The consensus is that bipolar hemiarthroplasty (BHA) in allograft-prosthesis composite (APC) reconstruction of the proximal femur following primary tumour resection provides more stability than total hip arthroplasty (THA). However, no comparative study has been performed. In this study, we have compared the outcome and complication rates of these two methods. In a retrospective study, 57 patients who underwent APC reconstruction of proximal femur following the primary tumour resection, either using BHA (29) or THA (28), were included. Functional outcome was assessed using the Musculoskeletal Tumour Society (MSTS) scoring system and Harris Hip Score (HHS). Postoperative complications of the two techniques were also compared.Aims
Methods
A case of benign chondroblastoma in the upper end of the humerus is described. A plea is made that radiotherapy should be avoided in the treatment of this tumour. It is suggested that
A case of salmonella osteomyelitis of the spine complicated by meningitis after needle
Schistosomiasis is a common parasitic infestation in Egypt. We describe the case of a 24-year-old Egyptian man who presented with the signs of acute septic arthritis of the hip and in whom
With recent progress in cancer treatment, the number of advanced-age patients with spinal metastases has been increasing. It is important to clarify the influence of advanced age on outcomes following surgery for spinal metastases, especially with a focus on subjective health state values. We prospectively analyzed 101 patients with spinal metastases who underwent palliative surgery from 2013 to 2016. These patients were divided into two groups based on age (< 70 years and ≥ 70 years). The Eastern Cooperative Oncology Group (ECOG) performance status (PS), Barthel index (BI), and EuroQol-5 dimension (EQ-5D) score were assessed at study enrolment and at one, three, and six months after surgery. The survival times and complications were also collected.Aims
Methods
As our understanding of hip function and disease improves, it is evident that the acetabular fossa has received little attention, despite it comprising over half of the acetabulum’s surface area and showing the first signs of degeneration. The fossa’s function is expected to be more than augmenting static stability with the ligamentum teres and being a templating landmark in arthroplasty. Indeed, the fossa, which is almost mature at 16 weeks of intrauterine development, plays a key role in hip development, enabling its nutrition through vascularization and synovial fluid, as well as the influx of chondrogenic stem/progenitor cells that build articular cartilage. The pulvinar, a fibrofatty tissue in the fossa, has the same developmental origin as the synovium and articular cartilage and is a biologically active area. Its unique anatomy allows for homogeneous distribution of the axial loads into the joint. It is composed of intra-articular adipose tissue (IAAT), which has adipocytes, fibroblasts, leucocytes, and abundant mast cells, which participate in the inflammatory cascade after an insult to the joint. Hence, the fossa and pulvinar should be considered in decision-making and surgical outcomes in hip preservation surgery, not only for their size, shape, and extent, but also for their biological capacity as a source of cytokines, immune cells, and chondrogenic stem cells. Cite this article:
1. Five cases of calcified enchondroma are described. In all except one the condition was symptomless and was discovered accidentally. 2. The radiographic features are described and the differential diagnosis is discussed. 3. It is emphasised that when the diagnosis is in doubt
The problems of diagnosis and treatment of osteoclastoma are considered. The importance of full investigation, and the advantages of drill
In a series of over 1000 elderly patients with femoral neck fracture, who were routinely screened by iliac crest bone
Two patients presented with pain in the arm and a radiographic lesion of the upper humerus which warranted surgical exploration and excision
This study presents patient-reported quality of life (QoL) over the first year following surgical debridement of long bone osteomyelitis. It assesses the bone involvement, antimicrobial options, coverage of soft tissues, and host status (BACH) classification as a prognostic tool and its ability to stratify cases into ‘uncomplicated’ or ‘complex’. Patients with long-bone osteomyelitis were identified prospectively between June 2010 and October 2015. All patients underwent surgical debridement in a single-staged procedure at a specialist bone infection unit. Self-reported QoL was assessed prospectively using the three-level EuroQol five-dimension questionnaire (EQ-5D-3L) index score and visual analogue scale (EQ-VAS) at five postoperative time-points (baseline, 14 days, 42 days, 120 days, and 365 days). BACH classification was applied retrospectively by two clinicians blinded to outcome.Aims
Methods
1. A case of polyarteritis nodosa is reported, the presenting manifestation of which was subperiosteal new bone formation in both legs. 2. The effect of cortisone on the symptoms is recorded. 3. The histology is reported after
A 65-year-old man presented with a painful hip five years after a cemented replacement. Histological examination of a
A patient with polyostotic fibrous dysplasia had several fractures of the right lower limb. An above-knee amputation was eventually performed, followed by arthrodesis of the hip. Five years later the stump became painful and swelled with dramatic rapidity.
Chondromas may arise from the ribs but seldom grow to giant size. In a series of twenty-one cases, four giant tumours were encountered. Three were treated by excision without leaving a significant defect of the chest wall or impairment of respiration; the fourth was examined by
1. Recently described histological and radiographic methods of diagnosing osteoporosis have been applied to patients with transcervical and intertrochanteric fractures of the femur. 2. Both methods indicate a higher incidence of osteoporosis in such patients than in a control series, especially in older women with intertrochanteric fractures. 3. A discrepancy between the results of
1. Twenty-five cases of benign giant-cell tumour of bone, treated at Westminster Hospital, London, are reported. 2. The diagnosis can often be made on clinical and radiographic grounds alone but
1. Three cases of cystic angiomatosis of bone are presented and the literature is reviewed. 2. The typical radiological appearances are described and illustrated. 3. The diagnosis must be confirmed by
