Functional outcome of direct anterior versus posterior approach in total hip arthroplasty: a propensity-matched Asian study.

Introduction: The direct anterior approach (DAA) to total hip arthroplasty (THA) is a surgical approach that minimises soft tissue trauma, resulting in faster rehabilitation when compared to a posterior approach (PA). This study aimed to evaluate the difference between the two groups in an Asian cohort using propensity score matching.

Methods: A retrospective review of prospectively collected registry data of 794 primary THAs was performed.

Predictors of 10-year Mortality After Hip Fracture Surgery in a Pre-Pandemic Cohort.

Introduction: Though hip fractures are associated with significant mortality and morbidity, increasing life expectancy in developed countries necessitates an analysis of mortality trends and factors predicting long term survival. The aim of this study is to identify the predictors of 10-year mortality as well as assess the correlation of Age-adjusted Charlson comorbidity index (ACCI) with 10-year mortality in a surgically treated Asian geriatric hip fracture population.

Materials And Methods: From January 1, 2007 to December 31, 2009, 766 patients who underwent surgery for hip fracture with a minimum follow up of 10-years were recruited to the study (92% follow-up rate).

Perioperative management of open fractures in the lower limb.

An open fracture is a fracture which communicates with the external environment through a wound in the skin. Severe open fractures are managed by both orthopaedic and plastic surgeons to address injuries in both the bone and soft tissue. This review outlines the management of open fractures in the lower limb from the initial patient presentation to operative management (including debridement, skeletal fixation, definitive soft tissue coverage) according to the standards jointly published by the British Orthopaedic Association (BOA) and the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS).

Perioperative management of distal radius fractures.

Fractures of the distal radius are the most common upper limb fracture and account for over a sixth of all fractures seen in emergency departments. Although most of these fractures are managed non-operatively, a significant number of complex injuries undergo operative management. This educational review of up to date guidelines discusses the perioperative management of distal radius fractures and provides readers with continuing professional development activities.

The accuracy of a hand-held navigation system in total knee arthroplasty.

Introduction: This study aims to evaluate the effectiveness of a new hand-held navigation system. The authors of this study hypothesize that this navigation system will improve overall lower limb alignment and implant placement without causing a delay in surgery.

Patients And Methods: Two hundred consecutive patients diagnosed with tricompartmental osteoarthritis and underwent total knee arthroplasty by a senior surgeon were included in this study.

Comparison of early outcome of Weil osteotomy and distal metatarsal mini-invasive osteotomy for lesser toe metatarsalgia.

Purpose: To compare the 6-month outcome of Weil osteotomy with distal metatarsal mini-invasive osteotomy (DMMO) in 33 patients with lesser toe metatarsalgia.

Methods: Records of 33 patients who underwent Weil osteotomy (n=20, 41 toes) or DMMO (n=13, 22 toes) for lesser toe metatarsalgia by a single surgeon were reviewed. 25 of them had a concurrent procedure on the 1st toe.

Is clinical evaluation alone sufficient for the diagnosis of a Bankart lesion without the use of magnetic resonance imaging?

Background: Imaging modalities such as magnetic resonance arthrogram (MRA) offer great utility in diagnosing Bankart lesions but they are associated with a high degree of intra and interobserver variability. This study aims to evaluate the diagnostic accuracy of clinical evaluation and imaging modalities in Bankart lesions such as magnetic resonance imaging (MRI) and MRA of the shoulder.

Methods: Between February 2004 to January 2015, a retrospectively review of the surgical records at a tertiary hospital identified a total of 250 patients treated with a shoulder arthroscopy for Bankart repair.

History of previous knee surgery does not affect the clinical outcomes of primary total knee arthroplasty in an Asian population.

Background: Patients with a history of previous knee surgeries, such as anterior cruciate ligament reconstruction (ACLR) and high tibial osteotomy (HTO), often have a higher likelihood of requiring a subsequent total knee arthroplasty (TKA). However, there is relatively limited data, especially in the Asian population, on how previous knee surgery could affect the clinical outcomes of TKA. Therefore, this study aims to evaluate the impact of previous knee surgeries on the clinical outcomes of future TKA.

Preoperative haemoglobin cut-off values for the prediction of post-operative transfusion in total knee arthroplasty.

Purpose: The purpose of this study is to determine preoperative haemoglobin cut-off values that could accurately predict post-operative transfusion outcome in patients undergoing primary unilateral total knee arthroplasty (TKA). This will allow surgeons to provide selective preoperative type and screen to only patients at high risk of transfusion.

Methods: A total of 1457 patients diagnosed with osteoarthritis and underwent primary unilateral TKA between January 2012 and December 2014 were retrospectively reviewed.

Fixed Flexion Deformity After Unicompartmental Knee Arthroplasty: How Much Is Too Much.

Background: The detrimental impact of postoperative fixed flexion deformity (FFD) after unicompartmental knee arthroplasty (UKA) is manifold. This study aims to define the amount of postoperative FFD that is clinically relevant after UKA.

Methods: Between 2005 and 2012, 803 patients who underwent a primary UKA at a tertiary hospital were prospectively followed up.

Low Infection Rates in Total Knee Arthroplasty in End Stage Renal Failure Patients.

End stage renal failure is considered a risk factor for postoperative infection and many surgeons are cautious in offering this group of patients total knee arthroplasty for symptomatic osteoarthritis. In this retrospective study, 16 total knee arthroplasties were performed in 13 patients and each case was followed up for an average of 5.1 years.

Prevalence of Metatarsus Adductus in Symptomatic Hallux Valgus and Its Influence on Functional Outcome.

Background: Metatarsus adductus (MA) increases the risk of developing symptomatic hallux valgus (HV). This study aimed to determine the prevalence of MA in patients with symptomatic HV and to evaluate how it affected the functional outcome after scarf osteotomy.

Methods: Between January 2007 and June 2012, a total of 206 patients who underwent scarf osteotomy for symptomatic HV at a tertiary hospital were included.

Accuracy of endorectal ultrasound for measurement of the closest predicted radial mesorectal margin for rectal cancer.

Background: At present, pelvic phased array-coil MR is used as the validated imaging modality for measurement of the closest predicted radial mesorectal margin for rectal cancer. Endorectal ultrasound is also used to assess the clinical stage of the cancer that will determine the recommendation for neoadjuvant chemoradiation, but it has not been used to assess the closest predicted radial margin.

Objective: We propose to assess endorectal ultrasound identification of mesorectal margins and the measurement of the closest predicted radial tumor-mesorectal margin.

A metastatic colon cancer model using nonoperative transanal rectal injection.

Background: This study aimed to develop a noninvasive orthotopic model for metastasis of colon and rectal cancer using a transanal approach. Currently, the most accurate orthotopic representation of metastatic human colon cancer is via a cecal injection. The transanal model allows for further examination of systemic immune responses, tumor take, and onset of metastasis without prior surgical intervention.