Aim: To evaluate and assess the validity and accuracy of various described ways of performing the McMurray’s test in the diagnosis of meniscal tears.

Material & Methods: Prospective study with patients divided into seven groups based on seven described ways of performing McMurray’s test. Twenty-five patients in each group, aged between 15 to 60 years-undergoing arthroscopy of knee for clinically suspected meniscal tear. Exclusion criteria were ACL tear on arthroscopy, radiological or arthroscopic evidence of osteoarthritis and patients within six weeks of injury.

All patients were assessed preoperatively with knee examined in one of seen different methods. EUA followed by arthroscopy. Clinical and arthroscopic findings were correlated and sensitivity and specificity were determined.

The study is ongoing with following results.

Conclusion: Accuracy of McMurrays test ranged between 0 to 95% in various studies. Factors determining outcome include patient selection difference in applying test and interpretation of results. McMur-rays original description included no varus or valgus stress and a click a was positive test. Other descriptions include varus or valgus stress and apart from click pain is also considered a positive test. Comparisons among results in literature are difficult with confusing results. Our study is incomplete but trends suggest Reider’s method may be the most accurate.

We conducted a prospective, randomised, controlled trial of 45 patients (47 elbows), with tennis elbow, who underwent either a formal open release or a percutaneous tenotomy. All patients had pre- and post-operative assessment using the Disability of Arm, Shoulder and Hand (DASH) scoring system. Both groups were followed up for a minimum of 12 months. Statistical analyses using the Mann-Whitney U test and repeated measured ANOVA showed significant improvements for patient satisfaction (p = 0.012), time to return to work (p = 0.0001), improvements in DASH score (p = 0.001) and improvement in sporting activities (p = 0.046) in the percutaneous group. Those patients undergoing a percutaneous release returned to work on average three weeks earlier and improved significantly more quickly than those undergoing an open procedure. The percutaneous procedure is a quicker and simpler procedure to undertake and produces significantly better results.

Proximal femoral fractures have always been in the centre of attention in terms of their demand on the manpower and resources of the NHS. With an ageing population, the number of these fractures will continue to be a big part of the workload of all the Orthopaedic and rehabilitation units. Hence it is important to be aware of any definite variation in the incidence of proximal femoral fractures for appropriate planning of the available resources.

We carried out a study to find out whether there is a definite variation in the incidence of these fractures. The number of operated proximal femoral fractures across 31 hospitals of North-west England and Scotland were collected on a monthly basis from 1994 to 1999. This database of 27, 000 operated proximal femoral fractures was assessed statistically.

Our analysis reveals that the incidence of these fractures during December is about 17% higher than the rest of the annual mean with a 2% standard error of the mean (SEM) and in January this increase is about 22% with an SEM of 1%. These trend and pattern were observed for both intra and extra capsular fractures of neck of femur and was consistent over the five years. There was no other significant change in the incidence pattern during other months of the year.

This study, one of the largest of its kind ever carried out in Britain, proves that there is an increase in the incidence of hip fractures in the months of December and January. There should be appropriate allocation of manpower and rehabilitation facilities along with a matching reduction in the elective Orthopaedic admissions during the months of December and January to tackle this seasonal variation.