Aims

This study aimed to evaluate the relationship between hip shape and mid-term function in Perthes’ disease. It also explored whether the modified three-group Stulberg classification can offer similar prognostic information to the five-group system.

Aims

The Patient-Reported Outcomes Measurement Information System (PROMIS) has demonstrated faster administration, lower burden of data capture and reduced floor and ceiling effects compared to traditional Patient Reported Outcomes Measurements (PROMs). We investigated the suitability of PROMIS Mobility score in assessing physical function in the sequelae of childhood hip disease.

Aims: To assess the medium term results of uncemented Low Contact Stress Rotating platform total knee replacement.

Methods: One hundred and nine primary uncemented Low Contact Stress rotating platform total knee replacements in 85 patients were reviewed 4 to 12 years after the operation as a prospective study on consecutive cases. 106 knees received uncemented metal backed rotating patella. All patients were followed up annually with subjective questionnaires and radiological assessment.

Results: At the time of final review, 69 patients with 87 rotating platform total knee replacement were alive. There was no loss to follow-up. The American Knee society score was used for objective assessment. The average knee score was 86.42 and the average functional score was 65.1. No evidence of radiological loosening was observed in any patient. One knee was revised because of medial collateral ligament laxity. The ten-year survival rate was 99.08% (95% CI - 91.9-99.9).

Conclusion: The uncemented LCS rotating platform knee replacement seems to be reliable at medium-term follow-up.

Aims: To assess the medium term results of uncemented meniscal bearing total knee replacement.

Methods: Fifty one knees in 40 patients with posterior cruciate ligament retaining meniscal bearing total knee replacement were reviewed 5 to 12 years after the arthroplasty. Forty nine knees had uncemented metal backed rotating patella. They were followed up annually with subjective questionnaires and radiological assessment.

Results: Forty eight out of the 51 knees were available at the time of final review. Three knees were lost due to the death of patients. They were reviewed after an average follow-up of 8 years 7 months. There was no loss to follow-up. There were three revisions due to excessive wear of the meniscal bearing. Defective polyethylene bearing was the reason for failure in one knee. The mal-rotation resulting from the posterior cruciate ligament deficiency could have been reason for the increased wear of the meniscal bearing and early failure in the other two knees. The ten-year survival rate was 93.08% (95% CI - 81.74-98.22). The objective assessment of the knee replacement was done with The Knee Society scoring system. The average knee score was 87.64 and the average functional score was 74.4.

Conclusion: The long-term survival of PCL sparing meniscal bearing knee replacement seems to be affected by increased polyethylene wear.

We performed a prospective, randomised controlled trial of the operative versus non-operative treatment of 42 displaced fractures of the distal femur in elderly patients.

Excellent or good results were achieved in 53% of the operated group and in 31% of the non-operated group. There were more complications in the latter, and the time to discharge was considerably longer.