Background. The surgical management of musculoskeletal tumours is a challenging problem, particularly in pelvic and diaphyseal tumour resection where accurate determination of bony transection points is extremely important to optimise oncologic, functional and reconstructive options. The use of
Surgical training has been greatly affected by the challenges of reduced training opportunities, shortened working hours, and financial pressures. There is an increased need for the use of training system in developing psychomotor skills of the surgical trainee for fracture fixation. The training system was developed to simulate dynamic hip screw fixation. 12 orthopaedic senior house officers performed dynamic hip screw fixation before and after the training on training system. The results were assessed based on the scoring system that included the amount of time taken, accuracy of guide wire placement and the number of exposures requested to complete the procedure. The result shows a significant improvement in amount of time taken, accuracy of fixation and the number of exposures after the training on simulator system. This was statistically significant using paired student t-test (p-value <0.05). Computer navigated training system appears to be a good training tool for young orthopaedic trainees The system has the potential to be used in various other orthopaedic procedures for learning of technical skills aimed at ensuring a smooth escalation in task complexity leading to the better performance of procedures in the operating theatre.
To confirm whether developmental dysplasia of
the hip has a risk of hip impingement, we analysed maximum ranges
of movement to the point of bony impingement, and impingement location
using three-dimensional (3D) surface models of the pelvis and femur
in combination with 3D morphology of the hip joint using computer-assisted methods.
Results of computed tomography were examined for 52 hip joints with
DDH and 73 normal healthy hip joints. DDH shows larger maximum extension
(p = 0.001) and internal rotation at 90° flexion (p <
0.001).
Similar maximum flexion (p = 0.835) and external rotation (p = 0.713)
were observed between groups, while high rates of extra-articular
impingement were noticed in these directions in DDH (p <
0.001).
Smaller cranial acetabular anteversion (p = 0.048), centre-edge
angles (p <
0.001), a circumferentially shallower acetabulum,
larger femoral neck anteversion (p <
0.001), and larger alpha
angle were identified in DDH. Risk of anterior impingement in retroverted
DDH hips is similar to that in retroverted normal hips in excessive
adduction but minimal in less adduction. These findings might be
borne in mind when considering the possibility of extra-articular
posterior impingement in DDH being a source of pain, particularly
for patients with a highly anteverted femoral neck. Cite this article:
We have investigated the benefits of patient
specific instrument guides, applied to osteotomies around the knee. Single,
dual and triple planar osteotomies were performed on tibias or femurs
in 14 subjects. In all patients, a detailed pre-operative plan was
prepared based upon full leg standing radiographic and CT scan information.
The planned level of the osteotomy and open wedge resection was
relayed to the surgery by virtue of a patient specific guide developed
from the images. The mean deviation between the planned wedge angle
and the executed wedge angle was 0° (-1 to 1, Cite this article:
Abstract. Introduction. Component mal-positioning in total hip replacement (THR) and total knee replacement (TKR) can increase the risk of revision for various reasons. Compared to conventional surgery, relatively improved accuracy of implant positioning can be achieved using
Study design. Literature review of the best available evidence on the accuracy of
Background: The use of sacro-iliac screws to restore the stability of posterior pelvic ring dissociations has become a standard technique. Several methods are described including fluoroscopy, CT and
Introduction: Obesity [Body Mass Index (BMI) >
30] is seen in a growing percentage of patients seeking joint replacement surgery. Recent studies have shown no clear influence of obesity on the five-year, clinical outcome of total knee replacement; except for the morbidly obese (BMI >
40). Computer navigation has shown improved consistency of prosthetic component alignment. However, this aid does significantly increase operation time. Aims:. To compare tourniquet times of standard and
We present minimum 20 year results of a randomized, prospective double blinded trial (RCT) of cross-linked versus conventional polyethylene (PE), using a
Since 2000 we have performed TKR with the aid of a
Background. Limb length discrepancy after total hip replacement is one of the possible complications of suboptimal positioning of the implant and cause of patients dissatisfaction.
Background. Stress fractures at tracker after computer navigated total knee replacement are rare. Periprosthetic fracture after Minimally Invasive Plate Osteosynthesis (MIPO) of stress fracture through femoral tracker is unique in orthopaedic literature. We are reporting this unique presentation of periprosthetic fractures after MIPO for stress fracture involving femoral pin site track in
Introduction. Post traumatic arthritis of the knee can be a conseguence of distal femur fracture and retained hardware can complicate any further surgical option including arthroplasty. Both staged surgical procedures to remove before the hardware or simultaneous procedure of arthroplasty and removal of hardware have been indicated with an increased risk of complications. Aim of this study is to present a consecutive series of TKA following distal femur fracture using a
To prospectively evaluate the accuracy as well as patient outcome of computer-assisted total knee replacement in a multi-centric randomised study. Two hundred and ninety-five patients in six European centers were randomised between two groups: One hundred and forty-seven in the conventional surgery group and one hundred and forty-eight in the
Objective:. Periacetabular spherical osteotomy for the treatment of dysplastic hip is effective but technically demanding. To help surgeons perform this difficult procedure reliably and safely, a
Introduction: There has been significant development in computer technology in recent years and this has led to applications in orthopaedic surgery. Of particular interest is
To determine the precision of conventional versus
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