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The Journal of Bone & Joint Surgery British Volume
Vol. 56-B, Issue 4 | Pages 613 - 617
1 Nov 1974
Cameron HU Kostuik JP

1. Thirty-nine patients with synovial sarcoma have been reviewed. 2. The average rate of five-year survival was 45 per cent; of ten-year survival, 30 per cent; and of survival for more than ten years, 10 per cent. 3. The only important factor influencing the long-term results was the method of treatment; primary amputation was by far the best


The Bone & Joint Journal
Vol. 102-B, Issue 7 | Pages 861 - 867
1 Jul 2020
Hiranaka T Yoshikawa R Yoshida K Michishita K Nishimura T Nitta S Takashiba K Murray D

Aims

Cementless unicompartmental knee arthroplasty (UKA) has advantages over cemented UKA, including improved fixation, but has a higher risk of tibial plateau fracture, particularly in Japanese patients. The aim of this multicentre study was to determine when cementless tibial components could safely be used in Japanese patients based on the size and shape of the tibia.

Methods

The study involved 212 cementless Oxford UKAs which were undertaken in 174 patients in six hospitals. The medial eminence line (MEL), which is a line parallel to the tibial axis passing through the tip of medial intercondylar eminence, was drawn on preoperative radiographs. Knees were classified as having a very overhanging medial tibial condyle if this line passed medial to the medial tibial cortex. They were also classified as very small if a size A/AA tibial component was used.


The Journal of Bone & Joint Surgery British Volume
Vol. 90-B, Issue 8 | Pages 1013 - 1018
1 Aug 2008
Goto K Kawanabe K Akiyama H Morimoto T Nakamura T

We reviewed 44 consecutive revision hip replacements in 38 patients performed using the cement-in-cement technique. All were performed for acetabular loosening in the presence of a well-fixed femoral component. The mean follow-up was 5.1 years (2 to 10.1). Radiological analysis at final follow-up indicated no loosening of the femoral component, except for one case with a continuous radiolucent line in all zones and peri-prosthetic fracture which required further revision. Peri-operative complications included nine proximal femoral fractures (20.4%) and perforation of the proximal femur in one hip. In five hips wiring or fixation with a braided suture was undertaken but no additional augmentation was required. There was an improvement in the mean Japanese Orthopaedic Association score from 55.5 (28 to 81) pre-operatively to 77.8 (40 to 95) at final follow-up (p < 0.001). Revision using a cement-in-cement technique allows increased exposure for acetabular revision and is effective in the medium term. Further follow-up is required to assess the long-term results in the light of in vitro studies which have questioned the quality of the cement-in-cement bond


The Journal of Bone & Joint Surgery British Volume
Vol. 68-B, Issue 5 | Pages 748 - 750
1 Nov 1986
Blasier D Mayba I Ferguson C DeSa D Bishop A Letts M

The existence of pulmonary metastases in patients presenting with osteosarcoma is known to indicate a poor prognosis. Lung resection of solitary lesions is now a standard treatment approach, but with limited successful long-term results. We report the progress of a 16-year-old girl with osteosarcoma of the proximal tibia who underwent 11 lung resections for pulmonary metastases over a two-year period, and who has since then been free of disease for seven years


The Journal of Bone & Joint Surgery British Volume
Vol. 59-B, Issue 2 | Pages 233 - 235
1 May 1977
Mitchell G

In cases of established calcaneus after anterior poliomyelitis the deformity can be greatly reduced by combining an extensive plantar release with an oblique transverse osteotomy of the calcaneus that permits displacement upwards and backwards of the posterior weight-bearing part of the bone. The procedure greatly improves the mechanical advantage of subsequent tendon transplantations to the heel. Between 1956 and 1969 fifteen such osteotomies were carried out and the long-term results have been reviewed


The Journal of Bone & Joint Surgery British Volume
Vol. 46-B, Issue 3 | Pages 426 - 444
1 Aug 1964
Sharrard WJW

1. The indications for and technique of posterior iliopsoas transplantation are described with particular reference to paralytic dislocation and subluxation of the hip in children. 2. Experience of 150 operations in ninety-five patients and of the long-term results of forty-one operations are given. 3. Reduction of the dislocation has been maintained in every case even when there was complete paralysis of all gluteal muscles. 4. All the children are able to walk without the aid of hip splintage


The Bone & Joint Journal
Vol. 102-B, Issue 7 | Pages 845 - 851
1 Jul 2020
Goh GS Liow MHL Tay YWA Chen JY Xu S Pang H Tay DK Chia S Lo N Yeo S

Aims

While patients with psychological distress have poorer short-term outcomes after total knee arthroplasty (TKA), their longer-term function is unknown. We aimed to 1) assess the influence of preoperative mental health status on long-term functional outcomes, quality of life, and patient satisfaction; and 2) analyze the change in mental health after TKA, in a cohort of patients with no history of mental health disorder, with a minimum of ten years’ follow-up.

Methods

Prospectively collected data of 122 patients undergoing primary unilateral TKA in 2006 were reviewed. Patients were assessed pre- and postoperatively at two and ten years using the Knee Society Knee Score (KSKS) and Function Score (KSFS); Oxford Knee Score (OKS); and the Mental (MCS) and Physical Component Summary (PCS) which were derived from the 36-Item Short-Form Health Survey questionnaire (SF-36). Patients were stratified into those with psychological distress (MCS < 50, n = 51) and those without (MCS ≥ 50, n = 71). Multiple regression was used to control for age, sex, BMI, Charlson Comorbidity Index (CCI), and baseline scores. The rate of expectation fulfilment and satisfaction was compared between patients with low and high MCS.


The Journal of Bone & Joint Surgery British Volume
Vol. 77-B, Issue 6 | Pages 920 - 921
1 Nov 1995
Stromsoe K Hoqevold H Skjeldal S Alho A

We randomised 50 patients with ankle fractures of Weber types B and C and a ruptured deltoid ligament treated by open reduction and internal fixation to two treatment groups to examine the influence of the repair of a ruptured deltoid ligament. No differences were found except for a longer duration of surgery in the repair group. Our findings suggest that a ruptured deltoid ligament can be left unexplored without any effect either on early mobilisation or on the long-term result


The Bone & Joint Journal
Vol. 102-B, Issue 5 | Pages 618 - 626
1 May 2020
Zhou W Sankar WN Zhang F Li L Zhang L Zhao Q

Aims

The goal of closed reduction (CR) in the treatment of developmental dysplasia of the hip (DDH) is to achieve and maintain concentricity of the femoral head in the acetabulum. However, concentric reduction is not immediately attainable in all hips and it remains controversial to what degree a non-concentric reduction is acceptable. This prospective study is aimed at investigating the dynamic evolution of the hip joint space after CR in DDH using MRI.

Methods

A consecutive series of patients with DDH who underwent CR since March 2014 were studied. Once the safety and stability were deemed adequate intraoperatively, reduction was accepted regardless of concentricity. Concentricity was defined when the superior joint space (SJS) and medial joint space (MJS) were both less than 2 mm, based on MRI. A total of 30 children, six boys and 24 girls, involving 35 hips, were recruited for the study. The mean age at CR was 13.7 months (3.5 to 27.6) and the mean follow-up was 49.5 months (approximately four years) (37 to 60). The joint space was evaluated along with the interval between the inverted and everted limbus.


The Journal of Bone & Joint Surgery British Volume
Vol. 77-B, Issue 3 | Pages 396 - 399
1 May 1995
Fraser R Menelaus M Williams P Cole W

We studied the long-term results of the Miller operation at a mean age of 13 years in 22 patients (38 feet) with persistently symptomatic mobile flat feet associated with an isolated naviculocuneiform break. At a mean of 12 years (3 to 27) after surgery, 84% of the feet had a satisfactory clinical result. We conclude that the Miller operation is a useful procedure for adolescent patients with persistently symptomatic flat feet with an isolated break at the naviculocuneiform joint


The Journal of Bone & Joint Surgery British Volume
Vol. 80-B, Issue 5 | Pages 754 - 756
1 Sep 1998
Shen G

The excellent long-term results for the first-generation Charnley stem may not apply to later versions with flanges. It seems possible that the early design functioned as a taper-slip system, as accepted in the Exeter prosthesis. Comparison with the requirements for the alternative composite-beam system for the femoral component shows considerable differences that have important implications. These include design, surface finish, cementing technique and the interpretation of radiological signs of loosening. A distinction should be made between the requirements for the successful use of the two different engineering systems.s


The Journal of Bone & Joint Surgery British Volume
Vol. 80-B, Issue 2 | Pages 325 - 327
1 Mar 1998
Hui JHP De SD Balasubramaniam P

Recurrent dislocation of peroneal tendons is uncommon and there are few reports of the long-term results after repair. The Singapore operation, first described in 1985, is an anatomical repair based on the Bankart-like lesion seen in the superior peroneal retinaculum. We reviewed 21 patients after a mean follow-up of 9.3 years, and found no recurrence. Eighteen had good functional results and had returned to their previous levels of vocational and sports activities. The three fair results were due to painful scars or neuromas


The Journal of Bone & Joint Surgery British Volume
Vol. 89-B, Issue 2 | Pages 215 - 221
1 Feb 2007
Krieg AH Hefti F

We evaluated 31 patients who were treated with a non-vascularised fibular graft after resection of primary musculoskeletal tumours, with a median follow-up of 5.6 years (3 to 26.7 years). Primary union was achieved in 89% (41 of 46) of the grafts in a median period of 24 weeks. All 25 grafts in 18 patients without additional chemotheraphy and/or radiotherapy achieved primary union, compared with 16 of the 21 grafts (76%; 13 patients) with additional therapy (p = 0.017). Radiographs showed an increase in diameter in 70% (59) of the grafts. There were seven fatigue fractures in six patients, but only two needed treatment. Non-vascularised fibular transfer is a simpler, less expensive and a shorter procedure than the use of vascularised grafts and allows remodelling of the fibula at the donor site. It is a biological reconstruction with good long-term results, and a relatively low donor site complication rate of 16%


The Journal of Bone & Joint Surgery British Volume
Vol. 80-B, Issue 3 | Pages 391 - 395
1 May 1998
Schreurs BW Slooff TJJH Buma P Gardeniers JWM Huiskes R

We report a long-term review of 60 acetabular components revised using impacted, morsellised bone allografts and a cemented polyethylene cup. The acetabular defects were cavitary (37) or combined (23). Follow-up was for a mean 11.8 years (10 to 15). Further revision was needed in five hips, two for septic and three for aseptic loosening. The overall survival rate at 11.8 years was 90%; excluding the septic cases it was 94%. Acetabular reconstruction with impacted morsellised cancellous grafts and cement gives satisfactory long-term results


The Journal of Bone & Joint Surgery British Volume
Vol. 75-B, Issue 3 | Pages 464 - 467
1 May 1993
Hodgkinson J Maskell A Paul A Wroblewski B

A flanged socket was introduced by Sir John Charnley for use in his low-friction hip arthroplasty in 1976. Experimental evidence has suggested that the flange offers an advantage in terms of cement pressurisation at the time of implantation. We have reviewed 302 primary Charnley arthroplasties followed for 9 to 11 years to determine the effect of the flanged socket on the radiological appearance. The incidence of radiological demarcation at the cement-bone interface is significantly reduced in early radiographs after the use of a flanged socket, and the advantage is maintained in the long-term results


The Journal of Bone & Joint Surgery British Volume
Vol. 36-B, Issue 2 | Pages 209 - 217
1 May 1954
Stammers FAR

1. The history of the development of the operation of sympathetic ganglionectomy for vasospasm is related. 2. A simple classification is given of the common diseases of the peripheral arteries. 3. The symptoms of peripheral arterial disease are described. 4. The investigations are discussed. 5. The treatment, both conservative and surgical, is discussed, with comments on arterial grafts. 6. Special points are made regarding poliomyelitis, acrocyanosis, Bazin's disease, cervical rib, vascular injuries and crutch arteritis. 7. The long-term results of sympathectomy are reviewed


The Journal of Bone & Joint Surgery British Volume
Vol. 73-B, Issue 4 | Pages 603 - 606
1 Jul 1991
Hooning van Duyvenbode J Keijser L Hauet E Obermann W Rozing P

We report the long-term results of the Matti-Russe operation for pseudarthrosis of the scaphoid in 100 cases, reported previously by Mulder in 1968. Clinical results for 77 patients and radiographic data for 74 were reviewed at 22 to 34.8 years after surgery. In general, there was satisfactory relief of pain and stiffness but some patients had limitation of motion and reduced grip-strength, with usually slight osteoarthritic changes. There was poor correlation between subjective, objective, and radiographic results but 88% of the patients were satisfied with their results


The Journal of Bone & Joint Surgery British Volume
Vol. 53-B, Issue 2 | Pages 183 - 197
1 May 1971
Garden RS

1. The long-term results in a consecutive series of 323 healed subcapital fractures of the femur show that, with few exceptions, the capital fragment maintains its integrity when the fragments are aligned within the narrow limits of good reduction, but undergoes superior segmental collapse when reduction is poor. 2. The effect of malreduction on the congruity of the hip joint is examined, and a remodelling response to malalignment of the aspherical femoral head in the imperfectly round acetabulum is proposed as an alternative interpretation of the radiological changes now considered to be the result of capital ischaemia


The Journal of Bone & Joint Surgery British Volume
Vol. 89-B, Issue 4 | Pages 516 - 520
1 Apr 2007
Bufquin T Hersan A Hubert L Massin P

We used an inverted shoulder arthroplasty in 43 consecutive patients with a mean age of 78 years (65 to 97) who had sustained a three- or four-part fracture of the upper humerus. All except two were reviewed with a mean follow-up of 22 months (6 to 58). The clinical outcome was satisfactory with a mean active anterior elevation of 97° (35° to 160°) and a mean active external rotation in abduction of 30° (0° to 80°). The mean Constant and the mean modified Constant scores were respectively 44 (16 to 69) and 66% (25% to 97%). Complications included three patients with reflex sympathetic dystrophy, five with neurological complications, most of which resolved, and one with an anterior dislocation. Radiography showed peri-prosthetic calcification in 36 patients (90%), displacement of the tuberosities in 19 (53%) and a scapular notch in ten (25%). Compared with conventional hemiarthroplasty, satisfactory mobility was obtained despite frequent migration of the tuberosities. However, long-term results are required before reverse shoulder arthroplasty can be recommended as a routine procedure in complex fractures of the upper humerus in the elderly


The Journal of Bone & Joint Surgery British Volume
Vol. 94-B, Issue 6 | Pages 746 - 754
1 Jun 2012
Jameson SS Baker PN Mason J Porter ML Deehan DJ Reed MR

Modern metal-on-metal hip resurfacing has been widely performed in the United Kingdom for over a decade. However, the literature reports conflicting views of the benefits: excellent medium- to long-term results with some brands in specific subgroups, but high failure rates and local soft-tissue reactions in others. The National Joint Registry for England and Wales (NJR) has collected data on all hip resurfacings performed since 2003. This retrospective cohort study recorded survival time to revision from a resurfacing procedure, exploring risk factors independently associated with failure. All patients with a primary diagnosis of osteoarthritis who underwent resurfacing between 2003 and 2010 were included in the analyses. Cox’s proportional hazard models were used to analyse the extent to which the risk of revision was related to patient, surgeon and implant covariates. A total of 27 971 hip resurfacings were performed during the study period, of which 1003 (3.59%) underwent revision surgery. In the final adjusted model, we found that women were at greater risk of revision than men (hazard ratio (HR) = 1.30, p = 0.007), but the risk of revision was independent of age. Of the implant-specific predictors, five brands had a significantly greater risk of revision than the Birmingham Hip Resurfacing (BHR) (ASR: HR = 2.82, p < 0.001, Conserve: HR = 2.03, p < 0.001, Cormet: HR = 1.43, p = 0.001, Durom: HR = 1.67, p < 0.001, Recap: HR = 1.58, p = 0.007). Smaller femoral head components were also significantly more likely to require revision (≤ 44 mm: HR = 2.14, p < 0.001, 45 to 47 mm: HR = 1.48, p = 0.001) than medium or large heads, as were operations performed by low-volume surgeons (HR = 1.36, p <  0.001). Once these influences had been removed, in 4873 male patients < 60 years old undergoing resurfacing with a BHR, the five-year estimated risk of revision was 1.59%. In summary, after adjustment for a range of covariates we found that there were significant differences in the rate of failure between brands and component sizes. Younger male patients had good five-year implant survival when the BHR was used