Bulk osteochondral allograft for massive Hill-Sachs defect combined with Latarjet procedure for bipolar bone loss in anterior instability.

A proportion of patients with anterior glenohumeral instability present with bipolar bone loss comprising large Hill-Sachs lesions and substantial glenoid defect. These are surgically difficult cases to treat. We describe a novel surgical procedure of bulk size-matched osteochondral allograft reconstruction for massive Hill-Sachs lesions combined with the Latarjet procedure for these challenging cases.

Seven-year survival analysis of the Global® CAP® (Conservative Anatomic Prosthesis) shoulder resurfacing.

Background: Shoulder resurfacings represent approximately one-third of shoulder arthroplasties and have the highest revision rates of any shoulder arthroplasty. We present a survival analysis of the Global CAP hemi-resurfacing implanted by multiple surgeons with up to 10 years of follow-up.

Methods: A life-table survival analysis of the Global CAP hemi-resurfacing was undertaken in a single site with multiple surgeons.

What is a Bristow-Latarjet procedure? A review of the described operative techniques and outcomes.

Objectives: A variety of operative techniques have been described as under the term 'Bristow-Latarjet' procedure. This review aims to define the original procedure, and compare the variation in techniques described in the literature, assessing any effect on clinical outcomes.

Materials And Methods: A systematic review of 24 studies was performed to compare specific steps of the technique (coracoid osteotomy site, subscapularis approach, orientation and position of coracoid graft fixation and fixation method, additional labral and capsular repair) and detect any effect this variability had on outcomes.

Treatment of chronic anterior locked glenohumeral dislocation with hemiarthroplasty.

Restoring good shoulder function in an active patient with a chronic anterior locked dislocation of the glenohumeral joint can be challenging. This case report describes a 58-year-old active patient who presented with a very late missed locked anterior dislocation of the glenohumeral joint. He had coexisting large bony defects in the anterior glenoid and humeral head with resultant loss of motion and pain secondary to glenohumeral arthrosis.

Ligament repair and reconstruction in traumatic dislocation of the knee.

We treated 21 patients with 22 dislocations of the knee by repair or reconstruction of all injured ligaments. Eight knees were treated in the acute phase (less than two weeks after injury); the remainder were treated more than six months after injury (6 to 72). Reconstructions were carried out with a combination of autograft and allograft tendons and by direct ligament repair where possible.

Functional rating for knee arthroplasty: comparison of three scoring systems.

This study evaluated the reliability of three rating systems for total knee arthroplasty. Twenty-nine patients were assessed by six observers with the American Knee Society Score, the British Orthopaedic Association Score, and the Oxford 12-item questionnaire. The inter- and intraobserver variations were calculated for the American Knee Society Score and the British Orthopaedic Association Score, as was the reproducibility of the Oxford 12-item questionnaire.

Treatment of established and anticipated nonunion of the tibia in childhood.

Nonunion in long bone fractures is rare in the skeletally immature patient. The authors report the outcome of a series of patients treated for tibial bone loss and nonunion at average follow-up of 66 months. Nine children aged 18 months to 17 years were treated.

Early mobilisation for minimally displaced radial head fractures is desirable. A prospective randomised study of two protocols.

We compared two protocols of early mobilisation for minimally displaced radial head fractures through a single-blinded, prospective randomised trial. Sixty patients were randomly allocated to either immediate active mobilisation or 5-day delay before active mobilisation was commenced. Patients were reviewed at 7 days, 4 weeks and 3 months after injuries.

The reliability of the American Knee Society Score.

We have investigated the reliability of the American Knee Society Score (AKS), a widely used functional outcome score for knee arthroplasty. 29 subjects were assessed in random order by 6 observers, each patient seen twice by each observer. The interobserver reference intervals were 16 points for the Knee Score (0-100 points) and 21 points for the Function Score (0-100 points).

Spiral computed tomography with two- and three-dimensional reconstruction in the management of tibial plateau fractures.

Spiral computed tomography (CT) with three-dimensional and multiplanar reconstructions was used in the evaluation of tibial fractures in nine patients. Computed tomography added important information to that obtained by plain radiographs. Five (55%) fractures were reclassified.

Which primary total knee replacement? A review of currently available TKR in the United Kingdom.

Comparative information on total knee replacements (TKRs) is not readily available. With the help of implant manufacturers and distributors, we have compiled a list of TKRs on the market in the UK and summarised the information about these implants in a table. There are 37 different TKRs, marketed by 14 companies; 54% have been introduced since 1990.

Hair thread tourniquet syndrome.

Tourniquet of hair and thread fibres may become tightly wrapped around a child's digit. The resultant ischaemia may lead to tissue necrosis and autoamputation. Experience with two patients is reported.