We conducted a randomised controlled trial to assess the accuracy
of positioning and alignment of the components in total knee arthroplasty
(TKA), comparing those undertaken using standard intramedullary
cutting jigs and those with patient-specific instruments (PSI). There were 64 TKAs in the standard group and 69 in the PSI group. The post-operative hip-knee-ankle (HKA) angle and positioning
was investigated using CT scans. Deviation of >
3° from the planned
position was regarded as an outlier. The operating time, Oxford
Knee Scores (OKS) and Short Form-12 (SF-12) scores were recorded.Aims
Patients and Methods
We wished to quantify the extent of soft-tissue damage sustained
during minimally invasive total hip arthroplasty through the direct
anterior (DA) and direct superior (DS) approaches. In eight cadavers, the DA approach was performed on one side,
and the DS approach on the other, a single brand of uncemented hip
prosthesis was implanted by two surgeons, considered expert in their
surgical approaches. Subsequent reflection of the gluteus maximus
allowed the extent of muscle and tendon damage to be measured and
the percentage damage to each anatomical structure to be calculated.Aims
Materials and Methods
To address the natural history of severe post-tuberculous (TB)
kyphosis, with focus upon the long-term neurological outcome, occurrence
of restrictive lung disease, and the effect on life expectancy. This is a retrospective clinical review of prospectively collected
imaging data based at a single institute. A total of 24 patients
of Southern Chinese origin who presented with spinal TB with a mean
of 113° of kyphosis (65° to 159°) who fulfilled inclusion criteria
were reviewed. Plain radiographs were used to assess the degree
of spinal deformity. Myelography, CT and MRI were used when available
to assess the integrity of the spinal cord and canal. Patient demographics,
age of onset of spinal TB and interventions, types of surgical procedure,
intra- and post-operative complications, and neurological status
were assessed. Aims
Patients and Methods
Preservation of both anterior and posterior cruciate ligaments in total knee arthroplasty (TKA) can lead to near-normal post-operative joint mechanics and improved knee function. We hypothesised that a patient-specific bicruciate-retaining prosthesis preserves near-normal kinematics better than standard off-the-shelf posterior cruciate-retaining and bicruciate-retaining prostheses in TKA. We developed the validated models to evaluate the post-operative kinematics in patient-specific bicruciate-retaining, standard off-the-shelf bicruciate-retaining and posterior cruciate-retaining TKA under gait and deep knee bend loading conditions using numerical simulation.Objectives
Methods
The aims of this study were to determine the proportion of patients
with outlier varus or valgus alignment in kinematically aligned
total knee arthroplasty (TKA), whether those with outlier varus
or valgus alignment have higher forces in the medial or lateral
compartments of the knee than those with in-range alignment and
whether measurements of the alignment of the limb, knee and components
predict compartment forces. The intra-operative forces in the medial and lateral compartments
were measured with an instrumented tibial insert in 67 patients
who underwent a kinematically aligned TKA during passive movement.
The mean of the forces at full extension, 45° and 90° of flexion
determined the force in the medial and lateral compartments. Measurements
of the alignment of the limb and the components included the hip-knee-ankle
(HKA) angle, proximal medial tibial angle (PMTA), and distal lateral
femoral angle (DLFA). Measurements of the alignment of the knee
and the components included the tibiofemoral angle (TFA), tibial
component angle (TCA) and femoral component angle (FCA). Alignment was
measured on post-operative, non-weight-bearing anteroposterior (AP)
scanograms and categorised as varus or valgus outlier or in-range
in relation to mechanically aligned criteria.Aims
Patients and Methods
Surgeons face a substantial risk of infection because of the occupational exposure to blood-borne pathogens (BBPs) from patients undergoing high-risk orthopaedic procedures. This study aimed to determine the seroprevalence of four BBPs among patients undergoing joint arthroplasty in Shanghai, China. In addition, we evaluated the significance of pre-operative screening by calculating a cost-to-benefit ratio. A retrospective observational study of pre-operative screening for BBPs, including hepatitis B and C viruses (HBV and HCV), human immunodeficiency virus (HIV) and Treponema pallidum (TP), was conducted for sequential patients in the orthopaedic department of a large urban teaching hospital between 01 January 2009 and 30 May 2016. Medical records were analysed to verify the seroprevalence of these BBPs among the patients stratified by age, gender, local origin, type of surgery, history of previous transfusion and marital status.Objectives
Methods
In the time since Letournel popularised the surgical
treatment of acetabular fractures, more than 25 years ago, there
have been many changes within the field, related to patients, surgical
technique, implants and post-operative care. However, the long-term
outcomes appear largely unchanged. Does this represent stasis or
have the advances been mitigated by other negative factors? In this
article we have attempted to document the recent changes within
the surgery of patients with a fracture involving the acetabulum,
outline contemporary management, and identify the major problem
areas where further research is most needed. Cite this article:
There is a paucity of information on the pre-operative coronal
imbalance in patients with degenerative lumbar scoliosis (DLS) and
its influence on surgical outcomes. A total of 284 DLS patients were recruited into this study, among
whom 69 patients were treated surgically and the remaining 215 patients
conservatively Patients were classified based on the coronal balance
distance (CBD): Type A, CBD <
3 cm; Type B, CBD >
3 cm and C7
Plumb Line (C7PL) shifted to the concave side of the curve; Type
C, CBD >
3 cm and C7PL shifted to the convex side.Aims
Patients and Methods
This prospective randomised controlled trial was designed to
evaluate the outcome of both the MRI- and CT-based patient-specific
matched guides (PSG) from the same manufacturer. A total of 137 knees in 137 patients (50 men, 87 women) were
included, 67 in the MRI- and 70 in the CT-based PSG group. Their
mean age was 68.4 years (47.0 to 88.9). Outcome was expressed as
the biomechanical limb alignment (centre hip-knee-ankle: HKA-axis)
achieved post-operatively, the position of the individual components
within 3° of the pre-operatively planned alignment, correct planned
implant size and operative data (e.g. operating time and blood loss).Aims
Patients and Methods
Anatomical total knee arthroplasty alignment
The aim of this study was a quantitative analysis of a surgeon’s
learning curve for scoliosis surgery and the relationship between
the surgeon’s experience and post-operative outcomes, which has
not been previously well described. We have investigated the operating time as a function of the
number of patients to determine a specific pattern; we analysed
factors affecting the operating time and compared intra- and post-operative
outcomes. We analysed 47 consecutive patients undergoing scoliosis
surgery performed by a single, non-trained scoliosis surgeon. Operating time
was recorded for each of the four parts of the procedures: dissection,
placement of pedicle screws, reduction of the deformity and wound
closure.Aims
Patients and Methods
