Aims. Surgical treatment of young femoral neck fractures often requires an open approach to achieve an anatomical reduction. The application of a
Aims. The aim of this study was to explore why some
Aims. This study aimed to determine whether lateral femoral wall thickness (LWT) < 20.5 mm was associated with increased revision risk of intertrochanteric fracture (ITF) of the hip following sliding hip screw (SHS) fixation when the medial
Aims. The aim of this study was to estimate the 90-day risk of revision for periprosthetic femoral fracture associated with design features of cementless femoral stems, and to investigate the effect of a collar on this risk using a biomechanical in vitro model. Materials and Methods. A total of 337 647 primary total hip arthroplasties (THAs) from the United Kingdom National Joint Registry (NJR) were included in a multivariable survival and regression analysis to identify the adjusted hazard of revision for periprosthetic fracture following primary THA using a cementless stem. The effect of a collar in cementless THA on this risk was evaluated in an in vitro model using paired fresh frozen cadaveric femora. Results. The prevalence of early revision for periprosthetic fracture was 0.34% (1180/337 647) and 44.0% (520/1180) occurred within 90 days of surgery. Implant risk factors included: collarless stem, non-grit-blasted finish, and triple-tapered design. In the in vitro model, a medial
Abstract. Objective. To estimate the effect of
The
Aims. In recent years, the use of a collared cementless femoral prosthesis has risen in popularity. The design intention of collared components is to transfer some load to the resected femoral
Aims. Fixation of osteoporotic proximal humerus fractures remains challenging even with state-of-the-art locking plates. Despite the demonstrated biomechanical benefit of screw tip augmentation with bone cement, the clinical findings have remained unclear, potentially as the optimal augmentation combinations are unknown. The aim of this study was to systematically evaluate the biomechanical benefits of the augmentation options in a humeral locking plate using finite element analysis (FEA). Methods. A total of 64 cement augmentation configurations were analyzed using six screws of a locking plate to virtually fix unstable three-part fractures in 24 low-density proximal humerus models under three physiological loading cases (4,608 simulations). The biomechanical benefit of augmentation was evaluated through an established FEA methodology using the average peri-screw bone strain as a validated predictor of cyclic cut-out failure. Results. The biomechanical benefit was already significant with a single cemented screw and increased with the number of augmented screws, but the configuration was highly influential. The best two-screw (mean 23%, SD 3% reduction) and the worst four-screw (mean 22%, SD 5%) combinations performed similarly. The largest benefits were achieved with augmenting screws purchasing into the
Total hip arthroplasty (THA) allows patients to return to an active lifestyle. Unfortunately one of the more common complications of cementless THA is a fracture of the greater trochanter (GT) or the
Introduction. Segmental defects of the femur present a major problem during revision hip arthroplasty. In particular,
The
Background. Post-operative periprosthetic femoral fractures (PFF) are a devastating complication associated with high mortality and are costly. Few risk factors are modifiable apart from implant choice. The design features governing risk of PFF are unknown. We estimated the 90-day risk of revision for PFF associated with design features of cementless femoral stems and to investigate the effect of a collar on early PFF risk using a biomechanical in-vitro model. Patients, materials and methods. 337 647 primary THAs from the National Joint Registry (UK) were included in a multivariable survival and regression analysis to identify the adjusted hazard of PFF revision following primary THA using cementless stems. The effect of a collar in cementless THA on early PFF was evaluated in an in-vitro model using paired fresh frozen cadaveric femora. Results. Prevalence of PFF revision was 0.34% (1180/337647) and 44.0% occurred (520/1180) within 90 days of surgery. Implant risk factors included: collarless stem, non grit-blasted finish and triple tapered design. In the in-vitro PFF model a medial
Metal meshes are used in revision surgery of the hip to contain impacted bone grafts in cases with cortical or
Background: The
Resorption of the
Resorption of the
Between January 1990 and October 2000, 108 total hip arthroplasties using a cemented polished titanium stem and a cemented ultra-high molecular weight polyethylene (UHMWP) cup were performed at our hospital. Because during routine follow-up visits we noted instances of resorption of the
We have previously reported on early lytic lesions occurring when collared titanium prostheses are used. Previous finite element analysis studies (FEAs) showed that lytic lesions of the
A consensus regarding management of calcaneal fractures eludes orthopaedic surgeons. While operative treatment has gained more acceptance, surgical morbidity remains high. We undertook a retrospective review of early complications and radiological outcomes following internal fixation of calcaneal fractures in our unit over 15 months. A consecutive series of 33 patients who underwent fixation of the