Advertisement for orthosearch.org.uk
Results 1 - 4 of 4
Results per page:
Applied filters
Content I can access

Include Proceedings
Dates
Year From

Year To
Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_9 | Pages 97 - 97
1 May 2017
Elbashir M Angadi D Latimer M
Full Access

Background

The pattern of appearance of secondary ossification centers in the elbow has been based on historical studies and is popularly referred to with the mnemonic CRITOL. However the six secondary ossification centers can be variable in their presentation and pose a challenge in assessment of children with elbow injuries. Furthermore limited studies available in the current literature have reported an aberration to the sequence of appearance especially with the ossification centers of trochlea and olecranon.

Aims

The aim of the study was to evaluate the relative sequence of appearance of secondary ossification centers for the trochlea and olecranon.


Introduction

Despite the multiple patho-aetiological basis of Hallux valgus (HV), corrective osteotomy is a common and globally performed orthopaedic procedure. Over-correction of the inter-metatarsal angle (IMA), however, is not without consequence. Through increased joint pressures, over-correction may predispose to joint degeneration. Hypothesizing that over-correction leads to an increase in intra-articular joint pressures, we constructed a mechanical simulation of the 1st metatarsal-phalangeal joint.

Methods

The vector forces of Flexor Hallucis Longus, Extensor Hallucis Longus, Extensor Hallucis Brevis and Adductor Hallucis, acting upon the 1st proximal phalanx were simulated with tensioned weighted rope. A Foley catheter balloon inflated to 1.5ml, simulated intra-articular distractive vector forces. The joint was freely mobile.

At 5° IMA intervals from 10° valgus to 15° varus, intrarticular pressures were recorded using a contact pressure (Graseby™, Hertfordshire, UK) transducer attached to a calibrated manometer (Digitech Instruments™, Ulhasnagar, India). At each angle, measurements were repeated five times with removal and recalibration of the pressure monitor after each measurement.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXIX | Pages 10 - 10
1 Sep 2012
Bloch B Angadi D Brown S Crawfurd E
Full Access

Method

286 patients underwent total hip arthroplasty with a cemented titanium femoral implant (Ultima, Johnson & Johnson) between July 1995 and July 2001. The acetabular component was either a porous coated cup or a cemented all-polyethylene cup. A 28mm cobalt chromium head was used in all patients. Patients were prospectively evaluated with clinical examination, Harris hip scores and radiographic assessment. Analysis of the data was performed.

Results

Of the 286 patients, 11 patients were excluded from analysis for reasons including incomplete data (8) and death (3). The remaining 275 patients were comprised of 118 males and 157 females with an average age of 70.8 years (55–89 years). The average follow up was 10.5 years (1.03–14.23). The median follow up was 10 years. 177 cemented all-polyethylene and 98 porous coated acetabular cups were used. The average Harris hip scores were 34.4 and 81.25 for preoperative and last follow up visit respectively. 11 stems were revised (aseptic loosening 9, infection 2). Radiographic assessment showed vertical subsidence in 30 patients (10.9%) (>5mm in 6 and < 5mm in 24 patients). Complete cement-bone radiolucency was noted in 11 stems (4%). Radiolucent lines covering < 50% of cement-bone interface were noted in 18 stems (6.5%). There were no cases of cement fracture. Kaplan-Meier survivorship was 91% at 10 years & 89.8% at 12 years.


Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_II | Pages 128 - 128
1 May 2011
Angadi D Brown S Crawfurd E
Full Access

Background: Cemented and cementless fixations of acetabular components in total hip arthroplasty are routine practice with inherent advantages and disadvantages. The aim of our prospective randomized study was to compare the clinical and radiographic results of cementless porous-coated cobalt chromium acetabular component with cemented all-polyethylene acetabular component in total hip arthroplasty.

Methods: Three hundred patients were randomized to receive a cementless hemispherical cobalt chromium porous-coated no-hole acetabular component (group 1) or cemented all-polyethylene acetabular component (group 2) with an identical cemented femoral stem and 28mm cobalt-chromium head. Patients were evaluated clinically with Harris Hip Scores (HHS) and radiographically. Analysis of both intention-to-treat groups was performed.

Results: Group 1 had 128 patients (55 male, 73 female) with average age of 70.3 years. Group 2 had 147 patients (63 male, 84 female) with average age of 71.2 years. Average follow-up was 9.5 years (1.03–13.23). The median follow-up was 10 years. 25 patients were excluded from analysis for reasons including unfit for surgery (2), operation cancelled (2), missing data (8) and non-study device (10). Average preoperative HHS improved from 34.4 and 34.5 to 80 and 82.5 postoperatively in group 1 and 2 respectively. There was no statistically significant difference between the average HHS of the two groups (p=0.449) at last follow-up. There were 7 revisions in group 1 [infection (2), cup migration (2), aseptic loosening (1), slipped cup (1) and fractured liner (1)]. 11 patients had revision in group 2 [aseptic loosening (8) and recurrent dislocations (3)]. Revision rate between the two groups was not statistically significant (p=0.465). 10-year survivorship was 93.8%; and 86.6%; for group 1 and 2 respectively. No statistically significant difference was noted for prognostic factors like gender (p=0.006), body mass index (p=0.433), age (p=0.657) and surgical approach (p=0.004) for the two groups. Prognostic factors like gender (male, p=0.006) and surgical approach (posterior, p=0.004) were noted to be significant but body mass index (p=0.433) and age (p=0.657) had no statistical significance. Bootstrapping analysis for the two groups (p-value calculations N=3000) showed a significant p-value for 19 and not significant p-value for 2981 calculations. 4 porous coated cups and 29 all-polyethylene cups had radiolucencies. None of the porous-coated cups had expansile osteolysis.

Conclusions: The results from our study indicate that patients with a cemented all-polyethylene cup and cementless porous coated cup have similar long term outcomes. In patients over 75 years cemented cups have excellent results (100% survivorship at 10 years).