Aims. The aims of the study were to review and analyse the reported
series of debridement, antibiotics and implant retention (DAIR)
in the management of infected total hip arthroplasties (THAs) to
establish the overall success and the influencing factors. Patients and methods. Using a standardised recognised study protocol, meta-analysis
of observational studies in epidemiology guidelines, a comprehensive
review and analysis of the literature was performed. The primary
outcome measure was the success of treatment. The search strategy
and inclusion criteria which involved an assessment of quality yielded
39 articles for analysis, which included 1296 patients. Results. The proportion of success following DAIR in the management of
an infected THA appeared to improve after 2004 with a pooled mean
proportion of success of 72.2%. For all reported series, from 1977
onwards, there was improved success with early
We have reviewed the current literature to compare
the results of surgery aimed to repair or debride a damaged acetabular
labrum. We identified 28 studies to be included in the review containing
a total of 1631 hips in 1609 patients. Of these studies 12 reported
a mean rate of good results of 82% (from 67% to 100%) for labral
Aims. To analyse the effectiveness of
Most animal studies indicate that early irrigation
and
We retrospectively assessed the value of identifying
impinging osteophytes using dynamic computer simulation of CT scans
of the elbow in assisting their arthroscopic removal in patients
with osteoarthritis of the elbow. A total of 20 patients were treated
(19 men and one woman, mean age 38 years (19 to 55)) and followed
for a mean of 25 months (24 to 29). We located the impinging osteophytes
dynamically using computerised three-dimensional models of the elbow
based on CT data in three positions of flexion of the elbow. These
were then removed arthroscopically and a capsular release was performed. The mean loss of extension improved from 23° (10° to 45°) pre-operatively
to 9° (0° to 25°) post-operatively, and the mean flexion improved
from 121° (80° to 140°) pre-operatively to 130° (110° to 145°) post-operatively.
The mean Mayo Elbow Performance Score improved from 62 (30 to 85)
to 95 (70 to 100) post-operatively. All patients had pain in the
elbow pre-operatively which disappeared or decreased post-operatively.
According to their Mayo scores, 14 patients had an excellent clinical
outcome and six a good outcome; 15 were very satisfied and five
were satisfied with their post-operative outcome. We recommend this technique in the surgical management of patients
with osteoarthritis of the elbow. Cite this article:
Aims. The study aimed to assess the clinical outcomes of arthroscopic
Aims. The principle strategies of fracture-related infection (FRI) treatment are
Aims. Despite long-standing dogma, a clear relationship between the timing of surgical irrigation and
There has been a marked increase in the number of hip arthroscopies performed over the past 16 years, primarily in the management of femoroacetabular impingement (FAI). Insights into the pathoanatomy of FAI, and high-level evidence supporting the clinical effectiveness of arthroscopy in the management of FAI, have fuelled this trend. Arthroscopic management of labral tears with repair may have superior results compared with
Aims. The treatment of septic arthritis of the shoulder is challenging.
The infection frequently recurs and the clinical outcome can be
very poor. We aimed to review the outcomes following the use of
continuous negative pressure after open
The purpose of this study was to evaluate treatment
results following arthroscopic triangular fibrocartilage complex (TFCC)
debridement for recalcitrant ulnar wrist pain. According to the
treatment algorithm, 66 patients (36 men and 30 women with a mean
age of 38.1 years (15 to 67)) with recalcitrant ulnar wrist pain
were allocated to undergo ulnar shortening osteotomy (USO; n = 24),
arthroscopic TFCC repair (n = 15), arthroscopic TFCC debridement
(n = 14) or prolonged conservative treatment (n = 13). The mean
follow-up was 36.0 months (15 to 54). Significant differences in
Hand20 score at 18 months were evident between the USO group and
TFCC
This study explores the relationship between
delay to
Aims. Failure of irrigation and
We compared the quality of
Aims. The results of irrigation and
In a prospective randomised trial 76 knees with isolated degenerative changes in the medial femoral condyle of grades 3 or 4 were treated by either arthroscopic
Infection is a potentially disastrous complication of total knee replacement (TKR). Retention of the prosthesis has been associated with high rates of persistent infection. Our study shows that in selected situations, arthroscopic
We measured the effect of arthroscopic lavage and
Animal studies have shown that implanted anterior cruciate ligament (ACL) grafts initially undergo a process of revascularisation prior to remodelling, ultimately increasing mechanical strength. We investigated whether minimal
Aim. Many aspects of the surgical treatment of patients with tuberculosis
(TB) of the spine, including the use of instrumentation and the
types of graft, remain controversial. Our aim was to report the
outcome of a single-stage posterior procedure, with or without posterior
decompression, in this group of patients. Patients and Methods. Between 2001 and 2010, 51 patients with a mean age of 62.5 years
(39 to 86) underwent long posterior instrumentation and short posterior
or posterolateral fusion for TB of the thoracic and lumbar spines,
followed by anti-TB chemotherapy for 12 months. No anterior debridement
of the necrotic tissue was undertaken. Posterior decompression with
laminectomy was carried out for the 30 patients with a neurological
deficit. Results. The mean kyphotic angle improved from 26.1° (- 1.8° to 62°) to
15.2° (-25° to 51°) immediately after the operation. At a mean follow-up
of 68.8 months (30 to 144) the mean kyphotic angle was 16.9° (-22°
to 54°), with a mean loss of correction of 1.6° (0° to 10°). There
was a mean improvement in neurological status of 1.2 Frankel grades
in those with a neurological deficit. Bony union was achieved in
all patients, without recurrent infection. Conclusions. Long posterior instrumentation with short posterior or posterolateral
fusion is effective in the treatment of TB spine. It controls infection,
corrects the kyphosis, and maintains correction and neurological
improvement over time. . Take home message: With effective anti-TB chemotherapy, a posterior
only procedure without