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Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_III | Pages 394 - 394
1 Jul 2010
Macfarlane RJ Hadi S Binns M
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Introduction: Trochanteric bursitis (TB) in association with increased femoral offset components in THA has not previously been reported. We report 15 cases of postoperative TB, all of whom were noted to have high offset femoral implants. Increasing awareness of this complication when inserting femoral components is an important consideration for the arthroplasty surgeon, emphasizing the need for preoperative templating.

Methods: We retrospectively reviewed casenotes and postoperative radiographs patients attending outpatients following THA, with lateral hip pain. A diagnosis of trochanteric bursitis was made in individuals complaining of lateral hip pain, worse on exercising, and tenderness over the trochanter. The presence of a high offset femoral component was noted from casenotes radiographs. Patients with pre-existing TB, recent local trauma, or inflammatory disease which may contribute to TB, were excluded.

Results: 15 cases were identified in a 3 year period. Female to male ratio 1.3:1. The mean age was 68 yrs with a range of 54–81yrs. 7/15 cases (46%) underwent posterior approach to the hip, 8/15 (54%) underwent a Hardinge lateral or modified lateral approach. All patients had clinical features of TB at first postoperative follow up. Mean time to onset of symptoms was 7.2 months, range 2–12 months. All femoral implants had 5mm offset or greater. Postoperative X-rays showed a mean increase in offset of 10.2mm, range 3–18mm.

Discussion: The results indicate that an increase in femoral offset may increase a patient’s risk of trochanteric bursitis, following THA. The data suggest the operating surgeon should consider carefully the use of increased-offset implants, particularly in those at a higher risk or TB e.g inflammatory disorders. This study emphasises the importance of preoperative templating in total hip arthroplasty.


Orthopaedic Proceedings
Vol. 90-B, Issue SUPP_III | Pages 545 - 545
1 Aug 2008
Ponnuru R Shetty A Binns M
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Introduction: Cementing technique is one of the important factors which determines the longevity of cemented joint replacements. There are a number of variables which determine good cementation. We hope to standardise one of the variable which is cement working and setting time.

Methods: Cement was stored in a controlled temperature refrigerators at 20 degree centigrade and brought out just before mixing.

Theatre temperature, cement mixing start time and time at which cement was set were recorded for 20 hip and knee replacements. These recordings were also done for 20 hip and knee replacements where cement was stored in the theatre and was used as a control.

Results: Cement stored in the controlled temperature refrigerator had a more predictable working and setting time as opposed to controls.

Discussion: Cement stored in the controlled temperature refrigerator eliminates one of the variables in cemented arthroplasty and may prevent complication which could occur if cement sets unpredictably.


The Journal of Bone & Joint Surgery British Volume
Vol. 90-B, Issue 8 | Pages 1101 - 1104
1 Aug 2008
Vanderstraeten L Binns M

We report a case of osteonecrosis of the femoral head in a young man who is a carrier of the prothrombin gene mutation. We suggest that an electrical injury to his lower limb may have triggered intravascular thrombosis as a result of this mutation with subsequent osteonecrosis of the femoral head. No case of osteonecrosis of the femoral head secondary to a distant electrical injury has previously been reported.


The Journal of Bone & Joint Surgery British Volume
Vol. 70-B, Issue 3 | Pages 420 - 422
1 May 1988
Binns M

Joint laxity was quantified by measuring the distance from the thumb tip to the forearm during passive apposition in 500 normal Southern Chinese women. Joint laxity was found to have a normal distribution throughout the population and to decrease with age. When 109 Chinese girls with idiopathic adolescent scoliosis were similarly tested they were found to have significantly more laxity, suggesting that the two conditions are associated.