The December 2015 Foot &
Ankle Roundup. 360 . looks at: The midfoot fusion bolt: has it had its day?; Ankle arthroplasty: only for the old?; A return to the Keller’s osteotomy for diabetic feet?;
To date, no study has demonstrated an improvement in postoperative outcomes following elective joint arthroplasty with a focus on nutritional intervention for patients with preoperative hypoalbuminaemia. In this prospective study, we evaluated differences in the hospital length of stay (LOS), rate of re-admission, and total patient charges for a malnourished patient study population who received a specific nutrition protocol before surgery. An analytical report was extracted from the electronic medical record (EMR; Epic, Verona, Wisconsin) of a five-hospital network joint arthroplasty patient data set between 2014 and 2017. A total of 4733 patients underwent joint arthroplasty and had preoperative measurement of albumin levels: 2220 at four hospitals and 2513 at the study hospital. Albumin ≤ 3.4 g/l, designated as malnutrition, was found in 543 patients (11.5%). A nutritional intervention programme focusing on a high-protein, anti-inflammatory diet was initiated in January 2017 at one study hospital. Hospital LOS, re-admission rate, and 90-day charges were compared for differential change between patients in study and control hospitals for all elective hip and knee arthroplasty patients, and for malnourished patients over time as the nutrition intervention was implemented.Aims
Patients and Methods
Dr J. Robert Close has been good enough to point out a misquotation from his article, "Some Applications of the Functional Anatomy of the Ankle Joint"(Journal of Bone and
Preclinical data showed poly(methyl methacrylate) (PMMA) loaded with microsilver to be effective against a variety of bacteria. The purpose of this study was to assess patient safety of PMMA spacers with microsilver in prosthetic hip infections in a prospective cohort study. A total of 12 patients with prosthetic hip infections were included for a three-stage revision procedure. All patients received either a gentamicin-PMMA spacer (80 g to 160 g PMMA depending on hip joint dimension) with additional loading of 1% (w/w) of microsilver (0.8 g to 1.6 g per spacer) at surgery 1 followed by a gentamicin-PMMA spacer without microsilver at surgery 2 or vice versa. Implantation of the revision prosthesis was carried out at surgery 3.Objectives
Methods
Aims. An evidence-based radiographic Decision Aid for meniscal-bearing
unicompartmental knee arthroplasty (UKA) has been developed and
this study investigates its performance at an independent centre. Patients and Methods. Pre-operative radiographs, including stress views, from a consecutive
cohort of 550 knees undergoing arthroplasty (UKA or total knee arthroplasty;
TKA) by a single-surgeon were assessed. Suitability for UKA was
determined using the Decision Aid, with the assessor blinded to
treatment received, and compared with actual treatment received, which
was determined by an experienced UKA surgeon based on history, examination,
radiographic assessment including stress radiographs, and intra-operative
assessment in line with the recommended indications as described
in the literature. Results. The sensitivity and specificity of the Decision Aid was 92% and
88%, respectively. Excluding knees where a clear pre-operative plan
was made to perform TKA, i.e. patient request, the sensitivity was
93% and specificity 96%. The false-positive rate was low (2.4%)
with all affected patients readily identifiable during
Although the importance of sound statistical principles in the design and analysis of data has gained prominence in recent years, biostatistics, the application of statistics to the analysis of biological and medical data, is still a subject which is poorly understood and often mishandled. This review introduces, in the context of orthopaedic research, the terminology and the principles involved in simple data analysis, and outlines areas of medical statistics that have gained prominence in recent years. It also lists and provides an insight into some of the more common errors that occur in published orthopaedic journals and which are frequently encountered at the review stage in papers submitted to the Journal of Bone and
As part of the government’s initiative to reduce waiting times for major
In this in vitro study of the
hip joint we examined which soft tissues act as primary and secondary
passive rotational restraints when the hip joint is functionally
loaded. A total of nine cadaveric left hips were mounted in a testing
rig that allowed the application of forces, torques and rotations
in all six degrees of freedom. The hip was rotated throughout a
complete range of movement (ROM) and the contributions of the iliofemoral
(medial and lateral arms), pubofemoral and ischiofemoral ligaments
and the ligamentum teres to rotational restraint was determined
by resecting a ligament and measuring the reduced torque required
to achieve the same angular position as before resection. The contribution
from the acetabular labrum was also measured. Each of the capsular
ligaments acted as the primary hip rotation restraint somewhere
within the complete ROM, and the ligamentum teres acted as a secondary
restraint in high flexion, adduction and external rotation. The
iliofemoral lateral arm and the ischiofemoral ligaments were primary
restraints in two-thirds of the positions tested. Appreciation of
the importance of these structures in preventing excessive hip rotation
and subsequent impingement/instability may be relevant for surgeons
undertaking both hip
1) Our attention has been called to an omission in the account sent to us of the May 1957 meeting of the South-West Orthopaedic Club held at Bath (Journal of Bone and
Intraoperative pulmonary fat and bone-marrow embolism is a serious complication of bone and
To validate the precision of digitally reconstructed radiograph (DRR) radiostereometric analysis (RSA) and the model-based method (MBM) RSA with respect to benchmark marker-based (MM) RSA for evaluation of kinematics in the native hip joint. Seven human cadaveric hemipelves were CT scanned and bone models were segmented. Tantalum beads were placed in the pelvis and proximal femoral bone. RSA recordings of the hips were performed during flexion, adduction and internal rotation. Stereoradiographic recordings were all analyzed with DRR, MBM and MM. Migration results for the MBM and DRR with respect to MM were compared. Precision was assessed as systematic bias (mean difference) and random variation (Pitman’s test for equal variance).Objectives
Methods
We reviewed all 717 manuscripts published in the 1997 issues of the British and American volumes of the Journal of Bone and