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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXIX | Pages 31 - 31
1 Sep 2012
Hossain M Andrew G
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Introduction

Following National patient safety alert on cement use in hip fracture surgery, we investigated the incidence and pattern of 72 hours peri-operative mortality after hip fracture surgery in a District General Hospital.

Methods

We reviewed all patients who had hip fracture surgery between 2005-April, 2010. We recorded demographic variables, type of fracture, implant used, medical co-morbidity, seniority of operating surgeon and anaesthetist, peri-operative haemodynamic status, time and cause of death.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXIX | Pages 14 - 14
1 Sep 2012
Hossain M Beard D Andrew G
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Introduction

There is uncertainty about the relationship between improvement in range of motion (ROM) and functional outcome or patient satisfaction after total hip arthroplasty (THA). Using data from a prospective multi-centre study we investigated this relationship.

Methods

We recorded the Oxford Hip Score (OHS), Merle d'Aubigne and Postel score (MDA) and range of motion (ROM) preoperatively and at one and five years and a patient satisfaction questionnaire at five years. Complete 5 year data were available for 342 patients.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXIX | Pages 19 - 19
1 Sep 2012
Barlow D Andrew G Badr S Rhee S Beard D Murray D
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We examined data from a large prospectively collected dataset which followed up patients after Exeter total hip replacement (THR) - the Exeter Primary Outcome Study. We studied 78 patients who had total hip replacement for osteoarthritis on a morphologically normal hip, and in whom the other hip was also morphologically normal for comparison. All selected patients had complete patient outcome data at 1 and 5 years, and x-rays at 1 year were available.

We measured accuracy of reconstruction on AP Pelvis radiographs. The parameters measured were difference in height of lesser trochanter from horizontal pelvic line (LLD); length from ASIS to greater trochanter (indicating abductor length, AL); length from symphysis to centre of femoral head (SFH); length from centre of head to axis of femur (offset). We examined clinical outcomes including gain of Oxford Hip Score (DOHS) at 1 and 5 years, absolute OHS at 1 and 5 years, and absolute SF-36 Physical Functioning and Role Physical scores at 1 and 5 years.

Examining the ratios of AL, SFH, Offset, Offset to SFH ratio and LLD between side of THR and unaffected side all showed marked variation. Thus the ratio of SFH varied from 0.85 to 1.11. For further analysis we divided the patients into 3 groups on the basis of variability of the ratio from 1; we examined whether the clinical scores above varied between these 3 groups. 1 way ANOVA demonstrated no significant difference for any of the clinical outcomes for any of the 5 grouped x-ray variables.

Accuracy of reconstruction has been shown to affect the risk of dislocation after THR. Our results indicate that clinical outcomes of total hip replacement appear resilient to some degree of surgical inaccuracy. Future trials of navigation should be designed to demonstrate not only improved accuracy but also improved clinical outcome.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXIX | Pages 12 - 12
1 Sep 2012
Hossain M Beard D Murray D Andrew G
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Introduction

Acetabular cup lucency predicts cup survival. The relationship of subchondral plate removal and cup survival is unclear. Using data from a prospective study conducted between January 1999 and January 2002 we investigated the role of subchondral plate removal in cemented acetabular cup survival at five years.

Methods

A number of cemented cups were implanted using antero-lateral and posterior approaches.1400 cups were inserted. 935 cups (67%) were followed up at 5 years and acetabular radiolucency (AR) recorded.