To asses the accuracy of total knee replacements performed using CT based patient specific instrumentation by postoperative CT scan. Approval from the Ethics Committee at The University of New South Wales Sydney Australia was granted prior to commencement of this study. 50 patients who had undergone total knee replacement (Evolis, Medacta International) using CT-based patient specific instrumentation (MY KNEE Medacta International) were assessed postoperatively using a CT scan and a validated measurement technique. The mechanical axis of the limb in the coronal plane, the varus/valgus positioning of the femoral component, the varus/valgus positioning of the tibial component, the flexion/extension of the posterior flange of the femoral component and the posterior slope of the tibial base plate were recorded. These results were then compared to each patient's preoperative planning. The percentage of patients found to be within 3 degrees of planned alignment were calculated. This represents the most comprehensive prospective study to utilize CT assessment of postoperative alignment in patient specific instrumentation. All other studies, to our knowledge have utilized scanograms or scout images and not full CT protocol as performed in this study.Aim
Method
This study presents the results of 60 consecutive hip arthroscopic procedures for the treatment of Acetabulo-Femoral Impingement. The procedures were performed by a single surgeon over a period of 36 months. The learning curve and the evolution of the current technique along with the clinical outcomes are discussed Additionally two new clinical signs of AFI are described, along with the correlation of radiological and arthroscopic findings. Sixty patients underwent hip arthroscopies. The procedures included labral debridement, labral repair, femoral and/or acetabular osteectomies. All patients underwent MRI examination and three-dimensional CT imaging to identify the impingement lesion. Follow up CT scanning was performed to assess the accuracy of the bony resection. Patients were reviewed at three months and subsequently at twelve monthly intervals. All patients participated in completing questionnaires. Post-operatively Modified Harris Hip score improved from 54 to 70, Non-Arthritic hip score improved from 58 to 75, SF12 score improved from 35 to 40. Three patients required a second procedure for further bony resection. One patient underwent a THR within 12 months. Two female patients suffered minor vaginal abrasions. Hip arthroscopy is a demanding procedure. Good clinical results are achieved only when the cause of impingement has been identified and treated.
This study describes a safe endoscopic technique for decompression of trochanteric bursa and presents the results of this procedure. Fifteen patients who had failed non-operative treatment for trochanteric bursitis were treated by endoscopic lengthening of fascia lata (FL) and trochanteric bursectomy. Two patients had also failed open decompressions performed at another institution prior to their endoscopic surgery. All patients took part in questionnaires pre-operatively and at three months and twelve months. A two-portal endoscopic procedure was performed in all subjects. A Cruciate incision was made in the FL hence lengthening it in three dimensions. A trochanteric bursectomy was then performed using a mechanical shaver. No patients were lost to follow up. At last review 14 patients rated their result as excellent and one patient had a fair result. There were no complications. The modified Harris hip score improved from 45 to 60, Non-arthritic hip score improved from 45 to 64 and SF12 score improved from 31 to 34. Endoscopic lengthening of FL and trochanteric bursectomy is a safe and effective procedure in relieving the symptoms of persistent trochanteric bursitis.
