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The Bone & Joint Journal
Vol. 102-B, Issue 4 | Pages 423 - 425
1 Apr 2020
Hoggett L Cross C Helm A

Aims

Dislocation remains a significant complication after total hip arthroplasty (THA), being the third leading indication for revision. We present a series of acetabular revision using a dual mobility cup (DMC) and compare this with our previous series using the posterior lip augmentation device (PLAD).

Methods

A retrospective review of patients treated with either a DMC or PLAD for dislocation in patients with a Charnley THA was performed. They were identified using electronic patient records (EPR). EPR data and radiographs were evaluated to determine operating time, length of stay, and the incidence of complications and recurrent dislocation postoperatively.


Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_9 | Pages 12 - 12
1 May 2018
Myatt D Cross C Helm A
Full Access

Fractured neck of femur is a significant health concern within the UK. NICE guidance on the management of displaced intracapsular fractures states that total hip arthroplasty should be offered when patients can; walk independently out of doors with no more than a stick, not cognitively impaired, medically fit for anaesthesia and the procedure. We previously managed this subgroup using THA with standard sockets. Following an audit of this practice a dislocation rate of 9% was identified and practice was changed to using dual mobility (THA-DM) with the theoretical advantage of reducing dislocation.

We reviewed all patients who underwent THA for fracture using Bluespier from 2013–2017. Operative notes and radiographs were reviewed to ensure the patients had undergone THA for displaced intracapsular fracture. Basic patient demographics were collected. Our primary outcome was dislocation rates at one year. Our secondary outcomes were length of time to surgery, length of stay, operative time, mortality, return to theatre rates and one year Oxford hip scores

We found a control group of 45 THA procedures and a dual mobility group of 143 procedures. The one year dislocation rate from the THA-SS group was 9% and the THA-DM group was 1.4%(CI±1.9%)(p=<0.05%). There were also non-significant reductions in time to surgery, length of stay, operative time, mortality, return to theatre rates. The one year Oxford hip score was comparable at 42.2 to 41.8.

This study demonstrates a significant reduction in one year dislocation rates with comparable oxford hip scores. Use of THA-DM should be considered in those patients who meet NICE criteria. Further research is needed into long term dislocation rates.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 387 - 387
1 Sep 2012
Bhutta M Cross C
Full Access

BACKGROUND

From 1995 the cost of litigation to the National Health Service (NHS) from surgical procedures has been over 1.3 billion GBP. Spinal patients can present diagnostic challenges and the consequences of delayed diagnosis and surgical complications can be devastating. As a consequence these patients represent a high risk when surgeons seek to indemnify themselves.

We therefore, aim to highlight the litigation patterns for these injuries within the United Kingdom.

METHOD

Data was obtained from the NHS Litigation Authority from 2002 to 2010 which was analysed.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXVI | Pages 31 - 31
1 Jun 2012
Cross C Kapoor V Todd B Bhutta M
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Background

Surgical patients have cost the NHS 1.3 billion GBP from 1995. Spinal pathologies can present diagnostic challenges, and the consequences of delayed diagnosis or surgical complications can be devastating and so creating high indemnity costs.

We aim to highlight the spinal associated litigation patterns within the United Kingdom.

Method

Data was obtained from the NHS Litigation Authority from 2002 to 2010.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXVI | Pages 26 - 26
1 Jun 2012
Bhutta MA Wilkinson J Cross C Tandon V Kapoor V Todd BD
Full Access

Introduction

Lumbar spinal pain can be a consequence of discogenic pain. After failure of conservative management, lumbar fusions are popular and considered the gold standard. However, these techniques are associated with significant morbidity.

A percutaneous trans-sacral technique may address these for L4/L5 and/or L5/S1 alone spinal fusions. Our unit has adopted this technique and presents our initial experience of 51 patients and preliminary results.

Method

Patients with a confirmed clinical and radiological evidence of degenerate intervertebral disc with or without prior surgical intervention were selected. Patients with a history of pelvic surgery/radiotherapy were excluded. Data was collected prospectively using the Global Patient Outcome Scoring System and Oswestry Disability Index (ODI) scores at clinical follow-up.