Retrospective review of a consecutive series of 1,168 total ankle replacements (TAR) performed at Wrightington, to analyse modes of failure and clinical outcomes following TAR failure. All patients undergoing TAR between November 1993 – June 2019 were collated (4–25 year follow-up; mean 13.7 years). 6 implants were used (300 STAR, 100 Buechal Pappas, 509 Mobility, 118 Zenith, 41 Salto and 100 Infinity). 5 surgeons, all trained in TAR, performed the surgery. Modes of failure were collated and clinical and radiological outcomes recorded for the revisional surgery following failure of the TAR.Aims
Methods
This is a multi-centre, prospective, observational study of 503 INFINITY fixed bearing total ankle arthroplasties. We report the minimum two-year results of this prosthesis which was introduced to the UK Market in 2014 and is now the most used ankle arthroplasty in the National Joint Registry of England and Wales. Patients were recruited from 11 centres in the United Kingdom between June 2016 and November 2019. Demographic, radiographic, and functional outcome data (Ankle Osteoarthritis Scale, Manchester Oxford Foot Ankle Questionnaire and Euroquol 5D-5L) were collected preoperatively, at 6 months, 1 year and 2 years and 5 years. The average age was 67.8 (range 23.9 to 88.5) and average BMI 29.3 (18.9 to 48.0). The COFAS grading system was used to stratify deformity. There were 261 (51.9%) COFAS Type 1, 122 (24.2%) COFAS Type 2, 31 (6.2%) COFAS 3 and 89 (17.7%) COFAS type 4. 38 patients (7.6%) presented with inflammatory arthritis. 99 (19.7%) implantations utilised patient specific instrumentation. Complications and reoperations were recorded as adverse events. Radiographs were assessed for lucencies, cysts and/or subsidence.Introduction
Methods
We report the long-term clinical and radiological outcomes of a consecutive series of 200 total ankle arthroplasties (TAAs, 184 patients) at a single centre using the Scandinavian Total Ankle Replacement (STAR) implants. Between November 1993 and February 2000, 200 consecutive STAR prostheses were implanted in 184 patients by a single surgeon. Demographic and clinical data were collected prospectively and the last available status was recorded for further survival analysis. All surviving patients underwent regular clinical and radiological review. Pain and function were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot scoring system. The principal endpoint of the study was failure of the implant requiring revision of one or all of the components. Kaplan–Meier survival curves were generated with 95% confidence intervals and the rate of failure calculated for each year.Aims
Patients and Methods
Traditional treatment for end-stage ankle arthritis has been ankle arthrodesis, however ankle arthroplasty is becoming an accepted alternative. The Zenith Ankle (Corin, UK) is 3rd generation implant with a mobile bearing design. In the NJR 2016 report, the Zenith was the commonest ankle prosthesis implanted in the UK. However, compared to other ankle implants, there's little published data on its performance and survival. The aim of this study was to analyse outcome in a consecutive series from a non-designer centre. We conducted a retrospective review of a consecutive series of 118 Zenith Ankle replacements implanted in our Unit (December 2010 to May 2016). Data was collected from our National Joint Registry entries, research databases, patient notes, PACS and PROMS.Introduction
Method
Recent articles in the medical press highlight the potential dangers of Cauda Equina Syndrome (CES). CES has the highest rates of litigation due to its long-term neurological impairment, which can lead to devastating outcome on patients. The aim of this study was to assess health care professionals knowledge with regards to the urinary symptoms of CES and the timeframe in which treatment should be offered. To assess health care professionals knowledge with regards to urinary symptoms of CES and when treatment should be offered.Background
Objectives
Recent articles in the medical press highlight the potential dangers of Cauda Equina Syndrome (CES). CES has the highest rates of litigation due to its long-term neurological impairment, which can lead to devastating outcome on patients. The aim of this study was to assess health care professionals knowledge with regards to the urinary symptoms of CES and the timeframe in which treatment should be offered. To assess health care professionals knowledge with regards to urinary symptoms of CES and when treatment should be offered. A 4-part questionnaire established profession and number of cases seen per week. The participant was asked to rank 15 urinary symptoms, 7 of these symptoms were not related to CES. The participants were asked the ideal time to surgical intervention for Complete CES and Incomplete CES. Primary and Secondary Care 60 questionnaires were complete. Participants had to successfully complete the first three parts of the questionnaire (n = 44). Any who failed to complete section four were excluded from analysis from that part only (n = 41). A total of 44 questionnaires were analysed. Both doctors and physiotherapists ranked the CES symptoms on average significantly higher than then the non-CES symptoms. The physiotherapists rated the CES symptoms significantly higher than the doctors (P = 0.05) and on average rated the non-CES symptoms significantly lower than doctors (P < 0.05). 87.8% thought that complete CES should be treated < 24 hours and 9.76% thought that complete CES should be treated from 24-48 hours. 46.34% thought that CESI should be treated < 24 hours and 43.9% thought that CESI should be treated from 24-48 hours. These results demonstrate that physiotherapists are better than Doctors at identifying the urinary symptoms in CES. The majority of health care professional who took part in this study stated that they would offer surgical intervention for both Complete and Incomplete CES within 24 hours. The gap in knowledge highlights the need for education to all medical professionals in the symptoms of CES and also the timing of treatment.
To assess health care professional's knowledge with regards to the urinary symptoms of CES and when treatment should be offered. Recent articles in the medical press highlight the potential dangers of Cauda Equina Syndrome (CES). CES has the highest rates of litigation due to its long-term neurological impairment.Objectives
Background
“Spine Class” was organised at Southport Hospitals NHS Trust. The course was awarded 6 CPD (Continuing Professional Development) points. We propose a new method for assessing the effectiveness of educational courses by pre and post testing and participant satisfaction. The course was attended by 64 delegates (49 Allied Health Professionals e.g. Physiotherapists and 15 Physicians). 21 lectures were planned for the day. The lecturers were asked to submit 2 True/False questions (TFQs), a total of 42 questions. Questions were answered prior to the course and immediately after. The lectures were evaluated on a scale of 1 to 5.Introduction:
Materials and Methods
We report the results of a 4- to 17-year clinical and radiological follow-up of 264 Charnley first-generation stems in comparison with those of 402 second- and subsequent-generation stems. The incidence of fracture was 4.1% in first-generation stems and 0.5% in second- and subsequent-generation stems. The incidence of stem loosening requiring or likely to require revision was 3.1% in first-generation and 11.4% in second-generation stems. We believe that the increased loosening rate in second- and subsequent-generation stems is due to their larger cross-sectional area, which produces an increase in flexural stiffness.
