Outcome Measures Used in Arthroplasty Trials: Systematic Review of the 2008 and 2013 Literature.

Objective: Previously published literature assessing the reporting of outcome measures used in joint replacement randomized controlled trials (RCT) has revealed disappointing results. It remains unknown whether international initiatives have led to any improvement in the quality of reporting and/or a reduction in the heterogeneity of outcome measures used. Our objective was to systematically assess and compare primary outcome measures and the risk of bias in joint replacement RCT published in 2008 and 2013.

The surgical management of symptomatic articular cartilage defects of the knee: Consensus statements from United Kingdom knee surgeons.

Background: Symptomatic articular cartilage and osteochondral lesions in the knee are an important source of pain and disability, and may lead to osteoarthritis. There are several surgical treatments for the condition, with emerging data evaluating their clinical effectiveness and longer-term clinical outcome. Health care providers have challenged the indications for the use of expensive techniques and have been reluctant to authorize funding or reimbursement.

Short-stretch inelastic compression bandage in knee swelling following total knee arthroplasty study (STICKS): study protocol for a randomised controlled feasibility study.

Background: Enhanced recovery programmes in total knee arthroplasty are well established. Post-operative knee swelling is common and impairs early post-operative function. The use of a short-stretch, inelastic compression bandage is hypothesised to reduce knee swelling and improve pain and early function.

Outcome Domains and Measures in Total Joint Replacement Clinical Trials: Can We Harmonize Them? An OMERACT Collaborative Initiative.

Objective: To develop a plan for harmonizing outcomes for people undergoing total joint replacement (TJR), to achieve consensus regarding TJR outcome research.

Methods: The TJR working group met during the 2014 Outcome Measures in Rheumatology (OMERACT) 12 meeting in Budapest, Hungary. Multiple conference calls preceded the face-to-face meeting.

A case series of 35 hip revisions for adverse reactions to metal debris following Cormet hip resurfacing.

The primary aim of this study was to analyse our painful metal-on-metal (MoM) hip resurfacing revisions with evidence of 'adverse reactions to metal debris' (ARMD). In our series of 35 revisions the median whole blood Cobalt levels were 58 nmols/l (range 12-1407 nmols/l), and whole blood Chromium levels were 73 nmols/l (range 2-353 nmols/l). Thirty-four of our 35 patients had abnormal imaging on Ultrasound scanning (USS).

Medial Patellofemoral Ligament Reconstruction for Patellar Dislocation: A Systematic Review.

Background: With improved understanding of the biomechanical importance of the medial patellofemoral ligament (MPFL), its reconstruction for patellar dislocation has become increasingly popular. The aim of this systematic review was to critically determine the effectiveness of MPFL reconstruction for patellar dislocation.

Hypothesis: MPFL reconstruction for patellar dislocation leads to a low redislocation rate with improved Kujala scores.

The effect of triclosan coated sutures on rate of surgical site infection after hip and knee replacement: a protocol for a double-blind randomised controlled trial.

Background: 187,000 hip and knee joint replacements are performed every year in the National Health Service (NHS). One of the commonest complications is surgical site infection (SSI), and this represents a significant burden in terms of patient morbidity, mortality and cost to health services around the world. The aim of this randomised controlled trial (RCT) is to determine if the addition of triclosan coated sutures to a standard regimen can reduce the rate of SSI after total knee replacement (TKR) and total hip replacement (THR).

Sensitivities, specificities, and predictive values of microbiological culture techniques for the diagnosis of prosthetic joint infection.

Background: Identifying the microorganism in a prosthetic joint infection is the key to appropriately targeting antimicrobial treatment. Despite the availability of various techniques, no single test is considered the definitive gold standard.

Aim: Our aim was to determine the sensitivity, specificity, and positive/negative predictive values for a variety of culture techniques.

The effect of high dose antibiotic impregnated cement on rate of surgical site infection after hip hemiarthroplasty for fractured neck of femur: a protocol for a double-blind quasi randomised controlled trial.

Background: Mortality following hip hemiarthroplasty is in the range of 10-40% in the first year, with much attributed to post-operative complications. One such complication is surgical site infection (SSI), which at the start of this trial affected 4.68% of patients in the UK having this operation.

Are the claims made in orthopaedic print advertisements valid?

Purpose: Advertisements are commonplace in orthopaedic journals and may influence the readership with claims of clinical and scientific fact. Since the last assessment of the claims made in orthopaedic print advertisements ten years ago, there have been legislative changes and media scrutiny which have shaped this practice. The purpose of this study is to re-evaluate these claims.

A systematic review of the evidence for single stage and two stage revision of infected knee replacement.

Background: Periprosthetic infection about the knee is a devastating complication that may affect between 1% and 5% of knee replacement. With over 79 000 knee replacements being implanted each year in the UK, periprosthetic infection (PJI) is set to become an important burden of disease and cost to the healthcare economy. One of the important controversies in treatment of PJI is whether a single stage revision operation is superior to a two-stage procedure.

The assessment of neutrophil CD64 count as an early warning marker of joint replacement infection.

120,000 hip and knee replacements are performed each year in the UK and more than 1 % of these require revision surgery due to infection. Current diagnostic tests used to diagnose infection of joint replacements, including the current gold standard C-reactive protein, which offers poor specificity when diagnosing infection in the post-operative period. In the post-operative period these tests are unable to differentiate between physiological inflammation and infection of the replacement.

Impact factors of orthopaedic journals between 2000 and 2010: trends and comparisons with other surgical specialties.

Purpose: The impact factors (IF) of orthopaedic journals is an important component in determining the future of orthopaedic research funding. We aim to characterise the trend in journal IF over the last decade and draw comparisons with other surgical specialties.

Methods: We conducted an analysis of impact factors from Journal Citation Reports between 2000 and 2010.

Bio-interference screw cyst formation in anterior cruciate ligament reconstruction--10-year follow up.

Purpose: This study used serial MRI to assess the absorption of a poly l-lactide Bioabsorbable interference screw used in the anterior cruciate ligament reconstruction with a 4-strand hamstring technique.

Methods: A consecutive series of ten patients undergoing anterior cruciate ligament reconstruction a 4-strand hamstring technique were assessed with magnetic resonance imaging (MRI) scans at 1, 2, 4, 7 and 10 years postoperatively.

Results: No resorption had occurred after 4 years in any of the patients.

A novel in vitro model to investigate behavior of articular chondrocytes in osteoarthritis.

Objective: To investigate in vivo simulation of the microenvironment in which osteoarthritis (OA) chondrocytes are cultured in vitro.

Methods: Human articular chondrocytes were cultured under normoxic and hypoxic conditions. Cells were cultured on standard culture plastic or a porous polyHEMA surface that closely resembles the in vivo cartilage microarchitecture.

Cup anteversion in hip resurfacing: validation of EBRA and the presentation of a simple clinical grading system.

The use of large metal on metal bearings has led to a reduction in the risk of dislocation post hip arthroplasty. Because of this, and also because of the technical difficulties associated with resurfacing surgery in particular, it could be argued that a less meticulous approach to acetabular cup placement has developed in comparison with conventional metal on polyethylene arthroplasty. Resurfacing cups may produce significant clinical problems when placed at the extremes of version, including increased production of metal debris and psoas tendonitis.

ASARM-truncated MEPE and AC-100 enhance osteogenesis by promoting osteoprogenitor adhesion.

Matrix extracellular phosphoglycoprotein (MEPE) is a member of the SIBLING (Small Integrin-Binding Ligand, N-linked Glycoprotein) family of secreted glycophosphoproteins. Several previous studies have demonstrated that MEPE and its peptide motif, AC-100, may regulate bone mass and influence osteoblast activity, suggesting its potential for inclusion in novel therapeutic strategies aimed at increasing osteogenesis. Our study uses in vitro approaches to assess how adhesion of nonadherent cells is influenced by MEPE and whether response to MEPE is dependent on the maturity of osteoblastic cells.