We compared the usefulness of
A group of patients were studied 10 years after stopping work in a high-pressure environment.
Impaction bone grafting for the reconstitution
of bone stock in revision hip surgery has been used for nearly 30 years.
Between 1995 and 2001 we used this technique in acetabular reconstruction,
in combination with a cemented component, in 304 hips in 292 patients
revised for aseptic loosening. The only additional supports used
were stainless steel meshes placed against the medial wall or laterally
around the acetabular rim to contain the graft. All Paprosky grades
of defect were included. Clinical and
A
A method is described which provides standardised reproducible
We recorded inter- and intra-observer variations in the classification of ankle fractures by the Lauge Hansen and Weber systems.
Eleven articulated scoliotic spines were examined radiographically and morphometrically. Measurement of the curve on anteroposterior radiographs of the specimens gave a mean Cobb angle of 70 degrees, though true anteroposterior radiographs of the deformity revealed a mean Cobb angle of 99 degrees (41% greater). Lateral radiographs gave the erroneous impression that there was a mean kyphosis of 41 degrees while true lateral projections revealed a mean apical lordosis of 14 degrees. Morphometric measurements confirmed the presence of a lordosis at bony level, the apical vertebral bodies being significantly taller anteriorly (P less than 0.02). There were significant correlations (P less than 0.01) between the true size of the lateral scoliosis, the amount of axial rotation and the size of the apical lordosis. This study illustrates the three-dimensional nature of the deformity in scoliosis and its property of changing in character and magnitude according to the plane of
To assess the effect of improved methods of femoral cementing on the loosening rates in young patients, we reviewed 50 'second-generation' cemented hip arthroplasties in 44 patients aged 50 years or less. The femoral stems were all collared and rectangular in cross-section with rounded corners. The cement was delivered by a gun into a medullary canal occluded distally with a cement plug. A clinical and
A computerised image analyser has been used experimentally to determine its possible usefulness in quantifying bone density. Rats were prepared for this purpose and ash weight/volume readings were obtained on femora which had been radiographed and studied to estimate
We report two new
We investigated a new method of stress
Assessment of bony union after anterior fusion of the lumbar spine has previously relied on the skilled interpretation of plain radiograph. A biplanar
Twenty patients were examined by standard
We have reviewed a series of 94 Chiari pelvic osteotomies carried out from 1966 to 1982. In 83 hips the indication for surgery had been pain, and of these patients 73 (88%) had appreciable relief within one year of operation. The other 11 hips were all in children and were painless; in them the osteotomy had successfully stabilised progressive subluxation of the hip. At review after a mean follow-up of 10 years (range, 2 to 18 years) 68 previously painful hips were reassessed. Although function of the hips had deteriorated slowly with time, four of the seven cases with 18 years' follow-up had good function and only minor symptoms. A detailed analysis of the
We treated 50 patients with fractures of the waist of the scaphoid in a below-elbow plaster cast for up to 13 weeks. Displacement of the fragments was assessed independently by two observers using MRI and radiographs performed within two weeks of injury. The MRI assessments showed that only the measurement of sagittal translation of the fragments and an overall assessment of displacement had satisfactory inter- and intra-observer reproducibility and revealed that nine of the 50 fractures were displaced. Only three of the 49 fractures with adequate follow-up failed to unite, and all were displaced with more than 1 mm of translation in the sagittal plane. If the MRI assessment of displacement of the fracture was used as the measurement of choice, assessment of displacement on the initial scaphoid series of radiographs showed a sensitivity of between 33% and 47% and a positive predictive value of between 27% and 86%. Neither observer was able correctly to identify more than 33% to 47% of the displaced fractures from the plain radiographs. Although the overall assessment of displacement and gapping and translation in the coronal plane on the plain radiographs influenced the rate of union, none of these parameters identified all three fractures which failed to unite. We conclude that the assessment of displacement of scaphoid fractures on MRI can probably be used to assess the likelihood of union although the small number of nonunions limits the power of the study. In contrast, the assessment of displacement on routine
A diastasis between the femoral head and the acetabulum can be achieved for a short while by the application of manual traction on the lower extremity. The intra-articular low-pressure area can be visualised radiographically and is known as a "vacuum phenomenon". The resulting arthrogram clearly outlines the shape, thickness and extent of the cartilage. In the presence of an effusion the diastasis occurs without a vacuum phenomenon. This simple, non-invasive and inoffensive method of traction
The degree of displacement of a fracture of the distal radius
is an important factor which can be assessed using simple radiographic
measurements. Our aim was to investigate the reliability and reproducibility
of these measurements and to determine if they should be used clinically. A 10% sample was randomly generated from 3670 consecutive adult
patients who had presented to University Hospitals of Leicester
NHS Trust between 2007 and 2010 with a fracture of the distal radius.
Radiographs of the 367 patients were assessed by two independent
reviewers. Four measurements of displacement of the fracture were recorded
and the inter-observer correlation assessed using the intra-class
correlation coefficient.Aims
Patients and Methods
Threaded acetabular components are widely used in cementless total hip replacement, despite a poor understanding of the nature of the bone-implant interface. We have examined one case in which the threaded titanium ring appeared to be well incorporated with no discernible radiolucency. Microradiography and histology surprisingly showed that the threads were entirely encapsulated in fibrous tissue. This raises doubt about the relevance of plain
We evaluated the accuracy of six clinical tests for posterior instability in 24 knees with acute surgically-proven posterior cruciate ligament injuries and intact anterior cruciate ligaments. We also performed stress