Internal hemipelvectomy without reconstruction of the pelvis is a viable treatment for pelvic sarcoma; however, the time it takes to return to excellent function is quite variable. Some patients require greater time and rehabilitation than others. To determine if psoas muscle recovery is associated with changes in ambulatory function, we retrospectively evaluated psoas muscle size and limb-length discrepancy (LLD) before and after treatment and their correlation with objective functional outcomes. T1-weighted MR images were evaluated at three intervals for 12 pelvic sarcoma patients following interval hemipelvectomy without reconstruction. Correlations between the measured changes and improvements in Timed Up and Go test (TUG) and gait speed outcomes were assessed both independently and using a stepwise multivariate regression model.Aims
Methods
The optimal management of intracapsular fractures of the femoral
neck in independently mobile patients remains open to debate. Successful
fixation obviates the limitations of arthroplasty for this group
of patients. However, with fixation failure rates as high as 30%,
the outcome of revision surgery to salvage total hip arthroplasty
(THA) must be considered. We carried out a systematic review to
compare the outcomes of salvage THA and primary THA for intracapsular
fractures of the femoral neck. We performed a Preferred Reporting Items for Systematic Reviews
and Meta-Analysis (PRISMA) compliant systematic review, using the
PubMed, EMBASE and Cochrane libraries databases. A meta-analysis
was performed where possible, and a narrative synthesis when a meta-analysis
was not possible.Aims
Patients and Methods
We prospectively followed 171 patients who underwent
bilateral unicompartmental knee replacement (UKR) over a period
of two years. Of these, 124 (72.5%) underwent a simultaneous bilateral
procedure and 47 (27.5%) underwent a staged procedure. The mean
cumulative operating time and length of hospital stay were both
shorter in the simultaneous group, by 22.5 minutes (p <
0.001)
and three days (p <
0.001), respectively. The mean reduction
in haemoglobin level post-operatively was greater by 0.15 g/dl in
the simultaneous group (p = 0.023), but this did not translate into
a significant increase in the number of patients requiring blood
transfusion (p = 1.000). The mean hospital cost was lower by $8892
in the simultaneous group (p <
0.001). There was no significant
difference in the rate of complications between the groups, and
at two-year follow-up there was no difference in the outcomes between
the two groups. We conclude that simultaneous bilateral UKR can be recommended
as an appropriate treatment for patients with bilateral medial compartment
osteoarthritis of the knee. Cite this article:
