Effects of combining electrical stimulation of the calf and thigh muscles in patients with osteoarthritis of the knee: protocol for a double-blind, randomised, sham-controlled trial.

Introduction: Knee osteoarthritis (KOA) is a leading cause of disability and is characterised by degenerative changes causing pain and loss of function. Neuromuscular electrical stimulation (NMES) has been shown to influence muscle size and strength in healthy subjects. A novel self-administered NMES device has been developed to help manage the symptoms of KOA.

Alteration of anterior cruciate ligament orientation in knees with trochlear dysplasia: description of a novel angle on MRI.

Aim: To assess changes in anterior cruciate ligament (ACL) geometry and inclination in trochlear dysplasia (TD) and analyse their significance.

Materials And Methods: Ninety-nine consecutive knees with TD and 23 normal knee magnetic resonance imaging (MRI) examinations were included as controls (n=122). Varying degrees of TD were classified into four distinct groups (A-D) according to the Dejour classification.

The Circulating Nucleic Acid Characteristics of Non-Metastatic Soft Tissue Sarcoma Patients.

Soft tissue sarcomas (STS) are rare, malignant tumours with a generally poor prognosis. Our aim was to explore the potential of cell free DNA (cfDNA) and circulating tumour DNA (ctDNA) analysis to track non-metastatic STS patients undergoing attempted curative treatment. The analysed cohort ( = 29) contained multiple STS subtypes including myxofibrosarcomas, undifferentiated pleomorphic sarcomas, leiomyosarcomas, and dedifferentiated liposarcomas amongst others.

Most unicompartmental knee replacement revisions could be avoided: a radiographic evaluation of revised Oxford knees in the National Joint Registry.

Purpose: The purpose of this study was to understand why the revision rate of unicompartmental knee replacement (UKR) in the National Joint Registry (NJR) is so high. Using radiographs, the appropriateness of patient selection for primary surgery, surgical technique, and indications for revision were determined. In addition, the alignment of the radiographs was assessed.

Circulating tumour-derived DNA in metastatic soft tissue sarcoma.

Following treatment 40% of soft tissue sarcoma (STS) patients suffer disease recurrence. In certain cancers circulating cell free DNA (cfDNA) and circulating tumour-derived DNA (ctDNA) characteristics correlate closely with disease burden, making them exciting potential sources of biomarkers. Despite this, the circulating nucleic acid characteristics of only 2 STS patients have been reported to date.

The outcome of secondary resurfacing of the patella following total knee arthroplasty: Results from the Trent and Wales Arthroplasty Register.

Background: We sought to determine whether patients undergoing secondary patella resurfacing (SPR) benefited from the procedure by assessing postoperative satisfaction via a postal questionnaire.

Methods: All such patients included in the Trent and Wales Arthroplasty Register were invited to participate using patient-reported outcome measures (PROMs). We identified 223 patients who had undergone SPR over a 20-year period.

Continuous Hyperfractionated Accelerated Radiotherapy (CHART) for Non-small Cell Lung Cancer (NSCLC): 7 Years' Experience From Nine UK Centres.

Aim: Continuous hyperfractionated accelerated radiotherapy (CHART) remains an option to treat non-small cell lung cancer (NSCLC; NICE, 2011). We have previously published treatment outcomes from 1998-2003 across five UK centres. Here we update the UK CHART experience, reporting outcomes and toxicities for patients treated between 2003 and 2009.

A regional registry study of 216 patients investigating if patient satisfaction after total knee arthroplasty changes over a time period of five to 20years.

Aims: To determine the temporal changes in patient dissatisfaction following primary knee arthroplasty surgery (TKA).

Patients And Methods: Three hundred and ninety patients that had previously indicated they were either dissatisfied or unsure with their TKA at one-year post-surgery in our region were mailed a simple questionnaire in addition to the Oxford Knee Score and EQ-5D.

Results: A 55% response rate was achieved.

Trends in total hip arthroplasty in young patients - results from a regional register.

Introduction: In the United Kingdom, over 83,000 primary total hip arthroplasties (THAs) were performed last year, of which 20% are in patients under the age of 60 years. These patients generally have a longer life expectancy and a higher activity level than an older cohort, which may potentially translate to higher revision rates.

Methods: We reviewed our Trent regional arthroplasty register to assess current surgical practice in younger patients undergoing total hip arthroplasty.

Total Knee Arthroplasty for Osteoarthritis in Patients Less Than Fifty-Five Years of Age: A Systematic Review.

Background: The proportion of younger patients undergoing total knee arthroplasty (TKA) is increasing and predictions state that the <55 age group will be the fastest growing group by 2030. We aim to collate data across studies to assess functional outcomes following TKA in patients <55 years of age using a systematic review.

Methods: The search identified 980 studies for title and abstract review.

Extra-abdominal desmoid fibromatosis: A review of management, current guidance and unanswered questions.

Extra abdominal desmoid fibromatosis is a complex condition with many recognised treatments including active observation, hormonal therapy, chemotherapy, radiotherapy and surgical resection. There is large variation in the natural history of individual desmoid tumours, with some cases progressing aggressively and others regressing spontaneously when observed alone. This combined with an absence of accurate clinical predictors of a desmoid tumour's behaviour has led to difficulties in identifying which patients would benefit most from aggressive treatment, and which could be adequately managed with a policy of active observation alone.

Nationwide trends in the current management of desmoid (aggressive) fibromatosis.

Aims: The optimal management of desmoid fibromatosis remains unclear, leading to significant variability in patient management. To assess this problem, the current approach of clinicians managing this complex condition in the UK was investigated.

Materials And Methods: A hypothetical case of intramuscular limb girdle desmoid fibromatosis in a fit 65-year-old patient was devised.

Mesenchymal chondrosarcoma: prognostic factors and outcome in 113 patients. A European Musculoskeletal Oncology Society study.

Background: Mesenchymal chondrosarcoma (MCS) is a distinct, very rare sarcoma with little evidence supporting treatment recommendations.

Patients And Methods: Specialist centres collaborated to report prognostic factors and outcome for 113 patients.

Results: Median age was 30 years (range: 11-80), male/female ratio 1.

Systematic review of proximal femoral arthroplasty for non-neoplastic conditions.

Proximal femoral arthroplasty (PFA) is an established treatment modality following oncological resection. Increasingly, these prostheses are being used for non-neoplastic conditions such as fractures and bone loss associated with septic or aseptic loosening. We performed a systematic review of the literature to determine the failure rates, mortality rates and hip outcome scores when PFAs were used in non-neoplastic conditions.

Extra-abdominal desmoid fibromatosis--a sarcoma unit review of practice, long term recurrence rates and survival.

Introduction: Desmoid fibromatosis (DF) carries a significant morbidity and a recognised mortality. Despite this there are currently limited diagnostic or treatment algorithms specific to cases of extra-abdominal DF. Historically surgical excision has formed the cornerstone of treatment.

Conversion of unicompartmental knee arthroplasty to total knee arthroplasty: the challenges and need for augments.

The potential advantages of unicompartmental knee arthroplasty (UKA) include lower morbidity and mortality, quicker recovery, good range of motion, good medium and long-term survival results, potential bone conservation and perceived easier revision. Converting a UKA to a total knee arthroplasty (TKA) may be challenging due to issues of bone loss, need for augmentation, restoring joint line and rotation. We present the intraoperative findings of 201 cases of failed UKA's from the Trent Wales arthroplasty audit group (TWAAG) register.