Survivorship of the Stryker Ascend Flex uncemented metaphyseal bearing stem at a minimum 2- and 5-year follow-up.

Introduction: The Ascend Flex short stem implant has been reported to have good early clinical outcomes and low revision rates. This retrospective study aimed to evaluate the early to mid-term radiographic and clinical outcomes of patients who underwent primary shoulder arthroplasty with this implant.

Methods: All consecutive patients who underwent primary shoulder arthroplasty with short uncemented Ascend Flex stems with a minimum of 24-month follow-up were included.

Proceedings of the United Kingdom Periprosthetic Joint Infection Meeting 2022: Fracture-Related Infection Session.

Implant-related infections represent a relatively common and significant challenge in the surgical management of musculoskeletal trauma patients. The third United Kingdom Periprosthetic Joint Infection (UK PJI) Meeting convened in Glasgow on 1 April 2022, and brought together over 180 delegates, representing orthopaedics, infectious diseases, microbiology, plastic surgery, anaesthetics, and allied health professions, including pharmacy and specialist nurses. The meeting comprised a plenary session for all delegates, and separate breakout sessions for fracture-related infection (FRI) and arthroplasty.

Mid to Long-Term Outcomes of Grade III-B Open Tibial Fractures Definitively Managed With a Circular Frame: A 13-Year Prospective Database Study at a Major Trauma Center.

Objectives: The aim of this study was to report experience of a major trauma center utilizing circular frames as definitive fixation in patients sustaining Gustilo-Anderson 3B open tibial fractures.

Design: A prospectively maintained database was retrospectively interrogated.

Setting: Single major trauma center in the United Kingdom.

Clinical outcome of wedged glenoid reconstruction in anatomic total shoulder arthroplasty for osteoarthritic retroverted glenoid: a minimum 2-year follow-up.

Background: Glenoid retroversion and humeral head subluxation is a progressive disorder due to abnormal force coupling and increased contact force. In situ placement of anatomic total shoulder arthroplasty (TSA) components in this scenario results in edge loading, progressive subluxation, and early failure. Wedged glenoid components have been demonstrated to improve glenohumeral alignment, but have not been correlated with mid-term clinical outcomes.

Proceedings of the United Kingdom Periprosthetic Joint Infection Meeting 2022: Combined and Arthroplasty Sessions.

Considerable variation in practice exists in the prevention, diagnosis, and treatment of periprosthetic joint infection (PJI), which is a devastating complication for patients and surgeons. The consensus principle has been increasingly embraced by the orthopaedic community to help guide practice, especially where high-level evidence remains unavailable. The third United Kingdom Periprosthetic Joint Infection (UK PJI) Meeting was held in Glasgow on April 1, 2022, with more than 180 delegates in attendance, representing orthopaedics, microbiology, infectious diseases, plastic surgery, anesthetics, and allied health professions, including pharmacy and arthroplasty nurses.

Clinical and radiologic outcomes of Lima ProMade custom 3D-printed glenoid components in primary and revision reverse total shoulder arthroplasty with severe glenoid bone loss: a minimum 2-year follow-up.

Background: The purpose of this study is to report the clinical and radiologic outcomes of patients undergoing primary or revision reverse total shoulder arthroplasty using custom 3D-printed components to manage severe glenoid bone loss with a minimum of 2-year follow-up.

Methods: Following ethical approval, patients were identified and invited to participate. Inclusion criteria were (1) severe glenoid bone loss necessitating the need for custom implants and (2) patients with definitive glenoid and humeral components implanted more than 2 years prior.

A Systematic Review of the Utility of Intraoperative Navigation During Total Shoulder Arthroplasty.

Total shoulder arthroplasty (TSA) has been demonstrated to successfully recover function to shoulders impaired by arthrosis and rotator cuff insufficiency. Long-term survival depends on the correct positioning of glenoid components and secure bone fixation. Computed tomography (CT)-based intraoperative navigation has proven to be an effective technique for successful TSA procedures.

Pin-site Infection: A Systematic Review of Prevention Strategies.

Introduction: Circular frame fixation remains a key tool in the armamentarium of the limb reconstruction surgeon. One of the key drawbacks is the onset of pin-site infection (PSI). As a result of limited evidence and consensus of PSI prevention, a wide variation in practice remains.

Autologous versus synthetic bone grafts for the surgical management of tibial plateau fractures: a systematic review and meta-analysis of randomized controlled trials.

Aims: Our objective was to conduct a systematic review and meta-analysis, to establish whether differences arise in clinical outcomes between autologous and synthetic bone grafts in the operative management of tibial plateau fractures.

Methods: A structured search of MEDLINE, EMBASE, the online archives of Bone & Joint Publishing, and CENTRAL databases from inception until 28 July 2021 was performed. Randomized, controlled, clinical trials that compared autologous and synthetic bone grafts in tibial plateau fractures were included.

Closed incision negative pressure wound therapy versus conventional dressings following soft-tissue sarcoma excision: a prospective, randomized controlled trial.

Aims: The primary objective of this study was to compare the postoperative infection rate between negative pressure wound therapy (NPWT) and conventional dressings for closed incisions following soft-tissue sarcoma (STS) surgery. Secondary objectives were to compare rates of adverse wound events and functional scores.

Methods: In this prospective, single-centre, randomized controlled trial (RCT), patients were randomized to either NPWT or conventional sterile occlusive dressings.

Nanoscale Coatings for Ultralow Dose BMP-2-Driven Regeneration of Critical-Sized Bone Defects.

While new biomaterials for regenerative therapies are being reported in the literature, clinical translation is slow. Some existing regenerative approaches rely on high doses of growth factors, such as bone morphogenetic protein-2 (BMP-2) in bone regeneration, which can cause serious side effects. An ultralow-dose growth factor technology is described yielding high bioactivity based on a simple polymer, poly(ethyl acrylate) (PEA), and mechanisms to drive stem cell differentiation and bone regeneration in a critical-sized murine defect model with translation to a clinical veterinary setting are reported.

Epidemiology of glenohumeral dislocation and subsequent instability in an urban population.

Background: Glenohumeral dislocation is the most commonly encountered adult joint instability. The epidemiology in the United Kingdom and worldwide is unclear and often limited to young, active groups that are not representative of general populations. Information regarding epidemiology and outcome from a first dislocation is useful for trauma service planning and patient counseling.

Radiofrequency ablation for osteoid osteoma - Recurrence rates and predictive factors.

Background And Purpose: Osteoid osteoma is an infrequent but debilitating benign bone lesion which can be successfully managed by percutaneous radiofrequency ablation (RFA). There are few studies investigating the efficacy and follow-up of this treatment. An arbitrary upper limit of 15 mm has been used to differentiate between osteoid osteoma and osteoblastoma with surgery used for lesions above this limit.

A national questionnaire survey on knee manipulation following total knee arthroplasty.

Background: Adequate range of knee motion is critical for successful total knee arthroplasty. While aggressive physical therapy is an important component, manipulation may be a necessary supplement. There seems to be a lack of consensus with variable practices existing in managing stiff postoperative knees following arthroplasty.

The risk of cardiorespiratory deaths persists beyond 30 days after proximal femoral fracture surgery.

Introduction: 30-day mortality is routinely used to assess proximal femoral fracture care, though patients might remain at risk for poor outcome for longer. This work has examined the survivorship out to one year of a consecutive series of patients admitted for proximal femoral fracture to a single institution. We wished to quantify the temporal impact of fracture upon mortality, and also the influence of patient age, gender, surgical delay and length of stay on mortality from both cardiorespiratory and non-cardiorespiratory causes.

Current concepts, which effect outcome following major hemorrhage.

There are a multitude of factors, which effect outcome following major trauma. The recent conflict in the middle-east has advanced our knowledge and developed clinical practice, here within the UK. This article reviews the current and emerging concepts, which effect the outcome of patients sustaining major hemorrage in trauma.

Stretching the indications: high tibial osteotomy used successfully to treat isolated ankle symptoms.

High tibial osteotomy (HTO) is successful in treating symptomatic varus arthritis of the knee. We present a case where ankle pain and instability were attributed to varus ankle malalignment. This was found to be secondary to constitutional varus of the proximal tibia but the patient's knee was asymptomatic.

Painless vertebral osteomyelitis: an unusual presentation.

Vertebral osteomyelitis or discitis is a condition characterised by inflammation to the vertebral disc space and is often related to infection. It usually involves the discovertebral junction, and may extend to the epidural space, posterior vertebral elements and paraspinal tissues. This is an unusual case of a 68-year-old gentleman who presented to hospital confused and unwell with a methicillin-resistant Staphylococcus aureus bacteraemia.

Catastrophic osteomyelitis following percutaneous wire fixation of a distal radial fracture: a cautionary tale of poor patient selection followed by surgical mishap.

We present a case of distal radius fracture. Several sequential unfortunate events resulted in a poor outcome. The patient was poorly selected because the degree of early dementia was not fully appreciated, due to intermittent periods of lucidity.