We describe 88 knees (79 patients) with lateral unicompartmental osteoarthritis which had been treated by the St Georg Sled prosthesis. At a mean follow-up of nine years (2 to 21) 15 knees had revision surgery, nine for progression of
We analysed the histological findings in 1146 osteoarthritic femoral heads which would have been considered suitable for bone-bank donation to determine whether pathological lesions, other than osteoarthritis, were present. We found that 91 femoral heads (8%) showed evidence of disease. The most common conditions noted were chondrocalcinosis (63 cases), avascular necrosis (13), osteomas (6) and malignant tumours (one case of low-grade chondrosarcoma and two of well-differentiated lymphocytic lymphoma). There were two with metabolic bone disease (Paget’s disease and hyperparathyroid bone disease) and four with inflammatory (rheumatoid-like)
We have reviewed six patients with old tuberculosis of the knee treated by total replacement an average of 35 years after the primary infection. Three patients had no antituberculous prophylaxis and three had drugs for two to three weeks before and three weeks after the operation. One patient with a missed primary diagnosis had a relapse of the tuberculous
Radiostereometric analysis (RSA) studies of vitamin E-doped, highly crosslinked polyethylene (VEPE) liners show low head penetration rates in cementless acetabular components. There is, however, currently no data on cemented VEPE acetabular components in total hip arthroplasty (THA). The aim of this study was to evaluate the safety of a new cemented VEPE component, compared with a conventional polyethylene (PE) component regarding migration, head penetration, and clinical results. We enrolled 42 patients (21 male, 21 female) with osteoarthritis and a mean age of 67 years (Aims
Patients and Methods
Thirty-two dysplastic hips with secondary osteoarthritis, in 28 patients aged 18 to 42 years, were treated by combined intertrochanteric and Chiari osteotomy. They were followed up for 2.5 to 10 years. Pain was the main presenting symptom in all the patients. The indication for surgery was based on the severity of disease with respect to congruency, secondary degenerative change and degree of dysplasia. The average pre-operative Harris hip score was 47.7 and the majority had severe dysplasia with degenerative changes. On final review the average score was 88. The radiographic appearances of degenerative
Little is known about the tissue reactions to various implant materials which coincide with an inflammatory reaction. We used the avridine
1. Correction of hallux valgus by spike osteotomy of the neck of the first metatarsal is described, and the results in eighty-two feet are presented. 2. A high proportion of satisfactory results can be obtained, but great care is needed in both selection and technique. 3. The ideal case is one of moderate deformity, without degenerative
We reviewed 24 feet in 15 patients who had undergone talectomy for recurrent equinovarus deformity; 21 were associated with arthrogryposis multiplex congenita, two with myelomeningocele and one with idiopathic congenital talipes equinovarus. The mean follow-up was 20 years. Good results were achieved in eight feet (33%) in which further surgery was not needed and walking was painless; a fair result was obtained in ten feet (42%) in which further surgery for recurrence of a hindfoot deformity had been necessary but walking was painless; the remaining six feet (25%) were poor, with pain on walking. All patients wore normal shoes and could walk independently, except one who was wheelchair-bound because of other joint problems. Recurrent deformity, the development of tibiocalcaneal
Thirteen patients suffering from rheumatoid arthritis had 19 stress fractures of the tibia or fibula. These patients characteristically presented with sudden, severe, unexplained pain with localised tenderness just below the knee or above the ankle. In seven patients examination of the adjacent joint indicated a flare-up of disease activity or a pyogenic
1. Rusty staining of the synovial membrane is the gross manifestation of loading of phagocytic synovial-lining cells and of macrophages in the stratum synoviale with haemosiderin. 2. Absorption of blood effused into the joint cavities is the commonest cause of such synovial pigmentation. 3. Obvious discolouration of the synovial tissues usually follows only after repeated haemarthroses, in such conditions as haemophilia, synovial tumour and in some cases of chronic rheumatoid arthritis. 4. An identical naked-eye appearance is seen in multiple joints of patients with generalised haemochromatosis. 5. In haemochromatosis the iron-containing pigment tends to be confined to the surface layer of cells of the synovial membrane. 6. The presence of haemosiderin in synovial cells, per se, leads to no disability of the joint and is unaccompanied either by inflammatory reaction or fibrosis.
Conventional high tibial osteotomy for osteoarthritis of the medial compartment of the knee with closed-wedge or dome osteotomy (DMO) may produce shortening of the patellar tendon and loss of inclination of the proximal tibial plateau or of the offset of the tibial condyle relative to its bony axis. This can make subsequent total knee arthroplasty technically demanding. We undertook a prospective study comparing these changes after DMO with those after using open-wedge osteotomy hemicallotasis (HCO). A total of 50 knees with
We have examined the effect of the Wagner spherical acetabular osteotomy on preserving the joint in 38 hips with a mean follow-up of 17 years. At the time of the initial operation, 55% of patients had clinical symptoms and 30 joints showed minimal or absent radiological signs of osteoarthritis. At follow-up, 54% of patients had a good functional result. The osteotomy improved the mean centre-edge angle from −3° to +15°, the mean anterior centre-edge angle to 23° and the acetabular head index to 75%. The obliquity of the acetabular roof decreased from 28° to 16°. One patient improved, but 14 deteriorated with joint degeneration. Of these, one progressed because of postoperative deep-tissue infection and five due to undercorrection. One patient needed total joint replacement after 14 years. At 17 years after operation, Wagner osteotomy had prevented progression of secondary
We present a prospective review of the outcome of 76 Lubinus patellofemoral arthroplasties carried out in 59 patients between 1989 and 1995. At a mean follow-up of 7.5 years, 62 knees in the 48 patients were reviewed; 11 patients (14 knees) had died. None was lost to follow-up. The clinical outcome using the Bristol Knee Scoring system was satisfactory in 45% of the cases. Maltracking of the patella, resulting in lateral tilt, subluxation and polyethylene wear, was the most common complication (32%). Revision surgery was carried out in 21 knees (28%) giving a cumulative survival rate of 65% (confidence interval (CI) 49 to 77) at eight years. The survival rate for revision and moderate pain was 48% (CI 36 to 59) at six years. Progression of
We compared implant and patient survival following intraoperative periprosthetic femoral fractures (IOPFFs) during primary total hip arthroplasty (THA) with matched controls. This retrospective cohort study compared 4831 hips with IOPFF and 48 154 propensity score matched primary THAs without IOPFF implanted between 2004 and 2016, which had been recorded on a national joint registry. Implant and patient survival rates were compared between groups using Cox regression.Aims
Patients and Methods
Two distinct lesions affect the articular cartilage of the patella. Surface degeneration occurs particularly on the odd facet; it is age dependent, often present in youth and it becomes more frequent with increasing age. It probably does not occasion patello-femoral pain in youth, but may predispose to degenerative
One hundred cases of Lambrinudi's arthrodesis are reviewed. The shortest follow-up was one year. and the longest twenty-seven years. Thirty-seven per cent were successful. Nineteen per cent were failures; many of these were associated with faulty technique, and one method of operation which gives good results is described. Success is likely if there is a balance of power between the dorsiflexors and plantarflexors of the ankle, especially if there is some fixed equinus before operation. Success is less likely when the operation is done for a flail foot. In such circumstances arthrodesis of the ankle may have to be considered subsequently for instability of the lateral ligament, recurrence of dropfoot, or
1. Recent published reports of neonatal osteomyelitis in long bones are reviewed. 2. Six further cases are described. 3. The source of infection is usually the skin or the umbilicus, and the common organisms are the haemolytic streptococcus and staphylococcus aureus. 4. Cases fall into two groups: in one the patient is acutely ill with septicaemia and the bone lesion is of secondary importance; in the other the general condition is well maintained even though there may be multiple bone lesions. 5. Sequestration is uncommon; but when it occurs it prevents the rapid healing that is usually observed after drainage. 6. The most important complication is suppurative
1. A method of denervating the elbow joint, based upon observations on the articular branches of the main nerve trunks, is presented. 2. In a small group of cases with post-traumatic