Thirty years' experience of excision of the trapezium for osteoarthritis of the trapeziometacarpal joint has shown that this simple operation is entirely satisfactory.
The Birmingham Hip Resurfacing (BHR) was introduced in 1997 to address the needs of young active patients using a historically proven large-diameter metal-on-metal (MoM) bearing. A single designer surgeon’s consecutive series of 130 patients (144 hips) was previously reported at five and ten years, reporting three and ten failures, respectively. The aim of this study was to extend the follow-up of this original cohort at 25 years. The study extends the reporting on the first consecutive 144 resurfacing procedures in 130 patients for all indications. All operations were undertaken between August 1997 and May 1998. The mean age at operation was 52.1 years (SD 9.93; 17 to 76), and included 37 female patients (28.5%). Failure was defined as revision of either component for any reason. Kaplan-Meier survival analysis was performed. Routine follow-up with serum metal ion levels, radiographs, and Oxford Hip Scores (OHSs) was undertaken.Aims
Methods
1. Arthroplasty of the knee joint should be performed only in carefully selected cases. Criteria for the operation are outlined. 2. In our experience, 70 per cent. of properly selected patients secure good or fair results. An additional 12 per cent., whose anatomical or functional results were classified as poor, preferred the movement which had been gained to ankylosis of the joint. 3. The major functional adaptation of the knee joint takes place during the first five years after arthroplasty. Several patients who had a poor range of movement after one or two years developed an excellent range by the end of five years. 4. Instability, when present, usually became apparent within the first five years. 5. Joints which were still stable at the end of five years usually remained so over a long period of time. Four patients have been traced for twenty to
Introduction. The Kaplan Meier estimator is widely used in orthopedics. In situations where another event prevents the occurrence of the event of interest, the Kaplan Meier estimator is not appropriate and a competing risks model has to be applied. We questioned how much bias is introduced by erroneous use of the Kaplan Meier estimator instead of a competing risks model in a hip revision surgery cohort. Methods. In our previously published cohort study, 62 acetabular revisions (58 patients) were performed between January 1979 and March 1986. Twenty to
We reported on the outcome of 84 Charnley low friction arthroplasties performed by one of us (GH), the period 1973 to 1984, in 69 patients, less than fifty-five years old, with osteoarthritis mainly due to congenital hip disease. The patients were followed prospectively; clinically using the Merle D’Aubigné and Postel scoring system, as modified by Charnley and also radiographically. At the time of the latest follow-up, thirty-seven hips had failed (44%). In thirty-two hips, twenty-eight acetabular and thirty femoral components were revised because of aseptic loosening (six of the femoral components were broken). Three hips were infected and converted to resection arthroplasty. In two more hips a periprosthetic femur fracture occurred three and ten years postoperatively and were treated with internal fixation. After a minimum of twenty-two years from the index operation, 37 original acetabular components and 36 original femoral components were in place for an average of 29 years. The probability of survival for both components with failure for any reason as the end point was 0.51 (95% confidence interval, 0.39 to 0.62) at
The purpose of this study was to analyse the twenty to twenty-five year outcomes of one hundred and ninetyfive cemented, matte finish, HD-2 THRs performed in one hundred and sixty-six patients with osteoarthritis of the hip by two surgeons. The one hundred and ninety-five THRs (one hundred and sixty-six patients) were followed prospectively by clinical assessment using the Harris Hip Score (HHS) and radiographic analysis. One hundred and forty-nine patients (90%) died with their implant still functioning or still had a successful implant at twenty to
Purpose: Fresh osteochondral allograft (FOCA) transplantation has been an effective treatment option with promising long-term clinical outcomes for focal post-traumatic or intra-articular lesions in the knee for young, active individuals. The goal of this study was to assess the osteochondral allograft to characterize the histopathologic features of early and late graft failure, as well as prolonged graft survival. Method: We examined histological features of thirtyfive fresh osteochondral allograft specimens retrieved at the time of subsequent graft revision, osteotomies or total knee arthroplasty. Results: The graft survival time in our samples ranged from one to
1. During the past
The management of symptomatic single bundle Anterior Cruciate Ligament (ACL) ruptures is still a surgical dilemma. Preservation of the intact fibres of the ACL bundle is considered to be a possible source of reinnervation of the ACL autograft which reflects on better proprioceptive knee control after major ligament reconstruction. Results of a prospective study of 67 patients who had a double stranded but single bundle Anterior Cruciate Ligament (ACL) reconstruction for partial ACL ruptures are presented. There were 43 males and 24 females in this study with a mean age at the time of injury of
1. Almost all patients with osteoarthritis of the hip who consult the surgeon do so because they wish to be relieved of pain. They all have limitation of movement in varying degrees but most of them will be either unaware of it or will have accepted it. What is more important, they would not have sought medical advice because of stiffness if there had been no pain. The primary objective of operative treatment must therefore be to relieve pain. 2. Displacement osteotomy will give substantial relief from pain in a high proportion of cases and the relief is lasting. Perhaps that explains why this operation, advocated by McMurray and Malkin
Drawing upon a total experience of 450 hips affected by established congenital dislocation or subluxation, the author presents the long-term results in 177 hips treated for the first time between the ages of nine months and three and a half years, in support of his contention that surgical endeavour should in the first place be directed towards the limbus and upper end of femur rather than the acetabulum. The 144 patients, all treated on lines previously described in this journal (Scott 1953; Somerville 1953a, b; Somerville and Scott 1957), have now been followed up annually for between ten and
A review of fifty cases of idiopathic pseudocoxalgia (Legg-CalveÌ-Perthes disease) followed into adult life for periods of eleven to thirty years (average seventeen years) after diagnosis shows:. 1. In the whole series rather more than one-third of the patients developed hips which were normal or nearly normal. 2. An equal number had hips which could only have been considered "fair.". 3. About one quarter had hips which gave pain and which showed marked loss of movement and gross degenerative changes radiologically. Judged from the point of view of symptoms, the results were better than the foregoing would suggest. Three-quarters of the patients were fully active and free from pain but only two-fifths had hips which were radiologically good. It is possible that such apparently good results are unlikely to be permanent, and I hope, therefore, to continue this follow-up for another ten or fifteen years. It can, however, be concluded at this stage that an immediate good result is likely to be maintained at least until the age of
Purpose: The purpose of this study was to determine psychometric properties of the Lysholm score and Tegner activity scale as patient-administered outcomes scores for anterior cruciate ligament injuries of the knee. We hypothesized that these two outcomes measures remain valid by today’s standards
Hyaline cartilage and immature nucleus pulposus possess similar macromolecules in their extracellular matrix, and there is no unique molecular marker to distinguish the two tissues. We show that in normal disc (fifteen to
1. A review of 204 cases of prolapsed intervertebral disc treated by the author by operation ten to
1. This is a simple clinical study of the end-results of arthrodesis of the hip joint in patients followed up and re-examined five to