The aim of the British Association for Surgery of the Knee (BASK) Meniscal Consensus Project was to develop an evidence-based treatment guideline for patients with meniscal lesions of the knee. A formal consensus process was undertaken applying nominal group, Delphi, and appropriateness methods. Consensus was first reached on the terminology relating to the definition, investigation, and classification of meniscal lesions. A series of simulated clinical scenarios was then created and the appropriateness of arthroscopic meniscal surgery or nonoperative treatment in each scenario was rated by the group. The process was informed throughout by the latest published, and previously unpublished, clinical and epidemiological evidence. Scenarios were then grouped together based upon the similarity of clinical features and ratings to form the guideline for treatment. Feedback on the draft guideline was sought from the entire membership of BASK before final revisions and approval by the consensus group.Aims
Materials and Methods
The aim of this study was to review the impact of smoking tobacco on the musculoskeletal system, and on bone fractures in particular. English-language publications of human and animal studies categorizing subjects into smokers and nonsmokers were sourced from MEDLINE, The Cochrane Library, and SCOPUS. This review specifically focused on the risk, surgical treatment, and prevention of fracture complications in smokers.Objectives
Methods
Informed patient consent is a legal prerequisite endorsed by
multiple regulatory institutions including the Royal College of
Surgeons and the General Medical Council. It is also recommended
that the provision of written information is available and may take
the form of a Patient Information Leaflet (PIL) with multiple PILs
available from leading orthopaedic institutions. PILs may empower
the patient, improve compliance, and improve the patient experience.
The national reading age in the United Kingdom is less than 12 years
and therefore PILs should be written at a readability level not
exceeding 12 years old. We aim to assess the readability of PILs
currently provided by United Kingdom orthopaedic institutions. The readability of PILs on 58 common conditions provided by seven
leading orthopaedic associations in January 2017, including the
British Orthopaedic Association, British Hip Society, and the British
Association of Spinal Surgeons, was assessed. All text in each PIL
was analyzed using readability scores including the Flesch–Kincaid Grade
Level (FKGL) and the Simple Measure of Gobbledygook (SMOG) test.Aims
Patients and Methods
A high rate of suicide has been reported in patients who sustain
fractures, but the association remains uncertain in the context
of other factors. The aim of this study was to examine the association
between fractures and the risk of suicide in this contextual setting. We performed a case-control study of patients aged 40 years or
older who died by suicide between 2000 and 2011. We included patients’
demographics, physical and mental health problems, and socioeconomic
factors. We performed conditional logistic regression to evaluate
the associations between fractures and the risk of suicide.Aims
Patients and Methods
It has been hypothesized that patellofemoral pain, a common knee condition in adolescents and young adults, may be a precursor of degenerative joint changes and may ultimately lead to patellofemoral osteoarthritis. Since both conditions share several mechanical disease characteristics, such as altered contact area between the femur and patella and increased joint stress, we investigated whether these conditions share similar and different shape characteristics of the patella compared with normal controls. This cross-sectional study compared three different study populations: 32 patellofemoral pain subjects (mean age, 32 years (22 to 45); 72% female); 56 isolated radiological patellofemoral osteoarthritis subjects (mean age, 54 years (44 to 58); 89% female); and 80 healthy control subjects (mean age, 52 years (44 to 58); 74% female). Measurements included questionnaires, and lateral and skyline radiographs of the knee. Two separate 30-point 2D statistical shape models of the patella were created from the lateral and skyline radiographs. A general linear model was used to test for differences in standardized shape modes (a specific shape variant of the patella) between patellofemoral osteoarthritis, patellofemoral pain, and controls, using Bonferroni correction and adjustment for body mass index and gender.Objectives
Methods
The purpose of this exploratory study was to investigate if the 24-hour activity profile (i.e. waking activities and sleep) objectively measured using wrist-worn accelerometry of patients scheduled for total hip arthroplasty (THA) improves postoperatively. A total of 51 THA patients with a mean age of 64 years (24 to 87) were recruited from a single public hospital. All patients underwent THA using the same surgical approach with the same prosthesis type. The 24-hour activity profiles were captured using wrist-worn accelerometers preoperatively and at 2, 6, 12, and 26 weeks postoperatively. Patient-reported outcomes (Hip Disability and Osteoarthritis Outcome Score (HOOS)) were collected at all timepoints except two weeks postoperatively. Accelerometry data were used to quantify the intensity (sedentary, light, moderate, and vigorous activities) and frequency (bouts) of activity during the day and sleep efficiency. The analysis investigated changes with time and differences between Charnley class.Aims
Patients and Methods
A single-centre prospective randomized trial was conducted to
investigate whether a less intensive follow-up protocol would not
be inferior to a conventional follow-up protocol, in terms of overall
survival, in patients who have undergone surgery for sarcoma of
the limb. Initial short-term results were published in 2014. The primary objective was to show non-inferiority of a chest
radiograph (CXR) group compared with a CT scan group, and of a less
frequent (six-monthly) group than a more frequent (three-monthly)
group, in two-by-two comparison. The primary outcome was overall
survival and the secondary outcome was a recurrence-free survival.
Five-year survival was compared between the CXR and CT scan groups
and between the three-monthly and six-monthly groups. Of 500 patients
who were enrolled, 476 were available for follow-up. Survival analyses
were performed on a per-protocol basis (n = 412).Aims
Patients and Methods
The aim of this study was to assess the influence of obesity on the clinical outcomes and survivorship ten years postoperatively in patients who underwent a fixed-bearing unicompartmental knee arthroplasty (UKA). We prospectively followed 184 patients who underwent UKA between 2003 and 2007 for a minimum of ten years. A total of 142 patients with preoperative body mass index (BMI) of < 30 kg/m2 were in the control group (32 male, 110 female) and 42 patients with BMI of ≥ 30 kg/m2 were in the obese group (five male, 37 female). Pre- and postoperative range of movement (ROM), Knee Society Score (KSS), Oxford Knee Score (OKS), 36-Item Short-Form Health Survey (SF-36), and survivorship were analyzed.Aims
Patients and Methods
This study investigated the influence of body mass index (BMI)
on patients’ function and quality of life ten years after total
knee arthroplasty (TKA). A total of 126 patients who underwent unilateral TKA in 2006
were prospectively included in this retrospective study. They were
categorized into two groups based on BMI: < 30 kg/m2 (control)
and ≥ 30 kg/m2 (obese). Functional outcome was assessed
using the Knee Society Function Score (KSFS), Knee Society Knee
Score (KSKS), and Oxford Knee Score (OKS). Quality of life was assessed
using the Physical (PCS) and Mental Component Scores (MCS) of the 36-Item
Short-Form Health Survey.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
