Aims. Osteochondral
Aims. In this study, we aimed to visualize the spatial distribution characteristics of femoral head necrosis using a novel measurement method. Methods. We retrospectively collected CT imaging data of 108 hips with non-traumatic osteonecrosis of the femoral head from 76 consecutive patients (mean age 34.3 years (SD 8.1), 56.58% male (n = 43)) in two clinical centres. The femoral head was divided into 288 standard units (based on the orientation of units within the femoral head, designated as N[Superior], S[Inferior], E[Anterior], and W[Posterior]) using a new measurement system called the longitude and latitude division system (LLDS). A computer-aided design (CAD) measurement tool was also developed to visualize the measurement of the spatial location of necrotic
Aims. Rotator cuff tear (RCT) is the leading cause of shoulder pain, primarily associated with age-related tendon degeneration. This study aimed to elucidate the potential differential gene expressions in tendons across different age groups, and to investigate their roles in tendon degeneration. Methods. Linear regression and differential expression (DE) analyses were performed on two transcriptome profiling datasets of torn supraspinatus tendons to identify age-related genes. Subsequent functional analyses were conducted on these candidate genes to explore their potential roles in tendon ageing. Additionally, a secondary DE analysis was performed on candidate genes by comparing their expressions between
Background. It is still controversial whether “labral tear” in the pelvis or “pincer type's femoroacetabular impingement syndrome” should be considered a pathologic
Aims. Osteoarthritis (OA) is a common degenerative joint disease. The osteocyte transcriptome is highly relevant to osteocyte biology. This study aimed to explore the osteocyte transcriptome in subchondral bone affected by OA. Methods. Gene expression profiles of OA subchondral bone were used to identify disease-relevant genes and signalling pathways. RNA-sequencing data of a bone loading model were used to identify the loading-responsive gene set. Weighted gene co-expression network analysis (WGCNA) was employed to develop the osteocyte mechanics-responsive gene signature. Results. A group of 77 persistent genes that are highly relevant to extracellular matrix (ECM) biology and bone remodelling signalling were identified in OA subchondral
The management of symptomatic osteochondral
Aims. The preoperative grading of chondrosarcomas of bone that accurately predicts surgical management is difficult for surgeons, radiologists, and pathologists. There are often discrepancies in grade between the initial biopsy and the final histology. Recent advances in the use of imaging methods have shown promise in the ability to predict the final grade. The most important clinical distinction is between grade 1 chondrosarcomas, which are amenable to curettage, and resection-grade chondrosarcomas (grade 2 and 3) which require en bloc resection. The aim of this study was to evaluate the use of a Radiological Aggressiveness Score (RAS) to predict the grade of primary chondrosarcomas in long bones and thus to guide management. Methods. A total of 113 patients with a primary chondrosarcoma of a long bone presenting between January 2001 and December 2021 were identified on retrospective review of a single oncology centre’s prospectively collected database. The nine-parameter RAS included variables from radiographs and MRI scans. The best cut-off of parameters to predict the final grade of chondrosarcoma after resection was determined using a receiver operating characteristic curve (ROC), and this was correlated with the biopsy grade. Results. A RAS of ≥ four parameters was 97.9% sensitive and 90.5% specific in predicting resection-grade chondrosarcoma based on a ROC cut-off derived using the Youden index. Cronbach’s α of 0.897 was derived as the interclass correlation for scoring the
Aims. The hypothesis of this study was that bone peg fixation in the treatment of osteochondral
A Morel-Lavallee
Aims. The aim of this study was to evaluate the outcome of Monteggia-like
Aims. Metal particles detached from metal-on-metal hip prostheses (MoM-THA) have been shown to cause inflammation and destruction of tissues. To further explore this, we investigated the histopathology (aseptic lymphocyte-dominated vasculitis-associated
Introduction. The ankle cartilage has an important function in walking movements, mainly in sports; for active young people, between 20 and 30 years old, the incidence of osteochondral
A number of causes have been advanced to explain the destructive discovertebral (Andersson)
Aims. Reconstruction of the acetabulum after resection of a periacetabular
malignancy is technically challenging and many different techniques
have been used with varying success. Our aim was to prepare a systematic
review of the literature dealing with these techniques in order
to clarify the management, the rate of complications and the outcomes. Patients and Methods. A search of PubMed and MEDLINE was conducted for English language
articles published between January 1990 and February 2017 with combinations
of key search terms to identify studies dealing with periacetabular
resection with reconstruction in patients with a malignancy. Studies
in English that reported radiographic or clinical outcomes were
included. Data collected from each study included: the number and
type of reconstructions, the pathological diagnosis of the
Osteochondral
Patients with differentiated thyroid carcinomas (DTCs) have a favourable long-term survival. Spinal metastases (SMs) cause a decline in performance status (PS), directly affecting mortality and indirectly preventing the use of systemic therapies. Metastasectomy is indicated, if feasible, as it yields the best local tumour control. Our study aimed to examine the long-term clinical outcomes of metastasectomy for SMs of thyroid carcinomas. We collected data on 22 patients with DTC (16 follicular and six papillary carcinomas) and one patient with medullary carcinoma who underwent complete surgical resection of SMs at our institution between July 1992 and July 2017, with a minimum postoperative follow-up of five years. The cancer-specific survival (CSS) from the first spinal metastasectomy to death or the last follow-up was determined using Kaplan-Meier analysis. Potential factors associated with survival were evaluated using the log-rank test. We analyzed the clinical parameters and outcome data, including pre- and postoperative disability (Eastern Cooperative Oncology Group PS 3), lung and non-spinal bone metastases, and history of radioiodine and kinase inhibitor therapies.Aims
Methods
Cartilage
Aims. The aims of this study were to evaluate the morphology of the ankle in patients with an osteochondral
Purpose: To compare the site of
Our aim in this prospective study was to determine the best diagnostic method for discriminating between patients with and without osteochondral
We investigated the incidence of soft-tissue
lesions after small head metal-on-metal total hip replacement (MoM THR).
Between December 1993 and May 1999, 149 patients (195 hips) underwent
primary cementless MoM THR. During the follow-up period, three patients (five THRs) died
and eight patients (14 THRs) were lost to follow-up. We requested
that all patients undergo CT evaluation. After exclusion of five
patients (six THRs) who had undergone a revision procedure, and
22 (28 THRs) who were unwilling to take part in this study, 111
patients (142 THRs) were evaluated. There were 63 men (88 THRs)
and 48 women (54 THRs) with a mean age of 45.7 years (37 to 56)
at the time of surgery. The mean follow-up was 15.4 years (13 to
19). A soft-tissue
ONFH with large or lateral-located
Hill-Sachs and reverse Hill-Sachs
The Hill-Sachs
There have been considerable recent advances in the understanding and management of femoroacetabular impingement and associated labral and chondral pathology. We have developed a classification system for acetabular chondral
Previously, we showed that case-specific non-linear
finite element (FE) models are better at predicting the load to failure
of metastatic femora than experienced clinicians. In this study
we improved our FE modelling and increased the number of femora
and characteristics of the
We reviewed, retrospectively, 65 patients who had undergone arthroscopic treatment for osteochondral
Objectives. We have encountered patients who developed large joint fluid collections with massive elevations in chromium (Cr) and cobalt (Co) concentrations following metal-on-metal (MoM) hip arthroplasties. In some cases, retrieval analysis determined that these ion concentrations could not be explained simply by the wear rates of the components. We hypothesized that these effects may be associated with aseptic lymphocyte-dominated vasculitis-associated
We have previously shown that cytological diagnosis based on fine-needle aspiration biopsy (FNAB) is a safe and efficient method for the discrimination between benign, primary malignant and metastatic bony
The treatment of osteochondral
We evaluated the histological changes before and after fixation in ten knees of ten patients with osteochondritis dissecans who had undergone fixation of the unstable
The incidence of horizontal cleavage
Purpose: The purpose of this study is to examine the rate of Buford complex in a consecutive series of patients with arthroscopic Bankart repair and to evaluate the postoperative outcome compared to a group of patients without this anatomical variation. Material and Method: The surgical findings of 138 consecutive shoulder arthroscopies for Bankart
The aim of this pilot study was to evaluate the accuracy of two different methods of navigated retrograde drilling of talar
The classic Hill-Sachs
Purpose of Study. We report the outcome of five cases of chronic paediatric Monteggia
The Hill-Sachs
The diagnosis of Osteochondral Chondral
Purpose. The purpose of the present study was to compare functional outcomes of medial unicompartmental knee arthroplasty (UKA) in patients with lateral meniscal lesion (LM (+) group) in the preoperative MRI and those without lateral meniscal pathology (LM (−) group) and to evaluate the effect of lateral meniscus
This study evaluates the outcome of arthroscopic femoral osteochondroplasty for cam
We reviewed 28 patients with brachial plexus
We report positive and negative factors associated with the most commonly-used methods of reconstruction after pathological fracture of the proximal femur. The study was based on 142 patients treated surgically for 146 metastatic
Between 2002 and 2008, 130 consecutive ankles were replaced with an hydroxyapatite (HA) and titanium-HA-coated Ankle Evolutive System total ankle prosthesis. Plain radiographs were analysed by two independent observers. Osteolytic
INTRODUCTION. Loss of joint function is only exploited in osteoarthritis (OA) once severe impairment is apparent. Animal models allow for
A clinical evaluation of the effect of MRI scan to bring about a change in surgical management of elderly patients who present with hip fracture with no history of trauma or a suspicious looking
Background. Fractures of the radial head result from an axial force that causes impaction against the capitellum. Associated
A total of 11 patients (12 knees) with stable
We have assessed the final strength of the deltoid in 121 patients who had repair of isolated or combined
Subacromial bursa fibrosis are linked to rotator cuff
We reviewed 19 patients who presented with aggressive granulomatosis around the femoral stem after hip replacement. All had experienced stress pain and had required revision arthroplasty on average 8.8 years after the primary operation. Fifteen patients were men and four were women; none had rheumatoid arthritis. One patient had an uncemented Moore hemiprosthesis; the others all had cemented total hip replacements. When first detected, the granulomatous
The recognition, investigation and management of osteoid osteoma has been well documented. Treatment can either be medical or surgical, studies have shown both options to have almost equal long term outcomes. However only surgical treatment involving complete excision of the
We reviewed
We describe six patients with aggressive granulomatous
The treatment of osteochondral
Total hip replacement in patients with advanced osteonecrosis of the femoral head is often complicated by early loosening of the femoral component. Recent evidence has suggested that abnormal bone extending into the proximal femur may be responsible for the early failure of the femoral component. We aimed to identify which patients were at high risk of early failure by evaluating gadolinium-enhanced MR images of histologically-confirmed osteonecrotic
Background. Cartilage
The oblique sagittal diameter of the lumbar spinal canal was measured by diagnostic ultrasound in seventy-three patients with symptomatic disc
A patient with recurrent dislocation of the hip is described. The initial injury had been a posterior dislocation without associated fracture of the acetabular wall, and the hip had not been immobilised or protected from weight-bearing during treatment. Exploration of the hip for recurrence revealed disruption of the posterosuperior acetabular labrum with formation of a pouch between the posterior acetabular wall and the short rotator muscles. We have found no previous report of this
INTRODUCTION. Osteochondral
We report our experience of treating 17 patients with benign
Introduction: The progression of the collapse is influenced by the extent and location of the necrotic focus of the necrotic femoral head. The authors studied the extent of the necrotic focus on the joint surface by conventional antero-posterior radiographs in neutral position, and antero-posterior radiographs at the 45 degrees flexion position. The differences of the
Two consecutive cases of chronic dislocation of the head of the radius after missed Bado type-I Monteggia
Introduction: We investigated the necrotic area and its shrinkage on stage 1 femoral head necrosis with band pattern low intensity on MRI. Materials and Methods: Eleven femoral heads (6 patients) with a history of steroid treatment were studied. In heads, band pattern was detected by MRI. The mean age was 40 years. The location of the
The type II Monteggia (posterior)
Osteonecrosis of the femoral head can be caused by a variety of disorders and affects the relatively young patient. Most studies have concentrated on the femoral changes; the sites of early
Matrix-induced autologous chondrocyte implantation
(MACI) is an established technique used to treat osteochondral lesions
in the knee. For larger osteochondral
Introduction: Pseudoarthrosis in Ankylosing spondylitis is often misdiagnosed as infection. It is a slow progressing
Purpose. Osteochondral
We have treated osteochondral
Introduction: There is controversy over whether the
Osteochondral
In this study a combination of autologous chondrocyte implantation (ACI) and the osteochondral autograft transfer system (OATS) was used and evaluated as a treatment option for the repair of large areas of degenerative articular cartilage. We present the results at three years post-operatively. Osteochondral cores were used to restore the contour of articular cartilage in 13 patients with large
Ten cases of missed Monteggia
We compared the quality of debridement of chondral
Most of surgical methods, suggested for habitual shoulder instability treatment provide almost similar percentage of successful results, being 90–95%. However, some investigations show unequal efficiency of standard methods in dependence on bone-cartilage
Several studies showed the efficacy of arthroscopic repair for Type II SLAP
Introduction: In cases of small and middle size osteonecrosis on conventional antero-posterior (AP) radiographs, we studied the extent of the
Introduction: The foot is an unusual site for presentation of Ewings tumour. Haemangioma of the vertebra is a common finding in adults, but is rarely reported in children. 1. Although rarely symptomatic, the
To prospectively evaluate patient outcome in terms of stability, function and satisfaction following an arthroscopic anterior Bankart repair in order to identify patient characteristics, surgical technique or instrumentation linked to poor outcomes. These findings can then be used to refine selection criteria such that patient benefit from the shoulder instability repair is maximised. Between April 2002 and June 2004 thirty-seven arthroscopic anterior Bankart
We investigated 29 cases, diagnosed clinically as having Morton’s neuroma, who had undergone MRI and ultrasound before a neurectomy. The accuracy with which pre-operative clinical assessment, ultrasound and MRI had correctly diagnosed the presence of a neuroma were compared with one another based on the histology and the clinical outcome. Clinical assessment was the most sensitive and specific modality. The accuracy of the ultrasound and MRI was similar and dependent on size. Ultrasound was especially inaccurate for small
Arthroscopic management has been recommended for some SLAP
A group of patients were studied 10 years after stopping work in a high-pressure environment. Radiographs of their long bones showed little change during the period, but only two of 12 scintigrams were normal. The 10 abnormal scintigrams contained 18 "hot-spots" which were not always associated with an abnormal radiographic appearance; the findings suggest that some
Aims: Arthroscopic drilling for the treatment of osteo-chondral
In order to clarify how intra-articular lesions
influence the survival of a periacetabular osteotomy in patients
with dysplasia of the hip, we performed an observational study of
121 patients (121 hips) who underwent a transposition osteotomy
of the acetabulum combined with an arthroscopy. Their mean age was
40.2 years (13 to 64) and the mean follow-up was 9.9 years (2 to
18). Labral and cartilage degeneration tended to originate from
the anterosuperior part of the acetabulum, followed by the femoral
side. In all, eight hips (6.6%) had post-operative progression to
Kellgren–Lawrence grade 4 changes, and these hips were associated
with the following factors: moderate osteoarthritis, decreased width
of the joint space, joint incongruity, and advanced intra-articular
lesions (subchondral bone exposure in the cartilage and a full-thickness
labral tear). Multivariate analysis indicated subchondral bone exposure
on the femoral head as an independent risk factor for progression
of osteoarthritis (p = 0.003). In hips with early stage osteoarthritis,
femoral subchondral bone exposure was a risk factor for progression of
the grade of osteoarthritis. . Although the outcome of transposition osteotomy of the acetabulum
was satisfactory, post-operative progression of osteoarthritis occurred
at a high rate in hips with advanced intra-articular
Femoral head collapse due to avascular necrosis (AVN) is a relatively rare occurrence following intertrochanteric fractures; however, with over thirty-thousand intertrochanteric fractures per year in England and Wales alone, and an incidence of up to 1.16%, it is still significant. Often patients are treated with a hip fixation device, such as a sliding hip screw or X-Bolt. This study aimed to investigate the influence of three factors on the likelihood of head collapse: (1) implant type; (2) the size of the femoral head; and (3) the size of the AVN
We report a hitherto undescribed type of peripheral nerve
Background. The aim of this prospective study was to assess the effectiveness of a single ultrasound-guided steroids injection in the treatment of Morton's neuromas and whether the response to injection correlates with the size of neuroma. Methods. Forty three patients with clinical features of Morton's neuroma underwent ultrasound scan assessment. Once the
Two patients presented with pain in the arm and a radiographic
We examined the relationship between the size
of the femoral cam in femoroacetabular impingement (FAI) and acetabular
pathomorphology to establish if pincer impingement exists in patients
with a femoral cam. CT scans of 37 symptomatic impinging hips with a femoral cam
were analysed in a three-dimensional study and were compared with
34 normal hips. The inclination and version of the acetabulum as
well as the acetabular rim angle and the bony acetabular coverage
were calculated. These measurements were correlated with the size
and shape of the femoral cams. While the size of the femoral cam varied characteristically,
the acetabular morphology of the two groups was similar in terms
of version (normal mean 23° (. sd. 7°); cam mean 22° (. sd. 9°)),
inclination (normal mean 57° (. sd. 5°); cam mean 56° (. sd. 5°)),
acetabular coverage (normal mean 41% (. sd. 5%); cam mean
42% (. sd. 4%)) and the mean acetabular rim angle (normal
mean 82° (. sd. 5°); cam mean 83° (. sd. 4°)). We found no correlation between acetabular morphology and the
severity of cam
Twenty-five patients with 30 chondral
We investigated the changes seen on serial metal
artefact reduction magnetic resonance imaging scans (MARS-MRI) of
metal-on-metal total hip arthroplasties (MoM THAs). In total 155
THAs, in 35 male and 100 female patients (mean age 70.4 years, 42
to 91), underwent at least two MRI scans at a mean interval of 14.6
months (2.6 to 57.1), at a mean of 48.2 months (3.5 to 93.3) after
primary hip surgery. Scans were graded using a modification of the
Oxford classification. Progression of disease was defined as an
increase in grade or a minimum 10% increase in fluid
We reviewed 42 consecutive children with a supination deformity of the forearm complicating severe birth
The effects of gamma irradiation on the growth plate have been studied in nineteen rabbits with a 1,000 rads/skin dose. The rabbits were killed after one to ninety days. The growth plates were studied by microscopic examination, thymidine-H3 autoradiography, and fluorescence with radiographic measurement. Changes were already detected after twenty-four hours at the cell mitosis level, which showed the sensitiveness of the chondrocyte itself. The
1. Two cases of fracture-dislocation of the spine at the lumbo-sacral level are reported. 2. One patient was treated conservatively and survived, with a cauda equina
Autologous chondrocyte implantation (ACI) and
mosaicplasty are methods of treating symptomatic articular cartilage
defects in the knee. This study represents the first long-term randomised
comparison of the two techniques in 100 patients at a minimum follow-up
of ten years. The mean age of the patients at the time of surgery was
31.3 years (16 to 49); the mean duration of symptoms pre-operatively
was 7.2 years (9 months to 20 years). The
Purpose: Appropriate management of complex trauma of the upper limb (CTUL) is a significant therapeutic challenge. The main difficulty is to determine in an emergency situation when ambitious conservative surgery is legitimate and when amputation in necessary. We propose a prognostic
In 16 patients we used uncemented Lord prostheses at revision operations for aggressive granulomatosis after cemented hip arthroplasties; in 12 bone grafts also were used. In 13 hips the granulomatous
The purpose of this study was to report the results of the vertical apical suture Bankart
We have reviewed 41 patients with pustulotic arthro-osteopathy (PAO), all having both the typical skin rash of pustulosis palmaris et plantaris and bone lesions. The most common bones affected were the clavicle, sternum and ribs. Changes in the clavicle started, not as an enthesopathy, but with periosteal bone formation, indicative of a bone marrow disorder. About 30% of the patients also had
Introduction: We performed rotational open wedge osteotomy ( ROWO ) for Perthes’ disease with an extensive