Excessive glenoid retroversion and posterior wear leads to technical challenges when performing anatomic shoulder replacement. Various techniques have been described to correct glenoid version, including eccentric reaming, bone graft, posterior augmentation and custom prosthesis. Clinical outcomes and survivorship of a Stemless humeral component with cemented pegged polyethylene glenoid with eccentric reaming to partially correct retroversion are presented. Between 2010– 2019, 115 Mathys Affinis Stemless Shoulder Replacements were performed. 50 patients with significant posterior wear and retroversion (Walch type B1, B2, B3 and C) were identified. Measurement of Pre-operative glenoid retroversion and Glenoid component version on a post op axillary view was performed by method as described by Matsen FA. Relative correction was correlated with clinical and radiological outcome.Abstract
Aim
Patients and Methods
There is debate regarding whether the use of computer-assisted technology, such as navigation and robotics, has any benefit on clinical or patient reported outcomes following total knee arthroplasty (TKA). This study aims to report on the association between intraoperative use of technology and outcomes in patients who underwent primary TKA. We retrospectively reviewed 7,096 patients who underwent primary TKA from 2016–2020. Patients were stratified depending on the technology utilized intraoperatively: navigation, robotics, or no technology. Patient demographics, clinical data, Forgotten Joint Score-12 (FJS), and Knee injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS, JR) were collected at various time points up to 1-year follow-up. Demographic differences were assessed with chi-square and ANOVA tests. Clinical data and mean FJS and KOOS, JR scores were compared using univariate ANCOVA, controlling for demographic differences.Introduction
Methods
The use of technology, such as navigation and robotic systems, may improve the accuracy of component positioning in total hip arthroplasty (THA) but its impact on patient reported outcomes measures (PROMs) remains unclear. This study aims to identify the association between intraoperative use of technology and patient reported outcomes measures (PROMs) in patients who underwent primary total hip arthroplasty (THA). We retrospectively reviewed patients who underwent primary THA between 2016 and 2020 and answered a post-operative PROM questionnaire. Patients were separated into three groups depending on the technology utilized intraoperatively: navigation, robotics, or no technology (i.e. manual THA. The Forgotten Joint Score (FJS-12) and Hip Disability and Osteoarthritis Outcome Score, Joint Replacement (HOOS, JR) were collected at various time points (FJS: 3m, 1y, and 2y; HOOS, JR: pre-operatively, 3m, and 1y). Demographic differences were assessed with chi-square and ANOVA. Mean scores between all groups were compared using univariate ANCOVA, controlling for observed demographic differences.Introduction
Methods
Aim was to compare the functional outcome of anterior cervical decompression and fusion (ACDF) with stand-alone tricotical iliac crest auto graft verses stand-alone PEEK cage. Prospectively collected data of 60 patients in each group was compared.Introduction
Material and methods
The intra-operative diagnosis of Prosthetic Joint Infection (PJI) is a dilemma requiring intra-operative sampling of suspicious tissues for frozen section, deep tissue culture and histopathology to secure a diagnosis. Alfa defensin-1 testing has been introduced as a quick and reliable test for confirming or ruling out PJI. This study aims to assess its intra-operative reliability compared to the standard tests. Twenty patients who underwent revision hip and knee arthroplasty surgery were included. Patients joint aspirate was tested intra-operatively with the Synovasure kit, which takes approximately ten minutes for a result. Our standard protocol of collecting 5 deep tissue samples for culture and one sample for histopathology was followed. Results for Alfa defensin-1 test were then compared with final culture and histopathology results in all these patients.Introduction
Methods
Aim was to compare the functional outcome of anterior cervical decompression and fusion (ACDF) with stand-alone tricotical iliac crest auto graft verses stand-alone PEEK cage. Prospectively collected data of 60 patients in each group was compared.Introduction
Material and methods
Total Knee Arthroplasty (TKA) in obese patients has been under rigorous scrutiny due concerns of less satisfying results and increased risk of perioperative complications. We conducted a prospective study to observe functional scores between obese and non obese patients at two years after mini-robot computer assisted TKA. Average stay, time for wound to be dry and perioperative complications were also compared. A prospective study was conducted between February 2007 and February 2008 involving 50 patients. Two different groups of 25 each were made on the basis of body mass index (BMI). Oxford and Knee society scores were obtained at two years to observe difference in functional scores between these groups. Rate of post operative complications or hospital stay was comparable between the two groups. Oxford and Knee society scores improved significantly in both the groups postoperatively. Obese patients had better Oxford and Knee society scores, which were not statistically significant. There is no difference in early functional outcome and complications between obese and non obese patients after navigated TKA. Navigated TKA in obese patients help precise component placement with appropriate soft tissue balancing leading to improved results.
Computer navigated Total Knee Arthroplasty is routinely performed with gratifying results. New navigation software is now designed to help surgeons balance soft tissues in Total Knee Arthroplasty (TKA). The aim of our study was to compare functional scores at two years between two different techniques of knee balancing. A prospective randomized control study was conducted between February 2007 and February 2008 involving 52 patients. Two different techniques of knee balancing were used namely, measured resection and gap balancing technique. Each group had 26 patients. Oxford and Knee society scores were done at two years to understand if one technique was better than other. Oxford and Knee Society Scores improved significantly in both the groups but gap balancing technique achieved slightly better functional scores which were not significant on statistical analysis. Computer assisted measured resection and gap balancing techniques in TKA reliably improves functional scores postoperatively. Either of the techniques if performed correctly with appropriate patient selection will have satisfactory outcomes.
Forefoot surgery causes postoperative pain which requires strong painkillers. Regional blocks are now increasingly used in order to control postoperative pain especially in the first twenty four hours when the pain is at its worst. We conducted a study to see whether timing of ankle block i.e. before or after application of tourniquet shows any difference in efficacy in postoperative analgesia in first twenty four hours. A prospective study was conducted between September and March 2011 involving 50 patients. Group A had ankle block after and Group B had block before application of tourniquet. Both group had twenty five patients each. Patients were given assessment forms to chart their pain on Visual Analogue Scale (VAS) at 4hrs and twenty four hours after surgery. Both groups demonstrated good postoperative pain control. Average pain score at four and twenty fours after surgery was 2.5 and 5 in Group A and 3.5 and 6.1 in Group B respectively. Pain control, both at four and twenty four hours surgery was better in Group A but this was not statistically significant. Ankle block should be routinely used in forefoot surgery to control postoperative pain. Ankle block before or after the application of tourniquet had comparable pain relief with no statistical difference.
