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Orthopaedic Proceedings
Vol. 106-B, Issue SUPP_11 | Pages 17 - 17
4 Jun 2024
Najefi AA Chan O Zaidi R Hester T Kavarthapu V
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Introduction

Surgical reconstruction of deformed Charcot feet carries high risk of non-union, metalwork failure and deformity recurrence. The primary aim of this study was to identify the factors contributing to these complications following hindfoot Charcot reconstructions.

Methods

We retrospectively analysed patients who underwent hindfoot Charcot reconstruction with an intramedullary nail between 2007 and 2019 in our unit. Patient demographics, co-morbidities, weightbearing status and post-operative complications were noted. Metalwork breakage, non-union, deformity recurrence, concurrent midfoot reconstruction and the measurements related to intramedullary nail were also recorded.


The Bone & Joint Journal
Vol. 104-B, Issue 6 | Pages 703 - 708
1 Jun 2022
Najefi A Zaidi R Chan O Hester T Kavarthapu V

Aims

Surgical reconstruction of deformed Charcot feet carries a high risk of nonunion, metalwork failure, and deformity recurrence. The primary aim of this study was to identify the factors contributing to these complications following hindfoot Charcot reconstructions.

Methods

We retrospectively analyzed patients who underwent hindfoot Charcot reconstruction with an intramedullary nail between January 2007 and December 2019 in our unit. Patient demographic details, comorbidities, weightbearing status, and postoperative complications were noted. Metalwork breakage, nonunion, deformity recurrence, concurrent midfoot reconstruction, and the measurements related to intramedullary nail were also recorded.


The Bone & Joint Journal
Vol. 100-B, Issue 7 | Pages 945 - 952
1 Jul 2018
Malhotra K Chan O Cullen S Welck M Goldberg AJ Cullen N Singh D

Aims

Gastrocnemius tightness predisposes to musculoskeletal pathology and may require surgical treatment. However, it is not clear what proportion of patients with foot and ankle pathology have clinically significant gastrocnemius tightness. The aim of this study was to compare the prevalence and degree of gastrocnemius tightness in a control group of patients with a group of patients with foot and ankle pathology.

Patients and Methods

This prospective, case-matched, observational study compared gastrocnemius tightness, as assessed by the lunge test, in a control group and a group with foot and ankle pathology. Gastrocnemius tightness was calculated as the difference in dorsiflexion of the ankle with the knee extended and flexed.


Orthopaedic Proceedings
Vol. 97-B, Issue SUPP_11 | Pages 33 - 33
1 Oct 2015
Morton S Chan O Pritchard M Parkes T Malliaras P Maffulli N Crisp T Padhiar N King J Morrissey D
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Introduction

An additional pathology should be considered for Achillodynia differentials – the intratendinous tear (ITT) – for which we describe symptoms, ultrasound findings and co-presenting pathology.

Materials and Methods

Examinations of 740 Achillodynic patients in one specialist centre were reviewed. ITTs were defined as a clearly visualised echopoor area situated centrally and extending to, but not through the tendon periphery, with pain on palpation and no clinical findings consistent with Achilles rupture. Descriptive statistics were used to analyse differences between pathological sub-groups, and images described qualitatively.


Orthopaedic Proceedings
Vol. 97-B, Issue SUPP_11 | Pages 34 - 34
1 Oct 2015
Morton S Chandra S Chan O Morrissey D
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Introduction

High-volume image guided injections (HVIGI) followed by structured rehabilitation have been shown to be effective in various musculoskeletal conditions including Achilles tendinopathy and shoulder impingement syndrome. The aim was to explore the effect of a HVIGI in Hoffa's fat pad impingement, a common cause of anterior knee pain.

Materials and Methods

100 consecutive subjects who received a HVIGI followed by a standardised physiotherapy rehabilitation regime for Hoffa's fat pad impingement (diagnosed using clinical history, examination and magnetic resonance imaging) at one specialist MSK centre were sent a follow-up questionnaire. The questionnaire collected demographics, symptom length and the percentage improvement in symptoms following the HVIGI. All had received HVIGI consisting of 10ml of 0.5% Marcaine and 50mg of hydrocortisone followed by a structured rehabilitation programme with a focus on lower limb alignment control, flexibility, hip and knee strengthening in line with best practice. Data was analysed using SPSS version 20 at this interim stage; data collection is continuing.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_17 | Pages 7 - 7
1 Apr 2013
Chan O Santhapuri S Anjarwalla N
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Background

Epidural steroid injections can provide temporary relief of symptoms in the treatment of lumbar spinal stenosis. Surgery is indicated when conservative measures fail. We hypothesise that patients who gain temporary relief of symptoms from the administration of epidural steroid injections are more likely to result in an improvement in symptoms following surgical intervention compared to patients who do not respond to injection therapy.

Method

The records of patients who had received both an epidural injection and surgical intervention for lumbar spinal stenosis between July 2008 and July 2010 were identified and retrospectively reviewed. Relief of symptoms following epidural injection was noted at 6 weeks post procedure and the patients symptoms following surgical intervention was noted and classified according to MacNab's criteria at 3 months post-surgery.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 488 - 488
1 Sep 2012
Chan O Coathup M Hing K Buckland T Campion C Blunn G
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INTRODUCTION

Autologous bone grafts are considered gold standard in the repair of bone defects. However they are limited in supply and are associated with donor site morbidity. This has led to the development of synthetic bone graft substitute (BGS) materials, many of which have been reported as being osteoinductive. The structure of the BGS is important and bone formation has been observed in scaffolds with a macroporous morphology. Smaller pores termed ‘strut porosity’ may also be important for osteoinduction. The aim of this study was to compare the osteoinductive ability of one silicate-substituted calcium phosphate (SiCaP) with differing strut porosities in an ectopic ovine model. Our hypothesis was that SiCaP with greater strut porosity would be more osteoinductive.

METHODS

The osteoinduction of SiCaP BGS with two different strut porosities (AF and AF++) was investigated. The materials had an identical chemical composition and morphological structure but differing strut porosity (AF=22.5%, AF++=47%). Implants were inserted into the paraspinal muscles in skeletally mature sheep. Procedures were carried out in compliance with UK Home Office regulations. There were 12 implants in each group. Implants remained in vivo for 8 and 12 weeks and on retrieval were prepared for undecalcified histology. Sections were stained and examined using light microscopy. A line intersection method was used to quantify bone, implant and implant surface/bone contact within seven random regions of interest along each implant. A Mann-Whitney U test was used for statistical analysis where p values < 0.05 were considered significant.


Orthopaedic Proceedings
Vol. 90-B, Issue SUPP_II | Pages 347 - 347
1 Jul 2008
Dharm-Datta S King JB Chan O Buxton PJ
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Introduction: Symptomatic osteochondral lesions of the talus have been managed with a variety of operative techniques involving open or arthroscopic approaches to the ankle joint. The purpose of this study is to report our technique of drilling stable osteochondral lesions of the talus via a percutaneous retrograde approach using computed tomography for guidance.

Materials and Methods: Seven adult patients with Berndt and Harty Stage 2 or 2A/5 (subchondral cyst positive) talar osteochondral lesions, confirmed by magnetic resonance imaging, had retrograde drilling with CT guidance performed under local anaesthesia. Follow-up MR imaging was performed to investigate radiological evidence of healing.

Results: All retrograde drillings performed were technically successful.

Discussion: The concept of retrograde drilling is to preserve intact articular cartilage while encouraging revascularisation of the osteochondral fragment. The use of CT allowed drilling without conventional direct visualisation of the articular surface via arthrotomy or arthroscopy. The procedure can therefore potentially be performed in an outpatient setting. Suggestions are made from review of the literature as to improve further the technique for future studies.