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Bone & Joint Journal

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https://www.readbyqxmd.com/read/28053270/the-quality-of-achilles-tendon-repair-five-to-eight-years-after-percutaneous-tenotomy-in-the-treatment-of-clubfoot-clinical-and-ultrasonographic-findings
#1
D A Maranho, F H L Leonardo, C F Herrero, E E Engel, J B Volpon, M H Nogueira-Barbosa
AIMS: Our aim was to describe the mid-term appearances of the repair process of the Achilles tendon after tenotomy in children with a clubfoot treated using the Ponseti method. PATIENTS AND METHODS: A total of 15 children (ten boys, five girls) with idiopathic clubfoot were evaluated at a mean of 6.8 years (5.4 to 8.1) after complete percutaneous division of the Achilles tendon. The contour and subjective thickness of the tendon were recorded, and superficial defects and its strength were assessed clinically...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28053269/the-outcome-and-complications-of-vascularised-fibular-grafts
#2
M T Houdek, C O Bayne, A T Bishop, A Y Shin
AIMS: Free vascularised fibular grafting has been used for the treatment of large bony defects for more than 40 years. However, there is little information about the risk factors for failure and whether newer locking techniques of fixation improve the rates of union. The purpose of this study was to compare the rates of union of free fibular grafts fixed with locking and traditional techniques, and to quantify the risk factors for nonunion and failure. PATIENTS AND METHODS: A retrospective review involved 134 consecutive procedures over a period of 20 years...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28053268/implant-options-for-the-treatment-of-intertrochanteric-fractures-of-the-hip-rationale-evidence-and-recommendations
#3
A R Socci, N E Casemyr, M P Leslie, M R Baumgaertner
AIMS: The aim of this paper is to review the evidence relating to the anatomy of the proximal femur, the geometry of the fracture and the characteristics of implants and methods of fixation of intertrochanteric fractures of the hip. MATERIALS AND METHODS: Relevant papers were identified from appropriate clinical databases and a narrative review was undertaken. RESULTS: Stable, unstable, and subtrochanteric intertrochanteric fractures vary widely in their anatomical and biomechanical characteristics, as do the implants used for their fixation...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28053267/assessment-of-resuscitation-as-measured-by-markers-of-metabolic-acidosis-and-features-of-injury
#4
D S Weinberg, A S Narayanan, T A Moore, H A Vallier
AIMS: The best time for definitive orthopaedic care is often unclear in patients with multiple injuries. The objective of this study was make a prospective assessment of the safety of our early appropriate care (EAC) strategy and to evaluate the potential benefit of additional laboratory data to determine readiness for surgery. PATIENTS AND METHODS: A cohort of 335 patients with fractures of the pelvis, acetabulum, femur, or spine were included. Patients underwent definitive fixation within 36 hours if one of the following three parameters were met: lactate < 4...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28053266/predictors-of-mortality-following-conservatively-managed-fractures-of-the-odontoid-in-elderly-patients
#5
S Bajada, A Ved, A G Dudhniwala, S Ahuja
AIMS: Rates of mortality as high as 25% to 30% have been described following fractures of the odontoid in the elderly population. The aim of this study was to examine whether easily identifiable variables present on admission are associated with mortality. PATIENTS AND METHODS: A consecutive series of 83 elderly patients with a fracture of the odontoid following a low-impact injury was identified retrospectively. Data that were collected included demographics, past medical history and the results of blood tests on admission...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28053265/effectiveness-of-open-and-arthroscopic-rotator-cuff-repair-ukuff-a-randomised-controlled-trial
#6
A Carr, C Cooper, M K Campbell, J Rees, J Moser, D J Beard, R Fitzpatrick, A Gray, J Dawson, J Murphy, H Bruhn, D Cooper, C Ramsay
AIMS: The appropriate management for patients with a degenerative tear of the rotator cuff remains controversial, but operative treatment, particularly arthroscopic surgery, is increasingly being used. Our aim in this paper was to compare the effectiveness of arthroscopic with open repair of the rotator cuff. PATIENTS AND METHODS: A total of 273 patients were recruited to a randomised comparison trial (136 to arthroscopic surgery and 137 to open surgery) from 19 teaching and general hospitals in the United Kingdom...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28053264/unconstrained-metacarpophalangeal-joint-arthroplasties-a-systematic-review
#7
R S Aujla, N Sheikh, P Divall, B Bhowal, J J Dias
AIMS: We performed a systematic review of the current literature regarding the outcomes of unconstrained metacarpophalangeal joint (MCPJ) arthroplasty. MATERIALS AND METHODS: We initially identified 1305 studies, and 406 were found to be duplicates. After exclusion criteria were applied, seven studies were included. Outcomes extracted included pre- and post-operative pain visual analogue scores, range of movement (ROM), strength of pinch and grip, satisfaction and patient reported outcome measures (PROMs)...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28053263/the-quality-of-randomised-controlled-trials-involving-surgery-from-the-hand-to-the-elbow-a-critical-analysis-of-the-literature
#8
J M Kim, R M Zimmerman, C M Jones, A Al Muhit, J P Higgins, K R Means
AIMS: Our purpose was to determine the quality of current randomised controlled trials (RCTs) in hand surgery using standardised metrics. MATERIALS AND METHODS: Based on five-year mean impact factors, we selected the six journals that routinely publish studies of upper extremity surgery. Using a journal-specific search query, 62 RCTs met our inclusion criteria. Then three blinded reviewers used the Jadad and revised Coleman Methodology Score (RCMS) to assess the quality of the manuscripts...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28053262/functional-outcomes-of-conservatively-managed-acute-ruptures-of-the-achilles-tendon
#9
J E Lawrence, P Nasr, D M Fountain, L Berman, A H N Robinson
AIMS: This prospective cohort study aims to determine if the size of the tendon gap following acute rupture of the Achilles tendon shows an association with the functional outcome following non-operative treatment. PATIENTS AND METHODS: All patients presenting within two weeks of an acute unilateral rupture of the Achilles tendon between July 2012 and July 2015 were considered for the study. In total, 38 patients (nine female, 29 male, mean age 52 years; 29 to 78) completed the study...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28053261/the-epidemiology-and-trends-in-management-of-acute-achilles-tendon-ruptures-in-ontario-canada-a-population-based-study-of-27-607-patients
#10
U Sheth, D Wasserstein, R Jenkinson, R Moineddin, H Kreder, S B Jaglal
AIMS: The aims of this study were to establish the incidence of acute Achilles tendon rupture (AATR) in a North American population, to select demographic subgroups and to examine trends in the management of this injury in the province of Ontario, Canada. PATIENTS AND METHODS: Patients ≥ 18 years of age who presented with an AATR to an emergency department in Ontario, Canada between 1 January 2003 and 31 December 2013 were identified using administrative databases...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28053260/comparison-of-the-elution-properties-of-commercially-available-gentamicin-and-bone-cement-containing-vancomycin-with-home-made-preparations
#11
N M Frew, T Cannon, T Nichol, T J Smith, I Stockley
AIMS: Vancomycin is commonly added to acrylic bone cement during revision arthroplasty surgery. Proprietary cement preparations containing vancomycin are available, but are significantly more expensive. We investigated whether the elution of antibiotic from 'home-made' cement containing vancomycin was comparable with more expensive commercially available vancomycin impregnated cement. MATERIALS AND METHODS: A total of 18 cement discs containing either proprietary CopalG+V; or 'home-made' CopalR+G with vancomycin added by hand, were made...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28053259/qualitative-%C3%AE-defensin-test-synovasure-for-the-diagnosis-of-periprosthetic-infection-in-revision-total-joint-arthroplasty
#12
I K Sigmund, J Holinka, J Gamper, K Staats, C Böhler, B Kubista, R Windhager
AIMS: The diagnosis of periprosthetic joint infection (PJI) remains demanding due to limitations of all the available diagnostic tests. The synovial fluid marker, α-defensin, is a promising adjunct for the assessment of potential PJI. The purpose of this study was to investigate the qualitative assessment of α-defensin, using Synovasure to detect or exclude periprosthetic infection in total joint arthroplasty. PATIENTS AND METHODS: We studied 50 patients (28 women, 22 men, mean age 65 years; 20 to 89) with a clinical indication for revision arthroplasty who met the inclusion criteria of this prospective diagnostic study...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28053258/ankle-joint-pressure-changes-in-high-tibial-and-distal-femoral-osteotomies-a-cadaver-study
#13
F Krause, A Barandun, G Klammer, I Zderic, B Gueorguiev, T Schmid
AIMS: To assess the effect of high tibial and distal femoral osteotomies (HTO and DFO) on the pressure characteristics of the ankle joint. MATERIALS AND METHODS: Varus and valgus malalignment of the knee was simulated in human cadaver full-length legs. Testing included four measurements: baseline malalignment, 5° and 10° re-aligning osteotomy, and control baseline malalignment. For HTO, testing was rerun with the subtalar joint fixed. In order to represent half body weight, a 300 N force was applied onto the femoral head...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28053257/knee-joint-distraction-compared-with-total-knee-arthroplasty-a-randomised-controlled-trial
#14
J A D van der Woude, K Wiegant, R J van Heerwaarden, S Spruijt, P J Emans, S C Mastbergen, F P J G Lafeber
AIMS: Knee joint distraction (KJD) is a relatively new, knee-joint preserving procedure with the goal of delaying total knee arthroplasty (TKA) in young and middle-aged patients. We present a randomised controlled trial comparing the two. PATIENTS AND METHODS: The 60 patients ≤ 65 years with end-stage knee osteoarthritis were randomised to either KJD (n = 20) or TKA (n = 40). Outcomes were assessed at baseline, three, six, nine, and 12 months. In the KJD group, the joint space width (JSW) was radiologically assessed, representing a surrogate marker of cartilage thickness...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28053256/high-prevalence-of-noise-following-delta-ceramic-on-ceramic-total-hip-arthroplasty
#15
P P Salo, P B Honkanen, I Ivanova, A Reito, J Pajamäki, A Eskelinen
AIMS: We evaluated the short-term functional outcome and prevalence of bearing-specific generation of audible noise in 301 patients (336 hips) operated on with fourth generation (Delta) medium diameter head, ceramic-on-ceramic (CoC) total hip arthroplasties (THAs). PATIENTS AND METHODS: There were 191 female (63%) and 110 male patients (37%) with a mean age of 61 years (29 to 78) and mean follow-up of 2.1 years (1.3 to 3.4). Patients completed three questionnaires: Oxford Hip Score (OHS), Research and Development 36-item health survey (RAND-36) and a noise-specific symptom questionnaire...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28053255/risk-of-early-mortality-after-cemented-compared-with-cementless-total-hip-arthroplasty-a-nationwide-matched-cohort-study
#16
A Garland, M Gordon, G Garellick, J Kärrholm, O Sköldenberg, N P Hailer
AIMS: It has been suggested that cemented fixation of total hip arthroplasty (THA) is associated with an increased peri-operative mortality compared with cementless THA. Our aim was to investigate this through a nationwide matched cohort study adjusting for age, comorbidity, and socioeconomic background. PATIENTS AND METHODS: A total of 178 784 patients with osteoarthritis who underwent either cemented or cementless THA from the Swedish Hip Arthroplasty Register were matched with 862 294 controls from the general population...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28053254/the-synergy-cementless-femoral-stem-in-primary-total-hip-arthroplasty-at-a-minimum-follow-up-of-15-years
#17
I De Martino, V De Santis, R D' Apolito, P K Sculco, M B Cross, G Gasparini
AIMS: We report on the outcome of the Synergy cementless femoral stem with a minimum follow-up of 15 years (15 to 17). PATIENTS AND METHODS: A retrospective review was undertaken of a consecutive series of 112 routine primary cementless total hip arthroplasties (THAs) in 102 patients (112 hips). There were 60 female and 42 male patients with a mean age of 61 years (18 to 82) at the time of surgery. A total of 78 hips in the 69 patients remain in situ; nine hips in eight patients died before 15 years, and 16 hips in 16 patients were revised...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28053253/minimally-invasive-periacetabular-osteotomy-using-a-modified-smith-petersen-approach-technique-and-early-outcomes
#18
O H Khan, A Malviya, P Subramanian, D Agolley, J D Witt
AIMS: Periacetabular osteotomy is an effective way of treating symptomatic hip dysplasia. We describe a new minimally invasive technique using a modification of the Smith-Peterson approach. We performed a prospective, longitudinal cohort study to assess for any compromise in acetabular correction when using this approach, and to see if the procedure would have a higher complication rate than that quoted in the literature for other approaches. We also assessed for any improvement in functional outcome...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28053252/instability-of-the-hip-after-anatomical-re-alignment-in-patients-with-a-slipped-capital-femoral-epiphysis
#19
A Aprato, M Leunig, A Massé, T Slongo, R Ganz
AIMS: Several studies have reported the safety and efficacy of subcapital re-alignment for patients with slipped capital femoral epiphysis (SCFE) using surgical dislocation of the hip and an extended retinacular flap. Instability of the hip and dislocation as a consequence of this surgery has only recently gained attention. We discuss this problem with some illustrative cases. MATERIALS AND METHODS: We explored the literature on the possible pathophysiological causes and surgical steps associated with the risk of post-operative instability and articular damage...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28053251/bias-and-unicompartmental-knee-arthroplasty
#20
D W Murray, A D Liddle, A Judge, H Pandit
We recently published a paper comparing the incidence of adverse outcomes after unicompartmental and total knee arthroplasty (UKA and TKA). The conclusion of this study, which was in favour of UKA, was dismissed as "biased" in a review in Bone & Joint 360 Although this study is one of the least biased comparisons of UKA and TKA, this episode highlights the biases that exist both for and against UKA. In this review, we explore the different types of bias, particularly selection, reporting and measurement. We conclude that comparisons between UKA and TKA are open to bias...
January 2017: Bone & Joint Journal
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