Aims
Patients and Methods
We have performed a prospective single-blinded randomised study to evaluate the role of antibiotic-impregnated cement in the prevention of deep
Aims
Patients and Methods
This study describes and compares the operative management and outcomes in a consecutive case series of patients with dislocated hemiarthroplasties of the hip, and compares outcomes with those of patients not sustaining a dislocation. Of 3326 consecutive patients treated with hemiarthroplasty for fractured neck of femur, 46 (1.4%) sustained dislocations. Of the 46 dislocations, there were 37 female patients (80.4%) and nine male patients (19.6%) with a mean age of 83.8 years (66 to 100). Operative intervention for each, and subsequent dislocations, were recorded. The following outcome measures were recorded: dislocation; mortality up to one-year post-injury; additional surgery; residential status; mobility; and pain score at one year.Aims
Patients and Methods
Recent studies of nonoperatively treated displaced midshaft clavicular fractures have shown a high incidence of nonunion and unsatisfactory functional outcome. Some studies have shown superior functional results and higher rates of healing following operative treatment. The aim of this study was to compare the outcome in these patients after nonoperative management with those treated with fixation. In a multicentre, parallel randomized controlled trial, 146 adult patients with an acute displaced fracture of the midthird of the clavicle were randomized to either nonoperative treatment with a sling (71, 55 men and 16 women with a mean age of 39 years, 18 to 60) or fixation with a pre-contoured plate and locking screws (75, 64 men and 11 women with a mean age of 40 years, 18 to 60). Outcome was assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) Score, the Constant Score, and radiographical evidence of union. Patients were followed for one year.Aims
Patients and Methods
Aims
Patients and Methods
The surgical treatment of tuberculosis (TB) of the spine consists
of debridement and reconstruction of the anterior column. Loss of
correction is the most significant challenge. Our aim was to report
the outcome of single-stage posterior surgery using bone allografts
in the management of this condition. The study involved 24 patients with thoracolumbar TB who underwent
single-stage posterior spinal surgery with a cortical bone allograft
for anterior column reconstruction and posterior instrumentation
between 2008 and 2015. A unilateral approach was used for 21 patients
with active TB, and a bilateral approach with decompression and closing-opening
wedge osteotomy was used for three patients with healed TB.Aims
Patients and Methods
The aim of this study was to evaluate the surface damage, the density of crosslinking, and oxidation in retrieved antioxidant-stabilized highly crosslinked polyethylene (A-XLPE) tibial inserts from total knee arthroplasty (TKA), and to compare the results with a matched cohort of standard remelted highly crosslinked polyethylene (XLPE) inserts. A total of 19 A-XLPE tibial inserts were retrieved during revision TKA and matched to 18 retrieved XLPE inserts according to the demographics of the patients, with a mean length of implantation of 15 months (1 to 42). The percentage areas of PE damage on the articular surfaces and the modes of damage were measured. The density of crosslinking of the PE and oxidation were measured at loaded and unloaded regions on these surfaces.Aims
Materials and Methods
The purpose of this retrospective study was to investigate the
clinical relevance of increased facet joint distraction as a result
of anterior cervical decompression and fusion (ACDF) for trauma. A total of 155 patients (130 men, 25 women. Mean age 42.7 years;
16 to 87) who had undergone ACDF between 1 January 2001 and 1 January
2016 were included in the study. Outcome measures included the Neck
Disability Index (NDI) and visual analogue scale (VAS) for pain.
Lateral cervical spine radiographs taken in the immediate postoperative
period were reviewed to compare the interfacet distance of the operated
segment with those of the facet joints above and below.Aims
Patients and Methods
Dislocation is one of the most common causes
of patient and surgeon dissatisfaction following hip replacement
and to treat it, the causes must first be understood. Patient factors
include age greater than 70 years, medical comorbidities, female
gender, ligamentous laxity, revision surgery, issues with the abductors,
and patient education. Surgeon factors include the annual quantity
of procedures and experience, the surgical approach, adequate restoration
of femoral offset and leg length, component position, and soft-tissue
or bony impingement. Implant factors include the design of the head
and neck region, and so-called skirts on longer neck lengths. There
should be offset choices available in order to restore soft-tissue
tension. Lipped liners aid in gaining stability, yet if improperly placed
may result in impingement and dislocation. Late dislocation may
result from polyethylene wear, soft-tissue destruction, trochanteric
or abductor disruption and weakness, or
1. Vascular anatomical studies of the spine are described and the possibility of spread of
A total of 219 hips in 192 patients aged between
18 and 65 years were randomised to 28-mm metal-on-metal uncemented
total hip replacements (THRs, 107 hips) or hybrid hip resurfacing
(HR, 112 hips). At a mean follow-up of eight years (6.6 to 9.3)
there was no significant difference between the THR and HR groups
regarding rate of revision (4.0% (4 of 99) vs 5.8%
(6 of 104), p = 0.569) or re-operation rates without revision (5.1%
(5 of 99) vs 2.9% (3 of 104), p = 0.428). In the
THR group one recurrent dislocation, two late deep
Using general practitioner records and hospital
notes and through direct telephone conversation with patients, we investigated
the accuracy of nine patient-reported complications gathered from
a self-completed questionnaire after elective joint replacement
surgery of the hip and knee. A total of 402 post-discharge complications
were reported after 8546 elective operations that were undertaken
within a three-year period. These were reported by 136 men and 240
women with a mean age of 71.8 years (34 to 93). A total of 319 reported
complications (79.4%; 95% confidence interval 75.4 to 83.3) were
confirmed to be correct. High rates of correct reporting were demonstrated
for
We reviewed 275 cases and calculated the prevalence of bacteriologically or radiologically confirmed acute haematogenous osteomyelitis in children under 13 resident in Greater Glasgow during 1970 to 1990. In the 20-year period there was a fall of over 50%, mainly involving cases of long-bone
Joint replacement in HIV-positive patients remains uncommon, with most experience gained in patients with haemophilia. We analysed retrospectively the outcome of 102 replacement arthroplasties in 73 HIV-positive patients from eight specialist haemophilia centres. Of these, 91 were primary procedures. The mean age of the patients at surgery was 39 years, and the median follow-up was for five years. The overall rate of deep sepsis was 18.7% for primary procedures and 36.3% for revisions. This is a much higher rate of
There are limited published data detailing the volumetric material loss from tapers of conventional metal-on-polyethylene (MoP) total hip arthroplasties (THAs). Our aim was to address this by comparing the taper wear rates measured in an explanted cohort of the widely used Exeter THA with those measured in a group of metal-on-metal (MoM) THAs. We examined an existing retrieval database to identify all Exeter V40 and Universal MoP THAs. Volumetric wear analysis of the taper surfaces was conducted using previously validated methodology. These values were compared with those obtained from a series of MoM THAs using non-parametric statistical methodology. A number of patient and device variables were accounted for using multiple regression modelling.Aims
Patients and Methods
Revision arthroplasty of the hip is expensive
owing to the increased cost of pre-operative investigations, surgical implants
and instrumentation, protracted hospital stay and drugs. We compared
the costs of performing this surgery for aseptic loosening, dislocation,
deep