Does resurfacing of asymptomatic full-thickness localized articular defects of the trochlea influence the outcome following unicompartmental knee arthroplasty of the medial compartment?: A retrospective cohort study with minimum seven-year follow-up.

Background: Patellofemoral joint (PFJ) degeneration has been found not to affect outcome following medial unicompartmental knee arthroplasty (UKA). However, PFJ disease occasionally presents as isolated trochlear cartilage lesions, with little available evidence regarding treatment options or necessity. We evaluated the effectiveness of concomitant trochlear resurfacing in patients undergoing medial UKA with asymptomatic trochlear lesions.

Wearable Sensor-Based Exercise Biofeedback for Orthopaedic Rehabilitation: A Mixed Methods User Evaluation of a Prototype System.

The majority of wearable sensor-based biofeedback systems used in exercise rehabilitation lack end-user evaluation as part of the development process. This study sought to evaluate an exemplar sensor-based biofeedback system, investigating the feasibility, usability, perceived impact and user experience of using the platform. Fifteen patients participated in the study having recently undergone knee replacement surgery.

Clinician perceptions of a prototype wearable exercise biofeedback system for orthopaedic rehabilitation: a qualitative exploration.

Objectives: This study explores the opinions of orthopaedic healthcare professionals regarding the opportunities and challenges of using wearable technology in rehabilitation. It continues to assess the perceived impact of an exemplar exercise biofeedback system that incorporates wearable sensing, involving the clinician in the user-centred design process, a valuable step in ensuring ease of implementation, sustained engagement and clinical relevance.

Design: This is a qualitative study consisting of one-to-one semi-structured interviews, including a demonstration of a prototype wearable exercise biofeedback system.

Long-term performance of exteriorized femoral stem after cortical perforation in revision cemented total hip replacement.

This is the first published report of a long-term, fourteen years close annual follow-up of a patient who underwent revision total hip replacement with per-operative anterior cortical perforation of femur while undertaking cemented femoral stem insertion. This patient has complete satisfaction in terms of clinical and radiological outcome. This patient has been walking full weight bearing on her operated leg after 3 months of her surgery.

Exsanguinators and tourniquets: do we need to change our practice?

Purpose: Exsanguinators and tourniquets are regularly used in orthopaedic theatres. A good understanding of their application and contraindications must be ensured to prevent injury to limb or life. However, the level of staff understanding is not well documented.

Chronic exertional compartment syndrome of the forearm in an elite rower.

We report a case of chronic exertional compartment syndrome (CECS) affecting the volar forearm compartment of an elite rower. CECS of the forearm is a less well recognised entity than lower limb CECS. We describe a typical history and detail a potential treatment.

The first 20 years of heart transplantation in Ireland.

Background: The first Irish heart transplant was performed on the 10th of September 1985. Over the next 20 years, 229 transplants were performed in 228 recipients.

Aims: To evaluate the success of the first generation of cardiac transplantation in Ireland.

The effect of pre-existing ischaemic heart disease on renal dysfunction in cardiac transplant recipients.

Renal dysfunction is a recognized complication of cardiac transplantation and can impact on the life expectancy of an already fragile population. A large proportion of these patients require transplantation because of the consequences of ischaemic heart disease (IHD) which, in turn, is often associated with ischaemic nephropathy. We studied the effect of IHD, diagnosed prior to transplantation, on the renal function of recipients who survived more than 6months after surgery.

Hip arthroplasty, changing trends in a national tertiary referral centre.

Background: Despite changes in techniques and management, little has been published comparing hip replacement surgery over a three-decade time span.

Aims: To document change in the practice of hip arthroplasty in a large elective orthopaedic centre.

Methods: A retrospective analysis of 100 patients in 1979 and in 1999 comparing demographics, surgical approaches, blood loss, transfusion requirements, morbidity and length of stay.

Long-term clinical outcome following coronary artery bypass grafting for isolated stenosis of the left anterior descending coronary artery.

Aims: To detail the clinical and angiographic profile, and long-term outcome in consecutive patients with isolated stenosis of the left anterior descending coronary artery undergoing bypass surgery.

Methods: A retrospective study of all patients (n = 301) (January 1984-December 1990) and undergoing coronary artery bypass grafting for isolated left anterior descending disease, in the Irish Republic, was performed. Survival was compared with that of an exact age- and gender-matched cohort.

Surgical relief of tracheobronchial obstruction in infants and children.

Objective: Congenital tracheobronchial obstruction (TBO) presents a complex problem both in terms of diverse aetiology, presence of associated anomalies and the operative strategy to be adopted. We report a single centre experience in managing this difficult problem.

Methods: Twenty-four infants and children with TBO referred to our unit over a 12-year period are reviewed.

Orthopaedic complications following cardiac transplantation.

Cardiac transplantation has become the treatment of choice for end stage heart disease. In 1990 2,000 transplants were performed worldwide. Orthopaedic Surgeons will be asked with increasing frequency to evaluate and treat bone and soft tissue problems with these patients.

Unilateral Fontan operation for tricuspid atresia.

A 12-year-old child with tricuspid atresia and acquired hypoplasia of the left pulmonary artery was successfully treated with unilateral Fontan operation. Angiography at age 2 months had shown a normal left pulmonary artery, and a modified Potts shunt was performed. An emergency central shunt was required a year later.

Ten years' experience of an aggressive reparative approach to congenital mitral valve anomalies.

Objective: Mitral valve repair is now well established in adults. Congenital anomalies of the mitral valve, however, represent a more complex and diverse population with a high prevalence of associated cardiac anomalies. Less is known about the results of valve sparing surgery in this group of patients.

Metastatic malignant schwannoma in the heart.

A rare case of metastatic malignant schwannoma is described. The secondary tumor in the right lung grew along the pulmonary vein and filled almost the whole of left atrium. Operation was later performed, and a large tumor extension from the left atrium was removed.

Atrial myxoma: national incidence, diagnosis and surgical management.

Despite being the most common benign intracardiac tumour with an excellent prognosis after surgical excision the incidence of atrial myxoma (except at autopsy) is unknown. We reviewed all patients admitted to the National Cardiac Surgery Unit (n = 26) with an atrial myxoma over a fifteen year period (1977-1991) to compile national incidence data and assess pre-operative diagnosis, management, surgical technique, and outcome. Preoperative symptoms were: congestive cardiac failure (12 patients), embolism (8 patients), constitutional (3 patients), asymptomatic (2 patients) and tachyarrhythmia (1 patient).

Systemic lupus erythematosus a rare cause of mitral stenosis.

An unusual case of mitral stenosis in a patient with Systemic Lupus Erythematosus (SLE) is presented. A middle aged lady, known to be suffering from SLE, was initially suspected to have left atrial myxoma. Only during surgery was the true rare pathology discovered: the valve was excised and replaced with a mechanical prosthesis.

Avascular necrosis of the femoral head post heart-transplantation and steroid dosage.

Avascular necrosis (avn) post heart-transplantation has been considered to be due to the high doses of steroids used to immunosuppress these patients in attempting to prevent transplant rejection. This study shows that avascular necrosis occurs even when low dose steroids regimes are used and demonstrates no significant correlation between steroid dosage and the development of avn. Patients with symptomatic avn benefit from early diagnosis and management of their condition in that the need for total joint arthroplasty can be prevented in many cases.

Lipomatous hypertrophy of the interatrial septum: an unusual intraoperative finding.

Lipomatous hypertrophy of the interatrial septum was an incidental finding in a man of 45 undergoing coronary artery bypass grafting for unstable angina. He was not overweight and did not have any rhythm disturbances. The diagnosis was made on frozen section.

Coronary artery bypass grafting for coronary thrombosis complicating polycythaemia rubra vera. Case report.

Coronary thrombosis complicating polycythaemia rubra vera in a 42-year-old woman was treated with coronary artery bypass grafting. Nonatherosclerotic causes of coronary obstruction, though rare, should be considered, especially in younger patients.

Cardiac surgery in Down syndrome.

Between January 1976 and December 1987 42 children with Down syndrome and congenital heart disease underwent cardiac surgery. Four children had two operations. Age at the time of surgery ranged from 11 days to 14 years.

Contractions to 5-hydroxytryptamine in human coronary artery and human saphenous vein.

Isometric contractions were obtained to 5-hydroxytryptamine receptor agonists in human saphenous vein and human coronary artery. Based on the interaction with the 5-HT2 receptor antagonist ketanserin, both 5-HT1 and 5-HT2 receptors are involved in contractions of human saphenous vein, but the predominant subtype involved in contractions of human coronary artery is the 5-HT1 receptor.