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Orthopaedic Proceedings
Vol. 105-B, Issue SUPP_13 | Pages 86 - 86
7 Aug 2023
Nanjundaiah R Guro R Chandratreya A Kotwal R
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Abstract

Aims

We studied the outcomes following arthroscopic primary repair of bucket handle meniscus tears to determine the incidence of re-tears and the functional outcomes of these patients.

Methodology

Prospective cohort study. Over a 4-year period (2016 to 2020), 35 adult patients presented with a bucket handle tear of the meniscus. Arthroscopic meniscal repair was performed using either the all inside technique or a combination of all-inside and inside-out techniques. 15 patients also underwent simultaneous arthroscopic anterior cruciate ligament reconstruction. Functional knee scores were assessed using IKDC and Lysholm scores.


Orthopaedic Proceedings
Vol. 104-B, Issue SUPP_7 | Pages 8 - 8
1 Jul 2022
Dalal S Guro R Kotwal R Chandratreya A
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Abstract

Methodology

Prospective single-surgeon case-series evaluating patients undergoing surgery by this technique. 76 cases (mean age of 33.2 years) who had primary ACL reconstruction with BTB or quadriceps tendon with bone block, were divided into 2 matched groups (age, sex and type of graft) of 38 each based on the method of femoral fixation used (interference screw or adjustable cortical suspension). Patients were followed up clinically and using PROMS from NLR with EQ-5D, KOOS, IKDC and Tegner scores. Complications and return to theatre were noted. Paired two-tailed student t-tests and Chi-square tests were employed for statistical analysis.

Results

At a mean follow-up of 82 months, peri-operative mean EQ-5D VAS, EQ-5D Index, KOOS, IKDC and Tegner activity scores showed significant improvement (p<0.05), but no significant difference between the two groups (p>0.05). Mean graft length and diameter was 77mm and 9.3 respectively. Mean interval from injury to surgery was 10.5 months. 18(23.7%) patients had associated meniscal tear with 73.3 % undergoing repair. 10 cases (13.2 %) returned to theatre including, MUA for arthrofibrosis (n=2) and intra-substance graft failure (n=2). 3 cases had to be converted to interference screw fixation due to the tightrope cutting through from the femoral bone block as a result of a technical pitfall.


Orthopaedic Proceedings
Vol. 104-B, Issue SUPP_7 | Pages 64 - 64
1 Jul 2022
Dayananda K Dalal S Thomas E Chandratreya A Kotwal R
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Abstract

INTRODUCTION

A paucity of literature exists regarding efficacy of lateral unloader bracing in treatment for pathologies effecting the lateral compartment of the knee.

We evaluate patient outcomes following customised lateral unloader bracing (cLUB) in treatment of lateral compartment osteoarthritis (LCOA), lateral tibial plateau fractures (LTPF) and spontaneous osteonecrosis of knee (SONK).

METHODS

Institutional study approval was obtained. All patients undergoing cLUB between January 2013 and January 2021 were included, and prospectively followed-up. Visual Analogue Scales (VAS), Oxford Knee Scores (OKS) and Knee Injury and Osteoarthritis Outcome Scores (KOOS) were assessed at brace fitting and final follow-up. Brace compliance, complications and surgical interventions were also collected. Statistical analysis utilised paired t-test.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXIX | Pages 34 - 34
1 Jul 2012
Brooks F Akram T Chandratreya A Roy S Pemberton D
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This study was designed to evaluate the performance of a new patient specific interpositional knee device. Treatment of osteoarthritis is evolving, allowing surgical treatment options at an earlier stage. The interpositional knee device is a recently developed patient specific implant used for the treatment of mild to moderate uni-compartmental osteoarthritis. The benefits over traditional methods of surgical management are: it's less invasive, can be a day procedure and does not limit future options. Young Adults with early uni-compartmental arthritis are suitable. A MRI scan of the patient's knee is reviewed by local and US radiologists to decide if the patient is suitable for the implant. A bespoke implant is produced. Prior to insertion an arthroscopic procedure is undertaken to allow proper positioning of the implant.

We treated 27 patients with the iForma Conformis interpositional knee implant in South Wales at the Princess of Wales Hospital, Bridgend and the Royal Glamorgan Hospital, Llantrisant since November 2007. The pre- and post-operative WOMAC scores were recorded. The average age was 54.7 years, BMI 32; 10 females and 20 males. The average pre-operative WOMAC score was 42.2 improving to 62.9 post-operatively. 35 implants were used. 7 patients experienced post-operative problems. No dislocations were reported. Average follow-up was 12.6 months.

Our early experience suggests patient selection plays a role in the outcome following surgery. It indicates that this device is a viable and safe alternative to a uni-compartmental knee replacement.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXIX | Pages 93 - 93
1 Jul 2012
Kempshall P Guro R Lewis M Mintowt-Czyz W Chandratreya A Roy W
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Aims

Wales in collaboration with the Welsh Assembly Government, has attempted to start a national ligament register.

Introduction

Norway is the lead in Europe for running a successful national quality knee ligament registry. As yet there is no UK wide registry encompassing all forms of knee ligament surgery. The issue has been discussed at previous society meetings, but no consensus has been reached.