Background. Jumper's knee is the result of violent and repeated contractions of quadriceps muscle caused by rapid acceleration and deceleration, jumping and kicking that load on patellar tendon stressing its mechanical resistance. The porpose of this retrospective study is to analyze the results, after the debridment of the patellar tendon and the patellar apex abrasion performed by arthroscopy, at a mean follow-up of seven years. Methods. From 1996 to 2006, sixty-four patients (seventy-three knees) affected by jumper's knee underwent surgical tretment after failure of nonoperative treatment. All knees were operated on by the same surgeon using the same surgical technique: arthroscopic debridement of the articular face of patellar tendon and arthroscopic abrasion of patellar apex. Pre-operative and post-operative evaluation was made according to IKDC score, Lysholm Knee Scale and VISA-P score. Results. The pre-operative subjective IKDC score was 52,96. This score significantly increased to 94,72 at 12 months post-operation, and has remained nearly constant at
Introduction. The number of total hip arthroplasties in young patients is continuosly increasing. Nowdays, the study of the materials wear, with the goal of improving the survivorship of implants, represents a fundamental subject in this kind of surgery. The role of ceramic materials in the valutation of types of wear is particularly known. Materials and Methods. We have selected 834 patients, underwent total hip arthroplasty, in which a ceramic head was impalnted with a maximum follow up of ten years. 367 patients were males and 467 were females, operated by 14 surgeons of the same equipe of Orthopaedic and Traumatology Department. A postero-lateral approach, according to Gibson Moore, and an extrarotator tendons transosseal repair was performed. Results. 446 ceramic liners, 354 polyethylene liners and 34 metallic liners were used. 18 types of stems, 5 of which stemless, were implanted. The mean survivorship of all cohrt of patients was 92% at
Purpose. to analyze the survivorship of the RSA with a minimum
Introduction: The Allofit cup is a hemispherical pressfit cup with a flattened pole for cementless implantation. Clinical use started in 1993 and we report our clinical and radiographic results of the first 100 cases. 75 hips of this group have been followed during the first 3 to 4 years using EBRA for migration analysis. These results also are presented. Material: Out of 100 hips 81 have been followed mith a mean of
This study evaluates the effect of lower limb post-operative mechanical axis on the long term risk of revision surgery following primary total knee arthroplasty (TKA). The study is relevant because many recent clinical trials have evaluated the optimal surgical technique for accurately aligning components in TKA, despite little evidence that alignment may effect the long-term clinical outcome. The data used in this study was collected prospectively as part of a randomized control trial comparing the long term survival of cemented versus uncemented TKA. The trial included 501 press-fit condylar posterior cruciate ligament-retaining prostheses performed by the senior author (PJG) or under his direct supervision. The post-operative mechanical axis alignment of the lower limb was measured following TKA using standard AP weight-bearing long leg alignment radiographs. A comparison was made between a well-aligned group with a mechanical axis alignment within 3° of neutral; and a poorly-aligned group whose mechanical axis alignment deviated greater than 3° from neutral. Survival analysis used revision surgery, with exchange of any of the three originally inserted components (femoral, tibial, polyethylene insert), as the endpoint. There was no loss to follow-up in this study. The minimum follow-up of TKAs in this study was 5.8 years. In the population of TKAs that were followed up at
The purpose of this study was to determine the survivorship for a MOM implant series performed by a single community surgeon followed using a practical clinical model. A retrospective cohort of 104 primary MOM THA procedures (94 patients) were all performed by one surgeon at three local hospitals now with 10–13 years follow-up. Sixteen patients are deceased and 16 patients have been lost to follow-up. In the remaining 62 patients, 8 are bilateral providing a total of 70 THA for study. The clinical follow-up model included: hip scores, X-rays, ultrasound, and metal ion concentrations (Co, Cr, Ti). Due to the diversity of patient location, a variety of clinical labs were utilized for metal ions. Statistical methods included Kaplan-Meier survival curve and One-way ANOVA. Hip scores were available for 70 THA and of these 61 had a hip score (HHS) above 80 (87%). X-rays were available for 49 hips and of these 38 (78%) had lateral/version angles in the safe zone (Fig 1: inclination ≤ 55 and anteversion ≤ 35). Thirty-eight ultrasound exams were performed and of these three yielded fluid collections (8%). Metal ion concentrations were documented in 39 of 62 patients (63%, either serum or whole blood). Six outliers were identified with high concentrations of metal ions (Fig 2); Co 0.3–143.9 ppb (median 3.6), Cr 0.2–200.3 ppb (median 2.2) and Ti 2-110 ppb (median 54). Six patients were revised by the original surgeon. Three of six with elevated ions were documented as wear problems and the other three were revised for infection, femur fracture and metal-ion sensitivity. The survivorship of 92.5% at
The topic of this study was to research the survival rate of ATLAS hip prosthesis (acetabular cup) performed by one operating surgeon only and with a minimum of
Introduction and Aims: Eight thousand Duraloc 300 cups were implanted worldwide in 2002. To our knowledge, no 10-year results have been published to date. We undertook this study to ascertain whether this optimism was justified. Method: One hundred consecutive total hip replacements using a Duraloc 300 cup were reviewed at a minimum of
Introduction and Aims: This longitudinal prospective study reports the 10-year results of anterior cruciate ligament (ACL) reconstruction in 90 patients with isolated ACL rupture. Method: Three hundred and thirty-three patients undergoing endoscopic ACL reconstruction over a 15-month period using patellar tendon autograft and interference screw fixation were evaluated prospectively. Those patients with an associated ligament injury, chondral damage, previous meniscectomy, excision >
1/3 of one meniscus, an abnormal radiograph or contra-lateral knee, or a compensable injury were excluded. This left 90 patients in the study group. Evaluation was conducted annually for five years, then at seven and
The aim of this study was to review the data held with the NHSLA database over the last
Purpose: We report a retrospective series of 98 consecutive total hip prostheses implanted without cement: the Aura stem and the Alizé cup coated with hydroxyapatite; reviewed at mean 9.6 years. The purpose of this analysis was to examine implant stability and wear. Material and methods: Total hip prostheses implanted in 98 patients from January 1991 to January 1992 were reviewed: 60 women and 38 men, operated on by the same surgeon using an Alizé cup and an Aura stem without cement. Mean age at implantation was 66.5 years (30–85). Mean follow-up was 9.67 years. We retained 56 patients for this analysis (17 patients had died, 13 were lost to follow-up, 9 could not be followed, and 3 stem removals (3.1%)). This was the first procedure in all patients. Clinical outcome was assessed with the Postel-Merle-d’Aubigné (PMA) score and with a self-administered questionnaire. Radiologically, we assessed stability (tilt, implant displacement) and implant wear using MetrOs software data processing of digitalized radiograms. We also searched for qualitative radiographic signs of bone reaction to the implant. Results: The overall PMA score improved from 11.96 preoperatively to 17.42 at the 5-year assessment and then fell to 15.67 at last follow-up. At five years 94% of the patients (92 hips) were satisfied and 98.3% (56 hips) were reviewed at
Cervical Spondylotic Mielopathy (CSM) is the most common cause of spinal cord dysfunction in the adult population. Treatment implies surgical decompression as soon as possible after the diagnosis. In this study the authors present the long term results of minimal
BACKGROUND. We originally performed metal-on-metal hip resurfacing using a Townley designed Vitallium Total Articular Replacement Arthroplasty (TARA) curved stemmed prosthesis. Neither the acetabular or femoral components were cemented or had porous coating. The bearing surfaces were consistently polar bearing. The surgical objectives were to preserve bone stock, maintain normal anatomy and mechanics of the hip joint and to approximate the normal stress transmission to the supporting femoral bone. The functional objectives were better sports participation, less thigh pain and limp, less perception of a leg length difference and a greater perception of a normal hip. Metal-on-metal was selected to conserve acetabular bone and avoid polyethylene associated osteolysis. Relatively few cases were performed until the Conserve Plus and later the Birmingham Hip Resurfacing systems became available. METHODS. We examined the results of metal-on-metal hip resurfacing in patient with at least
Aims: To asses the outcome of the knee arthroplasty in patients under 55 years old. Methods: 59 knees were performed in patients who were 55 years old and above between 1976 and 1990. No patient was lost to follow-up. The assessment was done using the Knee Society scoring systems. Survivorship analysis was done using the Kaplan-Meier method and analysed with log rank test. Results: The average age at surgery was 48 (19–55) years. There were 25 male and 34 female. Osteoarthrosis was diagnosis in 38 knees and 21 had rheumatoid arthritis. All living patients had a minimum of
Clinical experience of the ICLH method of resurfacing the hip now spans
Understanding the cause of failure of total knee arthroplasties (TKA) is essential in guiding clinical decision making and adjusting treatment concepts for revision surgery. The purpose of the study was to determine current mechanisms of failure of TKA and to describe changes and trends in revision surgery over the last
Over the long term, the results of the insertion of a Grammont inverted shoulder prothesis are unknown. The present study reports survivorship curves and the role of the initial aetiology in patients re-examined after 5 to
We report the results of cementless total hip arthroplasty using the Bi-metric titanium femoral stem at a minimum follow up of
Introduction and Aims: Problem: Patellar resurfacing in TKA remains controversial. Purpose: To evaluate the results of resurfacing/non-resurfacing of the patella in a randomised controlled clinical trial at a minimum of
Introduction: The collarless polished tapered stem (CPT) is a double tapered cemented femoral component designed for primary hip replacement and as a revision stem for impaction bone grafting. We report the outcome at a minimum of