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Journal of Orthopaedic Surgery and Research - Latest Articles
Comparison of cement pressurisation in flanged and unflanged acetabular cups
Rajarshi BhattacharyaFahad AttarSarah GreenAndrew Port Fri, 03 Feb 2012 00:00:00 -0000
Background: This biomechanical study examined difference in cement pressures generated by flanged and unflanged acetabular cups in hip arthroplasty.MethodUsing a model acetabulum, cement was inserted and pressurised followed by cup insertion and pressurisation. Pressures were recorded using transducers in the acetabulum. We compared Charnley Ogee (flanged), Exeter contemporary (flanged) and Exeter low profile (unflanged) cups using Simplex and CMW1 cements in turn. Results: Using Simplex, Charnley Ogee cup generated highest initial peak pressure and overall mean pressure. Exeter unflanged cup generated higher initial and mean pressures compared to Exeter flanged cup. With CMW, there was no significant difference between the pressures generated by the cups. Conclusions: Our experiment suggests that flanged cups do not consistently generate significantly higher cement pressures compared to unflanged cups.
Mid-term functional outcome after the internal fixation of distal radius fractures
Joideep PhadnisAlex TrompeterKieran GallagherLucy BradshawDavid ElliottKevin Newman Thu, 26 Jan 2012 00:00:00 -0000
Background: Distal radius fracture is a common injury with a variety of operative and non-operative management options. There remains debate as to the optimal treatment for a given patient and fracture. Despite the popularity of volar locking plate fixation, there are few large cohort or long term follow up studies to justify this modality. Our aim was to report the functional outcome of a large number of patients at a significant follow up time after fixation of their distal radius with a volar locking plate. Methods: 180 patients with 183 fractures and a mean age of 62.4 years were followed up retrospectively at a mean of 30 months (Standard deviation=10.4). Functional assessment was performed using the Disabilities of the Arm, Shoulder and Hand and modified MAYO wrist scores. Statistical analysis was performed to identify possible variables affecting outcome and radiographs were assessed to determine time to fracture union. Results: The median DASH score was 2.3 and median MAYO score was 90 for the whole group. Overall, 133 patients (74%) had a good or excellent DASH and MAYO score. Statistical analysis showed that no specific variable including gender, age, fracture type, post-operative immobilisation or surgeon grade significantly affected outcome. Complications occurred in 27 patients (15%) and in 11 patients were major (6%). Conclusion: This single centre large population series demonstrates good to excellent results in the majority of patients after volar locking plate fixation of the distal radius, with complication rates comparable to other non-operative and operative treatment modalities. On this basis we recommend this mode of fixation for distal radius fractures requiting operative intervention.
Open wedge high tibial osteotomy: cause of patellar descent
Jason Fan Thu, 12 Jan 2012 00:00:00 -0000
: This was a retrospective review of the nine open wedge high tibial osteotomy (HTO) done in a regional hospital in Hong Kong from 2006 to 2008. The mechanical hip-knee-ankle angle improved from average 169.5 degrees(164-175) to average 183.9 degrees (179-187). Patellar descent was noted in all patients postoperatively, with Blackburne-Peel (BP) index significantly changing from 0.78 (0.64-0.93) to 0.59 (0.38-0.78) (p<0.05). This change was strongly correlated with the size of anterior bone graft (r= -0.766; p= 0.016). The patellar tendon length as measured by Insall-Salvati index was not changed (pre-operative: 1.02 (0.88-1.25), final: 1.09 (0.8-1.22) (p=0.683)), inferring that scarring contracture of patellar tendon was not related to patellar descent.
Hook plate fixation of acute displaced lateral clavicle fractures: mid-term results and a brief literature overview
Davut TirenAlexander van BemmelDingeman SwankFrits van der Linden Wed, 11 Jan 2012 00:00:00 -0000
Background: The clavicle hook plate achieves like most other operative techniques, a high percentage of union and a low percentage of complications however concerns about long term complications still exist, particularly the involvement of the acromioclavicular joint. Methods: To evaluate the results and long term effects in use of this plate we performed a retrospective analysis with a mean follow up of 65 months (5.4 years) of 28 consecutive patients with acute displaced lateral clavicle fractures, treated with the clavicle hook plate. Results: Short term functional results in all patients were good to excellent. All but one patient had a united fracture (96%). Nine patients (32%) developed impingement symptoms and in 7 patients (25%) subacromial osteolysis was found. These findings resolved after plate removal. Twenty-four patients were re-evaluated at a mean follow-up period of 5.4 years. The Constant-Murley score was 97 and the DASH score was 3.5. Four patients (14%) developed acromioclavicular joint arthrosis of which one was symptomatic. Three patients (11%) had extra articular ossifications of which one was symptomatic. There was no relation between the impingement symptoms, subacromial osteolysis and development of acromioclavicular joint arthrosis or extra articular ossifications. Conclusions: The clavicle hook plate is a good primary treatment option for the acute displaced lateral clavicle fracture with few complications. At mid term the results are excellent and no long term complications can be addressed to the use of the plate.
Risk factor analysis for early femoral failure in metal-on-metal hip resurfacing arthroplasty: the effect of bone density and body mass index
Thomas GrossFei Liu Tue, 10 Jan 2012 00:00:00 -0000
Background: The importance of appropriately selecting patients based on factors such as bone mineral density, body mass index, age, gender, and femoral component size has been demonstrated in many studies as an aid in decreasing the rate of revisions and improving the outcomes for patients after hip resurfacing arthroplasty (HRA); however, there are few published studies quantitatively specifying the potential risk factors that affect early femoral component failures. Therefore, the purpose of this study was to investigate the specific causes of early femoral component failures in hip resurfacing separately and more carefully in order to develop strategies to prevent these failures, rather than excluding groups of patients from this surgical procedure. Methods: This retrospective study included 373 metal-on-metal HRAs performed by a single surgeon using the vascular sparing posterior minimally invasive surgical approach. The average length of follow-up was 30+/-6 months. In order to understand the causes of early femoral failure rate, a multivariable logistic regression model was generated in order to analyze the effects of bone mineral density (T-score), gender, diagnosis, body mass index, femoral implant fixation type, age, and femoral component size. Results: The average post-operative Harris hip score was 92+/-11 points and the average post-operative UCLA score was 7+/-2 points. There were three revisions due to femoral neck fracture and two for femoral component loosening. These occurred in two female and three male patients. In the multi-variable regression model, only T-score and body mass index showed significant effects on the failure rate of femoral components. Patients with a lower T-score and a higher body mass index had a significantly increased risk of early femoral component failure. Conclusions: We recommend that dual energy x-ray absorptiometry scan T-score tests should be routinely performed on all hip resurfacing patients pre-operatively. If a patient has a low T-score (=29 kg/m2).
A comparison of Leg Length and Femoral Offset discrepancies in Hip Resurfacing, Large Head Metal-on-Metal and Conventional Total Hip Replacement: a case series
Katherine HermanAlan HighcockJohn MooreheadSimon Scott Thu, 29 Dec 2011 00:00:00 -0000
Background: A discrepancy in leg length and femoral offset restoration is the leading cause of patient dissatisfaction in hip replacement surgery and has profound implications on patient quality of life. The aim of this study is to compare biomechanical hip reconstruction in hip resurfacing, large-diameter femoral head hip arthroplasty and conventional total hip replacement.MethodSixty patient's post-operative
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Comparison of cement pressurisation in flanged and unflanged acetabular cups
Rajarshi BhattacharyaFahad AttarSarah GreenAndrew Port Fri, 03 Feb 2012 00:00:00 -0000
Background: This biomechanical study examined difference in cement pressures generated by flanged and unflanged acetabular cups in hip arthroplasty.MethodUsing a model acetabulum, cement was inserted and pressurised followed by cup insertion and pressurisation. Pressures were recorded using transducers in the acetabulum. We compared Charnley Ogee (flanged), Exeter contemporary (flanged) and Exeter low profile (unflanged) cups using Simplex and CMW1 cements in turn. Results: Using Simplex, Charnley Ogee cup generated highest initial peak pressure and overall mean pressure. Exeter unflanged cup generated higher initial and mean pressures compared to Exeter flanged cup. With CMW, there was no significant difference between the pressures generated by the cups. Conclusions: Our experiment suggests that flanged cups do not consistently generate significantly higher cement pressures compared to unflanged cups.
Mid-term functional outcome after the internal fixation of distal radius fractures
Joideep PhadnisAlex TrompeterKieran GallagherLucy BradshawDavid ElliottKevin Newman Thu, 26 Jan 2012 00:00:00 -0000
Background: Distal radius fracture is a common injury with a variety of operative and non-operative management options. There remains debate as to the optimal treatment for a given patient and fracture. Despite the popularity of volar locking plate fixation, there are few large cohort or long term follow up studies to justify this modality. Our aim was to report the functional outcome of a large number of patients at a significant follow up time after fixation of their distal radius with a volar locking plate. Methods: 180 patients with 183 fractures and a mean age of 62.4 years were followed up retrospectively at a mean of 30 months (Standard deviation=10.4). Functional assessment was performed using the Disabilities of the Arm, Shoulder and Hand and modified MAYO wrist scores. Statistical analysis was performed to identify possible variables affecting outcome and radiographs were assessed to determine time to fracture union. Results: The median DASH score was 2.3 and median MAYO score was 90 for the whole group. Overall, 133 patients (74%) had a good or excellent DASH and MAYO score. Statistical analysis showed that no specific variable including gender, age, fracture type, post-operative immobilisation or surgeon grade significantly affected outcome. Complications occurred in 27 patients (15%) and in 11 patients were major (6%). Conclusion: This single centre large population series demonstrates good to excellent results in the majority of patients after volar locking plate fixation of the distal radius, with complication rates comparable to other non-operative and operative treatment modalities. On this basis we recommend this mode of fixation for distal radius fractures requiting operative intervention.
Open wedge high tibial osteotomy: cause of patellar descent
Jason Fan Thu, 12 Jan 2012 00:00:00 -0000
: This was a retrospective review of the nine open wedge high tibial osteotomy (HTO) done in a regional hospital in Hong Kong from 2006 to 2008. The mechanical hip-knee-ankle angle improved from average 169.5 degrees(164-175) to average 183.9 degrees (179-187). Patellar descent was noted in all patients postoperatively, with Blackburne-Peel (BP) index significantly changing from 0.78 (0.64-0.93) to 0.59 (0.38-0.78) (p<0.05). This change was strongly correlated with the size of anterior bone graft (r= -0.766; p= 0.016). The patellar tendon length as measured by Insall-Salvati index was not changed (pre-operative: 1.02 (0.88-1.25), final: 1.09 (0.8-1.22) (p=0.683)), inferring that scarring contracture of patellar tendon was not related to patellar descent.
Hook plate fixation of acute displaced lateral clavicle fractures: mid-term results and a brief literature overview
Davut TirenAlexander van BemmelDingeman SwankFrits van der Linden Wed, 11 Jan 2012 00:00:00 -0000
Background: The clavicle hook plate achieves like most other operative techniques, a high percentage of union and a low percentage of complications however concerns about long term complications still exist, particularly the involvement of the acromioclavicular joint. Methods: To evaluate the results and long term effects in use of this plate we performed a retrospective analysis with a mean follow up of 65 months (5.4 years) of 28 consecutive patients with acute displaced lateral clavicle fractures, treated with the clavicle hook plate. Results: Short term functional results in all patients were good to excellent. All but one patient had a united fracture (96%). Nine patients (32%) developed impingement symptoms and in 7 patients (25%) subacromial osteolysis was found. These findings resolved after plate removal. Twenty-four patients were re-evaluated at a mean follow-up period of 5.4 years. The Constant-Murley score was 97 and the DASH score was 3.5. Four patients (14%) developed acromioclavicular joint arthrosis of which one was symptomatic. Three patients (11%) had extra articular ossifications of which one was symptomatic. There was no relation between the impingement symptoms, subacromial osteolysis and development of acromioclavicular joint arthrosis or extra articular ossifications. Conclusions: The clavicle hook plate is a good primary treatment option for the acute displaced lateral clavicle fracture with few complications. At mid term the results are excellent and no long term complications can be addressed to the use of the plate.
Risk factor analysis for early femoral failure in metal-on-metal hip resurfacing arthroplasty: the effect of bone density and body mass index
Thomas GrossFei Liu Tue, 10 Jan 2012 00:00:00 -0000
Background: The importance of appropriately selecting patients based on factors such as bone mineral density, body mass index, age, gender, and femoral component size has been demonstrated in many studies as an aid in decreasing the rate of revisions and improving the outcomes for patients after hip resurfacing arthroplasty (HRA); however, there are few published studies quantitatively specifying the potential risk factors that affect early femoral component failures. Therefore, the purpose of this study was to investigate the specific causes of early femoral component failures in hip resurfacing separately and more carefully in order to develop strategies to prevent these failures, rather than excluding groups of patients from this surgical procedure. Methods: This retrospective study included 373 metal-on-metal HRAs performed by a single surgeon using the vascular sparing posterior minimally invasive surgical approach. The average length of follow-up was 30+/-6 months. In order to understand the causes of early femoral failure rate, a multivariable logistic regression model was generated in order to analyze the effects of bone mineral density (T-score), gender, diagnosis, body mass index, femoral implant fixation type, age, and femoral component size. Results: The average post-operative Harris hip score was 92+/-11 points and the average post-operative UCLA score was 7+/-2 points. There were three revisions due to femoral neck fracture and two for femoral component loosening. These occurred in two female and three male patients. In the multi-variable regression model, only T-score and body mass index showed significant effects on the failure rate of femoral components. Patients with a lower T-score and a higher body mass index had a significantly increased risk of early femoral component failure. Conclusions: We recommend that dual energy x-ray absorptiometry scan T-score tests should be routinely performed on all hip resurfacing patients pre-operatively. If a patient has a low T-score (=29 kg/m2).
A comparison of Leg Length and Femoral Offset discrepancies in Hip Resurfacing, Large Head Metal-on-Metal and Conventional Total Hip Replacement: a case series
Katherine HermanAlan HighcockJohn MooreheadSimon Scott Thu, 29 Dec 2011 00:00:00 -0000
Background: A discrepancy in leg length and femoral offset restoration is the leading cause of patient dissatisfaction in hip replacement surgery and has profound implications on patient quality of life. The aim of this study is to compare biomechanical hip reconstruction in hip resurfacing, large-diameter femoral head hip arthroplasty and conventional total hip replacement.MethodSixty patient's post-operative
Sites:
Academic Association of Orthopaedic Administrators: The AAOA provides a forum for the exchange of ideas among those engaged in Orthopedic surgery administration.American Academy of Orthopaedic Surgeons: Home site for the AAOS. About the journal, patient information, members services, library and archives.
American Association of Hip and Knee Surgeons: A membership based association for Orthopedic surgeons and professionals in the Orthopedic field.
American Orthopaedic Foot and Ankle Society: American Orthopaedic Foot & Ankle Society
AO North America: Health Care and Medical Education: The AONA is a nonprofit organization dedicated to the advancement for patient care, in orthopaedic, maxillofacial, spine and veterinary surgery
British Orthopaedic Association: The British Orthopaedic Association (BOA) is the professional association for orthopaedic and trauma surgeons in the United Kingdom and those abroad who have had orthopaedic training in the United Kingdom.
Female Orthopaedic Surgeons in Sweden - BGOS: A network providing professional and social activities, conferences and seminars for its members. [English and Swedish]
Iranian Orthopaedic Association: Dedicated to surgeons who worked in extraordinary conditions. Includes news, members, publications, and contacts.
Israel Orthopaedic (Orthopedic) Association: Information about the Association and orthopedic surgery in Israel.
National Association of Orthopaedic Technologists: Information about the association, membership, recognized schools. Based in North Carolina.
New Jersey Orthopaedic Society-Orthopaedic Surgeons of New Jersey: Membership information, mission, calendar of events, related links and contact information.
New York State Society of Orthopaedic Surgeons: Information on Federal and State legislators, orthopedic focus, meeting and membership information. (Clinton, NY)
Orthopaedic Trauma Association: Includes information about the OTA, its membership, meetings and courses, calendar, events, education, discussion forums and a newsletter.
Orthoptic Association of Australia: National allied health association: information on training, scientific conferences, membership
Società Italiana Chirurgia Ginocchio: English version of the Italian Society for Knee Surgery, with forum, surgical techniques, information about our society, othopaedic meetings and orthopaedic links.
Southern Orthopaedic Association: SOA was established to provide a forum for the exchange of original, practical, medical and surgical information in orthopaedics. An affiliate of Southern Medical Association and operates exclusively for charitable, scientific and educational purposes. Based in Alabama.
Texas Orthopaedic Association: TOA represents over 3,000 Texas Orthopaedic Surgeons. Find an orthopaedic surgeon in your city. Visit physician member web sites.
This directory is based on the Open Directory and may have been modified