Free vascularised fibular grafting has been reported
to be successful for adult patients with osteonecrosis of the femoral
head (ONFH). However, its benefit in teenage patients with post-traumatic
ONFH has not been determined. We evaluated the effectiveness of
free vascularised fibular grafting in the treatment of this condition
in children and adolescents. We retrospectively analysed 28 hips
in 28 patients in whom an osteonecrotic femoral head had been treated
with free vascularised fibular grafting between 2002 and 2008. Their
mean age was 16.3 years (13 to 19). The stage of the disease at
time of surgery, and results of treatment including pre- and post-operative
Harris hip scores, were studied. We defined clinical failure as
conversion to total hip replacement. All patients were followed
up for a mean of four years (2 to 7). The mean Harris hip score
improved from 60.4 (37 to 84) pre-operatively to 94.2 (87 to 100)
at final follow-up. At the latest follow-up we found improved or
unchanged radiographs in all four initially stage II hips and in
23 of 24 stage III or IV hips. Only one hip (stage V) deteriorated.
No patient underwent total hip replacement. Free vascularised fibular grafting is indicated for the treatment
of post-traumatic ONFH in teenage patients.
This study aims to assess the relationship between history of pseudotumour formation secondary to metal-on-metal (MoM) implants and periprosthetic joint infection (PJI) rate, as well as establish ESR and CRP thresholds that are suggestive of infection in these patients. We hypothesized that patients with a pseudotumour were at increased risk of infection. A total of 1,171 total hip arthroplasty (THA) patients with MoM articulations from August 2000 to March 2014 were retrospectively identified. Of those, 328 patients underwent metal artefact reduction sequence MRI and had minimum two years’ clinical follow-up, and met our inclusion criteria. Data collected included demographic details, surgical indication, laterality, implants used, history of pseudotumour, and their corresponding preoperative ESR (mm/hr) and CRP (mg/dl) levels. Multivariate logistic regression modelling was used to evaluate PJI and history of pseudotumour, and receiver operating characteristic curves were created to assess the diagnostic capabilities of ESR and CRP to determine the presence of infection in patients undergoing revision surgery.Aims
Methods
Reconstruction after osteoarticular resection of the proximal ulna for tumours is technically difficult and little has been written about the options that are available. We report a series of four patients who underwent radial neck to humeral trochlea transposition arthroplasty following proximal ulnar osteoarticular resection. Between July 2020 and July 2022, four patients with primary bone tumours of the ulna underwent radial neck to humeral trochlea transposition arthroplasty. Their mean age was 28 years (12 to 41). The functional outcome was assessed using the range of motion (ROM) of the elbow, rotation of the forearm and stability of the elbow, the Musculoskeletal Tumor Society score (MSTS), and the nine-item abbreviated version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH-9) score.Aims
Methods
The aim of this study was to report the medium-term outcomes of impaction bone allograft and fibular grafting for osteonecrosis of the femoral head (ONFH) and to define the optimal indications. A total of 67 patients (77 hips) with ONFH were enrolled in a single centre retrospective review. Success of the procedure was assessed using the Harris Hip Score (HHS) and rate of revision to total hip arthroplasty (THA). Risk factors were studied, including age, aetiology, duration of hip pain, as well as two classification systems (Association Research Circulation Osseous (ARCO) and Japanese Investigation Committee (JIC) systems).Aims
Methods
