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Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_15 | Pages 109 - 109
1 Mar 2013
Lambers A Jennings R Bucknill A
Full Access

Introduction

Accurate prosthetic cup placement is very important in total hip arthroplasty (THA). When the surgeon is impacting the acetabular cup, it is assumed that the patient's pelvis is perpendicular to the operating table. In reality the pelvis may not be truly lateral, and error in patient positioning may influence the resultant cup orientation.

Objectives

The primary aim of this study was to examine the accuracy of patient positioning prior to THA. A secondary aim was to see if patient BMI influenced the accuracy of positioning.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_15 | Pages 235 - 235
1 Mar 2013
Lambers A Jennings R Bucknill A
Full Access

Introduction

Past research has focused on complications of bony fixation of navigation reference frames such as fractures and cutting errors.

Objective

This study investigates the consequences of the use of iliac crest percutaneous navigational array pins in terms of pain, irritability and the impact on quality of life.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_15 | Pages 110 - 110
1 Mar 2013
Lambers A Jennings R Bucknill A
Full Access

Introduction

Leg length and offset are important considerations in total hip arthroplasty (THA). Navigation systems are capable of providing intra-operative measurements, which help guide the surgeon in leg length and offset adjustment.

Objective

This controlled study investigates whether the use of computer navigation leads to more accurate achievement of pre-operative leg length and offset targets in THA.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_15 | Pages 111 - 111
1 Mar 2013
Lambers A Jennings R Bucknill A
Full Access

Introduction

Leg length and offset are important considerations in total hip arthroplasty (THA). Navigation systems are capable of providing intra-operative measurements of leg length and offset, and high accuracy has been shown in experimental studies.

Objective

This in-vivo study assesses the accuracy of an imageless navigation system, with a pin-less femoral array, in measuring offset and leg length changes.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_2 | Pages 6 - 6
1 Jan 2013
Rudge B Jennings R Calder P
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Introduction

Lower limb mal-alignment as a result of fracture malunion can result in knee degenerative arthritis or predispose to early arthroplasty failure due to the altered mechanical axis. The choice of corrective osteotomy is often determined by potential complications. Opening wedge osteotomy is associated with poor bone healing especially in adult diaphyseal bone. Distraction osteogenesis enables gradual deformity correction with the gap filled by regenerate bone. Bone formation however is formed less favourably in the diaphysis and metaphyseal osteotomy is advised. We present a consecutive series of adult tibial diaphyseal correction using the Taylor Spatial Frame utilising the method of distraction osteogenesis.

Method

15 adults, 11 male and 3 female, underwent tibial deformity correction. A mid diaphyseal osteotomy was made using minimal soft tissue dissection and an osteotome. The site was determined by the centre of rotation of angulation (CORA). After a 6 day latency period distraction was undertaken by the Taylor Spatial Frame. Patients were encouraged to fully weight bear throughout the treatment process. Following regenerate consolidation the frame was removed and a below knee weight bearing cast applied for 4 weeks.


Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_I | Pages 77 - 77
1 Jan 2011
Rossi R Rose B Riley ND Jennings R Saifuddin A Skinner JA Cannon SR Briggs T Pollock R
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Introduction: Within a study group of 102 consecutive patients diagnosed with chondrosarcoma of the femur, tibia or humerus, an association with previously treated breast cancer was noted. We researched this proposed relationship.

Methods: We retrospectively reviewed the records of all patients diagnosed histologically with chondrosarcoma of the femur, tibia or humerus over a six-year period at a supra-regional bone tumour unit. We identified those patients who had previously been treated for breast cancer.

Results: There were 58 female and 44 male patients. The study group contained six females (10%, mean age 53 years) who had previously been treated for breast cancer, a higher proportion than would be expected. They were referred following identification of a solitary area of increased activity on routine screening with isotope bone scan, presumed to be a solitary bony metastasis. Most (86%) of this breast carcinoma sub-group had developed low-grade bone chondrosarcoma (Trojani grade 0.5-I) and only one case (14%) had developed high-grade chondrosarcoma (Trojani grade II–III).

Discussion: A suspicious long bone lesion on bone scan in a patient with a past medical history of breast cancer must, therefore, not be assumed to be a metastasis without further investigation; the possibility of a chondral lesion should be considered. It is important that patients receive a full multidisciplinary team investigation prior to treatment in order to obtain the correct tissue diagnosis, as the management of these conditions is often different. Our study suggests there may be a relationship between patients previously treated for breast cancer and the development of subsequent chondrosarcoma.


Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_I | Pages 77 - 77
1 Jan 2011
Jennings R Riley ND Rose B Rossi R Saifuddin A Skinner JA Cannon SR Briggs TWR Pollock R
Full Access

Introduction: Chondrosarcoma is the second most common primary malignant bone tumour. Distinguishing between grades is not necessarily straightforward and may alter the management of the disease. We evaluated the correlation between the pre-operative needle biopsy and excision biopsy histological grading of chondrosarcoma of the femur, tibia and humerus.

Methods: A consecutive retrospective series of 100 patients with a histological diagnosis of chondrosarcoma made at a supra-regional bone tumour unit was reviewed. Twenty-one patients were excluded because 20 had only excision biopsy, due to radiological confidence in the diagnosis, and one had only the pre-operative biopsy on record, thus this series included 79 available cases. The remaining patients underwent a pre-operative needle biopsy.

Results: In 11 instances, there was a discrepancy in histological grade. Therefore, there was an 86% (68 out of 79) accuracy rate for pre-operative histological grading of chondrosarcoma, based on needle biopsy. However, the accuracy of the diagnostic biopsy to distinguish low-grade from high-grade was 90% (71 out of 79).

Discussion: From this series we conclude that accurate image-guided biopsy is a very useful adjunct in determining histological grade of chondrosarcoma and the subsequent treatment plan. At present, a multidisciplinary approach, comprising experienced Orthopaedic Surgeons, Radiologists and Pathologists offers the most reliable means of accurately diagnosing and grading chondrosarcoma of long bones.


Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_III | Pages 449 - 449
1 Jul 2010
Rossi R Rose B Riley N Jennings R Saifuddin A Skinner J Cannon S Briggs T Pollock R
Full Access

Within a study group of 102 consecutive patients diagnosed at a supra-regional bone tumour unit with chondrosarcoma of the femur, tibia or humerus, an association with previously treated breast cancer was noted.

There were 58 female patients and 44 male patients. The study group contained six females (10%, mean age 53 years) who had previously been treated for breast cancer, a higher proportion than would be expected. They were referred following identification of a solitary area of increased activity on routine screening with isotope bone scan, presumed to be a solitary bony metastasis.

Most (86%) of this breast carcinoma sub-group had developed low-grade bone chondrosarcoma (Trojani grade 0.5-I) and only one case (14%) had developed high-grade chondrosarcoma (Trojani grade II-III).

A suspicious long bone lesion on bone scan in a patient with a past medical history of breast cancer must, therefore, not be assumed to be a metastasis without further investigation; the possibility of a chondral lesion should be considered. It is important that patients receive a full multidisciplinary team investigation prior to treatment in order to obtain the correct tissue diagnosis, as the management of these conditions is often different.

Our study suggests there may be a relationshipbetween patients previously treated for breast cancer and the development of subsequent chondrosarcoma.


Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_III | Pages 474 - 474
1 Jul 2010
Jennings R Riley N Rose B Rossi R Saifuddin A Skinner J Cannon S Briggs T Pollock R
Full Access

Chondrosarcoma is the second most common primary malignant bone tumour. Distinguishing between grades is not necessarily straightforward and may alter the management of the disease. We evaluated the correlation between the pre-operative needle biopsy and excision biopsy histological grading of chondrosarcoma of the femur, tibia and humerus.

A consecutive retrospective series of 100 patients with a histological diagnosis of chondrosarcoma was reviewed. Twenty-one patients were excluded because 20 had only excision biopsy and one had only the pre-operative biopsy on record, thus this series included 79 available cases. In 11 instances, there was a discrepancy in histological grade.

Therefore, there was an 86% (68 out of 79) accuracy rate for pre-operative histological grading of chondrosarcoma, based on needle biopsy. However, the accuracy of the diagnostic biopsy to distinguish low-grade from high-grade was 90% (71 out of 79).