Metabolic syndrome and low-grade systemic inflammation are associated with knee osteoarthritis (OA), but the relationships between these factors and OA in other synovial joints are unclear. The aim of this study was to determine if a high-fat/high-sucrose (HFS) diet results in OA-like joint damage in the shoulders, knees, and hips of rats after induction of obesity, and to identify potential joint-specific risks for OA-like changes. A total of 16 male Sprague-Dawley rats were allocated to either the diet-induced obesity group (DIO, 40% fat, 45% sucrose, n = 9) or a chow control diet (n = 7) for 12 weeks. At sacrifice, histological assessments of the shoulder, hip, and knee joints were performed. Serum inflammatory mediators and body composition were also evaluated. The total Mankin score for each animal was assessed by adding together the individual Modified Mankin scores across all three joints. Linear regression modelling was conducted to evaluate predictive relationships between serum mediators and total joint damage.Objectives
Methods
Free vascularised fibular grafting has been used for the treatment
of large bony defects for more than 40 years. However, there is
little information about the risk factors for failure and whether
newer locking techniques of fixation improve the rates of union.
The purpose of this study was to compare the rates of union of free
fibular grafts fixed with locking and traditional techniques, and
to quantify the risk factors for nonunion and failure. A retrospective review involved 134 consecutive procedures over
a period of 20 years. Of these, 25 were excluded leaving 109 patients
in the study. There were 66 men and 43 women, with a mean age of
33 years (5 to 78). Most (62) were performed for oncological indications,
and the most common site (52) was the lower limb. Rate of union
was estimated using the Kaplan-Meier method and risk factors for
nonunion were assessed using Cox regression. All patients were followed
up for at least one year.Aims
Patients and Methods
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. 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 Aim
Patients and Methods
α-defensin is a biomarker which has been described as having
a high degree of accuracy in the diagnosis of periprosthetic joint
infection (PJI). Current meta-analyses are based on the α-defensin
laboratory-based immunoassay rather than the quick on-table lateral
flow test kit. This study is the first meta-analysis to compare the
accuracy of the α-defensin laboratory-based immunoassay and the
lateral flow test kit for the diagnosis of PJI. A systematic review was performed according to the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Inclusion criteria were all clinical studies where the diagnosis
of PJI was uncertain. All studies selected used the Musculoskeletal
Infection Society (MSIS) or modified MSIS criteria. Two independent
reviewers reviewed the studies and extracted data. A meta-analysis
of results was carried out: pooled sensitivity, specificity, positive
and negative likelihood ratio, heterogeneity and areas under curves
are reported.Aims
Materials and Methods
The aim of this study was to compare the efficacy of a corticosteroid injection for the
treatment of carpal tunnel syndrome (CTS) in patients with and without Raynaud’s
phenomenon. In a prospective study, 139 patients with CTS were treated with a corticosteroid
injection (10 mg triamcinolone acetonide); 34 had Raynaud’s phenomenon and 105
did not (control group). Grip strength, perception of touch with a Semmes-Weinstein
monofilament and the Boston Carpal Tunnel Questionnaires (BCTQ) were assessed at
baseline and at six, 12 and 24 weeks after the injection. The Cold Intolerance Severity
Score (CISS) questionnaire was also assessed at baseline and 24 weeks after the
injection.Aims
Patients and Methods
To determine whether an early return to sport in professional
Australian Rules Football players after fixation of a non-thumb
metacarpal fracture was safe and effective. A total of 16 patients with a mean age of 25 years (19 to 30)
identified as having a non-thumb metacarpal fracture underwent open
reduction and internal plate and screw fixation. We compared the
players’ professional performance statistics before and after the
injury to determine whether there was any deterioration in their
post-operative performance.Aims
Patients and Methods
Our purpose was to determine the quality of current randomised
controlled trials (RCTs) in hand surgery using standardised metrics. Based on five-year mean impact factors, we selected the six journals
that routinely publish studies of upper extremity surgery. Using
a journal-specific search query, 62 RCTs met our inclusion criteria.
Then three blinded reviewers used the Jadad and revised Coleman Methodology
Score (RCMS) to assess the quality of the manuscripts.Aims
Materials and Methods
Myxofibrosarcomas (MFSs) are malignant soft-tissue sarcomas characteristically
presenting as painless slowly growing masses in the extremities.
Locally infiltrative growth means that the risk of local recurrence
is high. We reviewed our experience to make recommendations about
resection strategies and the role of the multidisciplinary team
in the management of these tumours. Patients with a primary or recurrent MFS who were treated surgically
in our unit between 1997 and 2012 were included in the study. Clinical
records and imaging were reviewed. A total of 50 patients with a
median age of 68.4 years (interquartile range 61.6 to 81.8) were
included. There were 35 men; 49 underwent surgery in our unit.Aims
Patients and Methods
To synthesise the literature and perform a meta-analysis detailing
the longitudinal recovery in the first two years following a distal
radius fracture (DRF) managed with volar plate fixation. Three databases were searched to identify relevant articles.
Following eligibility screening and quality assessment, data were
extracted and outcomes were assimilated at the post-operative time
points of interest. A state-of-the-art longitudinal mixed-effects
meta-analysis model was employed to analyse the data.Aims
Materials and Methods
The aim of the present study was to compare the 30- and 90-day
re-admission rates and complication rates of outpatient and inpatient
total shoulder arthroplasty (TSA). The United States Medicare Standard Analytical Files database
was questioned to identify patients who had undergone outpatient
or inpatient TSA between 2005 and 2012. Patient characteristics
were compared between the two groups using chi-squared analysis. Multivariate
logistic regression analysis was used to control for differences
in baseline patient characteristics and to compare the two groups
in terms of post-operative complications within 90 days and re-admission
within 30 days and 90 days.Aims
Patients and Methods
We compared the ceiling effects of two patient-rating
scores, the Disability of the Arm, Shoulder and Hand (DASH) and
Patient-Rated Wrist Evaluation (PRWE), and a physician-rating score,
the Modified Mayo Wrist Score (MMWS) in assessing the outcome of
surgical treatment of an unstable distal radial fracture. A total
of 77 women with a mean age of 64.2 years (50 to 88) who underwent
fixation using a volar locking plate for an unstable distal radial fracture
between 2011 and 2013 were enrolled in this study. All completed
the DASH and PRWE questionnaires one year post-operatively and were
assessed using the MMWS by the senior author. The ceiling effects
in the outcome data assessed for each score were estimated. The data assessed with both patient-rating scores, the DASH and
PRWE, showed substantial ceiling effects, whereas the data assessed
with MMWS showed no ceiling effect. Researchers should be aware of a possible ceiling effect in the
assessment of the outcome of the surgical treatment of distal radial
fractures using patient-rating scores. It could also increase the
likelihood of a type II error. Cite this article: