Pre-operative EQ-5D-5L is a strong predictor of meaningful improvement in quality of life following primary total knee arthroplasty.

Introduction: Predicting which patients will get meaningful benefit from total knee arthroplasty remains a challenge. Our aim was to assess if pre-operative quality of life (EuroQol 5-Dimension, 5-Level instrument; EQ-5D-5L) can predict the likelihood of a patient achieving post-operative improvement in patient-reported outcome measures (PROMS) following total knee arthroplasty to a level of minimum clinically-important difference (MCID).

Materials And Methods: This was a retrospective analysis of a prospective cohort of total knee arthroplasty patients.

The utility of cemented femoral stems in modern THA: a 10-year comparative analysis of the Charnley and Exeter stems.

Background: Total hip replacement (THR) is one of the most common surgical procedures performed worldwide. The controversy surrounding the relative merits of a cemented composite beam or cemented taper-slip stem in total hip replacement continues. Our aims primarily were to assess the 10-year outcomes of cemented stems using Charnley and Exeter prostheses with regional registry data and secondarily to assess the main predictors of revision.

Obesity trends over 10 years in primary hip and knee arthroplasty-a study of 12,000 patients.

Objectives/aims: Obesity and its increasing prevalence are global public health concerns. Following joint replacement, there is evidence to support that obese patients are more likely to suffer complications. We examined 10-year trends in BMI of the primary total hip and total knee replacement cohorts in our institution to discern whether the BMI of these patients has changed over time.

Outcomes of the Exeter V40 cemented femoral stem at a minimum of ten years in a non-designer centre.

Aims: The Exeter V40 cemented femoral stem was first introduced in 2000. The largest single-centre analysis of this implant to date was published in 2018 by Westerman et al. Excellent results were reported at a minimum of ten years for the first 540 cases performed at the designer centre in the Exeter NHS Trust, with stem survivorship of 96.

Crisis change management during COVID-19 in the elective orthopaedic hospital: Easing the trauma burden of acute hospitals.

Introduction: With the emergence of the 2019 novel coronavirus and its resulting pandemic status in March 2020 all routine elective orthopaedic surgery was cancelled in our institution. The developing picture in Italy, of acute hospitals becoming overwhelmed with treating patients suffering with severe and life-threatening symptoms from the disease, prompted the orthopaedic surgeons to formulate a plan to transfer trauma patients requiring surgery to the elective hospital to unburden the acute hospital system.

Methods: Under the threat of this pandemic; protocols and algorithms were established for referral, acceptance and care of trauma patients from acute hospitals in the region.

Regional trauma patterns during the COVID-19 pandemic.

Background: The current pandemic has impacted heavily on health systems, making unprecedented demands on resources, and forcing reconfiguration of services. Trauma and orthopaedic units have cancelled elective surgery, moved to virtual based clinics and have been forced to reconsider the provision of trauma. Our national elective orthopaedic centre has been re-designated as a trauma centre to allow tertiary centres re-direct triaged trauma.

Total hip replacement-the cause of failure in patients under 50 years old?

Aim: To establish the mode of failure of primary total hip replacement in patients under 50 years old.

Methods: A total of 1062 revision total hip arthroplasties were performed over a 5-year period, with 146 on patients under 50 years old. These were subdivided into early (< 5 years) and late (> 5 years) failures from the index procedure.

Consent documentation for elective orthopaedic surgery.

Objectives: Currently in Ireland, there is a lack of uniformity regarding the method in which the consent process is routinely documented. The purpose of this study was to evaluate the standard consent forms used in elective orthopaedic hospitals in Ireland. In addition, this paper explores the relevant guidelines from the UK and Ireland relating to consent documentation.

A Rare Case of Spontaneous Fusion of the Knee.

To our knowledge, this article is the first report of a case of spontaneous and progressive bony fusion of a knee joint without a prior diagnosis of inflammatory or septic arthritis or surgical arthrodesis.

Systematic review and meta-analysis of closed suction drainage versus non-drainage in primary hip arthroplasty.

The routine use of drains in surgery has been dogmatically instituted in some disciplines. Orthopaedic surgery is one such sub-speciality. The use of postoperative closed suction drainage in total hip arthroplasty (THA) has become increasingly controversial with multiple randomised control trials performed to assess the benefit to outcome in THA.

Imaging of periprosthetic infection.

Periprosthetic infection is one of the most challenging and difficult complications in orthopaedics. It can result in significant patient distress and disability, with repeated surgeries, increased cost and utilization of medical resources, and in rare cases even mortality. The biggest challenge to date is the correct diagnosis of periprosthetic infection and implementation of effective treatment regimens capable of eradicating the organism.

Diagnosis of periprosthetic joint infection using synovial C-reactive protein.

The diagnosis of periprosthetic joint infection (PJI) is a considerable challenge. This study examines the quantification of C-reactive protein (CRP) in synovial fluid for diagnosis of PJI. Synovial fluid samples were collected prospectively from 63 patients undergoing revision or primary joint arthroplasty.

Imaging of the postoperative hip.

A basic understanding of the surgical approach, technique, and potential complications in addition to the types of hardware used is essential in interpreting postoperative imaging of the hip. This article reviews the various surgical approaches to the hip and hardware components in total hip arthroplasty and hip preservation surgery and the potential complications that may arise. The various surgical treatments in the management of acetabular dysplasia and avascular necrosis and the imaging appearances of these on different imaging modalities are also discussed.

Intramedullary versus extramedullary alignment of the tibial component in the Triathlon knee.

Background: Long term survivorship in total knee arthroplasty is significantly dependant on prosthesis alignment. Our aim was determine which alignment guide was more accurate in positioning of the tibial component in total knee arthroplasty. We also aimed to assess whether there was any difference in short term patient outcome.

Effect of deferred treatment of supracondylar humeral fractures.

Purpose: Timing of surgery remains a controversial topic in the treatment of the supracondylar humeral fracture. In our institution, patients are not brought to theatre after midnight, except in the 'life or limb' situation. We hypothesised that time to surgery has no significant influence on complication rate with supracondylar fracture of the humerus.

Sonoporation mediated immunogene therapy of solid tumors.

Development of gene-based therapies for the treatment of inherited and acquired diseases, including cancer, has seen renewed interest in the use of nonviral vectors coupled to physical delivery modalities. Low-frequency ultrasound (US), with a well-established record in a clinical setting, has the potential to deliver DNA efficiently, accurately and safely. Optimal in vivo parameters for US-mediated delivery of naked plasmid DNA were established using the firefly luciferase reporter gene construct.

Comparison of complications in transtrochanteric and anterolateral approaches in primary total hip arthroplasty.

Three surgical approaches to primary total hip arthroplasty (THA) have been in use since Charnley popularized the transtrochanteric approach. This study was designed to examine the difference in morbidity between the transtrochanteric approach and the anterolateral approach in primary THA. Information on 891 patients who underwent primary THA performed by a single surgeon was collected prospectively between 1998 and 2003 using a modified SF-36 form, preoperatively, intraoperatively, and at 3 months postoperatively.