It has been suggested that an increased posterior
tibial slope (PTS) and a narrow notch width index (NWI) increase
the risk of anterior cruciate ligament (ACL) injury. The aim of
this study was to establish why there are conflicting reports on
their significance. A total of fifty patients with a ruptured ACL
and 50 patients with an intact ACL were included in the study. The
group with ACL rupture had a statistically significantly increased
PTS (p <
0.001) and a smaller NWI (p <
0.001) than the control
group. When a high PTS and/or a narrow NWI were defined as risk
factors for an ACL rupture, 80% of patients had at least one risk
factor present; only 24% had both factors present. In both groups
the PTS was negatively correlated to the NWI (correlation coefficient
= -0.28, p = 0.0052). Using a univariate model, PTS and NWI appear
to be correlated to rupture of the ACL. Using a logistic regression
model, the PTS (p = 0.006) and the NWI (p <
0.0001) remain significant
risk factors. From these results, either a steep PTS or a narrow
NWI predisposes an individual to ACL injury. Future studies should
consider these factors in combination rather than in isolation.
Between April 1992 and July 2005, 310 posterior lip augmentation devices were used for the treatment of recurrent dislocation of the hip in 307 patients who had received primary total hip replacements (THRs) using Charnley/Charnley Elite components with a cemented acetabulum. The mean number of dislocations before stabilisation with the device was five (1 to 16) with a mean time to this intervention from the first dislocation of 3.8 years (0 days to 22.5 years). The mean age of the patients at this reconstruction was 75.4 years (39 to 96). A retrospective clinical and radiological review was carried out at a mean follow-up of six years and nine months (4.4 months to 13 years and 7 months). Of the 307 patients, 53 had died at the time of the latest review, with a functioning THR and with the posterior lip augmentation device
