The primary purpose of this study of metal-on-metal (MoM) hip resurfacing was to compare the effect of using a cementless or cemented femoral component on the subsequent bone mineral density (BMD) of the femoral neck.

This was a single-centre, prospective, double-blinded control trial which randomised 120 patients (105 men and 15 women) with a mean age of 49.4 years (21 to 68) to receive either a cemented or cementless femoral component. Follow-up was to two years. Outcome measures included total and six-point region-of-interest BMD of the femoral neck, radiological measurements of acetabular inclination, neck-shaft and stem-shaft angles, and functional outcome scores including the Harris hip score, the Western Ontario and McMaster Universities Osteoarthritis Index and the University of California at Los Angeles activity scale.

In total, 17 patients were lost to follow-up leaving 103 patients at two years. There were no revisions in the cementless group and three revisions (5%) in the cemented group (two because of hip pain and one for pseudotumour).

The total BMD was significantly higher in the cementless group at six months (p < 0.001) and one year (p = 0.01) than in the cemented group, although there was a loss of statistical significance in the difference at two years (p = 0.155).

All patient outcomes improved significantly: there were no significant differences between the two groups.

The results show better preservation of femoral neck BMD with a cementless femoral component after two years of follow-up. Further investigation is needed to establish whether this translates into improved survivorship.

Cite this article: Bone Joint J 2015;97-B:1608–14.

The recent advance of drug therapy for RA tends to replace preventive surgery, for example synovectomy. A rupture of a dorsal extensor tendon of the hand is an absolute indication for surgery, however. Such tendon ruptures are usually treated by tendon reconstruction and synovectomy of wrist joint. At our department, reconstructive surgery was administered with synovectomy for extensor tendon ruptures of the hand in 97 hands for 86 patients until June 2005. Recently, however, we occasionally encounter ruptures of extensor tendons not associated with severe synovitis. To treat such tendon ruptures, we usually administer tendon transfers in combination with tenosynovectomy through a small skin incision. Because this surgical procedure has achieved excellent results, we report our experience.

This study included 15 patients who received tenosynovectomy in combination with tendon transfers in 14 hands since February 2001. This surgical procedure is indicated for tendon ruptures associated with mild synovitis (swelling) without instability on the ulnar distal end. As a rule, a 2–3 cm transverse skin incision was made on the dorsum of the hand under maxillary nerve block. After exposure of the distal ruptured end of the tendon, tenosynovectomy was administered through the incision. Then, the distal end was transferred to the adjacent normal tendon and fixed to it with sutures. Postoperatively, the repair was immobilized with bandage. The patient was allowed actively to extend and bend the hand on the next day. As a rule, this operation is administered on an outpatient basis. The postoperative course was uneventful, without rupture of the repair. The preoperative ranges of motion of the MP and PIP joints were retained postoperatively without difficulty in ADL.

Introduction: We reviewed clinical results of the performance of FNK-type total knee arthroplasties (TKAs) for treatment of rheumatoid arthritis (RA) knees.

Materials and Methods: Materials we had studied were 372 knee joints in 202 cases (21.1%) with RA (36 joints in 22 male patients, and 336 joints in 180 female) out of 1762 knee joints in 1032 cases who had undergone TKA using FNK type prostheses between May 1995 and December 2003. A mean age of patients at index procedures was 62.4 years (24 – 74 years), with a mean follow-up period of 6.7 years (1 – 9.4 years). With these cases, we discussed clinical evaluation on the basis of JOC rating scores, postoperative range of motion, complications, and others.

Results: 288 knee joints (77.4%) in 144 patients were involved in bilateral simultaneous TKA. The range of motion (ROM) had shown a significant improvement from a preoperative average of 15.2 – 110.2° to 2.3 – 125.0° at the last follow-up. There have been no cases of revision surgery at all, with excellent postoperative results.