Aims. The widely used and well-proven Palacos R (a.k.a. Refobacin Palacos
R) bone cement is no longer commercially available and was superseded
by Refobacin bone cement R and Palacos R + G in 2005. However, the
performance of these newly introduced bone cements have not been
tested in a phased evidence-based manner, including roentgen stereophotogrammetric
analysis (RSA). Patients and Methods. In this blinded, randomised, clinical RSA study, the migration
of the Stanmore femoral component was compared between Refobacin
bone cement R and Palacos R + G in 62 consecutive total hip arthroplasties.
The primary outcome measure was femoral component migration measured
using RSA and secondary outcomes were Harris hip
The coronavirus disease (COVID)-19 pandemic forced an unprecedented period of challenge to the NHS in the UK where hip fractures in the elderly population are a major public health concern. There are approximately 76,000 hip fractures in the UK each year which make up a substantial proportion of the trauma workload of an average orthopaedic unit. This study aims to assess the impact of the COVID-19 pandemic on hip fracture care service and the emerging lessons to withstand any future outbreaks. Data were collected retrospectively on 157 hip fractures admitted from March to May 2019 and 2020. The 2020 group was further subdivided into COVID-positive and COVID-negative. Data including the four-hour target, timing to imaging, hours to operation, anaesthetic and operative details, intraoperative complications, postoperative reviews, COVID status, Key Performance Indicators (KPIs), length of stay, postoperative complications, and the 30-day mortality were compiled from computer records and our local National Hip Fracture Database (NHFD) export data.Aims
Methods
Aims. We wished to compare the clinical outcome, as assessed by questionnaires
and the rate of complications, in total knee arthroplasty (TKA)
undertaken with patient-matched positioning guides (PMPGs) or conventional
instruments. Patients and Methods. A total of 180 patients (74 men, 106 women; mean age 67 years)
were included in a multicentre, adequately powered, double-blind,
randomised controlled trial. The mean follow-up was 44 months (24
to 57). Results. There were no significant or clinically relevant differences
between the two groups for all outcome measures (Knee Society
Aims. It has been suggested that mobile-bearing total knee arthroplasty
(TKA) might lead to better outcomes by accommodating some femorotibial
rotational mismatch, thereby reducing contact stresses and polyethylene
wear. The aim of this study was to determine whether there is a
difference between fixed- and mobile-bearing versions of a contemporary
TKA with respect to durability, range of movement (ROM) and function,
ten years postoperatively. Patients and Methods. A total of 240 patients who were enrolled in this randomized
controlled trial (RCT) underwent a primary cemented TKA with one
of three tibial components (all-polyethylene fixed-bearing, modular
metal-backed fixed-bearing and mobile-bearing). Patients were reviewed
at a median follow-up of ten years (IQR 9.2 to 10.4). Results. There was no difference in durability, as measured by survivorship
free of revision for any reason, nor in mean maximal ROM at ten
years (p = 0.8). There was also no difference in function, as measured
by Knee Society (KS) function
To compare the cost-utility of standard dressing with incisional negative-pressure wound therapy (iNPWT) in adults with closed surgical wounds associated with major trauma to the lower limbs. A within-trial economic evaluation was conducted from the UK NHS and personal social services (PSS) perspective based on data collected from the Wound Healing in Surgery for Trauma (WHiST) multicentre randomized clinical trial. Health resource utilization was collected over a six-month post-randomization period using trial case report forms and participant-completed questionnaires. Cost-utility was reported in terms of incremental cost per quality-adjusted life year (QALY) gained. Sensitivity analysis was conducted to test the robustness of cost-effectiveness estimates while uncertainty was handled using confidence ellipses and cost-effectiveness acceptability curves.Aims
Methods
To explore the effect of different types of articulating antibiotic-loaded cement spacers in two-stage revision for chronic hip prosthetic joint infection (PJI). A retrospective cohort study was performed involving 36 chronic PJI patients treated with different types of articulating antibiotic-loaded cement spacers between January 2014 and December 2017. The incidence of complications and the therapeutic effects of different types of antibiotic-loaded articulating cement spacers were compared.Aims
Methods
Aims. Our aim was to investigate the outcomes of patients with a displaced
fracture of the glenoid fossa who are treated conservatively. There
is little information in the literature about the treatment of these
rare injuries non-operatively. Patients and Methods. We reviewed 24 patients with a mean age of 52 years (19 to 81)
at a mean of 5.6 years (11 months to 18 years) after the injury. Results. At final follow-up, the mean Constant and Murley
The diagnosis of periprosthetic joint infection (PJI) has always been challenging. Recently, D-dimer has become a promising biomarker in diagnosing PJI. However, there is controversy regarding its diagnostic value. We aim to investigate the diagnostic value of D-dimer in comparison to ESR and CRP. PubMed, Embase, and the Cochrane Library were searched in February 2020 to identify articles reporting on the diagnostic value of D-dimer on PJI. Pooled analysis was conducted to investigate the diagnostic value of D-dimer, CRP, and ESR.Aims
Methods
Whether a combined anteroposterior fusion or a posterior-only fusion is more effective in the management of patients with Scheuermann’s kyphosis remains controversial. The aim of this study was to compare the radiological and clinical outcomes of these surgical approaches, and to evaluate the postoperative complications with the hypothesis that proximal junctional kyphosis would be more common in one-stage posterior-only fusion. A retrospective review of patients treated surgically for Scheuermann’s kyphosis between 2006 and 2014 was performed. A total of 62 patients were identified, with 31 in each group. Parameters were compared to evaluate postoperative outcomes using chi-squared tests, independent-samples Aims
Methods
The French registry for complex bone and joint infections (C-BJIs) was created in 2012 in order to facilitate a homogeneous management of patients presented for multidisciplinary advice in referral centres for C-BJI, to monitor their activity and to produce epidemiological data. We aimed here to present the genesis and characteristics of this national registry and provide the analysis of its data quality. A centralized online secured database gathering the electronic case report forms (eCRFs) was filled for every patient presented in multidisciplinary meetings (MM) among the 24 French referral centres. Metrics of this registry were described between 2012 and 2016. Data quality was assessed by comparing essential items from the registry with a controlled dataset extracted from medical charts of a random sample of patients from each centre. Internal completeness and consistency were calculated.Aims
Methods
The aim of this study was to systematically compare the safety and accuracy of robot-assisted (RA) technique with conventional freehand with/without fluoroscopy-assisted (CT) pedicle screw insertion for spine disease. A systematic search was performed on PubMed, EMBASE, the Cochrane Library, MEDLINE, China National Knowledge Infrastructure (CNKI), and WANFANG for randomized controlled trials (RCTs) that investigated the safety and accuracy of RA compared with conventional freehand with/without fluoroscopy-assisted pedicle screw insertion for spine disease from 2012 to 2019. This meta-analysis used Mantel-Haenszel or inverse variance method with mixed-effects model for heterogeneity, calculating the odds ratio (OR), mean difference (MD), standardized mean difference (SMD), and 95% confidence intervals (CIs). The results of heterogeneity, subgroup analysis, and risk of bias were analyzed.Aims
Methods
Aims. For this retrospective cohort study, patients aged ≤ 30 years
(very young) who underwent total hip arthroplasty (THA) were compared
with patients aged ≥ 60 years (elderly) to evaluate the rate of
revision arthroplasty, implant survival, the indications for revision,
the complications, and the patient-reported outcomes. Patients and Methods. We retrospectively reviewed all patients who underwent primary
THA between January 2000 and May 2015 from our institutional database.
A total of 145 very young and 1359 elderly patients were reviewed.
The mean follow-up was 5.3 years (1 to 18). Logistic generalized
estimating equations were used to compare characteristics and the revision
rate. Survival was evaluated using Kaplan–Meier curves and hazard
rates were created using Cox regression. Results. The overall revision rate was 11% (16/145) in the very young
and 3.83% (52/1359) in the elderly groups (odds ratio (OR) 2.58,
95% confidence interval (CI) 1.43 to 4.63). After adjusting for
the American Society of Anesthesiologists (ASA)
Aims. Tissue responses to debris formed by abrasion of polymethylmethacrylate
(PMMA) spacers at two-stage revision arthroplasty for prosthetic
joint infection are not well described. We hypothesised that PMMA
debris induces immunomodulation in periprosthetic tissues. Patients and Methods. Samples of tissue were taken during 35 two-stage revision arthroplasties
(nine total hip and 26 total knee arthroplasties) in patients whose
mean age was 67 years (44 to 85). Fourier transform infrared microscopy
was used to confirm the presence of PMMA particles. Histomorphometry
was performed using Sudan Red and Haematoxylin-Eosin staining.
CD-68, CD-20, CD-11(c), CD-3 and IL-17 antibodies were used to immunophenotype
the inflammatory cells. All slides were
Aims . To analyse the influence of upper extremity trauma on the long-term
outcome of polytraumatised patients. . Patients and Methods. A total of 629 multiply injured patients were included in a follow-up
study at least ten years after injury (mean age 26.5 years, standard
deviation 12.4). The extent of the patients’ injury was classified
using the Injury Severity