Impact of bone quality on surgical decision-making in total hip arthroplasty: a qualitative analysis in the UK.

Introduction: For total hip arthroplasty (THA) to be successful, surgeons need to make several decisions ranging from implant choice to impaction force. It is unclear, however, whether and how bone quality affects surgeon's decision-making and how surgeons evaluate bone quality.

Objectives: This inductive/deductive qualitative hybrid study aims to explore the impact of bone quality on the decision-making of surgeons performing elective primary THA.

Marine-Derived Lipases for Enhancing Enrichment of Very-Long-Chain Polyunsaturated Fatty Acids with Reference to Omega-3 Fatty Acids.

Omega-3 fatty acids are essential fatty acids that are not synthesised by the human body and have been linked with the prevention of chronic illnesses such as cardiovascular and neurodegenerative diseases. However, the current dietary habits of the majority of the population include lower omega-3 content compared to omega-6, which does not promote good health. To overcome this, pharmaceutical and nutraceutical companies aim to produce omega-3-fortified foods.

Safe and valid? A systematic review of the psychometric properties of culturally adapted depression scales for use among Indigenous populations.

Background: Implementing culturally sensitive psychometric measures of depression may be an effective strategy to improve acceptance, response rate, and reliability of psychological assessment among Indigenous populations. However, the psychometric properties of depression scales after cultural adaptation remain unclear.

Methods: We screened the Ovid Medline, PubMed, Embase, Global Health, PsycInfo, and CINAHL databases through three levels of search terms: Depression, Psychometrics, and Indigenous, following the PRISMA guidelines.

5 year follow up of a hydroxyapatite coated short stem femoral component for hip arthroplasty: a prospective multicentre study.

Short stem, uncemented femoral implants for hip arthroplasty are bone conserving achieving stability through initial metaphyseal press-fit and biological fixation. This study aimed to evaluate the survivorship, mid-term function and health related quality of life outcomes in patients who have undergone total hip arthroplasty (THA) with a fully hydroxyapatite coated straight short stem femoral component with up to 5 years follow-up. 668 patients were recruited to a multicentre study investigating the performance of the cementless Furlong Evolution stem for THA.

A Comparative Study to Assess Accuracy of Casts Prepared using Direct Impression Technique with and without Splinting of Multiple Dental Implants Utilising Two Different Splinting and Impression Materials.

Background: The current study examined the accuracy of casts generated using direct impression processes with and without splints for multiple dental implants utilizing two different splinting materials and impression materials.

Materials And Methods: Dental replacement base intensity alleviating acrylic tar was used to create a reference model of a mandible with four inserts (Uniti, Equinox, D-3.7 mm, and L-13 mm) in the front.

Clozapine and Sweet's syndrome: case report.

A patient developed fever, raised inflammatory markers and a maculopapular rash following commencement of clozapine for treatment of his schizoaffective disorder. Skin biopsy confirmed Sweet's syndrome. Identification of the cause was challenging, with a number of possible considerations including infection, malignancy and various potential drug triggers.

Enhancing acetabular reaming accuracy: optimal techniques and a novel reamer design.

Introduction: Successful press-fit implantation relies on an accurately reamed bone cavity. Inaccurate reaming can lead to a suboptimal press-fit risking fracture and cup deformation or excessive micromotion and loosening. Several factors may impact reaming accuracy including the reamer design, the surgeon's technique and the bone quality.

Can guided wave ultrasound predict bone mechanical properties at the femoral neck in patients undergoing hip arthroplasty?

The bone quality of patients undergoing hip replacement surgery is poorly predicted by radiographs alone. With better bone quality information available to a surgeon, the operation can be performed more safely. The aim of this study was to investigate whether ultrasound signals of cortical bone at peripheral sites such as the tibia and radius can be used to predict the compressive mechanical properties of cortical bone at the femoral neck.

A Safety Evaluation of the Resumption of Elective Orthopaedic Services in Higher Risk Patients During the COVID-19 Pandemic.

Introduction The COVID-19 pandemic has caused mass disruption to all aspects of society, with elective orthopaedics not spared. The pandemic has the potential to cause a tsunami of health burden in the community if elective services are not resumed to pre-pandemic levels of activity. Studies have shown that elective orthopaedics can be safely carried out in a COVID-19 free hospital.

Program evaluation of a student-led peer support service at a Canadian university.

Background: University students often experience numerous financial, social and emotional stressors that can affect their mental health. The Peer Support Centre (PSC) is a pilot project that was established to provide peer support to students in these stressful conditions. We wanted to investigate whether peer support is a viable form of support that would benefit university students.

Trainee performed total knee arthroplasty is safe and effective: A systematic review and meta-analysis comparing outcomes between trainees and consultants.

Background: There are concerns that trainee performed knee arthroplasty (KA) may adversely affect patient outcomes. Demand for KA is projected to increase, and trainees must therefore be competent to perform it.

Methods: A systematic literature search was performed identifying articles comparing outcomes following trainee versus consultant surgeon performed primary KA.

The effect of COVID-19 on the trauma burden, theatre efficiency and training opportunities in a district general hospital: planning for a future outbreak.

Aims: The aim of this study is to determine the effects of the UK lockdown during the COVID-19 pandemic on the orthopaedic admissions, operations, training opportunities, and theatre efficiency in a large district general hospital.

Methods: The number of patients referred to the orthopaedic team between 1 April 2020 and 30 April 2020 were collected. Other data collected included patient demographics, number of admissions, number and type of operations performed, and seniority of primary surgeon.

The impact of COVID-19 on elective and trauma spine service in a district general hospital.

Aims: The aim of this paper is to describe the impact of COVID-19 on spine surgery services in a district general hospital in England in order to understand the spinal service provisions that may be required during a pandemic.

Methods: A prospective cohort study was undertaken between 17 March 2020 and 30 April 2020 and compared with retrospective data from same time period in 2019. We compared the number of patients requiring acute hospital admission or orthopaedic referrals and indications of referrals from our admission sheets and obtained operative data from our theatre software.

Outcome measures of risk and recovery in Broadmoor High Secure Forensic Hospital: stratification of care pathways and moves to medium secure hospitals.

Background: Placements within high secure forensic hospitals consist of wards providing various different levels of relational security. They should form a coherent pathway through secure care, based on individual patient risks and needs. Moves to less secure wards within high secure forensic hospitals and moves on to lower secure hospital settings have rarely been systematically studied.

Recurrent acromioclavicular joint dislocation with an associated coracoid fracture following acromioclavicular joint reconstruction.

Acromioclavicular joint injuries are common and account for up to 12% of all shoulder girdle injuries and have been reported as being as high as 50% in sports-related shoulder injuries. While the majority of acromioclavicular joint dislocations can be treated non-operatively, there are certain injury configurations, which can include high-grade dislocations in overhead athletes, where surgery may be indicated. The surgical management of acromioclavicular joint instability has moved towards recreating the action of the coracoclavicular ligaments by resuspending the clavicle on to the coracoid.

Effect of Dentin Bonding Agent on Intrapulpal Temperature during Fabrication of Provisional Restorations by a Direct Method: An Study.

Aim: To determine the effect of three different provisional restorative materials (PRMs) and application of dentin bonding agent (DBA) on intrapulpal temperature rise during fabrication of provisional crowns using a direct method.

Materials And Methods: Three PRMs-polymethyl methacrylate resin (PMMA), bis-acrylic resin, and dimethyl methacrylate resin (DMMA)-were used in the study. Dentin bonding agent (Single Bond 2, 3M ESPE, Germany) was applied in a single layer or double layer as an insulating material.

An Automated Assay System to Study Novel Tank Induced Anxiety.

New environments are known to be anxiogenic initially for many animals including the zebrafish. In the zebrafish, a novel tank diving (NTD) assay for solitary fish has been used extensively to model anxiety and the effect of anxiolytics. However, studies can differ in the conditions used to perform this assay.

Higher Hospital Costs Do Not Result in Lower Readmission Rates Following Total Joint Arthroplasty.

Introduction: Hip and knee arthroplasty are high volume, clinically successful, but costly orthopedic surgical procedures. There is significant variation in volume, outcomes, and cost at various hospitals.

Methods: Using the Statewide Planning and Research Cooperative System (SPARCS) database to determine readmission rates and the New York State Department of Health (NYSDoH) hospital cost transparency database to obtain costs, we reviewed this data for hip and knee replacements to determine if there was a relationship between volume of procedures performed and cost or readmission rates.

Current concepts in the techniques, indications and outcomes of meniscal repairs.

Knee arthroscopy for meniscal tears is one of the most commonly performed orthopaedic procedures. In recent years, there has been an increasing incidence of meniscal repairs, as there are concerns that meniscectomy predisposes patients to early osteoarthritis. Indications for meniscal repair are increasing and can now be performed in older patients who are active, even if the tear is in the avascular zone.

The Diagnostic Utility and Clinical Impact of After-Hours CT Scans of the Abdomen and Pelvis Investigating Abdominal Pain.

Introduction: The aim of this study was to evaluate the diagnostic utility and impact on clinical management of after-hours CT scans investigating abdominal pain in surgical patients.

Methods: After-hours CT A/P reports investigating the acute surgical abdomen were compared with clinical outcomes and histopathological findings to assess sensitivity and specificity of CT reporting. Comparisons between CT reports and clinical notes were made.

Unicompartmental knee arthroplasties: robot vs. patient specific instrumentation.

Background: The technical reliability demonstrated by semi active robots in implant placement could render unicompartmental knee arthroplasties (UKAs) more favourable than they are currently. The relatively untested method using patient specific instrumentation (PSI), however, has the potential to match the accuracy produced by robots but without the barriers that have prevented them from being used more widely in clinical practice, namely operative time. Therefore this study took a step towards comparing the accuracy and time taken between the two technologies.

Robotic assistance enables inexperienced surgeons to perform unicompartmental knee arthroplasties on dry bone models with accuracy superior to conventional methods.

Robotic systems have been shown to improve unicompartmental knee arthroplasty (UKA) component placement accuracy compared to conventional methods when used by experienced surgeons. We aimed to determine whether inexperienced UKA surgeons can position components accurately using robotic assistance when compared to conventional methods and to demonstrate the effect repetition has on accuracy. Sixteen surgeons were randomised to an active constraint robot or conventional group performing three UKAs over three weeks.