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Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_27 | Pages 1 - 1
1 Jul 2013
Refaie R Reekhaye A Howard M Oswald T Carluke I Partington P Reed M
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INTRODUCTION

Deep infection is a potentially catastrophic complication of joint replacement surgery. Early intervention in suspected prosthetic joint infection in the form of aggressive Debridement and targeted Antibiotics can lead to successful Implant Retention (DAIR). In our centre, we adopt an aggressive approach to suspected prosthetic joint infection, working in a multi-disciplinary team with microbiologists and an infection surveillance team to identify and treat suspected infected cases at the earliest opportunity.

OBJECTIVES

To evaluate the efficacy of the treatment of prosthetic joint infection with DAIR.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXIX | Pages 16 - 16
1 Sep 2012
Lees D Jameson S James P Serrano-Pedraza I Partington P Muller S Meek D Reed M
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Background

Dislocation is a major complication following total hip arthroplasty (THA). Aetiology is multi-factorial, but increasing femoral head size may result in lower dislocation rates. The latest England and Wales National Joint Registry (NJR) annual report has highlighted a statistically significant increase in the use of femoral heads of size 36mm+ from 5% in 2005 to 26% in 2009, together with an increase in the use of the posterior approach. The aim of this study was to determine whether national dislocation rates have fallen over the same period.

Methods

Hospital episode statistics (HES) data for England was analysed so as to determine trends in national rates of 3-, 6-, 12- and 18-month dislocation rates following primary THA performed between 2005 and 2009 (247,546 THAs). 18-month revision rates were also examined.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXIX | Pages 197 - 197
1 Sep 2012
Jensen C Morrell R Steval A Partington P Reed M Muller S
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Introduction

Rivaroxaban has been recommended for routine use as a thromboprophylactic agent in patients undergoing lower limb arthroplasty. Trials supporting its use have not fully evaluated the risks of wound complications related to rivaroxaban.

Method

A retrospective cohort analysis of 1558 consecutive patients who underwent total hip or knee replacements within the same hospital during a 19 month period (2009–2010) was performed. The first 489 patients (Group 1) were given tinzaparin postoperatively as per NICE guidance. The following 559 patients (Group 2) were given rivaroxaban. Concerns regarding wound complications prompted a change back to tinzaparin for the next 510 patients (Group 3.) Other than the thromboprophylactic agent used there were no other differences in the pre and postoperative treatments of all these patients.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XL | Pages 17 - 17
1 Sep 2012
Bone M Lord J Patil S Partington P Joyce T
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Background

Hemiarthroplasty of the hip involves the replacement of the femoral side of the joint with a metal prosthesis, resulting in metal-on-cartilage articulation. The two most common types of hemiarthroplasty used are the Austin Moore and the Thomson, both of which are available in either Titanium (Ti) or cobalt chromium (CoCr). Hemiarthroplasty may be more cost effective in elderly patients who have lower life expectancy and are less active.

Materials and Methods

Three Ti and two CoCr hemiarthroplasty components were obtained following revision surgery. Four had an articulating diameter of 44mm and the other was 46mm diameter. These five hemiarthroplasties were analysed using a Mitutoyo LEGEX322 co-ordinate measuring machine (CMM) (manufacturer's claimed scanning accuracy of 0.8μm). In each case a wear map was generated and the wear volume from the articulating surface was calculated using a bespoke MATLAB program.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXV | Pages 75 - 75
1 Jun 2012
Gill I Krishnan M Reed M Partington P
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Introduction

To report the short to medium term results of acetabular reconstruction using reinforcement/reconstruction ring, morcellised femoral head allograft and cemented metal on metal cup.

Methods

Single centre retrospective study of 6 consecutive patients who underwent acetabular reconstruction for revision hip surgery.

The acetabulum was reconstructed using morcellised femoral head allograft and reinforcement or reconstruction ring fixed with screws. The Birmingham cup – designed for cementless fixation, was cemented into the ring in all cases. The uncemented Echelon stem with metal on metal modular head was used for reconstructing the femur.

Data from our previous in-vitro study had shown good pull out strength of a cemented Birmingham cup.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXV | Pages 74 - 74
1 Jun 2012
Gill I Krishnan M Reed M Partington P
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Introduction

The aim of this study is to report the results of Revision hip arthroplasty using large diameter, metal on metal bearing implants- minimum 2 year follow up.

Methods

A single centre retrospective study was performed of 22 consecutive patients who underwent acetabular revision surgery using metal on metal bearing implants between 2004 and 2007. Birmingham hip resurfacing (BHR) cup was used in all patients - monoblock, uncemented, without additional screws in 16 cases and cemented within reinforcement or reconstruction ring in 6 cases.

Femoral revisions were carried out as necessary.