This study investigated the influence of body mass index (BMI)
on the post-operative fall in the level of haemoglobin (Hb), length
of hospital stay (LOS), 30-day re-admission rate, functional outcome
and quality of life, two years after total knee arthroplasty (TKA). A total of 7733 patients who underwent unilateral primary TKA
between 2001 and 2010 were included. The mean age was 67 years (30
to 90). There were 1421 males and 6312 females. The patients were
categorised into three groups: BMI <
25.0 kg/m2 (normal);
BMI between 25.0 and 39.9 kg/m2 (obese); and BMI ≥ 40.0
kg/m2 (morbidly obese).Aims
Patients and Methods
There is no consensus on the benefit of arthroscopically
assisted reduction of the articular surface combined with fixation
using a volar locking plate for the treatment of intra-articular
distal radial fractures. In this study we compared the functional
and radiographic outcomes of fluoroscopically and arthroscopically
guided reduction of these fractures. Between February 2009 and May 2013, 74 patients with unilateral
unstable intra-articular distal radial fractures were randomised
equally into the two groups for treatment. The mean age of these
74 patients was 64 years (24 to 92). We compared functional outcomes
including active range of movement of the wrist, grip strength and Disabilities
of the Arm, Shoulder, and Hand scores at six and 48 weeks; and radiographic
outcomes that included gap, step, radial inclination, volar angulation
and ulnar variance. There were no significant differences between the techniques
with regard to functional outcomes or radiographic parameters. The
mean gap and step in the fluoroscopic and arthroscopic groups were
comparable at 0.9 mm (standard deviation Arthroscopic reduction conferred no advantage over conventional
fluoroscopic guidance in achieving anatomical reduction of intra-articular
distal radial fractures when using a volar locking plate. Cite this article:
This study aims to evaluate if micro-CT can work as a method for the 3D assessment and analysis of cancellous bone by comparing micro-CT with undecalcified histological sections in OVX rats. The mandible and tibia of sham, ovariectomised (OVX) and zoledronate-injected ovariectomised (OVX-ZOL) rats were assessed morphometrically. Specimens were scanned by micro-CT. Undecalcified histological sections were manufactured from the specimen scanned by micro-CT and stained with haematoxylin and eosin. Bivariate linear regressions and one-way analysis of variance were undertaken for statistics using SPSS 16.0.1 software.Objectives
Methods
The April 2014 Spine Roundup360 looks at: medical treatment for ankylosing spondylitis; unilateral TLIF effective; peg fractures akin to neck of femur fractures; sleep apnoea and spinal surgery; scoliosis in osteogenesis imperfect; paediatric atlanto-occipital dislocation; back pain and obesity: chicken or egg?; BMP associated with lumbar plexus deficit; and just how common is back pain?
The February 2014 Hip &
Pelvis Roundup360 looks at: length of stay; cementless metaphyseal fixation; mortality trends in over 400,000 total hip replacements; antibiotics in hip fracture surgery; blood supply to the femoral head after dislocation; resurfacing and THR in metal-on-metal replacement; diabetes and hip replacement; bone remodelling over two decades following hip replacement; and whether bisphosphonates affect acetabular fixation.
This study explores the epidemiology of patients with a fracture
of the scaphoid presenting to a regional teaching hospital. All patients with a confirmed fracture of the scaphoid over a
retrospective period between January 2010 and May 2013 were included.
Their demographics, deprivation status and when the fracture occurred
was noted and assessed. There were 415 fractures in 365 males and
50 females.Aims
Patients and Methods
The aim of this study was to find anatomical
landmarks for rotational alignment of the tibial component in total knee
replacement (TKR) in a CT-based study. Pre-operative CT scanning
was performed on 94 South Korean patients (nine men, 85 women, 188
knees) with osteoarthritis of the knee joint prior to TKR. The tibial
anteroposterior (AP) axis was defined as a line perpendicular to
the femoral surgical transepicondylar axis and passing through the centre
of the posterior cruciate ligament (PCL). The angles between the
defined tibial AP axis and anatomical landmarks at various levels
of the tibia were measured. The mean values of the angles between
the defined tibial AP axis and the line connecting the anterior
border of the proximal third of the tibia to the centre of the PCL
was -0.2° (-17 to 14.1, Cite this article:
We performed a systematic review of the literature to determine the safety and efficacy of bone morphogenetic protein (BMP) compared with bone graft when used specifically for revision spinal fusion surgery secondary to pseudarthrosis. The MEDLINE, EMBASE and Cochrane Library databases were searched using defined search terms. The primary outcome measure was spinal fusion, assessed as success or failure in accordance with radiograph, MRI or CT scan review at 24-month follow-up. The secondary outcome measure was time to fusion.Objectives
Methods
The August 2014 Foot &
Ankle Roundup360 looks at: calcaneotibial nail in ankle fractures; reamer irrigator aspirator for ankle fusion; periprosthetic bone infection; infection in ankle fixation; cheap and cheerful OK in MTP fusion plates; sliding fibular graft for peroneal tendon pathology and fusion for failed ankle replacement.
The primary aim of this study was to analyse the position of
the acetabular and femoral components in total hip arthroplasty
undertaken using an anterior surgical approach. In a prospective, single centre study, we used the EOS imaging
system to analyse the position of components following THA performed
via the anterior approach in 102 patients (103 hips) with a mean
age of 64.7 years (Aims
Patients and Methods
The treatment of bone loss in revision total
knee arthroplasty has evolved over the past decade. While the management
of small to moderate sized defects has demonstrated good results
with a variety of traditional techniques (cement and screws, small
metal augments, impaction bone grafting or modular stems), the treatment of
severe defects continues to be problematic. The use of a structural
allograft has declined in recent years due to an increased failure
rate with long-term follow-up and with the introduction of highly
porous metal augments that emphasise biological metaphyseal fixation.
Recently published mid-term results on the use of tantalum cones
in patients with severe bone loss has reaffirmed the success of
this treatment strategy. Cite this article:
The December 2015 Foot &
Ankle Roundup360 looks at: The midfoot fusion bolt: has it had its day?; Ankle arthroplasty: only for the old?; A return to the Keller’s osteotomy for diabetic feet?; Joint sparing surgery for ankle arthritis in the context of deformity?; Beware the subtalar fusion in the ankle arthrodesis patient?; Nonunion in the foot and ankle a predictive score; Cast
The aim of this study was to quantify the stability
of fracture-implant complex in fractures after fixation. A total
of 15 patients with an undisplaced fracture of the femoral neck,
treated with either a dynamic hip screw or three cannulated hip
screws, and 16 patients with an AO31-A2 trochanteric fracture treated
with a dynamic hip screw or a Gamma Nail, were included. Radiostereometric
analysis was used at six weeks, four months and 12 months post-operatively
to evaluate shortening and rotation. Migration could be assessed in ten patients with a fracture of
the femoral neck and seven with a trochanteric fracture. By four
months post-operatively, a mean shortening of 5.4 mm (-0.04 to 16.1)
had occurred in the fracture of the femoral neck group and 5.0 mm
(-0.13 to 12.9) in the trochanteric fracture group. A wide range
of rotation occurred in both types of fracture. Right-sided trochanteric
fractures seem more rotationally stable than left-sided fractures. This prospective study shows that migration at the fracture site
occurs continuously during the first four post-operative months,
after which stabilisation occurs. This information may allow the
early recognition of patients at risk of failure of fixation. Cite this article:
Given the increasing number of total hip arthroplasty
procedures being performed annually, it is imperative that orthopaedic
surgeons understand factors responsible for instability. In order
to treat this potentially complex problem, we recommend correctly
classifying the type of instability present based on component position, abductor
function, impingement, and polyethylene wear. Correct classification
allows the treating surgeon to choose the appropriate revision option
that ultimately will allow for the best potential outcome. Cite this article:
The purpose of this study was to compare the long-term results
of primary total hip arthroplasty (THA) in young patients using
either a conventional (CPE) or a highly cross-linked (HXLPE) polyethylene
liner in terms of functional outcome, incidence of osteolysis, radiological
wear and rate of revision. We included all patients between the ages of 45 and 65 years
who, between January 2000 and December 2001, had undergone a primary
THA for osteoarthritis at our hospital using a CPE or HXLPE acetabular
liner and a 28 mm cobalt-chrome femoral head. From a total of 160 patients, 158 (177 hips) were available for
review (CPE 89; XLPE 88). The mean age, body mass index (BMI) and
follow-up in each group were: CPE: 56.8 years (46 to 65); 30.7 kg/m2 (19
to 58); 13.2 years (2.1 to 14.7) and HXLPE: 55.6 years (45 to 65);
BMI: 30 kg/m2 (18 to 51); 13.1 years (5.7 to 14.4).Aims
Methods
The June 2014 Shoulder &
Elbow Roundup360 looks at: suprascapular nerve and rotator cuff pathology; anchors in Bankart repair: it’s not what you’ve got, but how you use it; not all shoulder PROMs are equal; reverse shoulder arthroplasty OK in trauma; not all in the mind: frozen shoulder personality debunked; open and arthroscopic repair equivalent in shoulder instability; natural history of olecranon fractures not so bleak?; and resurfacing of the shoulder: a Danish perspective.
