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The Bone & Joint Journal
Vol. 100-B, Issue 3 | Pages 338 - 345
1 Mar 2018
Watkins CEL Elson DW Harrison JWK Pooley J

Aim

The aim of this study was to report the long-term outcome and implant survival of the lateral resurfacing elbow (LRE) arthroplasty in the treatment of elbow arthritis.

Patients and Methods

We reviewed a consecutive series of 27 patients (30 elbows) who underwent LRE arthroplasty between December 2005 and January 2008. There were 15 women and 12 men, with a mean age of 61 years (25 to 82). The diagnosis was primary hypotrophic osteoarthritis (OA) in 12 patients (14 elbows), post-traumatic osteoarthritis (PTOA) in five (five elbows) and rheumatoid arthritis (RA) in ten patients (11 elbows). The mean clinical outcome scores including the Mayo Elbow Performance Score (MEPS), the American Shoulder and Elbow Surgeons elbow score (ASES-e), the mean range of movement and the radiological outcome were recorded at three, six and 12 months and at a mean final follow-up of 8.3 years (7.3 to 9.4). A one sample t-test comparing pre and postoperative values, and survival analysis using the Kaplan–Meier method were undertaken.


The Bone & Joint Journal
Vol. 100-B, Issue 3 | Pages 396 - 403
1 Mar 2018
Messner J Johnson L Taylor DM Harwood P Britten S Foster P

Aims

The aim of this study was to report the clinical, functional and radiological outcomes of children and adolescents with tibial fractures treated using the Ilizarov method.

Patients and Methods

Between 2013 and 2016 a total of 74 children with 75 tibial fractures underwent treatment at our major trauma centre using an Ilizarov frame. Demographic and clinical information from a prospective database was supplemented by routine functional and psychological assessment and a retrospective review of the notes and radiographs.


Bone & Joint Research
Vol. 7, Issue 1 | Pages 1 - 5
1 Jan 2018
Parsons N Griffin XL Achten J Chesser TJ Lamb SE Costa ML

Objectives

This study investigates the reporting of health-related quality of life (HRQoL) in patients following hip fracture. We compare the relative merits and make recommendations for the use for two methods of measuring HRQoL; (i) including patients who died during follow-up and (ii) including survivors only.

Methods

The World Hip Trauma Evaluation has previously reported changes in HRQoL using EuroQol-5D for patients with hip fractures. We performed additional analysis to investigate the effect of including or excluding those patients who died during the first four months of the follow-up period.


The Bone & Joint Journal
Vol. 100-B, Issue 1_Supple_A | Pages 55 - 61
1 Jan 2018
Kim K Elbuluk A Yu S Iorio R

Aims

The aim of this study was to determine the optimal regimen for the management of pain following total knee arthroplasty (TKA) by comparing the outcomes and cost-effectiveness of different protocols implemented at a large, urban, academic medical centre.

Patients and Methods

Between September 2013 and September 2015, we used a series of modifications to our standard regimen for the management of pain after TKA. In May 2014, there was a department-wide transition from protocols focused on femoral nerve blocks (FNB) to periarticular injections of liposomal bupivacaine. In February 2015, patient-controlled analgesia (PCA) was removed from the protocol while continuing liposomal bupivacaine injections. Quality measures and hospital costs were compared between the three protocols.


Bone & Joint 360
Vol. 6, Issue 5 | Pages 21 - 24
1 Oct 2017


Bone & Joint 360
Vol. 6, Issue 5 | Pages 18 - 20
1 Oct 2017


Bone & Joint 360
Vol. 4, Issue 1 | Pages 24 - 26
1 Feb 2015

The February 2015 Spine Roundup360 looks at: Paracetamol use for lower back pain; En-bloc resection of vertebra reported for the first time; Spinopelvic disassociation under the spotlight; Hope for back pain; Disc replacement and ACDF equivalent in randomised study; Interspinous process devices ineffective


Bone & Joint 360
Vol. 6, Issue 5 | Pages 27 - 30
1 Oct 2017


The Bone & Joint Journal
Vol. 98-B, Issue 5 | Pages 703 - 709
1 May 2016
Kim Y Kang HG Kim JH Kim S Lin PP Kim HS

Aims

The purpose of the study was to investigate whether closed intramedullary (IM) nailing with percutaneous cement augmentation is better than conventional closed nailing at relieving pain and suppressing tumours in patients with metastases of the femur and humerus.

Patients and Methods

A total of 43 patients (27 men, 16 women, mean age 63.7 years, standard deviation (sd) 12.2; 21 to 84) underwent closed IM nailing with cement augmentation for long bone metastases. A further 27 patients, who underwent conventional closed IM nailing, served as controls. Pain was assessed using a visual analogue scale (VAS) score pre-operatively (pre-operative VAS), one week post-operatively (immediate post-operative VAS), and at six weeks post-operatively (follow-up post-operative VAS). Progression of the tumour was evaluated in subgroups of patients using F-18-fludeoxyglucose (F-18-FDG) positron emission tomography (PET)/computed tomography (CT) and/or bone scintigraphy (BS), at a mean of 8.8 and 7.2 months post-operatively, respectively.


Bone & Joint 360
Vol. 6, Issue 4 | Pages 34 - 37
1 Aug 2017


The Bone & Joint Journal
Vol. 99-B, Issue 10 | Pages 1298 - 1303
1 Oct 2017
Schouten R Malone AA Frampton CM Tiffen C Hooper G

Aims

The primary aim of this independent prospective randomised trial was to compare serum metal ion levels for ceramic-on-metal (CoM) and metal-on-metal (MoM) bearing surfaces in total hip arthroplasty (THA). Our one-year results demonstrated elevation in metal ion levels above baseline with no significant difference between the CoM and MoM groups. This paper reviews the five-year data.

Patients and Methods

The implants used in each patient differed only in respect to the type of femoral head (ceramic or metal). At five-year follow-up of the 83 enrolled patients, data from 67 (36 CoM, 31 MoM) was available for comparison.


Bone & Joint 360
Vol. 6, Issue 4 | Pages 16 - 18
1 Aug 2017


Bone & Joint 360
Vol. 6, Issue 4 | Pages 20 - 22
1 Aug 2017


Aims

The aim of this study was to examine the efficacy and safety of multiple boluses of intravenous (IV) tranexamic acid (TXA) on the hidden blood loss (HBL) and inflammatory response following primary total hip arthroplasty (THA).

Patients and Methods

A total of 150 patients were allocated randomly to receive a single bolus of 20 mg/kg IV TXA before the incision (group A), a single bolus followed by a second bolus of 1 g IV-TXA three hours later (group B) or a single bolus followed by two boluses of 1 g IV-TXA three and six hours later (group C). All patients were treated using a standard peri-operative enhanced recovery protocol. Primary outcomes were HBL and the level of haemoglobin (Hb) as well as the levels of C-reactive protein (CRP) and interleukin-6 (IL-6) as markers of inflammation. Secondary outcomes included the length of stay in hospital and the incidence of venous thromboembolism (VTE).


The Bone & Joint Journal
Vol. 98-B, Issue 1 | Pages 102 - 108
1 Jan 2016
Kang C Kim C Moon J

Aims

The aims of this study were to evaluate the clinical and radiological outcomes of instrumented posterolateral fusion (PLF) performed in patients with rheumatoid arthritis (RA).

Methods

A total of 40 patients with RA and 134 patients without RA underwent instrumented PLF for spinal stenosis between January 2003 and December 2011. The two groups were matched for age, gender, bone mineral density, the history of smoking and diabetes, and number of fusion segments.

The clinical outcomes measures included the visual analogue scale (VAS) and the Korean Oswestry Disability Index (KODI), scored before surgery, one year and two years after surgery. Radiological outcomes were evaluated for problems of fixation, nonunion, and adjacent segment disease (ASD). The mean follow-up was 36.4 months in the RA group and 39.1 months in the non-RA group.


The Bone & Joint Journal
Vol. 99-B, Issue 9 | Pages 1190 - 1196
1 Sep 2017
Swarup I Henn CM Nguyen JT Dines DM Craig EV Warren RF Gulotta LV Henn III RF

Aims

Few studies have evaluated the relationship between patients’ pre-operative expectations and the outcome of orthopaedic procedures. Our aim was to determine the effect of expectations on the outcome after primary anatomical total shoulder arthroplasty (TSA). We hypothesised that patients with greater expectations would have better outcomes.

Patients and Methods

Patients undergoing primary anatomical TSA completed the Hospital for Special Surgery’s Shoulder Expectations Survey pre-operatively. The American Shoulder and Elbow Surgeons (ASES), Shoulder Activity Scale (SAS), Short-Form-36 (SF-36), and visual analogue scale (VAS) for pain, fatigue, and general health scores were also collected pre-operatively and two years post-operatively. Pearson correlations were used to assess the relationship between the number of expectations and the outcomes. Differences in outcomes between those with higher and lower levels of expectations for each expectation were assessed by independent samples t-test. Multivariable linear regression analysis was used to control for potential confounding factors.


Bone & Joint 360
Vol. 6, Issue 3 | Pages 21 - 24
1 Jun 2017


Bone & Joint 360
Vol. 6, Issue 3 | Pages 24 - 26
1 Jun 2017


Bone & Joint 360
Vol. 6, Issue 3 | Pages 16 - 19
1 Jun 2017


The Bone & Joint Journal
Vol. 99-B, Issue 6 | Pages 799 - 805
1 Jun 2017
Ketola S Lehtinen JT Arnala I

Aims

Rotator cuff tendinopathy has a multifactorial origin. Rejecting the mechanistic theory has also led to abandoning operative treatment at initial presentation in the first line. Physiotherapy exercise programmes are the accepted first line treatment. The aim of this study was to assess the long-term additional benefits of subacromial decompression in the treatment of rotator cuff tendinopathy.

Patients and Methods

This randomised controlled trial of 140 patients (52 men, 88 women, mean age 47.1 years; 18 to 60) with rotator cuff tendinopathy extended previous work up to a maximum of 13 years. The patients were randomised into two treatment groups: arthroscopic acromioplasty and a supervised exercise treatment and a similar supervised exercise treatment alone. Self-reported pain on a visual analogue scale (VAS) was the primary outcome measure. Secondary measures were disability, working ability, pain at night, Shoulder Disability Questionnaire score and the number of painful days during the three months preceding the final assessment.