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Abstract

Background

Rotator cuff injuries have traditionally been managed by either single-row or double-row arthroscopic repair techniques. Novel and more complex single-row methodologies have recently been proposed as a biomechanically stronger alternative. However, no rigorous meta-analysis has evaluated the effectiveness of complex single-row against double-row repair. This meta-analysis aims to evaluate clinical outcomes in patients with full-thickness rotator cuff injuries treated with both simple and complex single-row, as well as transosseous-equivalent double-row procedures.

Methods

An up-to-date literature search was performed using the pre-defined search strategy. All studies that met the inclusion criteria were assessed for methodological quality and included in the meta-analysis. Pain score, functional score, range-of-motion and Re-tear rate were all considered in the study.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_1 | Pages 33 - 33
1 Jan 2013
Colegate-Stone T Colaco H Harper-Smith H Skyrme A Armitage A Rajaratnam S
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Study Aim

To assess the impact of two oral thromboprophylaxis agents against Clexane with regard to range of movement (ROM) following TKR with or without haemostasis following tourniquet release.

Methods & Results

Thromboprophylaxis choice following total knee replacement (TKR) has become of interest with the introduction of oral anticoagulants and support for these by NICE. Specific concerns with oral agents include a perceived elevated level of anti-coagulation and soft tissue complications.

The population (n=264) was subclassified into cohorts regarding thromboprophylaxis cover: Clexane, Rivaroxaban and Dabigatran. Each subgroup was subdivided into whether surgery was performed with or without haemostasis following tourniquet release.

This study demonstrates Clexane is associated with a better and earlier return of ROM post-operatively as compared to oral the thromboprophylaxis agents. This effect was more obvious when combined with haemostasis following early tourniquet release (p< 0.05). The oral thromboprophylaxis agents Rivaroxaban and Dabigatran had a relative negative effect on ROM as compared against Clexane. This was independent of whether the surgery was performed with or without haemostasis following tourniquet release. There was no different between the subgroups with repect to change of serum haemoglobin, symptomatic venous thromboembolism or rate of return to theatre.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_IV | Pages 23 - 23
1 Mar 2012
Sivananthan S Colaco H Sherry E Warnke P
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Introduction

Bisphosphonates are among the most commonly prescribed drugs in Osteoporotic Patients. Their mode of action is anti-resorptive. Since remodeling is a key step in fracture healing, there has been concern regarding the effect of bisphosphonates on fracture healing.

Objectives

To assess the effect of alendronate on fracture healing in the rabbit ulna osteotomy model.


Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_III | Pages 303 - 303
1 Jul 2011
Colaco H Oussedik S Paton B Haddad F
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Aim: To investigate the relationship between patient psychological characteristics, adherence to rehabilitation physiotherapy and outcome at one year following anterior cruciate ligament reconstruction.

Methods: 75 consecutive patients undergoing ACL reconstruction by a single experienced surgeon received a pre-operative psychological assessment comprising of five questionnaires; Athletic Identity Measurement Scale (AIMS), Recovery Locus of Control Scale (RLCS), Self-Motivation Inventory (SMI), Hospital Anxiety and Depression Scale (HADS), and Short Form Social Support Questionnaire (SSQ6). Four functional questionnaires were completed pre-operatively by the patient; Subjective Knee Evaluation Form (IKDC 2000), Tegner Activity Scale (TAS), Lysholm Score (LS), and Lower Extremity Functional Score (LEFS). LEFS is a simple, sensitive subjective assessment tool which is sensitive to change. Final outcome was assessed by repeating the functional questionnaires at 1-year post-operatively following rehabilitation. Rehabilitation adherence was measured using the Sport Injury Rehabilitation Adherence Scale (SIRAS) and physiotherapy appointment attendance.

Results: The data were analysed using regression analysis (n=57). Self motivation score (R2= 0.142), a higher athletic identity (R2= 0.067), good social support (R2=0.170) and an internal locus of control or high self efficacy (R2=0.111) were all found to be positive predictors of final outcome. Poor self motivation and an external locus of control are associated with less successful final outcome.

Discussion and Conclusion: Self motivation and self efficacy are positive predictors of final outcome after ACL reconstruction. These aspects may be reinforced during rehabilitation. Patients with an external locus of control and poor self-motivation can be identified and their pre- and post-operative management may be adapted to achieve optimal outcome.