Aims. The primary aim of this study was to present the mid-term follow-up of a multicentre randomized controlled trial (RCT) which compared the
Aims. Custom-made partial pelvis replacements (PPRs) are increasingly used in the reconstruction of large acetabular defects and have mainly been designed using a triflange approach, requiring extensive soft-tissue dissection. The monoflange design, where primary intramedullary fixation within the ilium combined with a monoflange for rotational stability, was anticipated to overcome this obstacle. The aim of this study was to evaluate the design with regard to
Aims. There is no level I evidence dealing with the optimal period of immobilization for patients with a displaced distal radial fracture following closed reduction. A shorter period might lead to a better
Aims. The scapula is a rare site for a primary bone tumour. Only a small number of series have studied patient outcomes after treatment. Previous studies have shown a high rate of recurrence, with
Aims. Multiple secondary surgical procedures of the shoulder, such as soft-tissue releases, tendon transfers, and osteotomies, are described in brachial plexus birth palsy (BPBP) patients. The long-term
Background. Neglected clubfoot in this series is defined as untreated equino-cavo-adducto-varus in older children, or adults. Relapsed clubfoot is the residual deformity that remains after single or multiple surgical interventions. Severe neglected clubfoot rarely exists today in developed countries, except in some emigrants from low- and middle-income countries. Acute surgical management with corrective mid-foot osteotomy and elongation of the Achilles tendon has excellent
Aims. The aim of this study was to identify the origin and development of the threshold for surgical intervention, highlight the consequences of residual displacement, and justify the importance of accurate measurement. Methods. A systematic review of three databases was performed to establish the origin and adaptations of the threshold, with papers screened and relevant citations reviewed. This search identified papers investigating
Aims. Robotic-assisted unicompartmental knee arthroplasty (R-UKA) has been proposed as an approach to improve the results of the conventional manual UKA (C-UKA). The aim of this meta-analysis was to analyze the studies comparing R-UKA and C-UKA in terms of clinical outcomes, radiological results, operating time, complications, and revisions. Methods. The literature search was conducted on three databases (PubMed, Cochrane, and Web of Science) on 20 February 2024 according to the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Inclusion criteria were comparative studies, written in the English language, with no time limitations, on the comparison of R-UKA and C-UKA. The quality of each article was assessed using the Downs and Black Checklist for Measuring Quality. Results. Among the 3,669 articles retrieved, 21 studies on 19 series of patients were included. A total of 3,074 patients (59.5% female and 40.5% male; mean age 65.2 years (SD 3.9); mean BMI 27.4 kg/m. 2. (SD 2.2)) were analyzed. R-UKA obtained a superior Knee Society Score improvement compared to C-UKA (mean difference (MD) 4.9; p < 0.001) and better Forgotten Joint Score postoperative values (MD 5.5; p = 0.032). The analysis of radiological outcomes did not find a statistically significant difference between the two approaches. R-UKA showed longer operating time (MD 15.6; p < 0.001), but reduced complication and revision rates compared to C-UKA (5.2% vs 10.1% and 4.1% vs 7.2%, respectively). Conclusion. This meta-analysis showed that the robotic approach for UKA provided a significant improvement in
Objectives. Pilon fractures represent one of the most surgically challenging fractures in orthopaedics. Different techniques exist for their management, with open reduction and internal fixation (ORIF) and External fixation (Ex-Fix) the most widely used. Whilst there is a plethora of data regarding these strategies for Pilon fractures as a whole, very limited data exists solely on the management of open Pilon fractures. This study aimed to elucidate how surgical management options can influence postoperative complications, and if this can influence future management protocols. Materials and methods. We conducted a search in PubMed, EMBASE and CENTRAL for postoperative complications and
Abstract. Background. The primary objective of the study is to determine the function outcome and survivorship of patellofemoral replacement. The secondary aim is to find the determinants of successful/poor outcome. Methods. This retrospective study involved 45 patients who underwent AVON patellofemoral replacement between January 2015 to December 2020 with the minimal follow-up off for 12 months. The
Abstract. Objectives. This study aims to evaluate the
Abstract. INTRODUCTION. Fracture neck of femur is aptly called as “the fracture of necessity” owing to the various factors responsible for its non-union. Pauwel's inter-trochantric valgus osteotomy is a useful approach to deal with such fractures. AIM. The aim of this study is to evaluate the
Aims. The aim of this study was to investigate whether on-demand removal (ODR) is noninferior to routine removal (RR) of syndesmotic screws regarding
Dislocation is still one of the more common reasons for revision of THR.Registry and large institutional data has demonstrated the effectiveness of Dual Mobility articulations in reducing revision for dislocation after THR. There is little data about whether the use of dual mobility is associated with a comprised clinical
Aims. We introduced a self-care pathway for minimally displaced distal radius fractures, which involved the patient being discharged from a Virtual Fracture Clinic (VFC) without a physical review and being provided with written instructions on how to remove their own cast or splint at home, plus advice on exercises and return to function. Methods. All patients managed via this protocol between March and October 2020 were contacted by a medical secretary at a minimum of six months post-injury. The patients were asked to complete the Patient-Rated Wrist Evaluation (PRWE), a satisfaction questionnaire, advise if they had required surgery and/or contacted any health professional, and were also asked for any recommendations on how to improve the service. A review with a hand surgeon was organized if required, and a cost analysis was also conducted. Results. Overall 71/101 patients completed the telephone consultation; no patients required surgery, and the mean and median PRWE scores were 23.9/100 (SD 24.9) and 17.0/100 (interquartile range (IQR) 0 to 40), respectively. Mean patient satisfaction with treatment was 34.3/40 (SD 9.2), and 65 patients (92%) were satisfied or highly satisfied. In total there were 16 contact calls, 12 requests for a consultant review, no formal complaints, and 15 minor adjustment suggestions to improve patient experience. A relationship was found between intra-articular injuries and lower patient satisfaction scores (p = 0.025), however no relationship was found between PRWE scores and the nature of the fracture. Also, no relationship was found between the type of immobilization and the
Aims. In cases of severe periprosthetic joint infection (PJI) of the knee, salvage procedures such as knee arthrodesis (KA) or above-knee amputation (AKA) must be considered. As both treatments result in limitations in quality of life (QoL), we aimed to compare outcomes and factors influencing complication rates, mortality, and mobility. Methods. Patients with PJI of the knee and subsequent KA or AKA between June 2011 and May 2021 were included. Demographic data, comorbidities, and patient history were analyzed.
Abstract. Purpose. Since arthroscopic reconstruction of the anterior cruciate ligament (ACL) started, the use of peroneus longus grafts for primary ACL reconstruction (ACLR) was never thought of as there is very scant literature on it. So, our study aims to compare the
Aims. To compare the
Aims. The tibial component of total knee arthroplasty can either be an all-polyethylene (AP) implant or a metal-backed (MB) implant. This study aims to compare the five-year
Background. Patients who undergo either primary or revision total ankle replacement (TAR) expect improvements in pain, function and quality of life. The goal of this study was to measure the
The February 2024 Research Roundup360 looks at: If you use a surgical helmet, you should seal your gown-glove interface; The use of iodophor-impregnated drapes in patients with iodine-related allergies: a case series and review of the literature; Location of the ovaries in children and efficacy of gonadal shielding in hip and pelvis radiography; Prehospital tranexamic acid administration does not improve outcomes in severe trauma patients; Silver-coated distal femur megaprosthesis in chronic infections with severe bone loss: a multicentre case series.
Aims. To describe and analyze the mid-term
Aims. Nearly 99,000 total knee arthroplasties (TKAs) are performed in UK annually. Despite plenty of research, the satisfaction rate of this surgery is around 80%. One of the important intraoperative factors affecting the outcome is alignment. The relationship between joint obliquity and
Aims. The aim of this study was to evaluate the
Aims. The aim of this study was to define the complications and long-term outcome following adolescent mid-shaft clavicular fracture. Methods. We retrospectively reviewed a consecutive series of 677 adolescent fractures in 671 patients presenting to our region (age 13 to 17 years) over a ten-year period (2009 to 2019). Long-term patient-reported outcomes (abbreviated version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) score and EuroQol five-dimension three-level (EQ-5D-3L) quality of life score) were undertaken at a mean of 6.4 years (1.2 to 11.3) following injury in severely displaced mid-shaft fractures (Edinburgh 2B) and angulated mid-shaft fractures (Edinburgh 2A2) at a minimum of one year post-injury. The median patient age was 14.8 years (interquartile range (IQR) 14.0 to 15.7) and 89% were male (n = 594/671). Results. The majority of fractures were mid-shaft (n = 606) with angulation (Edinburgh 2A2, n = 241/606, 39.8%) or displacement (Edinburgh 2B1/2, n = 263/606, 43.4%). Only 7% of the displaced mid-shaft fractures underwent acute fixation (n = 18/263). The incidence of refracture over ten years following nonoperative management of mid-shaft fractures was 3.2% (n = 19/588) and all united without surgery. Fracture type, severity of angulation, or displacement were not associated with refracture. One nonunion occurred following nonoperative management in a displaced mid-shaft fracture (0.4%, n = 1/245). Of the angulated fractures, 61 had angulation > 30°, of which 68.9% (n = 42/61) completed outcome scores with a median QuickDASH of 0.0 (IQR 0.0 to 0.6), EQ-5D-3L 1.0 (1.0 to 1.0), and 98% satisfaction with shoulder function. For the displaced fractures, 127 had displacement beyond one cortical width of bone for which completed outcome scores were provided in 72.4% (n = 92/127). Of these 15 had undergone acute fixation. Following nonoperative treatment, the median QuickDASH was 0.0 (IQR 0.0 to 2.3), EQ-5D-3L 1.0 (1.0 to 1.0), and satisfaction with shoulder function was 95%. There were no significant differences in the patients’ demography or
Aims. To describe the clinical, radiological, and
Aims. The primary aim of this study was to assess whether non-fatal postoperative venous thromboembolism (VTE) within six months of surgery influences the knee-specific
Aims. MRI has been suggested as an objective method of assessing anterior crucate ligament (ACL) graft “ligamentization” after reconstruction. It has been proposed that the MRI appearances could be used as an indicator of graft maturity and used as part of a return-to-sport assessment. The aim of this study was to evaluate the correlation between MRI graft signal and postoperative functional scores, anterior knee laxity, and patient age at operation. Methods. A consecutive cohort of 149 patients who had undergone semitendinosus autograft ACL reconstruction, using femoral and tibial adjustable loop fixations, were evaluated retrospectively postoperatively at two years. All underwent MRI analysis of the ACL graft, performed using signal-to-noise quotient (SNQ) and the Howell score.
The first three months following Total Knee Arthroplasty (TKA) provide an early window into a patient's
Aims. Oxidised zirconium was introduced as a material for femoral components
in total knee arthroplasty (TKA) as an attempt to reduce polyethylene
wear. However, the long-term survival of this component is not known. . Methods. We performed a retrospective review of a prospectively collected
database to assess the ten year survival and clinical and radiological
outcomes of an oxidised zirconium total knee arthroplasty with the
Genesis II prosthesis. . The Western Ontario and McMaster Universities Osteoarthritis
Index (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS)
and a patient satisfaction scale were used to assess outcome. Results. A total of 303 consecutive TKAs were performed in 278 patients
with a mean age of 68 years (45 to 89). The rate of survival ten
years post-operatively as assessed using Kaplan–Meier analysis was
97% (95% confidence interval 94 to 99) with revision for any reason
as the endpoint. There were no revisions for loosening, osteolysis
or failure of the implant. There was a significant improvement in
all components of the WOMAC score at final follow-up (p <
0.001). The
mean individual components of the KOOS score for symptoms (82.4
points; 36 to 100), pain (87.5 points; 6 to 100), activities of
daily life (84.9 points; 15 to 100) and quality of life (71.4 points;
6 to 100) were all at higher end of the scale. . Discussion. This study provides further supportive evidence that the oxidised
zirconium TKA gives comparable rates of survival with other implants
and excellent
Aims. The primary aim of the study was to compare the knee-specific
Aims. Complex total hip arthroplasty (THA) with subtrochanteric shortening osteotomy is necessary in conditions other than developmental dysplasia of the hip (DDH) and septic arthritis sequelae with significant proximal femur migration. Our aim was to evaluate the hip centre restoration with THAs in these hips. Methods. In all, 27 THAs in 25 patients requiring THA with femoral shortening between 2012 and 2019 were assessed. Bilateral shortening was required in two patients. Subtrochanteric shortening was required in 14 out of 27 hips (51.9%) with aetiology other than DDH or septic arthritis. Vertical centre of rotation (VCOR), horizontal centre of rotation, offset, and
Aims. The primary aim was to assess the patient-perceived effect of restrictions imposed due to COVID-19 on rehabilitation following total hip arthroplasty (THA) and total knee arthroplasty (TKA). Secondary aims were to assess perceived restrictions, influence on mental health, and
Prompt mobilisation after the Fracture neck of femur surgery is one of the important key performance index (‘KPI caterpillar charts’ 2021) affecting the overall
Aims. We conducted a study to determine whether radiological parameters
correlate with patient reported
The aim of this study was to define the long-term outcome following adolescent clavicle fracture. We retrospectively reviewed all adolescent fractures presenting to our region (13–17years) over a 10-year period. Patient reported outcomes were undertaken at a minimum of 4 years post-injury (QuickDASH and EQ-5D) in completely displaced midshaft fractures (Edinburgh 2B, >2cm displacement, n=50) and angulated midshaft fractures (Edinburgh 2A2, >30 degrees angulation, n=32). 677 clavicle fractures were analysed. The median age was 14.8 (IQR 14.0–15.7) and 89% were male. The majority were midshaft (n=606, 89.5%) with either angulation (39.8%) or simple fully displaced (39.1%). Only 3% of midshaft fractures underwent acute fixation (n=18/606), all of which were fully displaced. The incidence of refracture following non-operative management of midshaft fractures was 3.2% (n=19/588), all united with non-operative management. Fracture type, severity of angulation or displacement was not associated with risk of refracture. There was one case of non-union encountered following non-operative management of all displaced midshaft fractures (0.4%, n=1/245). At a mean of 7.6 years following injury, non-operative management of both displaced and angulated fractures had a median QuickDASH was 0.0 (IQR 0.0–2.3), EQ-5D was 1.0 (IQR 1.0–1.0). 97% of angulated fractures and 94% of displaced fractures were satisfied with their final shoulder function. We conclude that Non-operative management of adolescent midshaft clavicle fractures result in excellent
Aims. The purpose of this study was to determine whether there were long-term differences in outcomes of reverse shoulder arthroplasty (RSA) undertaken for acute proximal humeral fracture versus rotator cuff deficiency with a minimum follow-up of five years. Methods. This was a prospective cohort study comparing 67 patients with acute complex proximal humeral fracture and 64 patients with irreparable rotator cuff deficiency who underwent primary RSA. In the fracture group, there were 52 (77.6%) females and 15 (22.4%) males, with a mean age of 73.5 years (51 to 85), while in the arthropathy group, there were 43 (67.1%) females and 21 (32.9%) males, with a mean age of 70.6 years (50 to 84). Patients were assessed by the Constant score, University of California Los Angeles shoulder score (UCLA), short version of the Disability of the Arm Shoulder and Hand score (QuickDASH), and visual analogue scales (VAS) for pain and satisfaction. Radiological evaluation was also performed. Results. Mean follow-up was 8.4 years (5 to 11). There were no significant differences in mean absolute (p = 0.125) or adjusted (p = 0.569) Constant, UCLA (p = 0.088), QuickDASH (p = 0.135), VAS-pain (p = 0.062), or range of movement at the final follow-up. However, patient satisfaction was significantly lower in the fracture group (p = 0.002). The complication rate was 1.5% (one patient) versus 9.3% (six patients), and the revision rate was 1.5% (one patient) versus 7.8% (five patients) in the fracture and arthropathy groups, respectively. The ten-year arthroplasty survival was not significantly different (p = 0.221). Conclusion. RSA may be used not only for patients with irreparable rotator cuff deficiencies, but also for those with acute complex proximal humeral fractures. We found that RSA provided similar
Aims. This prospective cohort study aims to determine if the size of
the tendon gap following acute rupture of the Achilles tendon shows
an association with the
Aims. This study assessed the association of classes of body mass index
in kg/m. 2. (classified as normal weight 18.5 kg/m. 2 . to
24.9 kg/m. 2. , overweight 25.0 kg/m. 2 . to 29.9
kg/m. 2. , and obese ≥ 30.0 kg/m. 2. ) with short-term
complications and
Fracture of the femoral head usually results from high-energy trauma, particularly motor vehicle accidents. These fractures are often associated with poor
Aim: To investigate factors that influence outcomes one year after distal radial fractures To investigate how deformity (radiologically),
Objectives. Preservation of posterior condylar offset (PCO) has been shown to correlate with improved functional results after primary total knee arthroplasty (TKA). Whether this is also the case for revision TKA, remains unknown. The aim of this study was to assess the independent effect of PCO on early
Currently long term survivorship is highly predictable for total knee replacements. However, they still do not have the
Aims. While patients with psychological distress have poorer short-term outcomes after total knee arthroplasty (TKA), their longer-term function is unknown. We aimed to 1) assess the influence of preoperative mental health status on long-term
Tibial shaft fractures require surgical stabilization preferably by intramedullary nailing. However, patients often report functional limitations even years after the injury. This study investigates the influence of the surgical approach (transpatellar vs. parapatellar) on gait performance and patient reported outcome six months after surgery. Twenty-two patients with tibial shaft fractures treated by intramedullary nailing through a transpatellar approach (TP: n=15, age 41±15, BMI 24±3) or a parapatellar approach (PP: n=7, age 34±15, BMI 23±2) and healthy, matched controls (n=22, age 39±13, BMI 24±2) were assessed by instrumented motion analysis six months after intramedullary nailing. Short musculoskeletal function assessment questionnaire (SMFA) as well as kinematic and kinetic gait data were collected during level walking. Comparisons among approach methods and control group were performed by analysis of variance and Mann-Whitney test. Six months after surgery, knee kinetics in both groups differed significantly compared to controls (p <.04). The approach method affected gait speed (TP: p = .002; PP: p = .08) and knee kinematics in the early stance phase (TP: p = .011; PP: p = .082), with the parapatellar approach showing a more favorable outcome. However, the difference between patient groups was not significant for any of the assessed gait parameters (p > .2). Also, no differences could be found in the bother index (BI) or function index (FI) of SMFA between surgical approach methods (BI: TP: Mdn = 7.2, PP: Mdn = 9.4; FI: TP: Mdn = 10.3, PP: Mdn = 9.2, p > .7). Our study demonstrates, that six months after surgery for tibial shaft fractures functional limitations remain. These limitations appear not to be different for either a trans- or a parapatellar approach for the insertion of the intramedullary nail. The findings of this study are limited by the relatively short follow up time period and small number of patients. Future studies should investigate the source of the functional limitation after intramedullary nailing of tibial shaft fractures.
The primary aim of our study was to assess the influence of age on hip-specific outcome following total hip arthroplasty (THA). Secondary aims were to assess health-related quality of life (HRQoL) and level of activity according to age. A prospective cohort study was conducted. All patients were fitted with an Exeter stem with a 32 mm head on highly cross-linked polyethylene (X3RimFit) cemented acetabulum. Patients were recruited into three age groups: < 65 years, 65 to 74 years, and ≥ 75 years, and assessed preoperatively and at three, 12, 24, and 60 months postoperatively. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Harris Hip Score (HHS), and Hip disability and Osteoarthritis Outcome Score (HOOS), were used to assess hip-specific outcome. EuroQol five-dimension five-level questionnaire (EQ-5D-5L) and 36-Item Short Form Survey (SF-36) scores were used to assess HRQoL. The Lower Extremity Activity Scale (LEAS) and Timed Up and Go (TUG) were used to assess level of activity.Aims
Methods
Introduction. Blunt trauma of the lower limb can lead to vascular injury causing devastating outcomes, including loss of limb and even loss of life. The primary aim of this study was to determine the limb salvage rate of patients sustaining such injuries when treated at Leeds General Infirmary (LGI) since becoming a Major Trauma Centre (MTC). Secondary aims included establishing the patient complications and outcomes. Materials and Methods. Retrospective analysis found that from 2013–18, 30 patients, comprising of 32 injured limbs, were treated for blunt trauma to the lower limb associated with vascular injury. Long-term
To evaluate if young patients have a poorer
Purpose: Fractures of the femoral head are relatively uncommon injuries and usually occur following a traumatic dislocation of the hip joint. The purpose of this study was to evaluate self-reported
Introduction. Aim was to compare the
Introduction. Aim was to compare the
Aim. This study was conducted to investigate the clinical outcome,
Recovery after femur fractures is slow, despite rapid bone union. Causes of disability require investigation. Forty patients with isolated, diaphyseal femur fractures treated with antegrade locked intramedullary nailing were prospectively studied.
Introduction. Distal tibial fractures are notoriously difficult to treat and a lack of consensus remains on the best approach. This study examined clinical and
We performed a systematic review of the literature
pertaining to the
Radiographic follow-up of traumatic spondylolisthesis of the axis is well documented in the literature. However, there is a paucity of studies regarding the long-term
Aims. Advocates of debridement, antibiotics and implant retention (DAIR)
in hip periprosthetic joint infection (PJI) argue that a procedure
not disturbing a sound prosthesis-bone interface is likely to lead
to better survival and
The outcomes following nonoperative management of minimally displaced greater tuberosity (GT) fractures, and the factors which influence patient experience, remain poorly defined. We assessed the early patient-derived outcomes following these injuries and examined the effect of a range of demographic- and injury-related variables on these outcomes. In total, 101 patients (53 female, 48 male) with a mean age of 50.9 years (19 to 76) with minimally displaced GT fractures were recruited to a prospective observational cohort study. During the first year after injury, patients underwent experiential assessment using the Disabilities of the Arm, Shoulder and Hand (DASH) score and assessment of associated injuries using MRI performed within two weeks of injury. The primary outcome was the one-year DASH score. Multivariate analysis was used to assess the effect of patient demographic factors, complications, and associated injuries, on outcome.Aims
Methods
Background. Cheilectomy and arthrodesis are accepted procedures for symptomatic hallux rigidus. Although good
Purpose. Investigate the
Introduction. We performed a longitudinal outcome study involving the operative management of ankle fractures at two university teaching hospitals. This was a retrospective review of the quality of reduction and a prospective study into the
To analyse and compare long-term
Ganz’s studies made it possible to address joint deformities on both the femoral and acetabular side brought about by Perthes’ disease. Femoral head reduction osteotomy (FHRO) was developed to improve joint congruency, along with periacetabular osteotomy (PAO), which may enhance coverage and containment. The purpose of this study is to show the clinical and morphological outcomes of the technique and the use of an implemented planning approach. From September 2015 to December 2021, 13 FHROs were performed on 11 patients for Perthes’ disease in two centres. Of these, 11 hips had an associated PAO. A specific CT- and MRI-based protocol for virtual simulation of the corrections was developed. Outcomes were assessed with radiological parameters (sphericity index, extrusion index, integrity of the Shenton’s line, lateral centre-edge angle (LCEA), Tönnis angle), and clinical parameters (range of motion, visual analogue scale (VAS) for pain, Merle d'Aubigné-Postel score, modified Harris Hip Score (mHHS), and EuroQol five-dimension five-level health questionnaire (EQ-5D-5L)). Early and late complications were reported.Aims
Methods
Aims. This prospective cohort study aimed to determine if the size of the tendon gap following acute tendo Achillis rupture influences the
Aims. The aim of this study was to investigate the difference in
Aims: Our objectives is to evaluate the
We retrospectively reviewed 30 patients with
a diffuse-type giant-cell tumour (Dt-GCT) (previously known as pigmented
villonodular synovitis) around the knee in order to assess the influence
of the type of surgery on the
Patellofemoral problems are probably the most common type of knee complaint in adolescents and adults. Our aim is to evaluate the mid- and long-term
The purpose of this study was to evaluate
The purpose of this study was to evaluate
Purpose: Identifying optimal treatment strategies in patients with traumatic foot and ankle injuries has been hampered by the variety of different measurement tools and lack of validation of generic and foot-specific functional measures. It remains plausible that the choice of
56 patients who had undergone lower limb lengthening in accordance with Ilizarov principles in 61 bone segments were retrospectively studied and
Introduction: Life expectancy is increasing, this leads to a major number of hip fracture and its subsequent complications and costs. Proximal femur fracture is not only a medical problem but also a social handicap. Our objective is to see, by means of a prospective observational study, how the function varies after hip fracture and which are the most influencing factors in order to get maximum benefits of resources for this patology. Materials and Methods: 262 patients had been hospitalized suffering hip fracture in our centre between june 2006 and December 2007.107 of them were included in the study, the others were excluded for different reasons: cognitive impairment (based on Folstein test), previous hip fracture or pathologic fractures. 86 female and 21 male. Mean age 74 years (65–93).44 suffering subcapital fracture and 63 pertrochanteric fracture. 76 patients underwent gamma nail or canulated screws and 31 hemi or total hip replacement. Mean surgery delay 3 days (1–14) At the moment of hospital registration we also determined marital status, familiar support, living at home or institution, morbidity pre- fracture (according to Charlson index), level of dependence (Barthel index), mental status (Folstein Mini Mental State Examination)quality of life perceived (short form 36 (SF-36)) and depression symptoms (Geriatric Depression Scale 15 (GDS 15)). At three months post discharge we determined again all the test mentioned before and also recorded the functional level (Harris test), which haven’t been passed preoperatively because it includes a part of physical evaluation, not possible to do in a fractured leg. Statistics: Analysis of Variance for repeated measures, Spearman correlation coefficient, level significance 0.05. Results: Most part of patients came from their own houses (87,6%), where only returned 23% of them at hospital discharge. In the control visit al 3 months most of them had returned at home (79%). There were no significant differences between
Twenty-three patients with scapular chondrosarcomas presented to our institution between 1989 and 2003. Twenty-two were treated surgically while one presented with metastases and was treated palliatively. Fourteen patients underwent partial scapulectomy and eight had a Tikhoff-Linberg procedure. There were no local recurrences and only two patients have suffered a systemic recurrence at mean follow-up of fifty-two months. Mean functional scores were: TESS – 88, MSTS 1987 – 27 and MSTS 1993 – 84. Overall, the oncologic and
This is a retrospective study of fifty nine hips in fourty nine patients with a previous total hip replacement for developmental dysplasia of the hip who underwent a revision arthroplasty of the hip. Fifty three patients were available for follow up. Radiographs and charts were reviewed and
Background. Adhesive capsulitis (frozen shoulder) is a debilitating condition affecting 2–5% of the adult population. Its aetiology is still unclear and there is no consensus on the most effective treatment. The aim of this retrospective study was to investigate the mid-term
Aim. To assess the influence of route of antibiotic administration on patient-reported outcome measures (PROMS) of individuals treated for hip and knee infections in the OVIVA multi-centre randomised controlled trial. Method. This study was designed to determine whether oral antibiotic therapy is non-inferior to intravenous (IV) therapy when given for the first six weeks of treatment for bone and joint infections. Of the 1054 participants recruited from 26 centres, 462 were treated for periprosthetic or native joint infections of the hip or knee. There were 243 participants in the IV antibiotic cohort and 219 in the oral cohort.
Introduction. Fracture around the knee can lead to posttraumatic osteoarthritis (PTOA) of the knee. Malunion, malalignment, intra-articular osseous defects, retained internal fixation devices, and compromised soft tissues may affect the outcome of total knee replacement (TKR). On average, the posttraumatic patient subsets were 10.4 years younger than those for primary knee OA. Recently, there were several studies reporting the outcome of THA for posttraumatic OA hip. However, no current literature defines the comparative
Introduction: The severity of symptoms, rate and completeness of recovery after closed treatment of the fractured clavicle has not been fully explored. Materials and Methods: The severity and duration of pain, analgesic requirements, ability to perform acts of daily living, return to work, driving and sport were recorded along with appearance of the shoulder in 58 patients between one to two years after fracture was recorded. Radiographs were assessed by Robinson’s classification8 supplemented by fracture displacement. Results: The majority of patients experienced severe pain that required codeine, paracetamol and ibuprofen. 13/58 patients (22%) ceased to experience pain by one month, 35/58 (60%) by three and 48/58 (83%) by six. There was no improvement in the remaining ten patients after six months. 21 patients described difficulty reaching and lifting (36%), 11/36 (31%) digging the garden, 13/58 (22%) were unable to reach between their shoulder blades. Over 90% had no difficulty with feeding (55/58), dressing (50/58), personal toilet (56/58), brushing hair (41/46), hanging up clothes (52/56) or ironing (37/41) but overall 23/58 patients (40%) had some functional restriction 1–2 years after injury. 18/48 patients (38%) returned to work within one month, 39 (81%) by three, and all by six. 28/30 (93%) clerical workers had returned within three months compared with 11/18 (61%) of manual (p <
0.05) 36/42 (86%) sportsmen returned. High impact sportsmen were less likely to resume than low impact or overhead. 38/46 (83%) of drivers returned by three months and all by six. 40/58 (69%) patients noted cosmetic deformity the severity of which was associated with worse
Aim. Data of optimal management of infections after internal fixation (IIF) is scarce and long-term follow-up results often lack. We analyzed characteristics of infections after intramedullary (IIIF) and extramedullary long bone fixation (IEIF) and evaluated their infection and
Introduction and Aims: The combination of ipsilateral intertrochanteric and femoral shaft fractures is an uncommon pattern associated with high-energy trauma. This retrospective study used self-report measures to evaluate
Purpose. Limited information is available regarding the
Introduction. Bilateral total knee replacement can either be simultaneous, in which both knees are operated in the same sitting, in one day, or staged, in which both knees are operated but not on the same day. With appropriate patient selection, the potential benefits of conducting this procedure in a simultaneous fashion outweigh the possible risks of the procedure. Very few studies have evaluated the results of bilateral knee replacement in a single sitting in Indian population. Objectives. To determine the
Management of pseudotumours associated with MoM THA can be difficult and complications are frequent. The
Introduction. Growing evidence in the literature suggests better clinical and
Introduction. Metal on metal hip resurfacing (MMHR) has been advocated for the younger patient for several reasons including for the preservation of bone stock and ease of revision to total hip replacement (THR), thus ‘buying an additional operation’ for the patient. This rationale however assumes a good
Computer assisted total knee arthroplasty helps in accurate and reproducible implant positioning, bony alignment, and soft-tissue balancing which are important for the success of the procedure. In TKR, there are two surgical techniques one is measured resection in which bony landmarks are used to guide the bone cuts and the other is gap balancing which equal collateral ligament tension in flexion and extension is done before and as a guide to final bone cuts. Both these procedures have their own advantages and disadvantages. We retrospectively collected the data of 128 consecutive patients who underwent computer-assisted primary TKA using either a gap-balancing technique or measured resection technique. All the operations were performed by a single surgeon using computer navigation system available during a period between June 2016 to October 2016. Inclusion criteria were all patients requiring a primary TKA, male or female patients, and who have given informed consent for participation in the study. All patients requiring revision surgery of a previous implanted TKA or affected by active infection or malignancy, who presented hip ankylosis or arthrodesis, neurological deficit or bone loss or necessity of more constrained implants were excluded from the study. Two groups measured resection and gap balancing was randomly selected. At 1-year follow-up, patients were assessed by a single orthopaedic registrar blinded to the type of surgery using the Knee Society score (KSS) and functional Knee Society score (FKSS). Outcomes of the 2 groups were compared using the paired t test. All the obtained data were analysed. Statistical analysis was performed using SPSS 11.5 statistical software (SPSS Inc. Chicago). Inter-class correlation coefficient (ICC) and paired t-test were used and statistical significance was set at P = 0.05. In the measured resection group, the mean FKSS increased from 48.8769 (SD, 2.3576), to 88.5692 (SD, 2.7178) respectively. In the gap balancing group, the respective scores increased from 48.9333 (SD, 3.6577) to 89.2133(SD, 7.377). Preoperative and Postoperative increases in the respective scores were slightly better with the gap balancing technique; the respective p values were 0.8493 and 0.1045. The primary goal of TKA is restoration of mechanical axis and soft-tissue balance. Improper restoration leads to poor
Background: Revision total hip replacement in patients with a previous diagnosis of developmental dysplasia of the hip (DDH) can be a challenging and technically demanding procedure. Two of the major concerns are deficient acetabular bone stock and the position of the acetabular implant, particularly if the hip centre was not restored during the primary procedure. The purpose of this study was to determine if cup height, lateralization or abduction angle are correlated with
Aim. Advocates of Debridement-Antibiotics-and-Implant-Retention (DAIR) in hip peri-prosthetic joint infection (PJI) argue that a procedure not disturbing a sound prosthesis-bone interface is likely to lead to better survival and
Purpose. Although classic teaching holds that the least amount of constraint should be implanted, there is very little in the literature to substantiate this. This study attempts to quantify the influence of constraint and various indications upon
Background:. Modified posterior approach and its effect on stability and
The purpose of this study was to evaluate
Purpose: Patello-femoral arthritis presents a considerable challenge to the orthopaedic surgeon. Traditionally, surgical options have produced unsatifactory results. Arthroscopic debridement, patellectomy, isolated patellar resurfacing and grafting have a poor long term clinical outcome. Patello-femoral arthroplasty is an alternative to total knee arthroplasty and patellectomy for anterior compartment osteoarthritis. Patello-femoral arthroplasty provides a more conservative approach in younger and more active patients especially. Advances in component design and biomechanics have led to many new generation replacements. The aim of this study was to look at the long term
Purpose. Identifying optimal treatment strategies for inpatients with traumatic foot and ankle injuries has been hampered by a wide variety of outcome measures with unproven reliability and validity. It remains plausible that the choice of
Improvements in functional results and long-term survival are variable following conversion of hip fusion to total hip arthroplasty (THA) and complications are high. The aim of the study was to analyze the clinical and functional results in patients who underwent conversion of hip fusion to THA using a consistent technique and uncemented implants. A total of 39 hip fusion conversions to THA were undertaken in 38 patients by a single surgeon employing a consistent surgical technique and uncemented implants. Parameters assessed included Harris Hip Score (HHS) for function, range of motion (ROM), leg length discrepancy (LLD), satisfaction, and use of walking aid. Radiographs were reviewed for loosening, subsidence, and heterotopic ossification (HO). Postoperative complications and implant survival were assessed.Aims
Methods
Introduction: The literature regarding the
Thirty-eight patients with nonunion of the humeral shaft underwent a comprehensive assessment including completion of three patient-based
This study demonstrates that harvesting a vascularized fibular graft has a significant number of minor complications. These complications do not result in significant morbidity but could be avoided by other newer methods of managing bony defects and avascular necrosis such as porous bone substitute rods. The purpose of this study was to evaluate
Background. The position of the hip-joint centre of rotation (HJC) within the pelvis is known to influence