Aims. In the native hip, the hip capsular
Aims. The Chopart joint complex is a joint between the midfoot and hindfoot. The static and dynamic support system of the joint is critical for maintaining the medial longitudinal arch of the foot. Any dysfunction leads to progressive collapsing flatfoot deformity (PCFD). Often, the tibialis posterior is the primary cause; however, contrary views have also been expressed. The present investigation intends to explore the comprehensive anatomy of the support system of the Chopart joint complex to gain insight into the cause of PCFD. Methods. The study was conducted on 40 adult embalmed cadaveric lower limbs. Chopart joint complexes were dissected, and the structures supporting the joint inferiorly were observed and noted. Results. The articulating bones exhibit features like a cuboid shelf and navicular beak, which appear to offer inferior support to the joint. The expanse of the spring
Aims. Triplane ankle fractures are complex injuries typically occurring in children aged between 12 and 15 years. Classic teaching that closure of the physis dictates the overall fracture pattern, based on studies in the 1960s, has not been challenged. The aim of this paper is to analyze whether these injuries correlate with the advancing closure of the physis with age. Methods. A fracture mapping study was performed in 83 paediatric patients with a triplane ankle fracture treated in three trauma centres between January 2010 and June 2020. Patients aged younger than 18 years who had CT scans available were included. An independent Paediatric Orthopaedic Trauma Surgeon assessed all CT scans and classified the injuries as n-part triplane fractures. Qualitative analysis of the fracture pattern was performed using the modified Cole fracture mapping technique. The maps were assessed for both patterns and correlation with the closing of the physis until consensus was reached by a panel of six surgeons. Results. Fracture map grouped by age demonstrates that, regardless of age (even at the extremes of the spectrum), the fracture lines consolidate in a characteristic Y-pattern, and no shift with closure of the physis was observed. A second fracture map with two years added to female age also did not show a shift. The fracture map, grouped by both age and sex, shows a Y-pattern in all different groups. The fracture lines appear to occur between the anterior and posterior inferior tibiofibular
Aims. The optimal procedure for the treatment of ossification of the posterior longitudinal
Injury to the triangular fibrocartilage complex (TFCC) may result in ulnar wrist pain with or without instability. One component of the TFCC, the radioulnar
Aims. Surgical approaches that claim to be minimally invasive, such as the direct anterior approach (DAA), are reported to have a clinical advantage, but are technically challenging and may create more injury to the soft-tissues during joint exposure. Our aim was to quantify the effect of soft-tissue releases on the joint torque and femoral mobility during joint exposure for hip resurfacing performed via the DAA. Methods. Nine fresh-frozen hip joints from five pelvis to mid-tibia cadaveric specimens were approached using the DAA. A custom fixture consisting of a six-axis force/torque sensor and motion sensor was attached to tibial diaphysis to measure manually applied torques and joint angles by the surgeon. Following dislocation, the torques generated to visualize the acetabulum and proximal femur were assessed after sequential release of the joint capsule and short external rotators. Results. Following initial exposure, the ischiofemoral
Aims. Paediatric triplane fractures and adult trimalleolar ankle fractures both arise from a supination external rotation injury. By relating the experience of adult to paediatric fractures, clarification has been sought on the sequence of injury,
Aims. The purpose of this study is to determine an individual’s age-specific prevalence of total knee arthroplasty (TKA) after cruciate
Aims. Mid-level constraint designs for total knee arthroplasty (TKA) are intended to reduce coronal plane laxity. Our aims were to compare kinematics and
Aims. Patients with midcarpal instability are difficult to manage. It is a rare condition, and few studies have reported the outcomes of surgical treatment. No prospective or retrospective study has reported the results of arthroscopic palmar capsuloligamentous suturing. Our aim was to report the results of a prospective study of arthroscopic suture of this
Aims. This study aims to identify the top unanswered research priorities in the field of knee surgery using consensus-based methodology. Methods. Initial research questions were generated using an online survey sent to all 680 members of the British Association for Surgery of the Knee (BASK). Duplicates were removed and a longlist was generated from this scoping exercise by a panel of 13 experts from across the UK who provided oversight of the process. A modified Delphi process was used to refine the questions and determine a final list. To rank the final list of questions, each question was scored between one (low importance) and ten (high importance) in order to produce the final list. Results. This consensus exercise took place between December 2020 and April 2022. A total of 286 clinicians from the BASK membership provided input for the initial scoping exercise, which generated a list of 105 distinct research questions. Following review and prioritization, a longlist of 51 questions was sent out for two rounds of the Delphi process. A total of 42 clinicians responded to the first round and 24 responded to the second round. A final list of 24 research questions was then ranked by 36 clinicians. The topics included arthroplasty, infection, meniscus, osteotomy, patellofemoral, cartilage, and
Aims. Complete ruptures of the ulnar collateral
Aims. The aim of this study is to provide a detailed description of cases combining bridging patch repair with artificial
Aims. The ideal management of acute syndesmotic injuries in elite athletes is controversial. Among several treatment methods used to stabilize the syndesmosis and facilitate healing of the
Aims. To test the hypothesis that reseeded anterior cruciate ligament (ACL)-derived cells have a better ability to survive and integrate into tendon extracellular matrix (ECM) and accelerate the
Aims. The purpose was to evaluate early clinical, patient-reported, and radiological outcomes of the scapholunate
Objectives. Many in vitro studies have investigated the mechanism by which mechanical signals are transduced into biological signals that regulate bone homeostasis via periodontal
Aims. Options for the treatment of intra-articular ligament injuries are limited, and insufficient
Aims. Total knee arthroplasty (TKA) with a highly congruent condylar-stabilized (CS) articulation may be advantageous due to increased stability versus cruciate-retaining (CR) designs, while mitigating the limitations of a posterior-stabilized construct. The aim was to assess ten-year implant survival and functional outcomes of a cemented single-radius TKA with a CS insert, performed without posterior cruciate
Aims. A significant percentage of patients remain dissatisfied after total knee arthroplasty (TKA). The aim of this study was to determine whether the sequential addition of accelerometer-based navigation for femoral component preparation and sensor-guided
Aims. The aim of this prospective study was to assess the long-term clinical, radiological, functional, and quality of life (QoL)-related outcome of patients treated with the synthetic
We reviewed retrospectively 490 patellar
Objectives. The aim of this study was to investigate the biomechanical effect of the anterolateral
There have been differing descriptions of the
anterolateral structures of the knee, and not all have been named
or described clearly. The aim of this study was to provide a clear
anatomical interpretation of these structures. We dissected 40 fresh-frozen
cadaveric knees to view the relevant anatomy and identified a consistent
structure in 33 knees (83%); we termed this the anterolateral ligament
of the knee. This structure passes antero-distally from an attachment
proximal and posterior to the lateral femoral epicondyle to the
margin of the lateral tibial plateau, approximately midway between
Gerdy’s tubercle and the head of the fibula. The
Objectives. Unicompartmental knee arthroplasty (UKA) is one surgical option for treating symptomatic medial osteoarthritis. Clinical studies have shown the functional benefits of UKA; however, the optimal alignment of the tibial component is still debated. The purpose of this study was to evaluate the effects of tibial coronal and sagittal plane alignment in UKA on knee kinematics and cruciate
Aims. The aim of this study was to assess the effect of posterior cruciate
Aims. The purpose of this study was to evaluate the relationships between the degree of injury to the medial and lateral collateral
Objectives. Ligaments which heal spontaneously have a healing process that
is similar to skin wound healing. Menopause impairs skin wound healing
and may likewise impair
The meniscofemoral
We describe the clinical outcome of a technique of surgical augmentation of chronic massive tears of the rotator cuff using a polyester
Contracture of the collateral
We designed an experimental study to prove the existence of the popliteofibular
We carried out a prospective study of 71 patients who had undergone reconstruction of the anterior cruciate ligament with the ABC scaffold. Their mean age was 28 years (18 to 50). All had either sub-acute or chronic traumatic deficiency of the
Ensuring the accuracy of the intra-operative orientation of the acetabular component during a total hip replacement can be difficult. In this paper we introduce a reproducible technique using the transverse acetabular
The requirement for release of collateral
We treated 43 acute tears of the calcaneofibular
We present the operative technique and clinical results of concomitant reconstruction of the medial collateral
The palmar
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
Rupture of a
The healing of anterior cruciate ligaments reconstructed with the Leeds-Keio artificial
Aims. The aim of this study was to evaluate two hypotheses. First,
that disruption of posterior bundle of the medial collateral ligament
(PMCL) has to occur for the elbow to subluxate in cases of posteromedial
rotatory instability (PMRI) and second, that ulnohumeral contact
pressures increase after disruption of the PMCL. Materials and Methods. Six human cadaveric elbows were prepared on a custom-designed
apparatus which allowed muscle loading and passive elbow motion
under gravitational varus. Joint contact pressures were measured
sequentially in the intact elbow (INTACT), followed by an anteromedial
subtype two coronoid fracture (COR), a lateral collateral
Chronic ankle instability after ligamentous injuries has been attributed to loss of proprioception, but there has been no previous study of the mechanoreceptors in human
Seven men with a mean age of 63.9 years (59 to 67) developed dysphagia because of oesophageal compression with ossification of the anterior longitudinal
We report the results of a prospective randomised trial which assessed the role of the posterior cruciate
1. The pathological anatomy of total rupture of the ulnar collateral
We have studied the mechanosensitive afferent units in the lateral
We used high-resolution ultrasonography to image the ulnar collateral
The posterior cruciate
Surgical treatment for traumatic, anterior glenohumeral instability requires repair of the anterior band of the inferior glenohumeral
We report a new surgical technique of open carpal
tunnel release with subneural reconstruction of the transverse carpal
ligament and compare this with isolated open and endoscopic carpal
tunnel release. Between December 2007 and October 2011, 213 patients with carpal
tunnel syndrome (70 male, 143 female; mean age 45.6 years; 29 to
67) were recruited from three different centres and were randomly
allocated to three groups: group A, open carpal tunnel release with
subneural reconstruction of the transverse carpal
The stress-tenogram is a radiological technique for the investigation of injuries to the lateral
Serial sections, in the frontal plane, of 12 human fetuses showed that the iliolumbar
We have tested the hypothesis that the meniscofemoral
We have undertaken a randomized clinical trial comparing two methods of reconstruction of the anterior cruciate ligament in patients with chronic instability. We used an ipsilateral bone-patellar-tendon-bone autograft in 27 patients and the
We randomised 50 patients with ankle fractures of Weber types B and C and a ruptured deltoid
Our purpose was to determine whether continuous passive motion enhanced the quality of knee
In 30 rabbits, the medial meniscus was used to replace the anterior or posterior cruciate
The LockDown device (previously called Surgilig)
is a braided polyester mesh which is mostly used to reconstruct the
dislocated acromioclavicular joint. More than 11 000 have been implanted
worldwide. Little is known about the tissue reaction to the device
nor to its wear products when implanted in an extra-articular site
in humans. This is of importance as an adverse immunological reaction
could result in osteolysis or damage to the local tissues, thereby affecting
the longevity of the implant. We analysed the histology of five LockDown implants retrieved
from five patients over the last seven years by one of the senior
authors. Routine analysis was carried out in all five cases and
immunohistochemistry in one. The LockDown device acts as a scaffold for connective tissue
which forms an investing fibrous pseudoligament. The immunological
response at the histological level seems favourable with a limited
histiocytic and giant cell response to micron-sized wear particles.
The connective tissue envelope around the implant is less organised
than a native
We have examined the relationship between the size of the flexion gap and the anterior translation of the tibia in flexion during implantation of a posterior cruciate
We report a retrospective analysis of the results of combined arthroscopically-assisted posterior cruciate ligament reconstruction and open reconstruction of the posterolateral corner in 19 patients with chronic (three or more months) symptomatic instability and pain in the knee. All the operations were performed between 1996 and 2003 and all the patients were assessed pre- and post-operatively by physical examination and by applying three different
After a severe ankle sprain the incidence of residual complaints, particularly on the medial side of the joint, is high. We studied a consecutive series of 30 patients who had operative repair of acute ruptures of lateral
The significance of the posterior cruciate
Techniques for the selective cutting of
The management of traumatic dislocation of the knee in 40 patients (41 knees) with a mean age of 26.3 years is described. They were treated by primary repair and reconstruction with autologous grafting of the anterior (ACL) and posterior cruciate
Most injuries to the medial collateral
In order to determine whether an allogeneic tendon could be used to replace an extra-articular
We investigated the role of a functional brace worn for four months in the treatment of patients with an acute isolated tear of the posterior cruciate
1. The results of three forms of treatment (mobilisation, immobilisation for six weeks, and suture with immobilisation for six weeks) for ruptures of the lateral
The development of the iliolumbar
A case of "clicking elbow" is described in which at operation the clicking appeared to be due to a"bucket handle" type of lesion of the annular
Aims. The aim of this prospective study was to evaluate the intermediate-term
outcomes after revision anatomical ankle
We performed a retrospective study to assess the long-term outcome of non-augmented anatomical direct repair of the lateral ankle
A total of 22 patients with a tibial avulsion
fracture involving the insertion of the posterior cruciate ligament
(PCL) with grade II or III posterior laxity were reduced and fixed
arthroscopically using routine anterior and double posteromedial
portals. A double-strand Ethibond suture was inserted into the joint
and wrapped around the PCL from anterior to posterior to secure
the
One hundred patients with acute ruptures of the lateral
Fresh frozen allogeneic tendon was used to reconstruct the lateral
We describe a new method for the reconstruction of ruptures of the patellar
Objectives. To evaluate the applicability of MRI for the quantitative assessment
of anterior talofibular
We studied 23 patients with spondylolysis of the fifth lumbar vertebra (L5) and 20 with spondylolytic spondylolisthesis at this level. All were more than 40 years of age. The transverse processes at L5 were significantly wider in the former group than in the latter. We also dissected 56 cadavers to study the morphological relationship between the transverse process of L5 and the iliolumbar
Chronic instability of the ankle is frequently due to disruption of the fibres of the anterior talofibular
Acquired flatfoot deformity after injury is usually due to partial or complete tearing of the tendon of tibialis posterior, with secondary failure of the other structures which maintain the medial longitudinal arch. We describe a patient in whom the rupture of the plantar calcaneonavicular (spring)
A computer-based model of the knee was used to study forces in the cruciate
Orientation of the native acetabular plane as defined by the transverse acetabular
An operation using either the medial or the lateral meniscus to effect the late repair of torn cruciate
We report 18 cases of pain and tenderness in the mid-part of the patellar
1. Forty-two previously asymptomatic patients presenting with a recent rupture of the lateral
Achieving deep flexion after total knee replacement remains a challenge. In this study we compared the soft-tissue tension and tibiofemoral force in a mobile-bearing posterior cruciate ligament-sacrificing total knee replacement, using equal flexion and extension gaps, and with the gaps increased by 2 mm each. The tests were conducted during passive movement in five cadaver knees, and measurements of strain were made simultaneously in the collateral
Objectives. Because posterior cruciate
We have studied the kinematics of the knee in the sagittal plane, using a four-bar linkage as model, and assuming that a "neutral fibre" in each
A 35-year-old man was seen with pain in the back of the knee. MRI showed a mass in the anterior cruciate ligament. Biopsy indicated mucoid degeneration. Arthroscopic resection of the
We present a case of disruption of the posterolateral corner of the knee with avulsion of the tendon of biceps femoris. Repair and reconstruction included an allogenic tendon graft to replace the posterior cruciate
1. Seventeen cases of knee injury are described in which the predominant lesion was rupture of the posterior cruciate
We set up a trial to test whether the KT1000 arthrometer would give consistent measurements of anteroposterior laxity when used by the same and different examiners on the knees of the same subjects on the same day. The results showed substantial inter- and intra-examiner variation in the measurements both of absolute displacement in single knees and of side-to-side differences between pairs of knees. This casts doubt on the reliability of the instrument when used to compare the results of different techniques for reconstructing injured cruciate
We have assessed the biomechanical properties of a 'double-bundle' prosthetic
We dissected 60 shoulders to demonstrate the anatomy of the coracohumeral
1. A case of disruption of patellar
We treated 39 knees with chronic deficiency of the anterior cruciate ligament by reconstruction using the ABC carbon and polyester prosthetic
We studied the stabilising effect of prosthetic replacement of the radial head and repair of the medial collateral