In patients with a “dry” aspiration during the investigation of prosthetic joint infection (PJI), saline lavage is commonly used to obtain a sample for analysis. The aim of this study was to investigate prospectively the impact of saline lavage on synovial fluid analysis in revision arthroplasty. Patients undergoing revision hip (THA) or knee arthroplasty (TKA) for any septic or aseptic indication were enrolled. Intraoperatively, prior to arthrotomy, the maximum amount of fluid possible was aspirated to simulate a dry tap (pre-lavage) followed by the injection with 20 ml of normal saline and re-aspiration (post-lavage). Pre- and post-lavage synovial white blood cell (WBC) count, percent polymorphonuclear cells (%PMN), and cultures were compared.Aims
Methods
We have reviewed a group of patients with iliopsoas impingement after
We studied the rate of revision in 84 consecutive
A total of 31 patients, (20 women, 11 men; mean
age 62.5 years old; 23 to 81), who underwent conversion of a Girdlestone
resection-arthroplasty (RA) to a
We have evaluated the extent to which diabetes affects the revision rate following
From 1969 through 1982, 305 hips in 290 patients had
Early failure associated with adverse reactions to metal debris is an emerging problem after hip resurfacing but the exact mechanism is unclear. We analysed our entire series of 660 metal-on-metal resurfacings (Articular Surface Replacement (ASR) and Birmingham Hip Resurfacing (BHR)) and large-bearing ASR
Residual pain after total hip due to a number of causes both local to and replacement may be distant from the hip. We describe pain related to the psoas muscle after
The aim of this study was to analyse the functional outcome after a displaced intracapsular fracture of the femoral neck in active patients aged over 70 years without osteoarthritis or rheumatoid arthritis of the hip, randomised to receive either a hemiarthroplasty or a
The primary aim of this paper was to outline the processes involved in building the Partners Arthroplasty Registry (PAR), established in April 2016 to capture baseline and outcome data for patients undergoing arthroplasty in a regional healthcare system. A secondary aim was to determine the quality of PAR’s data. A tertiary aim was to report preliminary findings from the registry and contributions to quality improvement initiatives and research up to March 2019. Structured Query Language was used to obtain data relating to patients who underwent total hip or knee arthroplasty (THA and TKA) from the hospital network’s electronic medical record (EMR) system to be included in the PAR. Data were stored in a secure database and visualized in dashboards. Quality assurance of PAR data was performed by review of the medical records. Capture rate was determined by comparing two months of PAR data with operating room schedules. Linear and binary logistic regression models were constructed to determine if length of stay (LOS), discharge to a care home, and readmission rates improved between 2016 and 2019.Aims
Methods
We evaluated the long-term results of 116
Failure of irrigation and debridement (I&D) for prosthetic joint infection (PJI) is influenced by numerous host, surgical, and pathogen-related factors. We aimed to develop and validate a practical, easy-to-use tool based on machine learning that may accurately predict outcome following I&D surgery taking into account the influence of numerous factors. This was an international, multicentre retrospective study of 1,174 revision total hip (THA) and knee arthroplasties (TKA) undergoing I&D for PJI between January 2005 and December 2017. PJI was defined using the Musculoskeletal Infection Society (MSIS) criteria. A total of 52 variables including demographics, comorbidities, and clinical and laboratory findings were evaluated using random forest machine learning analysis. The algorithm was then verified through cross-validation.Aims
Methods
Despite a lack of long-term follow-up, there
is an increasing trend towards using femoral heads of large diameter
in
We present the medium-term results of hybrid
Aims. The widely used and well-proven Palacos R (a.k.a. Refobacin Palacos
R) bone cement is no longer commercially available and was superseded
by Refobacin bone cement R and Palacos R + G in 2005. However, the
performance of these newly introduced bone cements have not been
tested in a phased evidence-based manner, including roentgen stereophotogrammetric
analysis (RSA). Patients and Methods. In this blinded, randomised, clinical RSA study, the migration
of the Stanmore femoral component was compared between Refobacin
bone cement R and Palacos R + G in 62 consecutive
We have previously demonstrated raised cobalt and chromium levels in patients with larger diameter femoral heads, following metal-on-polyethylene uncemented total hip arthroplasty. Further data have been collected, to see whether these associations have altered with time and to determine the long-term implications for these patients and our practice. Patients from our previous study who underwent Trident-Accolade primary total hip arthroplasties using a metal-on-polyethylene bearing in 2009 were reviewed. Patients were invited to have their cobalt and chromium levels retested, and were provided an Oxford Hip Score. Serum ion levels were then compared between groups (28 mm, 36 mm, and 40 mm heads) and over time.Aims
Methods
We report a case of iatrogenic sciatic nerve injury caused by pre-operative intraneural injection of local anaesthetic at
This study reviewed the results of a cementless anatomical femoral component to give immediate post-operative stability, and with a narrow distal section in order not to contact the femoral cortex in the diaphysis, ensuring exclusively metaphyseal loading. A total of 471 patients (601 hips) who had a
We evaluated an operative technique, described
by the Exeter Hip Unit, to assist accurate introduction of the femoral
component. We assessed whether it led to a reduction in the rate
of leg-length discrepancy after
We describe the survival of 134 consecutive JRI Furlong hydroxyapatite-coated uncemented