Robotic Arthroplasty Clinical and cost Effectiveness Randomised controlled trial (RACER-knee): a study protocol.

Introduction: Robotic-assisted knee replacement systems have been introduced to healthcare services worldwide in an effort to improve clinical outcomes for people, although high-quality evidence that they are clinically, or cost-effective remains sparse. Robotic-arm systems may improve surgical accuracy and could contribute to reduced pain, improved function and lower overall cost of total knee replacement (TKR) surgery. However, TKR with conventional instruments may be just as effective and may be quicker and cheaper.

Plate fixation of midshaft clavicle fractures for delayed union and non-union is a cost-effective intervention but functional deficits persist at long-term follow-up.

Background: The primary aim of this study was to compare the long-term functional outcome of midshaft clavicle fracture fixation for delayed (≥3 month) and non-union (≥6 month) compared to a matched cohort of patients that achieved union with non-operative management. The secondary aim was to assess cost-effectiveness of fixation.

Methods: A consecutive series of patients over 10-years were retrospectively reviewed using the QuickDASH, Oxford Shoulder Score and EuroQol five-dimension summary index (EQ-5D).

Oxford shoulder score in a normal population.

Background: The function of the asymptomatic normal shoulder may differ according to gender and could also deteriorate with age. This may result in a disparity in the normal Oxford shoulder score (OSS) according to these variables. If a difference were to exist an adjusted OSS, for age and gender, could be calculated from the raw score using the expected normal score.

Medium-term results of Oxford phase-3 medial unicompartmental knee arthroplasty.

Purpose: To review medium-term results of 49 consecutive patients who underwent Oxford phase-3 medial unicompartmental knee arthroplasty by a single surgeon.

Methods: Records of 28 women (mean age, 71 years) and 21 men (mean age, 68 years) who underwent minimally invasive Oxford phase-3 medial unicompartmental knee arthroplasty by a single surgeon were retrospectively reviewed. The Oxford knee score and visual analogue scale (VAS) scores for pain and satisfaction were assessed at the latest follow-up by an independent observer, as were postoperative radiographs for implant position, osteoarthritic changes in the non-replaced compartments, and radiolucent lines of >2 mm or implant subsidence.

Skeletal growth patterns in hereditary multiple exostoses: a natural history.

Hereditary multiple exostoses (HME) is a commonly inherited musculoskeletal condition and is associated with a diminished stature. We demonstrated that adults with HME were significantly shorter when compared with a control group (P<0.001); preadolescents, however, were significantly taller than predicted (P=0.

Malignant lesions are rare in medial third of the clavicle in children: the European Juvenile Medial End of Clavicle Tumour study.

Condensing osteitis is a condition presenting to all paediatric orthopaedic services, but the prevalence of the condition and optimal management is difficult to determine from the literature. Many case reports in the orthopaedic literature describe biopsy to exclude malignancy as mandatory, whereas expert radiological opinion has suggested that lesions can be classified as typical of sclerosing osteitis on imaging alone. The aim of this study was to calculate an accurate incidence of malignancy at the medial end of the clavicle in children based on data held by national and regional cancer registries in Europe.

Shoulder exostoses in hereditary multiple exostoses: probability of surgery and malignant change.

Hypothesis: Patients with hereditary multiple exostoses (HME) in association with palpable shoulder exostoses are more severely affected by their disease.

Materials And Methods: From a prospective database of 78 families with HME identified, 172 patients were identified. Demographic details, deformity, functional scores, standing height, number of exostoses, site, exostosin genotype (EXT1 and EXT2), surgical excision, and malignant change were recorded.

The metal-backed glenoid component in rheumatoid disease: eight- to fourteen-year follow-up.

Hypothesis: We believe the variable reported survivorship of the metal-backed glenoid is related to the design of the component. This study reports the outcome and survivorship of the uncemented glenoid in rheumatoid patients with an intact or repairable rotator cuff at surgery, and considers the key design features that may predict longevity of this component.

Method: Forty-six shoulders in 39 patients (31 women), with a mean age of 55 years (range, 35-86 years) received a total shoulder replacement with a screw-fixed porous coated metal-back glenoid.