Fifty-three failed
The stabilised gliding knee prosthesis is a compromise between hinged joints and condylar prostheses. It is a two-piece implant designed to allow normal gliding movements of flexion and extension and which, stabilised by a connecting rod between the femoral and tibial components, allows a designed laxity of rotation and lateral movements. A modification of the original femoral component is described. Two hundred and forty-five
Clinical experience of impaction bone grafting for revision
We recruited 89 patients who had hip or
A biomechanical study has been carried out on 20 cadaveric knees to investigate their load-absorbing mechanism. The impact load was applied using a weight falling onto the transected proximal femur and the force transmitted through the knee was measured at the transected distal tibia using a load transducer. The peak force transmitted increased as, sequentially, meniscus, articular cartilage and subchondral bone were damaged or removed. The most striking result was found in an implanted
Osteoarthritis of the medial compartment of the knee often shows a specific pattern of anterior wear. Review of our revisions from a series of medial metal-backed Brigham unicondylar
We analysed the serum C-reactive protein level, synovial fluid obtained by joint aspiration and five synovial biopsies from 145
Adductor canal block (ACB) has emerged as an alternative to femoral nerve block (FNB) for analgesia after total knee arthroplasty (TKA). The optimal duration of maintenance of the ACB is still questionable. The purpose of this study was to compare the analgesic benefits and physiotherapy (PT) outcomes of single-shot ACB to two different regimens of infusion of the continuous ACB, 24-hour and 48-hour infusion. This was a prospective, randomized, unblinded study. A total of 159 American Society of Anesthesiologists (ASA) physical status I to III patients scheduled for primary TKA were randomized to one of three study groups. Three patients did not complete the study, leaving 156 patients for final analysis. Group A (n = 53) was the single-shot group (16 female patients and 37 male patients with a mean age of 63.9 years (Aims
Patients and Methods
Fat embolism occurs following fractures of a long bone or arthroplasty. We investigated whether paradoxical embolisation through a venous-to-arterial circulation shunt (v-a) could lead to cerebral embolisation during elective hip or
Decreasing proprioception of the knee is multifactorial and is a function of age and degenerative joint disease. Soft-tissue release during total knee replacement may have an influence. We have quantified soft-tissue imbalance at the time of
Postoperative deep-vein thrombosis (DVT) is believed to be rare in Asians. We studied 88 consecutive patients in Malaysia who had operations for fracture of the proximal femur or for total hip or
We have investigated those factors which influence the range of movement after total knee arthroplasty, including sex, age, preoperative diagnosis and preoperative flexion deformity and flexion range. We also compared cemented and cementless tibial fixation, the influence of collateral ligament and lateral parapatellar releases and of replacement of the patella, and of the period of postoperative immobilisation. We reviewed 516 Johnson-Elloy (Accord)
We have studied 27 tibial prostheses retrieved from
We reviewed 40 cementless Porous Coated Anatomic
We performed a prospective, randomised study comparing the rates of glove perforation using double latex gloving with or without a disposable protective glove liner (Paraderm) on 118 patients undergoing primary or revision arthroplasty of the hip or knee by one surgeon (FRH). The patients were randomly allocated into two groups: in group 1 an inner and outer pair of latex gloves were worn as double gloves and in group 2 the glove liner was worn between the two latex gloves. There was glove perforation in at least one outer glove in 99 operations (84%). The operating surgeon was aware of the perforation in 21 of these. There were 22 perforations of the inner glove. Group 1 had a significantly higher perforation rate per operation (p <
0.05) than group 2. Our findings show that protective glove liners significantly reduce the rate of perforation of the inner glove during hip and
One hundred and three sequential Stanmore
Despite the use of ultraclean air, there are still cases of infection in total joint arthroplasty. One possible route by which bacteria may enter the wound is indirectly by contamination of instruments during skin preparation and draping. We found that bacterial air counts were 4.4 times higher during preparation and draping for hip or
All surgical operations have the potential for contamination, and the equipment used can harbour bacteria. We collected samples from 100 elective primary hip and