The influence of pre-operative Computed Tomography (CT) on surgical approach and fixation for fractures of the tibial plateau.

Background: It is well known that a computed tomography (CT) scan improves the classification of tibial plateau fractures (TPF) compared with radiographs. However, it is less clear how this translates into clinical practice. The aim of this study is to establish to what extent a pre-operative CT scan alters the approach, setup and fixation choice in TPF compared to radiographs.

The ability of medial patellofemoral ligament reconstruction to correct patellar kinematics and contact mechanics in the presence of a lateralized tibial tubercle.

Background: Tibial tubercle (TT) transfer and medial patellofemoral ligament (MPFL) reconstruction are used after patellar dislocations. However, there is no objective evidence to guide surgical decision making, such as the ability of MPFL reconstruction to restore normal behavior in the presence of a lateralized TT.

Hypothesis: MPFL reconstruction will only restore joint contact mechanics and patellar kinematics for TT-trochlear groove (TG) distances up to an identifiable limit.

Severe Heterotopic Ossification following Total Knee Replacement.

Although the incidence of minor heterotopic ossification is probably higher than what is usually expected, severe heterotopic ossification (HO) is an extremely rare event following total knee replacement surgery. We present the case of a 66-year-old woman who initially had achieved an excellent range of motion following bilateral uncemented rotating platform total knee replacement, before presenting with pain and loss of range of motion at 2 months after surgery. Severe HO was diagnosed on X-rays.

The effect of tibial tuberosity medialization and lateralization on patellofemoral joint kinematics, contact mechanics, and stability.

Background: Tibial tuberosity (TT) transfer is a common procedure to treat patellofemoral instability in patients with elevated TT-trochlear groove (TG) distances. However, the effects of TT lateralization or medialization on patellar stability, kinematics, and contact mechanics remain unclear.

Hypothesis: Progressive medialization and lateralization will have increasingly adverse effects on patellofemoral joint kinematics, contact mechanics, and stability.

Assessing Performance in Shoulder Arthroscopy: The Imperial Global Arthroscopy Rating Scale (IGARS).

Background: Surgical training is undergoing major changes with reduced resident work hours and an increasing focus on patient safety and surgical aptitude. The aim of this study was to create a valid, reliable method for an assessment of arthroscopic skills that is independent of time and place and is designed for both real and simulated settings. The validity of the scale was tested using a virtual reality shoulder arthroscopy simulator.

Age-associated changes in the monoaminergic innervation of rat lumbosacral spinal cord.

The effects of ageing on the innervation patterns of lumbosacral spinal nuclei involved in controlling lower urinary tract functions, including micturition, were studied using immunohistochemistry for serotonin (5-HT) and tyrosine hydroxylase (TH) in male Wistar rats of 3 and 24 months. Quantitative image analysis revealed significant age-associated declines in the innervation of most regions including the intermediolateral cell nucleus, sacral parasympathetic nucleus, dorsal grey commissure and in the ventral horn including the dorsolateral nucleus which in the rat is one of the component nuclei homologous to Onuf's nucleus in man. Notable exceptions to this generalised decline were observed in the 5-HT innervation of the sacral parasympathetic nucleus, which was maintained, and in the region of the dorsolateral motor nucleus where TH-like immunoreactivity did not significantly decline.