Advertisement for orthosearch.org.uk
Results 1 - 7 of 7
Results per page:
Bone & Joint Open
Vol. 3, Issue 4 | Pages 291 - 301
4 Apr 2022
Holleyman RJ Lyman S Bankes MJK Board TN Conroy JL McBryde CW Andrade AJ Malviya A Khanduja V

Aims

This study uses prospective registry data to compare early patient outcomes following arthroscopic repair or debridement of the acetabular labrum.

Methods

Data on adult patients who underwent arthroscopic labral debridement or repair between 1 January 2012 and 31 July 2019 were extracted from the UK Non-Arthroplasty Hip Registry. Patients who underwent microfracture, osteophyte excision, or a concurrent extra-articular procedure were excluded. The EuroQol five-dimension (EQ-5D) and International Hip Outcome Tool 12 (iHOT-12) questionnaires were collected preoperatively and at six and 12 months post-operatively. Due to concerns over differential questionnaire non-response between the two groups, a combination of random sampling, propensity score matching, and pooled multivariable linear regression models were employed to compare iHOT-12 improvement.


The Bone & Joint Journal
Vol. 97-B, Issue 1 | Pages 94 - 99
1 Jan 2015
Grammatopoulos G Wilson HA Kendrick BJL Pulford EC Lippett J Deakin M Andrade AJ Kambouroglou G

National Institute of Clinical Excellence guidelines state that cemented stems with an Orthopaedic Data Evaluation Panel (ODEP) rating of > 3B should be used for hemiarthroplasty when treating an intracapsular fracture of the femoral neck. These recommendations are based on studies in which most, if not all stems, did not hold such a rating.

This case-control study compared the outcome of hemiarthroplasty using a cemented (Exeter) or uncemented (Corail) femoral stem. These are the two prostheses most commonly used in hip arthroplasty in the UK.

Data were obtained from two centres; most patients had undergone hemiarthroplasty using a cemented Exeter stem (n = 292/412). Patients were matched for all factors that have been shown to influence mortality after an intracapsular fracture of the neck of the femur. Outcome measures included: complications, re-operations and mortality rates at two, seven, 30 and 365 days post-operatively. Comparable outcomes for the two stems were seen.

There were more intra-operative complications in the uncemented group (13% vs 0%), but the cemented group had a greater mortality in the early post-operative period (n = 6). There was no overall difference in the rate of re-operation (5%) or death (365 days: 26%) between the two groups at any time post-operatively.

This study therefore supports the use of both cemented and uncemented stems of proven design, with an ODEP rating of 10A, in patients with an intracapsular fracture of the neck of the femur.

Cite this article: Bone Joint J 2015;97-B:94–9.


Bone & Joint Research
Vol. 3, Issue 11 | Pages 321 - 327
1 Nov 2014
Palmer AJR Ayyar-Gupta V Dutton SJ Rombach I Cooper CD Pollard TC Hollinghurst D Taylor A Barker KL McNally EG Beard DJ Andrade AJ Carr AJ Glyn-Jones S

Aims

Femoroacetabular Junction Impingement (FAI) describes abnormalities in the shape of the femoral head–neck junction, or abnormalities in the orientation of the acetabulum. In the short term, FAI can give rise to pain and disability, and in the long-term it significantly increases the risk of developing osteoarthritis. The Femoroacetabular Impingement Trial (FAIT) aims to determine whether operative or non-operative intervention is more effective at improving symptoms and preventing the development and progression of osteoarthritis.

Methods

FAIT is a multicentre superiority parallel two-arm randomised controlled trial comparing physiotherapy and activity modification with arthroscopic surgery for the treatment of symptomatic FAI. Patients aged 18 to 60 with clinical and radiological evidence of FAI are eligible. Principal exclusion criteria include previous surgery to the index hip, established osteoarthritis (Kellgren–Lawrence ≥ 2), hip dysplasia (centre-edge angle < 20°), and completion of a physiotherapy programme targeting FAI within the previous 12 months. Recruitment will take place over 24 months and 120 patients will be randomised in a 1:1 ratio and followed up for three years. The two primary outcome measures are change in hip outcome score eight months post-randomisation (approximately six-months post-intervention initiation) and change in radiographic minimum joint space width 38 months post-randomisation. ClinicalTrials.gov: NCT01893034.

Cite this article: Bone Joint Res 2014;3:321–7.


Bone & Joint Research
Vol. 2, Issue 2 | Pages 33 - 40
1 Feb 2013
Palmer AJR Thomas GER Pollard TCB Rombach I Taylor A Arden N Beard DJ Andrade AJ Carr AJ Glyn-Jones S

Objectives

The number of surgical procedures performed each year to treat femoroacetabular impingement (FAI) continues to rise. Although there is evidence that surgery can improve symptoms in the short-term, there is no evidence that it slows the development of osteoarthritis (OA). We performed a feasibility study to determine whether patient and surgeon opinion was permissive for a Randomised Controlled Trial (RCT) comparing operative with non-operative treatment for FAI.

Methods

Surgeon opinion was obtained using validated questionnaires at a Specialist Hip Meeting (n = 61, 30 of whom stated that they routinely performed FAI surgery) and patient opinion was obtained from clinical patients with a new diagnosis of FAI (n = 31).


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXIX | Pages 22 - 22
1 Jul 2012
Rafiq I Liddle A Iyer S Fergusson CM Andrade AJ
Full Access

Introduction

Peri-prosthetic infections due to P. acnes may present as Prosthesis dysfunction without any obvious sepsis. We present our experience of efficient management of total knee prosthesis infection secondary to P. acnes which is one of the biggest case series.

Materials and methods

From 2008 to 2009, 9 patients diagnosed with P. acnes infection after knee arthroplasty were retrospectively reviewed and analysed for clinical diagnosis; laboratory data (ESR, CRP); Radiological Imaging; number of days for culture growth of P acnes; organism sensitivities; antibiotic regimen and length of treatment and surgical management. Infection was diagnosed by 2 positive cultures.


The Journal of Bone & Joint Surgery British Volume
Vol. 94-B, Issue 6 | Pages 825 - 828
1 Jun 2012
Rajagopal TS Walia M Wilson HA Marshall RW Andrade AJ Iyer S

We report on two cases of infective spondylodiscitis caused by Gemella haemolysans in otherwise healthy patients. This organism has only rarely been identified as a cause of bone and joint infection, with only two previous reports of infective spondylodiscitis.

We describe the clinical features, investigations and treatment options.


Orthopaedic Proceedings
Vol. 84-B, Issue SUPP_III | Pages 218 - 218
1 Nov 2002
Andrade AJ Lambert SM
Full Access

Purpose of Study: In the UK locoregional soft tissue cover is more traditionally within the remit of Plastic Surgeons. Currently only seven hospitals in the UK have Plastic Surgical units within trauma hospitals so that soft tissue cover often requires patient transfer between hospitals, with associated significant delays to surgery. This study set out to identify whether the current practice of soft tissue cover by an orthopaedic surgeon was justified.

Methods: 21 patients with a mean age of 44 years (range 7–87 years) had locoregional soft tissue cover surgery since 1996.

Results: Of 15 patients with open tibial fractures 3 (16%) went on to require an amputation at a mean of 10 months after injury (range 2–21 months). The mean delay between injury and soft tissue cover was 9 days (range 0–51 days). 11 cases went on to union at a mean of 7 months (range 4–11 months). 4 cases are yet to achieve union.

Of 22 flaps carried out there were only two flap failures. One was revised successfully with a gastrocnemius flap, whilst the other required a free latissimus dorsi flap which also failed requiring an above knee amputation.

Conclusions: These results are comparable to those from Plastic Surgical units. Locoregional soft tissue cover in the lower limb is therefore still safely within the remit of the Orthopaedic Surgeon. In the present economic climate there are strong financial incentives for avoiding transfer of trauma patients to other centres for such surgery.