1. 63,284 patients presented with neck of femur fractures in England in 2020 (NHFD report 2021)2. To maximise theatre efficiency during the first wave of COVID-19, NHSE guidance recommended the use of HA for most patients requiring arthroplasty.3. The literature reports an incidence of Hemiarthroplasty dislocations of 1–15%. 1. To study the number and possible causes of dislocations in patients with Primary hemiarthroplasty for fracture neck of femur2. To compare our data with national and international data in terms of dislocation and revision rates for Hemiarthroplasty.Abstract
Background
Aims
Hip dislocations remain one of the most common complications of total-hip-arthroplasty (Zahar et al.,2013). There is contradicting evidence whether the surgical approach affects dislocation rates (Sheth et al., 2015; Maratt, 2018). The aim of this study was to develop instrumentation to measure hip forces during simulated range-of-motion tests where the hip was forced to dislocate in cadaveric specimen. A total-hip-replacement was completed on both hips of a single cadaveric specimen by a trained orthopaedic surgeon during a lab initiated by DePuy. A direct-anterior surgical approach was performed on the right leg and a posterior approach was performed on the left. Before final implantation of the femoral component, a trial reduction with a femoral neck trial was performed. The neck trial was modified with strain gauges placed around the shaft which were designed to measure resultant hip forces throughout the range-of-motion assessment. A force-calibration was performed using a calibration-block to convert strain to force values.Abstract
OBJECTIVES
METHODS
The highest incidence of recurrent shoulder instability is in young patients, surgical repair can reduce recurrent instability and improve shoulder function. This has led to an increasing rate of stabilisation and use of MRI to identify associated injuries in first time dislocations. MRA has the benefit of distending the joint and is becoming increasingly used. The aim of this study is to establish the sensitivity and specificity of MRA in the investigation of patients with traumatic anterior shoulder dislocations. A retrospective analysis of patients undergoing both magnetic resonance arthrography and arthroscopy after a traumatic anterior shoulder dislocation between January 2011 and 2014. Images were interpreted by eight musculoskeletal radiologists and arthroscopic findings were obtained from surgical notes and used as a reference. The sensitivity, specificity and positive predictive value for the different injuries were calculated.Introduction
Methods
The reduction for unstable femoral intertrochanteric fracture should be extramedullary, which means that the proximal fragment protrudes for the distal fragment. However, only few articles have compared extramedullary and intramedullary reductions in a biomechanical study. Thus, we created unstable femoral intertrochanteric fracture models using imitational bone (extramedullary and intramedullary groups, each with 12 cases) and evaluated their biomechanical stabilities. The fracture type was 31-A2 according to the AO-OTA Classification of Fractures and
The hip's capsular ligaments (CL) passively restrain extreme range of motion (ROM) by wrapping around the native femoral head/neck, and protect against impingement and instability. We compared how CL function was affected by device (hip resurfacing arthroplasty, HRA; dual mobility total hip arthroplasty, DM-THA; and conventional THA, C-THA), and surgical approach (anterior and posterior), with and without CL surgical-repair. We hypothesized that CL function would only be preserved when native head-size (HRA/DM-THA) was restored. CL function was quantified on sixteen cadaveric hips, by measuring ROM by internally (IR) and externally rotating (ER) the hip in six functional positions, ranging from full extension with abduction to full flexion with adduction (squatting). Native ROM was compared to ROM after posterior capsulotomy (right hips) or anterior capsulotomy (left hips), and HRA, and C-THA and DM-THA, before and after CL repair. Independent of approach, ROM increased most following C-THA (max 62°), then DM-THA (max 40°), then HRA (max 19°), indicating later CL engagement and reduced biomechanical function with smaller head-size.
Summary Statment. The dual-mobility cup seems to bring more stability without changing the gait pattern. Introduction.