This study aimed to assess the impact of using the metal-augmented glenoid baseplate (AGB) on improving clinical and radiological outcomes, as well as reducing complications, in patients with superior glenoid wear undergoing reverse shoulder arthroplasty (RSA). From January 2016 to June 2021, out of 235 patients who underwent primary RSA, 24 received a superior-AGB after off-axis reaming (Group A). Subsequently, we conducted propensity score matching in a 1:3 ratio, considering sex, age, follow-up duration, and glenoid wear (superior-inclination and retroversion), and selected 72 well-balanced matched patients who received a standard glenoid baseplate (STB) after eccentric reaming (Group B). Superior-inclination, retroversion, and lateral humeral offset (LHO) were measured to assess preoperative glenoid wear and postoperative correction, as well as to identify any complications. Clinical outcomes were measured at each outpatient visit before and after surgery.Aims
Methods
The aim of this study was to compare the clinical and radiological outcomes of reverse shoulder arthroplasty (RSA) using small and standard baseplates in Asian patients, and to investigate the impact of a mismatch in the sizes of the glenoid and the baseplate on the outcomes. This was retrospective analysis of 50 and 33 RSAs using a standard (33.8 mm, ST group) and a small (29.5 mm, SM group) baseplate of the Equinoxe reverse shoulder system, which were undertaken between January 2017 and March 2021. Radiological evaluations included the size of the glenoid, the Aims
Methods
This study compared patients who underwent arthroscopic repair of large to massive rotator cuff tears (LMRCTs) with isolated incomplete repair of the tear and patients with incomplete repair with biceps tendon augmentation. We aimed to evaluate the additional benefit on clinical outcomes and the capacity to lower the re-tear rate. We retrospectively reviewed 1,115 patients who underwent arthroscopic rotator cuff repair for full-thickness tears between October 2011 and May 2019. From this series, we identified 77 patients (28 male, 49 female) with a mean age of 64.1 years (50 to 80). Patients were classified into groups A (n = 47 incomplete) and B (n = 30 with biceps augmentation) according to the nature of their reconstruction. Clinical scores were checked preoperatively and at six months, one year, and two years postoperatively. In preoperative MRI, we measured the tear size, the degree of fatty infiltration, and muscle volume ratio of the supraspinatus. In postoperative MRI, the integrity of the repaired rotator cuff tendon was assessed using the Sugaya classification. Tendon thickness at the footprint was evaluated on T2-weighted oblique coronal view.Aims
Methods
There is no single standardised method of measuring
the orientation of the acetabular component on plain radiographs
after total hip arthroplasty. We assessed the reliability and accuracy
of three methods of assessing anteversion of the acetabular component
for 551 THAs using the PolyWare software and the methods of Liaw
et al, and of Woo and Morrey. All measurements of the three methods
had excellent intra- and inter-observer reliability. The values
of the PolyWare software, which determines version of the acetabular
component by edge detection were regarded as the reference standard.
Although the PolyWare software and the method of Liaw et al were similarly
precise, the method of Woo and Morrey was significantly less accurate
(p <
0.001). The method of Liaw et al seemed to be more accurate
than that of Woo and Morrey when compared with the measurements
using the PolyWare software. If the qualified lateral radiograph
was selected, anteversion measured using the method of Woo and Morrey
was considered to be relatively reliable. Cite this article:
Revision TKA using CCK prosthesis showed comparable outcome to PS prosthesis in clinical and radiological results. In revision total knee arthroplasty (TKA), the goal should be to obtain good motion, function and most importantly stability. The stability depends on remaining soft tissue and implant design. The more the ligaments retain function, the less the implant constraint is needed to achieve stability. With increased constraint, the transfer of joint reaction forces to implant-bone interface may lead to mechanical loosening of the implant. Constrained condylar knee (CCK) prosthesis provides more constraint compared with posterior stabilized (PS) prosthesis. The purpose of this study was to compare the clinical, radiological outcome and survivorship of CCK and PS prosthesis in revision TKA.Summary
Introduction
UC TKA showed similar anteroposterior translation and more femoral external rotation of earlier onset when compared to PS TKA. Recently highly conforming ultracongruent TKA has been reintroduced with improved wear characteristics and lower complications. The purpose of the study was to assess kinematics and clinical outcome of posterior stabilized and ultracongruent rotating-platform mobile bearing TKA.Summary
Introduction
To evaluate the clinical and radiologic midterm results of rotational acetabular osteotomy (RAO) in incongruent hip joints. A consecutive series of 15 hips in 14 patients who underwent RAO in incongruent hip joint were evaluated at an average follow-up of 52.3 months (range from 36 to 101 months). The average age at operation was 27 years (range from 12 to 38 years) old. The preoperative diagnoses were developmental dysplasia in 4 hips, sequelae of Legg-Calvé-Perthes disease in 8 hips, and multiple epiphyseal dysplasia in 3 hips. The RAO procedures were combined with a femoral valgus oseotomy in 10 hips, advance osteotomy of greater trochanter in 4 hips, derotational osteotomy in 2 hips. Clinically, Harris hip score, range of motion, leg length discrepancy(LLD) and hip joint pain were evaluated. Radiological changes of anterior and lateral center-edge(CE) angle, acetabular roof angle, acetabular head index(AHI), ratio of body weight moment arm to abductor moment arm, and a progression of osteoarthritis were analyzed.Purpose
Material and Methods
The generation of particle debris from ultra high molecular weight polyethylene (UHMWPE) against metal hip joints has been shown to cause osteolysis leading to joint loosening in the medium term. This is known as late aseptic loosening since infection is absent In an attempt to reduce the volume of wear debris, attention has moved to metal-on-metal prostheses as the total volume of wear debris is less. However, the size, shape and number of the particles are important as well as the total volume as these affect the biological response of the body leading to aseptic loosening. The Durham Mk I Hip Joint Simulator was used to generate CoCrMo wear particles in a series of tests. Four simulator tests took place in succession, initially 50 mm Birmingham hip replacements were tested where both the head and the cup were as-cast CoCrMo alloy. A second test was conducted where the components were 38 mm and both head and cup were as-cast CoCrMo. A third test using 50 mm components was completed where both head and cup were double heat treated CoCrMo alloy and a final test took place where both components were 50 mm the head was as-cast and the cup was as-cast which had been pre-worn to 5 million cycles. Bovine serum with a concentration of 17 g/l of protein was used as a lubricant and particles were sampled every half million cycles. The volumetric wear was also obtained gravimetrically. A double enzymatic protocol was used to cleave the proteins from the particles taking great care to minimise any effect on the particles. Finally the particles were suspended in distilled, de-ionised water to enable them to be analysed using a NanoSight LM10 particle analyser. This yielded the size distribution of the particles. This was then confirmed by placing an aliquot of the suspended particles onto a carbon coated copper grid and drying them under a lamp. These particles were then imaged in the TEM. Energy Dispersive X-ray analysis was also used to obtain the chemical composition of the particles. The results indicated a strong correlation between the gravimetric wear and the number of particles. All the as-cast CoCrMo alloy tests showed a consistent particle modal average size. The double heat treated particles were shown to be smaller, with occasional large flake like particulates which were identified under the TEM. This particle data correlates extremely well with previous data from simple material testing pin on plate experiments. Previous studies have used microscopy to investigate the size and morphology of the particulate debris
We investigated patterns of refracture and their risk factors in patients with congenital pseudarthrosis of the tibia after Ilizarov osteosynthesis. We studied 43 cases in 23 patients. Temporal and spatial patterns of refracture and refracture-free survival were analysed in each case. The refracture-free rate of cumulative survival was 47% at five years and did not change thereafter. Refracture occurred at the previous pseudarthrosis in 16 of 19 cases of refracture. The risk of refracture was significantly higher when osteosynthesis was performed below the age of four years, when the tibial cross-sectional area was narrow, and when associated with persistent fibular pseudarthrosis. Refracture occurs frequently after successful osteosynthesis in these patients. Delaying osteosynthesis, maximising the tibial cross-sectional area and stabilising the fibula may reduce the risk of refracture.
