Introduction: Intra-articular steroid injection has long been used to treat osteoarthritis of the knee and hip by orthopaedic surgeons, rheumatologists and general practitioners. Recent literature has shown conflicting results with regard to its safety. We aimed to investigate whether a relationship exists between preoperative intra-articular steroid injection and postoperative infection in total knee arthroplasty (TKA).

Patients and Methods: We reviewed the records of all patients having TKA between April 2005 and April 2007 in University Hospital Aintree, Liverpool. The operations were carried out by 6 consultants. Exclusion criteria for analysis were: previous knee infection, revision knee surgery, fracture around the knee, skin disorders, diabetes, blood transfusion, rheumatoid arthritis and immunosuppressive medication. Eligible patients were divided into two groups: group I had received intra-articular steroid injection (each subject receiving 1–3 (mean 1.6) injections between 1–12 (mean 5) months before TKA); group II had received no injection. Mean follow-up was 17 months.

Results: 425 patients had TKA, of which 361 met our criteria. 121 patients in group I and 240 patients in group II. No-one in group I developed acute infection. In group II, 7 patients developed acute infection (5 superficial and 2 deep) between 1 and 6 weeks (mean 3.7 weeks) post-operatively. There were no late infections. The difference in infection rate between groups I and II was not statistically significant (P=0.1, Fisher’s exact test).

Conclusion: We found no evidence that intra-articular steroid injection prior to TKA increased the incidence of postoperative infection.

Aim: The aim of this study was to evaluate prospectively the mid-term outcome following arthroscopic Bankart repair using two types of suture anchor, the G II (Mitek) non-absorbable and the Panalok (Mitek) absorbable anchor.

Method: Patients with a diagnosis of recurrent traumatic anterior instability of the shoulder seen between April 2000 and June 2003 in a single unit were considered for inclusion in the study. Patients were assessed preoperatively and postoperatively using a subjective patient related outcome measurement tool (Oxford instability score), visual analogue scales for pain and instability and a quality of life questionnaire (SF-12). Patients were randomised to undergo surgical repair with either non-absorbable or absorbable anchors. Length of follow-up was 3.3–6.5 (mean 5.0) years. The incidence of recurrent instability and the level of sporting ability were recorded.

Results: 130 patients were included in the study. 25 patients were lost to follow-up, 105 patients (81%) completed the study. 5 patients in absorbable group and 4 patients in non-absorbable group experienced further dislocation (8.5%). Both types of anchor were highly effective. There were no differences in the rate of recurrence or any of the scores between the two.

Conclusions: There are no differences in the outcome of arthroscopic Bankart repair using either absorbable or non-absorbable anchors. Both are highly effective, showing a redislocation rate of 8.5%.

Aim: To compare 2 rehabilitation regimes after arthroscopic interval release: immediate mobilization versus immediate mobilization and external rotation night splint for ten days.

Methods: 30 patients aged 40–67 years with primary frozen shoulder were included in the study. The surgical procedure consisted of release of the coracohumeral ligament, rotator interval and the posterior capsule with electrocautery, followed by gentle manipulation. Patients were randomised into 2 rehabilitation groups: immediate mobilization (IM) or immediate mobilization with external rotation night splint (ERS) used for 10 days post-operatively. Patients were assessed pre & post operatively and using the visual analogue score for pain, Constant and Oxford scoring systems.

Results: There were 15 patients in the IM group and 15 in ERS group. In the IM group the Constant score improved from 35±10 (mean±SD) pre-operatively to 63±14 at 1 month and 75±11 at 6 months, and in the ERS group the Constant score improved from 33±9 pre-operatively to 59±14 at 1 month and 75±7 at 6 months. The Oxford score in the IM group improved from 35±9 pre-operatively to 25±8 at 1 month and 18±9 at 6 months, and in the ERS group from 38±9 pre-operatively to 27±8 at 1 month and 18±8 at 6 months (all changes P< 0.001 cf pre-operative, but NS from 1 to 6 months). Improvements in VAS were significant in both groups (P< 0.02) at 6 months but not at 1 month. There was no significant difference between the two groups in terms of Oxford or Constant scores or VAS at 1 and 6 months.

Conclusion: Arthroscopic interval release is successful in restoring range of motion in patients with idiopathic frozen shoulder. Both groups showed significant improvement during the study period with most improvement in terms of range of movement occurring in the first month. There was no significant difference in outcome between the two groups studied.

Purpose: The aim of this study was to evaluate prospectively the outcome following arthroscopic Bankart repair using two types of suture anchors, absorbable and non-absorbable.

Method: Patients with a diagnosis of recurrent traumatic anterior instability of the shoulder, seen between April 2000 and June 2003, in a single unit were considered for inclusion in the study. Patients were assessed preoperatively and postoperatively using a subjective patient related outcome measurement tool (Oxford instability score), a visual analogue scale for pain and instability (VAS Pain and VAS instability) and a quality of life questionnaire (SF-12). Length of follow up was 1.5 to 5 years, mean 2.6 years. The incidence of recurrent instability and the level of sporting ability were recorded. Patients were randomised to undergo surgical repair with either non-absorbable or absorbable anchors.

Results: 130 patients were included in the study. 6 patients were lost to follow up; therefore 124 patients (95%) completed the study. Both types of anchors were highly effective. There were no differences in the rate of recurrence or any of the scores between the two groups. 4 patients in the non-absorbable group and 3 in the absorbable group experienced further episodes of dislocation after a traumatic event: the rate of redislocation in the whole series was therefore 6%. In addition 4 patients, all of them in the absorbable group (4%,) described ongoing symptoms of instability but no true dislocations. 85% of the patients have returned to their previous level of sporting activity.

Conclusions: There are no differences in the outcome of Arthroscopic Bankart repair using either absorbable or non-absorbable anchors. Both are highly effective, showing a redislocation rate of 5.6%.