The aim of this systematic literature review was to assess the clinical level of evidence of commercially available demineralised bone matrix (DBM) products for their use in trauma and orthopaedic related surgery. A total of 17 DBM products were used as search terms in two available databases: Embase and PubMed according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses statement. All articles that reported the clinical use of a DBM-product in trauma and orthopaedic related surgery were included.Objectives
Methods
The aim of this study was to investigate the outcomes of Vancouver
type B2 and B3 fractures by performing a systematic review of the
methods of surgical treatment which have been reported. A systematic search was performed in Ovid MEDLINE, Embase and
the Cochrane Central Register of Controlled Trials. For inclusion,
studies required a minimum of ten patients with a Vancouver type
B2 and/or ten patients with a Vancouver type B3 fracture, a minimum
mean follow-up of two years and outcomes which were matched to the type
of fracture. Studies were also required to report the rate of re-operation
as an outcome measure. The protocol was registered in the PROSPERO
database. Aims
Materials and Methods
Our aim was to examine the clinical and radiographic outcomes
in 257 consecutive Oxford unicompartmental knee arthroplasties (OUKAs)
(238 patients), five years post-operatively. A retrospective evaluation was undertaken of patients treated
between April 2008 and October 2010 in a regional centre by two
non-designing surgeons with no previous experience of UKAs. The
Oxford Knee Scores (OKSs) were recorded and fluoroscopically aligned
radiographs were assessed post-operatively at one and five years.Aims
Patients and Methods
We assessed the difference in hospital based and early clinical
outcomes between the direct anterior approach and the posterior
approach in patients who undergo total hip arthroplasty (THA). The outcome was assessed in 448 (203 males, 245 females) consecutive
patients undergoing unilateral primary THA after the implementation
of an ‘Enhanced Recovery’ pathway. In all, 265 patients (mean age:
71 years (49 to 89); 117 males and 148 females) had surgery using
the direct anterior approach (DAA) and 183 patients (mean age: 70
years (26 to 100); 86 males and 97 females) using a posterior approach.
The groups were compared for age, gender, American Society of Anesthesiologists
grade, body mass index, the side of the operation, pre-operative
Oxford Hip Score (OHS) and attendance at ‘Joint school’. Mean follow-up
was 18.1 months (one to 50).Aims
Patients and Methods
Using a systematic review, we investigated whether there is an
increased risk of post-operative infection in patients who have
received an intra-articular corticosteroid injection to the hip
for osteoarthritis prior to total hip arthroplasty (THA). Studies dealing with an intra-articular corticosteroid injection
to the hip and infection following subsequent THA were identified
from databases for the period between 1990 to 2013. Retrieved articles
were independently assessed for their methodological quality.Aims
Methods
Computer hexapod assisted orthopaedic surgery (CHAOS), is a method
to achieve the intra-operative correction of long bone deformities
using a hexapod external fixator before definitive internal fixation
with minimally invasive stabilisation techniques. The aims of this study were to determine the reliability of this
method in a consecutive case series of patients undergoing femoral
deformity correction, with a minimum six-month follow-up, to assess
the complications and to define the ideal group of patients for
whom this treatment is appropriate. The medical records and radiographs of all patients who underwent
CHAOS for femoral deformity at our institution between 2005 and
2011 were retrospectively reviewed. Records were available for all
55 consecutive procedures undertaken in 49 patients with a mean
age of 35.6 years (10.9 to 75.3) at the time of surgery.Aims
Patients and Methods
Joint-preserving surgery of the hip (JPSH) has evolved considerably
and now includes a number of procedures, including arthroscopy,
surgical dislocation, and redirectional osteotomies of the femur
and acetabulum. There are a number of different factors which lead
to failure of JPSH. Consequently, it is of interest to assess the
various modes of failure in order to continue to identify best practice
and the indications for these procedures. Using a retrospective observational study design, we reviewed
1013 patients who had undergone JPSH by a single surgeon between
2005 and 2015. There were 509 men and 504 women with a mean age
of 39 years (16 to 78). Of the 1013 operations, 783 were arthroscopies,
122 surgical dislocations, and 108 peri-acetabular osteotomies (PAO).
We analysed the overall failure rates and modes of failure. Re-operations
were categorised into four groups: Mode 1 was arthritis progression
or organ failure leading to total hip arthroplasty (THA); Mode 2
was an Incorrect diagnosis/procedure; Mode 3 resulted from malcorrection
of femur (type A), acetabulum (type B), or labrum (type C) and Mode 4
resulted from an unintended consequence of the initial surgical
intervention.Aims
Patients and Methods
Nylon sutures and skin staples are used commonly in total knee arthroplasty (TKA) surgical wound closure. However, there is no study that compares the wound healing efficacy and patient satisfaction scores of both techniques in the same knee. We randomised 70 patients who underwent primary TKA into two groups. In one group of 34 patients, the skin at the upper half of the wound was closed with skin staples and the lower half of the wound was closed with simple interrupted nylon sutures. In the other group of 36 patients, the skin at the upper half of the wound was closed with nylon stitches and the lower half of the wound was closed with skin staples. We recorded the wound closure time, pain score at the time of stitch removal, wound complication rate, patient satisfaction score, and the Hollander wound evaluation score at the post-operative periods of five days, 14 days, six weeks, three months, and six months. Each half wound was analysed separately.Objectives
Methods
We present a case series of five patients who had revision surgery
following magnetic controlled growing rods (MGCR) for early onset
scoliosis. Metallosis was found during revision in four out of five
patients and we postulated a mechanism for rod failure based on
retrieval analysis. Retrieval analysis was performed on the seven explanted rods.
The mean duration of MCGR from implantation to revision was 35 months
(17 to 46). The mean age at revision was 12 years (7 to 15; four
boys, one girl).Aims
Patients and Methods
We performed a systematic review of the current literature regarding
the outcomes of unconstrained metacarpophalangeal joint (MCPJ) arthroplasty. We initially identified 1305 studies, and 406 were found to be
duplicates. After exclusion criteria were applied, seven studies
were included. Outcomes extracted included pre- and post-operative
pain visual analogue scores, range of movement (ROM), strength of
pinch and grip, satisfaction and patient reported outcome measures
(PROMs). Clinical and radiological complications were recorded.
The results are presented in three groups based on the design of
the arthroplasty and the aetiology (pyrocarbon-osteoarthritis (pyro-OA),
pyrocarbon-inflammatory arthritis (pyro-IA), metal-on-polyethylene
(MoP)).Aims
Materials and Methods
To compare radiographic failure and re-operation rates of anatomical
coracoclavicular (CC) ligament reconstructional techniques with
non-anatomical techniques after chronic high grade acromioclavicular
(AC) joint injuries. We reviewed chronic AC joint reconstructions within a region-wide
healthcare system to identify surgical technique, complications,
radiographic failure and re-operations. Procedures fell into four
categories: Aims
Patients and Methods
The aims of this study were to evaluate the clinical and radiological
outcomes of the Universal-2 total wrist arthroplasty (TWA) in patients
with rheumatoid arthritis. This was a retrospective review of all 95 Universal-2 TWAs which
were performed in our institution between 2003 to 2012 in patients
with rheumatoid arthritis. A total of six patients were lost to
follow-up and two died of unrelated causes. A total of ten patients
had bilateral procedures. Accordingly, 75 patients (85 TWAs) were
included in the study. There were 59 women and 16 men with a mean
age of 59 years (26 to 86). The mean follow-up was 53 months (24
to 120). Clinical assessment involved recording pain on a visual
analogue score, range of movement, grip strength, the Quick Disabilities
of the Arm, Shoulder and Hand (DASH) and Wrightington wrist scores.
Any adverse effects were documented with particular emphasis on
residual pain, limitation of movement, infection, dislocation and
the need for revision surgery. Radiographic assessment was performed pre-operatively and at
three, six and 12 months post-operatively, and annually thereafter.
Arthroplasties were assessed for distal row intercarpal fusion and
loosening. Radiolucent zones around the components were documented
according to a system developed at our institution.Aims
Patients and Methods
Extendible endoprostheses have been available for more than 30
years and have become more sophisticated with time. The latest generation
is ‘non-invasive’ and can be lengthened with an external magnetic
force. Early results have shown a worryingly high rate of complications
such as infection. This study investigates the incidence of complications
and the need for further surgery in a cohort of patients with a
non-invasive growing endoprosthesis. Between 2003 and June 2014, 50 children (51 prostheses) had a
non-invasive growing prosthesis implanted for a primary bone sarcoma.
The minimum follow-up was 24 months for those who survived. Their
mean age was 10.4 years (6 to 14). The incidence of complications
and further surgery was documented.Aims
Patients and Methods
In approximately 20% of patients with ankle fractures, there
is an concomitant injury to the syndesmosis which requires stabilisation,
usually with one or more syndesmotic screws. The aim of this review
is to evaluate whether removal of the syndesmotic screw is required
in order for the patient to obtain optimal functional recovery. A literature search was conducted in Medline, Embase and the
Cochrane Library for articles in which the syndesmotic screw was
retained. Articles describing both removal and retaining of syndesmotic
screws were included. Excluded were biomechanical studies, studies
not providing patient related outcome measures, case reports, studies
on skeletally immature patients and reviews. No restrictions regarding
year of publication and language were applied.Aims
Materials and Methods