The classical longitudinal incision used for the direct anterior
approach (DAA) to the hip does not follow the tension lines of the
skin and can lead to impaired wound healing and poor cosmesis. The
purpose of this retrospective study was to determine the satisfaction
with the scar, and functional and radiographic outcomes comparing
the classic longitudinal incision with a modified skin crease ‘bikini’
when the DAA is used for total hip arthroplasty (THA). A total of 964 patients (51% female; 59% longitudinal, 41% ‘bikini’)
completed a follow-up questionnaire between two and four years postoperatively,
including the Oxford Hip Score (OHS), the University of North Carolina
‘4P’ scar scale (UNC4P) and two items for assessing the aesthetic
appearance of the scar and symptoms of numbness. The positioning
of the components, rates of heterotopic ossification (HO) and rates
of revision were assessed.Aims
Patients and Methods
We performed a meta-analysis investigating the association between preoperative psychological distress and postoperative pain and function after total knee arthroplasty (TKA). Pubmed/Medline, Embase, PsycINFO, and the Cochrane library were searched for studies on the influence of preoperative psychological distress on postoperative pain and physical function after TKA. Two blinded reviewers screened for eligibility and assessed the risk of bias and the quality of evidence. We used random effects models to pool data for the meta-analysis.Aims
Materials and Methods
The aim of this study was to investigate the association between the type of operation used to treat a trochanteric fracture of the hip and 30-day mortality. Data on 82 990 patients from the National Hip Fracture Database were analyzed using generalized linear models with incremental case-mix adjustment for patient, non-surgical and surgical characteristics, and socioeconomic factors.Aims
Patients and Methods
What represents clinically significant acetabular undercoverage
in patients with symptomatic cam-type femoroacetabular impingement
(FAI) remains controversial. The aim of this study was to examine
the influence of the degree of acetabular coverage on the functional
outcome of patients treated arthroscopically for cam-type FAI. Between October 2005 and June 2016, 88 patients (97 hips) underwent
arthroscopic cam resection and concomitant labral debridement and/or
refixation. There were 57 male and 31 female patients with a mean
age of 31.0 years (17.0 to 48.5) and a mean body mass index (BMI)
of 25.4 kg/m2 (18.9 to 34.9). We used the Hip2Norm, an
object-oriented-platform program, to perform 3D analysis of hip
joint morphology using 2D anteroposterior pelvic radiographs. The lateral
centre-edge angle, anterior coverage, posterior coverage, total
femoral coverage, and alpha angle were measured for each hip. The
presence or absence of crossover sign, posterior wall sign, and
the value of acetabular retroversion index were identified automatically
by Hip2Norm. Patient-reported outcome scores were collected preoperatively
and at final follow-up with the Hip Disability and Osteoarthritis
Outcome Score (HOOS).Aims
Patients and Methods
Aims
Patients and Methods
The aims of this study were to compare the efficacy and safety
of intra-articular and intravenous (IV) tranexamic acid (TXA) in
controlling perioperative blood loss in total knee arthroplasty
(TKA) using a randomized, double-blinded equivalence trial. A total of 182 patients aged between 45 and 75 years undergoing
unilateral TKA at a tertiary centre were randomized to receive TXA,
either 1.5 g intra-articularly after closure of the wound (n = 91)
or two doses of 10 mg/kg IV (n = 91). The primary outcome measure
was the reduction in the level of haemoglobin (Hb) in the blood
on the fifth postoperative day. Secondary outcome measures were
the total, visible, and hidden blood losses (TBL, VBL, HBL). We
assumed equivalence of the primary outcome in both routes with a
margin of ± 0.35gm/dl. Block randomization using computer-generated
random numbers was used. The patients and the assessor of outcome were
blinded.Aims
Patients and Methods
The aims of this systematic review were to describe the quantity and methodological quality of meta-analyses in orthopaedic surgery published during the last 17 years. MEDLINE, EMBASE, and PubMed, between 1 January 2000 and 31 December 2016, were searched for meta-analyses in orthopaedic surgery dealing with at least one surgical intervention. Meta-analyses were included if the interventions involved a human muscle, ligament, bone or joint.Aims
Materials and Methods
Given the function of adiponectin (ADIPOQ) on the inflammatory condition of obesity and osteoarthritis (OA), we hypothesized that the ADIPOQ gene might be a candidate gene for a marker of susceptibility to OA. We systematically screened three tagging polymorphisms (rs182052, rs2082940 and rs6773957) in the ADIPOQ gene, and evaluated the association between the genetic variants and OA risk in a case-controlled study that included 196 OA patients and 442 controls in a northern Chinese population. Genotyping was performed using the Sequenom MassARRAY iPLEX platform.Objectives
Methods
It has been suggested that the use of a pilot-hole may reduce the risk of fracture to the lateral cortex. Therefore the purpose of this study was to determine the effect of a pilot hole on the strains and occurrence of fractures at the lateral cortex during the opening of a high tibial osteotomy (HTO) and post-surgery loading. A total of 14 cadaveric tibias were randomized to either a pilot hole (n = 7) or a no-hole (n = 7) condition. Lateral cortex strains were measured while the osteotomy was opened 9 mm and secured in place with a locking plate. The tibias were then subjected to an initial 800 N load that increased by 200 N every 5000 cycles, until failure or a maximum load of 2500 N.Aim
Materials and Methods
This multicentre, retrospective study aimed to improve our knowledge
of primary pyogenic spinal infections in children by analyzing a
large consecutive case series. The medical records of children with such an infection, treated
at four tertiary institutions between 2004 and 2014, were analyzed
retrospectively. Epidemiological, clinical, paraclinical, radiological,
and microbiological data were evaluated. There were 103 children,
of whom 79 (76.7%) were aged between six months and four years.Aims
Patients and Methods
The aim of this study was to investigate the structural integrity of torn and non-torn human acetabular labral tissue. A total of 47 human labral specimens were obtained from a biobank. These included 22 torn specimens and 25 control specimens from patients undergoing total hip arthroplasty with macroscopically normal labra. The specimens underwent dynamic shear analysis using a rheometer to measure storage modulus, as an indicator of structural integrity.Objectives
Methods
To compare the early management and mortality of older patients
sustaining major orthopaedic trauma with that of a younger population
with similar injuries. The Trauma Audit Research Network database was reviewed to identify
eligible patients admitted between April 2012 and June 2015. Distribution
and severity of injury, interventions, comorbidity, critical care
episodes and mortality were recorded. The population was divided
into young (64 years or younger) and older (65 years and older) patients.Aims
Patients and Methods
The aim of this study was to determine if positive Waddell signs
were related to patients’ demographics or to perception of their
quality of life. This prospective cross-sectional study included 479 adult patients
with back pain from a university spine centre. Each completed SF-12
and Oswestry Disability Index (ODI) questionnaires and underwent
standard spinal examinations to elicit Waddell signs. The relationship
between Waddell signs and age, gender, ODI, Mental Component Score
(MCS), and Physical Component Score (PCS) scores was determined.Aims
Patients and Methods
This systematic review examines the current literature regarding surgical techniques for restoring articular cartilage in the hip, from the older microfracture techniques involving perforation to the subchondral bone, to adaptations of this technique using nanofractures and scaffolds. This review discusses the autologous and allograft transfer systems and the autologous matrix-induced chondrogenesis (AMIC) technique, as well as a summary of the previously discussed techniques, which could become common practice for restoring articular cartilage, thus reducing the need for total hip arthroplasty. Using the
