1. Details of clinical, radiological, biochemical and histological investigations of a case of metaphysial dysostosis are presented. 2. The patient was a boy of seven years, and showed widespread
We reviewed 44 patients with 44 full-thickness rotator-cuff tears at an average of 4.2 years after arthroscopically-assisted repair. There were 25 women and 19 men aged between 35 and 76 years (average 58); 35% of the shoulders had other intra-articular
We studied arthroscopically the meniscal pathology in 100 patients with functional instability of the knee from isolated rupture of the anterior cruciate ligament at an average time of three years after injury. Meniscal tears were observed in 86 patients and multiple
We report 13 patients with missed bilateral facet dislocation of the lower cervical spine who subsequently developed severe spinal-cord involvement. There were more women and the patients were older than in most groups with spinal injury. The commonest cause was a fall, and paralysis appeared from six to 48 hours after injury in most patients. Ten patients made some recovery after late reduction but three remained totally paralysed. We discuss the pathogenesis of the late cord
Between 1976 and 1988, 50 primary total knee arthroplasties were performed on 34 patients with psoriasis vulgaris. The skin
In 28 patients with a solitary diagnosis of instability of the trapeziometacarpal joint because of a rupture of the anterior oblique ligament, reconstruction was carried out using a slip of the tendon of flexor carpi radialis. We were able to review 26 patients. The results after a follow-up of four years seven months showed that most (87%) had significant relief from pain and symptoms. Seventeen were graded as good to excellent. The mean grip strength recovered to 86% of the contralateral side. Most patients (81%) felt that they had subjective improvement and would have undergone the operation again. A lesser functional result was seen in those who developed a flexion deformity because of overtightening of the reconstruction. Increased awareness of this
We report seven cases of patients with seropositive rheumatoid arthritis in whom involvement of the thoracic and lumbar vertebrae occurred. Histological corroboration is presented in four. Pathological
We used high-resolution ultrasonography to image the ulnar collateral ligament in 39 patients who had sustained recent injuries of the metacarpophalangeal joint of the thumb. All the patients were subsequently operated on and the
Two cases of bilateral slipping of the upper femoral epiphysis in boys with end-stage renal failure due to megacystis and mega-ureter with severe renal osteodystrophy are reported. In one patient the
1. One hundred patients with osteochondritis dissecans of the knee have been reviewed. Sixty-eight were male. Unilateral
1. Monostotic fibrous dysplasia in the long bones occurs most frequently in adolescence. In the jaws it is found mainly in early adult life. It presents later in the ribs, probably because it is often asymptomatic in this site. 2. The disease is equally distributed in both sexes. 3. Reactivation may occasionally occur in later life and in pregnancy. 4. Successful surgical treatment is by no means always easily achieved, and requires, in addition to the problems of fracture fixation and the correction of deformity, careful consideration of the age of the patient, the activity of the
1. It is suggested that slow recovery and post-operative effusion after meniscectomy may often be due to "scar friction" when the incision in the synovial membrane is in contact with the non-articular surface of the femoral condyle. 2. The advantages of a horizontal incision are discussed, particularly with regard to early recovery. 3. The results of one hundred and three cases of meniscectomy are analysed. An attempt to trace the cause of incompletely successful results in 25 per cent. of cases failed to show any relation to minor coincident
A prospective single-cohort study was designed to include 20 patients with enchondromas but was stopped because of poor early results. Four patients with an enchondroma, three in the proximal humerus and one in the distal femur, were treated by curettage and filling of the defect with Norian SRS cement. Clinical and radiological follow-up including CT and MRI was carried out for 18 months. All three patients with
What represents clinically significant acetabular undercoverage
in patients with symptomatic cam-type femoroacetabular impingement
(FAI) remains controversial. The aim of this study was to examine
the influence of the degree of acetabular coverage on the functional
outcome of patients treated arthroscopically for cam-type FAI. Between October 2005 and June 2016, 88 patients (97 hips) underwent
arthroscopic cam resection and concomitant labral debridement and/or
refixation. There were 57 male and 31 female patients with a mean
age of 31.0 years (17.0 to 48.5) and a mean body mass index (BMI)
of 25.4 kg/m2 (18.9 to 34.9). We used the Hip2Norm, an
object-oriented-platform program, to perform 3D analysis of hip
joint morphology using 2D anteroposterior pelvic radiographs. The lateral
centre-edge angle, anterior coverage, posterior coverage, total
femoral coverage, and alpha angle were measured for each hip. The
presence or absence of crossover sign, posterior wall sign, and
the value of acetabular retroversion index were identified automatically
by Hip2Norm. Patient-reported outcome scores were collected preoperatively
and at final follow-up with the Hip Disability and Osteoarthritis
Outcome Score (HOOS).Aims
Patients and Methods
Sickle-cell disease (SCD) is probably the commonest cause of avascular necrosis worldwide, and its prevalence appears to be rising in developed countries. Avascular necrosis of the humeral head is a common complication but has not been previously studied in detail. We have reviewed 138 patients with SCD for clinical, radiological and functional abnormalities of the shoulder, using a radiological classification designed for avascular necrosis of the shoulder. Radiographic
Fretting and corrosion at the modular head/neck junction, known
as trunnionosis, in total hip arthroplasty (THA) is a cause of adverse
reaction to metal debris (ARMD). We describe the outcome of revision
of metal-on-polyethylene (MoP) THA for ARMD due to trunnionosis
with emphasis on the risk of major complications. A total of 36 patients with a MoP THA who underwent revision
for ARMD due to trunnionosis were identified. Three were excluded
as their revision had been to another metal head. The remaining
33 were revised to a ceramic head with a titanium sleeve. We describe
the presentation, revision findings, and risk of complications in
these patients.Aims
Patients and Methods
We studied 19 videotaped knee arthroscopies in 19 patients with mild to moderate osteoarthritis (OA) of the knee in order to compare the intraobserver and interobserver reliability and the patterns of disagreement between four orthopaedic surgeons. The classifications of OA of Collins, Outerbridge and the French Society of Arthroscopy were used. Intraobserver and interobserver agreements using kappa measures were 0.42 to 0.66 and 0.43 to 0.49, respectively. Only 6% to 8% of paired intraobserver classifications differed by more than one category. Observer-specific disagreement was evident both within and between observers. A small, but significant, occasional variation was also seen. Although reliability may improve by an analysis of disagreement, it appears that the arthroscopic grading of early osteoarthritic
The treatment of osteochondritis dissecans after Legg-Calvé-Perthes’disease hasnot been clearly determined. It may be either by simple observation or surgical removal of the osteochondral fragment. We studied the evolution of the