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The Bone & Joint Journal
Vol. 102-B, Issue 9 | Pages 1167 - 1175
14 Sep 2020
Gromov K Petersen PB Jørgensen CC Troelsen A Kehlet H

Aims

The aim of this prospective multicentre study was to describe trends in length of stay and early complications and readmissions following unicompartmental knee arthroplasty (UKA) performed at eight different centres in Denmark using a fast-track protocol and to compare the length of stay between centres with high and low utilization of UKA.

Methods

We included data from eight dedicated fast-track centres, all reporting UKAs to the same database, between 2010 and 2018. Complete ( > 99%) data on length of stay, 90-day readmission, and mortality were obtained during the study period. Specific reasons for a length of stay of > two days, length of stay > four days, and 30- and 90-day readmission were recorded. The use of UKA in the different centres was dichotomized into ≥ 20% versus < 20% of arthroplasties which were undertaken being UKAs, and ≥ 52 UKAs versus < 52 UKAs being undertaken annually.


The Journal of Bone & Joint Surgery British Volume
Vol. 77-B, Issue 3 | Pages 501 - 503
1 May 1995
Wilkinson M Birch R

Elective repair of lesions of the common peroneal nerve was carried out in 27 patients between 1982 and 1992. Twenty-three have been reviewed of whom 11 recovered power sufficient to prevent foot drop and 13 recovered protective sensation or better


The Bone & Joint Journal
Vol. 102-B, Issue 9 | Pages 1158 - 1166
14 Sep 2020
Kaptein BL den Hollander P Thomassen B Fiocco M Nelissen RGHH

Aims

The primary objective of this study was to compare migration of the cemented ATTUNE fixed bearing cruciate retaining tibial component with the cemented Press-Fit Condylar (PFC)-sigma fixed bearing cruciate retaining tibial component. The secondary objectives included comparing clinical and radiological outcomes and Patient Reported Outcome Measures (PROMs).

Methods

A single blinded randomized, non-inferiority study was conducted including 74 patients. Radiostereometry examinations were made after weight bearing, but before hospital discharge, and at three, six, 12, and 24 months postoperatively. PROMS were collected preoperatively and at three, six, 12, and 24 months postoperatively. Radiographs for measuring radiolucencies were collected at two weeks and two years postoperatively.


The Journal of Bone & Joint Surgery British Volume
Vol. 51-B, Issue 3 | Pages 506 - 507
1 Aug 1969
Rifaat MA Massoud AF Shafie MB

1. A case of traumatic aneurysm of the descending genicular artery complicating elective operation on the knee joint is reported. 2. The aneurysm was mainly intra-articular, presenting as a pulsating haemarthrosis soon after operation. 3. The pathogenesis, symptomatology, diagnosis and management are briefly discussed


Bone & Joint Open
Vol. 1, Issue 9 | Pages 541 - 548
8 Sep 2020
MacDonald DRW Neilly DW Davies PSE Crome CR Jamal B Gill SL Jariwala AC Stevenson IM Ashcroft GP

Aims

The UK government declared a national lockdown on 23 March 2020 to reduce transmission of COVID-19. This study aims to identify the effect of lockdown on the rates, types, mechanisms, and mortality of musculoskeletal trauma across Scotland.

Methods

Data for all musculoskeletal trauma requiring operative treatment were collected prospectively from five key orthopaedic units across Scotland during lockdown (23 March 2020 to 28 May 2020). This was compared with data for the same timeframe in 2019 and 2018. Data collected included all cases requiring surgery, injury type, mechanism of injury, and inpatient mortality.


Bone & Joint Open
Vol. 1, Issue 9 | Pages 530 - 540
4 Sep 2020
Arafa M Nesar S Abu-Jabeh H Jayme MOR Kalairajah Y

Aims

The coronavirus disease (COVID)-19 pandemic forced an unprecedented period of challenge to the NHS in the UK where hip fractures in the elderly population are a major public health concern. There are approximately 76,000 hip fractures in the UK each year which make up a substantial proportion of the trauma workload of an average orthopaedic unit. This study aims to assess the impact of the COVID-19 pandemic on hip fracture care service and the emerging lessons to withstand any future outbreaks.

Methods

Data were collected retrospectively on 157 hip fractures admitted from March to May 2019 and 2020. The 2020 group was further subdivided into COVID-positive and COVID-negative. Data including the four-hour target, timing to imaging, hours to operation, anaesthetic and operative details, intraoperative complications, postoperative reviews, COVID status, Key Performance Indicators (KPIs), length of stay, postoperative complications, and the 30-day mortality were compiled from computer records and our local National Hip Fracture Database (NHFD) export data.


Bone & Joint 360
Vol. 9, Issue 4 | Pages 41 - 44
1 Aug 2020


The Bone & Joint Journal
Vol. 102-B, Issue 9 | Pages 1219 - 1228
14 Sep 2020
Hall AJ Clement ND Farrow L MacLullich AMJ Dall GF Scott CEH Jenkins PJ White TO Duckworth AD

Aims

The primary aim was to assess the independent influence of coronavirus disease (COVID-19) on 30-day mortality for patients with a hip fracture. The secondary aims were to determine whether: 1) there were clinical predictors of COVID-19 status; and 2) whether social lockdown influenced the incidence and epidemiology of hip fractures.

Methods

A national multicentre retrospective study was conducted of all patients presenting to six trauma centres or units with a hip fracture over a 46-day period (23 days pre- and 23 days post-lockdown). Patient demographics, type of residence, place of injury, presentation blood tests, Nottingham Hip Fracture Score, time to surgery, operation, American Society of Anesthesiologists (ASA) grade, anaesthetic, length of stay, COVID-19 status, and 30-day mortality were recorded.


The Journal of Bone & Joint Surgery British Volume
Vol. 43-B, Issue 1 | Pages 61 - 67
1 Feb 1961
Tudway RC

1. Nine patients treated for osteogenic sarcoma by elective radical irradiation are reviewed. Five of the nine patients have survived for from three to fourteen years, but one patient has metastases. 2. These results are compared with those from primary amputation. 3. The importance of histological grading in prognosis is emphasised. 4. It is concluded that radical irradiation should be considered in place of primary amputation for osteogenic sarcoma in the upper limb


The Journal of Bone & Joint Surgery British Volume
Vol. 81-B, Issue 5 | Pages 893 - 894
1 Sep 1999
Armstrong PM Ilyas I Pandey R Berendt AR Conlon CP Simpson AHRW

We describe a case of pyoderma gangrenosum which presented with severe wound breakdown after elective hip replacement. The patient was treated successfully with minimal wound debridement and steroids. This diagnosis should always be considered when confronted with an enlarging painful skin lesion which does not grow organisms when cultured and fails to respond to antibiotic therapy, especially if there are similar lesions in other sites. In patients who have a past history of pyoderma gangrenosum, prophylactic steroids may be indicated at the time of surgery or may be required early in the postoperative period


Bone & Joint Open
Vol. 1, Issue 7 | Pages 415 - 419
15 Jul 2020
Macey ARM Butler J Martin SC Tan TY Leach WJ Jamal B

Aims

To establish if COVID-19 has worsened outcomes in patients with AO 31 A or B type hip fractures.

Methods

Retrospective analysis of prospectively collected data was performed for a five-week period from 20 March 2020 and the same time period in 2019. The primary outcome was mortality at 30 days. Secondary outcomes were COVID-19 infection, perioperative pulmonary complications, time to theatre, type of anaesthesia, operation, grade of surgeon, fracture type, postoperative intensive care admission, venous thromboembolism, dislocation, infection rates, and length of stay.


Bone & Joint 360
Vol. 9, Issue 3 | Pages 3 - 3
1 Jun 2020
Ollivere B


The Journal of Bone & Joint Surgery British Volume
Vol. 75-B, Issue 5 | Pages 769 - 771
1 Sep 1993
Milligan K Macafee A Fogarty D Wallace R Ramsey P

A randomised double-blind study was carried out on 60 patients undergoing elective lumbar discectomy. Patients in the study group (n = 30) received an injection of 10 ml of 0.5% bupivacaine into the wound; the control group (n = 30) received none. Postoperative pain was measured by a visual analogue pain scale and by the amount of morphine administered by a patient-controlled analgesia system. Patients in the study group had lower pain scores, used less morphine, waited longer until their first demand for analgesia and reported their postoperative pain to be less severe


The Journal of Bone & Joint Surgery British Volume
Vol. 74-B, Issue 2 | Pages 284 - 286
1 Mar 1992
Nolan P Nicholas R Mulholland B Mollan R Wilson D

We cultured human osteoblasts from trabecular bone explants and confirmed their phenotype by alkaline phosphatase assay, increased cyclic adenosine monophosphate production in response to prostaglandin E2 and radiographic micro-analysis of nodules of calcification. The osteoblasts were seeded on to demineralised human bone fragments and examined at ten-day intervals over a 50-day period by scanning electron microscopy. During this time the bank bone became progressively repopulated by the cultured osteoblasts. This system may offer a means of graft enhancement in elective orthopaedic and maxillofacial surgery by delivery of cultured autologous human osteoblasts to bone defects


Bone & Joint Research
Vol. 9, Issue 6 | Pages 268 - 271
1 Jun 2020
Buchalter DB Kirby DJ Egol KA Leucht P Konda SR


The Journal of Bone & Joint Surgery British Volume
Vol. 60-B, Issue 2 | Pages 178 - 180
1 May 1978
Du Toit G Relton J Gillespie R

Homologous blood transfusions are not without risks, especially in young women and girls. In patients undergoing certain elective surgical procedures autologous blood transfusion is a good alternative. Normovolaemic haemodilution in association with autotransfusion offers the additional advantages of reduced loss of red cell mass during the operation and an increase in tissue blood flow. In this study twenty-seven adolescent patients undergoing Harrington instrumentation for idiopathic scoliosis had haemodilutional autotransfusions during their operations, none requiring homologous blood. Eighteen were given an average of 750 millilitres of homologous blood in the postoperative period which compared favourably with controls who required 1280 millilitres


The Bone & Joint Journal
Vol. 102-B, Issue 7 Supple B | Pages 41 - 46
1 Jul 2020
Ransone M Fehring K Fehring T

Aims

Patients with abnormal spinopelvic mobility are at increased risk for instability. Measuring the change in sacral slope (ΔSS) can help determine spinopelvic mobility preoperatively. Sacral slope (SS) should decrease at least 10° to demonstrate adequate posterior pelvic tilt. There is potential for different ΔSS measurements in the same patient based on sitting posture. The purpose of this study was to determine the effect of sitting posture on the ΔSS in patients undergoing total hip arthroplasty (THA).

Methods

In total, 51 patients undergoing THA were reviewed to quantify the variability in preoperative spinopelvic mobility when measuring two different sitting positions using SS for planning.


Bone & Joint 360
Vol. 8, Issue 5 | Pages 21 - 24
1 Oct 2019


The Journal of Bone & Joint Surgery British Volume
Vol. 72-B, Issue 4 | Pages 601 - 604
1 Jul 1990
Langkamer V Ackroyd C

We studied 55 patients who had undergone elective removal of forearm plates between 1980 and 1986; 44 plates were removed from the radius and 37 from the ulna. Before removal only 20 patients (36%) had definite symptoms attributable to the plates, but 44 patients (80%) were advised by the surgeon to have the plates removed. In 22 cases (40%) the operation was followed by a significant complication. The complication rate was higher with junior surgeons and was permanent in 50% of cases. It is recommended that forearm plates should be removed only if they are causing significant symptoms, and that the operation should not be delegated to the most junior surgeon


The Bone & Joint Journal
Vol. 102-B, Issue 7 | Pages 933 - 940
1 Jul 2020
Maempel JF Clement ND Wickramasinghe NR Duckworth AD Keating JF

Aims

The aim was to compare long-term patient-reported outcome measures (PROMs) after operative and nonoperative treatment of acute Achilles tendon rupture in the context of a randomized controlled trial.

Methods

PROMs including the Short Musculoskeletal Function Assessment (SMFA), Achilles Tendon Total Rupture Score (ATRS), EuroQol five-dimension (EQ-5D), satisfaction, net promoter score and data regarding re-rupture, and venous thromboembolic rates were collected for patients randomized to receive either operative or nonoperative treatment for acute Achilles tendon rupture in a previous study. Of the 80 patients originally randomized, 64 (33 treated surgically, 31 nonoperatively) patients were followed up at a mean of 15.7 years (13.4 to 17.7).