The aim of this study was to analyze and compare clinical, radiological and mortality outcomes of patients who underwent cemented hip hemiarthroplasty for displaced neck of femur fractures using a SPAIRE technique when compared to a pair-matched control cohort who underwent the same procedure using the direct lateral approach. A retrospective review of patients who underwent cemented hip hemiarthroplasty for displaced neck of femur fractures by a single surgeon using a SPAIRE technique over a two-year period between July 2019 and July 2021 was performed. These were subsequently pair matched in a 5:1 ratio for age, gender, ASA grade and residential status with a control group who underwent cemented hip hemiarthroplasty by 4 other surgeons using a direct lateral approach The study included a total of 240 patients (40 and 200 pairmatched to SPAIRE and control groups respectively), with a mean age of 81.0 ± 8.2 years (63–99) and a mean follow-up of 12 ± 3 months (3–30). Overall, there was no significant difference in any of the radiological or mortality outcome scores assessed between the SPAIRE and control groups (p > 0.05 for all). There was a significantly lower number of patients in the SPAIRE group who dropped a level of mobility from their pre-injury baseline at 30-days post-operatively (8.1% versus 31.6%; p = 0.003). However, this appeared to have resolved at 120-day follow-up with no significant differences between the groups in terms of those acquiring a new baseline mobility at 120-days post-operatively (2.7% versus 13.2%, p = 0.09). In cases of cemented hip hemiarthroplasty for displaced intracapsular neck of femur fractures, the SPAIRE technique appears to offer patients an earlier return to levels of baseline pre-injury mobility when compared to a direct lateral approach.
Reverse Geometry shoulder replacement requires fixation of a base plate (called a metaglene) to the glenoid to which a convex glenosphere is attached. Most systems use screws to achieve this fixation. The suprascapular nerve passes close to the glenoid and is known to be at risk of injury when devices and sutures are inserted into the glenoid. We investigate the risk posed to the suprascapular nerve by placement of metaglene fixation screws. Ten cadaveric shoulder specimens were used. A metaglene was inserted and fixed using 4 screws. The suprascapular nerve was dissected and its branches identified. The screw tips and their proximity to the nerve and branches were identified and recorded.Background
Materials and Methods
Surgical experience has been shown to improve the clinical outcomes in Total hip arthroplasty. The objective of this study was to compare clinical and radiological outcomes between Consultants and NCHDs grade surgeons for the Exeter total hip replacement taken from the Cappagh National Orthopaedic Hospital Joint Register. Between 2005 and 2008, 2749 primary total hip replacements were done, 433(15.78%) were Exeter total hip system. 380(86%) out of 433 were included in the study, 227(59%) were females and 154(41%) were males. A consultant was the primary surgeon for 193(51%) patients and an NCHD was the primary surgeon for 187(49%) patients. Mean age, at time of operation was 68 years. Clinical outcome was assessed with WOMAC and SF36 scoring system. Patients were invited to fill in the WOMAC and SF36 questionnaire, pre-operatively, at 6 months and at 2 years after the operation. Radiographs were evaluated for radiolucency with a standardized technique.Introduction
Methods & Materials
The treatment of olecranon fractures frequently involves the use of tension band fixation. Although associated with high union rates, this method has a high incidence of morbidity associated with soft tissue compromise and limitation of range of movement requiring frequent re-operation for removal of metal. We describe the use of a simple jig to ensure intramedullary placement of longitudinal K-wires and compare the accuracy of placement of wires using this device with the traditional free hand method.Background
Objectives
