Haemorrhagic Pseudotumour Following Metal-on-Metal Hip Replacement.

We present a unique report of a spontaneous haemorrhage into a pseudotumour five years following revision surgery for failed metal-on-metal hip arthroplasty. The patient sustained no trauma, was not taking anticoagulants and had no bleeding disorder. Rapid progression in the size of the pseudotumour caused significant symptoms and functional impairment.

Prolonged operative time increases risk of blood loss and transfusion requirements in revision hip surgery.

Introduction: Revision hip surgery is well documented to have a high association with substantial blood loss and the associated need for a blood transfusion. This exposes the patient to increased risk of transfusion reaction and blood borne infection. There are many strategies to minimize allogeneic transfusion rates in revision surgery such as pre-operative autologous donation, peri-operative tranexamic acid, thrombin sealants, normovolaemic haemodilution, intra-operative blood salvage and the use of post-operative autologous drains.

Improving the accuracy of digital templating: achieving success through stakeholder management.

The use of a marker ball in digital templating for hip arthroplasty is a well-established method of preoperative planning and is used to overcome the inherent magnification in plain film radiographs. Our hospital policy is to place a marker ball in all anteroposterior pelvic films taken in the emergency department (ED) which have been requested for suspected neck of femur fractures. We carried out a baseline measurement followed by three Plan-Do-Study-Act cycles for all pelvic films taken in ED during July 2016, November 2016, February 2017 and November 2017.

Cable plating with a single strut allograft in the treatment of periprosthetic fractures of the femur.

Background:: Hip arthroplasties are increasing worldwide resulting in an increasing number of periprosthetic fractures. These fractures are difficult to treat with various the different fixation or revision options described, many of which have high complication rates.

Purpose:: To investigate whether our described method of treating periprosthetic fractures is an effective, safe and reproducible method of treating patients.

Leg length discrepancy in total hip arthroplasty with the use of cemented and uncemented femoral stems. A prospective radiological study.

Leg length discrepancy may occur following total hip arthroplasty, with a potentially impaired functional outcome as a result. The aim of this study was to compare the leg length discrepancy between both cemented and uncemented femoral stems when used in total hip arthroplasty. A prospective radiological study of 200 consecutive primary total hip arthroplasties was performed between June 2005 and December 2006.

Acetabular cement mantles and component position: are we achieving "ideal" results?

Radiographs of 100 primary cemented total hip arthroplasties were studied. Acetabular component positioning and cement mantles were assessed with respect to implant type, grade of surgeon, and operated side. Seventy-eight percent of the components were eccentrically placed, with increasing cement mantle thickness from zone 1 to zone 3.