To determine whether an early return to sport in professional
Australian Rules Football players after fixation of a non-thumb
metacarpal fracture was safe and effective. A total of 16 patients with a mean age of 25 years (19 to 30)
identified as having a non-thumb metacarpal fracture underwent open
reduction and internal plate and screw fixation. We compared the
players’ professional performance statistics before and after the
injury to determine whether there was any deterioration in their
post-operative performance.Aims
Patients and Methods
Alarm over the reported high failure rates for metal-on-metal (MoM) hip implants as well as their potential for locally aggressive Adverse Reactions to Metal Debris (ARMDs) has prompted government agencies, internationally, to recommend the monitoring of patients with MoM hip implants. Some have advised that a blood ion level >7 µg/L indicates potential for ARMDs. We report a systematic review and meta-analysis of the performance of metal ion testing for ARMDs. We searched MEDLINE and EMBASE to identify articles from which it was possible to reconstruct a 2 × 2 table. Two readers independently reviewed all articles and extracted data using explicit criteria. We computed a summary receiver operating curve using a Bayesian random-effects hierarchical model.Objectives
Methods
The optimal method of tibial component fixation remains uncertain
in total knee arthroplasty (TKA). Hydroxyapatite coatings have been
applied to improve bone ingrowth in uncemented designs, but may
only coat the directly accessible surface. As peri-apatite (PA)
is solution deposited, this may increase the coverage of the implant
surface and thereby fixation. We assessed the tibial component fixation
of uncemented PA-coated TKAs Patients were randomised to PA-coated or cemented TKAs. In 60
patients (30 in each group), radiostereometric analysis of tibial
component migration was evaluated as the primary outcome at baseline,
three months post-operatively and at one, two and five years. A
linear mixed-effects model was used to analyse the repeated measurements.Aims
Patients and Methods
This is the second of a series of reviews of registries. This review looks specifically at worldwide registry data that have been collected on knee arthroplasty, what we have learned from their reports, and what the limitations are as to what we currently know.
A recent Supreme Court ruling in the United Kingdom
has significantly altered the emphasis of informed consent, moving
from a historically ‘doctor-focused’ to a more ‘patient-focused’ approach,
in line with the situation in other international jurisdictions. The reasons for the change are discussed with some recommendations
about how our attitudes need to change in the future. Cite this article:
Trauma and orthopaedics is the largest of the
surgical specialties and yet attracts a disproportionately small
fraction of available national and international funding for health
research. With the burden of musculoskeletal disease increasing,
high-quality research is required to improve the evidence base for
orthopaedic practice. Using the current research landscape in the
United Kingdom as an example, but also addressing the international
perspective, we highlight the issues surrounding poor levels of
research funding in trauma and orthopaedics and indicate avenues
for improving the impact and success of surgical musculoskeletal
research. Cite this article:
The use of robotics in arthroplasty surgery is expanding rapidly as improvements in the technology evolve. This article examines current evidence to justify the usage of robotics, as well as the future potential in this emerging field.
We conducted a prospective study of a delta ceramic total hip
arthroplasty (THA) to determine the rate of ceramic fracture, to
characterise post-operative noise, and to evaluate the mid-term
results and survivorship. Between March 2009 and March 2011, 274 patients (310 hips) underwent
cementless THA using a delta ceramic femoral head and liner. At
each follow-up, clinical and radiological outcomes were recorded.
A Kaplan-Meier analysis was undertaken to estimate survival.Aims
Patients and Methods
Metal-on-metal resurfacing of the hip (MoMHR)
has enjoyed a resurgence in the last decade, but is now again in question
as a routine option for osteoarthritis of the hip. Proponents of
hip resurfacing suggest that its survival is superior to that of
conventional hip replacement (THR), and that hip resurfacing is
less invasive, is easier to revise than THR, and provides superior
functional outcomes. Our argument serves to illustrate that none
of these proposed advantages have been realised and new and unanticipated
serious complications, such as pseudotumors, have been associated
with the procedure. As such, we feel that the routine use of MoMHR
is not justified. Cite this article:
The use of ceramic femoral heads in total hip arthroplasty (THA) has increased due to their proven low bearing wear characteristics. Ceramic femoral heads are also thought to reduce wear and corrosion at the head-stem junction with titanium (Ti) stems when compared with metal heads. We sought to evaluate taper damage of ceramic compared with metal heads when paired with cobalt chromium (CoCr) alloy stems in a single stem design. This retrieval study involved 48 total hip arthroplasties (THAs) with CoCr V40 trunnions paired with either CoCr (n = 21) or ceramic (n = 27) heads. The taper junction of all hips was evaluated for fretting/corrosion damage and volumetric material loss using a roundness-measuring machine. We used linear regression analysis to investigate taper damage differences after adjusting for potential confounding variables.Objectives
Methods
We recently published a paper comparing the incidence
of adverse outcomes after unicompartmental and total knee arthroplasty
(UKA and TKA). The conclusion of this study, which was in favour
of UKA, was dismissed as “biased” in a review in Cite this article:
There are significant differences in the methods and styles of orthopaedic surgical training between continents, all with the aim to produce competent consultant surgeons, but the differences in training content and pathway are vast. We review and contrast the key differences between three continents.
Our aim was to report survivorship data and lessons learned with
the Corail/Pinnacle cementless total hip arthroplasty (THA) system. Between August 2005 and March 2015, a total of 4802 primary cementless
Corail/Pinnacle THAs were performed in 4309 patients. In March 2016,
we reviewed these hips from a prospectively maintained database.Aims
Patients and Methods
The aim of this study was to investigate differences in pain,
range of movement function and satisfaction at three months and
one year after total knee arthroplasty (TKA) in patients with an
oblique pattern of kinematic graph of the knee and those with a
varus pattern. A total of 91 patients who underwent TKA were included in this
retrospective study. Patients (59 women and 32 men with mean age
of 68.7 years; 38.6 to 88.4) were grouped according to kinematic
graphs which were generated during navigated TKA and the outcomes
between the groups were compared.Aims
Patients and Methods
Rib fracture fixation by orthopaedic and cardiothoracic surgeons has become increasingly popular for the treatment of chest injuries in trauma. The literature, though mainly limited to Level II and III evidence, shows favourable results for operative fixation. In this paper we review the literature and discuss the indications for rib fracture fixation, surgical approaches, choice of implants and the future direction for management. With the advent of NICE guidance and new British Orthopaedic Association Standards for Trauma (BOAST) guidelines in production, the management of rib fractures is going to become more and more commonplace.
The aim of this consensus was to develop a definition of post-operative
fibrosis of the knee. An international panel of experts took part in a formal consensus
process composed of a discussion phase and three Delphi rounds.Aims
Patients and Methods
