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The Bone & Joint Journal
Vol. 100-B, Issue 3 | Pages 318 - 323
1 Mar 2018
Raiss P Alami G Bruckner T Magosch P Habermeyer P Boileau P Walch G

Aims

The aim of this study was to analyze the results of reverse shoulder arthroplasty (RSA) in patients with type 1 sequelae of a fracture of the proximal humerus in association with rotator cuff deficiency or severe stiffness of the shoulder.

Patients and Methods

A total of 38 patients were included: 28 women and ten men. Their mean age at the time of arthroplasty was 73 years (54 to 91). Before the RSA, 18 patients had been treated with open reduction and internal fixation following a fracture. A total of 22 patients had a rotator cuff tear and 11 had severe stiffness of the shoulder with < 0° of external rotation. The mean follow-up was 4.3 years (1.5 to 10). The Constant score and the range of movement of the shoulder were recorded preoperatively and at final follow-up.

Preoperatively, radiographs in two planes were performed, as well as CT or arthro-CT scans; radiographs were also performed at final follow-up.


The Bone & Joint Journal
Vol. 100-B, Issue 10 | Pages 1336 - 1344
1 Oct 2018
Powell AJ Crua E Chong BC Gordon R McAuslan A Pitto RP Clatworthy MG

Aims

This study compares the PFC total knee arthroplasty (TKA) system in a prospective randomized control trial (RCT) of the mobile-bearing rotating-platform (RP) TKA against the fixed-bearing (FB) TKA. This is the largest RCT with the longest follow-up where cruciate-retaining PFC total knee arthroplasties are compared in a non-bilateral TKA study.

Patients and Methods

A total of 167 patients (190 knees with 23 bilateral cases), were recruited prospectively and randomly assigned, with 91 knees receiving the RP and 99 knees receiving FB. The mean age was 65.5 years (48 to 82), the mean body mass index (BMI) was 29.7 kg/m2 (20 to 52) and 73 patients were female. The Knee Society Score (KSS), Knee Society Functional Score (KSFS), Oxford Knee Score (OKS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), and 12-Item Short-Form Health Survey Physical and Mental Component Scores (SF-12 PCS, SF-12 MCS) were gathered and recorded preoperatively, at five-years’ follow-up, and at ten years’ follow-up. Additionally, Knee Injury and Osteoarthritis Outcome Scores (KOOS) were collected at five- and ten-year follow-ups. The prevalence of radiolucent lines (RL) on radiographs and implant survival were recorded at five- and ten-year follow-ups.


The Bone & Joint Journal
Vol. 100-B, Issue 7 | Pages 829 - 830
1 Jul 2018
Callaghan JJ Haddad FS


The Bone & Joint Journal
Vol. 100-B, Issue 3 | Pages 296 - 302
1 Mar 2018
Sprowson† AP Jensen C Parsons N Partington P Emmerson K Carluke I Asaad S Pratt R Muller S Ahmed I Reed MR

Aims

Surgical site infection (SSI) is a common complication of surgery with an incidence of about 1% in the United Kingdom. Sutures can lead to the development of a SSI, as micro-organisms can colonize the suture as it is implanted. Triclosan-coated sutures, being antimicrobical, were developed to reduce the rate of SSI. Our aim was to assess whether triclosan-coated sutures cause a reduction in SSIs following arthroplasty of the hip and knee.

Patients and Methods

This two-arm, parallel, double-blinded study involved 2546 patients undergoing elective total hip (THA) and total knee arthroplasty (TKA) at three hospitals. A total of 1323 were quasi-randomized to a standard suture group, and 1223 being quasi-randomized to the triclosan-coated suture group. The primary endpoint was the rate of SSI at 30 days postoperatively.


Bone & Joint 360
Vol. 7, Issue 4 | Pages 25 - 28
1 Aug 2018


The Bone & Joint Journal
Vol. 100-B, Issue 8 | Pages 1018 - 1024
1 Aug 2018
Ando W Yasui H Yamamoto K Oinuma K Tokunaga H Inaba Y Kobayashi N Aihara M Nakanishi R Ohzono K

Aims

The purpose of this study was to compare two different types of metal-on-metal (MoM) bearing for total hip arthroplasty (THA): one with a large femoral head (38 mm to 52 mm) and the other with a conventional femoral head (28 mm or 32 mm). We compared clinical outcome, blood metal ion levels, and the incidence of pseudotumour in the two groups.

Patients and Methods

Between December 2009 and December 2011, 62 patients underwent MoM THA with a large femoral head (Magnum group) and 57 patients an MoM THA with a conventional femoral head (conventional group). Clinical outcome was assessed using the Harris Hip score, University of California, Los Angeles (UCLA) activity score and EuroQol-5D (EQ-5D). Blood metal ion levels were measured and MRI scans were analyzed at a minimum of five years postoperatively.


Bone & Joint 360
Vol. 7, Issue 4 | Pages 12 - 15
1 Aug 2018


Bone & Joint 360
Vol. 7, Issue 4 | Pages 19 - 22
1 Aug 2018


The Bone & Joint Journal
Vol. 100-B, Issue 6 | Pages 685 - 686
1 Jun 2018
Haddad FS


The Bone & Joint Journal
Vol. 100-B, Issue 7 | Pages 909 - 914
1 Jul 2018
Sheth NP Melnic CM Brown N Sporer SM Paprosky WG

Aims

The aim of this study was to examine the results of the acetabular distraction technique in achieving implantation of a stable construct, obtaining biological fixation, and producing healing of chronic pelvic discontinuity at revision total hip arthroplasty.

Patients and Methods

We identified 32 patients treated between 2006 and 2013 who underwent acetabular revision for a chronic pelvic discontinuity using acetabular distraction, and who were radiographically evaluated at a mean of 62 months (25 to 160). Of these patients, 28 (87.5%) were female. The mean age at the time of revision was 67 years (44 to 86). The patients represented a continuous series drawn from two institutions that adhered to an identical operative technique.


Bone & Joint 360
Vol. 7, Issue 3 | Pages 2 - 6
1 Jun 2018
Mayne AIW Campbell DM


Bone & Joint 360
Vol. 7, Issue 3 | Pages 21 - 24
1 Jun 2018


The Bone & Joint Journal
Vol. 100-B, Issue 7 | Pages 853 - 861
1 Jul 2018
Leunig M Hutmacher JE Ricciardi BF Impellizzeri FM Rüdiger HA Naal FD

Aims

The classical longitudinal incision used for the direct anterior approach (DAA) to the hip does not follow the tension lines of the skin and can lead to impaired wound healing and poor cosmesis. The purpose of this retrospective study was to determine the satisfaction with the scar, and functional and radiographic outcomes comparing the classic longitudinal incision with a modified skin crease ‘bikini’ when the DAA is used for total hip arthroplasty (THA).

Patients and Methods

A total of 964 patients (51% female; 59% longitudinal, 41% ‘bikini’) completed a follow-up questionnaire between two and four years postoperatively, including the Oxford Hip Score (OHS), the University of North Carolina ‘4P’ scar scale (UNC4P) and two items for assessing the aesthetic appearance of the scar and symptoms of numbness. The positioning of the components, rates of heterotopic ossification (HO) and rates of revision were assessed.


The Bone & Joint Journal
Vol. 100-B, Issue 6 | Pages 703 - 711
1 Jun 2018
Marson BA Deshmukh SR Grindlay DJC Scammell BE

Aims

The aim of this review was to evaluate the available literature and to calculate the pooled sensitivity and specificity for the different alpha-defensin test systems that may be used to diagnose prosthetic joint infection (PJI).

Materials and Methods

Studies using alpha-defensin or Synovasure (Zimmer Biomet, Warsaw, Indiana) to diagnose PJI were identified from systematic searches of electronic databases. The quality of the studies was evaluated using the Quality Assessment of Studies of Diagnostic Accuracy (QUADAS) tool. Meta-analysis was completed using a bivariate model.


The Bone & Joint Journal
Vol. 100-B, Issue 3 | Pages 294 - 295
1 Mar 2018
Sprowson† AP Jensen C Ahmed I Parsons N Partington P Emmerson K Carluke I Asaad S Pratt R Muller S Reed MR


Bone & Joint 360
Vol. 6, Issue 5 | Pages 21 - 24
1 Oct 2017


The Bone & Joint Journal
Vol. 100-B, Issue 5 | Pages 579 - 583
1 May 2018
Xu S Chen JY Lo NN Chia SL Tay DKJ  Pang HN Hao Y Yeo SJ

Aims

This study investigated the influence of body mass index (BMI) on patients’ function and quality of life ten years after total knee arthroplasty (TKA).

Patients and Methods

A total of 126 patients who underwent unilateral TKA in 2006 were prospectively included in this retrospective study. They were categorized into two groups based on BMI: < 30 kg/m2 (control) and ≥ 30 kg/m2 (obese). Functional outcome was assessed using the Knee Society Function Score (KSFS), Knee Society Knee Score (KSKS), and Oxford Knee Score (OKS). Quality of life was assessed using the Physical (PCS) and Mental Component Scores (MCS) of the 36-Item Short-Form Health Survey.


The Bone & Joint Journal
Vol. 99-B, Issue 7 | Pages 944 - 950
1 Jul 2017
Fan G Fu Q Zhang J Zhang H Gu X Wang C Gu G Guan X Fan Y He S

Aims

Minimally invasive transforaminal lumbar interbody fusion (MITLIF) has been well validated in overweight and obese patients who are consequently subject to a higher radiation exposure. This prospective multicentre study aimed to investigate the efficacy of a novel lumbar localisation system for MITLIF in overweight patients.

Patients and Methods

The initial study group consisted of 175 patients. After excluding 49 patients for various reasons, 126 patients were divided into two groups. Those in Group A were treated using the localisation system while those in Group B were treated by conventional means. The primary outcomes were the effective radiation dosage to the surgeon and the exposure time.


Bone & Joint Research
Vol. 6, Issue 11 | Pages 631 - 639
1 Nov 2017
Blyth MJG Anthony I Rowe P Banger MS MacLean A Jones B

Objectives

This study reports on a secondary exploratory analysis of the early clinical outcomes of a randomised clinical trial comparing robotic arm-assisted unicompartmental knee arthroplasty (UKA) for medial compartment osteoarthritis of the knee with manual UKA performed using traditional surgical jigs. This follows reporting of the primary outcomes of implant accuracy and gait analysis that showed significant advantages in the robotic arm-assisted group.

Methods

A total of 139 patients were recruited from a single centre. Patients were randomised to receive either a manual UKA implanted with the aid of traditional surgical jigs, or a UKA implanted with the aid of a tactile guided robotic arm-assisted system. Outcome measures included the American Knee Society Score (AKSS), Oxford Knee Score (OKS), Forgotten Joint Score, Hospital Anxiety Depression Scale, University of California at Los Angeles (UCLA) activity scale, Short Form-12, Pain Catastrophising Scale, somatic disease (Primary Care Evaluation of Mental Disorders Score), Pain visual analogue scale, analgesic use, patient satisfaction, complications relating to surgery, 90-day pain diaries and the requirement for revision surgery.


Bone & Joint 360
Vol. 7, Issue 2 | Pages 35 - 38
1 Apr 2018