Aims. This study aims to determine difference in annual rate of early-onset (≤ 90 days) deep surgical site infection (SSI) following primary total knee arthroplasty (TKA) for
Aims. The aim of this study was to investigate the distribution of phenotypes in Asian patients with end-stage
Aims. This study investigates whether primary knee arthroplasty (KA) restores health-related quality of life (HRQoL) to levels expected in the general population. Methods. This retrospective case-control study compared HRQoL data from two sources: patients undergoing primary KA in a university-teaching hospital (2013 to 2019), and the Health Survey for England (HSE; 2010 to 2012). Patient-level data from the HSE were used to represent the general population. Propensity score matching was used to balance covariates and facilitate group comparisons. A propensity score was estimated using logistic regression based upon the covariates sex, age, and BMI. Two matched cohorts with 3,029 patients each were obtained for the adjusted analyses (median age 70.3 (interquartile range (IQR) 64 to 77); number of female patients 3,233 (53.4%); median BMI 29.7 kg/m. 2. (IQR 26.5 to 33.7)). HRQoL was measured using the three-level version of the EuroQol five-dimension questionnaire (EQ-5D-3L), and summarized using the Index and EuroQol visual analogue scale (EQ-VAS) scores. Results. Patients awaiting KA had significantly lower EQ-5D-3L Index scores than the general population (median 0.620 (IQR 0.16 to 0.69) vs median 0.796 (IQR 0.69 to 1.00); p < 0.001). By one year postoperatively, the median EQ-5D-3L Index score improved significantly in the KA cohort (mean change 0.32 (SD 0.33); p < 0.001), and demonstrated no clinically relevant differences when compared to the general population (median 0.796 (IQR 0.69 to 1.00) vs median 0.796 (IQR 0.69 to 1.00)). Compared to the general population cohort, the postoperative EQ-VAS was significantly higher in the KA cohort (p < 0.001). Subgroup comparisons demonstrated that older age groups had statistically better EQ-VAS scores than matched peers in the general population. Conclusion. Patients awaiting KA for
Many different designs of total hip arthroplasty
(THA) with varying performance and cost are available. The identification
of those which are the most cost-effective could allow significant
cost-savings. We used an established Markov model to examine the
cost effectiveness of five frequently used categories of THA which differed
according to bearing surface and mode of fixation, using data from
the National Joint Registry for England and Wales. Kaplan–Meier
analyses of rates of revision for men and women were modelled with
parametric distributions. Costs of devices were provided by the
NHS Supply Chain and associated costs were taken from existing studies.
Lifetime costs, lifetime quality-adjusted-life-years (QALYs) and
the probability of a device being cost effective at a willingness
to pay £20 000/QALY were included in the models. The differences in QALYs between different categories of implant
were extremely small (<
0.0039 QALYs for men or women over the
patient’s lifetime) and differences in cost were also marginal (£2500
to £3000 in the same time period). As a result, the probability
of any particular device being the most cost effective was very
sensitive to small, plausible changes in quality of life estimates
and cost. Our results suggest that available evidence does not support
recommending a particular device on cost effectiveness grounds alone.
We would recommend that the choice of prosthesis should be determined
by the rate of revision, local costs and the preferences of the
surgeon and patient. Cite this article:
Aims. The aim of this study was to report the pooled prevalence of post-traumatic
Aims. The objective of this study was to present the outcomes of rotational acetabular osteotomy (RAO) over a 30-year period for
Aims. In recent years, the use of a collared cementless femoral prosthesis has risen in popularity. The design intention of collared components is to transfer some load to the resected femoral calcar and prevent implant subsidence within the cancellous bone of the metaphysis. Conversely, the load transfer for a cemented femoral prosthesis depends on the cement-component and cement-bone interface interaction. The aim of our study was to compare the three most commonly used collared cementless components and the three most commonly used tapered polished cemented components in patients aged ≥ 75 years who have undergone a primary total hip arthroplasty (THA) for
Aims. The aim of this study was to determine whether total hip arthroplasty (THA) for chronic hip pain due to unilateral primary
Aims. The aim of this study was to determine the clinical outcomes and factors contributing to failure of transposition osteotomy of the acetabulum (TOA), a type of spherical periacetabular osteotomy, for advanced osteoarthritis secondary to hip dysplasia. Methods. We reviewed patients with Tönnis grade 2
Aims. Both anatomical and reverse total shoulder arthroplasty (aTSA and rTSA) provide functional improvements. A reported benefit of aTSA is better range of motion (ROM). However, it is not clear which procedure provides better outcomes in patients with limited foward elevation (FE). The aim of this study was to compare the outcome of aTSA and rTSA in patients with glenohumeral
Aims. The aim of this study was to estimate the 90-day periprosthetic joint infection (PJI) rates following total knee arthroplasty (TKA) and total hip arthroplasty (THA) for
Aims. Base of thumb
Aims. Rotational acetabular osteotomy (RAO) has been reported to be effective in improving symptoms and preventing
Aim. Mesenchymal stem cells (MSCs) have several properties that may support their use as an early treatment option for
The lateral compartment is predominantly affected
in approximately 10% of patients with
Aims. Controversy about the use of an anatomical total shoulder arthroplasty
(aTSA) in young arthritic patients relates to which is the ideal
form of fixation for the glenoid component: cemented or cementless.
This study aimed to evaluate implant survival of aTSA when used
in patients aged < 60 years with primary glenohumeral
Although the association between femoroacetabular impingement and
The majority of patients with
Aims. The modified Dunn procedure has the potential to restore the anatomy in hips with severe slipped capital femoral epiphyses (SCFE). However, there is a risk of developing avascular necrosis of the femoral head (AVN). In this paper, we report on clinical outcome, radiological outcome, AVN rate and complications, and the cumulative survivorship at long-term follow-up in patients undergoing the modified Dunn procedure for severe SCFE. Patients and Methods. We performed a retrospective analysis involving 46 hips in 46 patients treated with a modified Dunn procedure for severe SCFE (slip angle > 60°) between 1999 and 2016. At nine-year-follow-up, 40 hips were available for clinical and radiological examination. Mean preoperative age was 13 years, and 14 hips (30%) presented with unstable slips. Mean preoperative slip angle was 64°. Kaplan–Meier survivorship was calculated. Results. At the latest follow-up, the mean Merle d’Aubigné and Postel score was 17 points (14 to 18), mean modified Harris Hip Score was 94 points (66 to 100), and mean Hip Disability and
The purpose of this study was to evaluate the
effect of various non-operative modalities of treatment (transcutaneous
electrical nerve stimulation (TENS); neuromuscular electrical stimulation
(NMES); insoles and bracing) on the pain of
Aims. The aim of this study was to evaluate the clinical and radiological
outcome of using an anatomical short-stem shoulder prosthesis to
treat primary
We have undertaken a prospective clinical and radiological analysis of 124 shoulder arthroplasties (113 patients) carried out for
Aims. The aim of this study was to compare the Push Ortho Thumb Brace
CMC and a custom-made orthosis in the treatment of patients with
primary
Thoracic back pain caused by
Deformity of the proximal femur in fibrous dysplasia
leads to deviation of the mechanical axis of the hip, which may lead
to the development of secondary
Aims. Recently, there has been considerable interest in quantifying
the associations between bony abnormalities around and in the hip
joint 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
We report a study of 112 patients with primary anteromedial
This is a retrospective review of the results of the Acclaim total elbow replacement in 11 older patients aged ≥ 65 years with primary
We evaluated the short-term of 0 to 90 days and the longer term, up to 12.7 years, mortality for patients undergoing primary total hip replacement (THR) in Denmark in comparison to the general population. Through the Danish Hip Arthroplasty Registry we identified all primary THRs undertaken for
1. The capsular changes in
Excessive acetabular cover secondary to a retroverted acetabulum causes pincer impingement, which may cause early osteoarthritis of the hip. Our aim was to determine if there was a relationship between acetabular version and
There have been several studies examining the
association between the morphological characteristics seen in acetabular
dysplasia and the incidence of the
We assessed the clinical results, radiographic
outcomes and complications of patients undergoing total shoulder replacement
(TSR) for
Our aim in this prospective study was to evaluate the outcome of total shoulder replacement in the treatment of young and middle-aged active patients with primary glenohumeral
The patellofemoral joint is an important source of symptoms in
The foot and ankle outcome score (FAOS) has been
evaluated for many conditions of the foot and ankle. We evaluated
its construct validity in 136 patients with
Treatment for
We retrospectively examined the long-term outcome of 96 asymptomatic hips in 96 patients with a mean age of 49.3 years (16 to 65) who had radiological evidence of femoroacetabular impingement. When surveillance commenced there were 17, 34, and 45 hips with cam, pincer, and mixed impingement, respectively. Overall, 79 hips (82.3%) remained free of
In this retrospective study we have assessed the results of low tibial valgus osteotomy for varus-type
The division of
Aims. This retrospective cohort study compared the results of vascularised
and non-vascularised anterior sliding tibial grafts for the treatment
of
This study validates the short-form WOMAC function scale for assessment of conservative treatment of
We investigated 60 patients (89 feet) with a
mean age of 64 years (61 to 67) treated for congenital clubfoot deformity,
using standardised weight-bearing radiographs of both feet and ankles
together with a functional evaluation. Talocalcaneal and talonavicular
relationships were measured and the degree of osteo-arthritic change
in the ankle and talonavicular joints was assessed. The functional
results were evaluated using a modified Laaveg-Ponseti score. The
talocalcaneal (TC) angles in the clubfeet were significantly lower
in both anteroposterior (AP) and lateral projections than in the
unaffected feet (p <
0.001 for both views). There was significant
medial subluxation of the navicular in the clubfeet compared with
the unaffected feet (p <
0.001). Severe
Using radiography and computer tomography (CT) we studied the morphology of 83 hips in 69 Caucasian adults with
We compared 55 consecutive total hip replacements performed on 53 morbidly obese patients with
Previous studies from single centres or single-surgeon
series report good early and mid-term results for high tibial osteotomy
(HTO) in the treatment of
The Motec cementless modular metal-on-metal ball-and-socket
wrist arthroplasty was implanted in 16 wrists with scaphoid nonunion
advanced collapse (SNAC; grades 3 or 4) and 14 wrists with scapholunate
advanced collapse (SLAC) in 30 patients (20 men) with severe (grades
3 or 4) post-traumatic
Medial tibial plateaux excised during 46 unicompartmental arthroplasties for
There are theoretical and practical advantages to modular rather than monoblock designs of prostheses for shoulder arthroplasty, but there are no reported studies which specifically compare the clinical and radiological results of their use. We have compared the results of unconstrained total shoulder arthroplasty for
1. In fifteen patients with unilateral
We compared the length of hospitalisation, rate
of infection, dislocation of the hip and revision, and mortality following
primary hip and knee arthroplasty for
1 . Criticisms are expressed of previous reports on the use of intra-articular injections in the treatment of
1. The venographic findings in clinical primary
We used single-photon emission computed tomography (SPECT) to determine the long-term risk of degenerative change after reconstruction of the anterior cruciate ligament (ACL). Our study population was a prospective series of 31 patients with a mean age at injury of 27.8 years (18 to 47) and a mean follow-up of ten years (9 to 13) after bone-patellar tendon-bone reconstruction of the ACL. The contralateral normal knee was used as a control. All knees were clinically stable with high clinical scores (mean Lysholm score, 93; mean Tegner activity score, 6). Fifteen patients had undergone a partial meniscectomy and ACL reconstruction at or before reconstruction of their ACL. In the group with an intact meniscus, clinical symptoms of
The management of
1. Thirty-seven hips with
We carried out three total knee replacements with proximal realignment in two patients with severe
We report eight patients with prominent cystic changes in the head of the fibula. Seven of these had
1. Osteotomy for
Interest in unicompartmental knee arthroplasty (UKA) for the treatment of medial compartment osteoarthritis has increased in recent years with apparent improvement in the long-term results. This is a result of improved surgical technique, patient selection, and implant design. In an effort further to improve patient selection we analysed the relationship between the pre-operative alignment of the knee and the anatomical findings at the time of surgery. We compared these findings with the indications for UKA. From 4021 total knee arthroplasties we compared intra-operative observations with the pre-operative clinical data in order to identify knees with isolated, medial, compartment changes, which would have been ideal candidates for UKA. We found that only 247 of the knees (6.1%) met anatomical qualifications for isolated, medial, unicompartmental
We evaluated the long-term results of 116 total hip replacements with a superolateral shelfplasty in 102 patients with
We suggest that different mechanisms underlie joint pain at rest and on movement in
We carried out radial MRI in 30 hips with moderate
In order to evaluate the relationship between acetabular and proximal femoral alignment in the initiation and evolution of
We have carried out a retrospective review of 11 Souter-Strathclyde primary total elbow arthroplasties in ten patients with
We measured the plasma 25-hydroxyvitamin D. 3. (25(OH)D. 3. ) levels in 62 consecutive Caucasian patients undergoing total hip replacement for
We compared inflammation in the knee after total knee replacement (TKR) for primary
In this cross-over study, we evaluated two types of knee brace commonly used in the conservative treatment of
An experimental model of
We investigated the relationship between the pain experienced by 50 patients with
1. Phlebography has been done on seven hips showing no radiological evidence of
Fractures of the distal radius occurring in young adults are treated increasingly by open surgical techniques, partly because of concern that failure to restore the alignment of the fracture accurately may cause symptomatic post-traumatic
We report the use of a 15° face-changing cementless
acetabular component in patients undergoing total hip replacement
for
We performed 52 cemented ankle arthroplasties for painful
1. The bone cysts of
We used electrogoniometers to measure the range of movement (ROM) of the knee during various activities, comparing 50 patients with
We compared the results ten years after an inverted V-shaped high tibial osteotomy with those of a historical series of conventional closing-wedge osteotomies. The closing-wedge series consisted of 56 knees in 51 patients with a mean follow-up of 11 years (10 to 15). The inverted V-shaped osteotomy was evaluated in 48 knees in 43 patients at a mean follow-up of 14 years (10 to 19). All the patients were scored using the Japanese Orthopaedic Association rating scale for
1. The synovial membrane and capsule in
We have analysed from the Finnish Arthroplasty Register the long-term survivorship of the 12 most commonly-used cemented implants between 1980 and 2005 in patients aged 55 years or older with
Three women with
We analysed which pre-operative factors could be used to predict the length of in-patient stay following unilateral primary total hip replacement undertaken for
We reviewed the results of 277 intertrochanteric valgus-extension osteotomies performed between 1973 and 1975 for primary or secondary
The relationship between meniscal tearing and degenerative joint disease was studied by macroscopic examination of 115 knees at necropsy. The incidence of meniscal pathology was 57 per cent. There was no overall difference in the severity and distribution of tibiofemoral degeneration, whether the meniscus was torn or normal. We found little evidence that degenerative meniscal tears cause
Joint deÌbridement, by excision of synovial membrane, osteophytes, degenerate cartilage, loose bodies, and frequently the patella, has relieved the symptoms of
Conclusions based on forty-six osteotomies show this to be a sound pain-relieving operation for
1. The clinical and radiological results of seventy-one osteotomies for primary
1. The results are presented of upper tibial osteotomy carried out in ten patients for
Intertrochanteric osteotomy may postpone the need for total hip replacement (THR). In young patients with an acquired deformity of the femoral head and secondary
We have investigated the factors which affect the progression of
A radiological review of two groups of intertrochanteric osteotomies of the femur for primary
A total of 370 consecutive primary total knee replacements performed for
During the 11-year-period from 1970 to 1980, 799 total hip arthroplasties with metal-on-plastic prostheses were performed for primary
From a prospective, cross-sectional survey of 402 patients who had a total hip (THR) or a total knee (TKR) replacement for idiopathic
In a population-based study we identified a cohort of 282 women, whose children had been treated for
1 . Intertrochanteric osteotomy is valuable in the treatment of patients with
This study aims to determine the proportion of patients with end-stage knee osteoarthritis (OA) possibly suitable for partial (PKA) or combined partial knee arthroplasty (CPKA) according to patterns of full-thickness cartilage loss and anterior cruciate ligament (ACL) status. A cross-sectional analysis of 300 consecutive patients (mean age 69 years (SD 9.5, 44 to 91), mean body mass index (BMI) 30.6 (SD 5.5, 20 to 53), 178 female (59.3%)) undergoing total knee arthroplasty (TKA) for Kellgren-Lawrence grade ≥ 3 knee OA was conducted. The point of maximal tibial bone loss on preoperative lateral radiographs was determined as a percentage of the tibial diameter. At surgery, Lachman’s test and ACL status were recorded. The presence of full-thickness cartilage loss within 16 articular surface regions (two patella, eight femoral, six tibial) was recorded.Aims
Methods
We have determined the natural history of hip development in 42 patients with multiple epiphyseal dysplasia (MED). Premature