BMI is a Better Predictor of Periprosthetic Joint Infection Risk Than Local Measures of Adipose Tissue After TKA.

Background: Both body mass index (BMI) and local measures of adiposity at the surgical site have been identified as independent risk factors for periprosthetic joint infection (PJI) (periprosthetic joint infection) after total knee arthroplasty (TKA). We aimed to 1) evaluate previously used measures of assessing knee adiposity and 2) determine the best measure for predicting both surgical duration and PJI after TKA.

Methods: We performed a multicentre retrospective review of 4745 patients who underwent primary TKA between January 2013 and December 2016.

Two-hole versus four-hole plate dynamic hip screw: a systematic review of current evidence.

Background: The dynamic hip screw (DHS) is a common device used in the fixation of hip fractures. Traditionally, this involves the use of a four-hole side plate. Reducing the length of the side plate would theoretically reduce the amount of surgical exposure required, decrease surgery duration, and decrease perioperative morbidity and mortality.

Assessing the Time to Ward Transfer in Patients Presenting to the Emergency Department with an Acute Hip Fracture: A Closed-loop Audit.

Introduction The British Orthopaedic Association and British Geriatric Association Blue Book guidelines for patients presenting acutely with a hip fracture stipulate that the patient should be admitted to an acute orthopedic ward within four hours of presentation to the emergency department (ED).  Materials and methods A retrospective review of all patients who presented to the ED with a hip fracture diagnosed on plain film X-Ray over an eight-week period by a single auditor. Time of arrival, time to X-ray, time of blood draw, time to orthopedic referral, time to orthopedic review, and time to arrival at the orthopedic ward were documented.

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.

Bilateral distal tibial stress fractures in a healthy field-hockey goalkeeper.

Stress fractures occurring within the lower limbs are relatively common in athletes and military personnel. The specific bones affected are often predictable when the patient's activities are considered. We present an unusual case of bilateral distal tibial stress fractures sustained while playing as a goalkeeper in field hockey, in an otherwise healthy 46-year-old woman.

Locking plate fixation with and without inferomedial screws for proximal humeral fractures: a biomechanical study.

PURPOSE. To compare the efficacy of locking plate fixation with and without inferomedial screws in maintaining the reduction of a proximal humeral fracture. METHODS.

Transstyloid, transscaphoid, transcapitate fracture: a variant of scaphocapitate fractures.

Transstyloid, transscaphoid, transcapitate fractures are uncommon. We report the case of a 28-year-old man who sustained this fracture following direct trauma. The patient was successfully treated by open reduction internal fixation of the scaphoid and proximal capitate fragment, with a good clinical outcome at 1-year follow-up.

Effect of calcium triphosphate cement on proximal humeral fracture osteosynthesis: a cadaveric biomechanical study.

PURPOSE. To evaluate the effect of filling a central humeral bone void with calcium triphosphate cement on the strength and stability of an osteosynthesis in elderly cadavers. METHODS.

Attitudes of the medical profession to whole body and organ donation.

Cadaveric dissection remains an important part of undergraduate medical education in anatomy. In a concerted effort to rise the number of doctors in practice in Ireland the amount of medical school placements has been increased steadily since 1995. This poses a problem as the number of cadavers has remained unchanged despite an overall increase in the population Ireland over the last twenty years.

Acute traumatic spinal injury following bicycle accidents: a report of three cases.

Although the vast majority of injuries suffered while cycling are minor, acute spinal injuries have been reported. We describe three cases of acute spinal injury occurring while cycling. All three patients reported being thrown over the handlebars, while travelling downhill at speed.

A prospective randomised study comparing the jubilee dressing method to a standard adhesive dressing for total hip and knee replacements.

Aim Of The Study: It is important to reduce potential wound complications in total hip and total knee arthroplasty procedures. The purpose of this study was to compare the jubilee dressing method to a standard adhesive dressing.

Method: 124 patients (62 total hip replacements and 62 total knee replacements) were randomly selected to have either a standard adhesive dressing or jubilee method dressing.

Locking plate fixation for proximal humerus fractures.

Locking plates are increasingly used to surgically treat proximal humerus fractures. Knowledge of the bone quality of the proximal humerus is important. Studies have shown the medial and dorsal aspects of the proximal humeral head to have the highest bone strength, and this should be exploited by fixation techniques, particularly in elderly patients with osteoporosis.

Musculoskeletal oncology training during residency.

Purpose: To evaluate the efficacy of a musculoskeletal oncology training module during residency.

Methods: 24 orthopaedic residents with differing years of experience were recruited. 12 of them received musculoskeletal oncology training for 6 months.

The Segond fracture: a clue to intra-articular knee pathology.

This short report presents the case of a 32-year-old man with a knee injury sustained while playing football. A plain radiograph revealed a Segond fracture and a subsequent MRI confirmed a complete anterior cruciate ligament rupture. While the Segond fracture, and its associated intra-articular pathology, is well recognised among orthopaedic surgeons, it is less well recognised among staff in the emergency department.

Outcome of periacetabular osteotomy for the management of acetabular dysplasia: experience in an academic centre.

Periacetabular osteotomy (PAO) is a very effective reconstructive procedure for treatment of acetabular dysplasia. An orthopaedic paediatric surgeon and a reconstructive hip arthroplasty surgeon performed this procedure together in the early phase of their learning curve and then performed it individually. The early clinical and radiographic results of 85 consecutive PAOs performed in this academic orthopaedic unit were reviewed.

Diagnostic gait pattern of a patient with longstanding left femoral nerve palsy: a case report.

The gait pattern of a 35-year-old man with longstanding, left femoral nerve palsy was assessed using 3-dimensional kinematic and kinetic analysis. Stability of his left knee in stance was achieved by manipulating the external moments of the limb so that the ground reaction force passes in front of the knee joint. This compensatory mechanism of locking the knee in extension is reliant on the posterior capsular structures.

An unusual cause of pain post ankle arthrodesis in patients with rheumatoid arthritis.

Rheumatoid arthritis is an autoimmune disease which frequently affects the ankle and foot. End stage ankle arthritis from rheumatic disease is commonly managed by the established practice of ankle arthrodesis. Among the adverse sequelae causing pain following this surgery is infection, pseudo-arthrosis and non-union.

Mechanism of loosening of the Souter-Strathclyde total elbow replacement evidence from revision surgery.

Nine Souter-Strathclyde humeral and ulnar components retrieved from revision surgery for aseptic loosening were examined macro- and microscopically. The wear patterns were compared and photographed. Humeral components demonstrated no evidence of wear.

Contamination of histology biopsy specimen - a potential source of error for surgeons: a case report.

Tissue contamination is a common occurrence in pathology, but surgeons are relatively unaware of this. We present the case of a 45-year-old man with Barrett's oesophagus, in which the histology of routine biopsies of an asymptomatic patient, were reported as 'carcinoma in situ'. Further biopsies were taken over a three month period but showed no evidence of malignancy.

An isolated proximal tibiofibular joint dislocation in a young male playing soccer: a case report.

Isolated dislocation of the proximal tibiofibular joint is a rare injury. We present a 23-year-old caucasian man who sustained a traumatic anterolateral dislocation of the proximal tibiofibular joint. There is no consenus on definitive management, and we review the different published treatment and rehabilitation regimens for this injury.