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The Journal of Bone & Joint Surgery British Volume
Vol. 65-B, Issue 5 | Pages 536 - 543
1 Nov 1983
Ansell B Swann M


The Journal of Bone & Joint Surgery British Volume
Vol. 41-B, Issue 4 | Pages 681 - 688
1 Nov 1959
Rowling DE


The Journal of Bone & Joint Surgery British Volume
Vol. 33-B, Issue 4 | Pages 584 - 590
1 Nov 1951
Lawson TL


The Journal of Bone & Joint Surgery British Volume
Vol. 92-B, Issue 6 | Pages 817 - 822
1 Jun 2010
Beekman PDA Katusic D Berghs BM Karelse A De Wilde L

We retrospectively reviewed 11 consecutive patients with an infected reverse shoulder prosthesis. Patients were assessed clinically and radiologically, and standard laboratory tests were carried out. Peroperative samples showed Propionbacterium acnes in seven, coagulase-negative Staphylococcus in five, methicillin-resistant staphylococcus aureus in one and Escherichia coli in one. Two multibacterial and nine monobacterial infections were seen. Post-operatively, patients were treated with intravenous cefazolin for at least three days and in all antibiotic therapy was given for at least three months. Severe pain (3 of 11) or severe limitation of function (3 of 11) are not necessarily seen. A fistula was present in eight, but function was not affected. All but one patient were considered free of infection after one-stage revision at a median follow-up of 24 months, and without antibiotic treatment for a minimum of six months. One patient had a persistent infection despite a second staged revision, but is now free of infection with a spacer. Complications included posterior dislocation in one, haematoma in one and a clavicular fracture in one. At the most recent follow-up the median post-operative Constant-Murley score was 55, 6% adjusted for age, gender and dominance.

A one-stage revision arthroplasty reduces the cost and duration of treatment. It is reliable in eradicating infection and good functional outcomes can be achieved.


The Journal of Bone & Joint Surgery British Volume
Vol. 85-B, Issue 6 | Pages 931 - 931
1 Aug 2003
KWAN O FRIEL J


The Journal of Bone & Joint Surgery British Volume
Vol. 80-B, Issue 3 | Pages 490 - 492
1 May 1998
Moritomo H Tada K Yoshida T Kawatsu N

Persistent dislocation of the elbow after a fracture of the coronoid process is a difficult problem. We have performed an open reduction with reconstruction of the coronoid by an osteocartilaginous graft from the ipsilateral olecranon for two patients.

Both achieved a painless, stable joint with a functional range of movement. The joint surface of the graft has a similar curve to that of the coronoid giving good congruency and stability. The technique is simple and the graft is obtained through the same incision.


The Journal of Bone & Joint Surgery British Volume
Vol. 73-B, Issue 1 | Pages 178 - 179
1 Jan 1991
Lokiec F Siev-Ner I Pritsch M


The Journal of Bone & Joint Surgery British Volume
Vol. 34-B, Issue 1 | Pages 80 - 81
1 Feb 1952
Lawrie RW


The Journal of Bone & Joint Surgery British Volume
Vol. 34-B, Issue 4 | Pages 642 - 645
1 Nov 1952
Waugh W


The Journal of Bone & Joint Surgery British Volume
Vol. 90-B, Issue 6 | Pages 795 - 800
1 Jun 2008
Liu T Zhang X Li Z Zeng W Peng D Sun C

Nonunion of the humerus with bone loss and shortening due to osteomyelitis is rare but difficult to treat. We describe our experience with a callus distraction technique using a monolateral external fixator for the treatment of this condition.

Between October 1994 and January 2004, 11 patients were treated. There were seven males and four females, with a mean age of 14 years (10 to 17). The mean bone loss was 1.9 cm (1 to 2.7) and the mean length discrepancy in the upper limb was 5.6 cm (3.5 to 8.0).

The mean follow-up was for 106 months (54 to 166). The mean external fixation index was 34.8 days/cm (29.8 to 40.5). The mean lengthening was 9.5 cm (5.5 to 13.4). There were seven excellent results, three good and one poor. There were nine excellent functional results and two good.

The treatment of humeral nonunion with bone loss and shortening due to osteomyelitis by callus distraction is a safe and effective means of improving function and cosmesis.


The Journal of Bone & Joint Surgery British Volume
Vol. 67-B, Issue 5 | Pages 703 - 708
1 Nov 1985
Gerber C Terrier F Ganz R

Symptomatic impingement of the rotator cuff between the humeral head and the coracoid process has been studied and three varieties recognised: idiopathic, iatrogenic and traumatic. In all three the clinical findings consisted of pain in front of the shoulder, referred to the upper arm and forearm, and especially felt during forward flexion and medial rotation; the pain could be reproduced by medial rotation with the arm in 90 degrees of abduction, or by adduction with the shoulder flexed to 90 degrees. Patients were relieved of their symptoms by restoring adequate subcoracoid clearance.


The Journal of Bone & Joint Surgery British Volume
Vol. 88-B, Issue 11 | Pages 1533 - 1538
1 Nov 2006
Meyer DC Lajtai G von Rechenberg B Pfirrmann CWA Gerber C

We released the infraspinatus tendons of six sheep, allowed retraction of the musculotendinous unit over a period of 40 weeks and then performed a repair. We studied retraction of the musculotendinous unit 35 weeks later using CT, MRI and macroscopic dissection.

The tendon was retracted by a mean of 4.7 cm (3.8 to 5.1) 40 weeks after release and remained at a mean of 4.2 cm (3.3 to 4.7) 35 weeks after the repair. Retraction of the muscle was only a mean of 2.7 cm (2.0 to 3.3) and 1.7 cm (1.1 to 2.2) respectively at these two points. Thus, the musculotendinous junction had shifted distally by a mean of 2.5 cm (2.0 to 2.8) relative to the tendon. Sheep muscle showed an ability to compensate for approximately 60% of the tendon retraction in a hitherto unknown fashion. Such retraction may not be a quantitatively reliable indicator of retraction of the muscle and may overestimate the need for elongation of the musculotendinous unit during repair.


The Journal of Bone & Joint Surgery British Volume
Vol. 86-B, Issue 2 | Pages 165 - 171
1 Mar 2004
Speed CA


The Journal of Bone & Joint Surgery British Volume
Vol. 78-B, Issue 2 | Pages 233 - 237
1 Mar 1996
Rompe JD Hopf C Küllmer K Heine J Bürger R

We report a controlled, prospective study to investigate the effect of treatment by low-energy extracorporeal shock waves on pain in tennis elbow. We assigned at random 100 patients who had had symptoms for more than 12 months to two groups to receive low-energy shock-wave therapy. Group I received a total of 3000 impulses of 0.08 mJ/mm2 and group II, the control group, 30 impulses.

The patients were reviewed after 3, 6 and 24 weeks. There was significant alleviation of pain and improvement of function after treatment in group I in which there was a good or excellent outcome in 48% and an acceptable result in 42% at the final review, compared with 6% and 24%, respectively, in group II.


The Journal of Bone & Joint Surgery British Volume
Vol. 76-B, Issue 2 | Pages 325 - 327
1 Mar 1994
Majeed S


The Journal of Bone & Joint Surgery British Volume
Vol. 72-B, Issue 3 | Pages 468 - 469
1 May 1990
Porteous M Miller A

Delay in the diagnosis of posterior shoulder dislocation is common. We present two such cases treated satisfactorily by rotation osteotomy of the surgical neck of the humerus and discuss the indications for this procedure.


The Journal of Bone & Joint Surgery British Volume
Vol. 47-B, Issue 2 | Pages 247 - 255
1 May 1965
France WG Wolf P

1. Orthopaedic treatment of joint deformities in thirteen patients with haemophilia is reviewed over a period of seven years.

2. Forms of treatment discussed include open operation, manipulation under general anaesthesia, continuous traction, splintage and physiotherapy. The amount of intravenous therapy required for each form of treatment is indicated.

3. In discussing prevention of joint deformity the histories of a further eighteen patients have been taken into account. It is concluded that initially painless haemarthroses provide the main threat to joint deformity in haemophilia.

4. The best preventive treatment is early immobilisation followed by prolonged splintage and physiotherapy; intravenous therapy with antihaemophilic factor plays a less important role here than in other forms of haemorrhage.

5. Evidence is presented that joint deformity in severe haemophilia can often be entirely avoided.


The Journal of Bone & Joint Surgery British Volume
Vol. 84-B, Issue 1 | Pages 116 - 118
1 Jan 2002
Jain S Monbaliu D Thompson JF

Traumatic posterior dislocation of the sternoclavicular joint is an unusual injury. We report a rare, late complication in the form of a thoracic outlet syndrome. Resection of the first rib resulted in prompt and complete resolution of the symptoms and would appear to be the appropriate treatment, avoiding the complications associated with resection of the clavicle.


The Bone & Joint Journal
Vol. 96-B, Issue 1 | Pages 54 - 58
1 Jan 2014
Vijayan S Bentley G Rahman J Briggs TWR Skinner JA Carrington RWJ

The management of failed autologous chondrocyte implantation (ACI) and matrix-assisted autologous chondrocyte implantation (MACI) for the treatment of symptomatic osteochondral defects in the knee represents a major challenge. Patients are young, active and usually unsuitable for prosthetic replacement. This study reports the results in patients who underwent revision cartilage transplantation of their original ACI/MACI graft for clinical or graft-related failure. We assessed 22 patients (12 men and 10 women) with a mean age of 37.4 years (18 to 48) at a mean of 5.4 years (1.3 to 10.9). The mean period between primary and revision grafting was 46.1 months (7 to 89). The mean defect size was 446.6 mm2 (150 to 875) and they were located on 11 medial and two lateral femoral condyles, eight patellae and one trochlea.

The mean modified Cincinnati knee score improved from 40.5 (16 to 77) pre-operatively to 64.9 (8 to 94) at their most recent review (p < 0.001). The visual analogue pain score improved from 6.1 (3 to 9) to 4.7 (0 to 10) (p = 0.042). A total of 14 patients (63%) reported an ‘excellent’ (n = 6) or ‘good’ (n = 8) clinical outcome, 5 ‘fair’ and one ‘poor’ outcome. Two patients underwent patellofemoral joint replacement. This study demonstrates that revision cartilage transplantation after primary ACI and MACI can yield acceptable functional results and continue to preserve the joint.

Cite this article: Bone Joint J 2014;96-B:54–8.


The Journal of Bone & Joint Surgery British Volume
Vol. 73-B, Issue 3 | Pages 395 - 398
1 May 1991
Ellman H Kay S

Subacromial decompression was performed arthroscopically on 65 patients who were evaluated two to five years after the procedure. None had full thickness rotator cuff tears. Patients with partial thickness cuff tears were included in this study in order to allow comparison of arthroscopic acromioplasty with open acromioplasty for stage II impingement. On the UCLA shoulder rating scale, 89% of the cases in this study achieved a satisfactory result. These results compare favourably with those reported following open acromioplasty. The arthroscopic procedure is technically demanding. When properly performed in patients with appropriate indications, hospitalisation is brief, return to activities is rapid, there is little risk of deltoid muscle complications, and the results are lasting.