Patients from a randomised trial on resurfacing
hip arthroplasty (RHA) (n = 36, 19 males; median age 57 years, 24
to 65) comparing a conventional 28 mm metal-on-metal total hip arthroplasty
(MoM THA) (n = 28, 17 males; median age 59 years, 37 to 65) and
a matched control group of asymptomatic patients with a 32 mm ceramic-on-polyethylene
(CoP) THA (n = 33, 18 males; median age 63 years, 38 to 71) were
cross-sectionally screened with metal artefact reducing sequence-MRI
(MARS-MRI) for pseudotumour formation at a median of 55 months (23
to 72) post-operatively. MRIs were scored by consensus according
to three different classification systems for pseudotumour formation. . Clinical scores were available for all patients and metal ion
levels for MoM bearing patients. . Periprosthetic lesions with a median volume of 16 mL (1.5 to
35.9) were diagnosed in six patients in the RHA group (17%), one
in the MoM THA group (4%) and six in the CoP group (18%). The classification
systems revealed no clear differences between the groups. Solid
lesions (n = 3) were exclusively encountered in the RHA group. Two patients
in the RHA group and one in the MoM THA group underwent a revision
for pseudotumour formation. There was no statistically significant
relationship between clinical scoring, metal ion levels and periprosthetic
lesions in any of the groups. . Periprosthetic fluid collections are seen on MARS-MRI after conventional
CoP THA and RHA and may reflect a soft-tissue collection or effusion. . Currently available MRI classification systems seem to score
these collections as pseudotumours, causing an-overestimatation
of the
1. Recently described histological and radiographic methods of diagnosing osteoporosis have been applied to patients with transcervical and intertrochanteric fractures of the femur. 2. Both methods indicate a higher
We report the
Between March 1969 and May 1978, 36 babies sustained birth injuries of the brachial plexus at the National Women's Hospital, Auckland, New Zealand. This gives an
In a prospective study of 295 male Israeli military recruits a 31%
Injuries to the tarsometatarsal (Lisfranc) joint are not common, and the results of treatment are often unsatisfactory. Since no individual is likely to see many such injuries, we decided to make a retrospective study of patients from five different centres. In this way 119 patients with injuries of the Lisfranc joint have been collected. This paper classifies these injuries and describes their
We examined the
The patellar clunk syndrome describes painful catching, grinding or jumping of the patella when the knee moves from a flexed to an extended position after total knee replacement (TKR). The posterior stabilised TKR had been noted to have a higher
In a prospective five-year study, 294 episodes of acute transient synovitis of the hip were diagnosed in 275 children. The average annual
We report a prospective single-blind controlled
study of the
Spinal injury at more than one level is not uncommon. Awareness of multilevel injury of the spine and associated neurological patterns is important for the proper initial management of the patient. This study presents the
We have studied the natural history of spontaneous dislocation of the hip in cerebral palsy, with particular reference to the pattern of neurological involvement. In patients with bilateral hemiplegia and severe involvement of the upper limbs the
Opinion varies as to the
The
A consecutive series of 100 cases of wrist injury, other than those referred with a radial fracture, have been reviewed to determine the
In a consecutive series of 124 children with spina bifida we found that 220 (89%) of the 248 feet were deformed: 70 had a calcaneus deformity; 126 were in equinus; 16 were in valgus; 3 were in varus; and 5 had convex pes valgus. Operations were performed on 171 (78%) of the deformed feet. Spasticity of the muscles controlling the foot was detected in 36 (51%) of the 70 calcaneus feet and in 22 (17%) of the 126 equinus feet. The deformities were symmetrical in 94 children. There is a high
Since the introduction of the National Institute
for Health and Care Excellence (NICE) guidelines on thromboprophylaxis
and the use of extended thromboprophylaxis with new oral agents,
there have been reports of complications arising as a result of
their use. We have looked at the
We used MRI to study a prospective series of 95 patients with inversion injuries of the ankle and no fracture on plain radiographs. We found an
We have evaluated prospectively the
There are many reports concerning the aetiology and prophylaxis of deep-vein thrombosis (DVT) but little is known about its natural history. The purpose of our study was to identify the