Outcomes for Younger Patients with Femoral Neck Fractures.

Background: There is a paucity of longer-term outcome data in younger adult patients who undergo fixation for an intracapsular hip fracture. The aims of this study were to evaluate the outcomes for young adult patients undergoing intracapsular hip fracture fixation and to assess factors associated with failure and patient-reported outcome measures (PROMs).

Methods: From 2008 to 2018, 112 consecutive patients ≤60 years of age (mean age, 48 years [range, 20 to 60 years]; 54% male) were retrospectively identified as having undergone fixation of an intracapsular hip fracture.

The Estimated Lifetime Risk of Revision After Primary Knee Arthroplasty Is Influenced by Implant Design and Patient Age: Data From the National Joint Registries.

Background: The aim of this study was to determine the lifetime risk of revision surgery after primary knee arthroplasty (KA) according to implant choice and patient age.

Methods: The risk of revision according to the implant type (unicondylar, unconstrained, semiconstrained, and fully constrained) was obtained from the National Joint Registry of England and Wales. Mortality risk according to age was estimated from the Scottish Arthroplasty Project (1998 to 2019).

Operatively Managed Transverse or Short Oblique B1 Periprosthetic Fractures Around a Polished Taper-Slip Femoral Stem Are Associated With Reoperation in One Third of Cases: A Retrospective Cohort Study.

Background: Transverse or short oblique periprosthetic femoral fractures around total hip arthroplasty (THA) stems are typically classified as B1 fractures (stem well-fixed) and usually managed with fixation. These fractures have high non-union rates. This study aimed to identify reoperation rates in patients with operatively managed transverse or short oblique fractures around a cemented polished taper-slip stem and determine any associations with treatment failure.

Dual Plating for Periprosthetic Distal Femoral Fractures Using the Extensile Medial or Lateral Parapatellar Approach.

Periprosthetic distal femoral fractures (PDFFs) are increasing in incidence, typically affecting frail elderly patients who have complex needs. Although the use of distal femoral endoprostheses in the management of these fractures is increasing exponentially, concerns about their longevity and mechanical failures in younger patients should limit their use to older patients with limited life expectancies. In this study, we report the surgical technique for dual plating PDFFs using an extensile medial or lateral parapatellar approach and illustrate this technique with case examples.

Polyethylene wear in metal-backed tibial components in unicompartmental knee prostheses.

The utilization of unicompartmental knee arthroplasty (UKA) has increased worldwide and has become a favourable alternative to total knee arthroplasty (TKA) in patients with isolated single-compartment knee osteoarthritis. With the increase in UKA utilization, there has been an increase in the number of revisions. The two most common causes of revision are the progression of osteoarthritis in other compartments and aseptic loosening with polyethylene wear, with other common causes for revision including periprosthetic fracture, bearing dislocation, infection, instability and unexplained pain.

Long-Term Outcomes of Primary Cemented Total Hip Arthroplasty with Acetabular Bone Graft for Protrusio Acetabuli: Minimum 10-Year Follow-Up.

: This study reports the long-term survivorship of primary total hip arthroplasty (THA) for protrusio acetabuli. : Patients undergoing THA utilising cement and bone graft acetabular reconstruction for protrusio acetabuli in a university teaching hospital during the period 2003 to 2014 were included. Kaplan-Meier survival estimates were calculated with 95% confidence intervals (CI) up to 15 years following surgery.

Item response theory validation of the Oxford knee score and Activity and Participation Questionnaire: a step toward a common metric.

Objectives: The Oxford knee score (OKS) and OKS Activity and Participation Questionnaire (OKS-APQ) are patient-reported outcome measures used to assess people undergoing knee replacement surgery. They have not explicitly been tested for unidimensionality (whether they measure one underlying trait such as 'knee health'). This study applied item response theory (IRT) to improve the validity of the instruments to optimize for ongoing use.

Gender diversity in the National Joint Registry.

Aims: Our primary aim was to establish the proportion of female orthopaedic consultants who perform arthroplasty via cases submitted to the National Joint Registry (NJR), which covers England, Wales, Northern Ireland, the Isle of Man, and Guernsey. Secondary aims included comparing time since specialist registration, private practice participation, and number of hospitals worked in between male and female surgeons.

Methods: Publicly available data from the NJR was extracted on the types of arthroplasty performed by each surgeon, and the number of procedures of each type undertaken.

Research priorities of members of the British Association for Surgery of the Knee.

Aims: This study aims to identify the top unanswered research priorities in the field of knee surgery using consensus-based methodology.

Methods: Initial research questions were generated using an online survey sent to all 680 members of the British Association for Surgery of the Knee (BASK). Duplicates were removed and a longlist was generated from this scoping exercise by a panel of 13 experts from across the UK who provided oversight of the process.

Double plating is a suitable option for periprosthetic distal femur fracture compared to single plate fixation and distal femoral arthroplasty.

Aims: The purpose of this study was to compare reoperation and revision rates of double plating (DP), single plating using a lateral locking plate (SP), or distal femoral arthroplasty (DFA) for the treatment of periprosthetic distal femur fractures (PDFFs).

Methods: All patients with PDFF primarily treated with DP, SP, or DFA between 2008 and 2022 at a university teaching hospital were included in this retrospective cohort study. The primary outcome was revision surgery for failure following DP, SP, or DFA.

Socioeconomic deprivation is associated with worse health-related quality of life and greater opioid analgesia use while waiting for hip and knee arthroplasty.

Aims: The overall aim of this study was to determine the impact of deprivation with regard to quality of life, demographics, joint-specific function, attendances for unscheduled care, opioid and antidepressant use, having surgery elsewhere, and waiting times for surgery on patients awaiting total hip arthroplasty (THA) and total knee arthroplasty (TKA).

Methods: Postal surveys were sent to 1,001 patients on the waiting list for THA or TKA in a single Northern Ireland NHS Trust, which consisted of the EuroQol five-dimension five-level questionnaire (EQ-5D-5L), visual analogue scores (EQ-VAS), and Oxford Hip and Knee Scores. Electronic records determined prescriptions since addition to the waiting list and out-of-hour GP and emergency department attendances.

Item Response Theory Validation of the Forgotten Joint Score for Persons Undergoing Total Knee Replacement.

Background: The Forgotten Joint Score (FJS), a commonly used patient-reported outcome measure, was developed without fully confirming assumptions such as unidimensionality (all items reflect 1 underlying factor), appropriate weighting of each item in scoring, absence of differential item functioning (in which different groups, e.g., men and women, respond differently), local dependence (pairs of items are measuring only 1 underlying factor), and monotonicity (persons with higher function have a higher score).

Patient health-related quality of life deteriorates significantly while waiting six to 12 months for total hip or knee arthroplasty.

Aims: The primary aim was to assess change in health-related quality of life (HRQoL) of patients as they waited from six to 12 months for a total hip (THA) or total or partial knee arthroplasty (KA). Secondary aims were to assess change in joint-specific function, mental health, quality of sleep, number living in a state worse than death (WTD), wellbeing, and patient satisfaction with their healthcare.

Methods: This prospective study included 142 patients awaiting a THA (mean age 66.

Pre-existing knee osteoarthritis and severe joint depression are associated with the need for total knee arthroplasty after tibial plateau fracture in patients aged over 60 years.

Aims: This study aims to determine the rate of and risk factors for total knee arthroplasty (TKA) after operative management of tibial plateau fractures (TPFs) in older adults.

Methods: This is a retrospective cohort study of 182 displaced TPFs in 180 patients aged ≥ 60 years, over a 12-year period with a minimum follow-up of one year. The mean age was 70.

Editorial: factors influencing the outcome of total hip and knee arthroplasty.

Background: Total hip and knee arthroplasty for end stage arthritis are among the most cost-effective interventions available in all of medicine. Success of hip and knee arthroplasties is not universal and approximately one in ten patients are not satisfied with their arthroplasty and 10 to 34% of patients have an unfavourable long term pain outcome. The aim of this edition of Arthroplasty was to identify factors associated with: (1) poor joint specific outcome, (2) poor health related quality of life outcome and (3) dissatisfaction following total hip and knee arthroplasty.

Fifteen-year prospective longitudinal cohort study of outcomes following single radius total knee arthroplasty.

Aims: This prospective study reports longitudinal, within-patient, patient-reported outcome measures (PROMs) over a 15-year period following cemented single radius total knee arthroplasty (TKA). Secondary aims included reporting PROMs trajectory, 15-year implant survival, and patient attrition from follow-up.

Methods: From 2006 to 2007, 462 consecutive cemented cruciate-retaining Triathlon TKAs were implanted in 426 patients (mean age 69 years (21 to 89); 290 (62.

Acute Total Knee Arthroplasty for Unicondylar Tibial Plateau Fracture Using Metaphyseal Cones.

Tibial plateau fractures (TPFs) in older adults are increasing in incidence and now account for 8% of all fractures in patients over 60 years of age. Although primary fixation remains standard, the risk of fixation failure, loss of reduction, and the development of posttraumatic osteoarthritis are all markedly increased in this age group with higher rates of conversion to total knee arthroplasty (TKA) of 12%. When joint depression is severe with significant subchondral bone loss, up to half ultimately require TKA.

Primary Versus Secondary Total Knee Arthroplasty for Tibial Plateau Fractures in Patients Aged 55 or Over-A Systematic Review and Meta-Analysis.

Background: Total knee arthroplasty allows immediate postoperative weight-bearing and is increasingly recognized as a suitable treatment option for older patients who have tibial plateau fractures (TPFs). This systematic review evaluated the clinical and functional outcomes associated with primary versus secondary TKA for the treatment of TPFs in patients aged ≥55 years.

Methods: Various databases were searched from inception to December 2021.

Between-Sex Differences in Risk Factors for Cardiovascular Disease among Patients with Myocardial Infarction-A Systematic Review.

Between-sex differences in the presentation, risk factors, management, and outcomes of acute myocardial infarction (MI) are well documented. However, as such differences are highly sensitive to cultural and social changes, there is a need to continuously re-evaluate the evidence. The present contemporary systematic review assesses the baseline characteristics of men and women presenting to secondary, tertiary, and quaternary centres with acute myocardial infarction (MI).

The painful truth of waiting for hip and knee arthroplasty in Northern Ireland.

Aims: The aim of this study was to report health-related quality of life (HRQoL) and joint-specific function in patients waiting for total hip or knee arthroplasty surgery (THA or TKA) in Northern Ireland, compared to published literature and a matched normal population. Secondary aims were to report emergency department (ED) and out-of-hours general practitioner (OOH GP) visits, new prescriptions of strong opioids, and new prescriptions of antidepressants while waiting.

Methods: This was a cohort study of 991 patients on the waiting list for arthroplasty in a single Northern Ireland NHS trust: 497 on the waiting list for ≤ three months; and 494 waiting ≥ three years.

Robotic Arthroplasty Clinical and cost Effectiveness Randomised controlled trial (RACER-knee): a study protocol.

Introduction: Robotic-assisted knee replacement systems have been introduced to healthcare services worldwide in an effort to improve clinical outcomes for people, although high-quality evidence that they are clinically, or cost-effective remains sparse. Robotic-arm systems may improve surgical accuracy and could contribute to reduced pain, improved function and lower overall cost of total knee replacement (TKR) surgery. However, TKR with conventional instruments may be just as effective and may be quicker and cheaper.

Surgical approaches to periprosthetic femoral fractures for plate fixation or revision arthroplasty.

Periprosthetic femoral fractures are increasing in incidence, and typically occur in frail elderly patients. They are similar to pathological fractures in many ways. The aims of treatment are the same, including 'getting it right first time' with a single operation, which allows immediate unrestricted weightbearing, with a low risk of complications, and one that avoids the creation of stress risers locally that may predispose to further peri-implant fracture.

Patellar resurfacing versus retention in cruciate-retaining and posterior-stabilized total knee arthroplasty.

Aims: This systematic review and meta-analysis aimed to compare the influence of patellar resurfacing following cruciate-retaining (CR) and posterior-stabilized (PS) total knee arthroplasty (TKA) on the incidence of anterior knee pain, knee-specific patient-reported outcome measures, complication rates, and reoperation rates.

Methods: A systematic review of MEDLINE, PubMed, and Google Scholar was performed to identify randomized controlled trials (RCTs) according to search criteria. Search terms used included: arthroplasty, replacement, knee (Mesh), TKA, prosthesis, patella, patellar resurfacing, and patellar retaining.