Does long-term surveillance of primary linked total elbow arthroplasty identify failing implants requiring revision?

Background: Scoping review has identified a lack of evidence guiding long-term follow-up of elbow arthroplasty. We report the effectiveness of primary linked total elbow arthroplasty surveillance in identifying failing implants requiring revision.

Methods: A prospective database recording consecutive primary linked total elbow arthroplasty and subsequent surveillance in an elbow unit was analysed.

Can we develop consensus on long-term follow-up and surveillance of primary shoulder arthroplasty? A study protocol using a real-time Delphi technique among expert clinicians in the UK.

Background: Shoulder arthroplasty incidence is projected to continue its exponential growth and the resultant burden of monitoring patients with shoulder arthroplasty implants creates significant pressure on orthopaedic services. Surveillance offers the opportunity to study implant longevity, detect failing implants and potentially perform revision at lower morbidity and cost. There is a paucity of evidence to support recommendations on long-term follow-up in shoulder arthroplasty.

Discovery Elbow System arthroplasty polyethylene bearing exchange: outcomes and experience.

Background: The Discovery Elbow System (DES) utilizes a polyethylene bearing within the ulnar component. An exchange bearing requires preoperative freezing and implantation within 2 minutes of freezer removal to allow insertion. We report our outcomes and experience using this technique.

synthesis of g-CN/TiCT nano-heterostructures for enhanced photocatalytic H generation water splitting.

Herein, we demonstrated the synthesis of g-CN/TiCT nano-heterostructures for hydrogen generation under UV visible light irradiation. The formation of the g-CN/TiCT nano-heterostructures was confirmed powder X-ray diffraction and supported by XPS. The FE-SEM images indicated the formation of layered structures of MXene and g-CN.

Scoping review: Evidence for long-term follow-up and monitoring in shoulder and elbow arthroplasty.

Aims: Long-term follow-up and monitoring of asymptomatic shoulder and elbow arthroplasty remains contentious, with a wide spectrum of non-evidence-based mechanisms used. This scoping review aims to outline related evidence, thereby informing research requirements.

Methods: Studies relevant to shoulder and elbow arthroplasty follow-up, surveillance and time-related failure were included.

Does long-term follow-up and monitoring of primary shoulder arthroplasty identify failing implants requiring revision?

Background: Published scoping review has identified evidence paucity related to long-term follow-up of shoulder arthroplasty. We aim to report effectiveness of elective primary shoulder arthroplasty surveillance in identifying failing implants requiring revision.

Methods: A prospective database recording shoulder arthroplasty and subsequent follow-up surveillance in a shoulder unit was analyzed.

Clinical Outcomes of Arthroscopic Revision Rotator Cuff Repair.

Aims: Multiple studies have shown excellent clinical results in primary rotator cuff repairs; however, not much evidence is available in the literature on the outcomes of arthroscopic revision rotator cuff repairs. The purpose of this study was to report a cohort of patients who underwent revision arthroscopic rotator cuff repair and identify factors that may influence its outcomes.

Methods: We examined a cohort of 62 patients which underwent revision arthroscopic rotator cuff repair in a single UK institution with a minimum of 24 months follow-up.

Mid- to long-term outcomes of a cemented, all-polyethylene pegged glenoid component in anatomic total shoulder arthroplasty.

Background: The primary aim of this study was to evaluate mid- to long-term survival of an all-polyethylene pegged glenoid component used in anatomic total shoulder arthroplasty (TSA). The secondary aim was to review clinical and radiologic outcomes.

Methods: A retrospective analysis of a prospectively collected local arthroplasty register of consecutive patients undergoing TSA with an all-polyethylene pegged glenoid between January 2009 and December 2018 was undertaken.

Two-Stage Primary Arthroplasty in the Infected Native Knee: A Systematic Review and Pooled Analysis.

Introduction: The knee is the commonest native joint to develop an infection. A two-stage primary knee replacement, with an interim stage of debridement and cement spacer application, modelled after two-stage revision for periprosthetic joint infections (PJI) has been reported for the management of chronic infections.

Aims: To systematically review the literature to find the infection-free survival and outcomes of this operation and explore its indications.

Surgical fixation of isolated greater tuberosity fractures of the humerus- systematic review and meta-analysis.

Objectives: A systematic review was undertaken based on PRISMA guidelines to study the results of surgical treatment of Greater Tuberosity fractures of the Humerus by different techniques (Open, Percutaneous or Arthroscopic) and using different fixation devices (Sutures, Screws and Plates).

Data Sources: Literature searches were performed for studies in English on four online databases (MEDLINE®, Embase®, Ovid® Emcare and CINAHL®) using a pre-planned search strategy.

Study Selection: Studies were screened against pre-decided inclusion and exclusion criteria.

Introduction of an enhanced recovery programme for total shoulder arthroplasty: report of a novel pathway.

Background: Enhanced recovery (ER) programmes are well established in hip and knee arthroplasty, but are not yet commonplace for total shoulder arthroplasty (TSA). This study analyses the effect of implementing an ER programme with TSA, on length of stay (LOS), functional outcome and patient satisfaction.

Local Problem: No established programme applying ER to the specifics of upper-limb arthroplasty existed at our unit.

Minimum five-year outcomes of reverse total shoulder arthroplasty using a trabecular metal glenoid base plate.

Aims: Reverse total shoulder arthroplasty (RTSA) using trabecular metal (TM)-backed glenoid implants has been introduced with the aim to increase implant survival. Only short-term reports on the outcomes of TM-RTSA have been published to date. We aim to present the seven-year survival of TM-backed glenoid implants along with minimum five-year clinical and radiological outcomes.

The flail elbow: Every surgeon's nightmare.

A flail elbow joint has an excessive or abnormal degree of mobility resulting in loss of function. Such a situation can arise from structural damage or loss of neuromuscular control. Structural damage may be in terms of loss of integrity of bony, ligamentous, or both components, and this is commonly caused by trauma, failed arthroplasty, infections - either in the native joint or associated with the above, or inflammatory arthritides.

Primary open elbow arthrolysis in post-traumatic elbow stiffness - A comparison of outcomes in severity of elbow injury.

Purpose: Stiffness is a sequelae of elbow trauma. Arthrolysis may be considered to increase range of movement (ROM). Little is published on the outcomes/complications of elbow arthrolysis.

Rising to the challenge: medical students as Doctors' Assistants; an evaluation of a new clinical role.

Introduction: The COVID-19 Pandemic brought clinical placements to a halt for many UK medical students. A University Hospitals Trust offered clinical phase students the opportunity to support the National Health Service (NHS) in newly defined roles as Doctors' Assistants (DAs). This study evaluates the experience of students working in a single NHS Trust.

Mid- to long-term survivorship of the cemented, semiconstrained Discovery total elbow arthroplasty.

Background: The incidence of total elbow arthroplasty (TEA) is increasing, and an improved understanding of elbow kinematics and biomaterials has driven advances in implant design. In modern practice, cemented, semiconstrained devices are most frequently used. The Discovery TEA has demonstrated promising early results, although there are a paucity of follow-up studies and no dedicated mid- to long-term series.

Predicting the Behavior of Humeral Shaft Fractures: An Independent Validation Study of the Radiographic Union Score for HUmeral Fractures and Value of Assessing Fracture Mobility.

Objectives: To externally validate the Radiographic Union Score for HUmeral fractures (RUSHU) and to quantify the predictive relationship of fracture motion on physical examination to nonunion.

Design: Retrospective cohort study.

Setting: Single institutional center (University teaching hospital).

Protocol for a multi-site pilot and feasibility randomised controlled trial: Surgery versus PhysiothErapist-leD exercise for traumatic tears of the rotator cuff (the SPeEDy study).

Background: Clinically, a distinction is made between types of rotator cuff tear, traumatic and non-traumatic, and this sub-classification currently informs the treatment pathway. It is currently recommended that patients with traumatic rotator cuff tears are fast tracked for surgical opinion. However, there is uncertainty about the most clinically and cost-effective intervention for patients with traumatic rotator cuff tears and further research is required.

Management of tennis elbow: a survey of UK clinical practice.

Background: Tennis elbow is a common condition in the UK but there are no guidelines on how best to manage the condition. The purpose of the present study was to establish the current UK practice in managing patients with chronic tennis elbow.

Methods: A cross-sectional online survey of UK surgeons and therapists was conducted in June 2017.

Chronic adhesive capsulitis (Frozen shoulder): Comparative outcomes of treatment in patients with diabetes and obesity.

Despite an abundance of information about frozen shoulders, larger prospective studies on the outcomes of intervention are limited. The purpose of our study was to assess the functional and clinical outcomes with a further aim to analyse the independent effects of diabetes and BMI. A prospective cohort study of all 210 primary frozen shoulders over a 12 - month period was analysed.

Surgery for tennis elbow: a systematic review.

Background: There is no consensus on the most suitable treatment for tennis elbow but, in the USA, surgical intervention is increasing despite a lack of supportive research evidence. The aim of this systematic review was to provide a balanced update based on all relevant published randomized controlled trials conducted to date.

Methods: An electronic search of MEDLINE, EMBASE, CINAHL, BNI, AMED, PsycINFO, HBE, HMIC, PubMed, TRIP, Dynamed Plus and The Cochrane Library was complemented by hand searching.

Proximal humerus deformity, in a four-limb amputee following meningococcal septicaemia.

We present a challenging case of proximal humerus varus deformity in a four-limb amputee, caused by growth arrest from meningococcal septicaemia. The deformity resulted in a loss of function for our patient with inhibition of activities of daily living, requiring corrective osteotomy to help improve the range of motion of the shoulder. We describe in detail the management of our patient, highlight the importance of the orthopaedic manifestations of meningococcal septicaemia, and demonstrate the importance of monitoring potential deformities from growth arrest in these patients.

Management of type IIB and IIIB olecranon fractures. Case series.

Objectives: to report and evaluate the functional outcome of plate fixation in comminuted olecranon fractures (Mayo types IIB and IIIB).

Method: 23 consecutive patients with comminuted fractures of the olecranon presenting to our unit Between Feb 2011 and Jan 2015, at a mean follow-up of thirty-six months. Main outcome measurements include radiographic healing, post-operative range of motion, complications, outcome score and patient satisfaction.