α-defensin is a biomarker which has been described as having
a high degree of accuracy in the diagnosis of periprosthetic joint
infection (PJI). Current meta-analyses are based on the α-defensin
laboratory-based immunoassay rather than the quick on-table lateral
flow test kit. This study is the first meta-analysis to compare the
accuracy of the α-defensin laboratory-based immunoassay and the
lateral flow test kit for the diagnosis of PJI. A systematic review was performed according to the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Inclusion criteria were all clinical studies where the diagnosis
of PJI was uncertain. All studies selected used the Musculoskeletal
Infection Society (MSIS) or modified MSIS criteria. Two independent
reviewers reviewed the studies and extracted data. A meta-analysis
of results was carried out: pooled sensitivity, specificity, positive
and negative likelihood ratio, heterogeneity and areas under curves
are reported.Aims
Materials and Methods
The aims of this study were to investigate any possible relationship
between a preoperative sensitivity to pain and the degree of pain
at rest and on exertion with postoperative function in patients
who underwent stemless total shoulder arthroplasty (TSA). In this prospective study, we included 63 patients who underwent
stemless TSA and were available for evaluation one year postoperatively.
There were 31 women and 32 men; their mean age was 71 years (53
to 89). The pain threshold, which was measured using a Pain Matcher
(PM) unit, the degree of pain (visual analogue scale at rest and
on exertion, and function using the short version of the Disabilities
of the Arm, Shoulder and Hand questionnaire (QuickDASH), were recorded
preoperatively, as well as three and 12 months postoperatively.Aims
Patients and Methods
Since long-term outcome of teres major tendon transfer surgery
for irreparable posterosuperior rotator cuff (RC) tears is largely
unknown, the primary aim of this study was to evaluate the long-term
outcome of the teres major transfer. We also aimed to report on
the results of a cohort of patients with a similar indication for
surgery that underwent a latissimus dorsi tendon transfer. In this prospective cohort study, we reported on the long-term
results of 20 consecutive patients with a teres major tendon transfer
for irreparable massive posterosuperior RC tears. Additionally,
we reported on the results of the latissimus dorsi tendon transfer
(n = 19). The mean age was 60 years (47 to 77). Outcomes included
the Constant score (CS), and pain at rest and during movement using
the Visual Analogue Scale (VAS).Aims
Patients and Methods
To explore whether orthopaedic surgeons have adopted the Proximal Fracture of the Humerus: Evaluation by Randomisation (PROFHER) trial results routinely into clinical practice. A questionnaire was piloted with six orthopaedic surgeons using a ‘think aloud’ process. The final questionnaire contained 29 items and was distributed online to surgeon members of the British Orthopaedic Association and British Elbow and Shoulder Society. Descriptive statistics summarised the sample characteristics and fracture treatment of respondents overall, and grouped them by whether they changed practice based on PROFHER trial findings. Free-text responses were analysed qualitatively for emerging themes using Framework Analysis principles.Objectives
Methods
In the initial development of total shoulder arthroplasty (TSA),
the humeral component was usually fixed with cement. Cementless
components were subsequently introduced. The aim of this study was
to compare the long-term outcome of cemented and cementless humeral
components in arthroplasty of the shoulder. All patients who underwent primary arthroplasty of the shoulder
at our institution between 1970 and 2012 were included in the study.
There were 4636 patients with 1167 cemented humeral components and
3469 cementless components. Patients with the two types of fixation
were matched for nine different covariates using a propensity score
analysis. A total of 551 well-balanced pairs of patients with cemented
and cementless components were available after matching for comparison
of the outcomes. The clinical outcomes which were analysed included loosening
of the humeral component determined at revision surgery, periprosthetic
fractures, post-operative infection and operating time.Aims
Patients and Methods
Increasing innovation in rapid prototyping (RP)
and additive manufacturing (AM), also known as 3D printing, is bringing
about major changes in translational surgical research. This review describes the current position in the use of additive
manufacturing in orthopaedic surgery. Cite this article:
Controversy about the use of an anatomical total shoulder arthroplasty
(aTSA) in young arthritic patients relates to which is the ideal
form of fixation for the glenoid component: cemented or cementless.
This study aimed to evaluate implant survival of aTSA when used
in patients aged < 60 years with primary glenohumeral osteoarthritis (OA),
and to compare the survival of cemented all-polyethylene and cementless
metal-backed glenoid components. A total of 69 consecutive aTSAs were performed in 67 patients
aged < 60 years with primary glenohumeral OA. Their mean age
at the time of surgery was 54 years (35 to 60). Of these aTSAs,
46 were undertaken using a cemented polyethylene component and 23
were undertaken using a cementless metal-backed component. The age, gender,
preoperative function, mobility, premorbid glenoid erosion, and
length of follow-up were comparable in the two groups. The patients
were reviewed clinically and radiographically at a mean of 10.3
years (5 to 12, Aims
Materials and Methods
Metabolic syndrome and low-grade systemic inflammation are associated with knee osteoarthritis (OA), but the relationships between these factors and OA in other synovial joints are unclear. The aim of this study was to determine if a high-fat/high-sucrose (HFS) diet results in OA-like joint damage in the shoulders, knees, and hips of rats after induction of obesity, and to identify potential joint-specific risks for OA-like changes. A total of 16 male Sprague-Dawley rats were allocated to either the diet-induced obesity group (DIO, 40% fat, 45% sucrose, n = 9) or a chow control diet (n = 7) for 12 weeks. At sacrifice, histological assessments of the shoulder, hip, and knee joints were performed. Serum inflammatory mediators and body composition were also evaluated. The total Mankin score for each animal was assessed by adding together the individual Modified Mankin scores across all three joints. Linear regression modelling was conducted to evaluate predictive relationships between serum mediators and total joint damage.Objectives
Methods
The October 2015 Shoulder &
Elbow Roundup360 looks at: Culture time important in propionibacterium acnes; Microvascularisation of the cuff footprint; Degenerative cuff tears: evidence for repair; Middle ground in distal humeral fractures?; Haste needed in elbow heterotopic ossification; Iatrogenic frozen shoulder; Salvage of failed humeral fixation
