To determine ten-year failure rates following 36 mm metal-on-metal
(MoM) Pinnacle total hip arthroplasty (THA), and identify predictors
of failure. We retrospectively assessed a single-centre cohort of 569 primary
36 mm MoM Pinnacle THAs (all Corail stems) followed up since 2012
according to Medicines and Healthcare Products Regulation Agency
recommendations. All-cause failure rates (all-cause revision, and
non-revised cross-sectional imaging failures) were calculated, with predictors
for failure identified using multivariable Cox regression.Aims
Patients and Methods
This study sought to establish the prevalence of the cross over
sign (COS) and posterior wall sign (PWS) in relation to the anterior
pelvic plane (APP) in an asymptomatic population through reliable
and accurate 3D-CT based assessment. Data from pelvic CT scans of 100 asymptomatic subjects (200 hips)
undertaken for conditions unrelated to disorders of the hip were
available for analysis in this study. A previously established 3D
analysis method was applied to assess the prevalence of the COS
and PWS in relation to the APP.Aims
Materials and Methods
The posterior malleolus component of a fracture
of the ankle is important, yet often overlooked. Pre-operative CT scans
to identify and classify the pattern of the fracture are not used
enough. Posterior malleolus fractures are not difficult to fix.
After reduction and fixation of the posterior malleolus, the articular
surface of the tibia is restored; the fibula is out to length; the
syndesmosis is more stable and the patient can rehabilitate faster.
There is therefore considerable merit in fixing most posterior malleolus
fractures. An early post-operative CT scan to ensure that accurate
reduction has been achieved should also be considered. Cite this article:
The aim of the current study was to analyse the effects of posterior cruciate ligament (PCL) deficiency on forces of the posterolateral corner structure and on tibiofemoral (TF) and patellofemoral (PF) contact force under dynamic-loading conditions. A subject-specific knee model was validated using a passive flexion experiment, electromyography data, muscle activation, and previous experimental studies. The simulation was performed on the musculoskeletal models with and without PCL deficiency using a novel force-dependent kinematics method under gait- and squat-loading conditions, followed by probabilistic analysis for material uncertain to be considered.Objectives
Methods
Using a systematic review, we investigated whether there is an
increased risk of post-operative infection in patients who have
received an intra-articular corticosteroid injection to the hip
for osteoarthritis prior to total hip arthroplasty (THA). Studies dealing with an intra-articular corticosteroid injection
to the hip and infection following subsequent THA were identified
from databases for the period between 1990 to 2013. Retrieved articles
were independently assessed for their methodological quality.Aims
Methods
Slipped capital femoral epiphysis (SCFE) may
lead to symptomatic femoroacetabular impingement (FAI). We report our
experience of arthroscopic treatment, including osteochondroplasty,
for the sequelae of SCFE. Data were prospectively collected on patients undergoing arthroscopy
of the hip for the sequelae of SCFE between March 2007 and February
2013, including demographic data, radiological assessment of the
deformity and other factors that may influence outcome, such as
the presence of established avascular necrosis. Patients completed
the modified Harris hip score (mHHS) and the non-arthritic hip score
(NAHS) before and after surgery. In total, 18 patients with a mean age of 19 years (13 to 42),
were included in the study. All patients presented with pain in
the hip and mechanical symptoms, and had evidence of FAI (cam or
mixed impingement) on plain radiographs. The patients underwent arthroscopic osteoplasty of the femoral
neck. The mean follow-up was 29 months (23 to 56). The mean mHHS and NAHS scores improved from 56.2 (27.5 to 100.1)
and 52.1 (12.5 to 97.5) pre-operatively to 75.1 (33.8 to 96.8, p
= 0.01) and 73.6 (18.8 to 100, p = 0.02) at final follow-up, respectively.
Linear regression analysis demonstrated a significant association
between poorer outcome scores and increased time to surgery following SCFE
(p <
0.05 for all parameters except baseline MHHS). Symptomatic FAI following (SCFE) may be addressed using arthroscopic
techniques, and should be treated promptly to minimise progressive
functional impairment and chondrolabral degeneration. Take home message: Arthroscopy of the hip can be used to treat
femoroacetabular impingement successfully following SCFE. However,
this should be performed promptly after presentation in order to
prevent irreversible progression and poorer clinical outcomes. Cite this article:
Malrotation of the femoral component can result in post-operative complications in total knee arthroplasty (TKA), including patellar maltracking. Therefore, we used computational simulation to investigate the influence of femoral malrotation on contact stresses on the polyethylene (PE) insert and on the patellar button as well as on the forces on the collateral ligaments. Validated finite element (FE) models, for internal and external malrotations from 0° to 10° with regard to the neutral position, were developed to evaluate the effect of malrotation on the femoral component in TKA. Femoral malrotation in TKA on the knee joint was simulated in walking stance-phase gait and squat loading conditions.Objectives
Materials and Methods
Successful management of late presenting hip
dislocation in childhood is judged by the outcome not just at skeletal
maturity but well beyond into adulthood and late middle age. This
review considers different methods of treatment and looks critically
at the handful of studies reporting long-term follow-up after successful
reduction. Cite this article
Our aim was to investigate the prevalence of A total of 46 patients undergoing either an arthroscopic capsular
release or stabilisation had biopsies taken from the subcutaneous
fat and capsule of the shoulder at the time of surgery. These samples
were sent for culture in enrichment, and also for Nucleic Acid Amplification
testing. The prevalence of Aims
Patients and Methods
Hip hemiarthroplasty is a standard treatment for intracapsular
proximal femoral fractures in the frail elderly. In this study we
have explored the implications of early return to theatre, within
30 days, on patient outcome following hip hemiarthroplasty. We retrospectively reviewed the hospital records of all hip hemiarthroplasties
performed in our unit between January 2010 and January 2015. Demographic
details, medical backround, details of the primary procedure, complications,
subsequent procedures requiring return to theatre, re-admissions,
discharge destination and death were collected.Aims
Patients and Methods
The aim of this study was to compare the incidence of aseptic
loosening after the use of a cemented acetabular component and a
Trabecular Metal (TM) acetabular component (Zimmer Inc., Warsaw,
Indiana) at acetabular revision with bone impaction grafting. A total of 42 patients were included in the study. Patients were
randomised to receive an all- polyethylene cemented acetabular component
(n = 19) or a TM component (n = 23). Radiostereometric analysis
and conventional radiographic examinations were performed regularly
up to two years post-operatively or until further revision.Aims
Patients and Methods
We present the results of correcting a double or triple curve
adolescent idiopathic scoliosis using a convex segmental pedicle
screw technique. We reviewed 191 patients with a mean age at surgery of 15 years
(11 to 23.3). Pedicle screws were placed at the convexity of each
curve. Concave screws were inserted at one or two cephalad levels
and two caudal levels. The mean operating time was 183 minutes (132
to 276) and the mean blood loss 0.22% of the total blood volume
(0.08% to 0.4%). Multimodal monitoring remained stable throughout
the operation. The mean hospital stay was 6.8 days (5 to 15).Aims
Patients and Methods
We have previously investigated an association between the genome copy number variation (CNV) and acetabular dysplasia (AD). Hip osteoarthritis is associated with a genetic polymorphism in the aspartic acid repeat in the N-terminal region of the asporin ( Acetabular coverage of all subjects was evaluated using radiological findings (Sharp angle, centre-edge (CE) angle, acetabular roof obliquity (ARO) angle, and minimum joint space width). Genomic DNA was extracted from peripheral blood leukocytes. Agilent’s region-targeted high-density oligonucleotide tiling microarray was used to analyse 64 female AD patients and 32 female control subjects. All statistical analyses were performed using EZR software (Fisher’s exact probability test, Pearson’s correlation test, and Student’s Objectives
Methods
We investigated changes in the axial alignment of the ipsilateral
hip and knee after total hip arthroplasty (THA). We reviewed 152 patients undergoing primary THA (163 hips; 22
hips in men, 141 hips in women) without a pre-operative flexion
contracture. The mean age was 64 years (30 to 88). The diagnosis
was osteoarthritis (OA) in 151 hips (primary in 18 hips, and secondary
to dysplasia in 133) and non-OA in 12 hips. A posterolateral approach
with repair of the external rotators was used in 134 hips and an
anterior approach in 29 hips. We measured changes in leg length
and offset on radiographs, and femoral anteversion, internal rotation
of the hip and lateral patellar tilt on CT scans, pre- and post-operatively. Aims
Patients and Methods
We wished to quantify the extent of soft-tissue damage sustained
during minimally invasive total hip arthroplasty through the direct
anterior (DA) and direct superior (DS) approaches. In eight cadavers, the DA approach was performed on one side,
and the DS approach on the other, a single brand of uncemented hip
prosthesis was implanted by two surgeons, considered expert in their
surgical approaches. Subsequent reflection of the gluteus maximus
allowed the extent of muscle and tendon damage to be measured and
the percentage damage to each anatomical structure to be calculated.Aims
Materials and Methods
The aim of this study was to report the outcome following primary
fixation or a staged protocol for type C fractures of the tibial
plafond. We studied all patients who sustained a complex intra-articular
fracture (AO type C) of the distal tibia over an 11-year period.
The primary short-term outcome was infection. The primary long-term
outcome was the Foot and Ankle Outcome Score (FAOS).Aims
Patients and Methods
The aim of this study was to evaluate the long-term clinical
and radiographic outcomes of the Birmingham Interlocking Pelvic
Osteotomy (BIPO). In this prospective study, we report the mid- to long-term clinical
outcomes of the first 100 consecutive patients (116 hips; 88 in
women, 28 in men) undergoing BIPO, reflecting the surgeon’s learning
curve. Failure was defined as conversion to hip arthroplasty. The
mean age at operation was 31 years (7 to 57). Three patients (three
hips) were lost to follow-up.Aims
Patients and Methods
The purposes of this study were to clarify first, the incidence
of peroneal tendon dislocation in patients with a fracture of the
talus and second the factors associated with peroneal tendon dislocation. We retrospectively examined 30 patients (30 ankles) with a mean
age of 37.5 years, who had undergone internal fixation for a fracture
of the talus. Independent examiners assessed for peroneal tendon
dislocation using the pre-operative CT images. The medical records
were also reviewed for the presence of peroneal tendon dislocation.
The associations between the presence of dislocation with the patient
characteristics or radiological findings, including age, mechanism
of injury, severity of fracture, and fleck sign, were assessed using Fisher’s
exact tests.Aims
Patients and Methods
