We investigated whether strontium-enriched calcium
phosphate cement (Sr-CPC)-treated soft-tissue tendon graft results
in accelerated healing within the bone tunnel in reconstruction
of the anterior cruciate ligament (ACL). A total of 30 single-bundle
ACL reconstructions using tendo Achillis allograft were performed
in 15 rabbits. The graft on the tested limb was treated with Sr-CPC,
whereas that on the contralateral limb was untreated and served
as a control. At timepoints three, six, nine, 12 and 24 weeks after
surgery, three animals were killed for histological examination.
At six weeks, the graft–bone interface in the control group was
filled in with fibrovascular tissue. However, the gap in the Sr-CPC
group had already been completely filled in with new bone, and there
was evidence of the early formation of Sharpey fibres. At 24 weeks,
remodelling into a normal ACL–bone-like insertion was found in the
Sr-CPC group. Coating of Sr-CPC on soft tissue tendon allograft
leads to accelerated graft healing within the bone tunnel in a rabbit
model of ACL reconstruction using
We treated 63 club feet in 44 patients by a defined programme of strapping from birth followed by one of two operations performed at six weeks, either a simple
Spasm or contracture of the gastrocnemius muscle is predominantly responsible for the equinus deformity of the foot in cerebral palsy. Its release is therefore logical in the treatment of all cases which do not respond to conservative measures. The authors have demonstrated, by the use of metal markers and radiographic control at operation, that adequate release cannot be achieved by severance of the
The aim of this study was to gain an agreement on the management of idiopathic congenital talipes equinovarus (CTEV) up to walking age in order to provide a benchmark for practitioners and guide consistent, high-quality care for children with CTEV. The consensus process followed an established Delphi approach with a predetermined degree of agreement. The process included the following steps: establishing a steering group; steering group meetings, generating statements, and checking them against the literature; a two-round Delphi survey; and final consensus meeting. The steering group members and Delphi survey participants were all British Society of Children’s Orthopaedic Surgery (BSCOS) members. Descriptive statistics were used for analysis of the Delphi survey results. The Appraisal of Guidelines for Research & Evaluation checklist was followed for reporting of the results.Aims
Methods
This is a prospective analysis on 30 physically
active individuals with a mean age of 48.9 years (35 to 64) with chronic
insertional tendinopathy of the tendo Achillis. Using a transverse
incision, the tendon was debrided and an osteotomy of the posterosuperior
corner of the calcaneus was performed in all patients. At a minimum
post-operative follow-up of three years, the Victorian Institute
of Sports Assessment scale –
No randomized comparative study has compared the extensile lateral approach (ELA) and sinus tarsi approach (STA) for Sanders type 2 calcaneal fractures. This randomized comparative study was conducted to confirm whether the STA was prone to fewer wound complications than the ELA. Between August 2013 and August 2018, 64 patients with Sanders type 2 calcaneus fractures were randomly assigned to receive surgical treatment by the ELA (32 patients) and STA (32 patients). The primary outcome was development of wound complications. The secondary outcomes were postoperative complications, pain scored of a visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, 36-item Short Form health survey, operative duration, subtalar joint range of motion (ROM), Böhler’s angle and calcaneal width, and posterior facet reduction.Aims
Methods
The aim of this study was to prepare a scoping review to investigate the use of biologic therapies in the treatment of musculoskeletal injuries in professional and Olympic athletes. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews and Arksey and O’Malley frameworks were followed. A three-step search strategy identified relevant published primary and secondary studies, as well as grey literature. The identified studies were screened with criteria for inclusion comprising clinical studies evaluating the use of biologic therapies in professional and Olympic athletes, systematic reviews, consensus statements, and conference proceedings. Data were extracted using a standardized tool to form a descriptive analysis and a thematic summary.Aims
Methods
In our unit, we adopt a two-stage surgical reconstruction approach using internal fixation for the management of infected Charcot foot deformity. We evaluate our experience with this functional limb salvage method. We conducted a retrospective analysis of prospectively collected data of all patients with infected Charcot foot deformity who underwent two-stage reconstruction with internal fixation between July 2011 and November 2019, with a minimum of 12 months’ follow-up.Aims
Methods
Arthroplasty has become increasingly popular to treat end-stage ankle arthritis. Iatrogenic posterior neurovascular and tendinous injury have been described from saw cuts. However, it is hypothesized that posterior ankle structures could be damaged by inserting tibial guide pins too deeply and be a potential cause of residual hindfoot pain. The preparation steps for ankle arthroplasty were performed using the Infinity total ankle system in five right-sided cadaveric ankles. All tibial guide pins were intentionally inserted past the posterior tibial cortex for assessment. All posterior ankles were subsequently dissected, with the primary endpoint being the presence of direct contact between the structure and pin.Aims
Methods
To assess the characteristic clinical features, management, and outcome of patients who present to orthopaedic surgeons with functional dystonia affecting the foot and ankle. We carried out a retrospective search of our records from 2000 to 2019 of patients seen in our adult tertiary referral foot and ankle unit with a diagnosis of functional dystonia.Aims
Methods
Disruption of the extensor mechanism in total
knee arthroplasty may occur by tubercle avulsion, patellar or quadriceps
tendon rupture, or patella fracture, and whether occurring intra-operatively
or post-operatively can be difficult to manage and is associated
with a significant rate of failure and associated complications.
This surgery is frequently performed in compromised tissues, and
repairs must frequently be protected with cerclage wiring and/or
augmentation with local tendon (semi-tendinosis, gracilis) which
may also be used to treat soft-tissue loss in the face of chronic
disruption. Quadriceps rupture may be treated with conservative
therapy if the patient retains active extension. Component loosening
or loss of active extension of 20° or greater are clear indications
for surgical treatment of patellar fracture. Acute patellar tendon
disruption may be treated by primary repair. Chronic extensor failure
is often complicated by tissue loss and retraction can be treated
with medial gastrocnemius flaps,
The study was undertaken to compare the efficacy of Woodcast splints and plaster-of-Paris casts in maintaining correction following sequential manipulation of idiopathic clubfeet. In this randomized prospective trial, 23 idiopathic clubfeet were immobilized with plaster-of-Paris casts and 23 clubfeet were immobilized with a splint made of Woodcast that encircled only two-thirds the circumference of the limb. The number of casts or splints needed to obtain full correction, the frequency of cast or splint-related complications, and the time taken for application and removal of the casts and splints were compared.Aims
Methods
High-grade dysplastic spondylolisthesis is a disabling disorder for which many different operative techniques have been described. The aim of this study is to evaluate Scoliosis Research Society 22-item (SRS-22r) scores, global balance, and regional spino-pelvic alignment from two to 25 years after surgery for high-grade dysplastic spondylolisthesis using an all-posterior partial reduction, transfixation technique. SRS-22r and full-spine lateral radiographs were collected for the 28 young patients (age 13.4 years (SD 2.6) who underwent surgery for high-grade dysplastic spondylolisthesis in our centre (Scottish National Spinal Deformity Service) between 1995 and 2018. The mean follow-up was nine years (2 to 25), and one patient was lost to follow-up. The standard surgical technique was an all-posterior, partial reduction, and S1 to L5 transfixation screw technique without direct decompression. Parameters for segmental (slip percentage, Dubousset’s lumbosacral angle) and regional alignment (pelvic tilt, sacral slope, L5 incidence, lumbar lordosis, and thoracic kyphosis) and global balance (T1 spino-pelvic inclination) were measured. SRS-22r scores were compared between patients with a balanced and unbalanced pelvis at final follow-up.Aims
Methods