The aims of the study were to report for a cohort aged younger than 40 years: 1) indications for HRA; 2) patient-reported outcomes in terms of the modified Harris Hip Score (HHS); 3) dislocation rate; and 4) revision rate. This retrospective analysis identified 267 hips from 224 patients who underwent an hip resurfacing arthroplasty (HRA) from a single fellowship-trained surgeon using the direct lateral approach between 2007 and 2019. Inclusion criteria was minimum two-year follow-up, and age younger than 40 years. Patients were followed using a prospectively maintained institutional database.Aims
Methods
It has been generally accepted that open fractures require early skeletal stabilization and soft-tissue reconstruction. Traditionally, a standard gauze dressing was applied to open wounds. There has been a recent shift in this paradigm towards negative pressure wound therapy (NPWT). The aim of this study was to compare the clinical outcomes in patients with open tibial fractures receiving standard dressing versus NPWT. This multicentre randomized controlled trial was approved by the ethical review board of a public sector tertiary care institute. Wounds were graded using Gustilo-Anderson (GA) classification, and patients with GA-II to III-C were included in the study. To be eligible, the patient had to present within 72 hours of the injury. The primary outcome of the study was patient-reported Disability Rating Index (DRI) at 12 months. Secondary outcomes included quality of life assessment using 12-Item Short-Form Health Survey questionnaire (SF-12), wound infection rates at six weeks and nonunion rates at 12 months. Logistic regression analysis and independent-samples Aims
Methods
The Medicines and Healthcare Products Regulatory Agency (MHRA) of the UK have published guidelines for annual follow up of patients with metal on metal hip replacements following widespread concern regarding metallosis We followed up 718 total hip replacements (594 stemmed hips and 124 resurfacing) with metal on metal bearing, implanted between April 1999 and August 2010 in dedicated clinics with clinical and radiological assessment along with assessment of serum metal ions. Survival was calculated using Kaplan Meier analysis.Introduction
Methods
We aimed to examine the characteristics of deep venous flow in
the leg in a cast and the effects of a wearable neuromuscular stimulator
(geko; FirstKind Ltd) and also to explore the participants’ tolerance
of the stimulator. This is an open-label physiological study on ten healthy volunteers.
Duplex ultrasonography of the superficial femoral vein measured
normal flow and cross-sectional area in the standing and supine
positions (with the lower limb initially horizontal and then elevated).
Flow measurements were repeated during activation of the geko stimulator
placed over the peroneal nerve. The process was repeated after the
application of a below-knee cast. Participants evaluated discomfort
using a questionnaire (verbal rating score) and a scoring index
(visual analogue scale).Objectives
Methods
Limited forefoot amputation in diabetic patients
with osteomyelitis is frequently required. We retrospectively reviewed
diabetic patients with osteomyelitis, an unhealed ulcer and blood
pressure in the toe of >
45 mmHg who underwent limited amputation
of the foot with primary wound closure. Between 2006 and 2012, 74
consecutive patients with a mean age of 67 years (29 to 93), and
a median follow-up of 31 months, were included. All the wounds healed
primarily at a median of 37 days (13 to 210; mean 48). At a median
of 6 months (1.5 to 18; mean 353 days), 23 patients (31%) suffered
a further ulceration. Of these, 12 patients (16% of the total) required
a further amputation. We conclude that primary wound closure following limited amputation
of the foot in patients with diabetes is a safe and effective technique
when associated with appropriate antibiotic treatment. Cite this article:
Our aim was to compare displayed pressure with actual intra-articular pressure using three fluid delivery systems. The pumps used were the Arthrex, FMS and Dyonics. We investigated thirty patients undergoing shoulder arthroscopy. Patients with a previous disruption to the joint capsule were excluded. A standard set-up was used with the patient in a lateral position and arm in traction. The arthroscope was introduced from the posterior portal. The rotator interval was identified and the needle introduced from this point. The needle was attached to a arterial pressure transducer. The pressure transducer was coupled to the anaesthetic machine. Pressures of 30, 50 and 80 mmHg were dialled on the fluid management systems. Once the pressures stabilised on the pumps the intra-articular pressure was measured independently using the pressure transducer. Median pressures for the FMS and Arthrex pumps were approximately twice set pressures. Median pressures for the Dyonics pump were closer to set pressures but the range of values was wider. The three pumps were inaccurate and behaved differently to each other. They are not interchangeable. Each pump performed inconsistently.
