Bone Morphogenetic Protein (BMP) has been used in clinical practice to stimulate fracture healing and spinal arthrodesis. Difficulty in localising and maintaining BMP at the target site has resulted in the use of large doses of BMP, and has been associated with significant adverse effects. We have previously shown clay hydrogels can bind growth factors for localised efficacy. We hypothesised that localisation of BMP within clay gels would reduce the dose required to mediate bone formation. 2×10-4mg and 1×10-5 mg BMP were mixed in Laponite and applied to collagen sponge. 3 sponges containing high dose, and 3 containing low dose BMP were implanted subcutaneously in a mouse. This process was repeated in 8 mice, for controls, alginate hydrogel was used in a further 8 mice, and 1 mouse received 6 blank collagen scaffolds. Micro Computed Tomography was used to assess bone formation fortnightly; at 8 weeks the mice were culled and underwent histological analysis.Background
Methods
We investigated the effect of weekend knee arthroplasty surgery on length of inpatient stay. 341 consecutive patients undergoing primary total knee replacement were retrospectively identified. Of these 62 underwent surgery during the weekend. Length of inpatient stay, age, sex, pre-operative haemoglobin, ASA rating, and day of surgery were recorded. Multiple regression analysis was used to determine the effect of these preoperative factors on length of post-operative inpatient stay.PURPOSE OF STUDY
METHODS
We present the results of a technique of dynamic hip screw insertion through a very small incision, typically 2.5cm.
The mean post-operative drop in haemoglobin concentration in the percutaneous group was 2.2 g/dl (range 0 to 4.4 g/dl) compared to 3.5 g/dl (range 1.2–5.4) in the control group (p=0.014). The mean haematocrit drop was 0.07 (range 0 to 0.12) in the percutaneous group compared to 0.10 (range 0.03 to 0.17) in the control group (p=0.017) The mean theatre time with the percutaneous technique was 57 minutes (range 40–75 minutes) and in the control group, 60 minutes (range 30–95). There were no wound problems.
