Distal femoral replacement in periprosthetic fracture around total knee arthroplasty.

Introduction: Total knee arthroplasty is a common orthopaedic procedure in the UK; consequently, revision surgery and periprosthetic fractures are increasing in incidence. Strategies for management of these cases include non-operative strategies, internal plate fixation and revision of the distal femoral component. One under-reported practice is to perform distal femoral replacement in cases with poor distal femoral bone stock.

Time to surgery and 30-day morbidity and mortality of periprosthetic hip fractures.

Background And Aim: The management of femoral periprosthetic fractures following hip replacement surgery is a complex and challenging situation. Whilst the early complications for both primary hip arthroplasty and proximal femoral fracture surgery have been widely documented, there is a paucity of published data regarding early outcomes following periprosthetic fracture surgery. Delay to surgery for native proximal femoral fractures has been clearly documented as a predictor towards adverse outcome.

The LISS plate treatment of supracondylar fractures above a total knee replacement: a case-control study.

The aim of this study was to assess the outcome of periprosthetic fractures above a total knee arthroplasty treated by LISS plate fixation. The primary outcome measure was the radiological union. Secondary outcome measures were knee function using the Oxford Knee Score, and quality of life using the SF-12 questionnaire.

MR imaging of acute anterior cruciate ligament injuries.

MRI of the knee has become an indispensable clinical tool in the management of chronic knee conditions. MRI for acute knee injuries is less well established but is becoming increasingly prevalent. MRI in acute ACL injuries is particularly useful for identifying associated injuries that will influence the early management of the patient.

Ankle arthrodesis for failed total ankle replacement.

Between 1999 and 2005, 23 failed total ankle replacements were converted to arthrodeses. Three surgical techniques were used: tibiotalar arthrodesis with screw fixation, tibiotalocalcaneal arthrodesis with screw fixation, and tibiotalocalcaneal arthrodesis with an intramedullary nail. As experience was gained, the benefits and problems became apparent.

Delayed repair of the quadriceps using the Mitek anchor system: a case report and review of the literature.

Extensor mechanism disruptions are relatively uncommon knee injuries. Within this group, delayed treatment is an infrequent but difficult clinical situation. Fibrous degeneration, muscle contraction and subsequent hiatus present a challenge to the orthopaedic surgeon.

A biomechanical comparison of the Mitek RapidLoc, Mitek Meniscal repair system, clearfix screws and vertical PDS and Ti-Cron sutures.

The aim of this in vitro study was to measure and compare the biomechanical properties and mode of failure of the five different methods of meniscal repair. Reproducible tears were created in 50 bovine medial menisci and repaired in a standardized fashion with one of the following devices: the RapidLoc meniscal repair device (Mitek Products, Westwood, MA), an 8 mm Mitek meniscal repair system (Mitek Products, Westwood, MA), Clearfix screw (Innovasive Devices, Marlborough, MA), a single vertical mattress suture of 2-0 Ti-Cron (Ethicon, Massachusetts) and a vertical mattress suture of No. 1 PDS II (Johnson and Johnson Int.

Subungual exostosis following toe nail removal--case report.

Removal of toe nail is a minor procedure that can be under ring block with no significant complications. We report the case of a young lady who developed a rapidly growing subungual exostosis on her right great toe following nail removal. Inadvertent iatrogenic injury to the nail bed and underlying phalangeal periosteum during nail removal might have triggered off rapid bone growth resulting in the large exostosis.

The role of MRSA screening in joint-replacement surgery.

The aim of this prospective study was to determine the effect of screening for methicillin-resistant Staphylococcus aureus (MRSA), in patients undergoing total hip and knee replacements, on reducing hospital-acquired infections and the length of hospital stay. We included 395 patients admitted to the elective orthopaedic ward for hip and knee replacements (knee 210; hip 185) from 16 October 2000 to 15 October 2001. Group 1 included 164 admissions before 16 April 2001 when MRSA swabs were not compulsory.

The effect of tibial implant size on post-operative alignment following medial unicompartmental knee replacement.

We have retrospectively reviewed a consecutive series of 71 medial unicompartmental knee replacements in 56 patients performed between 1991 and 1996 by a single surgeon. The aim of this study was to quantify the amount of correction in the tibiofemoral angle, which is achievable with each thickness of polyethylene tibial insert. Our results have shown that the amount of correction which can be expected with an 8 mm, 10 mm, 12 mm and 14 mm insert are 5.

Instability of the neonatal hip: the role of early or late splintage.

From January 1992 to December 1997, 59 dislocatable hips (37 children), confirmed by ultrasound, were splinted by Pavlik bracing within 2 weeks of birth. The majority were splinted within 1 week. From January 1998 to December 1999, 16 dislocatable hips (11 children) were evaluated by ultrasound and were not initially splinted but were followed up by serial ultrasound.

Migration of a broken meniscal arrow: a case report and review of the literature.

Meniscal repair is a common procedure that can be performed by the inside-out, outside-in, and all-inside techniques. The all-inside technique using the meniscal arrow is increasingly popular. We report a case in which a broken segment of a meniscal arrow was found on exploration of a subcutaneous swelling around the knee three weeks following meniscal repair.