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Bone & Joint Journal

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https://www.readbyqxmd.com/read/28860409/effects-of-multilevel-surgery-on-a-flexed-knee-gait-in-adults-with-cerebral-palsy
#1
C Putz, S I Wolf, E M Mertens, A Geisbüsch, S Gantz, F Braatz, L Döderlein, T Dreher
AIMS: A flexed knee gait is common in patients with bilateral spastic cerebral palsy and occurs with increased age. There is a risk for the recurrence of a flexed knee gait when treated in childhood, and the aim of this study was to investigate whether multilevel procedures might also be undertaken in adulthood. PATIENTS AND METHODS: At a mean of 22.9 months (standard deviation 12.9), after single event multi level surgery, 3D gait analysis was undertaken pre- and post-operatively for 37 adult patients with bilateral cerebral palsy and a fixed knee gait...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28860408/late-presentation-of-developmental-dysplasia-of-the-hip-a-15-year-observational-study
#2
C Talbot, J Adam, R Paton
AIMS: Despite the presence of screening programmes, infants continue to present with late developmental dysplasia of the hip (DDH), the impact of which is significant. The aim of this study was to assess infants with late presenting dislocation of the hip despite universal clinical neonatal and selective ultrasound screening. PATIENTS AND METHODS: Between 01 January 1997 to 31 December 2011, a prospective, longitudinal study was undertaken of a cohort of 64 670 live births...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28860407/is-it-safe-to-preserve-the-deltoid-when-resecting-the-proximal-humerus-for-a-primary-malignant-bone-tumour-a-comparative-study
#3
COMPARATIVE STUDY
V Cladière-Nassif, C Bourdet, V Audard, A Babinet, P Anract, D Biau
AIMS: Resection of the proximal humerus for the primary malignant bone tumour sometimes requires en bloc resection of the deltoid. However, there is no information in the literature which helps a surgeon decide whether to preserve the deltoid or not. The aim of this study was to determine whether retaining the deltoid at the time of resection would increase the rate of local recurrence. We also sought to identify the variables that persuade expert surgeons to choose a deltoid sparing rather than deltoid resecting procedure...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28860406/vascularised-fibular-grafts-for-reconstruction-of-extremity-bone-defects-after-resection-of-bone-and-soft-tissue-tumours-a-single-institutional-study-of-49-patients
#4
M Emori, M Kaya, H Irifune, N Takahashi, J Shimizu, E Mizushima, Y Murahashi, T Yamashita
AIMS: The aims of this study were to analyse the long-term outcome of vascularised fibular graft (VFG) reconstruction after tumour resection and to evaluate the usefulness of the method. PATIENTS AND METHODS: We retrospectively reviewed 49 patients who had undergone resection of a sarcoma and reconstruction using a VFG between 1988 and 2015. Their mean follow-up was 98 months (5 to 317). Reconstruction was with an osteochondral graft (n = 13), intercalary graft (n = 12), inlay graft (n = 4), or resection arthrodesis (n = 20)...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28860405/the-use-of-an-anterior-pelvic-internal-fixator-to-treat-disruptions-of-the-anterior-pelvic-ring-a-report-of-technique-indications-and-complications
#5
M Dahill, J McArthur, G L Roberts, M R Acharya, A J Ward, T J S Chesser
AIMS: The anterior pelvic internal fixator is increasingly used for the treatment of unstable, or displaced, injuries of the anterior pelvic ring. The evidence for its use, however, is limited. The aim of this paper is to describe the indications for its use, how it is applied and its complications. PATIENTS AND METHODS: We reviewed the case notes and radiographs of 50 patients treated with an anterior pelvic internal fixator between April 2010 and December 2015 at a major trauma centre in the United Kingdom...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28860404/the-changing-face-of-fractures-of-the-hip-in-northern-ireland-a-15-year-review
#6
A Tucker, K J Donnelly, S McDonald, J Craig, A P Foster, J D Acton
AIMS: We reviewed all patients who sustained a fracture of the hip and were treated in Northern Ireland over a period of 15 years to identify trends in incidence, the demographics of the patients, the rates of mortality, the configuration of the fracture and the choice of implant. PATIENTS AND METHODS: Since 01 January 2001 data about every fracture of the hip sustained in an adult have been collected centrally in Northern Ireland. All adults with such a fracture between 2000 and 2015 were included in the study...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28860403/surgery-for-a-fracture-of-the-hip-within-24-hours-of-admission-is-independently-associated-with-reduced-short-term-post-operative-complications
#7
M C Fu, V Boddapati, E B Gausden, A M Samuel, L A Russell, J M Lane
AIMS: We aimed to characterise the effect of expeditious hip fracture surgery in elderly patients within 24 hours of admission on short-term post-operative outcomes. PATIENTS AND METHODS: Patients age 65 or older that underwent surgery for closed femoral neck and intertrochanteric hip fractures were identified from the American College of Surgeons National Surgical Quality Improvement Program between 2011 and 2014. Multivariable propensity-adjusted logistic regressions were performed to determine associations between early surgery within 24 hours and post-operative complications, controlling for selection bias in patients undergoing early surgery based on observable characteristics...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28860402/sliding-hip-screw-versus-the-targon-pft-nail-for-trochanteric-hip-fractures-a-randomised-trial-of-400-patients
#8
RANDOMIZED CONTROLLED TRIAL
M J Parker, S Cawley
AIMS: To compare the outcomes for trochanteric fractures treated with a sliding hip screw (SHS) or a cephalomedullary nail. PATIENTS AND METHODS: A total of 400 patients with a trochanteric hip fracture were randomised to receive a SHS or a cephalomedullary nail (Targon PFT). All surviving patients were followed up to one year from injury. Functional outcome was assessed by a research nurse blinded to the implant used. RESULTS: Recovery of mobility, as assessed by a mobility scale, was superior for those treated with the intramedullary nail compared with the SHS at eight weeks, three and nine months (p-values between 0...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28860401/venous-thromboembolism-in-adult-elective-spinal-surgery-a-tertiary-centre-review-of-2181-patients
#9
H M T Fawi, K Saba, A Cunningham, S Masud, M Lewis, M Hossain, I Chopra, S Ahuja
AIMS: To evaluate the incidence of primary venous thromboembolism (VTE), epidural haematoma, surgical site infection (SSI), and 90-day mortality after elective spinal surgery, and the effect of two protocols for prophylaxis. PATIENTS AND METHODS: A total of 2181 adults underwent 2366 elective spinal procedures between January 2007 and January 2012. All patients wore anti-embolic stockings, mobilised early and were kept adequately hydrated. In addition, 29% (689) of these were given low molecular weight heparin (LMWH) while in hospital...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28860400/mid-term-outcomes-of-77-modular-radial-head-prostheses
#10
P Laumonerie, N Reina, D Ancelin, S Delclaux, M E Tibbo, N Bonnevialle, P Mansat
AIMS: Radial head arthroplasty (RHA) may be used in the treatment of non-reconstructable radial head fractures. The aim of this study was to evaluate the mid-term clinical and radiographic results of RHA. PATIENTS AND METHODS: Between 2002 and 2014, 77 RHAs were implanted in 54 men and 23 women with either acute injuries (54) or with traumatic sequelae (23) of a fracture of the radial head. Four designs of RHA were used, including the Guepar (Small Bone Innovations (SBi)/Stryker; 36), Evolutive (Aston Medical; 24), rHead RECON (SBi/Stryker; ten) or rHead STANDARD (SBi/Stryker; 7) prostheses...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28860399/effect-of-pre-operative-expectations-on-the-outcomes-following-total-shoulder-arthroplasty
#11
I Swarup, C M Henn, J T Nguyen, D M Dines, E V Craig, R F Warren, L V Gulotta, R F Henn
AIMS: Few studies have evaluated the relationship between patients' pre-operative expectations and the outcome of orthopaedic procedures. Our aim was to determine the effect of expectations on the outcome after primary anatomical total shoulder arthroplasty (TSA). We hypothesised that patients with greater expectations would have better outcomes. PATIENTS AND METHODS: Patients undergoing primary anatomical TSA completed the Hospital for Special Surgery's Shoulder Expectations Survey pre-operatively...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28860398/revision-anatomical-reconstruction-of-the-lateral-ligaments-of-the-ankle-augmented-with-suture-tape-for-patients-with-a-failed-brostr%C3%A3-m-procedure
#12
B K Cho, Y M Kim, S M Choi, H W Park, N F SooHoo
AIMS: The aim of this prospective study was to evaluate the intermediate-term outcomes after revision anatomical ankle ligament reconstruction augmented with suture tape for a failed modified Broström procedure. PATIENTS AND METHODS: A total of 30 patients with persistent instability of the ankle after a Broström procedure underwent revision augmented with suture tape. Of these, 24 patients who were followed up for more than two years were included in the study...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28860397/diagnosis-of-prosthetic-joint-infection-with-alpha-defensin-using-a-lateral-flow-device-a-multicentre-study
#13
MULTICENTER STUDY
P Berger, M Van Cauter, R Driesen, J Neyt, O Cornu, J Bellemans
AIMS: The purpose of this current multicentre study is to analyse the presence of alpha-defensin proteins in synovial fluid using the Synovasure lateral flow device and to determine its diagnostic reliability and accuracy compared with the prosthetic joint infection (PJI) criteria produced by the Musculoskeletal Infection Society (MSIS). PATIENTS AND METHODS: A cohort of 121 patients comprising 85 total knee arthroplasties and 36 total hip arthroplasties was prospectively evaluated between May 2015 and June 2016 in three different orthopaedic centres...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28860396/early-patient-reported-outcomes-versus-objective-function-after-total-hip-and-knee-arthroplasty-a-prospective-cohort-study
#14
I E Luna, H Kehlet, B Peterson, H R Wede, S J Hoevsgaard, E K Aasvang
AIMS: The purpose of this study was to assess early physical function after total hip or knee arthroplasty (THA/TKA), and the correlation between patient-reported outcome measures, physical performance and actual physical activity (measured by actigraphy). PATIENTS AND METHODS: A total of 80 patients aged 55 to 80 years undergoing THA or TKA for osteoarthritis were included in this prospective cohort study. The main outcome measure was change in patient reported hip or knee injury and osteoarthritis outcome score (HOOS/KOOS) from pre-operatively until post-operative day 13 (THA) or 20 (TKA)...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28860395/no-difference-in-time-dependent-improvement-in-functional-outcome-following-closing-wedge-versus-opening-wedge-high-tibial-osteotomy-a-randomised-controlled-trial-with-two-year-follow-up
#15
RANDOMIZED CONTROLLED TRIAL
T K Nerhus, A Ekeland, G Solberg, B H Olsen, J E Madsen, S Heir
AIMS: The aim of this prospective randomised study was to compare the time course of clinical improvement during the first two years following a closing or opening wedge high tibial osteotomy (HTO). It was hypothesised that there would be no differences in clinical outcome between the two techniques. PATIENTS AND METHODS: Between 2007 and 2013, 70 consecutive patients were randomly allocated to undergo either a closing or opening wedge HTO. All patients had medial compartment osteoarthritis (OA), and were aged between 30 years and 60 years...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28860394/does-tantalum-exhibit-any-intrinsic-antimicrobial-or-antibiofilm-properties
#16
P L Harrison, T Harrison, I Stockley, T J Smith
AIMS: Tantalum (Ta) trabecular metal components are increasingly used to reconstruct major bone defects in revision arthroplasty surgery. It is known that some metals such as silver have antibacterial properties. Recent reports have raised the question regarding whether Ta components are protective against infection in revision surgery. This laboratory study aimed to establish whether Ta has intrinsic antibacterial properties against planktonic bacteria, or the ability to inhibit biofilm formation...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28860393/mild-or-moderate-renal-insufficiency-does-not-increase-circulating-levels-of-cobalt-and-chromium-in-patients-with-metal-on-metal-hip-arthroplasty
#17
O Lainiala, A Reito, P Jämsä, A Eskelinen
AIMS: To determine whether there is any association between glomerular filtration rate (GFR) and blood cobalt (Co) and chromium (Cr) levels in patients with metal-on-metal (MoM) hip arthroplasty. PATIENTS AND METHODS: We identified 179 patients with a unilateral 36 mm diameter head as part of a stemmed Summit-Pinnacle MoM hip arthroplasty. GFR was calculated using the Modification of Diet in Renal Disease formula. RESULTS: Normal renal function (GFR ≥ 90 ml/min/1...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28860392/factors-affecting-the-potential-for-posterior-bony-impingement-after-total-hip-arthroplasty
#18
T Shoji, T Yamasaki, S Izumi, H Murakami, K Mifuji, M Sawa, Y Yasunaga, N Adachi, M Ochi
AIMS: Our aim was to evaluate the radiographic characteristics of patients undergoing total hip arthroplasty (THA) for the potential of posterior bony impingement using CT simulations. PATIENTS AND METHODS: Virtual CT data from 112 patients who underwent THA were analysed. There were 40 men and 72 women. Their mean age was 59.1 years (41 to 76). Associations between radiographic characteristics and posterior bony impingement and the range of external rotation of the hip were evaluated...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28860391/the-mucopolysaccharidoses-advances-in-medical-care-lead-to-challenges-in-orthopaedic-surgical-care
#19
REVIEW
N Williams, D Challoumas, D Ketteridge, P J Cundy, D M Eastwood
The mucopolysaccharidoses (MPS) are a group of inherited lysosomal storage disorders with clinical manifestations relevant to the orthopaedic surgeon. Our aim was to review the recent advances in their management and the implications for surgical practice. The current literature about MPSs is summarised, emphasising orthopaedic complications and their management. Recent advances in the diagnosis and management of MPSs include the recognition of slowly progressive, late presenting subtypes, developments in life-prolonging systemic treatment and potentially new indications for surgical treatment...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28860390/contemporary-acetabular-fracture-surgery-treading-water-or-swimming-upstream
#20
REVIEW
M Rickman, V D Varghese
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...
September 2017: Bone & Joint Journal
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