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Bone & Joint 360
Vol. 13, Issue 4 | Pages 43 - 45
2 Aug 2024
Evans JT Evans JP Whitehouse MR


Bone & Joint 360
Vol. 13, Issue 2 | Pages 47 - 49
1 Apr 2024
Burden EG Krause T Evans JP Whitehouse MR Evans JT


Bone & Joint 360
Vol. 12, Issue 6 | Pages 49 - 51
1 Dec 2023
Burden EG Whitehouse MR Evans JT


Bone & Joint 360
Vol. 11, Issue 6 | Pages 49 - 50
1 Dec 2022
Evans JT Whitehouse MR


Bone & Joint 360
Vol. 12, Issue 4 | Pages 44 - 46
1 Aug 2023
Burden EG Whitehouse MR Evans JT


Bone & Joint 360
Vol. 11, Issue 5 | Pages 46 - 47
1 Oct 2022
Das A


Bone & Joint Research
Vol. 9, Issue 4 | Pages 162 - 172
1 Apr 2020
Xie S Conlisk N Hamilton D Scott C Burnett R Pankaj P

Aims. Metaphyseal tritanium cones can be used to manage the tibial bone loss commonly encountered at revision total knee arthroplasty (rTKA). Tibial stems provide additional fixation and are generally used in combination with cones. The aim of this study was to examine the role of the stems in the overall stability of tibial implants when metaphyseal cones are used for rTKA. Methods. This computational study investigates whether stems are required to augment metaphyseal cones at rTKA. Three cemented stem scenarios (no stem, 50 mm stem, and 100 mm stem) were investigated with 10 mm-deep uncontained posterior and medial tibial defects using four loading scenarios designed to mimic activities of daily living. Results. Small micromotions (mean < 12 µm) were found to occur at the bone-implant interface for all loading cases with or without a stem. Stem inclusion was associated with lower micromotion, however these reductions were too small to have any clinical significance. Peak interface micromotion, even when the cone is used without a stem, was too small to effect osseointegration. The maximum difference occurred with stair descent loading. Stress concentrations in the bone occurred around the inferior aspect of each implant, with the largest occurring at the end of the long stem; these may lead to end-of-stem pain. Stem use is also found to result in stress shielding in the bone along the stem. Conclusion. When a metaphyseal cone is used at rTKA to manage uncontained posterior or medial defects of up to 10 mm depth, stem use may not be necessary. Cite this article:Bone Joint Res. 2020;9(4):162–172


Bone & Joint 360
Vol. 11, Issue 4 | Pages 44 - 46
1 Aug 2022
Evans JT Walton TJ Whitehouse MR


Bone & Joint Research
Vol. 9, Issue 3 | Pages 146 - 151
1 Mar 2020
Waldstein W Koller U Springer B Kolbitsch P Brodner W Windhager R Lass R

Aims. Second-generation metal-on-metal (MoM) articulations in total hip arthroplasty (THA) were introduced in order to reduce wear-related complications. The current study reports on the serum cobalt levels and the clinical outcome at a minimum of 20 years following THA with a MoM (Metasul) or a ceramic-on-polyethylene (CoP) bearing. Methods. The present study provides an update of a previously published prospective randomized controlled study, evaluating the serum cobalt levels of a consecutive cohort of 100 patients following THA with a MoM or a CoP articulation. A total of 31 patients were available for clinical and radiological follow-up examination. After exclusion of 11 patients because of other cobalt-containing implants, 20 patients (MoM (n = 11); CoP (n = 9)) with a mean age of 69 years (42 to 97) were analyzed. Serum cobalt levels were compared to serum cobalt levels five years out of surgery. Results. The median cobalt concentration in the MoM group was 1.04 μg/l (interquartile range (IQR) 0.64 to 1.70) at a mean of 21 years (20 to 24) postoperatively and these values were similar (p = 0.799) to cobalt levels at five years. In the CoP control group, the median cobalt levels were below the detection limit (< 0.3 μg/l; median 0.15 μg/l, IQR 0.15 to 0.75) at 20 years. The mean Harris Hip Score was 91.4 points (61 to 100) in the MoM group and 92.8 points (63 to 100) in the CoP group. Conclusion. This study represents the longest follow-up series evaluating the serum cobalt levels after 28 mm head MoM bearing THA and shows that serum cobalt concentrations remain at low levels at a mean of 21 years (20 to 24) after implantation. Cite this article:Bone Joint Res. 2020;9(3):145–150


Bone & Joint 360
Vol. 10, Issue 6 | Pages 48 - 50
1 Dec 2021
Evans JT French JMR Whitehouse MR


Bone & Joint 360
Vol. 10, Issue 4 | Pages 49 - 51
1 Aug 2021
Evans JT Welch M Whitehouse MR


Bone & Joint 360
Vol. 10, Issue 2 | Pages 57 - 59
1 Apr 2021
Evans JT Whitehouse MR Evans JP


Bone & Joint Research
Vol. 9, Issue 8 | Pages 531 - 533
1 Aug 2020
Magan AA Plastow R Haddad FS


Bone & Joint 360
Vol. 7, Issue 1 | Pages 41 - 42
1 Feb 2018
Foy MA


The Bone & Joint Journal
Vol. 96-B, Issue 12 | Pages 1578 - 1585
1 Dec 2014
Rankin KS Sprowson AP McNamara I Akiyama T Buchbinder R Costa ML Rasmussen S Nathan SS Kumta S Rangan A

Trauma and orthopaedics is the largest of the surgical specialties and yet attracts a disproportionately small fraction of available national and international funding for health research. With the burden of musculoskeletal disease increasing, high-quality research is required to improve the evidence base for orthopaedic practice. Using the current research landscape in the United Kingdom as an example, but also addressing the international perspective, we highlight the issues surrounding poor levels of research funding in trauma and orthopaedics and indicate avenues for improving the impact and success of surgical musculoskeletal research.

Cite this article: Bone Joint J 2014; 96-B:1578–85.