Aims. Waiting times for arthroplasty surgery in Northern Ireland are among the longest in the NHS, which have been further lengthened by the onset of the COVID-19 global pandemic in March 2020. The Department of Health in Northern Ireland has announced a new Elective Care Framework (ECF), with the framework proposing that by March 2026 no patient will wait more than 52 weeks for inpatient/day case treatment. We aimed to assess the feasibility of achieving this with reference to
Aims. The aims of this study were to determine the clinical and radiographic
outcomes, implant survivorship, and complications of patients with
a history of poliomyelitis undergoing
There is little evidence on the cost effectiveness
of different brands of hip prostheses. We compared lifetime cost effectiveness
of frequently used brands within types of prosthesis including cemented
(Exeter V40 Contemporary, Exeter V40 Duration and Exeter V40 Elite
Plus Ogee), cementless (Corail Pinnacle, Accolade Trident, and Taperloc Exceed)
and hybrid (Exeter V40 Trilogy, Exeter V40 Trident, and CPT Trilogy).
We used data from three linked English national databases to estimate
the lifetime risk of revision, quality-adjusted life years (QALYs)
and cost. . For women with osteoarthritis aged 70 years, the Exeter V40 Elite
Plus Ogee had the lowest risk of revision (5.9% revision risk, 9.0
QALYs) and the CPT Trilogy had the highest QALYs (10.9% revision
risk, 9.3 QALYs). Compared with the Corail Pinnacle (9.3% revision
risk, 9.22 QALYs), the most commonly used brand, and assuming a
willingness-to-pay of £20 000 per QALY gain, the CPT Trilogy is
most cost effective, with an incremental net monetary benefit of £876.
Differences in cost effectiveness between the hybrid CPT Trilogy
and Exeter V40 Trident and the cementless Corail Pinnacle and Taperloc
Exceed were small, and a cautious interpretation is required, given
the limitations of the available information. However, it is unlikely that cemented brands are among the most
cost effective. Similar patterns of results were observed for men
and other ages. The gain in quality of life after
Aims. We report on the outcome of the Exeter Contemporary flanged cemented
all-polyethylene acetabular component with a mean follow-up of 12
years (10 to 13.9). This study reviewed 203 hips in 194 patients.
129 hips in 122 patients are still in situ; 66
hips in 64 patients were in patients who died before ten years,
and eight hips (eight patients) were revised. Clinical outcome scores
were available for 108 hips (104 patients) and radiographs for 103
hips (100 patients). Patients and Methods. A retrospective review was undertaken of a consecutive series
of 203 routine primary cemented
Aims. Achieving accurate implant positioning and restoring native hip biomechanics are key surgeon-controlled technical objectives in
The aim of this study was to investigate whether the use of antibiotic-loaded bone cement influenced the risk of revision surgery after primary total hip arthroplasty (THA) for osteoarthritis. The study involved data collected by the National Joint Registry (NJR) for England and Wales, Northern Ireland and the Isle of Man between 1 September 2005 and 31 August 2017. Cox proportional hazards were used to investigate the association between use of antibiotic-loaded bone cement and the risk of revision due to prosthetic joint infection (PJI), with adjustments made for the year of the initial procedure, age at the time of surgery, sex, American Society of Anesthesiologists (ASA) grade, head size, and body mass index (BMI). We looked also at the association between use of antibiotic-loaded bone cement and the risk of revision due to aseptic loosening or osteolysis.Aims
Methods
Dual mobility (DM) bearings are an attractive treatment option to obtain hip stability during challenging primary and revision total hip arthroplasty (THA) cases. The purpose of this study was to analyze data submitted to the American Joint Replacement Registry (AJRR) to characterize utilization trends of DM bearings in the USA. All primary and revision THA procedures reported to AJRR from 2012 to 2018 were analyzed. Patients of all ages were included and subdivided into DM and traditional bearing surface cohorts. Patient demographics, geographical region, hospital size, and teaching affiliation were assessed. Associations were determined by chi-squared analysis and logistic regression was performed to assess outcome variables.Aims
Methods
Aims. The primary objective of this study was to develop a validated classification system for assessing iatrogenic bone trauma and soft-tissue injury during
Aims. Iliopsoas impingement occurs in 4% to 30% of patients after undergoing
Aims. Conventional patient-reported surveys, used for patients undergoing
Aims.
Aims. In 2015, we published the results of our ceramic-on-metal (CoM)
Aims. This study aimed to describe practice variation in the use of
Aims. Manual impaction, with a mallet and introducer, remains the standard method of installing cementless acetabular cups during
Aims. The aim of this study was to evaluate the survival of a collarless, straight, hydroxyapatite-coated femoral stem in
Aims. A significant reduction in wear at five and ten years was previously reported when comparing Durasul highly cross-linked polyethylene with nitrogen-sterilized Sulene polyethylene in
Aims. Leg length discrepancy (LLD) is a common pre- and postoperative issue in
Aims. Femoral component anteversion is an important factor in the success of
Aims. The aim of this study was to explore the functional results in a fitter subgroup of participants in the Hip Fracture Evaluation with Alternatives of
Aims. Implant waste during
Aims. Professional dancers represent a unique patient population in the setting of hip arthroplasty, given the high degree of hip strength and mobility required by their profession. We sought to determine the clinical outcomes and ability to return to professional dance after
Aims. The aims of this systematic review were to assess the learning curve of semi-active robotic arm-assisted
Given the increasing number of total hip arthroplasty
procedures being performed annually, it is imperative that orthopaedic
surgeons understand factors responsible for instability. In order
to treat this potentially complex problem, we recommend correctly
classifying the type of instability present based on component position, abductor
function, impingement, and polyethylene wear. Correct classification
allows the treating surgeon to choose the appropriate revision option
that ultimately will allow for the best potential outcome. Cite this article:
Aims. Computer-assisted 3D preoperative planning software has the potential to improve postoperative stability in
Aims. This study aimed to assess the carbon footprint associated with
Aims. Young adults undergoing
Aims. Postoperative length of stay (LOS) and discharge dispositions following arthroplasty can be used as surrogate measurements for improvements in patients’ pathways and costs. With the increasing use of robotic technology in arthroplasty, it is important to assess its impact on LOS. The aim of this study was to identify factors associated with decreased LOS following robotic arm-assisted
Aims. The aim of this study was to evaluate the suitability of the tapered cone stem in
Aims. Obesity is associated with an increased risk of hip osteoarthritis, resulting in an increased number of
Aims. The aim of this study was to evaluate the reliability and validity of a patient-specific algorithm which we developed for predicting changes in sagittal pelvic tilt after
This was a randomised controlled trial studying
the safety of a new short metaphyseal fixation (SMF) stem. We hypothesised
that it would have similar early clinical results and micromovement
to those of a standard-length tapered Synergy metaphyseal fixation
stem. Using radiostereometric analysis (RSA) we compared the two
stems in 43 patients. A short metaphyseal fixation stem was used
in 22 patients and a Synergy stem in 21 patients. No difference
was found in the clinical outcomes pre- or post-operatively between
groups. RSA showed no significant differences two years post-operatively
in mean micromovement between the two stems (except for varus/valgus tilt
at p = 0.05) (subsidence 0.94 mm ( Cite this article:
Aims. The aim of this study was to compare the early postoperative mortality and morbidity in older patients with a fracture of the femoral neck, between those who underwent
Aims. For displaced femoral neck fractures (FNFs) in geriatric patients, there remains uncertainty regarding the effect of
Aims. Osteoporosis is common in
Aims. A revision for periprosthetic joint infection (PJI) in
Aims. Adult patients with history of childhood infection pose a surgical challenge for
Aims. The prevalence of obesity is increasing substantially around the world. Elevated BMI increases the risk of complications following
Aims. Excessive posterior pelvic tilt (PT) may increase the risk of anterior instability after
Aims. The volume of ambulatory
Aims. Mechanical impingement of the iliopsoas (IP) tendon accounts for 2% to 6% of persistent postoperative pain after
Aims. Osteoporosis can determine surgical strategy for
Aims. Despite higher rates of revision after
Aims. Surgery is often delayed in patients who sustain a hip fracture and are treated with a
Aims. Oxidized zirconium (OxZi) and highly cross-linked polyethylene (HXLPE) were developed to minimize wear and risk of osteolysis in
Aims. This study was designed to develop a model for predicting bone mineral density (BMD) loss of the femur after
Aims. Dual-mobility acetabular components (DMCs) have improved
Aims. Precise implant positioning, tailored to individual spinopelvic biomechanics and phenotype, is paramount for stability in
The aim of this study was to investigate the
relationship between the geometry of the proximal femur and the incidence
of intra-operative fracture during uncemented total hip arthroplasty
(THA). We studied the pre-operative CT scans of 100 patients undergoing
THA with an uncemented femoral component. We measured the anteroposterior
and mediolateral dimensions at the level of division of the femoral
neck to calculate the aspect ratio of the femur. Wide variations
in the shape of the femur were observed, from round, to very narrow
elliptic. The femurs of women were narrower than those of men (p
<
0.0001) and small femurs were also narrower than large ones.
Patients with an intra-operative fracture of the calcar had smaller
and narrower femurs than those without a fracture (p <
0.05)
and the implanted Corail stems were smaller in those with a fracture
(mean size 9 The variability of the shape of the femoral neck at the level
of division contributes to the understanding of the causation of
intra-operative fractures in uncemented THA. Cite this article:
Aims. Better prediction of outcome after
Aims. The aim of this investigation was to compare risk of infection in both cemented and uncemented hemiarthroplasty (HA) as well as in