Background

We present the results of cementless total hip arthroplasty using anatomically adapted stem and hemispherical cup with a fully coated Spongiosa metal surface, first introduced in 1982, which aims to achieve a surface structure approaching that of human cancellous bone. This implant is still being used in clinical practice with minor modifications.

Background

Labral tears are now recognised as a common pathology especially in young adults. With advancement of arthroscopic techniques, most recent published literature is focused on short- or mid-term results of labral repair or re-fixation. There is limited data regarding long-term results of labral debridement and effect of co-existing pathology on outcomes. We investigated long-term results after arthroscopic labral debridement, the predictors of outcomes and correlation with any co-existing hip pathology.

Background

Fractures of the radial head result from an axial force that causes impaction against the capitellum. Associated lesions of the capitellum in this pattern of injury have been previously reported in the orthopaedic literature as an uncommon occurrence.

Introduction: The Less Invasive Stabilisation System (L.I.S.S.) is a new internal fixator for the treatment of complex distal femoral and proximal tibial fractures. Traditional treatment of these injuries is associated with recognised complications and fixation failure.

The LISS is designed to preserve periosteal perfusion and to facilitate a minimally invasive application. Self drilling unicortical screws provide angular stability with the implant giving it a mechanical and biological advantage over conventional fixation methods.

Aim: To evaluate clinical & radiological results of our experience with the LISS in the stabilisation of distal femoral and proximal tibial fractures

Method: Twenty two patients (12 male & 10 female), mean age 60.7 years (range 12–95 years) were treated in our institution over a 29 month period. Nine patients treated with proximal tibial fractures included 4 tibial plateau fractures (AO 41-B, 41-C) and 5 metaphyseal fractures (AO 41-A). Thirteen distal femoral fractures (AO-33) were treated of which 3 were periprosthetic. There were 15 low energy and 7 high energy fractures. Three open fractures of which two required soft tissue cover. Nineteen primary procedures performed following acute fractures and 3 revisions. Quality of life score was measured with SF12.

Results: Follow up rate of 91% (20/22; one died and the other left the country). Union was seen in 90% (18/20) of cases. Mean time to union was17 weeks (range 12–26) for low energy fractures and 27 weeks (range 13–52) for high energy fractures. Complications included: 2 delayed union, 2 late infections, 1 implant failure and 1 varus malunion.

Conclusion: This study demonstrates the LISS system is a useful implant for the treatment of complex fractures of the distal femur and proximal tibia, especially when bone quality is poor.

Purpose: Although transient osteoporosis of the hip was initially described in pregnant women, now most frequently identified in middle-age and older men. Has also been reported to occur in either hip and in both successively. This condition is referred as migratory transient osteoporosis of the hip. In this study the authors describe five cases of migratory hip osteoporosis and the differential diagnosis with osteonecrosis is also discussed.

Material and Methods: Thirty-four patients with transient osteoporosis were presented. Of the 34 patients five had a similar episode of severe pain in the contralateral hip 14 months mean time later. Early bone scans and MRI of the hips had been carried out in all of the patients. After the evaluation of these findings and thorough exclusion of other conditions diagnosis of migratory transient osteoporosis was demonstrated, and confirmed by the natural course of the disease.

Results: All cases were treated with nonsteroidal anti-inflammatory medications and protected weight-bearing. The course of the disease has not been appreciably altered by medical treatment, and the mean time interval from the onset of symptoms to clinical recovery was 4.6 months (range 3 to 6 months). Imaging findings on MR confirmed the diagnosis during both episodes and paralleled the reduction of pain.

Conclusions: Migratory transient osteoporosis of the hip is a rare self-limited condition of uncertain etiology and pathogenesis, which “migrate” from one hip to the other. Magnetic resonance imaging is highly sensitive in the early detection of this condition and moreover is helpful in the exclusion of other entities. Although the diagnosis is one of exclusion, it must be considered and contrasted with hip osteonecrosis.

Results are given of a study of four cases of osteogenesis imperfecta using biophysical methods comprising microradiography, microscopy using polarised light, and x-ray diffraction. Rebuilding of bone tissue was infrequent in the material studied and has been shown to occur in an abnormal manner. The mineralisation of the bone is more uniform than is found in normal bone. The collagen has an abnormal organisation and is sparse. The ultrastructure of bone salts and their orientation are as in normal bone.