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Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_2 | Pages 19 - 19
1 Jan 2014
Kelsall N Chapman A Sangar A Farrar M Taylor H
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Introduction:

The dorsal closing wedge calcaneal osteotomy has been described for the treatment of insertional pathology of the tendo-achilles. The aim of this study was to evaluate the efficacy of the technique using outcome measures.

Method:

This was a prospective case series. Patients were included if they had tendo-achilles insertional pathology (calcific tendonitis, bursitis or Haglund's deformity). A short extended lateral approach was used and a 1 cm dorsally based closing wedge osteotomy of the calcaneus performed. Fixation was with 2 staples. Patients were scored pre-operatively and at 6 and 12 months post-operatively using the VISA-A and AOFAS ankle-hindfoot scores. Results were analysed with the paired student t-test.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXVI | Pages 55 - 55
1 Jun 2012
Sharma H Breakwell L Chiverton N Michael A Townsend R Highland A Chapman A Cole A
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Introduction

Spinal infections constitute a spectrum of disease comprising pyogenic, tuberculous, nonpyogenic-nontuberculous and postoperative spinal infections. The aim of this study was to review the epidemiology, diagnostic yield of first and second biopsy procedures and microbiology trends from Sheffield Spinal Infection Database along with analysing prognostic predictors in spinal infections.

Materials and Methods

Sheffield Spinal Infection Database collects data prospectively from regularly held Spinal infection MDTs. We accrued 125 spinal infections between September 2008 and October 2010. The medical records, blood results, radiology and bacteriology results of all patients identified were reviewed. In patients with negative first biopsy, second biopsy is contemplated and parenteral broad spectrum antibiotic treatment initiated.


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_II | Pages 253 - 253
1 May 2006
Raman R Kandiyil N White W Chapman A Chakrabarty G
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Aim: To report the intermediate clinical and radiological results of a consecutive series of knee arthroplasies using PFC Sigma endoprosthesis.

Methods: 525 total knee replacements (469 patients) were performed from Aug 97 to Jun 01 using the PFC Sigma components. Cruciate retaining femoral component was used in 219 knees. All patients were prospectively followed up at 6 weeks, 3 months and yearly. Pre operative HSS knee scores and Oxford knee scores were compared with annual scores. Quality of life was assessed using SF12 questionnaire. Knee Society scores were used to assess the radiographs. The average follow up was 61 months (36–84). 11 patients lost to follow up.

Results: Of the 469 patients, 64% were females. Mean age was 74.2 yrs (59–90). Pre operative valgus deformity of at least 10 deg was present in 87 (16.5%). Patella resurfacing was performed in 80.5%. A lateral release was performed in 20 patients. Post operative mobilisation was standardised in all patients. 34 patients developed radiologically proven DVT. 24 patients died from unrelated causes. 16 (3%) patients developed superficial and 6 developed deep infection. 4 patients underwent revision surgery (3 for infection, 1- catastrophic failure). The HSS scores improved from 29(16–65) to 86(59–97) at final follow up (p=0.004). Pre operative Oxford knee scores improved from 10(6–31) to 43(37–48) at last follow up (p=0.008). Radiological knee society score for the femur were less than 5 in 477/478 patients and 7 in 1 patient. The scores for the tibia were less than 5 in 475/478 patients and 6 in 3 patients. Average femoral flexion was 1–9.2 deg (3.9), knee valgus angle 0.5–7.4 (3.5) degrees and the tibial slope was 3.1 deg (0–7.1). SF 12 health scores revealed a good functional outcome of both the physical and mental components. With failure defined as repeat revision because of aseptic loosening, the rate of survival at 5 years months was 99.1% and overall survival at 5 years with removal or repeat revision of any component for any reason as the end point was 97.5%.

Conclusion: Our prospective study of patients with primary knee arthroplasties supports the use of PFC sigma total knee endoproshesis. Our results show excellent clinical outcome comparable with other prosthesis. A longer follow up is needed to establish the durability and longevity of this prosthesis given its excellent intermediate term results


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_I | Pages 86 - 86
1 Mar 2006
Raman R Kandiyil N White W Chapman A Chakrabarty G
Full Access

Aim: To report the intermediate clinical and radiological results of a consecutive series of knee arthroplasies using PFC Sigma endoprosthesis.

Methods: 525 total knee replacements (469 patients) were performed from Aug 97 to Jun 01 using the PFC Sigma components. Cruciate retaining femoral component was used in 219 knees. All patients were prospectively followed up at 6 weeks, 3 months and yearly. Pre operative HSS knee scores and Oxford knee scores were compared with annual scores. Quality of life was assessed using SF12 questionnaire. Knee Society scores were used to assess the radiographs. The average follow up was 61 months (36–84). 11 patients lost to follow up.

Results: Of the 469 patients, 64% were females. Mean age was 74.2 yrs(59–90). Valgus deformity of at least 10 deg was present in 87 (16.5%). Patella resurfacing was performed in 80.5%. A lateral release was performed in 20 patients. Post operative mobilisation was standardised in all patients. 34 patients developed radiologically proven DVT. 24 patients died to unrelated causes. 21 were lost to follow up. 16 (3%) patients developed superficial and 6 developed deep infection. 4 patients underwent revision surgery (3 – infection,1- catastrophic failure). The HSS scores improved from 29(16–65) to 86(59–97) at final follow up (p=0.004). Pre operative Oxford knee scores improved from 10(6–31) to 43(37–48) at last follow up (p=0.008). Radiological knee society score for the femur were less than 5 in 477/478 patients and 7 in 1 patient. The scores for the tibia were less than 5 in 475/478 patients and 6 in 3 patients. Average femoral flexion was 1– 9.2 deg (3.9), knee valgus angle 0.5 – 7.4 (3.5) degrees and the tibial slope was 3.1 deg(0–7.1). SF 12 health scores revealed a good functional outcome of both the physical and mental components. With failure defined as repeat revision because of aseptic loosening, the rate of survival at 5 years months was 99.1% and overall survival at 5 years with removal or repeat revision of any component for any reason as the end point was 97.5%.

Conclusion: Our prospective study of patients with primary knee arthroplasties supports the use of the PFC Sigma total knee proshesis. Our results show excellent clinical outcome comparable with other prostheses. A longer follow-up is needed to establish the durability and longevity of this prosthesis given its excellent intermediate term results