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The Bone & Joint Journal
Vol. 99-B, Issue 11 | Pages 1533 - 1536
1 Nov 2017
Nie K Rymaruk S Paton RW

Aims

A clicky hip is a common referral for clinical and sonographic screening for developmental dysplasia of the hip (DDH). There is controversy regarding whether it represents a true risk factor for pathological DDH. Therefore a 20-year prospective, longitudinal, observational study was undertaken to assess the relationship between the presence of a neonatal clicky hip and pathological DDH.

Patients and Methods

A total of 362 infants from 1997 to 2016 were referred with clicky hips to our ‘one-stop’ paediatric hip screening clinic. Hips were assessed clinically for instability and by ultrasound imaging using a simplified Graf/Harcke classification. Dislocated or dislocatable hips were classified as Graf Type IV hips.


Bone & Joint 360
Vol. 6, Issue 6 | Pages 25 - 28
1 Dec 2017


The Bone & Joint Journal
Vol. 99-B, Issue 11 | Pages 1515 - 1519
1 Nov 2017
Saltzman BM Mayo BC Bohl DD Frank RM Cole BJ Verma NN Nicholson GP Romeo AA

Aims

To determine the incidence and timing of post-operative fevers following shoulder arthroplasty and the resulting investigations performed.

Patients and Methods

A retrospective review was conducted of all patients undergoing shoulder arthroplasty over a nine-year period. The charts of all patients with a post-operative fever (≥ 38.6°C) were reviewed and the results of all investigations were analysed.


Bone & Joint 360
Vol. 6, Issue 5 | Pages 21 - 24
1 Oct 2017


Bone & Joint 360
Vol. 6, Issue 5 | Pages 30 - 33
1 Oct 2017


The Bone & Joint Journal
Vol. 98-B, Issue 12 | Pages 1604 - 1610
1 Dec 2016
Callary SA Field JR Campbell DG

Aims

The increased in vivo resistance to wear of highly crosslinked polyethylene (HXLPE) in total hip arthroplasty (THA) has led to an increased use of larger articulations which have been shown to reduce the incidence of early dislocation. To date, there are few reports of the wear of larger articulations using second generation HXLPE liners. Our prospective cohort study measured the bedding-in and early wear of large (36 mm and 40 mm diameter) articulations involving a second generation X3 HXLPE liner and compared our findings with previous clinical and in vitro studies of the same material.

Patients and Methods

The proximal penetration of the femoral head five years post-operatively was measured for 15 patients using radiostereometric analysis (RSA).


The Bone & Joint Journal
Vol. 99-B, Issue 4 | Pages 451 - 457
1 Apr 2017
Gromov K Bersang A Nielsen CS Kallemose T Husted H Troelsen A

Aims

The aim of this study was to identify patient- and surgery-related risk factors for sustaining an early periprosthetic fracture following primary total hip arthroplasty (THA) performed using a double-tapered cementless femoral component (Bi-Metric femoral stem; Biomet Inc., Warsaw, Indiana).

Patients and Methods

A total of 1598 consecutive hips, in 1441 patients receiving primary THA between January 2010 and June 2015, were retrospectively identified. Level of pre-operative osteoarthritis, femoral Dorr type and cortical index were recorded. Varus/valgus placement of the stem and canal fill ratio were recorded post-operatively. Periprosthetic fractures were identified and classified according to the Vancouver classification. Regression analysis was performed to identify risk factors for early periprosthetic fracture.


The Bone & Joint Journal
Vol. 99-B, Issue 5 | Pages 592 - 600
1 May 2017
Matharu GS Nandra RS Berryman F Judge A Pynsent PB Dunlop DJ

Aims

To determine ten-year failure rates following 36 mm metal-on-metal (MoM) Pinnacle total hip arthroplasty (THA), and identify predictors of failure.

Patients and Methods

We retrospectively assessed a single-centre cohort of 569 primary 36 mm MoM Pinnacle THAs (all Corail stems) followed up since 2012 according to Medicines and Healthcare Products Regulation Agency recommendations. All-cause failure rates (all-cause revision, and non-revised cross-sectional imaging failures) were calculated, with predictors for failure identified using multivariable Cox regression.


Bone & Joint 360
Vol. 6, Issue 5 | Pages 16 - 18
1 Oct 2017


The Bone & Joint Journal
Vol. 99-B, Issue 11 | Pages 1458 - 1466
1 Nov 2017
Tsang SJ Ting J Simpson AHRW Gaston P

Aims

The aims of the study were to review and analyse the reported series of debridement, antibiotics and implant retention (DAIR) in the management of infected total hip arthroplasties (THAs) to establish the overall success and the influencing factors.

Patients and methods

Using a standardised recognised study protocol, meta-analysis of observational studies in epidemiology guidelines, a comprehensive review and analysis of the literature was performed. The primary outcome measure was the success of treatment. The search strategy and inclusion criteria which involved an assessment of quality yielded 39 articles for analysis, which included 1296 patients.


Bone & Joint 360
Vol. 6, Issue 5 | Pages 12 - 16
1 Oct 2017


The Bone & Joint Journal
Vol. 99-B, Issue 12 | Pages 1618 - 1628
1 Dec 2017
Hunt LP Blom A Wilkinson JM

Aims

To investigate whether elective joint arthroplasty performed at the weekend is associated with a different 30-day mortality versus that performed between Monday and Friday.

Patients and Methods

We examined the 30-day cumulative mortality rate (Kaplan-Meier) for all elective hip and knee arthroplasties performed in England and Wales between 1st April 2003 and 31st December 2014, comprising 118 096 episodes undertaken at the weekend and 1 233 882 episodes performed on a weekday. We used Cox proportional-hazards regression models to assess for time-dependent variation and adjusted for identified risk factors for mortality.


Bone & Joint 360
Vol. 6, Issue 4 | Pages 34 - 37
1 Aug 2017


The Bone & Joint Journal
Vol. 99-B, Issue 12 | Pages 1665 - 1676
1 Dec 2017
Stinton SB Graham PL Moloney NA Maclachlan LR Edgar DW Pappas E

Aims

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.

Materials and Methods

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.


The Bone & Joint Journal
Vol. 99-B, Issue 2 | Pages 255 - 260
1 Feb 2017
Macke C Winkelmann M Mommsen P Probst C Zelle B Krettek C Zeckey C

Aims

To analyse the influence of upper extremity trauma on the long-term outcome of polytraumatised patients.

Patients and Methods

A total of 629 multiply injured patients were included in a follow-up study at least ten years after injury (mean age 26.5 years, standard deviation 12.4). The extent of the patients’ injury was classified using the Injury Severity Score. Outcome was measured using the Hannover Score for Polytrauma Outcome (HASPOC), Short Form (SF)-12, rehabilitation duration, and employment status. Outcomes for patients with and without a fracture of the upper extremity were compared and analysed with regard to specific fracture regions and any additional brachial plexus lesion.


Bone & Joint 360
Vol. 6, Issue 4 | Pages 25 - 29
1 Aug 2017


Bone & Joint 360
Vol. 6, Issue 4 | Pages 20 - 22
1 Aug 2017


The Bone & Joint Journal
Vol. 99-B, Issue 1 | Pages 100 - 106
1 Jan 2017
Aujla RS Sheikh N Divall P Bhowal B Dias JJ

Aims

We performed a systematic review of the current literature regarding the outcomes of unconstrained metacarpophalangeal joint (MCPJ) arthroplasty.

Materials and Methods

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)).


Bone & Joint 360
Vol. 6, Issue 4 | Pages 23 - 25
1 Aug 2017


The Bone & Joint Journal
Vol. 99-B, Issue 9 | Pages 1216 - 1222
1 Sep 2017
Fu MC Boddapati V Gausden EB Samuel AM Russell LA Lane JM

Aims

We aimed to characterise the effect of expeditious hip fracture surgery in elderly patients within 24 hours of admission on short-term post-operative outcomes.

Patients and Methods

Patients age 65 or older that underwent surgery for closed femoral neck and intertrochanteric hip fractures were identified from the American College of Surgeons National Surgical Quality Improvement Program between 2011 and 2014. Multivariable propensity-adjusted logistic regressions were performed to determine associations between early surgery within 24 hours and post-operative complications, controlling for selection bias in patients undergoing early surgery based on observable characteristics.