Magnetic resonance imaging (MRI) is one of the most widely used investigations for knee pain as it provides detailed assessment of the bone and soft tissues. The aim of this study was to report the frequency of each diagnosis identified on MRI scans of the knee and explore the relationship between MRI results and onward treatment. Consecutive MRI reports from a large NHS trust performed in 2017 were included in this study. The hospital electronic system was consulted to identify whether a patient underwent x-ray prior to the MRI, attended an outpatient appointment or underwent surgery.Abstract
Objectives
Methods
Polytrauma patients are at high risk of systematic inflammatory response syndrome (SIRS) due to an exaggerated unbalanced immune response that can lead to multiple organ failure and increased mortality. This response is often heightened following acute surgical management as a result, damage-control orthopaedics (DCO) was born. This allows the patient to be stabilised using external fixation allowing physiology to improve. This systematic review aims to compare DCO against early total care (ETC) (<24hrs intramedullary nailing) in polytraumatised patients with femoral shaft fractures using a diagnosis of acute lung injury (ALI) as the primary outcome measure. A systematic review of MEDLINE, EMBASE, CENTRAL and AMED was carried out to identify all English language studies comparing ETC versus DCO using ALI as the primary outcome measure. Two authors independently screened the studies and performed data extraction. Risk of bias was assessed using the Cochrane risk of bias tool and the Risk-of-Bias Assessment Tool for Non-randomised Studies.Background
Method
Clavicle development occurs before the age of 9 in females and 12 in males. Children below the age of 10 with displaced midshaft clavicle fractures recover well with conservative management. However adolescents are more demanding of function and satisfaction following clavicle fractures and may benefit from operative management. Study aims: 1) Perform a systematic review of the current evidence supporting intramedullary fixation of adolescent clavicle fractures. 2) Review current management in a major trauma center (MTC) with a view to assess feasibility for a randomised controlled trial (RCT). The MEDLINE, EMBASE and AMED databases were searched in October 2014 to identify all English language studies evaluating intramedullary fixation in children aged 10–18 years using MeSH terms. Data was extracted using a standardised data collection sheet and studies were critically appraised by aid of the PRISMA checklist. All patients aged 9–15 attending an MTC receiving clavicle radiographs in 2014 were retrospectively reviewed for type of fracture, management and outcome.Background
Methods
Tourniquets are routinely used in total knee arthroplasty (TKA) with an estimated use by up to 93% of surgeons. Advantages include the ability to provide a bloodless field of view to facilitate cement application and increase the success of the procedure. Overall reduction in blood loss is another perceived advantage, however recent research has demonstrated no measurable reduction and conversely a substantial increase in complications such as deep vein thrombosis and systemic emboli. Given the significant complications of tourniquet use we aim to identify patients’ views on tourniquets and of emphasis their awareness of the possible risks involved prior to the procedure. A questionnaire-based study was carried out on 35 patients attending an elective orthopaedic centre for TKA surgery. Ethical approval was granted by NRES committee – East of England (REC Ref: 14/EE/1265). Patients were provided with an information sheet detailing the reasons for the tourniquet use and the associated risks and benefits. They were then provided with a questionnaire to ascertain their views and previous understanding of the subject. Simple statistical measures were implemented to analyse the data.Background
Method
Acetabular fractures occur as a result of high-velocity trauma and are often associated with other life threatening injuries. Approximately one-third of these fractures are associated with dislocation of the femoral head but there are only few studies documenting the long term outcomes of this group of acetabular fracture. This was undertaken at the Royal Infirmary of Edinburgh which provides the definitive orthopaedic treatment for all major trauma including all acetabular fractures for the South East of Scotland. We retrospectively reviewed patients who sustained an acetabular fracture associated with a posterior hip dislocation from a prospectively gathered trauma database between 1990 to 2010. Patient characteristics, complications and the requirement for further surgery were recorded. Patient outcomes were measured using the Oxford Hip score and Short Form SF-12 health survey.Background
Methods
Tourniquets are routinely used in total knee arthroplasty (TKA) with an estimated use by up to 93% of surgeons. Advantages include the ability to provide a bloodless field of view to facilitate cement application and increase the success of the procedure. Overall reduction in blood loss is another perceived advantage, however recent research has demonstrated no measurable reduction and conversely a substantial increase in complications such as deep vein thrombosis and systemic emboli. Given the significant complications of tourniquet use we aim to identify patients' views on tourniquets and of emphasis their awareness of the possible risks involved prior to the procedure. A questionnaire-based study was carried out on 35 patients attending an elective orthopaedic centre for TKA surgery. Ethical approval was granted by NRES committee – East of England (REC Ref: 14/EE/1265). Patients were provided with an information sheet detailing the reasons for the tourniquet use and the associated risks and benefits. They were then provided with a questionnaire to ascertain their views and previous understanding of the subject. Simple statistical measures were implemented to analyse the data.Background
Method
Total Knee Replacement (TKR) is an effective treatment for knee arthritis. One long held principle of TKRs is positioning the components in alignment with the mechanical axis to restore the overall limb alignment to 180 ± 3 degrees. However, this view has been challenged recently. Given the high number of replacements performed, clarity on this integral aspect is necessary. Our objective was to investigate the association between malalignment and outcome (both PROMs and revision) following primary TKR. A systematic review of MEDLINE, CINHAL, and EMBASE was carried out to identify studies published from 2000 onwards. The study protocol including search strategy can be found on the PROSPERO database for systematic reviews.Background
Metod
Bioresorbable materials offer the potential of developing fracture fixation plates with similar properties to bone thereby minimising the “stress shielding” associated with metal plates and obviating the need for implant removal. Phosphate glass fibre reinforced (PGF)-polylactic acid (PLA) composites are bioresorbable and have demonstrated sufficient retention of mechanical properties to enable load bearing applications. To determine the potential in vivo “stress shielding” effects of a novel PGF reinforced PLA composite plate in an animal model.Background
Aim
