Cantilever Failure of Modular Uncemented Femoral Revision Stem in Patients with Poor Proximal Femoral Support; How to avoid it?

Objectives: Revision hip arthroplasty is a major surgical challenge and is even more difficult in cases with a deficient proximal femur. Modular uncemented cone body revision femoral stems were introduced as a solution. They have the advantage of optimising joint kinematics by allowing the variable degrees of version, offset and leg length.

Validity of direct magnetic resonance arthrogram in patients with femoroacetabular impingement and their outcome post hip arthroscopy.

Femoroacetabular Impingement is an established cause of labral tears and chondral delamination. The aim was to test the validity of direct magnetic resonance arthrogram [dMRA] in the diagnosis of the same. We also looked at the short term functional outcome in these patients post hip arthroscopy.

Comparison of the reconstruction trochanteric antigrade nail (TAN) with the proximal femoral nail antirotation (PFNA) in the management of reverse oblique intertrochanteric hip fractures.

Reverse oblique intertrochanteric fractures have unique mechanical characteristics and are often treated with intramedullary implants. We compared the outcomes of the reconstruction trochanteric antegrade nail (TAN) with the proximal femoral nail antirotation (PFNA). Between July 2008 and February 2014, we reviewed all patients with reverse oblique intertrochanteric fractures treated at our hospital.

The anatomy and function of the obturator externus.

There is limited knowledge regarding the anatomic relationships and functional anatomy of the Obturator Externus muscle (OE). It is described as a muscle which originates from the external bony margin of the obturator foramen with a cylindrical tendon which passes like a sling under the femoral neck and inserts in the trochanteric fossa. The primary aim of this study is to describe the OE morphology and its anatomic relationship to the acetabulum.

The innervation of the human acetabular labrum and hip joint: an anatomic study.

Background: The aim of the current study was to evaluate the innervation of the acetabular labrum in the various zones and to understand its potential role in nociception and proprioception in hips with labral pathology.

Methods: A total of twenty hip labrums were tagged and excised intraoperatively from patients undergoing a total hip replacement. After preparation, the specimens were cut to a thickness of 10 μm and divided into four quadrants (zones) using a clock face pattern.

A safe overhang limit for unicompartmental knee arthroplasties based on medial collateral ligament strains: an in vitro study.

Excessive tibial component overhang during unicompartmental knee arthroplasty (UKA) may cause medial collateral ligament (MCL) impingement, which, in turn, may lead to medial knee pain [Chau et al. Tibial component overhang 226 following unicompartmental knee replacement-does it matter? The Knee. 2009;16(5):310-3].

Aseptic loosening of total hip replacement presenting as an anterior thigh mass.

Aseptic loosening is one of the commonest complications of total hip replacement that can cause pain and instability. The chronic inflammatory response to the wear debris from the polyethylene or metal can cause osteolysis and implant failure. We report a case of aseptic loosening of the hip, presented with a swelling over the anterior thigh without any pain or instability in the joint.

Bilateral femoral insufficiency fractures likely related to long-term alendronate therapy.

Osteoporosis-related fractures are a major public health problem and one in two women and one in four men are affected with osteoporosis-related fractures. Alendronate (Fosamax) is one of the first bisphosphonates used to treat osteoporosis effectively. Recently, however, there is a concern regarding long bone insufficiency fractures related to long-term alendronate therapy.

Irreducible shoulder dislocation - a word of caution.

Anterior dislocation of shoulder is usually amenable to closed manipulation. Failure to achieve satisfactory reduction can be due to soft tissue or osseous interposition. We report a case of irreducible anterior shoulder dislocation with the interposition of the musculocutaneous nerve.

Stress fracture of the fourth metatarsal in a child: a case report and review of the literature.

Metatarsal stress fractures are uncommon in the children. They usually occur in the distal part of the metatarsal and common in second and third metatarsals. Stress fracture in the proximal fourth metatarsal in a child is very rare.

Primary septic arthritis of the acromio-clavicular joint: case report and review of literature.

Primary septic arthritis of the Acromio clavicular joint is an uncommon disorder and is rarely seen even in an immunocompromised individual. We report a case of primary septic arthritis of the acromio-clavicular (A-C) joint caused by Staphylococcus aureus without any predisposing factors. The patient was admitted with left shoulder pain, restricted movements and fever.

Should doctors stop taking the generic history? A comparison of house officers' and nursing staff clerking in general surgery.

Purpose: The purpose of this paper is to show how the implementation of the European Working Time Directive in August 2004 has dramatically decreased junior doctors' working hours, as a consequence of which new ways of working will need to be found. Traditionally both doctors and nurses record the same generic history (past medical history, social and family history, drug history and allergies) in their own notes. This is unnecessary duplication and maybe only nursing staff should record this information.