this study was to determine the weightbearing practice of operatively managed fragility fractures in the setting of publically funded health services in the UK and Ireland.

Methods

The Fragility Fracture Postoperative Mobilisation (FFPOM) multicentre audit included all patients aged 60 years and older undergoing surgery for a fragility fracture of the lower limb between 1 January 2019 and 30 June 2019, and 1 February 2021 and 14 March 2021. Fractures arising from high-energy transfer trauma, patients with multiple injuries, and those associated with metastatic deposits or infection were excluded. We analyzed this patient cohort to determine adherence to the British Orthopaedic Association Standard, “all surgery in the frail patient should be performed to allow full weight-bearing for activities required for daily living”.


Bone & Joint 360
Vol. 9, Issue 2 | Pages 15 - 18
1 Apr 2020


The Bone & Joint Journal
Vol. 100-B, Issue 4 | Pages 522 - 526
1 Apr 2018
Tutton E Achten J Lamb SE Willett K Costa ML

Aims

The aim of this study was to explore the patients’ experience of recovery from open fracture of the lower limb in acute care.

Patients and Methods

A purposeful sample of 20 participants with a mean age of 40 years (20 to 82) (16 males, four females) were interviewed a mean of 12 days (five to 35) after their first surgical intervention took place between July 2012 and July 2013 in two National Health Service (NHS) trusts in England, United Kingdom. The qualitative interviews drew on phenomenology and analysis identified codes, which were drawn together into categories and themes.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 301 - 301
1 Sep 2012
Gómez-Galván M Román S Quirós I Quiles M
Full Access

Hip fractures are common in the elderly. These people often had a history of multiple falls, and previous fractures. Fear of falling (FOF) have being reported in the follow-up of hip fractures. Aims. To evaluate the FOF in patients just after hip fracture and before surgical treatment. Material and methods. Prospective study of patients admitted in our hospital with hip fracture (subcapital, trochanteric and subtrochanteric). All patients were evaluated using the FES-I score for FOF before surgical treatment. Clinical and social data, previous history of falls, and fractures were recorded. Exclusion criteria were a score below 8 on the Minimental test on admission and previous hip fracture. Stadistical analysis were peformed using ANOVA, chi square and contingency tables. Results. During the 7 months that lasted this work 144 hip fracture were admitted to our hospital. Only 40 had a Minimental score of 8 or more, mean age was 82 years old, they were 33 female and 7 male, 18% of them were living at home, alone, 82% with their partners or other family members, 40% had no history of previous falls, 10 falls in the last year was reported by one patient. No or little FOF were reported by 52% of patients, while 48% had fear or too much fear. We have found a statistical significant relationship between FOF and patient age (p<0,001), fracture type (p<0,05), and previous history of falls (p<0,05). Conclusion. FOF prior to hip fracture is strongly related to of age, previous falls and fracture type


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_I | Pages 4 - 4
1 Mar 2006
Todd* C Yardley** L
Full Access

Background: ProFaNE is an EC-funded network supporting collaboration between researchers in the field of falls injury prevention. One component of ProFaNE concerns psychosocial aspects of falls prevention, which include assessment of fear of falling and attitudes to falls prevention programmes. Findings from members’ collaborative qualitative research on attitudes to falls prevention will be presented. Methods: We conducted interviews with older people, assessing their beliefs and attitudes regarding falls prevention programmes. Interviews were structured around the Theory of Planned Behaviour, were carried out in the UK, the Netherlands, Germany, Switzerland, Norway, Greece and Italy. The thematic analysis reported here compares the beliefs of those who had taken part in a falls prevention programme and those who had not been offered this option. Findings: Whilst many may reject the notion that falls are anything to do with them, participants reported being motivated to take part in programmes that are designed to improve strength and balance chiefly by a desire for, and experiences of, immediate benefits (including improved functioning and mobility, enjoyment and increased self-confidence) rather than by fear of falling. The main reported barriers to participation included lack of familiarity with such programmes, concern about exertion, transport and financial obstacles, and lack of motivation. Conclusions: Falls prevention has negative connotations for many older people. Participation in falls prevention programmes may be enhanced by maximising and promoting their immediate benefits rather than their potential for reducing falls, by removing practical barriers, and by providing opportunities to sample programmes in order to demonstrate their immediate benefits. A focus on exercise as promoting health, fitness and independence may have wider acceptability